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Low HDL-C predicts risk and PCI outcomes in the Han Chinese population
Qun Lu1, Gang Tian, Yong Zhang
1Department of Cardiovascular Medicine, First Affiliated Hospital of Medical College, School of Medicine of Xi'an Jiaotong University, and Institute of Cardiovascular Channelopathy, Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), the Ministry of Education, Key Laboratory of Molecular Cardiology, No. 277 Yanta West Road, Xi'an, Shaanxi Province 710061, PR China.
Insights
Low high-density lipoprotein cholesterol (HDL-C) strongly predicts coronary heart disease (CHD) risk and outcomes in the Han Chinese population. This finding highlights HDL-C as a crucial lipid marker for cardiovascular health in this demographic.
Area of Science:
- Cardiology
- Lipid Metabolism
- Public Health
Background:
- High-density lipoprotein cholesterol (HDL-C) is a known predictor of coronary heart disease (CHD) in Western populations.
- The predictive role of HDL-C in Chinese populations, specifically the Han Chinese, remains less understood.
- This study aimed to clarify the association between HDL-C levels and CHD risk and outcomes in the Han Chinese population.
Purpose of the Study:
- To evaluate the diagnostic value of HDL-C for CHD in the Han Chinese population.
- To determine the predictive capability of HDL-C for major adverse cardiovascular events (MACE) in Han Chinese patients with CHD who have undergone percutaneous coronary intervention (PCI).
Main Methods:
- A case-control study compared plasma HDL-C levels between CHD patients and healthy controls.
- A prospective cohort study followed CHD patients post-PCI to assess the relationship between HDL-C levels and MACE development.
- Statistical analyses included logistic regression, stratified analysis, Kaplan-Meier analysis, and Cox regression.
Main Results:
- Case-control study: Significantly lower HDL-C levels were observed in CHD patients compared to controls (P < 0.05). HDL-C showed the strongest association with CHD among lipid parameters.
- Prospective cohort study: Patients with low HDL-C post-PCI had a significantly higher incidence of MACE (24.9%) compared to those with high HDL-C (6.8%, P < 0.05).
- Low HDL-C was identified as an independent predictor of MACE during follow-up (hazard ratio = 0.395, P = 0.005).
Conclusions:
- Low HDL-C is a powerful and independent predictor of both the risk and clinical outcomes of CHD in the Han Chinese population.
- HDL-C levels are significantly associated with CHD diagnosis and prognosis in this specific ethnic group.
- These findings underscore the importance of monitoring HDL-C for cardiovascular risk assessment in Han Chinese individuals.
Background:
High-density lipoprotein cholesterol (HDL-C) can predict the occurrence and prognosis of coronary heart disease (CHD) in the Western population; however, the role of HDL-C in Chinese populations is unclear. Thus, we investigated the predictive value of HDL-C on the risk and clinical outcomes of CHD in the Han Chinese population.
Methods:
In a case-control study, plasma HDL-C levels of CHD patients and controls were evaluated to analyse the diagnostic value of HDL-C on CHD. In a prospective cohort study, the predictive value of HDL-C on the development of major adverse cardiovascular events (MACE) was determined in CHD patients who underwent a percutaneous coronary intervention (PCI).
Results:
In the case-control study, HDL-C levels were significantly lower in patients with CHD (n = 375) compared to the controls (n = 328, P < 0.05). There were more male patients in the CHD group than in the control group. Logistic regression analysis showed that, relative to other lipid parameters, the relationship between HDL-C levels and CHD showed the strongest association. A stratified analysis showed that gender did not affect the relationship between HDL-C levels and CHD. The prospective cohort study found that in the low HDL-C subgroup of CHD patients (n = 249) who underwent PCI, 62 (24.9%) patients experienced a MACE during the 120-week follow-up period. However, only 15 (6.8%) patients experienced a MACE in the high HDL-C subgroup (n = 219; P < 0.05). Kaplan-Meier analysis revealed that the MACE rate and death rate were significantly higher in the low HDL-C subgroup than in their counterparts with high HDL-C levels (P < 0.05). The Cox regression analysis showed that HDL-C was an independent predictor of a MACE during the follow-up period (hazard ratio = 0.395, P = 0.005).
Conclusions:
Low HDL-C was the most powerful lipid parameter for predicting the risk and the clinical outcome of CHD in the Han Chinese population.
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