Related Experiment Videos
High-density lipoprotein cholesterol level and smoking modify the prognosis of patients with coronary vasospasm
1Second Department of Internal Medicine, Toyama Medical and Pharmaceutical University, Japan.
Insights
Patients with vasospastic coronary artery disease experiencing cardiovascular events had lower baseline HDL-C levels. Smoking cessation and increased HDL-C may reduce cardiovascular event risk in these patients.
Area of Science:
- Cardiology
- Vascular Medicine
- Lipid Metabolism
Background:
- Vasospastic coronary artery disease (CAD) is a significant cause of cardiovascular events.
- Understanding risk factors beyond traditional lipid profiles is crucial for managing vasospastic CAD.
- Low high-density lipoprotein cholesterol (HDL-C) is a known cardiovascular risk factor.
Purpose of the Study:
- To analyze cardiovascular events in patients with vasospastic CAD.
- To investigate the role of lipid profiles, particularly HDL-C, in predicting cardiovascular events.
- To assess the impact of smoking on cardiovascular events and HDL-C levels in this patient cohort.
Main Methods:
- Analysis of 80 consecutive patients with vasospastic CAD.
- Follow-up period of 30 months to record cardiovascular events (myocardial infarction, unstable angina, stroke).
- Baseline and follow-up assessment of serum lipid profiles (total cholesterol, LDL-C, triglycerides, HDL-C) and smoking status.
Main Results:
- Patients experiencing cardiovascular events (Group A) had significantly lower baseline HDL-C compared to event-free patients (Group B).
- HDL-C levels increased significantly in event-free patients but not in those with events during follow-up.
- Current smokers at follow-up were more prevalent in Group A and had a higher incidence of cardiovascular accidents; their HDL-C levels did not increase.
Conclusions:
- Lower baseline HDL-C is associated with an increased risk of cardiovascular events in vasospastic CAD patients.
- Smoking cessation may be crucial for improving HDL-C levels and reducing cardiovascular event risk.
- Further research into HDL-C modulation and smoking cessation interventions is warranted for vasospastic CAD management.
Abstract:
A cardiovascular event analysis was performed in a subset of 80 consecutive patients with vasospastic coronary artery disease. During the follow-up period (30 +/- 2 months, mean +/- SD), 9 patients had vascular accidents, including acute myocardial infarction, unstable angina, and stroke (Group A), while the remaining 71 patients were eventfree (Group B). Serum total-cholesterol, low-density lipoprotein cholesterol, and triglyceride levels were not different between the two groups at the baseline as well as after follow-up. However, the HDL-C level at baseline was significantly lower in Group A (33.5 +/- 2.6 mg/dl) than in Group B (41.9 +/- 1.7 mg/dl, p < 0.05). The HDL-C level increased significantly during the follow-up in Group B (delta HDL-C: 6.2 +/- 1.2 mg/dl, p < 0.01), but not in Group A (delta HDL-C: -3.2 +/- 2.7 mg/dl). The HDL-C level after follow-up was significantly lower in Group A (30.3 +/- 2.9 mg/dl) than in Group B (48.1 +/- 1.5 mg/dl, p < 0.01). Current smokers at the end of the follow-up period were more prevalent in Group A (67%) than in Group B (11%, p < 0.01). Cardiovascular accidents occurred more often in current smokers (6/14, 43%) at the end of the follow-up than in current nonsmokers, including quitters (3/66, 5%; p < 0.05). The HDL-C level was increased significantly (delta HDL: 6.2 +/- 1.3 mg/dl, p < 0.01) in the latter patients, but not in the former (delta HDL: -0.4 +/- 2.9 mg/dl).(ABSTRACT TRUNCATED AT 250 WORDS)