Association of remnant cholesterol inflammation index with future cardiovascular disease risk in patients with cardiovascular-kidney-metabolic syndrome stages 0-3.

AIMS: This study aims to investigate the association between remnant cholesterol inflammation index (RCII) and future cardiovascular diseases (CVD) risk across cardiovascular-kidney-metabolic (CKM) syndrome stages 0-3 population.

METHODS

This study included 7,527 participants with CKM syndrome stages 0-3 and without a prior history of CVD from the China Health and Retirement Longitudinal Study. RCII was calculated as remnant cholesterol (RC) (mg/dL) × high-sensitivity C-reactive protein (hsCRP) (mg/L)/10. The primary endpoint was CVD. Multivariable Cox regression and restricted cubic spline analyses were performed to evaluate the association between RCII and CVD.

RESULTS

Over a median follow-up of 7 years, 1,247 participants (16.5%) experienced CVD events. Compared with participants in the lowest quartile of RCII, those in the highest quartile had a 1.25-fold higher risk of future CVD (hazard ratio: 1.25, 95% confidence interval: 1.03-1.52, P for trend = 0.009). Kaplan-Meier analysis demonstrated that the optimal dichotomous cutoff of RCII for CVD was 1.488 (log-rank test: P < 0.05). RC and hs-CRP exhibited a synergistic effect on CVD, with elevated hs-CRP partially mediating the association between RC and CVD, accounting for 18.87% of the effect (P = 0.040).

CONCLUSIONS

Among individuals with CKM syndrome stages 0-3, elevated RCII levels were associated with future risk of CVD.