What is the clinical evidence from this study?

Study design: Cohort. Population: coronary heart disease (n=4800). Intervention: Elevated remnant cholesterol vs. Lowest quartile of remnant cholesterol (<23 mg/dL). Primary outcome: Incidence of CHD (definite or probable myocardial infarction, unstable angina, angiographically-proven CHD, and CHD death) (HR 1.30, 95% CI 1.05-1.62).

What question did this study set out to answer?

The study aims to clarify the relationship between remnant cholesterol and the incidence of coronary heart disease beyond traditional lipid measures.

February 8, 2026European Heart Journal

Remnant cholesterol and risk of coronary heart disease beyond LDL-cholesterol and HDL-cholesterol: a population-based prospective cohort study

Q: What are the key findings of this study?

Elevated remnant cholesterol (>37 mg/dL) was significantly associated with an increased risk of coronary heart disease compared to levels <23 mg/dL (HR 1.30; 95% CI 1.05-1.62).

Q: What question did this study set out to answer?

The study aims to clarify the relationship between remnant cholesterol and the incidence of coronary heart disease beyond traditional lipid measures.

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Key result

Elevated remnant cholesterol is linked to ~30% higher CHD risk.

HR 1.30
95% CI 1.05-1.62
n=4,800

Why the study?

Does elevated remnant cholesterol increase the risk of incident coronary heart disease beyond LDL-C and HDL-C in adults without prior CHD?

Population

4,800 individuals aged ≥40 years without a prior history of CHD, mean age 54 years, 54% women, from the…

Comparison

Elevated Remnant cholesterol (Remnant-C) levels vs Lower Remnant-C levels

Design

Cohort

Follow-up

median 18.5 years

Authors

AAAmir AbdiIslamic Azad University Medical Branch of Tehran MHMitra HasheminiaReproductive Science Center PHParto HadaeghResearch Institute for Endocrine Sciences

Discussion

Member takes

Implication

Elevated remnant cholesterol is independently associated with an increased risk of incident coronary heart disease, particularly when co-occurring with high LDL-C.

Key Points

The study aims to clarify the relationship between remnant cholesterol and the incidence of coronary heart disease beyond traditional lipid measures.
Conducted a prospective cohort study with 4,800 individuals aged ≥40 years.
Calculated remnant cholesterol by subtracting HDL and LDL cholesterol from total cholesterol.
Used Cox models to adjust for potential confounding factors and estimate associations.
Stratified participants into categories based on levels of remnant and LDL cholesterol.
Over 18.5 years, 1,017 cases of coronary heart disease were recorded.
Each unit increase in remnant cholesterol was linked to a 6% higher risk of CHD.
The highest remnant cholesterol quartile showed a 30% higher risk of CHD compared to the lowest quartile.
All stratified groups exhibited increased risks associated with remnant and LDL cholesterol levels.

Study Design

Type

Cohort (n=4,800)

Structured PICO

Does elevated remnant cholesterol increase the risk of incident coronary heart disease beyond LDL-C and HDL-C in adults without prior CHD?

Population

4,800 individuals aged ≥40 years without a prior history of CHD, with a mean age of 54 years and 54% women, followed for a median of 18.5 years.

Exposure

Elevated Remnant cholesterol (Remnant-C) levels

Comparator

Lower Remnant-C levels (lowest quartile <23 mg/dL or Low Remnant-C ≤ 39 mg/dL / Low LDL-C ≤ 130 mg/dL reference group)

Outcome

Incidence of CHD (composite of definite or probable myocardial infarction diagnosed by ECG and biomarkers, unstable angina, angiographically-proven CHD, and CHD death)composite

Main Result

Hazard Ratio: 1.3 (95% CI 1.05–1.62)

Elevated remnant cholesterol is independently associated with an increased risk of incident coronary heart disease, particularly when co-occurring with high LDL-C.

Cite This Study

Abdi et al. (2025) conducted a cohort in coronary heart disease (n=4,800). Elevated remnant cholesterol vs. Lowest quartile of remnant cholesterol (<23 mg/dL) was evaluated on Incidence of CHD (definite or probable myocardial infarction, unstable angina, angiographically-proven CHD, and CHD death) (HR 1.30, 95% CI 1.05-1.62). Elevated remnant cholesterol (>37 mg/dL) was significantly associated with an increased risk of coronary heart disease compared to levels <23 mg/dL (HR 1.30; 95% CI 1.05-1.62).

synapsesocial.com/papers/698828fd0fc35cd7a8848e25 https://doi.org/10.1093/eurheartj/ehaf784.3688

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Implication

Elevated remnant cholesterol is independently associated with an increased risk of incident coronary heart disease, particularly when co-occurring with high LDL-C.

Remnant cholesterol and risk of coronary heart disease beyond LDL-cholesterol and HDL-cholesterol: a population-based prospective cohort study

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Remnant cholesterol and risk of coronary heart disease beyond LDL-cholesterol and HDL-cholesterol: a population-based prospective cohort study

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Also Consider

Also Consider