Remnant Cholesterol Predicts Major Cardiovascular Events in Patients with Coronary Artery Disease Both among Patients with Type 2 Diabetes and in Nondiabetic Individuals

Remnant cholesterol, which is calculated as total cholesterol minus LDL cholesterol minus HDL cholesterol has attracted interest as a marker of cardiovascular event risk. The power of remnant cholesterol to predict major cardiovascular events (MACE) in patients with established coronary artery disease is unclear and is addressed in the present study. We enrolled 1472 consecutive patients with established coronary artery disease. Prospectively, cardiovascular events were recorded over a mean follow-up period of 8.0±5.03 years. At baseline, remnant cholesterol was significantly higher in patients with T2DM (n=446) than in non-diabetic subjects (27±24 vs. 21±23 mg/dl; p<0.001) . During follow-up, 493 of our patients suffered MACE; the event rate was significantly higher in patients with T2DM than in non-diabetic subjects (62.5 vs. 37.5%; p<0.001) . Remnant cholesterol in Cox regression models adjusting for age, sex, hypertension, smoking, body mass index and LDL cholesterol independently predicted MACE in the total study population (standardized adjusted HR 1.17 [1.09-1.28], p<0.001) , and in patients with T2DM as well as in non-diabetic subjects (standardized adjusted HRs 1.24 [1.07-1.44], p=0.0 and 1.14 [1.02-1.26], p=0.017, respectively) . From our data we conclude that remnant cholesterol in patients with established coronary artery disease predicts MACE both among patients with T2DM and among non-diabetic subjects. Disclosure A.Mader: None. L.Sprenger: None. A.Vonbank: None. B.Larcher: None. M.Maechler: None. A.Leiherer: None. A.Muendlein: None. H.Drexel: None. C.H.Saely: None.