Recent publications on Residual Risk

Remnant cholesterol is associated with significant coronary atherosclerotic burden even among patients with well-controlled low-density lipoprotein cholesterol (LDL-C) levels, according to this report. This was a multicentre study involving 587 patients (mean age 61 ± 12 years) with suspected coronary artery disease, who underwent computed tomography coronary angiography and a fasting lipid profile within 3 months. Remnant cholesterol was calculated as: total cholesterol – (LDL-C + high-density lipoprotein cholesterol [HDL-C]). Overall, 134 (23%) patients had LDL-C levels <1.8 mmol/L and most of these (82%) were on a statin. In this subgroup, multivariable analysis adjusting for HDL-C and traditional cardiovascular risk factors showed that remnant cholesterol was predictive of significant coronary atherosclerotic burden, as defined by a computed tomography-Leaman score >5 (odds ratio 3.87, 95% confidence interval 1.34-7.55, p = 0.004). These findings add further support for the rationale of therapeutic targeting of elevated remnant cholesterol to reduce the residual atherosclerotic risk.