Abstract
The atherogenic potential of remnant cholesterol, which refers to the cholesterol content of triglyceride-rich, non-low-density lipoprotein (LDL) particles in circulation, has gained increasing attention recently. Unfortunately, very limited information is available regarding remnant cholesterol levels in Indian subjects. This was a retrospective study conducted at a premier, tertiary care center in North India. A total of 3064 consecutive subjects [mean age 61.3±10.3 years, 2550 (83.2%) men] with newly diagnosed coronary artery disease (CAD) undergoing coronary revascularization were included. Enzymatic assays were used for measuring various lipid parameters. Remnant cholesterol was calculated by subtracting LDL cholesterol (LDL-C) and high-density lipoprotein cholesterol from total cholesterol. A value>30mg/dL was considered elevated. The mean LDL-C was 79.1±33.1mg/dL with 46.4% of all subjects having LDL-C <70mg/dL and only 16.9% having LDL-C <50mg/dL. The median remnant cholesterol level was 17.0mg/dL (interquartile range 12.0-24.0mg/dL) with only 11.9% of subjects having values>30mg/dL. Only 4.5% of the patients with LDL-C <70mg/dL and 2.9% of those with LDL-C <50mg/dL had elevated remnant cholesterol. These proportions were significantly greater in patients with serum triglycerides >200mg/dL. Our study shows that in a North-Indian population with CAD, elevated remnant cholesterol was present in only a small proportion. The prevalence of elevated remnant cholesterol decreased further as the LDL-C control improved. These findings suggest that elevated remnant cholesterol may not be a clinically relevant therapeutic target in most patients with LDL-C below the currently recommended goals.
Published Version
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