Remnant lipoproteins play an important role of in-stent restenosis in type 2 diabetes undergoing percutaneous coronary intervention: a single-centre observational cohort study
Open accessAbstract
BACKGROUND: Increasing evidence has suggested that the presence of remnant lipoproteins is a significant risk factor for atherosclerosis. Remnant lipoproteins are lipoproteins that are rich in triglycerides (TGs), and the main components include very-low-density lipoprotein (VLDL) in the fasting state. Diabetic patients often have hypertriglyceridemia with elevated levels of VLDL cholesterol but normal levels of low-density lipoprotein cholesterol (LDL-C). The aim of the present study was to elucidate the potential role of remnant lipoproteins-induced atherosclerosis in the occurrence and development of in-stent restenosis (ISR) in diabetic patients with coronary artery disease. METHODS: The present study enrolled 2312 patients with type 2 diabetes mellitus who underwent percutaneous coronary intervention from January 2013 to December 2014 and who were followed up by angiography. Patients were divided into two groups based on the presence or absence of ISR, and multivariate Cox's proportional hazards regression modelling showed that remnant-like particle cholesterol (RLP-C) was an independent risk factor for ISR. According to the receiver operating characteristic curve, the optimal cutoff point of the RLP-C was identified, and the patients were further divided into 2 groups. Propensity score matching analysis was performed, and 762 pairs were successfully matched. Log-rank tests were used to compare Kaplan-Meier curves for overall follow-up to assess ISR. RESULTS: The multivariate Cox's proportional hazards regression analysis showed that RLP-C was independently associated with ISR, and the baseline RLP-C level at 0.505 mmol/L was identified as the optimal cutoff point to predict ISR. Patients were divided into 2 groups by RLP levels. After propensity score matching analysis, a total of 762 pairs matched patients were generated. Kaplan-Meier curves showed that the estimated cumulative rate of ISR was significantly higher in patients with RLP-C levels ≥ 0.505 mmol/L (log-rank P < 0.001; HR equal to 4.175, 95% CI = 3.045-5.723, P < 0.001) compared to patients with RLP-C levels < 0.505 mmol/L. CONCLUSIONS: The present study emphasized the importance of remnant-like particle cholesterol in cardiovascular pathology in diabetic patients. Physicians should take measures to control RLP-C below the level of 0.505 mmol/L to better prevent of in-stent restenosis in diabetic patients.
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Qin et al. measured plasma levels of RCs in 2312 patients with type 2 diabetes mellitus undergoing coronary angioplasty and highlighted that patients with higher values of these lipoproteins more frequently suffered in-stent restenosis.
“Qin, Z. et al. measured the plasma levels of RCs in 2312 patients with type 2 diabetes mellitus undergoing coronary angioplasty and highlighted that patients with higher values of these lipoproteins more frequently suffered in-stent restenosis (ISR).”
From Residual Cardiovascular Risk: Role of Remnants Cholesterol, Monocyte/HDL Ratio and Lipoprotein Ratios on Personalized Cardiovascular Prevention (2024) · cites this paper as [25]
The Methods (Study patients) report an analysis of 2,312 patients with type 2 diabetes who underwent stent implantation, and the Results report significantly more in-stent restenosis among those with higher RLP-C. However, the Methods (Laboratory analysis) say RLP-C was calculated from other lipid measurements, not directly measured as the claim suggests. (LLM, conf=0.87)
Experimental — accuracy not yet measuredThe baseline value of 0.505 mmol/L (19.5 mg/dL) was identified as the optimal cut-off to predict in-stent restenosis after coronary angioplasty.
“and in particular, the baseline value of 0.505 mmol/L (19.5 mg/dL was identified as the optimal cut-off to predict this complication of coronary angioplasty [25].”
From Residual Cardiovascular Risk: Role of Remnants Cholesterol, Monocyte/HDL Ratio and Lipoprotein Ratios on Personalized Cardiovascular Prevention (2024) · cites this paper as [25]
The Results section (‘Baseline clinical and angiographic characteristics’) identifies baseline RLP-C of 0.505 mmol/L as the optimal cut-off for predicting in-stent restenosis. It gives the equivalent as 19.4 mg/dL, not 19.5 mg/dL, and the finding is limited to patients with type 2 diabetes after PCI with drug-eluting stents, rather than coronary angioplasty patients generally. (LLM, conf=0.85)
Experimental — accuracy not yet measuredRC values were independently associated with in-stent restenosis.
“In fact, the statistical analysis showed that the RC values were independently associated with the ISR, and in particular, the baseline value of 0.505 mmol/L (19.5 mg/dL was identified as the optimal cut-off to predict this complication of coronary angioplasty [25].”
From Residual Cardiovascular Risk: Role of Remnants Cholesterol, Monocyte/HDL Ratio and Lipoprotein Ratios on Personalized Cardiovascular Prevention (2024) · cites this paper as [25]
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“In fact, the statistical analysis showed that the RC values were independently associated with the ISR, and in particular, the baseline value of 0.505 mmol/L (19.5 mg/dL was identified as the optimal cut-off to predict this complication of coronary angioplasty [25].”
BackgroundInfluentialArterial Stiffness and Incident Diabetes
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Self-citationSun, Y., Shao, F., Xu, X., Liu, Y., & Ma, Y. (2026) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2026.1842544
Yu, C., Sun, Z., Wu, Q., Zhou, Z., Chen, W., & Xu, B. (2026) · Frontiers in Endocrinology · doi:10.3389/fendo.2026.1932335
- Authors
- Qin, Z., Zhou, K., Li, Y.-P., Wang, J.-L., Cheng, W.-J., Hu, C.-P., Shi, C., He, H., & Zhou, Y.-J.
- Affiliations
- Capital Medical University (CN)
- Venue
- Cardiovascular Diabetology
- Published
- 2019-01-28
- Volume
- 18
- Issue
- 1
- Pages
- 11-11
- ISSN
- 1475-2840 (ISSN-L)
- PMC
- PMC6348605
- OpenAlex
- W2924462859
- Cited by
- 56
- References
- 35
- Citations by year
- 2026: 2 · 2025: 7 · 2024: 7 · 2023: 10 · 2022: 5 · 2021: 14 · 2020: 8 · 2019: 3
- FWCI
- 7.17
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Cardiovascular Diabetology (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- Boston Scientific Corporation
- Capital Medical University
- MicroPort
- Topics
- Health Sciences › Medicine › Surgery › Coronary Interventions and Diagnostics
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- remnant lipoproteins, remnant-like particle cholesterol, in-stent restenosis, type 2 diabetes, percutaneous coronary intervention, coronary artery disease, hypertriglyceridemia, atherosclerosis risk factors, VLDL cholesterol, propensity score matching, cardiovascular risk stratification
- MeSH terms
- Beijing, Aged, Cholesterol, Coronary Artery Disease, Diabetes Mellitus, Type 2, Female, Humans, Lipoproteins, Cholesterol, LDL, Male, Middle Aged, Retrospective Studies, Risk Factors, Time Factors, Triglycerides, Cholesterol, VLDL, Biomarkers, Stents, Treatment Outcome, Coronary Angiography, Risk Assessment, Coronary Restenosis, Percutaneous Coronary Intervention
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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