Association between non‐high‐density lipoprotein cholesterol levels and asymptomatic vulnerable carotid atherosclerotic plaques

Background and purpose Carotid atherosclerosis, especially rupture of plaques, is related to cerebrovascular diseases. Non‐high‐density lipoprotein cholesterol (non‐HDL‐C) is relevant to cerebrovascular diseases and may be a potential risk factor. We designed this study to investigate the association between non‐HDL‐C and the prevalence of asymptomatic vulnerable carotid atherosclerotic plaques. Methods We enrolled 2888 participants who underwent carotid atherosclerotic plaque detection and non‐HDL‐C measurement, with no history of taking lipid‐lowering agents, from the Asymptomatic Polyvascular Abnormalities in Community study. We used multivariable logistic regression to estimate the association between non‐HDL‐C levels and the presence of asymptomatic vulnerable carotid atherosclerotic plaques. Results In our study, 1505 subjects had asymptomatic vulnerable carotid atherosclerotic plaques and 1383 subjects had stable plaques. After adjustment for confounding factors, the odds ratios for vulnerable plaques of non‐HDL‐C levels in the middle and highest tertile groups were 1.02 (95% confidence interval, 0.84–1.23) and 1.50 (95% confidence interval, 1.23–1.82), respectively ( P trend < 0.01). Conclusion In our community‐based observational and cross‐sectional study, non‐HDL‐C level was a significant risk factor for the occurrence of asymptomatic vulnerable carotid plaques.