{"id":"6f036f676609","type":"article","url":"https://hartvaat.nl/2020/12/08/remnant-cholesterol-versus-ldl-en-incident-cv-ziekte/","title":"Remnant cholesterol versus LDL en incident CV-ziekte","title_en":"Remnant Cholesterol, Not LDL Cholesterol, Is Associated With Incident Cardiovascular Disease.","category":"cholesterol","category_label":"Cholesterol","professions":["cardioloog","internist"],"tags":["dyslipidemie","ezetimibe","ldl-cholesterol"],"journal":"Journal of the American College of Cardiology","doi":"10.1016/j.jacc.2020.10.008","source_url":"https://doi.org/10.1016/j.jacc.2020.10.008","authors":["Olga Castañer","Xavier Pintó","Isaac Subirana","Antonio J Amor","Emilio Ros","Álvaro Hernáez","Miguel Ángel Martínez-González","Dolores Corella","Jordi Salas-Salvadó","Ramón Estruch","José Lapetra","Enrique Gómez-Gracia","Angel M Alonso-Gomez","Miquel Fiol","Lluís Serra-Majem","Emili Corbella","David Benaiges","Jose V Sorli","Miguel Ruiz-Canela","Nancy Babió","Lucas Tojal Sierra","Emilio Ortega","Montserrat Fitó"],"significance":7,"published":"2020-12-08","source_date":"2020-12-08","image":"","kennis":["https://hartvaat.nl/kennis/lipiden/ldl-cholesterol-mechanisme/","https://hartvaat.nl/kennis/lipiden/lpa-meten-wanneer-waarom/"],"congress":"","summary_en":"This study demonstrated that remnant cholesterol (cholesterol in triglyceride-rich lipoproteins) is more strongly associated with incident cardiovascular disease than LDL cholesterol, shifting attention to triglyceride-rich lipoproteins as therapeutic targets.","created":"2026-07-03T10:28:57Z","updated":"2026-07-03T13:28:05Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Studie die aantoont dat remnant cholesterol sterker geassocieerd is met incident cardiovasculaire ziekte dan LDL-cholesterol. Verschuift de focus van LDL naar remnants.","abstract_original":"BACKGROUND: Genetic, observational, and clinical intervention studies indicate that circulating levels of triglycerides and cholesterol transported in triglyceride-rich lipoproteins (remnant cholesterol) can predict cardiovascular events. OBJECTIVES: This study evaluated the association of triglycerides and remnant cholesterol (remnant-C) with major cardiovascular events in a cohort of older individuals at high cardiovascular risk. METHODS: This study determined the baseline lipid profile and searched for major adverse cardiovascular events (MACEs) in the high-risk primary prevention PREDIMED (Prevención con Dieta Mediterránea) trial population (mean age: 67 years; body mass index: 30 kg/m2; 43% men; 48% with diabetes) after a median follow-up of 4.8 years. Unadjusted and adjusted Cox proportional hazard models were used to assess the association between lipid concentrations (either as continuous or categorical variables) and incident MACEs (N = 6,901; n cases = 263). RESULTS: In multivariable-adjusted analyses, triglycerides (hazard ratio [HR]: 1.04; 95% confidence interval [CI]: 1.02 to 1.06, per 10 mg/dl [0.11 mmol/l]; p < 0.001), non-high-density lipoprotein cholesterol (HDL-C) (HR: 1.05; 95% CI: 1.01 to 1.10, per 10 mg/dl [0.26 mmol/l]; p = 0.026), and remnant-C (HR: 1.21; 95% CI: 1.10 to 1.33, per 10 mg/dl [0.26 mmol/l]; p < 0.001), but not low-density lipoprotein cholesterol (LDL-C) or HDL-C, were associated with MACEs. Atherogenic dyslipidemia (triglycerides >150 mg/dl [1.69 mmol/l] and HDL-C <40 mg/dl [1.03 mmol/l] in men or <50 mg/dl [1.29 mmol/l] in women) was also associated with MACEs (HR: 1.44; 95% CI: 1.04 to 2.00; p = 0.030). Remnant-C ≥30 mg/dl (0.78 mmol/l) differentiated subjects at a higher risk of MACEs compared with those at lower concentrations, regardless of whether LDL-C levels were on target at ≤100 mg/dl (2.59 mmol/l). CONCLUSIONS: In overweight or obese subjects at high cardiovascular risk, levels of triglycerides and remnant-C, but not LDL-C, were associated with cardiovascular outcomes independent of other risk factors."}