Abstract
Residual cholesterol (RC) is associated with an increased risk of atherosclerosis. High levels of RC have been shown to be associated with unstable plaque in healthy populations. However, the association between RC and unstable carotid plaque in specific populations with carotid stenosis has not been investigated. In this study, the association between RC and unstable carotid plaque in patients with carotid stenosis was investigated. Carotid ultrasound was used to determine the stability of carotid plaque. The relationship between RC levels and unstable carotid plaque was analyzed using logistic regression. The relationship between RC levels and unstable carotid plaque was assessed according to the degree of carotid stenosis. In addition, the predictive efficacy of RC levels for unstable plaques was determined by receiver operating characteristic (ROC) curves. A total of 507 patients with carotid stenosis were included in the study. 271 with stable carotid plaque and 236 with unstable carotid plaque. Multiple logistic regression analysis revealed that RC (OR, 1.44 [95% CI 1.09-1.91]) remained a risk factor for carotid artery unstable plaque after adjusting for statistically significant variables identified via LASSO regression. The OR was significantly greater for severe stenosis (OR, 2.16 [95% CI 1.49-3.15]) than for mild-moderate stenosis (OR, 1.03 [95% CI 1.00-1.07]). The area under the curve (AUC) of the RC in patients with unstable carotid plaque was 0.694. The cutoff value of the RC was 0.435 mmol/L. RC levels were significantly associated with unstable carotid plaque in patients with carotid stenosis. The association was stronger in severe stenosis than in mild-moderate stenosis, and patients with carotid stenosis whose RC level was greater than 0.435 mmol/L had an increased risk of developing unstable plaque.