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High cholesterol levels are associated with coronary microvascular dysfunction

Fabio Mangiacapra1, Bernard De Bruyne, Aaron J Peace

  • 1Cardiovascular Center Aalst, OLV Hospital, Aalst, Belgium.

Journal of Cardiovascular Medicine (Hagerstown, Md.)
|February 21, 2012
PubMed

Insights

High cholesterol, particularly LDL cholesterol, is linked to impaired coronary microvascular function in patients with coronary artery disease. This study used invasive measurements to confirm the association between cholesterol and microvascular resistance.

Area of Science:

  • Cardiology
  • Vascular Biology
  • Metabolic Syndrome

Background:

  • Coronary microvascular dysfunction (CMD) is an important contributor to ischemic heart disease.
  • The relationship between serum lipid profiles and CMD remains incompletely understood.

Purpose of the Study:

  • To investigate the association between serum cholesterol levels and coronary microvascular function, assessed by the index of microvascular resistance (IMR).
  • To determine if cholesterol levels are independent predictors of CMD in patients with coronary artery disease.

Main Methods:

  • Invasive measurement of IMR during coronary angiography in patients with intermediate coronary stenosis.
  • Measurement of serum total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides before catheterization.
  • Multivariate analysis to identify independent predictors of IMR, adjusting for epicardial disease severity and fractional flow reserve.

Main Results:

  • A significant positive correlation was observed between IMR and both total cholesterol (r=0.28, P=0.003) and LDL cholesterol (r=0.30, P=0.001).
  • Low-density lipoprotein (LDL) cholesterol emerged as the sole independent predictor of IMR.
  • Microvascular dysfunction (IMR > 26) was present in 29% of the investigated coronary arteries.

Conclusions:

  • Invasive assessment of microvascular resistance supports a significant correlation between cholesterol levels and coronary microvascular dysfunction.
  • Elevated LDL cholesterol is independently associated with impaired coronary microvascular function in patients with coronary artery disease.
Abstract

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