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Updated: Jan 29, 2026

Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
Published on: August 28, 2018
Decrease in oxidized high-density lipoprotein is associated with slowed progression of coronary artery calcification:
Takashi Miki1, Toru Miyoshi1, Kazuhiko Kotani2
1Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Density and Pharmaceutical Sciences, Okayama, Japan.
Insights
A decrease in oxidized high-density lipoprotein (oxHDL) levels was linked to slower progression of coronary artery calcification (CAC). This suggests oxHDL may be a target for preventing atherosclerosis.
Area of Science:
- Cardiovascular research
- Atherosclerosis studies
- Lipoprotein metabolism
Background:
- Oxidized high-density lipoprotein (oxHDL) has diminished anti-inflammatory properties compared to HDL.
- The specific role of oxHDL in coronary artery calcification (CAC) pathogenesis is not fully understood.
- CAC is a key indicator of subclinical atherosclerosis.
Purpose of the Study:
- To prospectively examine the association between changes in oxHDL levels and CAC progression.
- To evaluate oxHDL as a potential biomarker and therapeutic target in atherosclerosis.
Main Methods:
- A substudy of 140 patients from a multicenter trial was conducted.
- Patients received pitavastatin with or without eicosapentaenoic acid.
- Coronary artery calcification (CAC) was measured at baseline and 1-year follow-up using computed tomography.
Main Results:
- A significant decrease in oxHDL levels was observed post-treatment (167 to 122 U/ml, p < 0.001).
- Annual CAC change positively correlated with changes in oxHDL (r=0.17, p=0.04), triglycerides, and hs-CRP.
- A decrease in oxHDL was independently associated with reduced CAC progression (OR, 0.95; 95% CI, 0.90-0.99; p=0.04).
Conclusions:
- Reduced oxHDL levels correlate with attenuated CAC progression.
- oxHDL may serve as a potential therapeutic target for atherosclerosis prevention.
- Further research into oxHDL's role in cardiovascular disease is warranted.
Background And Aims:
Oxidized high-density lipoprotein (oxHDL) is characterized by reduced anti-inflammatory properties compared with HDL. However, the role of oxHDL in the pathogenesis of coronary artery calcification (CAC), a marker of subclinical atherosclerosis, remains unclear. We prospectively investigated the association between the change in oxHDL and progression of CAC in a substudy of a multicenter study.
Methods:
In the principal study, patients with a CAC score of 1-999 were treated with pitavastatin with/without eicosapentaenoic acid. Measurement of CAC with multidetector-row computed tomography and a blood test were performed at baseline and at the 1-year follow-up. In the principal study, the increase in CAC did not differ among treatment groups. In this substudy, patients were divided into two groups: CAC progression (change in Agatston score of >0) and no CAC progression.
Results:
In total, 140 patients were analyzed. The oxHDL level significantly decreased from 167 (132-246) at baseline to 122 (103-149) after treatment (median [25th-75th percentile], U/ml) (p < 0.001). The annual change in CAC was significantly positively associated with changes in oxHDL (r = 0.17, p = 0.04), triglycerides (r = 0.17, p = 0.04), and high-sensitivity C-reactive protein (r = 0.22, p = 0.01) but was not associated with changes in low-density lipoprotein cholesterol or HDL-cholesterol. Multiple logistic analysis demonstrated that the decrease in oxHDL per 10 U/ml was independently associated with CAC progression (odds ratio, 0.95; 95% confidence interval, 0.90-0.99; p = 0.04).
Conclusions:
The decrease in oxHDL is associated with the attenuation of CAC progression, suggesting that oxHDL is a potential target for atherosclerosis prevention.
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