Association between remnant lipoprotein cholesterol, high-sensitivity C-reactive protein, and risk of atherosclerotic cardiovascular disease events in the Multi-Ethnic Study of Atherosclerosis (MESA)

Parag Anilkumar Chevli, Tareq Islam, Yashashwi Pokharel, Fatima Rodriguez, Salim S. Virani, Michael J. Blaha, Alain G. Bertoni, Matthew Budoff, James D. Otvos, Michael D. Shapiro

Research output: Contribution to journalArticlepeer-review

11 Citations (Scopus)

Abstract

BACKGROUND: Elevated remnant-lipoprotein (RLP)-cholesterol (RLP-C) and high-sensitivity C-reactive protein (hsCRP) are each individually associated with atherosclerotic cardiovascular disease (ASCVD). OBJECTIVE: To evaluate the interplay of nuclear magnetic resonance (NMR)-derived RLP-C and hsCRP and their association with ASCVD in the Multi-Ethnic Study of Atherosclerosis (MESA). METHODS: Lipoprotein particles were measured using NMR spectroscopic analysis at baseline. RLP-C includes very-low-density lipoprotein cholesterol and intermediate-density lipoprotein cholesterol. Four groups were created as follows: Group 1: RLP-C ≤ median (≤29.14 mg/dL) and hsCRP < 2 mg/L; Group 2: RLP-C ≤ median and hsCRP≥ 2 mg/L; Group 3: RLP-C > median and hsCRP level < 2 mg/L; and Group 4: RLP-C > median and hsCRP level ≥ 2 mg/L. Kaplan-Meier survival curves and multivariable-adjusted Cox proportional hazard models were used to examine the relationship between RLP-C and hsCRP with incident ASCVD. RESULTS: A total of 6,720 MESA participants (mean age 62.2 y, 53% female) with a median follow-up of 15.6 years were included. In the fully adjusted model, compared to those in the reference group (Group 1), participants in Group 2, Group 3, and Group 4 demonstrated a 20% (95% CI, -2%-48%), 18% (-4%-44%), and 43% (18%-76%) increased risk of incident ASCVD events, respectively (p < 0.01). An additive and multiplicative interaction between RLP-C and hsCRP was not statistically significant. CONCLUSION: NMR-derived RLP-C and hsCRP showed a similar independent association with incident ASCVD. Notably, the combination of increased RLP-C and hsCRP was associated with an increased risk of future ASCVD events.

Original languageEnglish
Pages (from-to)870-877
Number of pages8
JournalJournal of Clinical Lipidology
Volume16
Issue number6
DOIs
Publication statusPublished - 1 Nov 2022
Externally publishedYes

Keywords

  • Atherosclerotic cardiovascular disease (ASCVD)
  • High-sensitivity C-reactive protein (hsCRP)
  • Nuclear magnetic resonance (NMR)
  • Remnant-lipoprotein cholesterol (RLP-C)

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