Remnant-cholesterol-inflammatory-index as a novel predictor of cardiometabolic risk and cardiovascular mortality in elderly patients with severe aortic stenosis
- 1Diagnostic and Interventional Cardiology Department, Fondazione Toscana Gabriele Monasterio
- 2Italian National Research Council, Institute of Clinical Physiology
- 3Laboratory Medicine Department, Fondazione Toscana Gabriele Monasterio
Abstract
Background: Inflammaging activates a vicious cycle common to the progression of structural cardiovascular alterations, cardiometabolic diseases as well as degenerative aortic stenosis (AoS). The remnant cholesterol inflammatory index (RCII) is a new recently proposed biomarker that combines remnant cholesterol and high-sensitivity C-reactive protein, resembling inflammaging. However, the role of RCII in terms of cardiometabolic risk and cardiovascular mortality in AoS elderly patients has not been evaluated still now.
Aim: to assess the association between RCII and cardiovascular risk factors and mortality in AoS elderly patients.
Results: RCII levels correlated with systemic inflammation biomarkers (closer correlation with interleukin-6), glucose, creatinine, vascular endothelial growth factor and frailty in AoS patients. Inverse correlations were observed with albumin (typically reduced in inflammatory states) and with HDL concentration. The Kaplan-Meier survival estimates showed significantly worse survival in patients with elevated RCII levels (p<0.01) (mean follow-up 19 ± 4 months). In an exploratory multivariable Cox analysis, higher RCII was associated with cardiovascular mortality (HR = 3.5, 95% CI: 1.0–12.0).
Conclusion: RCII is associated with cardiometabolic risk and adverse prognosis in elderly patients with AoS, providing an additional perspective on the prognostic implications of the coexistence of lipid abnormalities and low-grade inflammation in this population. However, the limited number of cardiovascular deaths warrants cautious interpretation of this estimate. Moreover, external validation, standardized thresholds, serial measurements, and comparison with established risk models are needed before RCII clinical implementation.
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BibTeX
@article{mazzone2026remnantcholesterolinflammatoryindex,
title = {{Remnant-cholesterol-inflammatory-index as a novel predictor of cardiometabolic risk and cardiovascular mortality in elderly patients with severe aortic stenosis}},
author = {Annamaria Mazzone and Melania Gaggini and Ilenia Foffa and Serena Del Turco and Fabrizio Minichilli and Sergio Berti and Cristina Vassalle},
journal = {Frontiers in Endocrinology},
year = {2026},
month = oct,
doi = {10.3389/fendo.2026.1894558},
url = {https://www.frontiersin.org/articles/10.3389/fendo.2026.1894558/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Remnant-cholesterol-inflammatory-index as a novel predictor of cardiometabolic risk and cardiovascular mortality in elderly patients with severe aortic stenosis
AU - Annamaria Mazzone
AU - Melania Gaggini
AU - Ilenia Foffa
AU - Serena Del Turco
AU - Fabrizio Minichilli
AU - Sergio Berti
AU - Cristina Vassalle
PY - 2026
DA - 2026/10/19
JO - Frontiers in Endocrinology
DO - 10.3389/fendo.2026.1894558
UR - https://www.frontiersin.org/articles/10.3389/fendo.2026.1894558/full
AB - Background: Inflammaging activates a vicious cycle common to the progression of structural cardiovascular alterations, cardiometabolic diseases as well as degenerative aortic stenosis (AoS). The remnant cholesterol inflammatory index (RCII) is a new recently proposed biomarker that combines remnant cholesterol and high-sensitivity C-reactive protein, resembling inflammaging. However, the role of RCII in terms of cardiometabolic risk and cardiovascular mortality in AoS elderly patients has not been evaluated still now. Aim: to assess the association between RCII and cardiovascular risk factors and mortality in AoS elderly patients. Results: RCII levels correlated with systemic inflammation biomarkers (closer correlation with interleukin-6), glucose, creatinine, vascular endothelial growth factor and frailty in AoS patients. Inverse correlations were observed with albumin (typically reduced in inflammatory states) and with HDL concentration. The Kaplan-Meier survival estimates showed significantly worse survival in patients with elevated RCII levels (p<0.01) (mean follow-up 19 ± 4 months). In an exploratory multivariable Cox analysis, higher RCII was associated with cardiovascular mortality (HR = 3.5, 95% CI: 1.0–12.0). Conclusion: RCII is associated with cardiometabolic risk and adverse prognosis in elderly patients with AoS, providing an additional perspective on the prognostic implications of the coexistence of lipid abnormalities and low-grade inflammation in this population. However, the limited number of cardiovascular deaths warrants cautious interpretation of this estimate. Moreover, external validation, standardized thresholds, serial measurements, and comparison with established risk models are needed before RCII clinical implementation.
SN - 1664-2392
ER -