Parveen K Garg1, Neal W Jorgensen2, Robyn L McClelland2, Matthew Allison3, James H Stein4, Laurent Yvan-Chavret5, Alan R Tall6, Steven Shea7. 1. Division of Cardiology, University of Southern California, Los Angeles, CA, USA. Electronic address: parveeng@med.usc.edu. 2. Department of Biostatistics, University of Washington, Seattle, WA, USA. 3. Division of Preventive Medicine, University of California, San Diego School of Medicine, San Diego, CA, USA. 4. Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA. 5. Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA; University of Nice, France. 6. Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA. 7. Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.
Abstract
BACKGROUND AND AIMS: We aimed to assess the relationship of HDL (high-density lipoprotein)-mediated cholesterol mass efflux capacity (CMEC) with risk of incident peripheral artery disease (PAD). METHODS: CMEC was measured in 1458 Multi-Ethnic Study of Atherosclerosis participants between 2000 and 2002 as part of a case-control study matched for incident cardiovascular disease and progression of carotid plaque by ultrasound. Incident clinical PAD, adjudicated on the basis of a positive history for the presence of disease-related symptoms or treatment, was ascertained through 2015 in 1419 individuals without clinical PAD at baseline. Subclinical PAD, defined as an ankle-brachial index (ABI) ≤1.0, was assessed among 1255 individuals with a baseline ABI >1.0 and at least one follow-up ABI measurement 3-10 years later. Cox proportional hazards and relative risk regression modeling per SD increment of CMEC were used to determine the association of CMEC with clinical and subclinical PAD, respectively. RESULTS: There were 38 clinical PAD and 213 subclinical PAD events that occurred over a mean follow-up of 6.0 and 6.5 years respectively. After adjustment for age, gender, and race, higher CMEC levels were not associated with clinical PAD (hazard ratio 1.25; 95% CI 0.89, 1.75) or subclinical PAD (risk ratio 1.02; 95% CI, 0.94, 1.11). CONCLUSIONS: These findings suggest that HDL-mediated cholesterol efflux is not significantly associated with incident clinical and subclinical PAD.
BACKGROUND AND AIMS: We aimed to assess the relationship of HDL (high-density lipoprotein)-mediated cholesterol mass efflux capacity (CMEC) with risk of incident peripheral artery disease (PAD). METHODS: CMEC was measured in 1458 Multi-Ethnic Study of Atherosclerosis participants between 2000 and 2002 as part of a case-control study matched for incident cardiovascular disease and progression of carotid plaque by ultrasound. Incident clinical PAD, adjudicated on the basis of a positive history for the presence of disease-related symptoms or treatment, was ascertained through 2015 in 1419 individuals without clinical PAD at baseline. Subclinical PAD, defined as an ankle-brachial index (ABI) ≤1.0, was assessed among 1255 individuals with a baseline ABI >1.0 and at least one follow-up ABI measurement 3-10 years later. Cox proportional hazards and relative risk regression modeling per SD increment of CMEC were used to determine the association of CMEC with clinical and subclinical PAD, respectively. RESULTS: There were 38 clinical PAD and 213 subclinical PAD events that occurred over a mean follow-up of 6.0 and 6.5 years respectively. After adjustment for age, gender, and race, higher CMEC levels were not associated with clinical PAD (hazard ratio 1.25; 95% CI 0.89, 1.75) or subclinical PAD (risk ratio 1.02; 95% CI, 0.94, 1.11). CONCLUSIONS: These findings suggest that HDL-mediated cholesterol efflux is not significantly associated with incident clinical and subclinical PAD.
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