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Arquivos Brasileiros de Cardiologia

Print version ISSN 0066-782XOn-line version ISSN 1678-4170


MASSON, Walter; LOBO, Martín; MOLINERO, Graciela  and  SINIAWSKI, Daniel. Discordant Lipid Pattern and Carotid Atherosclerotic Plaque. Importance of Remnant Cholesterol. Arq. Bras. Cardiol. [online]. 2017, vol.108, n.6, pp.526-532. ISSN 0066-782X.


Subjects with levels of non-HDL-C 30 mg/dL above those of LDL-C (lipid discordance) or with high remnant cholesterol levels could have a greater residual cardiovascular risk.


To determine the prevalence of lipid discordance in a primary prevention population and analyze the clinical variables associated with it;

To investigate the association between lipid discordance and remnant cholesterol with the presence of carotid plaque.


Primary prevention patients without diabetes or lipid-lowering therapy were included. Regardless of the LDL-C level, we define “lipid discordance” if the non-HDL-C value exceeded 30 mg/dL that of LDL-C. Remnant cholesterol was calculated as total cholesterol minus HDL-C minus LDL-C when triglycerides were < 4.0 mmol/L. Ultrasound was used to assess carotid plaque occurrence. Multiple regression logistic models were performed.


The study included 772 patients (mean age 52 ± 11 years, 66% women). The prevalence of lipid discordance was 34%. Male sex and body mass index were independently associated with discordant lipid pattern. The prevalence of carotid plaque was higher in subjects with lipid discordance (40.2% vs. 29.2, p = 0.002). The multivariate analysis showed that the discordant lipid pattern was associated with the greater probability of carotid plaque (OR 1.58, 95% CI 1.08-2.34, p = 0.02). Similarly, a significant association between calculated remnant cholesterol and carotid plaque was found.


Lipid discordance and presence of a higher level of calculated remnant cholesterol are associated with subclinical atherosclerosis. Our findings could be used to improve the residual cardiovascular risk evaluation.

Keywords : Atherosclerosis / complications; Plaque, Atherosclerotic; Carotid Arteries; Cholesterol, LDL; Lipoproteins, LDL; Cholesterol, VLDL.

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