Key result
RC ≥24 mg/dl combined with hs-CRP ≥3 mg/l strongly predicts CAD morbidity and mortality, more than RC ≥24 mg/dl with LDL-C ≥130 mg/dl, highlighting synergistic inflammation impact.
Why the study?
Research has suggested a combined effect of hs-CRP and RC, as well as LDL and RC, in CAD development, but their combined impact on CAD mortality and morbidity required further investigation.
Does the combination of elevated remnant cholesterol with elevated LDL-C or hsCRP predict CAD morbidity and mortality in adults aged 35 to 65?
Does the combination of elevated remnant cholesterol with elevated LDL-C or hsCRP predict CAD morbidity and mortality in adults aged 35 to 65?
The combination of elevated remnant cholesterol and hsCRP is a stronger predictor of CAD morbidity and mortality than combined remnant cholesterol and LDL-C, highlighting the synergistic risk of inflammation and lipid disorders.
Background Lipid disorders, especially those involving high cholesterol and low-density lipoprotein cholesterol (LDL-C), are major risk factors for coronary artery disease (CAD). Recently, remnant cholesterol (RC) and high-sensitivity C-reactive protein (hs-CRP) have also been identified as CAD risk factors. Research has suggested a combined effect of hs-CRP and RC, as well as LDL and RC, in the development of CAD. This study aims to explore the combined impact of hsCRP-RC and LDL-RC on the risk of CAD mortality and morbidity in a large cohort study. Purpose The purpose of this study is to investigate the combined impact of hsCRP-RC and LDL-RC on the risk of developing CAD mortality and morbidity among participants in a large cohort study. Method In a large cohort study, 9,704 individuals aged 35 to 65 were enrolled, with 7,560 completing a decade-long follow-up. Detailed demographic, anthropometric, biochemical, and clinical data were collected. CAD was confirmed after referring suspected cases to a cardiologist. In total, 757 cases were diagnosed using stress echocardiography, radioisotope scans, coronary angiography, coronary CT angiography, or exercise tolerance tests. Statistical analyses were conducted using SPSS version 26 to evaluate the predictive role of LDL-C, RC, and hs-CRP in predicting cardiovascular disease and its mortality. The Classic Cox regression model was utilized to identify the association between RC, LDL, hs-CRP, and CAD. Data were also adjusted for confounding factors like age, education, occupation, marital status, smoking, physical activity, and energy intake. Results Our study found that having both RC ≥24 mg/dl and LDL-C ≥130 mg/dl, compared to just one of these factors, is a strong predictor of CAD morbidity (p <0.001) but not mortality in this group. Additionally, RC ≥24 mg/dl combined with hsCRP ≥3 mg/l are stronger predictors of CAD morbidity and mortality than RC ≥24 mg/dl combined with LDL-C ≥130 mg/dl. The shortest median survival times were observed in individuals with RC ≥24 mg/dl and hsCRP ≥3 mg/l.figure 1,2 Conclusion Our study found that while lipid disorders are significant in the development of CAD, inflammation has a synergistic effect, particularly on CAD mortality. Controlling inflammation along with lipid disorders appears to reduce the incidence and mortality of CAD.
No takes yet. Share an insight, caveat, or question.
Bikdelu et al. (2025) studied this question. RC ≥24 mg/dl combined with hs-CRP ≥3 mg/l strongly predicts CAD morbidity and mortality, more than RC ≥24 mg/dl with LDL-C ≥130 mg/dl, highlighting synergistic inflammation impact.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: