Could cholesterol remnants predict long-term cardiovascular events after NSTACS?

Abstract Introduction The remnant cholesterol (RC) promotes atherosclerotic cardiovascular disease. However, the prognostic impact of elevated RC levels in patients with non-ST-elevation acute coronary syndrome have not been established in the current population. Then, our objetive is investigated the effect of RC in terms of long-term mortality in patients admitted for NSTACS Methods This is an observational study in which we included all patients discharged from cardiology for ACS in two centers from 2003 to 2018. Patients were classified by low RC values <23 mg/dL or high RC values ≥24 mg/dL in the first blood count performed during hospitalization. We analyzed the effect of RC (continuous variable) on all-cause mortality, cardiovascular mortality and MACE using the Cox regression model adjusted for several confounding variables. Results We included 5685 patients diagnosed with ACS, with a mean age of 66.50 (SD ±13.20) years, 27.1% female. The baseline, during admission and discharge characteristics are shown in table (1 and 2). During follow-up (median 56 months, IQR 21–79 months) there was an increased risk of all-cause mortality in patients with higher levels os RC unadjusted and adjusted for several factors (age, sex, GRACE, early coronariography, hypertension, treatment at discharge), HR (1.003, CI 1.000–1.005, p 0.003). Similar results were observed for cardiovascular mortality (HR 1.003, CI 1.000–1.006, p 0.003), and MACE (HR 1.002, CI 1.000–1.003, p 0.002) Conclusion RC could have prognostic impact in the long-term follow up in patients with NSTACS, even after adjusting for risk factors and evidence-based treatments. There results should be taken under consideration for the treatment and management of NSTACS patients. Funding Acknowledgement Type of funding sources: None.