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Impact of Remnant Cholesterol on Cardiovascular Outcomes in Non-Myocardial Infarction Patients Undergoing

Nicholas Pitaro1, Benjamin Bay1,2, Samantha Sartori1

  • 1Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

European Journal of Preventive Cardiology
|October 22, 2025
PubMed

Insights

High remnant cholesterol (RC) levels, a marker of triglyceride-rich lipoproteins, increased the risk of myocardial infarction (MI) in patients undergoing percutaneous coronary intervention (PCI) for non-MI conditions.

Area of Science:

  • Cardiology
  • Lipid Metabolism
  • Interventional Cardiology

Background:

  • Remnant cholesterol (RC) is linked to cardiovascular outcomes.
  • Limited data exists on RC's impact in stable patients undergoing percutaneous coronary intervention (PCI).

Purpose of the Study:

  • To assess the effect of RC on clinical outcomes in patients undergoing PCI for non-myocardial infarction (MI).

Main Methods:

  • Analysis of 19,289 patients undergoing PCI between 2012-2023.
  • Patients stratified into RC percentile subgroups (<50th, 50th-<75th, 75th-<90th, ≥90th).
  • Primary endpoint: composite Major Adverse Cardiovascular Event (MACE) at one year (all-cause mortality, spontaneous MI, stroke).

Main Results:

  • Higher RC percentiles associated with younger age, non-white ethnicity, higher BMI, and more comorbidities.
  • No significant difference in composite MACE rates across RC groups.
  • Significantly increased risk of incident MI in the highest RC percentile group (≥90th) compared to the lowest (<50th).

Conclusions:

  • RC did not associate with the composite MACE endpoint.
  • Elevated RC concentrations serve as a marker for incident ischemic events, specifically MI, in PCI patients without prior MI.
Abstract

Keywords:
Percutaneous coronary interventioncardiovascular outcomeslipoproteinsremnant cholesterol

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