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Associations between High-Density Lipoprotein Functionality and Major Adverse Cardiovascular Events in Patients Who
Hiroko Inoue1, Yuhei Shiga2, Kenji Norimatsu1,2
1Department of Cardiology, Fukuoka University Nishijin Hospital, Fukuoka 814-8522, Japan.
Insights
Total cholesterol efflux capacity (CEC) and HDL cholesterol (HDL-C) levels are linked to major adverse cardiovascular events (MACE) after coronary computed tomography angiography (CCTA). Specific HDL functionalities did not show significant associations with MACE.
Area of Science:
- Cardiovascular Medicine
- Biochemistry
- Medical Imaging
Background:
- High-density lipoprotein (HDL) plays a crucial role in reverse cholesterol transport.
- Assessing HDL functionality beyond cholesterol levels is vital for cardiovascular risk prediction.
- Coronary computed tomography angiography (CCTA) identifies patients at risk for cardiovascular events.
Purpose of the Study:
- To investigate the association between HDL functionality and major adverse cardiovascular events (MACE) in patients undergoing CCTA.
- To evaluate specific HDL functionality assays, including cholesterol efflux capacity (CEC), caspase-3/7 activity, and monocyte chemoattractant protein-1 (MCP-1) secretion.
- To determine if HDL functionality predicts MACE independently of HDL cholesterol (HDL-C) levels.
Main Methods:
- Prospective cohort study of 151 patients who underwent CCTA with up to 5 years of follow-up.
- Measurement of HDL functionality using cholesterol efflux capacity (CEC), caspase-3/7 activity, and MCP-1 secretion.
- Comparison of HDL parameters between patients with and without MACE.
Main Results:
- Total CEC and HDL-C were significantly lower in patients with MACE compared to those without.
- No significant differences were observed in %CEC, caspase-3/7 activity, or MCP-1 secretion between the groups.
- Total CEC was correlated with HDL-C, and ROC analysis showed similar predictive values for total CEC and HDL-C for MACE.
Conclusions:
- Total cholesterol efflux capacity (CEC), alongside HDL cholesterol (HDL-C), is associated with the presence of major adverse cardiovascular events (MACE) in patients post-CCTA.
- Specific aspects of HDL functionality, such as anti-inflammatory and anti-apoptotic properties, were not found to be associated with MACE in this cohort.
- These findings suggest that total CEC may serve as a valuable functional marker for cardiovascular risk assessment in patients evaluated with CCTA.
Abstract:
The present study aimed to investigate the associations between high-density lipoprotein (HDL) functionality and major adverse cardiovascular events (MACE) in patients who have undergone coronary computed tomography angiography (CCTA). We performed a prospective cohort study and enrolled 151 patients who underwent CCTA and had a follow-up of up to 5 years. We measured cholesterol efflux capacity (CEC), caspase-3/7 activity and monocyte chemoattractant protein-1 (MCP-1) secretion as bioassays of HDL functionality. The patients were divided into MACE(-) (n = 138) and MACE(+) (n = 13) groups. While there was no significant difference in %CEC, caspase-3/7 activity or MCP-1 secretion between the MACE(-) and MACE(+) groups, total CEC and HDL cholesterol (HDL-C) in the MACE(+) group were significantly lower than those in the MACE(-) group. Total CEC was correlated with HDL-C. A receiver-operating characteristic curve analysis showed that there was no significant difference between the areas under the curves for total CEC and HDL-C. In conclusion, total CEC in addition to HDL-C, but not %CEC, was associated with the presence of MACE. On the other hand, HDL functionality with regard to anti-inflammatory and anti-apoptosis effects was not associated with MACE.
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