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Cholesterol uptake capacity: A new measure of high-density lipoprotein functionality as a predictor of subsequent
Daichi Fujimoto1, Hiromasa Otake1, Hiroyuki Kawamori1
1Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
Insights
Low cholesterol-uptake capacity (CUC) of high-density lipoprotein (HDL) predicts revascularization after percutaneous coronary intervention (PCI). This finding suggests CUC may help predict future cardiovascular events in PCI patients.
Area of Science:
- Cardiovascular Medicine
- Biochemistry
- Medical Diagnostics
Background:
- High-density lipoprotein (HDL) functionality is crucial in coronary artery disease (CAD) development.
- A novel cell-free assay, cholesterol-uptake capacity (CUC), directly measures HDL's ability to accept cholesterol.
- HDL's role in CAD pathogenesis necessitates evaluating its functional capacity.
Purpose of the Study:
- To assess the association between HDL cholesterol-uptake capacity (CUC) and revascularization in patients post-percutaneous coronary intervention (PCI).
- To determine if CUC can serve as a predictive marker for subsequent revascularization events.
Main Methods:
- Retrospective review of patients undergoing PCI, with analysis of those who had subsequent revascularization or angiography without revascularization.
- Measurement of serum CUC levels from frozen blood samples collected at the time of index PCI and follow-up.
- Multivariate logistic regression analysis to identify independent predictors of revascularization, adjusting for cardiovascular risk factors.
Main Results:
- Patients who underwent revascularization had significantly lower serum CUC levels at the index PCI compared to those without revascularization.
- Decreased serum CUC levels at the time of PCI were independently associated with subsequent revascularization.
- Lower CUC levels at index PCI, follow-up, and a greater decrease in CUC were observed in the revascularization group after adjusting for 16 cardiovascular risk factors.
Conclusions:
- Serum CUC level at the time of index PCI is an independent predictor of subsequent revascularization.
- Continuous assessment of HDL functionality using CUC may aid in predicting revascularization after PCI.
- CUC assay offers a promising tool for evaluating HDL function and predicting cardiovascular outcomes.
Background And Aims:
High-density lipoprotein (HDL) functionality is an important determinant of coronary artery disease (CAD) development. We recently developed cholesterol-uptake capacity (CUC), a rapid cell-free assay system that directly evaluates the capacity of HDL to accept additional cholesterol. We aimed to evaluate the association between CUC and revascularization in patients who have undergone percutaneous coronary intervention (PCI).
Methods:
We retrospectively reviewed patients who underwent PCI with subsequent revascularization or coronary angiography (CAG) without revascularization. The patients who had frozen blood samples for which CUC were measurable at the index PCI and follow-up were enrolled.
Results:
We finally enrolled 74 patients who underwent subsequent revascularization and 183 patients who underwent follow-up CAG without revascularization. The serum CUC level at the index PCI was significantly lower in the revascularization group than that in the non-revascularization group (84.3 [75.2-98.9] vs. 92.0 [81.6-103.3 A U.]; p = 0.004). Multivariate logistic regression analysis revealed that decreased serum CUC level at the index PCI was independently associated with subsequent revascularization (odds ratio, 0.98; 95% confidence interval, 0.969-1.000). After adjusting for 16 cardiovascular risk factors, the serum CUC level at the index PCI and follow-up and the absolute change in serum CUC level from the index PCI to follow-up were significantly lower in the revascularization group than those in the non-revascularization group.
Conclusions:
Serum CUC level at index PCI was independently associated with subsequent revascularization after PCI. Continuous assessment of HDL functionality by CUC might help predict subsequent revascularization after PCI.
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