Georg Goliasch1, Franz Wiesbauer2, Hermann Blessberger3, Svitlana Demyanets4, Johann Wojta5, Kurt Huber6, Gerald Maurer7, Martin Schillinger2, Walter S Speidl2. 1. Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria. Electronic address: georg.goliasch@meduniwien.ac.at. 2. Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria. 3. Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria; Department of Internal Medicine I-Cardiology, Linz General Hospital, Johannes Kepler University School of Medicine, Linz, Austria. 4. Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria; Ludwig Boltzmann Cluster for Cardiovascular Research, Vienna, Austria. 5. Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria; Ludwig Boltzmann Cluster for Cardiovascular Research, Vienna, Austria; Core Facilities, Medical University of Vienna, Vienna, Austria. 6. 3rd Medical Department, Cardiology and Intensive Care Medicine, Wilhelminen Hospital, Vienna, Austria. 7. Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria; Ludwig Boltzmann Cluster for Cardiovascular Research, Vienna, Austria.
Abstract
BACKGROUND: Remnant cholesterol has been defined as the cholesterol present in triglyceride-rich remnant lipoproteins. Elevated levels of remnant cholesterol have been associated with increased cardiovascular risk. Acute myocardial infarction (AMI) in very young individuals (≤40 years) represents a rare disease with a typical risk factor profile and a lipid phenotype that is characterized by a predominance of elevated triglyceride-rich lipoproteins. OBJECTIVE: The aim of this study was to investigate the role of remnant cholesterol in premature AMI. METHODS: We prospectively enrolled 302 patients into our multicenter case-control study comprising 102 consecutive myocardial infarction survivors (≤40 years) and 200 hospital controls. Myocardial infarction patients were frequency matched for age, gender, and center. Remnant cholesterol was calculated from standard lipid parameters. RESULTS: Remnant cholesterol was 1.7-fold higher in premature AMI patients compared with controls (61.1 ± 36.8 vs 35.8 ± 16.8 mg/dL; P < .001). Remnant cholesterol was the lipid fraction most strongly associated with premature myocardial infarction (odds ratio 3.87; 95% confidence interval 2.26-6.64; P < .001) for an increase of 1-standard deviation. This observation was independent from clinical risk factors and plasma lipid levels. CONCLUSIONS: Remnant cholesterol is strongly associated with premature myocardial infarction, can be easily calculated, and might serve as a new potent risk marker in this young patient population.
BACKGROUND: Remnant cholesterol has been defined as the cholesterol present in triglyceride-rich remnant lipoproteins. Elevated levels of remnant cholesterol have been associated with increased cardiovascular risk. Acute myocardial infarction (AMI) in very young individuals (≤40 years) represents a rare disease with a typical risk factor profile and a lipid phenotype that is characterized by a predominance of elevated triglyceride-rich lipoproteins. OBJECTIVE: The aim of this study was to investigate the role of remnant cholesterol in premature AMI. METHODS: We prospectively enrolled 302 patients into our multicenter case-control study comprising 102 consecutive myocardial infarction survivors (≤40 years) and 200 hospital controls. Myocardial infarctionpatients were frequency matched for age, gender, and center. Remnant cholesterol was calculated from standard lipid parameters. RESULTS: Remnant cholesterol was 1.7-fold higher in premature AMI patients compared with controls (61.1 ± 36.8 vs 35.8 ± 16.8 mg/dL; P < .001). Remnant cholesterol was the lipid fraction most strongly associated with premature myocardial infarction (odds ratio 3.87; 95% confidence interval 2.26-6.64; P < .001) for an increase of 1-standard deviation. This observation was independent from clinical risk factors and plasma lipid levels. CONCLUSIONS: Remnant cholesterol is strongly associated with premature myocardial infarction, can be easily calculated, and might serve as a new potent risk marker in this young patient population.
Authors: Nisha Hosadurg; Brittany M Bogle; Golsa Joodi; Murrium I Sadaf; Irion Pursell; Philip M Mendys; John P Mounsey; Ross J Simpson Journal: Mayo Clin Proc Innov Qual Outcomes Date: 2018-08-24