{
  "abstract": "Background\n\nSmall dense low-density lipoprotein cholesterol (sdLDL-C) is an atherogenic LDL subfraction that may reflect lipid-related coronary risk beyond conventional cholesterol levels. Estimated sdLDL-C (E-sdLDL-C) is calculated from a standard lipid panel, but its prognostic relevance for myocardial infarction in patients undergoing dialysis remains uncertain.Methods\n\nThis nationwide cohort study included 21,671 adults with end-stage kidney disease (ESKD) receiving long-term dialysis who underwent health screening in 2009-2017. E-sdLDL-C was calculated from fasting lipid profiles and categorised into quartiles. Incident myocardial infarction and ischemic stroke were the primary and secondary outcomes, respectively, assessed through December 2022.Results\n\nDuring 166,428 person-years, 993 myocardial infarctions occurred, with 9,426 deaths before myocardial infarction. Fully adjusted hazard ratios for myocardial infarction in Quartiles 2-4 versus Quartile 1 were 1.24 (95% CI, 1.01-1.52), 1.61 (1.32-1.96), and 1.44 (1.15-1.80), respectively. The association remained significant after accounting for competing mortality. For ischemic stroke, 1,249 events and 9,254 competing deaths occurred during 165,727 person-years, with no significant association with E-sdLDL-C after full adjustment. Adding E-sdLDL-C increased the C-index for myocardial infarction from 0.716 to 0.726 (Δ = 0.010), without significant differences from models including LDL-C (0.725; p = 0.453) or non-HDL-C (0.727; p = 0.264).Conclusion\n\nAmong patients undergoing long-term dialysis, E-sdLDL-C was associated with incident myocardial infarction after multivariable adjustment, whereas no significant association was observed with ischemic stroke. These findings support the potential relevance of E-sdLDL-C for myocardial infarction risk assessment in patients with ESKD, although its clinical utility requires further validation.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Internal Medicine, Hanyang University College of Medicine, Hanyang University Guri Hospital, Guri, Republic of Korea.",
    "Biostatistics Lab, Medical Research Collaborating Center, Industry-University Cooperation Foundation, Hanyang University, Seoul, Republic of Korea.",
    "Department of Pre-Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Byung Sik Kim",
      "orcid": "0000-0002-7813-4733"
    },
    {
      "affs": [
        0
      ],
      "name": "Hyun-Jin Kim"
    },
    {
      "affs": [
        1,
        2
      ],
      "name": "Jiyeong Kim"
    },
    {
      "affs": [
        1
      ],
      "name": "Nayeon Choi"
    },
    {
      "affs": [
        0
      ],
      "name": "Jeong-Hun Shin",
      "orcid": "0000-0002-6718-9763"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/f7f5nfjvksrmt.bib",
  "cited_by": 0,
  "doi": "10.1080/07853890.2026.2745096",
  "fulltext_url": "https://europepmc.org/articles/PMC13656698",
  "id": "f7f5nfjvksrmt",
  "issns": [
    "0785-3890",
    "1365-2060"
  ],
  "landing_url": "https://europepmc.org/article/MED/42851132",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2746|Lipoproteins and Cardiovascular Health"
    ]
  ],
  "openalex": "W7221079488",
  "pdf_url": "https://europepmc.org/articles/PMC13656698?pdf=render",
  "pmcid": "PMC13656698",
  "pmid": "42851132",
  "published": "2026-10-09",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/f7f5nfjvksrmt.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:18:02Z",
      "native_id": "MED:42851132",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42851132"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Lipoproteins and Cardiovascular Health",
      "subfield": "surgery"
    }
  ],
  "title": "Estimated small dense low-density lipoprotein cholesterol and incident myocardial infarction in patients undergoing dialysis: a nationwide cohort study.",
  "title_text": "Estimated small dense low-density lipoprotein cholesterol and incident myocardial infarction in patients undergoing dialysis: a nationwide cohort study.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:18:02Z",
  "url": "https://research.draconitic.com/paper/f7f5nfjvksrmt",
  "venue": "Annals of medicine",
  "versions": []
}