Cardiology · 4 h ago
High remnant cholesterol linked to coronary disease risk in familial hypercholesterolaemia
An analysis of the Copenhagen General Population Study and UK Biobank examined remnant cholesterol and coronary artery disease in people with and without familial hypercholesterolaemia (FH). Remnant cholesterol of at least 1 mmol/L was associated with higher coronary disease risk, although estimates varied across FH definitions and some confidence intervals included no association.
- Two population cohorts included more than 537,000 participants.
- Remnant cholesterol threshold was 1 mmol/L (39 mg/dL).
- Risk associations varied across FH definitions and cohorts.
- Observational findings do not establish treatment benefit.
Researchers analysed 108,751 participants in the Copenhagen General Population Study and 428,625 in UK Biobank, classifying FH using clinical criteria and genetic mutations. During the studies, 7,708 and 50,997 participants, respectively, experienced coronary artery disease. The analysis compared coronary disease risk in people with remnant cholesterol levels of at least 1 mmol/L (39 mg/dL) with risk in those below that threshold.
After multivariable adjustment, the association in participants classified as having FH varied by definition and cohort. Hazard ratios ranged from 1.14 to 1.60 across the reported clinical FH groups; estimates for genetic FH were 1.48 (95% CI 0.59–3.69) in the Copenhagen cohort and 1.39 (0.88–2.19) in UK Biobank. Several subgroup confidence intervals included no association. In participants without FH, hazard ratios were 1.49 and 1.47 in the two cohorts.
The findings suggest that higher remnant cholesterol may mark additional coronary risk in FH, alongside the elevated risk associated with lifelong high LDL cholesterol. The observational analysis establishes an association, not that remnant cholesterol causes events or that lowering it reduces risk. Estimates were not consistent across all FH definitions, and the supplied abstract does not report treatment effects.
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European Journal of Preventive Cardiology: In familial hypercholesterolaemia, remnant cholesterol above 1 mmol/L is associated with 50% higher risk of coronary artery disease ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.