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Prognostic value of combined LDL-C and remnant cholesterol stratification for 24-month major adverse cardiovascular events after primary PCI in patients with STEMI.

Created on 16 Sep 2026

Authors

Qianying Xie, Chaoyi Wang, Wenjing Zhao, Lei Cai, Changjie Yu, Liting Pang

Published in

Frontiers in cardiovascular medicine. Volume 13. Pages 1901661. Epub Sep 01, 2026.

Abstract

This single-center prospective observational cohort study aimed to investigate the prognostic value of combined low-density lipoprotein cholesterol (LDL-C) and remnant cholesterol (RC) stratification in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI).
A total of 812 STEMI patients were enrolled and stratified into four groups according to LDL-C and RC levels measured at 1-month post-PCI. The primary endpoint was 24-month major adverse cardiovascular events (MACE).
The overall MACE rate increased stepwise across the four subgroups (P < 0.001). Multivariate Cox regression showed that elevated RC was independently associated with MACE (HR = 1.559, 95% CI: 1.018-2.386, P = 0.041), whereas isolated high LDL-C was not (HR = 1.329, 95% CI: 0.992-1.781, P = 0.057). Compared with the low LDL-C + low RC group, the high LDL-C + high RC group carried the highest MACE risk (HR = 2.535, 95% CI: 1.591-4.041, P < 0.001), followed by the low LDL-C + high RC group (HR = 1.874, 95% CI: 1.153-3.045, P = 0.011).
Combined LDL-C and RC stratification may assist risk evaluation in STEMI patients after primary PCI. Elevated RC, rather than isolated high LDL-C, is associated with adverse outcomes, which may help identify patients with residual lipid-related risk.

PMID:
42745846
Bibliographic data and abstract were imported from PubMed on 16 Sep 2026.

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