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 cardiovascular events in patients with established cardiovascular disease is unclear and is addressed in the present study. We enrolled 1822 consecutive patients with angiographically proven stable CAD (n=1472) and sonographically proven peripheral artery disease (n=350). Prospectively, cardiovascular events were recorded over a mean follow-up period of 6.2±3.2 years. At baseline, remnant cholesterol was significantly higher in patients with T2DM (n=608) than in nondiabetic subjects (27±25 vs. 21±21 mg/dl; p<0.001). During follow-up, 584 of our patients suffered cardiovascular events; the event rate was significantly higher in patients with T2DM than in nondiabetic subjects (45.4 vs. 32.2%; p<0.001). Remnant cholesterol in Cox regression models adjusting for age, sex, hypertension, smoking, body mass index and LDL cholesterol independently predicted cardiovascular events in the total study population (standardized adjusted HR 1.15 [1.07-1.23]; p<0.001), and in patients with T2DM as well as in nondiabetic subjects (standardized adjusted HRs 1.17 [1.03-1.34]; p=0.013 and 1.12 [1.01-1.23]; p=0.028, respectively). From our data we conclude that remnant cholesterol in patients with established Cardiovascular Disease predicts cardiovascular events both among patients with T2DM and among nondiabetic subjects.


A. Mader: None. C. H. Saely: None. L. Sprenger: None. A. Vonbank: None. B. Larcher: None. M. Maechler: None. B. Mutschlechner: None. A. Leiherer: None. A. Muendlein: None. H. Drexel: None.

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