Abstract 47: Estimated Remnant Lipoprotein Particle Cholesterol, Very Low-Density Lipoprotein Cholesterol, and Incident Ischemic Stroke Risk - The Cardiovascular Health Study

Abstract

Introduction: Serum remnant lipoprotein particle cholesterol (RLP-C), which includes very-low density lipoproteins (VLDL) and its lipolytic products, contributes to atherosclerotic plaque formation. Novel methods for estimating RLP-C and VLDL-cholesterol (VLDL-C) from a serum fasting lipid profile (FLP) have been proposed (Figure). 1,2,3 We evaluated the relationship of estimated serum RLP-C and VLDL-C with the risk of incident ischemic stroke (IS) in the Cardiovascular Health Study (CHS), a population-based longitudinal cohort of older adults. Methods: Eligible CHS participants were free of prevalent stroke and completed an FLP at the 1989-1990 or 1992-1993 baseline study visit. The relationships of a two-fold increase in RLP-C Varbo , RLP-C Sampson , and VLDL-C estimates with incident total IS were evaluated using Cox proportional hazards regression, adjusting for demographics and IS risk factors, including low-density and high-density lipoprotein cholesterol. Secondary analyses evaluated the relationship with incident cardioembolic IS, non-cardioembolic IS, and large artery atherosclerotic or lacunar IS. Results: Of 5,427 eligible participants, mean age was 72.8 (±5.6) years, 57.6% were women, and 15.7% were Black. Over a median follow-up of 12.4 years, 895 participants experienced an incident IS. RLP-C Varbo , RLP-C Sampson , and VLDL-C were each associated with incident total IS risk, non-cardioembolic IS risk, and large artery atherosclerotic or lacunar IS risk, after adjusting for confounders, but not with cardioembolic IS risk (Table). Conclusions: In older adults, RLP-C and VLDL-C are associated with IS risk, especially atherosclerotic IS.