Abstract 1057: Association Between Remnant Cholesterol And All-cause Mortality And Cardiovascular Mortality In Young And Middle-aged American Adults: A Retrospective Cohort Study

Background: The association of remnant cholesterol with all-cause mortality and cardiovascular mortality in young, middle-aged American adults remains unclear. The purpose of the study is to explore this relationship. Methods: This retrospective cohort study included 16428 patients aged from 18 to 65 years old from the National Health and Nutrition Examination Survey (1999–2018) with follow-up mortality outcomes records linked to the National Death Index (NDI) until December 31, 2019. Participants were divided into four groups based on the RC quartile: a Q1 group (≤0.359 mmol/L), a Q2 group (0.359–0.517 mmol/L), a Q3 group (0.518–0.768 mmol/L), and a Q4 group (≥0.768 mmol/L). Multivariable Cox proportional hazards models were used to estimate the risk of mortality. Results: During a 123-month follow-up, a total of 931 (5.02%) all-cause deaths and 239 (1.22%) CVD-related deaths were recorded. After adjusting for multiple potential confounding factors and comparing them with the Q1 RC group of the participants, the adjusted hazard ratios for all-cause mortality for the Q2–Q4 groups were 0.98 (0.69, 1.38), 1.02 (0.74, 1.39), and 1.45 (1.09, 1.92) ( P for trend = 0.001), and those for cardiovascular mortality were 1.41 (0.68, 2.94), 1.77 (0.86, 3.62), and 2.98 (1.38, 6.43), respectively ( P for trend =0.001). The restricted cubic splines revealed a non-linear association between the baseline RC and cardiovascular mortality. Interestingly, an interaction effect was found between gender and RC in all-cause mortality. Conclusion: RC was associated with an increased risk of all-cause mortality and cardiovascular mortality in young and middle-aged American populations.