Optimal cutoff value of high-density lipoprotein cholesterol for predicting coronary artery disease in Taiwanese...

Area of Science:

• Cardiovascular Medicine
• Biochemistry
• Epidemiology

Background:

• Coronary artery disease (CAD) is a leading cause of mortality globally.
• Identifying reliable biomarkers for CAD risk prediction is crucial for preventative strategies.
• High-density lipoprotein cholesterol (HDL-C) is recognized for its cardioprotective effects, but optimal predictive thresholds require population-specific validation.

Purpose of the Study:

• To determine an optimal cutoff value for high-density lipoprotein cholesterol (HDL-C) in predicting coronary artery disease (CAD) risk.
• To evaluate the predictive performance of HDL-C compared to low-density lipoprotein cholesterol (LDL-C) and the LDL-C/HDL-C ratio in a Taiwanese population.
• To assess the association between HDL-C levels and CAD risk after adjusting for relevant confounders.

Main Methods:

• A hospital-based case-control study was conducted.
• Cases (n=184) had ≥70% coronary artery stenosis; controls (n=516) were healthy individuals.
• Multiple logistic regression and receiver operating characteristic (ROC) curve analyses were employed to assess predictive values.

Main Results:

• An HDL-C level ≤60 mg/dL was associated with a significantly higher odds ratio (7.72) for CAD.
• The area under the ROC curve for HDL-C (0.85) was substantially higher than for LDL-C (0.61).
• The optimal HDL-C cutoff value for predicting CAD was identified as 46 mg/dL, with a sensitivity of 71.74% and specificity of 81.40%.

Conclusions:

• Lower levels of HDL-C are strongly associated with an increased risk of coronary artery disease.
• An optimal cutoff value of 46 mg/dL for HDL-C is proposed for predicting CAD in the Taiwanese population.
• These findings underscore the importance of HDL-C as a key biomarker for CAD risk assessment in this demographic.