Abstract
To investigate the predictive value of non-high-density lipoprotein cholesterol (non-HDL-C) and remnant cholesterol (remnant-C) for the progression of non-culprit coronary lesions with quantitative flow ratio ≤ 0.80. A total of 214 patients with coronary artery disease undergoing percutaneous coronary intervention from January 2022 to March 2024 were consecutively enrolled, with 321 non-culprit lesions. All patients completed at least 24 months of clinical follow-up. Based on follow-up quantitative coronary angiography assessment, patients were divided into lesion progression and non-progression groups. Baseline clinical data, laboratory parameters, and coronary angiography characteristics were collected. Univariate and multivariate logistic regression analyses were performed to assess the independent predictive value of non-HDL-C and remnant-C for lesion progression. Predictive performance was compared using receiver operating characteristic curves, and subgroup analyses were conducted. During follow-up, 62 patients (29.0%) experienced non-culprit lesion progression. The median angiographic follow-up interval was 14.2 months (interquartile range, 10.8–18.1; range, 6.1–23.8) overall and did not differ significantly between the progression and non-progression groups (14.6 vs 14.0 months,
P
= .47). Multivariable logistic regression showed that, after adjustment for prespecified clinical covariates, both non-HDL-C (odds ratio = 1.68, 95% confidence interval: 1.22–2.31,
P
= .001) and remnant-C (odds ratio = 1.52, 95% confidence interval: 1.24–1.86,
P
P
values were >.05. Non-HDL-C and remnant-C are independent predictors of progression of non-culprit coronary lesions with quantitative flow ratio ≤ 0.80. Combining them with traditional risk factors significantly improves predictive performance, offering clinical value for high-risk patient identification and secondary prevention optimization.