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Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
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A. Basics
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01. History of Cardiology
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04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
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21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
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26. Cardiovascular Surgery
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28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
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Abstract
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Association of remnant cholesterol with risk of coronary artery disease and cardiovascular events
Session:
Sessão de Posters 07 - Lípidos para além do LDL: a nova fronteira do risco
Speaker:
francisco sousa
Congress:
CPC 2026
Topic:
J. Preventive Cardiology
Theme:
28. Risk Factors and Prevention
Subtheme:
28.4 Lipids
Session Type:
Posters Eletrónicos
FP Number:
---
Authors:
Francisco Sousa; M. I. Mendonça; G. Abreu; M. Ferreira; F. Escórcio Silva; S. Freitas; E. Henriques; M. Rodrigues; S. Borges; A. Drumond; A.C. Sousa; R. Palma Dos Reis
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Introduction</strong>: Remnant cholesterol (RC) is a proven independent and causal risk factor for coronary artery disease (CAD), beyond LDL-C, HDL-C, triglycerides, diabetes, and other traditional risk factors. It reflects the <strong><span style="font-family:"Calibri",sans-serif">cholesterol content of triglyceride-rich lipoproteins, </span></strong>and is strongly associated with subclinical inflammation and endothelial dysfunction.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Objective:</strong> Determine whether remnant cholesterol is independently associated with CAD in a coronary population. Investigate in a coronary population whether remnant cholesterol is a risk factor of CAD, independently of traditional/clinical risk factors.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Methods</strong>: A case-control study performed between 2000 and 2023 included 1,722 successive coronary patients (mean age 53.3±7.9 years, 78.8% male) and 1,435 controls (mean age 52.7±7.8 years, 76.2% male). RC was calculated by the formula: total cholesterol - (LDL-C + HDL-C) (mg/dl) and categorized as below or above the median. Multivariate logistic regression was performed to assess the association between RC and CAD, adjusting for age, sex, smoking, physical inactivity, type 2 diabetes, hypertension, body mass index, alcohol consumption, and chronic kidney disease. Patients were prospectively followed for an extended period (median 7.6±6.7 years), and an adjusted Cox regression analysis was applied to identify independent predictors of cardiovascular (CV) events.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Results:</strong> The median RC value was 26.4 mg/dl (19.0-39.0) and this value was used in the statistical analyses. Multivariate logistic regression showed that RC remained independently associated with CAD (OR=1.004; CI95%-1.001-1.008; p=0.023), together with smoking, type 2 diabetes, physical inactivity, and chronic kidney disease (all p<0.0001). During the follow-up, 715 CV events were recorded. Cox regression showed that RC is independently associated with CV events (HR=1.004; 95% CI 1.001-1.007; p=0.005).</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Conclusion:</strong> Elevated RC was associated with CAD and long-term CV events, independently of major traditional risk factors. These findings underscore the potential value of targeted RC reduction, which may refine lipid risk profiles and reduce the burden of coronary disease.</span></span></p>
Slides
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