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Longitudinal changes in remnant cholesterol and the risk of cardiovascular disease
Yijun Zhang1,2,3,4, Qin Xu1,2,3, Xue Tian1,2,3,4
1Department of Epidemiology, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, No. 119 S 4th Ring W Rd, Fengtai District, Beijing, 100070, China.
Insights
Maintaining stable high remnant cholesterol (RC) significantly increases cardiovascular disease (CVD) risk, including myocardial infarction and stroke. Keeping RC levels optimal can reduce lifetime CVD risk and extend disease-free years.
Area of Science:
- Cardiology
- Lipid Metabolism
- Preventive Medicine
Background:
- Longitudinal changes in remnant cholesterol (RC) and cardiovascular disease (CVD) risk require further investigation.
- Understanding RC dynamics is crucial for predicting and preventing CVD events.
Purpose of the Study:
- To examine the association between longitudinal changes in remnant cholesterol (RC) and the risk of cardiovascular disease (CVD) and its subtypes.
- To analyze both short-term and long-term RC change patterns in relation to CVD incidence.
Main Methods:
- Utilized data from the Kailuan study, defining RC short-term and long-term change patterns based on specific cutoff points and trajectories.
- Employed multivariate Cox proportional models to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for CVD, myocardial infarction (MI), and stroke.
- Established RC cutoff values at 0.52 mmol/L (2006) and 0.51 mmol/L (2008) for short-term analysis.
Main Results:
- A stable high RC level was associated with a 31% increased risk of CVD, 73% increased risk of MI, and 21% increased risk of stroke in the short-term analysis.
- Long-term analysis revealed a 1.34-fold increased risk of CVD, 1.66-fold for MI, and 1.22-fold for stroke in the high stable RC group compared to the low stable group.
- Specific HRs and CIs were provided for both short-term and long-term RC change patterns and CVD outcomes.
Conclusions:
- Stable high remnant cholesterol (RC) is significantly linked to an elevated risk of cardiovascular disease (CVD).
- Maintaining optimal RC levels is essential for mitigating lifetime CVD risk.
- Strategies to manage RC can potentially prolong the years of life free from CVD.
Background And Aim:
The analyses of longitudinal changes in remnant cholesterol (RC) and cardiovascular disease (CVD) remains are limited. The objective of the study was to investigate the associations of longitudinal changes in RC with the risks of CVD and its subtypes (myocardial infarction [MI] and stroke).
Methods And Results:
The participants were enrolled in the Kailuan study. The RC short-term change pattern was defined by RC cutoff points according to equivalent percentiles for low-density lipoprotein cholesterol of 2.6 mmol/L at visits in 2006 and 2008. The RC long-term change pattern was defined as the RC trajectories from 2006 to 2010. Multivariate Cox proportion models were used to calculate hazard ratios (HRs) and their 95% confidence intervals (CIs). The cutoff values of RC were 0.52 mmol/L at the 2006 visit and 0.51 mmol/L at the 2008 visit. In the RC short-term change analysis, the participants in the high stable group had a 31% increased risk of CVD (HR 1.31; 95% CI 1.22-1.41), 73% increased risks of MI (HR 1.73; 95% CI 1.47-2.03), and 21% increased risks of stroke (HR 1.21; 95% CI 1.12-1.31) compared with participants in the low stable group. Three RC trajectories were employed in the RC long-term change analysis. Compared with the low stable group, the high stable group had a 1.34-fold risk of CVD (HR 1.34; 95% CI 1.17-1.53), 1.66-fold risk of MI (HR 1.66; 95% CI 1.24-2.21), and 1.22-fold risk of stroke (HR 1.22; 95% CI 1.05-1.42).
Conclusions:
The stable high RC was associated with a higher risk of CVD. Maintaining optional RC levels could reduce the lifetime risk of CVD and prolong the year of life free from CVD.
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