{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T04:08:45Z","timestamp":1789013325920,"version":"build-2803163510"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"15","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,8,4]]},"abstract":"\n Background<\/jats:title>\n Remnant cholesterol (RC) is a significant cardiovascular risk factor, but its prognostic value in critically ill patients with heart failure remains inadequately characterized. This study evaluated the association between RC levels and all\u2010cause mortality in this population.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This retrospective cohort study used data from 3750 critically ill patients with heart failure from the Medical Information Mart for Intensive Care III\/IV databases. RC was calculated as total cholesterol minus high\u2010density and low\u2010density lipoprotein cholesterol. Optimal RC thresholds were determined by X\u2010tile: low (<22.7\u2009mg\/dL), intermediate (22.7\u201354.0\u2009mg\/dL), and high (\u226554.0\u2009mg\/dL). Primary end points were 30\u2010day and 1\u2010year all\u2010cause mortality.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Mortality occurred in 16.9% of patients at 30\u2009days and 34.1% at 1\u2009year. After multivariable adjustment, each 10 mg\/dL increment in RC was associated with reduced risks of 30\u2010day (hazard ratio [HR], 0.88 [95% CI, 0.82\u20130.95]) and 1\u2010year mortality (HR, 0.92 [95% CI, 0.88\u20130.97]). Compared with the low RC group, the high RC group exhibited significant reductions in 30\u2010day (HR, 0.52 [95% CI, 0.31\u20130.87]) and 1\u2010year mortality (HR, 0.61 [95% CI, 0.44\u20130.8]7). Restricted cubic spline analysis confirmed a linear inverse relationship.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Higher RC levels are independently associated with lower all\u2010cause mortality in critically ill patients with heart failure. These findings suggest a protective, context\u2010dependent role of RC during acute illness.<\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.126.049077","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T11:18:11Z","timestamp":1785496691000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Remnant Cholesterol Paradox: Higher Levels Are Associated With Reduced Mortality in Critically Ill Patients With Heart Failure"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-3727-2333","authenticated-orcid":false,"given":"Zhiqiang","family":"Zhang","sequence":"first","affiliation":[{"name":"The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital","place":["Jinan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanbin","family":"Su","sequence":"additional","affiliation":[{"name":"Tianjin Medical University General Hospital","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7144-6788","authenticated-orcid":false,"given":"ShanShan","family":"Tang","sequence":"additional","affiliation":[{"name":"Tianjin Medical University General Hospital Airport Hospital","place":["Tianjin, 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