Title : Frequency of residual risk in cardiovascular secondary prevention in patients treated at the Reina Fabiola University Clinic
Abstract:
Introduction: Globally, ischemic heart disease has become one of the leading causes of disability-adjusted life years (DALYs), ranking first among adults over the age of 50. Residual risk can be classified into three main domains, residual lipid risk: persists despite LDL-C control, due to unaddressed atherogenic particles such as elevated triglycerides, remnant cholesterol, apolipoprotein B (apoB), and lipoprotein(a) [Lp(a)]. Residual inflammatory risk: characterized by chronic vascular inflammation, identifiable through biomarkers such as high-sensitivity C-reactive protein (hs-CRP). Residual prothrombotic/metabolic risk: associated with coagulation abnormalities, insulin resistance, and endothelial dysfunction
Methods: A descriptive, randomized, retrospective and observational study. The investigation will be conducted by the Cardiology Department of the Reina Fabiola University Clinic, including all patients from January 1, 2024, to January 1, 2026. The variables analyzed were HDLc(mg%), LDLc (mg%), hs-CPR (mg%), Lpa (mg%). Lipid-lowering treatment with statins, ezetimibe, or PCSK9 inhibitors for at least 4 weeks, starting 4 weeks after the event.
Results: Regarding hs-CRP values, a significant difference was found between developing and not developing an inflammatory condition: 4.00 ± 0.51 vs. 0.7 ± 0.09 (F(1, 183) = 62.72, P < 0.0001). Lpa, when analyzing its values in the RCV, showed a higher value, 90.0 ± 6.60 vs 11.41 ± 1.36; (F (1, 183 = 267.2 P < 0.0001 compared to patients who do not present this event. An analysis using artificial neural networks (multilayer perceptron) regarding the inflammatory profile revealed that, when using 20% of the studied patients—with various analytes as predictors—there was an 80% probability of patients experiencing the event (Figure 2); the model demonstrated a sensitivity of 97.5%, with high-sensitivity C-reactive protein (hs-CRP) identified as the primary predictor variable (100%)
Conclusion: The incorporation, analysis and evaluation of biochemical parameters such as atherogenic lipoproteins they act as reliable and safty predictors of vascular inflammation in the secondary prevention of cardiovascular events
