2-year changes in remnant cholesterol predictive of stroke

Substantial changes in remnant cholesterol levels over time are associated with a heightened risk of stroke in the general population, according to a study.

Researchers obtained data from a prospective cohort study conducted in the Kailuan community of Tangshan City, Hebei Province, China. They identified 62,443 individuals (mean age 50.76 years, 77.81 percent male) who were stroke-free for inclusion in the study.

Blood samples were collected and analysed. Total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) levels were measured separately. Remnant cholesterol was the difference between TC and the sum of LDL‐C and HDL‐C, calculated over 2 years (from 2006 at baseline to 2008).

The baseline remnant cholesterol level was 1.09 mmol/L. Over 2 years, remnant cholesterol levels increased in 39.82 percent of participants. A total of 3,780 stroke events occurred during a median follow-up of 10.30 years.

Changes in remnant cholesterol was associated with an increased risk of stroke. Specifically, participants in the fourth vs the first quartile of changes in remnant cholesterol had a 14-percent higher risk of stroke (hazard ratio [HR], 1.14, 95 percent confidence interval [CI], 1.02–1.28) and 18-percent higher risk of ischaemic stroke (HR, 1.18, 95 percent CI, 1.04–1.32).

When compared with participants whose remnant cholesterol levels remained stable, those who showed 2-year increases in remnant cholesterol were likewise at higher risk of stroke (HR, 1.12, 95 percent CI, 1.04–1.20) and nonischaemic stroke (HR, 1.15, 95 percent CI, 1.07–1.24).

The findings highlight the potential of monitoring long‐term changes in remnant cholesterol for early identification of people at risk of stroke.