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Remnant cholesterol and coronary atherosclerotic plaque burden

Remnant cholesterol is associated with significant coronary atherosclerotic burden even among patients with well-controlled low-density lipoprotein cholesterol (LDL-C) levels, according to this report. This was a multicentre study involving 587 patients (mean age 61 ± 12 years) with suspected coronary artery disease, who underwent computed tomography coronary angiography and a fasting lipid profile within 3 months. Remnant cholesterol was calculated as: total cholesterol – (LDL-C + high-density lipoprotein cholesterol [HDL-C]). Overall, 134 (23%) patients had LDL-C levels <1.8 mmol/L and most of these (82%) were on a statin. In this subgroup, multivariable analysis adjusting for HDL-C and traditional cardiovascular risk factors showed that remnant cholesterol was predictive of significant coronary atherosclerotic burden, as defined by a computed tomography-Leaman score >5 (odds ratio 3.87, 95% confidence interval 1.34-7.55, p = 0.004). These findings add further support for the rationale of therapeutic targeting of elevated remnant cholesterol to reduce the residual atherosclerotic risk.
Remnant cholesterol and coronary atherosclerotic plaque burden assessed by computed tomography coronary angiography.

Lin A, Nerlekar N, Rajagopalan A et al.