Prevention & lipidsCohort study
The role of systemic inflammation in remnant cholesterol-associated cardiovascular risk: insights from the EPIC-Norfolk study
- Prospective cohort study
- mediation analysis
Authors' conclusion
Plasma remnant cholesterol levels are independently associated with systemic inflammation and cardiovascular events. Inflammation, as measured with hsCRP, contributed minorly to the association between remnant cholesterol and MACE.
Study context
- Population
- Participants without prior atherosclerotic CVD from the EPIC-Norfolk study (mean age 58.8 ± 9.1 years; 56.9% women)
- Participants
- 16,445 participants
- Exposure
- Remnant cholesterol vs low-density lipoprotein (LDL) cholesterol
- Outcome
- Proportion of the effect of remnant and LDL cholesterol on (non)fatal MACE (CAD and ischaemic stroke) mediated by inflammation (hsCRP)
Main finding
As reported in the abstract
Mediation by hsCRP of the effect on MACE
High-sensitivity C-reactive protein (hsCRP) mediated share of remnant cholesterol effect on major adverse cardiovascular events (MACE)
5.9% (95% CI: 1.2, 10.6%, P < 0.001)
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| MACE per 1 mmol/L higher cholesterol — Remnant cholesterol | 1.31 (1.14–1.50) | P < 0.001 | |
| MACE per 1 mmol/L higher cholesterol — LDL cholesterol | 1.21 (1.13–1.31) | P < 0.001 | |
| 0.512Hazard ratio (log scale) |
| Outcome | % higher hsCRP (95% CI) | P value |
|---|---|---|
| hsCRP levels per 1 mmol/L higher cholesterol | 29.5% (22.1–37.4) | P < 0.001 |
hsCRP levels per 1 mmol/L higher cholesterol
- LDL cholesterol not significantly associated with hsCRP (fully adjusted model)
Original publication
The role of systemic inflammation in remnant cholesterol-associated cardiovascular risk: insights from the EPIC-Norfolk study. Eur J Prev Cardiol. Published 6 February 2025. doi:10.1093/eurjpc/zwaf037
Summarised from the published abstract; every number is checked against it