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Cholesterol Efflux Assay
07:54

Cholesterol Efflux Assay

Published on: March 6, 2012

Ability of serum to decrease cellular acylCoA:cholesterol acyl transferase activity predicts cardiovascular outcomes

Julio A Chirinos1, Juan P Zambrano, Simon Chakko

  • 1Miller School of Medicine, University of Miami, Miami, FL 33138, USA.

Circulation
|October 19, 2005
PubMed

Insights

Serum cholesterol efflux activity, measured by its ability to decrease cholesterol for esterification, independently predicts major adverse cardiovascular events (MACE) and death in men. This finding offers new insights into cardiovascular risk assessment.

Area of Science:

  • Cardiovascular Medicine
  • Biochemistry
  • Lipid Metabolism

Background:

  • Investigated the association between serum cholesterol efflux activity and coronary artery disease (CAD).
  • Examined the link between cholesterol efflux and the risk of major adverse cardiovascular events (MACE) and death.

Purpose of the Study:

  • To determine if serum cholesterol efflux activity predicts the presence of angiographic CAD.
  • To assess the association of cholesterol efflux activity with the risk of MACE and death.

Main Methods:

  • Studied 168 men undergoing coronary angiography.
  • Measured in vitro cholesterol efflux activity using patient serum and human skin fibroblasts.
  • Defined efflux activity by the serum's ability to decrease cholesterol available for acylCoA:cholesterol acyl transferase (ACAT) esterification.
  • Followed patients for 4.5 years to track MACE and death.

Main Results:

  • Serum-induced changes in ACAT activity did not correlate with HDL levels or CAD presence.
  • Patients in the highest tertile of ACAT activity change had significantly higher risk for MACE (HR, 2.15) and death (HR, 2.23).
  • These correlations remained independent of other risk markers like LDL, HDL, and C-reactive protein.

Conclusions:

  • Serum's ability to deplete cellular cholesterol for ACAT esterification is a strong, independent predictor of MACE and death.
  • Speculated that this activity involves ATP binding cassette transporter A1 (ABCA1)-mediated efflux.
  • Hypothesized that increased ACAT-influencing HDL particles in serum relate to limited in vivo ABCA1 activity.
Abstract

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