RCII is associated with cardiometabolic risk and adverse prognosis in elderly patients with aortic stenosis, but the limited number of cardiovascular deaths warrants cautious interpretation, and external validation is needed before clinical use.
RCII levels correlated with systemic inflammation biomarkers in elderly patients with severe aortic stenosis, most closely with interleukin-6.
RCII correlated with glucose, creatinine, vascular endothelial growth factor, and frailty in AoS patients.
RCII was inversely correlated with albumin and with HDL concentration.
Patients with elevated RCII had significantly worse survival in Kaplan-Meier analysis.
In an exploratory multivariable Cox analysis, higher RCII was associated with cardiovascular mortality.
The authors conclude that RCII is associated with cardiometabolic risk and adverse prognosis in elderly AoS patients, but that it is not yet ready for clinical implementation.
This study looked at a blood-based score called the remnant cholesterol inflammatory index (RCII) in elderly people with severe aortic stenosis, a narrowing of the heart's aortic valve. The score combines remnant cholesterol, a type of fat-carrying particle, with C-reactive protein, a marker of inflammation. It is meant to capture the low-grade chronic inflammation that comes with aging, sometimes called inflammaging. Higher RCII was linked to higher levels of other inflammation markers (most strongly interleukin-6), higher glucose and creatinine, higher vascular endothelial growth factor, and greater frailty. It was linked to lower albumin and lower HDL ("good") cholesterol. Over an average follow-up of about 19 months, patients with higher RCII had significantly worse survival. In an exploratory analysis, higher RCII was associated with about 3.5 times the risk of cardiovascular death, but the estimate was very imprecise (95% CI 1.0-12.0). This research suggests RCII may help show how fat abnormalities and inflammation together relate to health risks in older people with aortic stenosis. The number of cardiovascular deaths was small, so the findings should be read cautiously. The authors say the score needs confirmation in other groups of patients, agreed cutoff values, repeated measurements over time, and comparison with existing risk tools before it could be used in clinical care.
Mazzone A, Gaggini M, Foffa I, Del Turco S, Minichilli F, Berti S, et al.. (2026). Remnant-cholesterol-inflammatory-index as a novel predictor of cardiometabolic risk and cardiovascular mortality in elderly patients with severe aortic stenosis.. Frontiers in endocrinology. https://doi.org/10.3389/fendo.2026.1894558