Perioperative Myocardial Injury/Infarction in Patients with Stable or Unstable Angina Pectoris Undergoing Elective Percutaneous Coronary Intervention: The Effects of Preoperative Lipid Management
Xuefeng Chen,1 Wenlou Bai,1 Peng Qi,1 Yantao Zhang,2 Wenjing Yao,1 Yi Dang1 1Department of Cardiovascular Internal Medicine, Hebei General Hospital, Shijiazhuang, 050000, People’s Republic of China; 2Department of Cardiovascular Internal Medicine, Handan Central Hospital, Handan, 056001, People’s Re...
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Dove Medical Press
2025-02-01
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| author | Chen X Bai W Qi P Zhang Y Yao W Dang Y |
| author_facet | Chen X Bai W Qi P Zhang Y Yao W Dang Y |
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| description | Xuefeng Chen,1 Wenlou Bai,1 Peng Qi,1 Yantao Zhang,2 Wenjing Yao,1 Yi Dang1 1Department of Cardiovascular Internal Medicine, Hebei General Hospital, Shijiazhuang, 050000, People’s Republic of China; 2Department of Cardiovascular Internal Medicine, Handan Central Hospital, Handan, 056001, People’s Republic of ChinaCorrespondence: Yi Dang, Department of Cardiovascular Internal Medicine, Hebei General Hospital, 348 Shijiazhuang Heping West Road, Shijiazhuang, 050000, People’s Republic of China, Tel +18603270563, Email 90030172@hebmu.edu.cnBackground: Identifying the risk factors for perioperative myocardial injury/infarction (PMI) is critical to prevent postoperative adverse cardiovascular events. However, whether reducing the preoperative LDL-C can mitigate the risk of PMI remains unclear. We therefore investigated the effect of the preoperative LDL-C level in patients with stable angina pectoris (SAP) or unstable angina pectoris (UAP) on perioperative myocardial injury/infarction (PMI) after elective percutaneous coronary intervention (PCI).Methods: Patients with SAP or UAP who received PCI from January 2021 to June 2023 at one of the two institutions (Hebei Provincial People’s Hospital, Handan Central Hospital) were reviewed. The occurrence of PMI was determined based on the elevation of cardiac troponin I (cTnI) after the operation. The preoperative low density lipoprotein cholesterol (LDL-C) level was divided into three grades: low, < 1.4 mmol/L; medium, 1.4– 1.8 mmol/L; high, > 1.8 mmol/L. The relationship between PMI and preoperative LDL-C was analyzed.Results: Of all 308 included patients, 226 did not have PMI and 82 experienced PMI. Positive correlation was found both between PMI and preoperative LDL-C level (r = 0.322, P < 0.05) and between PMI and preoperative LDL-C grade (r = 0.189, P < 0.05). According to the multivariate logistic regression analysis, the preoperative LDL-C grade (Medium vs Low, OR=3.994, P < 0.05; High vs Medium, OR=6.140, P < 0.05) and the number of stents implanted during PCI were independent risk factors for PMI (OR=1.940; P < 0.05).Conclusion: For SAP and UAP patients, decreasing LDL-C to < 1.4 mmol/L before elective PCI can reduce the incidence of PMI after the operation. We strongly recommend the practice of sufficiently reducing LDL-C level below 1.4 for patients with SAP or UAP who receive elective PCI.Keywords: percutaneous coronary intervention, stable angina pectoris, unstable angina pectoris, low-density lipoprotein cholesterol, perioperative myocardial injury and infarction |
| format | Article |
| id | doaj-art-5713bcd6046b4f4a8f592b3d573c41d6 |
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| publishDate | 2025-02-01 |
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| spelling | doaj-art-5713bcd6046b4f4a8f592b3d573c41d62025-08-20T03:00:51ZengDove Medical PressInternational Journal of General Medicine1178-70742025-02-01Volume 18939945100386Perioperative Myocardial Injury/Infarction in Patients with Stable or Unstable Angina Pectoris Undergoing Elective Percutaneous Coronary Intervention: The Effects of Preoperative Lipid ManagementChen XBai WQi PZhang YYao WDang YXuefeng Chen,1 Wenlou Bai,1 Peng Qi,1 Yantao Zhang,2 Wenjing Yao,1 Yi Dang1 1Department of Cardiovascular Internal Medicine, Hebei General Hospital, Shijiazhuang, 050000, People’s Republic of China; 2Department of Cardiovascular Internal Medicine, Handan Central Hospital, Handan, 056001, People’s Republic of ChinaCorrespondence: Yi Dang, Department of Cardiovascular Internal Medicine, Hebei General Hospital, 348 Shijiazhuang Heping West Road, Shijiazhuang, 050000, People’s Republic of China, Tel +18603270563, Email 90030172@hebmu.edu.cnBackground: Identifying the risk factors for perioperative myocardial injury/infarction (PMI) is critical to prevent postoperative adverse cardiovascular events. However, whether reducing the preoperative LDL-C can mitigate the risk of PMI remains unclear. We therefore investigated the effect of the preoperative LDL-C level in patients with stable angina pectoris (SAP) or unstable angina pectoris (UAP) on perioperative myocardial injury/infarction (PMI) after elective percutaneous coronary intervention (PCI).Methods: Patients with SAP or UAP who received PCI from January 2021 to June 2023 at one of the two institutions (Hebei Provincial People’s Hospital, Handan Central Hospital) were reviewed. The occurrence of PMI was determined based on the elevation of cardiac troponin I (cTnI) after the operation. The preoperative low density lipoprotein cholesterol (LDL-C) level was divided into three grades: low, < 1.4 mmol/L; medium, 1.4– 1.8 mmol/L; high, > 1.8 mmol/L. The relationship between PMI and preoperative LDL-C was analyzed.Results: Of all 308 included patients, 226 did not have PMI and 82 experienced PMI. Positive correlation was found both between PMI and preoperative LDL-C level (r = 0.322, P < 0.05) and between PMI and preoperative LDL-C grade (r = 0.189, P < 0.05). According to the multivariate logistic regression analysis, the preoperative LDL-C grade (Medium vs Low, OR=3.994, P < 0.05; High vs Medium, OR=6.140, P < 0.05) and the number of stents implanted during PCI were independent risk factors for PMI (OR=1.940; P < 0.05).Conclusion: For SAP and UAP patients, decreasing LDL-C to < 1.4 mmol/L before elective PCI can reduce the incidence of PMI after the operation. We strongly recommend the practice of sufficiently reducing LDL-C level below 1.4 for patients with SAP or UAP who receive elective PCI.Keywords: percutaneous coronary intervention, stable angina pectoris, unstable angina pectoris, low-density lipoprotein cholesterol, perioperative myocardial injury and infarctionhttps://www.dovepress.com/perioperative-myocardial-injuryinfarction-in-patients-with-stable-or-u-peer-reviewed-fulltext-article-IJGMpercutaneous coronary interventionstable angina pectorisunstable angina pectorislow-density lipoprotein cholesterolperioperative myocardial injury and infarction |
| spellingShingle | Chen X Bai W Qi P Zhang Y Yao W Dang Y Perioperative Myocardial Injury/Infarction in Patients with Stable or Unstable Angina Pectoris Undergoing Elective Percutaneous Coronary Intervention: The Effects of Preoperative Lipid Management International Journal of General Medicine percutaneous coronary intervention stable angina pectoris unstable angina pectoris low-density lipoprotein cholesterol perioperative myocardial injury and infarction |
| title | Perioperative Myocardial Injury/Infarction in Patients with Stable or Unstable Angina Pectoris Undergoing Elective Percutaneous Coronary Intervention: The Effects of Preoperative Lipid Management |
| title_full | Perioperative Myocardial Injury/Infarction in Patients with Stable or Unstable Angina Pectoris Undergoing Elective Percutaneous Coronary Intervention: The Effects of Preoperative Lipid Management |
| title_fullStr | Perioperative Myocardial Injury/Infarction in Patients with Stable or Unstable Angina Pectoris Undergoing Elective Percutaneous Coronary Intervention: The Effects of Preoperative Lipid Management |
| title_full_unstemmed | Perioperative Myocardial Injury/Infarction in Patients with Stable or Unstable Angina Pectoris Undergoing Elective Percutaneous Coronary Intervention: The Effects of Preoperative Lipid Management |
| title_short | Perioperative Myocardial Injury/Infarction in Patients with Stable or Unstable Angina Pectoris Undergoing Elective Percutaneous Coronary Intervention: The Effects of Preoperative Lipid Management |
| title_sort | perioperative myocardial injury infarction in patients with stable or unstable angina pectoris undergoing elective percutaneous coronary intervention the effects of preoperative lipid management |
| topic | percutaneous coronary intervention stable angina pectoris unstable angina pectoris low-density lipoprotein cholesterol perioperative myocardial injury and infarction |
| url | https://www.dovepress.com/perioperative-myocardial-injuryinfarction-in-patients-with-stable-or-u-peer-reviewed-fulltext-article-IJGM |
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