Relationship Between Remnant Cholesterol and Risk of Heart Failure in a Community Population Without Cardiovascular Disease: Results of the China Patient‐Centered Evaluative Assessment of Cardiac Events Million Persons Project

Background The association between heart failure (HF) and remnant cholesterol (RC) has not been comprehensively elucidated. Methods This study assessed data from 90 280 individuals (mean age, 54 years; 61.2% women) in the China Patient‐Centered Evaluative Assessment of Cardiac Events Million Persons...

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Main Authors: Qiujin Huang, Weida Qiu, Chaolei Chen, Jiabin Wang, Yanqiu Ou, Yingqing Feng
Format: Article
Language:English
Published: Wiley 2025-06-01
Series:Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
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Online Access:https://www.ahajournals.org/doi/10.1161/JAHA.124.040039
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author Qiujin Huang
Weida Qiu
Chaolei Chen
Jiabin Wang
Yanqiu Ou
Yingqing Feng
author_facet Qiujin Huang
Weida Qiu
Chaolei Chen
Jiabin Wang
Yanqiu Ou
Yingqing Feng
author_sort Qiujin Huang
collection DOAJ
description Background The association between heart failure (HF) and remnant cholesterol (RC) has not been comprehensively elucidated. Methods This study assessed data from 90 280 individuals (mean age, 54 years; 61.2% women) in the China Patient‐Centered Evaluative Assessment of Cardiac Events Million Persons Project, all free of cardiovascular disease at baseline. RC was calculated by the equation: total cholesterol minus high‐density lipoprotein cholesterol minus low‐density lipoprotein cholesterol (LDL‐C), with low‐density lipoprotein cholesterol derived using the Friedewald equation. Cox proportional hazards model was used to examine the relationship of RC to HF risk. We also assessed the correlation between left ventricular structure and function and RC levels using multivariable linear regression models in 15 004 participants with echocardiographic data. Results The study had a median follow‐up period of 3.52 years and recorded 1105 new‐onset HF events. In multivariable models, every SD increment in RC was associated with a 7% increased risk of HF (hazard ratio [HR], 1.07 [95% CI, 1.01–1.13]), with a noted gradient of association. Even after accounting for interim myocardial infarction/coronary heart disease, individuals with high baseline RC (≥1.1 mmol/L) remained at a 24% greater HF risk (HR, 1.24 [95% CI, 1.05–1.46]) than the low group (<0.63 mmol/L). Each SD in the log‐transformed baseline RC increase was significantly correlated with increases in relative wall thickness (β=0.0014; P=0.01) and left ventricular mass index (β=0.45; P=0.01). Conclusions Elevated RC is linked to unfavorable left ventricular structure and function alterations, increasing the risk of subsequent HF. This association with HF appears to be independent of interim myocardial infarction/coronary heart disease.
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spelling doaj-art-c8afaac21ba240828179fce658f779132025-08-20T03:14:57ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802025-06-01141110.1161/JAHA.124.040039Relationship Between Remnant Cholesterol and Risk of Heart Failure in a Community Population Without Cardiovascular Disease: Results of the China Patient‐Centered Evaluative Assessment of Cardiac Events Million Persons ProjectQiujin Huang0Weida Qiu1Chaolei Chen2Jiabin Wang3Yanqiu Ou4Yingqing Feng5Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences Southern Medical University Guangzhou 510080 ChinaGuangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences Southern Medical University Guangzhou 510080 ChinaGuangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences Southern Medical University Guangzhou 510080 ChinaGuangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences Southern Medical University Guangzhou 510080 ChinaGuangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences Southern Medical University Guangzhou 510080 ChinaGuangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences Southern Medical University Guangzhou 510080 ChinaBackground The association between heart failure (HF) and remnant cholesterol (RC) has not been comprehensively elucidated. Methods This study assessed data from 90 280 individuals (mean age, 54 years; 61.2% women) in the China Patient‐Centered Evaluative Assessment of Cardiac Events Million Persons Project, all free of cardiovascular disease at baseline. RC was calculated by the equation: total cholesterol minus high‐density lipoprotein cholesterol minus low‐density lipoprotein cholesterol (LDL‐C), with low‐density lipoprotein cholesterol derived using the Friedewald equation. Cox proportional hazards model was used to examine the relationship of RC to HF risk. We also assessed the correlation between left ventricular structure and function and RC levels using multivariable linear regression models in 15 004 participants with echocardiographic data. Results The study had a median follow‐up period of 3.52 years and recorded 1105 new‐onset HF events. In multivariable models, every SD increment in RC was associated with a 7% increased risk of HF (hazard ratio [HR], 1.07 [95% CI, 1.01–1.13]), with a noted gradient of association. Even after accounting for interim myocardial infarction/coronary heart disease, individuals with high baseline RC (≥1.1 mmol/L) remained at a 24% greater HF risk (HR, 1.24 [95% CI, 1.05–1.46]) than the low group (<0.63 mmol/L). Each SD in the log‐transformed baseline RC increase was significantly correlated with increases in relative wall thickness (β=0.0014; P=0.01) and left ventricular mass index (β=0.45; P=0.01). Conclusions Elevated RC is linked to unfavorable left ventricular structure and function alterations, increasing the risk of subsequent HF. This association with HF appears to be independent of interim myocardial infarction/coronary heart disease.https://www.ahajournals.org/doi/10.1161/JAHA.124.040039community populationechocardiographyheart failureremnant cholesterolrisk factors
spellingShingle Qiujin Huang
Weida Qiu
Chaolei Chen
Jiabin Wang
Yanqiu Ou
Yingqing Feng
Relationship Between Remnant Cholesterol and Risk of Heart Failure in a Community Population Without Cardiovascular Disease: Results of the China Patient‐Centered Evaluative Assessment of Cardiac Events Million Persons Project
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
community population
echocardiography
heart failure
remnant cholesterol
risk factors
title Relationship Between Remnant Cholesterol and Risk of Heart Failure in a Community Population Without Cardiovascular Disease: Results of the China Patient‐Centered Evaluative Assessment of Cardiac Events Million Persons Project
title_full Relationship Between Remnant Cholesterol and Risk of Heart Failure in a Community Population Without Cardiovascular Disease: Results of the China Patient‐Centered Evaluative Assessment of Cardiac Events Million Persons Project
title_fullStr Relationship Between Remnant Cholesterol and Risk of Heart Failure in a Community Population Without Cardiovascular Disease: Results of the China Patient‐Centered Evaluative Assessment of Cardiac Events Million Persons Project
title_full_unstemmed Relationship Between Remnant Cholesterol and Risk of Heart Failure in a Community Population Without Cardiovascular Disease: Results of the China Patient‐Centered Evaluative Assessment of Cardiac Events Million Persons Project
title_short Relationship Between Remnant Cholesterol and Risk of Heart Failure in a Community Population Without Cardiovascular Disease: Results of the China Patient‐Centered Evaluative Assessment of Cardiac Events Million Persons Project
title_sort relationship between remnant cholesterol and risk of heart failure in a community population without cardiovascular disease results of the china patient centered evaluative assessment of cardiac events million persons project
topic community population
echocardiography
heart failure
remnant cholesterol
risk factors
url https://www.ahajournals.org/doi/10.1161/JAHA.124.040039
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