ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Cardiovascular Endocrinology
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1603907
Association Between Residual Cholesterol and Vulnerable Non-Culprit Lesions Progressing to Major Adverse Cardiovascular Events
Provisionally accepted
Fengfeng Wang*
Qun Li- Fuwai Central China Cardiovascular Hospital, Zhengzhou, China
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Background: Residual cholesterol (RC), a key indicator of lipid metabolism disorders, has been increasingly implicated in atherosclerotic progression. However, its association with vulnerable thin-cap fibroatheromas (TCFA) in non-culprit coronary lesions (NCCLs) and the subsequent risk of major adverse cardiovascular events (MACE) remains insufficiently explored.In this prospective observational study conducted between June 2022 and September 2023, patients diagnosed with TCFA within NCCLs were followed for at least 12 months. Participants were grouped according to MACE occurrence. Spearman correlation and multivariate logistic regression were used to examine associations between RC levels, plaque vulnerability features, and MACE.Results: RC showed significant correlations with key vulnerability markers-negatively with fibrous cap thickness (rs = -0.61, P < 0.001) and positively with lipid arc (rs = 0.75, P < 0.001). In univariate analysis, elevated RC was associated with a 1.88-fold increased risk of MACE. RC remained an independent risk factor in multivariate analysis (OR = 1.127, 95% CI: 1.101-1.593, P = 0.031). ROC analysis yielded moderate predictive value (AUC = 0.720).Elevated RC is associated with greater plaque vulnerability and increased MACE risk in patients with NCCL-TCFA. These findings suggest RC's potential role in cardiovascular risk stratification, warranting further validation in larger studies.
Keywords: Residual cholesterol, Non-culprit lesion, Thin-cap fibroatheroma, Major adverse cardiovascular events, CVD (cardio vascular disease)
Received: 01 Apr 2025; Accepted: 30 Jun 2025.
Copyright: © 2025 Wang and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Fengfeng Wang, Fuwai Central China Cardiovascular Hospital, Zhengzhou, China
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