Remnant Cholesterol as a Predictor of No-Reflow Phenomenon in Patients With ST-Segment Elevation Myocardial Infarction

Remnant cholesterol (RC) has been implicated in the progression of atherosclerotic cardiovascular disease. However, the impact of RC levels on the occurrence of no-reflow in patients with ST-segment elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (pPCI) remains poorly understood. Patients were classified into 2 groups: those (n = 90) who developed no-reflow (+) and those (n = 350) who did not develop no-reflow (-). RC was calculated as total cholesterol minus low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C). RC (Odds Ratio [OR] = 1.28, <i>P</i> < .001), diabetes mellitus (OR = 2.72, <i>P</i> = .002), stent length (OR = 1.07, <i>P</i> = .020), door-to-balloon time (OR = 1.04, <i>P</i> = .047), symptom-to-admission time (OR = 2.07, <i>P</i> = .002) and presence of thrombus (OR = 2.34, <i>P</i> < 0.001) were independent predictors of no-reflow. RC was shown to predict no-reflow development (Area under the curve [AUC] = 0.923, <i>P</i> < .001). The present study revealed a significant association between RC levels and the occurrence of the no-reflow phenomenon following pPCI in patients with STEMI. Assessment of RC levels may assist in identifying high-risk groups in STEMI patients and may prove to be an important factor to manage for cardiovascular health.