Concordant and discordant roles of remnant cholesterol and hs-CRP in cardiovascular disease; gender stratified analysis

INTRODUCTION: Evidence has found that high-sensitivity C-reactive protein (hs-CRP) can predict cardiovascular disease (CVD). Additionally, some research has suggested a combined effect of hs-CRP and remnant cholesterol (RC) in the development of CVD. Recognizing the significance of assessing both markers as predictive factors, this study aims to examine the association between RC and hs-CRP levels with the occurrence of CVD, coronary artery disease (CAD), and brain ischemic stroke in the Iranian population, categorized by gender. MATERIALS AND METHODS: The research involved 6985 participants from an Iranian cohort study. At the onset of the study, serum hs-CRP and RC levels were assessed. After ten years, occurrences of CVD, CAD, and brain ischemic events were evaluated. Furthermore, a survival and gender-stratified analysis was conducted to understand this association better. RESULTS: Participants with high RC but low hs-CRP had a 23.5% and 24% increase in CVD and CAD risk, while those with both elevated RC and hs-CRP had a 44.9% and 57% higher risk for CVD and CAD. Among women, the combination of elevated RC and hs-CRP was linked to a 36.7% increase in CAD risk. Survival analysis supported these findings, showing that individuals with elevated RC and hs-CRP levels had the shortest survival times for CVD (134.55 months) and CAD (135.30 months). CONCLUSION: The combined use of RC and hs-CRP markers can strongly predict CVD and CAD, particularly in men. However, no association was found between RC and hs-CRP in brain ischemic stroke. To definitively address this issue, it is crucial to conduct future studies with a larger sample size that specifically target brain ischemic stroke.