Abstract：
OBJECTIVE: Nontraditional lipid parameters are associated with intracranial atherosclerotic stenosis (ICAS) progression. This study aimed to investigate the association of nontraditional lipid parameters with the risk of restenosis in patients with ICAS after endovascular treatment (EVT).
METHODS: This study retrospectively enrolled consecutive patients with symptomatic ICAS after successful EVT followed by at least 3 months of angiography. Participants were divided into restenosis or non-restenosis groups based on the angiographic follow-up results. The nontraditional lipid parameters were calculated from conventional lipid parameters. The COX regression models and restricted cubic splines (RCS) were used to explore the association between nontraditional lipid parameters and restenosis.
RESULTS: This study recruited 222 cases with 224 lesions eligible for our study, of which 56 (25%) had restenosis. Compared with the non-restenosis group, patients in the restenosis group had higher levels of the atherogenic index of plasma (AIP) (0.211, interquartile range, IQR, 0.065-0.404 vs. 0.083, IQR, -0.052-0.265, P = 0.001), remnant cholesterol (RC) (0.55, IQR, 0.33-0.77 vs. 0.30, IQR, 0.18-0.49, P < 0.001) and Castelli\'s index‑I (CRI-I) (4.13, IQR, 3.39-5.34 vs. 3.74, IQR, 2.94-4.81, P = 0.030). In the multivariable COX regression analysis, a 0.1 unit increase of AIP was an independent risk factor for restenosis (hazard ratio, HR = 1.20, 95% confidence interval, CI 1.05-1.35, P = 0.005) whereas such an association was not observed for RC (HR = 1.01, 95% CI 0.90-1.15, P = 0.835). The restricted cubic spline (RCS) plot revealed a linear relationship between AIP and restenosis (P for nonlinear = 0.835) but a nonlinear relationship for RC (P for nonlinear = 0.012). Patients were stratified according to tertiles (T) of AIP and RC and the risk of restenosis increased in T3 compared to T1 (HR = 3.21, 95% CI 1.35-7.62, P = 0.008 and HR = 2.99, 95% CI 1.11-8.03, P = 0.030, respectively). Furthermore, this association remained stable within each LDL‑C level subgroup.
CONCLUSIONS: The AIP and RC were positively and independently associated with restenosis in patients with ICAS after EVT.
METHODS: This study retrospectively enrolled consecutive patients with symptomatic ICAS after successful EVT followed by at least 3 months of angiography. Participants were divided into restenosis or non-restenosis groups based on the angiographic follow-up results. The nontraditional lipid parameters were calculated from conventional lipid parameters. The COX regression models and restricted cubic splines (RCS) were used to explore the association between nontraditional lipid parameters and restenosis.
RESULTS: This study recruited 222 cases with 224 lesions eligible for our study, of which 56 (25%) had restenosis. Compared with the non-restenosis group, patients in the restenosis group had higher levels of the atherogenic index of plasma (AIP) (0.211, interquartile range, IQR, 0.065-0.404 vs. 0.083, IQR, -0.052-0.265, P = 0.001), remnant cholesterol (RC) (0.55, IQR, 0.33-0.77 vs. 0.30, IQR, 0.18-0.49, P < 0.001) and Castelli\'s index‑I (CRI-I) (4.13, IQR, 3.39-5.34 vs. 3.74, IQR, 2.94-4.81, P = 0.030). In the multivariable COX regression analysis, a 0.1 unit increase of AIP was an independent risk factor for restenosis (hazard ratio, HR = 1.20, 95% confidence interval, CI 1.05-1.35, P = 0.005) whereas such an association was not observed for RC (HR = 1.01, 95% CI 0.90-1.15, P = 0.835). The restricted cubic spline (RCS) plot revealed a linear relationship between AIP and restenosis (P for nonlinear = 0.835) but a nonlinear relationship for RC (P for nonlinear = 0.012). Patients were stratified according to tertiles (T) of AIP and RC and the risk of restenosis increased in T3 compared to T1 (HR = 3.21, 95% CI 1.35-7.62, P = 0.008 and HR = 2.99, 95% CI 1.11-8.03, P = 0.030, respectively). Furthermore, this association remained stable within each LDL‑C level subgroup.
