In familial hypercholesterolaemia, remnant cholesterol above 1 mmol/L is associated with 50% higher risk of coronary artery disease
Authors' conclusion
In familial hypercholesterolaemia, remnant cholesterol ≥1 mmol/L (39 mg/dL) vs below is associated with ≈50% higher risk of coronary artery disease, that is, above the already high risk due to lifelong genetically elevated LDL cholesterol.
Study context
- Population
- Individuals classified as with or without familial hypercholesterolaemia (FH) according to clinical scores and genetic mutations, in the Copenhagen General Population Study (CGPS) and UK BiobankIndividuals classified as with or without FH, no combined total printed · CGPS 108,751 · UK Biobank 428,625
- Comparison
- Remnant cholesterol ≥1 vs. < 1 mmol/L
- Outcome
- Coronary artery disease
Methodological detailsCopenhagen General Population Study and UK Biobank
- Copenhagen General Population Study and UK Biobank
Main finding
As reported in the abstract
Remnant cholesterol ≥1 mmol/L vs Remnant cholesterol < 1 mmol/LMultivariable adjusted hazard ratio (95% CI)
CGPS, individuals without FH
1.49(1.39–1.59)
UK Biobank, individuals without FH
1.47(1.43–1.52)
CGPS, Simon Broome FH
1.59(1.31–1.93)
UK Biobank, Simon Broome FH
1.18(1.10–1.27)
CGPS, MEDPED FH
1.50(1.08–2.08)
UK Biobank, MEDPED FH
1.14(0.89–1.45)
CGPS, DLCN FH
1.60(1.17–2.21)
UK Biobank, DLCN FH
1.59(1.20–2.09)
CGPS, genetic FH
1.48(0.59–3.69)
UK Biobank, genetic FH
1.39(0.88–2.19)
Further findings
Individuals who experienced coronary artery disease
- CGPS
- 7,708
- UK Biobank
- 50,997
Remnant cholesterol ≥1 mmol/L (39 mg/dL), share within each FH category
- CGPS, of individuals without FH (N = 104,226)
- 12%
- UK Biobank, of individuals without FH (N = 403,172)
- 11%
- CGPS, with Simon Broome FH (N = 3,923)
- 33%
- UK Biobank, with Simon Broome FH (N = 23,860)
- 40%
- CGPS, with MEDPED FH (N = 1,005)
- 44%
- UK Biobank, with MEDPED FH (N = 2,465)
- 78%
- CGPS, with DLCN FH (N = 744)
- 33%
- UK Biobank, with DLCN FH (N = 1,207)
- 34%
- CGPS, of individuals with genetic FH (N = 188)
- 12%
- UK Biobank, of individuals with genetic FH (N = 875)
- 21%
Original publication
In familial hypercholesterolaemia, remnant cholesterol above 1 mmol/L is associated with 50% higher risk of coronary artery disease. Eur J Prev Cardiol. Published 3 November 2026. doi:10.
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