Günther Silbernagel1, Philipp Pagel2, Volker Pfahlert2, Bernd Genser3,4,5, Hubert Scharnagl6, Marcus E Kleber7, Graciela Delgado7, Haruna Ohrui8, Andreas Ritsch9, Tanja B Grammer3, Wolfgang Koenig10,11, Winfried März6,7,12. 1. Division of Angiology, Department of Internal Medicine, Medical University of Graz, Graz, Austria; guenther.silbernagel@yahoo.com. 2. Numares AG, Regensburg, Germany. 3. Institute of Public Health, Social and Preventive Medicine, Mannheim Medical Faculty, University of Heidelberg, Mannheim, Germany. 4. BG Stats Consulting, Vienna, Austria. 5. Institute of Public Health, Federal University of Bahia, Salvador, Brazil. 6. Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria. 7. Department of Internal Medicine 5 (Nephrology, Hypertensiology, Endocrinology, Diabetology, Rheumatology), Mannheim Medical Faculty, University of Heidelberg, Mannheim, Germany. 8. Skylight Biotech Inc., Akita, Japan. 9. Department of Internal Medicine 1 (Endocrinology and Metabolism), Innsbruck Medical University, Innsbruck, Austria. 10. Department of Cardiology, German Heart Center, Technical University Munich and DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany. 11. Department of Internal Medicine II- Cardiology, University of Ulm Medical Center, Ulm, Germany. 12. Synlab Academy, Synlab Services GmbH, Mannheim and Augsburg, Germany.
Abstract
BACKGROUND: The inverse relationship between HDL cholesterol and cardiovascular mortality is weakened in coronary artery disease (CAD). We aimed to investigate the associations of HDL particle concentrations with cardiovascular mortality and the impact of CAD on these associations. We also sought to comparatively evaluate HDL cholesterol and HDL particle concentrations in predicting cardiovascular mortality. METHODS: Total and subclass HDL particle concentrations were measured by nuclear magnetic resonance spectroscopy in 2290 participants of the LUdwigshafen RIsk and Cardiovascular Health study referred for coronary angiography. The participants were prospectively followed over a median (interquartile range) duration of 10.0 (6.1-10.6) years. RESULTS: The mean (SD) age of the participants (1575 males, 715 females) was 62.9 (10.4) years; body mass index, 27.6 (4.1) kg/m2; HDL cholesterol, 39 (11) mg/dL [1 (0.29) mmol/L]; and total HDL particle concentration, 24.1 (5.8) μmol/L. Of the participants, 434 died from cardiovascular diseases. In multivariate analyses, tertiles of total HDL particle concentrations were inversely related to cardiovascular mortality (hazard ratio for third vs first tertile = 0.55, P < 0.001). This association was primarily mediated by small HDL particles (P < 0.001). Adding total or small HDL particle concentrations rather than HDL cholesterol to multivariate prediction models improved performance metrics for cardiovascular mortality. The presence of CAD had no impact on the associations between HDL particle concentrations and cardiovascular mortality. CONCLUSIONS: High HDL particle concentration is consistently and independently of CAD associated with decreased cardiovascular mortality. Whether the inverse relationship between HDL particle concentration and cardiovascular mortality may be translated into novel therapies is under investigation.
BACKGROUND: The inverse relationship between HDL cholesterol and cardiovascular mortality is weakened in coronary artery disease (CAD). We aimed to investigate the associations of HDL particle concentrations with cardiovascular mortality and the impact of CAD on these associations. We also sought to comparatively evaluate HDL cholesterol and HDL particle concentrations in predicting cardiovascular mortality. METHODS: Total and subclass HDL particle concentrations were measured by nuclear magnetic resonance spectroscopy in 2290 participants of the LUdwigshafen RIsk and Cardiovascular Health study referred for coronary angiography. The participants were prospectively followed over a median (interquartile range) duration of 10.0 (6.1-10.6) years. RESULTS: The mean (SD) age of the participants (1575 males, 715 females) was 62.9 (10.4) years; body mass index, 27.6 (4.1) kg/m2; HDL cholesterol, 39 (11) mg/dL [1 (0.29) mmol/L]; and total HDL particle concentration, 24.1 (5.8) μmol/L. Of the participants, 434 died from cardiovascular diseases. In multivariate analyses, tertiles of total HDL particle concentrations were inversely related to cardiovascular mortality (hazard ratio for third vs first tertile = 0.55, P < 0.001). This association was primarily mediated by small HDL particles (P < 0.001). Adding total or small HDL particle concentrations rather than HDL cholesterol to multivariate prediction models improved performance metrics for cardiovascular mortality. The presence of CAD had no impact on the associations between HDL particle concentrations and cardiovascular mortality. CONCLUSIONS: High HDL particle concentration is consistently and independently of CAD associated with decreased cardiovascular mortality. Whether the inverse relationship between HDL particle concentration and cardiovascular mortality may be translated into novel therapies is under investigation.
Authors: Martin Rief; Reinhard Raggam; Peter Rief; Philipp Metnitz; Tatjana Stojakovic; Markus Reinthaler; Marianne Brodmann; Winfried März; Hubert Scharnagl; Günther Silbernagel Journal: Biomedicines Date: 2022-07-21
Authors: Sudipa Sarkar; Sabina Haberlen; Seamus Whelton; Edward E Schneider; Lawrence Kingsley; Frank Palella; Mallory D Witt; Theodoros Kelesidis; Annabelle Rodriguez; Wendy S Post; Todd T Brown Journal: Open Forum Infect Dis Date: 2019-11-13 Impact factor: 4.423
Authors: Katharina Lechner; Amy L McKenzie; Nicolle Kränkel; Clemens Von Schacky; Nicolai Worm; Uwe Nixdorff; Benjamin Lechner; Johannes Scherr; Oliver Weingärtner; Ronald M Krauss Journal: Metab Syndr Relat Disord Date: 2020-03-02 Impact factor: 1.894
Authors: Thomas Metzner; Deborah R Leitner; Karin Mellitzer; Andrea Beck; Harald Sourij; Tatjana Stojakovic; Gernot Reishofer; Winfried März; Ulf Landmesser; Hubert Scharnagl; Hermann Toplak; Günther Silbernagel Journal: Biomedicines Date: 2022-01-17