AIM To investigate the predictive value of coronary flow reserve fraction (FFRCT) combined with remnant cholesterol (RC) for the risk of major adverse cardiovascular events (MACE).

METHODS A total of 284 suspected coronary heart disease patients were selected from the Fourth Medical Center of the PLA General Hospital from June 2022 to June 2023. The patients were followed up for 1 year and divided into MACE group (36 cases) and non-MACE group (248 cases) according to whether MACE occurred. Serum total cholesterol, low density lipoprotein, high density lipoprotein and RC and FFR were measured. Multivariate logistic regression model was constructed to analyze the risk factors affecting the occurrence of MACE in patients with suspected coronary heart disease and receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of serum FFR combined with RC for the 1-year MACE risk in patients with suspected coronary heart disease.

RESULES  After the 1 year follow-up, there were no lost cases. The incidence of MACE was 12.7% (36/284) in 284 patients with suspected coronary heart disease. Compared with those in non-MACE group, FFR value was decreased and serum RC level was increased in MACE group (P<0.05). Multiple Logistic regression analysis showed that gender, RC, glycosylated hemoglobin, creatinine, total calcification score and FFR were independent influencing factors (P<0.05). ROC curve analysis showed that the area under the curve of FFR combined with RC to predict the risk of MACE in patients with suspected coronary heart disease after 1 year was 0.814, which was larger than 0.646 and 0.789 predicted by RC or FFR alone.

CONCLUSION  The increase of RC level and the decrease of FFR value are closely related to the occurrence of MACE in patients with suspected CHD. The combined value of FFR and RC is high in predicting the risk of MACE in patients with suspected CHD.