Meyer Elbaz1, Julien Faccini2, Vanina Bongard3, Cécile Ingueneau2, Dorotea Taraszkiewicz4, Bertrand Perret5, Jean Ferrières4, Jean-Bernard Ruidavets6, Cécile Vindis7. 1. Inserm UMR-1048, Institute of Metabolic and Cardiovascular Diseases, 1, avenue Jean-Poulhès, 31432 Toulouse, France; Toulouse University Paul-Sabatier, 31062 Toulouse, France; Department of Cardiology, CHU de Toulouse, 31432 Toulouse, France. 2. Inserm UMR-1048, Institute of Metabolic and Cardiovascular Diseases, 1, avenue Jean-Poulhès, 31432 Toulouse, France; Toulouse University Paul-Sabatier, 31062 Toulouse, France. 3. Toulouse University Paul-Sabatier, 31062 Toulouse, France; Inserm UMR-1027, épidémiologie et analyses en santé publique, 31000 Toulouse, France. 4. Toulouse University Paul-Sabatier, 31062 Toulouse, France; Department of Cardiology, CHU de Toulouse, 31432 Toulouse, France; Inserm UMR-1027, épidémiologie et analyses en santé publique, 31000 Toulouse, France. 5. Inserm UMR-1048, Institute of Metabolic and Cardiovascular Diseases, 1, avenue Jean-Poulhès, 31432 Toulouse, France; Department of Biochemistry, CHU de Toulouse, 31432 Toulouse, France. 6. Toulouse University Paul-Sabatier, 31062 Toulouse, France; Department of Cardiology, CHU de Toulouse, 31432 Toulouse, France. 7. Inserm UMR-1048, Institute of Metabolic and Cardiovascular Diseases, 1, avenue Jean-Poulhès, 31432 Toulouse, France; Toulouse University Paul-Sabatier, 31062 Toulouse, France. Electronic address: cecile.vindis@inserm.fr.
Abstract
BACKGROUND: High-density lipoproteins (HDLs) are highly heterogeneous particles, and the specific contribution of each subclass to the prediction of clinical outcome in coronary artery disease (CAD) remains controversial. OBJECTIVE: To examine the relationship between HDL subclass profile and mortality in patients with CAD, using a new and rapid electrophoretic quantitative method for the assessment of HDL particle size phenotype. METHODS: We investigated 403 patients with CAD admitted for cardiovascular examination in the context of evaluation and management of CAD. HDL subclass distribution was analysed using the Quantimetrix Lipoprint® HDL system. Cumulative survival of patients according to lipid variables was determined by the Kaplan-Meier method. The relationship between baseline variables and outcome criteria was assessed using Cox proportional hazards regression analysis. RESULTS: During follow-up (9.8±3.1 years) the mortality rate was 31.0%; 60.8% of deaths were related to CAD. The concentration of total HDL cholesterol was similar in deceased patients (42±13mg/dL) and alive patients (43±12mg/dL); the concentrations of small, intermediate and large HDL cholesterol subclasses were not significantly different in alive and deceased patients (P=0.17, P=0.34 and P=0.81, respectively). We did not observe any independent associations between overall or cardiovascular mortality and total HDL cholesterol or any HDL subclass. However, heart rate, left ventricular ejection fraction and severity score for coronary atherosclerosis were more associated with mortality than classical cardiovascular risk factors. CONCLUSIONS: HDL subclass profile is not associated with mortality in patients with CAD. Further investigations linking HDL subclass repartition with prediction of residual cardiovascular risk are required. Copyright Â
BACKGROUND: High-density lipoproteins (HDLs) are highly heterogeneous particles, and the specific contribution of each subclass to the prediction of clinical outcome in coronary artery disease (CAD) remains controversial. OBJECTIVE: To examine the relationship between HDL subclass profile and mortality in patients with CAD, using a new and rapid electrophoretic quantitative method for the assessment of HDL particle size phenotype. METHODS: We investigated 403 patients with CAD admitted for cardiovascular examination in the context of evaluation and management of CAD. HDL subclass distribution was analysed using the Quantimetrix Lipoprint® HDL system. Cumulative survival of patients according to lipid variables was determined by the Kaplan-Meier method. The relationship between baseline variables and outcome criteria was assessed using Cox proportional hazards regression analysis. RESULTS: During follow-up (9.8±3.1 years) the mortality rate was 31.0%; 60.8% of deaths were related to CAD. The concentration of total HDL cholesterol was similar in deceased patients (42±13mg/dL) and alive patients (43±12mg/dL); the concentrations of small, intermediate and large HDL cholesterol subclasses were not significantly different in alive and deceased patients (P=0.17, P=0.34 and P=0.81, respectively). We did not observe any independent associations between overall or cardiovascular mortality and total HDL cholesterol or any HDL subclass. However, heart rate, left ventricular ejection fraction and severity score for coronary atherosclerosis were more associated with mortality than classical cardiovascular risk factors. CONCLUSIONS: HDL subclass profile is not associated with mortality in patients with CAD. Further investigations linking HDL subclass repartition with prediction of residual cardiovascular risk are required. Copyright Â
Authors: Raissa de Miranda Teixeira; Nicole Cruz de Sá; Ana Paula Caires Dos Santos; Vanessa Rocha Anjos E Silva; Elaine Christine de Magalhães Cabral Albuquerque; Luiz Claudio Lemos Correia; Ricardo David Couto Journal: Cardiol Res Pract Date: 2019-03-03 Impact factor: 1.866