Remnant cholesterol, also known as remnant lipoprotein, is a type of cholesterol that is composed primarily of very low-density lipoprotein (VLDL) and intermediate-density lipoprotein (IDL) . It is all plasma cholesterol that is not LDL cholesterol or HDL cholesterol, which are triglyceride-poor lipoproteins. Each remnant particle contains about 40 times more cholesterol than LDL. Recent research suggests that remnant cholesterol can be a useful tool for measuring your risk of heart disease and stroke. In fact, it could be a 40% to 50% higher risk. According to one study, high remnant cholesterol is more predictive of myocardial infarction than any other lipid particle. Remnant cholesterol is especially predictive of coronary artery disease in patients with normal total cholesterol. Remnant cholesterol has about twice the association with ischemic heart disease as LDL cholesterol. Although remnant cholesterol tends to be higher in people who are overweight (high body mass index), normal-weight persons with high remnant cholesterol tend to have a higher risk of myocardial infarction. Remnant cholesterol is associated with chronic inflammation, whereas LDL cholesterol is not.

To calculate remnant cholesterol, you can take your total cholesterol and then subtract your LDL and your HDL. For example, if your recent lipid panel shows a total cholesterol of 200 mg/dL, an LDL of 100 mg/dL, and an HDL of 50 mg/dL, your remnant cholesterol would be 50 mg/dL (200 - 100 - 50 = 50) .

In summary, remnant cholesterol is a type of cholesterol that is composed primarily of VLDL and IDL. Recent research suggests that it can be a useful tool for measuring your risk of heart disease and stroke. It is associated with chronic inflammation and is especially predictive of coronary artery disease in patients with normal total cholesterol.