Association between remnant cholesterol and incident atherosclerotic cardiovascular disease, heart failure, and atrial fibrillation

被引:6
作者
Tada, Hayato [1 ]
Kaneko, Hidehiro [2 ,3 ,10 ]
Suzuki, Yuta [2 ,4 ]
Okada, Akira [5 ]
Takeda, Norifumi [2 ]
Fujiu, Katsuhito [2 ,3 ]
Morita, Hiroyuki [2 ]
Ako, Junya [6 ]
Node, Koichi [7 ]
Takeji, Yasuaki [1 ]
Takamura, Masayuki [1 ]
Yasunaga, Hideo [8 ]
Komuro, Issei [2 ,9 ]
机构
[1] Kanazawa Univ, Grad Sch Med Sci, Dept Cardiovasc Med, Kanazawa, Japan
[2] Univ Tokyo, Dept Cardiovasc Med, Tokyo, Japan
[3] Univ Tokyo, Dept Adv Cardiol, Tokyo, Japan
[4] Natl Inst Publ Hlth, Ctr Outcomes Res & Econ Evaluat Hlth, Saitama, Japan
[5] Univ Tokyo, Grad Sch Med, Dept Prevent Diabet & Lifestyle Related Dis, Tokyo, Japan
[6] Kitasato Univ, Dept Cardiovasc Med, Sch Med, Minato, Kanagawa, Japan
[7] Saga Univ, Dept Cardiovasc Med, Saga, Japan
[8] Univ Tokyo, Sch Publ Hlth, Dept Clin Epidemiol & Hlth Econ, Tokyo, Japan
[9] Int Univ Hlth & Welf, Tokyo, Japan
[10] Tokyo Univ Hosp, Dept Cardiovasc Med, 7-3-1 Hongo,Bunkyo Ku, Tokyo 1138655, Japan
关键词
Remnant cholesterol; Triglycerides; Heart failure; Atrial fibrillation; Apolipoprotein B; RISK; MORTALITY; EVENTS; TRIALS; STROKE; LDL;
D O I
10.1016/j.jacl.2023.10.006
中图分类号
R9 [药学];
学科分类号
1007 ;
摘要
BACKGROUND: It remains unclear if remnant cholesterol is associated with atherosclerotic cardiovascular disease (ASCVD) (myocardial infarction, angina pectoris and stroke), heart failure (HF), and atrial fibrillation (AF) under primary prevention settings. OBJECTIVE: We aimed to clarify this issue among a general population without a history of ASCVD, HF or AF. METHODS: Analyses were conducted with a nationwide health claims database collected in the JMDC Claims Database between 2005 and 2022 ( n = 1,313,722; median age, 42 years; 54.6% men). We assessed the associations between remnant cholesterol calculated as total cholesterol minus HDL choles terol minus LDL cholesterol and composite CVD outcomes, including, ASCVD, HF, and AF using Cox proportional hazard model, dividing the individuals into tertiles of remnant cholesterol (T1-T3). RESULTS: The mean follow-up duration was 3.0 years. In total, 43,755 events were recorded. Remnant cholesterol was significantly associated with composite CVD outcomes after adjustments (T3 vs T1: hazard ratio [HR]; 1.07, 95% confidence interval [CI]: 1.04-1.10, p -trend < 0.001). Remnant cholesterol was associated with myocardial infarction (T3 vs T1:HR: 1.20, 95% CI: 1.06-1.34, p -trend = 0.002), angina pectoris (T3 vs T1:HR: 1.09, 95% CI: 1.05-1.14, p -trend < 0.001), stroke (T3 vs T1:HR: 1.08, 95% CI: 1.02-1.14, p -trend = 0.007), and HF (T3 vs T1:HR: 1.08, 95% CI: 1.04-1.12, p -trend < 0.001), while we found a marginal inverse association between remnant cholesterol and AF (T3 vs T1:HR: 0.92, 95% CI: 0.86-1.00, p -trend = 0.054). CONCLUSION: Remnant cholesterol was positively associated with ASCVD and HF, while we found a marginal inverse association between remnant cholesterol and AF. (c) 2023 National Lipid Association. Published by Elsevier Inc. All rights reserved.
引用
收藏
页码:3 / 10
页数:8
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