Association of Increased Remnant Cholesterol and the Risk of Coronary Artery Disease: A Retrospective Study
Open accessAbstract
Background and Aims: Low-density lipoprotein cholesterol (LDL-C) is the primary target of lipid-lowering therapy in coronary artery disease (CAD). But some patients with the normal levels of LDL-C still suffer from CAD progression and malignant outcomes (e.g., major adverse cardiovascular events [MACEs]), and the mechanism is unclear. The previous prospective studies demonstrated that the remnant cholesterol (RC) and non-high-density lipoprotein cholesterol (non-HDL-C) were capable to predict the risk of CAD. This study evaluated the association between RC and non-HDL-C with the risk of CAD. Methods: In our study, 12,563 patients were enrolled. We categorized patients into four concordance/discordance groups according to the median of RC, LDL-C, and non-HDL-C. Then, we performed a propensity score matching (PSM) strategy. The unadjusted and adjusted multivariate logistic regression models were used to evaluate the relationship between the lipid concentrations. Results: In this study, 8,658 (68.9%) patients were male with a median age of 61 (54 and 67) years. The multivariate logistic regression showed the odds ratio (OR) of RC was 1.952 (CI = 1.276–2.988, p = 0.002). The OR of the low RC/high LDL-C group was 0.626 (CI = 0.504–0.778, p < 0.001) and the OR of the low RC/high non-HDL-C group was 0.574 (CI = 0.462–0.714, p < 0.001). The p-values for interaction between the RC and hypertension, diabetes were both < 0.001. Conclusion: Our study showed a significant association between the RC and CAD. The level of RC was more capable to reflect the risk of CAD than LDL-C and non-HDL-C. There was an interaction relationship between RC and age, gender, hypertension, diabetes, in CAD. But we did not find whether there was a relationship between the non-HDL-C and CAD.
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Elevated levels of cholesterol-enriched remnant lipoproteins contribute to the development of premature coronary and peripheral atherosclerosis.
“As a result, elevated levels of cholesterol-enriched remnant lipoproteins contribute to the development of premature coronary [22,23,24] and peripheral [25,26] atherosclerosis.”
From Spectrum and Prevalence of Rare APOE Variants and Their Association with Familial Dysbetalipoproteinemia (2024) · cites this paper as [24]
The Introduction identifies elevated remnant cholesterol as a risk factor for atherosclerosis, and the Discussion links it to CAD and describes a possible plaque-forming mechanism. The cited paper does not establish that this occurs prematurely, and its retrospective findings show an association rather than demonstrating causation. The peripheral claim is attached to different citations, so it is not assessed against this source. (LLM, conf=0.84)
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References 33 · Cited by 28
Research works printed but not linked: 23
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- Authors
- Kexin, W., Yaodong, D., Wen, G., Rui, W., Jiaxin, Y., Xiaoli, L., Hua, S., & Hailong, G.
- Affiliations
- Capital Medical University (CN)
- Venue
- Frontiers in Cardiovascular Medicine
- Publisher
- Frontiers Media SA
- Published
- 2021-10-29
- Volume
- 8
- Pages
- 740596-740596
- ISSN
- 2297-055X (ISSN-L)
- PMC
- PMC8585757
- OpenAlex
- W3178744151
- Cited by
- 28
- References
- 33
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 4 · 2023: 10 · 2022: 9
- FWCI
- 5.40
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Cardiovascular Medicine (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Beijing Municipal Health Commission
- Topics
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipid metabolism and disorders
- Keywords
- remnant cholesterol, coronary artery disease, non-HDL cholesterol, LDL cholesterol, lipid-lowering therapy, major adverse cardiovascular events, cardiovascular risk prediction, hypertension, diabetes mellitus
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