Non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio is associated with cardiovascular outcomes after percutaneous coronary intervention in patients with type 2 diabetes.

Authors

Xi He, Guanlian He, Liqin Qi, Yujie Chen, Zhaorong Lin, Wenjia Chen, Qintao Huang, Libin Liu, Zhaoyang Chen, Ruonan Gao

Published in

Frontiers in endocrinology. Volume 17. Pages 1844237. Epub May 15, 2026.

Abstract

The non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) is a novel, reliable indicator of dyslipidemia. However, its association with cardiac outcomes in patients with type 2 diabetes mellitus (T2DM) following percutaneous coronary intervention (PCI) remains unclear. We investigated the association of the NHHR with the risks of major adverse cardiovascular events (MACEs) following PCI in adults with T2DM.
This retrospective cohort study included 1176 adults with T2DM undergoing PCI after new-onset acute myocardial infarction between January 1, 2019, and December 31, 2023. Patients were categorized into NHHR quartiles. The relationship between the NHHR and post-PCI MACE risk was investigated using univariate and multivariate Cox regression analyses. Restricted cubic splines and smooth curve fitting evaluated the nonlinear association between the NHHR and MACE risk; receiver operating characteristic (ROC) curves determined the prognostic significance of the NHHR.
Over 21.0 ± 6.6 months, 246 MACEs occurred. In multivariate analysis, the NHHR was associated with MACE incidence, even after adjustments (vs. group Q1: hazard ratio [95% confidence interval] in groups Q3 and Q4, 4.00 [2.47-6.48] and 6.28 [3.92-10.05], respectively; both P < 0.05). The NHHR and MACEs were non-linearly related. Within the threshold of 3.12-5.10, every 1-unit rise in the NHHR elevated the MACE risk 1.4-fold. The area under the ROC curve of the NHHR combined with the Global Registry of Acute Coronary Events risk score was 0.84 for predicting post-PCI MACEs (sensitivity, 71.54%; specificity, 83.86%). The NHHR/MACE association persisted in subgroup analysis. No significant interactive effects were found for age, sex, hypertension, smoking, body mass index, glycated hemoglobin, and medications (P for interaction > 0.05).
Our findings suggested a nonlinear positive association between NHHR and MACE risk in T2DM patients undergoing PCI. Routine NHHR assessment may facilitate early risk identification and tailored care for these patients.

PMID:
42222067
Bibliographic data and abstract were imported from PubMed on 16 Sep 2026.

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