The relationship between high-density lipoprotein cholesterol and coronary collateral circulation in patients with coronary artery disease

Abstract

Introduction: High-density lipoprotein cholesterol (HDL-C) promotes cholesterol efflux from macrophage foam cells in atheroma plaques. In addition, HDL-C has anti-inflammatory and endothelium-protective properties. Despite that the only prerequisite for collateral development is shown to be the degree of coronary artery stenosis, there are significant differences even among patients with a similar degree of coronary artery disease.

Objective: We designed this study to investigate a possible association between HDL-C and coronary collateral circulation (CCC).

Materials and methods: All study participants had at least one occluded major coronary artery. Demographic, clinical, and laboratory data were obtained from patients' medical records. To classify CCC, we used Rentrop classification. The patients were then classified as having poor CCC (Rentrop grades 0-1) or good CCC (Rentrop grades 2-3). We performed t test and the χ test in comparing groups and multivariate logistics regression analysis to determine the predictors of CCC. The study population consisted of 151 patients (mean age, 63.7 ± 9 years; 76.2% male).

Results: Forty-nine patients had poor CCC and 102 patients had good CCC. The proportion of previous myocardial infarctions, serum triglycerides, and low HDL-C levels were more frequent in the poor CCC group (P = 0.026, P = 0.015, and P < 0.001, respectively). Multivariate logistic regression analysis revealed that low HDL-C is a predictor of CCC (B = 1.456; P < 0.001; odds ratio, 4.3; 95% confidence interval, 1.964-9.369).

Conclusion: We found that low HDL-C frequency was more frequent in the poor CCC group than the good CCC group, and HDL-C was a predictor of CCC.