Lipids & metabolic liver disease
Remnant cholesterol and the risk of aortic valve calcium progression: insights from the MESA study
Authors' conclusion
In atherosclerotic cardiovascular disease-free individuals, elevated RC is identified as a residual risk for AVC progression, independent of traditional cardiovascular risk factors. The causal relationship of RC to AVC and the potential for targeted RC reduction in primary prevention require deeper exploration.
Study context
- Population
- Individuals without atherosclerotic CVD at baseline, MESA; 61.8 ± 10.1 years, 47.5% men; Remnant cholesterol (RC) = total cholesterol minus high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) (Martin/Hopkins)
- Participants
- 5,597 individuals
- Exposure
- RC quartiles; RC vs LDL-C discordant/concordant groups
- Outcome
- AVC progression
- Follow-up
- Median 2.4 ± 0.9 years
Methodological detailspopulation-based, Multi-Ethnic Study of Atherosclerosis, adjusted Cox regression, discordance analysis
- Population-based
- Multi-Ethnic Study of Atherosclerosis
- Adjusted Cox regression
- Discordance analysis
Main finding
As reported in the abstract
Hazard ratio (95% CI)
Q2vs Q1
1.195(0.925–1.545)
Q3vs Q1
1.322(1.028–1.701)
Q4vs Q1
1.546(1.188–2.012)
- Participants with AVC progression
- 568 (10.1%)
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| AVC progression: discordant high RC/low LDL-Cvs concordant low RC/LDL-C (by medians) | 1.528 (1.201–1.943) | |
| 0.512Hazard ratio (log scale) |
AVC progression: discordant high RC/low LDL-C vs concordant low RC/LDL-C (by medians)
- Pattern persisted with LDL-C thresholds of 100 and 130 mg/dL; consistent across sensitivity analyses
Original publication
Remnant cholesterol and the risk of aortic valve calcium progression: insights from the MESA study. Cardiovasc Diabetol. Published 9 January 2024. doi:10.
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