AUTHOR=Kexin Wang , Yaodong Ding , Wen Gao , Rui Wang , Jiaxin Yang , Xiaoli Liu , Hua Shen , Hailong Ge 

TITLE=Association of Increased Remnant Cholesterol and the Risk of Coronary Artery Disease: A Retrospective Study

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=8

YEAR=2021

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2021.740596

DOI=10.3389/fcvm.2021.740596

ISSN=2297-055X

ABSTRACT=<p><bold>Background and Aims:</bold> Low-density lipoprotein cholesterol (LDL-C) is the primary target of lipid-lowering therapy in coronary artery disease (CAD). But some patients with the normal levels of LDL-C still suffer from CAD progression and malignant outcomes (e.g., major adverse cardiovascular events [MACEs]), and the mechanism is unclear. The previous prospective studies demonstrated that the remnant cholesterol (RC) and non-high-density lipoprotein cholesterol (non-HDL-C) were capable to predict the risk of CAD. This study evaluated the association between RC and non-HDL-C with the risk of CAD.</p><p><bold>Methods:</bold> In our study, 12,563 patients were enrolled. We categorized patients into four concordance/discordance groups according to the median of RC, LDL-C, and non-HDL-C. Then, we performed a propensity score matching (PSM) strategy. The unadjusted and adjusted multivariate logistic regression models were used to evaluate the relationship between the lipid concentrations.</p><p><bold>Results:</bold> In this study, 8,658 (68.9%) patients were male with a median age of 61 (54 and 67) years. The multivariate logistic regression showed the odds ratio (<italic>OR</italic>) of RC was 1.952 (<italic>CI</italic> = 1.276–2.988, <italic>p</italic> = 0.002). The <italic>OR</italic> of the low RC/high LDL-C group was 0.626 (<italic>CI</italic> = 0.504–0.778, <italic>p</italic> &lt; 0.001) and the <italic>OR</italic> of the low RC/high non-HDL-C group was 0.574 (<italic>CI</italic> = 0.462–0.714, <italic>p</italic> &lt; 0.001). The <italic>p</italic>-values for interaction between the RC and hypertension, diabetes were both &lt; 0.001.</p><p><bold>Conclusion:</bold> Our study showed a significant association between the RC and CAD. The level of RC was more capable to reflect the risk of CAD than LDL-C and non-HDL-C. There was an interaction relationship between RC and age, gender, hypertension, diabetes, in CAD. But we did not find whether there was a relationship between the non-HDL-C and CAD.</p>