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Association between remnant cholesterol and cardiac conduction block: A prospective cohort study

Xintao Li1, Man Li2, Liuliu Cao3

  • 1Department of Cardiology, The First Affiliated Hospital of Soochow University, Jiangsu, China.

Heart Rhythm
|January 22, 2026
PubMed

Insights

Both low and high remnant cholesterol (RC) levels increase cardiac conduction block (CCB) risk. Maintaining optimal RC levels is crucial for cardiovascular health and preventing CCB.

Area of Science:

  • Cardiology
  • Atherosclerosis Research
  • Public Health

Background:

  • Elevated remnant cholesterol (RC) is a known risk factor for atherosclerotic cardiovascular disease.
  • The association between remnant cholesterol and cardiac conduction block (CCB) risk is not well-established.

Purpose of the Study:

  • To investigate the relationship between serially measured remnant cholesterol (RC) levels and the incidence of cardiac conduction block (CCB).

Main Methods:

  • Utilized data from the Kailuan Study, measuring RC levels at baseline and biennial follow-ups.
  • Calculated cumulative average RC levels for 80,853 participants over a median follow-up of 10.40 years.
  • Employed Cox proportional hazards regression and restricted cubic splines to analyze associations between RC and CCB incidence.

Main Results:

  • Identified 3203 incident CCB cases, revealing a U-shaped association between cumulative average RC and CCB risk (P nonlinearity = 0.001).
  • Participants with RC < 0.76 mmol/L (HR 1.55) and RC ≥1.40 mmol/L (HR 1.78) showed significantly higher CCB risk compared to the 0.76-1.05 mmol/L group.
  • Consistent U-shaped associations were observed for CCB subtypes, including atrioventricular block, left bundle branch block, and right bundle branch block.

Conclusions:

  • Both low and high cumulative average remnant cholesterol levels are linked to increased risk of cardiac conduction block.
  • Findings underscore the importance of maintaining remnant cholesterol within an optimal range to mitigate CCB risk.
Abstract

Keywords:
Atrioventricular blockCardiac conduction blockCohort studyLeft bundle branch blockRemnant cholesterolRight bundle branch blockRisk factor

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