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Joint associations of LDL-C and HDL-C with in-hospital major bleeding in Chinese patients with acute coronary syndrome undergoing PCI: findings from the CCC-ACS project

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Le résumé fourni par la source

Low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) have each been associated with bleeding risk; however, their joint association with bleeding outcomes remains insufficiently characterized. We included patients with acute coronary syndrome (ACS) who underwent percutaneous coronary intervention (PCI) and were enrolled in the Improving Care for Cardiovascular Disease in China-ACS project between 2014 and 2019. This study was registered at ClinicalTrials.gov (NCT02306616) on November 29, 2014. Restricted cubic spline analysis assessed dose–response relationships, and multivariable fractional polynomial interaction analysis evaluated lipoprotein interdependence. Heatmaps visualized risk patterns across LDL-C/HDL-C combinations. Among 42,378 patients, 615 in-hospital major bleeding events were recorded. Restricted cubic spline analysis revealed a J-shaped association between HDL-C and bleeding risk, with HDL-C levels below 28 mg/dL associated with a 38% increased bleeding risk (adjusted odds ratio 1.38, 95% CI 1.07–1.79). In the multivariable fractional polynomial interaction analysis, the higher estimated bleeding risk associated with LDL-C < 70 mg/dL was most evident at HDL-C levels below approximately 45 mg/dL ( P for interaction = 0.012), whereas the reverse interaction analysis for HDL-C < 28 mg/dL across continuous LDL-C levels was not statistically significant ( P for interaction = 0.608). Heatmap visualization showed higher estimated bleeding risks when both LDL-C and HDL-C were in lower ranges. In this nationwide ACS registry, HDL-C showed a J-shaped association with in-hospital major bleeding, and LDL-C and HDL-C were jointly associated with in-hospital major bleeding among patients undergoing PCI. Higher estimated risk was observed when both lipoproteins were in lower ranges, consistent with a conditional joint risk pattern.

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Le contrôle bibliographique ouvert

DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.

Titre Crossref
Joint associations of LDL-C and HDL-C with in-hospital major bleeding in Chinese patients with acute coronary syndrome undergoing PCI: findings from the CCC-ACS project
Date Crossref
27/08/2026
Éditeur
Springer Science and Business Media LLC
Type
journal-article

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Les sujets associés

Antiplatelet Therapy and Cardiovascular DiseasesBlood properties and coagulationDiabetes, Cardiovascular Risks, and Lipoproteins

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