title: Premature myocardial infarction is strongly associated with increased levels of remnant cholesterol.
abstract: BACKGROUND
  Remnant cholesterol has been defined as the cholesterol present in triglyceride-rich remnant lipoproteins. Elevated levels of remnant cholesterol have been associated with increased cardiovascular risk. Acute myocardial infarction (AMI) in very young individuals (≤40 years) represents a rare disease with a typical risk factor profile and a lipid phenotype that is characterized by a predominance of elevated triglyceride-rich lipoproteins.
  
  
  OBJECTIVE
  The aim of this study was to investigate the role of remnant cholesterol in premature AMI.
  
  
  METHODS
  We prospectively enrolled 302 patients into our multicenter case-control study comprising 102 consecutive myocardial infarction survivors (≤40 years) and 200 hospital controls. Myocardial infarction patients were frequency matched for age, gender, and center. Remnant cholesterol was calculated from standard lipid parameters.
  
  
  RESULTS
  Remnant cholesterol was 1.7-fold higher in premature AMI patients compared with controls (61.1 ± 36.8 vs 35.8 ± 16.8 mg/dL; P < .001). Remnant cholesterol was the lipid fraction most strongly associated with premature myocardial infarction (odds ratio 3.87; 95% confidence interval 2.26-6.64; P < .001) for an increase of 1-standard deviation. This observation was independent from clinical risk factors and plasma lipid levels.
  
  
  CONCLUSIONS
  Remnant cholesterol is strongly associated with premature myocardial infarction, can be easily calculated, and might serve as a new potent risk marker in this young patient population.
authors.affiliation: Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria. Electronic address: georg.goliasch@meduniwien.ac.at.
authors.forename: Georg
authors.initials: G
authors.lastname: Goliasch
authors.affiliation: Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria.
authors.forename: Franz
authors.initials: F
authors.lastname: Wiesbauer
authors.affiliation: Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria; Department of Internal Medicine I-Cardiology, Linz General Hospital, Johannes Kepler University School of Medicine, Linz, Austria.
authors.forename: Hermann
authors.initials: H
authors.lastname: Blessberger
authors.affiliation: Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria; Ludwig Boltzmann Cluster for Cardiovascular Research, Vienna, Austria.
authors.forename: Svitlana
authors.initials: S
authors.lastname: Demyanets
authors.affiliation: Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria; Ludwig Boltzmann Cluster for Cardiovascular Research, Vienna, Austria; Core Facilities, Medical University of Vienna, Vienna, Austria.
authors.forename: Johann
authors.initials: J
authors.lastname: Wojta
authors.affiliation: 3rd Medical Department, Cardiology and Intensive Care Medicine, Wilhelminen Hospital, Vienna, Austria.
authors.forename: Kurt
authors.initials: K
authors.lastname: Huber
authors.affiliation: Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria; Ludwig Boltzmann Cluster for Cardiovascular Research, Vienna, Austria.
authors.forename: Gerald
authors.initials: G
authors.lastname: Maurer
authors.affiliation: Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria.
authors.forename: Martin
authors.initials: M
authors.lastname: Schillinger
authors.affiliation: Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria.
authors.forename: Walter S
authors.initials: WS
authors.lastname: Speidl
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D002784:Cholesterol / Q000097:blood*; D005260:Female; D006801:Humans; D008074:Lipoproteins / Q000097:blood; D008297:Male; D009203:Myocardial Infarction / Q000097:blood*; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D008074:Lipoproteins; D002784:Cholesterol
keywords: Lipids; Premature myocardial infarction; Remnant cholesterol