This study was a large single-center retrospective cohort study conducted at the First Affiliated Hospital of Xinjiang Medical University from January 2008 to December 2016. The details of the study design have been registered at http://www.chictr.org.cn (Chictr-ORC-16010153). Inclusion criteria: CAD was confirmed by coronary angiography (CAG), which showed at least one main coronary artery stenosis ≥ 70%. Patients meeting the diagnostic criteria of CAD and who were treated with at least one stent were recruited for the present study. We excluded subjects with no baseline monocyte counts and/or ApoA1, hematological disease, malignancy, active infection, renal or hepatic insufficiency, severe valvular disease, hyperthyroidism and hypothyroidism. Finally, we enrolled 5678 patients in the present study. The research protocol was approved by the Ethics Committee of the First Affiliated Hospital of Xinjiang Medical University.
Hypertension was defined as patients who were taking antihypertensive medication or who exhibited 3 blood pressure measurements of systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg[15–16]. Diabetes was defined as patients who were taking hypoglycemic agents or who exhibited fasting blood glucose ≥ 7.0 mmol/L, random blood glucose ≥ 11.1 mmol/L or an oral glucose tolerance test for 2 hours of blood glucose ≥ 11.1 mmol/L. Hyperlipidemia was defined in accordance with the "Chinese Adult Diabetes Management Guide (2016) ". Smoking was defined as regular smoking over the past 6 months.
All patients received 300 mg of clopidogrel, 300 mg of aspirin and 100 U/kg of heparin before PCI. PCI was performed using a standard radial or femoral approach, and all patients had at least one successful stent implant. Surgeons determined the need for pre-expansion, post-expansion, and glycoprotein IIb/IIIa receptor inhibitors according to the patients’ conditions. Experienced cardiac intervention specialists performed all procedures, and the numbers and the characteristics of lesions were recorded. All patients received beta-blockers, angiotensin-converting enzyme inhibitors, and statins in the absence of contraindications. After PCI, all the patients took 75 mg of clopidogrel and 100 mg of aspirin daily for at least 12 months.
The primary endpoint was long-term mortality, including ACM and CM. The secondary endpoints were major cardiovascular adverse events (MACE), which were defined as the combination of nonfatal myocardial infarction, cardiac death and target vessel revascularization, and major cardiovascular and cerebrovascular adverse events (MACCE) were defined as non-fatal myocardial infarction, nonfatal stroke, cardiac death, and target vessel revascularization.
All of the indicators of blood tests were measured in the center laboratory of the First Affiliated Hospital of Xinjiang Medical University according to a unified standard protocol, including blood cell tests and serum concentrations of blood urea nitrogen (BUN), creatinine (Cr), uric acid (UA), total cholesterol (TC), triglycerides (TG), glucose (GLU), high-density lipoprotein-C (HDL-C), low-density lipoprotein-C (LDL-C), apolipoprotein A1 (ApoAI), apolipoprotein B (ApoB) and lipoprotein A (Lp(a)).