THE IMPACT OF REMNANT CHOLESTEROL AND LIPID PROFILE DISCORDANCE ON CAROTID INTIMA-MEDIA THICKNESS AMONG INDIAN PATIENTS WITH CORONARY ARTERY DISEASE: AN EXPLORATORY OBSERVATIONAL STUDY WITH ADVANCED REGRESSION ANALYSIS

Background: Residual cardiovascular risk persists despite optimal LDL-C lowering, suggesting that remnant cholesterol (RC) may contribute to atherosclerosis. Objective: To evaluate the association between RC, lipid profile discordance, and cIMT, and determine if RC and lipid discordance are independent predictors of increased cIMT after adjusting for traditional cardiovascular risk factors. Methods: In this cross-sectional study of 60 patients (mean age 56 ± 10 years, 63% male) with cardiovascular conditions, cIMT measurements and lipid profiles were obtained. RC was calculated as total cholesterol minus LDL-C minus HDL-C. Patients were grouped into four categories based on median LDL-C and RC levels. Statistical analyses assessed associations between RC, lipid discordance, cIMT, and cardiovascular risk factors. Results: RC showed a moderate positive correlation with cubed mean cIMT (r = 0.36, p = 0.0047). Patients with high discordant RC had significantly higher cubed mean cIMT compared to those with low concordant levels. In regression analysis, body mass index (β = 0.337, p < 0.001), smoking status (β = 0.819, p = 0.002), and LDL-C (β = 0.010, p = 0.044) were significant predictors of cubed cIMT, while RC showed a trend toward significance (β = 0.129, p = 0.110). Conclusion: Elevated RC and lipid discordance are associated with increased cIMT. Incorporating RC into cardiovascular risk models could help identify high-risk patients who might benefit from targeted therapies. Further research is needed to confirm these findings.