Journal article
Remnant cholesterol and long-term incidence of death in coronary artery disease patients
Atherosclerosis, v 401, p119048
01 Feb 2025
PMID: 39632214
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Remnant cholesterol (RC), defined as non-HDL-non-LDL cholesterol, has attracted recent scientific interest as a candidate lipid factor for residual cardiovascular risk. Despite a rising amount of epidemiologic information, there are imprecisions because most available data arise from non-fasting, frozen and calculated values.
We enrolled 1474 consecutive patients with angiographically proven CAD, and measured RC in strictly fasting, non-frozen samples with a direct assay for LDL-C. Prospectively, all-cause mortality, cardiovascular mortality, and major adverse cardiovascular events (MACE) were recorded over a mean follow-up period of 11.6 ± 5.0 years, covering 17098 patient years.
During follow-up, CAD patients had a rate of all-cause mortality of 52.2 % (n = 769), of cardiovascular mortality of 20.6 % (n = 303), and an incidence of major adverse cardiovascular events (MACE) of 39.1 % (n = 576). Prospectively, RC was associated with all-cause mortality (HR 1.12 [1.03–1.23], p = 0.009), cardiovascular mortality (HR 1.20 [1.06–1.36], p = 0.005), and MACE (HR 1.10 [1.01–1.21], p = 0.033) in Cox regression analyses across various levels of adjustment (age, sex, smoking, LDL-C, HDL-C, hypertension, T2DM, and BMI). Findings did not differ between women and men. Furthermore, there was no discernible influence of statin treatment.
From our data we conclude that RC is associated with future all-cause mortality, cardiovascular mortality and MACE in patients with established coronary artery disease. Proper pre-analytic and analytic methods provided, RC represents a reliable indicator of residual risk.
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•Remnant cholesterol (RC) links to severe outcomes: all-cause mortality, cardiovascular mortality, and major adverse cardiovascular events (MACE).•Findings on RC are novel in the field of coronary artery disease patients.•Robust methodology: large cohort, long observation period, precise lipid measurements, meticulous sample handling.
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Details
- Title
- Remnant cholesterol and long-term incidence of death in coronary artery disease patients
- Creators
- Heinz Drexel - Vorarlberg Institute for Vascular Investigation and TreatmentArthur Mader - Vorarlberg Institute for Vascular Investigation and TreatmentBarbara Larcher - Private University in the Principality of LiechtensteinAndreas Festa - Private University in the Principality of LiechtensteinAlexander Vonbank - Vorarlberg Institute for Vascular Investigation and TreatmentPeter Fraunberger - Medical Central Laboratories, Feldkirch, AustriaAndreas Leiherer - Private University in the Principality of LiechtensteinChristoph H. Saely - Private University in the Principality of Liechtenstein
- Publication Details
- Atherosclerosis, v 401, p119048
- Publisher
- Elsevier B.V
- Resource Type
- Journal article
- Language
- English
- Web of Science ID
- WOS:001422500100001
- Scopus ID
- 2-s2.0-85211022408
- Other Identifier
- 991022197424504721
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- Collaboration types
- International collaboration
- Web of Science research areas
- Cardiac & Cardiovascular Systems
- Peripheral Vascular Disease