CONCLUSIONS: The AIP and RC were positively and independently associated with restenosis in patients with ICAS after EVT.
摘要：
目的：非传统的血脂参数与颅内动脉粥样硬化狭窄（ICAS）进展相关。本研究旨在探讨血管内治疗（EVT）后ICAS患者的非传统脂质参数与再狭窄风险的关系。
方法：本研究回顾性纳入了连续的患者，这些患者在成功进行EVT并进行至少3个月的血管造影后出现症状性ICAS。根据血管造影随访结果，将参与者分为再狭窄或非再狭窄组。从常规脂质参数计算非传统脂质参数。使用COX回归模型和限制性三次样条（RCS）来探索非传统脂质参数与再狭窄之间的关系。
结果：这项研究招募了222例患者，其中224个病变符合我们的研究条件，其中56（25％）有再狭窄。与非再狭窄组相比,再狭窄组患者的血浆动脉粥样硬化指数（AIP）水平较高（0.211，四分位距，IQR,0.065-0.404vs.0.083,IQR,-0.052-0.265，P=0.001），残余胆固醇（RC）（0.55，IQR，0.33-0.77vs.0.30，IQR，0.18-0.49，P<0.001)和Castelli指数-I(CRI-I)(4.13，IQR，3.39-5.34vs.3.74,IQR,2.94-4.81,P=0.030)。在多变量COX回归分析中，AIP增加0.1个单位是再狭窄的独立危险因素(风险比，HR=1.20，95%置信区间，CI1.05-1.35，P=0.005），而RC未观察到这种关联（HR=1.01，95％CI0.90-1.15，P=0.835）。受限三次样条（RCS）图显示AIP与再狭窄之间存在线性关系（非线性的P=0.835），但RC的非线性关系（非线性的P=0.012）。根据AIP和RC的三元性（T）对患者进行分层，T3与T1相比，再狭窄的风险增加（HR=3.21，95％CI1.35-7.62，P=0.008和HR=2.99，95％CI1.11-8.03，P=0.030）。此外，这种关联在每个LDL-C水平亚组内保持稳定.
结论：在EVT后ICAS患者中，AIP和RC与再狭窄呈正相关且独立相关。
方法：本研究回顾性纳入了连续的患者，这些患者在成功进行EVT并进行至少3个月的血管造影后出现症状性ICAS。根据血管造影随访结果，将参与者分为再狭窄或非再狭窄组。从常规脂质参数计算非传统脂质参数。使用COX回归模型和限制性三次样条（RCS）来探索非传统脂质参数与再狭窄之间的关系。
结果：这项研究招募了222例患者，其中224个病变符合我们的研究条件，其中56（25％）有再狭窄。与非再狭窄组相比,再狭窄组患者的血浆动脉粥样硬化指数（AIP）水平较高（0.211，四分位距，IQR,0.065-0.404vs.0.083,IQR,-0.052-0.265，P=0.001），残余胆固醇（RC）（0.55，IQR，0.33-0.77vs.0.30，IQR，0.18-0.49，P<0.001)和Castelli指数-I(CRI-I)(4.13，IQR，3.39-5.34vs.3.74,IQR,2.94-4.81,P=0.030)。在多变量COX回归分析中，AIP增加0.1个单位是再狭窄的独立危险因素(风险比，HR=1.20，95%置信区间，CI1.05-1.35，P=0.005），而RC未观察到这种关联（HR=1.01，95％CI0.90-1.15，P=0.835）。受限三次样条（RCS）图显示AIP与再狭窄之间存在线性关系（非线性的P=0.835），但RC的非线性关系（非线性的P=0.012）。根据AIP和RC的三元性（T）对患者进行分层，T3与T1相比，再狭窄的风险增加（HR=3.21，95％CI1.35-7.62，P=0.008和HR=2.99，95％CI1.11-8.03，P=0.030）。此外，这种关联在每个LDL-C水平亚组内保持稳定.
结论：在EVT后ICAS患者中，AIP和RC与再狭窄呈正相关且独立相关。
