Remnant cholesterol and risk of myocardial infarction in patients with coronary artery disease undergoing revascularization

Zafrir, Barak; Khoury, Razi; Saliba, Walid

doi:10.1016/j.jacl.2023.03.009

Cited by 6 publications

(5 citation statements)

References 39 publications

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“…Overall, the results of recently published observational and genetic Mendelian randomization studies support a causal association between elevated remnant cholesterol and ASCVD (Table 1) [20 ▪▪ ,22 ▪▪ ,23–25,26 ▪ –28 ▪ ,29–32,33 ▪ ,34–39]. Furthermore, the results imply that remnant particles have a substantially greater per particle atherogenicity than LDL, most probably because remnants per particle carry substantially more cholesterol than LDL [20 ▪▪ ,21] (Fig.…”

Section: Recent Evidencementioning

confidence: 58%

Remnant cholesterol and low-grade inflammation jointly in atherosclerotic cardiovascular disease: implications for clinical trials

Elías-López,

Doi,

Nordestgaard

et al. 2023

Current Opinion in Clinical Nutrition &Amp; Metabolic Care

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Purpose of review Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of death despite the development of effective treatments. Recently, elevated remnant cholesterol and low-grade inflammation have emerged as factors explaining part of the residual ASCVD risk. Interestingly, the coexistence of both high remnant cholesterol and low-grade inflammation can further increase the risk of ASCVD. The aim of this review is to describe the role of elevated remnant cholesterol and low-grade inflammation, separately and combined, in ASCVD. Recent findings Results from recently published studies, including observational and genetic Mendelian randomization studies, support a causal relationship between elevated remnant cholesterol and low-grade inflammation on risk of ASCVD in both primary and secondary prevention settings. In addition, current evidence from observational studies suggests that the coexistence of elevated remnant cholesterol and low-grade inflammation further increases the risk of ASCVD. Summary Recent observational studies suggest that high remnant cholesterol combined with low-grade inflammation may confer a particular high risk for ASCVD. Attention on the dual threat from high remnant cholesterol and low-grade inflammation is necessary, and further research in this field is warranted. The effect of remnant cholesterol-lowering drugs and anti-inflammatory drugs on ASCVD risk alone and combined remains to be elucidated. Video abstract http://links.lww.com/COCN/A20

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Section: Recent Evidencementioning

confidence: 58%

Remnant cholesterol and low-grade inflammation jointly in atherosclerotic cardiovascular disease: implications for clinical trials

Elías-López,

Doi,

Nordestgaard

et al. 2023

Current Opinion in Clinical Nutrition &Amp; Metabolic Care

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“…1, Supplemental digital content 1, http://links.lww.com/MCA/A666). A total of 28 articles, including 31 cohorts comprising 2 349 944 subjects, were included [10–37]. Out of these, 9 cohorts reported calculated remnant cholesterol as a continuous variable and 24 cohorts reported calculated remnant cholesterol as a categorical variable (15 cohorts with quartiles, 4 cohorts with tertiles, and 5 cohorts with dichotomies); 2 cohorts included measured remnant cholesterol as a continuous variable and 3 cohorts included measured remnant cholesterol as a categorical variable.…”

Section: Resultsmentioning

confidence: 99%

Remnant cholesterol and risk of major adverse cardiovascular events: a systematic review and dose–response meta-analysis of cohort studies

Bian,

Zhang,

Shao

et al. 2024

Coronary Artery Disease

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Emerging evidence indicates a significant role of remnant cholesterol in contributing to the residual risk associated with major adverse cardiovascular events (MACE). This study aims to evaluate the dose–response relationship between remnant cholesterol and the risk of MACE. PubMed, Embase and Cochrane databases were reviewed to identify cohort studies published in English up to 1 August 2023. Twenty-eight articles were selected. Pooled hazard ratios (HR) and their 95% confidence intervals (CIs) were calculated using fixed or random-effects models to evaluate the association between remnant cholesterol and the risk of MACE. The dose–response relationship between remnant cholesterol levels and the risk of MACE was analyzed using the linear model and restricted cubic spline regression models. For calculated remnant cholesterol levels, the pooled HR (95% CI) of MACE for per 1-SD increase was 1.13 (1.08, 1.17); HR (95% CI) for the second quartile (Q2), the third quartile (Q3) and the highest quartile (Q4) of remnant cholesterol levels were 1.14 (1.03, 1.25), 1.43 (1.23, 1.68) and 1.68 (1.44, 1.97), respectively, compared with the lowest quartile (Q1). For measured remnant cholesterol levels, the pooled HR (95% CI) of MACE per 1-SD increase was 1.67 (1.39, 2.01). The dose–response meta-analysis showed a dose–response relationship between remnant cholesterol levels and the risk of MACE, both on a linear trend (P < 0.0001) and a nonlinear trend (P < 0.0001). The risk of MACE is associated with increased levels of remnant cholesterol, and the dose–response relationship between remnant cholesterol levels and the risk of MACE showed both linear and nonlinear trends.

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“…Adverse cardiovascular events associated with RC have been documented in numerous clinical studies. However, RC has been proposed as a potential means of identifying individuals at higher risk for T2DM, cardiovascular diseases, chronic kidney disease, fatty liver and Mets [ 33 – 38 ], no studies have reported on the correlation between the prevalence of HUA and the increased RC yet.…”

Section: Discussionmentioning

confidence: 99%

Correlation between remnant cholesterol and hyperuricemia in patients with type 2 diabetes mellitus: a cross-sectional study

Lin,

Xu,

Teng

2024

Lipids Health Dis

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Background Remnant cholesterol (RC) has been known as an important factor for the assessment of the metabolic syndrome (Mets) risk. However, the correlation between RC and hyperuricemia (HUA) in type 2 diabetes mellitus (T2DM) remains unclear. This study aims to explore the correlation between RC and HUA in patients with T2DM. Methods A total of 2956 patients with T2DM admitted to the Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University from 2020 to 2022 were included. The correlation between RC and HUA was evaluated with Spearman’s correlation, multiple logistic regression, subgroup analyses, receiver operating characteristic (ROC) curves analyses and generalized smooth curve fitting. Total cholesterol (TC) < 5.18mmol/L was defined as normal TC. Results RC was correlated with uric acid in patients with T2DM (Spearman’s correlation coefficient = 0.279, P < 0.001). According to the multiple logistic regression analyses, there was an independent positive correlation between RC and HUA (OR = 1.63, 95%CI = 1.40, 1.90). In addition, a non-linear correlation between RC and HUA was identified. The area under the ROC curve (AUC) of RC (0.658, 95%CI = 0.635, 0.681) was the largest compared with those of low-density lipoprotein cholesterol (LDL-C), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C) and TC. Subgroup analyses showed a more significant positive correlation among females or normal TC groups. Conclusion Elevated RC is correlated with HUA in patients with T2DM significantly and positively. RC is better in its predictability for HUA than that of conventional lipid indexes.

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Remnant cholesterol and risk of myocardial infarction in patients with coronary artery disease undergoing revascularization

Cited by 6 publications

References 39 publications

Remnant cholesterol and low-grade inflammation jointly in atherosclerotic cardiovascular disease: implications for clinical trials

Remnant cholesterol and low-grade inflammation jointly in atherosclerotic cardiovascular disease: implications for clinical trials

Remnant cholesterol and risk of major adverse cardiovascular events: a systematic review and dose–response meta-analysis of cohort studies

Correlation between remnant cholesterol and hyperuricemia in patients with type 2 diabetes mellitus: a cross-sectional study

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