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Remnant Cholesterol, Not LDL Cholesterol, Is Associated With Incident Cardiovascular Disease

Journal of the American College of Cardiology, 2020-12, Vol.76 (23), p.2712-2724 [Peer Reviewed Journal]

2020 ;Copyright © 2020. Published by Elsevier Inc. ;ISSN: 0735-1097 ;EISSN: 1558-3597 ;DOI: 10.1016/j.jacc.2020.10.008 ;PMID: 33272365

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Title:
Remnant Cholesterol, Not LDL Cholesterol, Is Associated With Incident Cardiovascular Disease
Author: Castañer, Olga ; Pintó, Xavier ; Subirana, Isaac ; Amor, Antonio J. ; Ros, Emilio ; Hernáez, Álvaro ; Martínez-González, Miguel Ángel ; Corella, Dolores ; Salas-Salvadó, Jordi ; Estruch, Ramón ; Lapetra, José ; Gómez-Gracia, Enrique ; Alonso-Gomez, Angel M. ; Fiol, Miquel ; Serra-Majem, Lluís ; Corbella, Emili ; Benaiges, David ; Sorli, Jose V. ; Ruiz-Canela, Miguel ; Babió, Nancy ; Sierra, Lucas Tojal ; Ortega, Emilio ; Fitó, Montserrat
Subjects: Aged ; Body Mass Index ; cardiovascular disease ; Cardiovascular Diseases - blood ; Cardiovascular Diseases - epidemiology ; Cardiovascular Diseases - prevention & control ; Cholesterol - blood ; Cohort Studies ; Diet, Mediterranean ; Female ; Humans ; Lipoproteins - blood ; Male ; Middle Aged ; non−HDL-cholesterol ; Proportional Hazards Models ; remnant cholesterol ; Risk Factors ; triglycerides ; Triglycerides - blood
Is Part Of: Journal of the American College of Cardiology, 2020-12, Vol.76 (23), p.2712-2724
Description: Genetic, observational, and clinical intervention studies indicate that circulating levels of triglycerides and cholesterol transported in triglyceride-rich lipoproteins (remnant cholesterol) can predict cardiovascular events. This study evaluated the association of triglycerides and remnant cholesterol (remnant-C) with major cardiovascular events in a cohort of older individuals at high cardiovascular risk. This study determined the baseline lipid profile and searched for major adverse cardiovascular events (MACEs) in the high-risk primary prevention PREDIMED (Prevención con Dieta Mediterránea) trial population (mean age: 67 years; body mass index: 30 kg/m2; 43% men; 48% with diabetes) after a median follow-up of 4.8 years. Unadjusted and adjusted Cox proportional hazard models were used to assess the association between lipid concentrations (either as continuous or categorical variables) and incident MACEs (N = 6,901; n cases = 263). In multivariable-adjusted analyses, triglycerides (hazard ratio [HR]: 1.04; 95% confidence interval [CI]: 1.02 to 1.06, per 10 mg/dl [0.11 mmol/l]; p < 0.001), non−high-density lipoprotein cholesterol (HDL-C) (HR: 1.05; 95% CI: 1.01 to 1.10, per 10 mg/dl [0.26 mmol/l]; p = 0.026), and remnant-C (HR: 1.21; 95% CI: 1.10 to 1.33, per 10 mg/dl [0.26 mmol/l]; p < 0.001), but not low-density lipoprotein cholesterol (LDL-C) or HDL-C, were associated with MACEs. Atherogenic dyslipidemia (triglycerides >150 mg/dl [1.69 mmol/l] and HDL-C <40 mg/dl [1.03 mmol/l] in men or <50 mg/dl [1.29 mmol/l] in women) was also associated with MACEs (HR: 1.44; 95% CI: 1.04 to 2.00; p = 0.030). Remnant-C ≥30 mg/dl (0.78 mmol/l) differentiated subjects at a higher risk of MACEs compared with those at lower concentrations, regardless of whether LDL-C levels were on target at ≤100 mg/dl (2.59 mmol/l). In overweight or obese subjects at high cardiovascular risk, levels of triglycerides and remnant-C, but not LDL-C, were associated with cardiovascular outcomes independent of other risk factors. [Display omitted]
Publisher: United States: Elsevier Inc
Language: English
Identifier: ISSN: 0735-1097
EISSN: 1558-3597
DOI: 10.1016/j.jacc.2020.10.008
PMID: 33272365
Source: Freely Accessible Journals
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Remnant Cholesterol, Not LDL Cholesterol, Is Associated With Incident Cardiovascular Disease

2020 ;Copyright © 2020. Published by Elsevier Inc. ;ISSN: 0735-1097 ;EISSN: 1558-3597 ;DOI: 10.1016/j.jacc.2020.10.008 ;PMID: 33272365

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