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. 2021 Oct;36(10):1457-1465.
doi: 10.1007/s00380-021-01831-0. Epub 2021 Mar 21.

Association between high-density lipoprotein cholesterol levels and major adverse cardiovascular events in patients who underwent coronary computed tomography angiography: FU-CCTA registry

Yuto Kawahira #  1   2 , Yuhei Shiga #  1 , Hiroko Inoue  2 , Yasunori Suematsu  1 , Kohei Tashiro  1 , Yuta Kato  1 , Kanta Fujimi  1   3 , Yosuke Takamiya  1 , Takashi Kuwano  1 , Makoto Sugihara  1 , Shin-Ichiro Miura  4   5   6
Affiliations

Association between high-density lipoprotein cholesterol levels and major adverse cardiovascular events in patients who underwent coronary computed tomography angiography: FU-CCTA registry

Yuto Kawahira et al. Heart Vessels. 2021 Oct.

Abstract

It is unclear whether higher levels of serum high-density lipoprotein cholesterol (HDL-C) prevent major adverse cardiovascular events (MACE). We prospectively evaluated 501 patients who had undergone coronary computed tomography angiography at Fukuoka University Hospital and either were clinically suspected of having coronary artery disease (CAD) or had at least one cardiovascular risk factor with a follow-up of up to 5 years. The primary endpoint was MACE (cardiovascular death, ischemic stroke, acute myocardial infarction and coronary revascularization). The patients were divided into tertiles according to the HDL-C level: 47 mg/dl ≥ HDL-C level [n = 167, lower HDL-C level (L-HDL)], 58 mg/dl ≥ HDL-C level ≥ 48 mg/dl [n = 167, middle HDL-C level (M-HDL)] and HDL-C level ≥ 59 mg/dl [n = 167, higher HDL-C level (H-HDL)] groups. There were significant differences in %CAD among the L-HDL, M-HDL and H-HDL groups. Unexpectedly, there was no difference in %MACE between M-HDL and H-HDL, although %MACE in M-HDL was significantly lower than that in L-HDL (p < 0.05). By a multivariate logistic regression analysis, MACE in H-HDL-C was independently associated with diabetes mellitus (DM) (p = 0.03). A Kaplan-Meier curve according to the HDL subgroup indicated that M-HDL, not H-HDL, enjoyed the greatest freedom from MACE among the 3 groups (log-rank test p = 0.047). Finally, the results of a Cox regression model indicated that L-HDL and H-HDL had significantly higher risk of MACE than M-HDL. In conclusions, patients with middle HDL-C levels, not higher HDL-C levels, showed the greatest freedom from MACE. Patients with higher HDL-C levels need to be strictly managed for DM to prevent MACE.

Keywords: Coronary artery disease; Coronary computed tomography angiography; High-density lipoprotein cholesterol; Major adverse cardiovascular events.

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References

    1. Chapman MJ, Redfern JS, McGovern ME, Giral P (2010) Niacin and fibrates in atherogenic dyslipidemia: pharmacotherapy to reduce cardiovascular risk. Pharmacol Therapeutics 126:314–345 - DOI
    1. Mora S, Wenger NK, Demicco DA, Breazna A, Boekholdt SM, Arsenault BJ, Deedwania P, Kastelein JJ, Waters DD (2012) Determinants of residual risk in secondary prevention patients treated with high- versus low-dose statin therapy: the treating to new targets (TNT) study. Circulation 125:1979–1987 - DOI
    1. Miura S, Shiga Y, Ike A, Iwata A (2019) Atherosclerotic coronary artery disease in patients with cardiometabolic syndrome. Cardiol Res 10:69–73 - DOI
    1. M Kinoshita K Yokote H Arai M Iida Y Ishigaki S Ishibashi S Umemoto G Egusa H Ohmura T Okamura S Kihara S Koba I Saito T Shoji H Daida K Tsukamoto J Deguchi S Dohi K Dobashi H Hamaguchi M Hara T Hiro S Biro Y Fujioka C Maruyama Y Miyamoto Y Murakami M Yokode H Yoshida H Rakugi A Wakatsuki S Yamashita Committee for Epidemiology and Clinical Management of Atherosclerosis (2018) Japan atherosclerosis society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017. J Atheroscler Thromb 25:846–984 - DOI
    1. Di Bartolo BA, Psaltis PJ, Bursill CA, Nicholls SJ (2018) Translating evidence of HDL and plaque regression. Arterioscler Thromb Vasc Biol 38:1961–1968 - DOI

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