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Background: Increased levels of remnant cholesterol (RC) and inflammation are linked to higher risks of atherosclerotic cardiovascular disease. Whether a combination of C-reactive protein (CRP) and RC improves the predictive ability for evaluating the severity of coronary artery lesions remains unknown. Methods: A total of 1675 patients with coronary artery disease were stratified according to the Synergy Between Percutaneous Coronary Intervention (SYNTAX) score (SYNTAX score ≤ 22 versus SYNTAX score > 22). Logistic regression and restricted cubic spline models were used to evaluate the relationship between RC, CRP and the severity of coronary artery lesions. Multivariate logistic regression was used to identify predictors of a mid/high SYNTAX score (SYNTAX score > 22). The predictive value of RC combined with CRP was estimated by the ROC curve, continuous net reclassification improvement (NRI) and integrated discrimination improvement (IDI). Results: The multivariable-adjusted odds ratios (95% CIs) for the highest versus lowest quartile of RC were 2.143 (1.450– 3.166) for a mid/high SYNTAX score (SYNTAX score > 22). The association of RC with severity of coronary artery lesions was maintained significant in the subsample of patients, regardless of traditional cardiovascular risk factors like LDL-C levels and glycemic metabolism status. Moreover, the addition of CRP and RC to the baseline risk model had an incremental effect on the predictive value for a mid/high SYNTAX score (increase in C‑statistic value from 0.650 to 0.698; IDI 0.03; NRI 0.306; all P < 0.01). Conclusion: Elevated RC levels were significantly associated with the severity of coronary artery lesions even in patients with optimal low-density lipoprotein cholesterol levels. Adjustment of the RC by CRP further improved the predictive ability for the severity of coronary artery lesions. The combination of RC and CRP might serve as a noninvasive predictor of CAD complexity and could potentially influence the management and therapeutic approach. [ABSTRACT FROM AUTHOR]

Background: A novel non-contact system for remote parameter testing and reprogramming offers an alternative method for assessing device parameters during cardiac implantable electronic devices (CIEDs) implantation without the need for physical contact with the manufacturer's clinical service technician. The safety and feasibility of using this system in CIEDs implantation procedures remains to be determined., Objective: Evaluate the safety and feasibility of remote parameter testing in CIEDs implantation procedures., Methods: A single center, randomized, open-label, non-inferiority trial (ChiCTR2200057587) was conducted to compare the two approaches for interrogating CIEDs during implantation procedures: routine interrogation performed by on-site technicians or remote interrogation performed by technicians using the 5G-Cloud Technology Platform. Patients aged ≥18 years and elected to receive CIEDs were eligible for inclusion. The primary endpoint was the completion rate of the parameter test. Safety and efficiency were evaluated in all randomly assigned participants., Results: A total of 480 patients were finally enrolled and were randomly assigned to routine group ( n  = 240) or remote group ( n  = 240). The primary endpoint was achieved by 100% in both groups ( P  = 0.0060 for noninferiority). The parameters of sensing, threshold, and impedance regarding the right atrium, right ventricle, and left ventricle had no statistical significance between the two groups ( P  > 0.05). Procedure time, parameter testing time, and both duration and dose of x-ray irradiation were not significantly different between the two groups ( P  > 0.05). Shut-open door frequency was significantly higher in the routine group than the remote group [6.00 (4.00, 8.00) vs. 0, P  < 0.0001]. Notably, no clinical or technical complications were observed in the remote group., Conclusions: Remote parameter testing is safe and feasible across various devices implantation procedures. The utilization of remote parameter testing and reprogramming could represent an innovative approach to improve healthcare accessibility and unlock the full potential of secondary centers in managing CIEDs., The Registration Identification: ChiCTR2200057587., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2024 Xiong, Qin, Tong, Long, Luo, Feng, Peng, Jiang, Xiong, Li, Zhang, Zhang, Liu and Cai.)