Development of a model for prediction of coronary atherosclerotic regression: evaluation of high-density lipoprotein cholesterol level and peripheral blood monocyte count

Abstract

Monocytes and high-density lipoprotein cholesterol (HDL-C) play important roles in the process of coronary atherosclerosis. We hypothesized that a reasonable predictive model of coronary plaque regression might be constructed using the change in the peripheral monocyte count and the serum HDL-C level. The plaque volume, as assessed by volumetric intravascular ultrasound, was measured at the baseline and after 6 months of pravastatin therapy in 114 patients with coronary artery disease. After 6 months of pravastatin therapy, a significant decrease of the plaque volume by 9.9% (p < 0.0001, vs. baseline) was observed; furthermore, a corresponding increase of the serum HDL-C level and decrease of the peripheral blood monocyte count were also seen (12.5%, p < 0.01 and -7.3%, p < 0.0001). In a multivariate regression analysis using the serum lipids and traditional risk factors as the covariates, the increase in the serum HDL-C (β -0.56, p < 0.0001) and the decrease in monocyte count (β 0.23, p = 0.03) were identified as independent predictors of the plaque regression. A model for the prediction of plaque regression according to whether the achieved the change in (Δ) monocyte count and ΔHDL-C were above or below the median values was prepared. Among the four groups, the group with ΔHDL-C ≥8.8% and Δmonocyte count ≤-8.6% showed the largest plaque regression (-20.4%), and the group with ΔHDL-C <8.8% and Δmonocyte count >-8.6% showed the increase of the plaque volume (2.6%). In view of the inflammatory nature of atherosclerosis, the model constructed using the two predictors may be a useful model for the prediction of plaque regression.

Monocyte to high-density lipoprotein ratio was associated with the severity of coronary artery disease: results from a large cohort study

“…Cetin and colleagues reported in their study which recruited 2661 patients a significant positive correlation between MHR and Gensini score 22 . In this study which included 4980 patients, we also found that MHR was positively associated with Gensini score, indicating that MHR could be an independent indicator to predict the prevalence and severity of CAD, which was consistent with previous studies 19,20,22 . In addition, this study presents a number of important strengths.…”

Enhancement of HDL Formation and Normalization of Intravascular HDL Remodeling

“…Moreover, in a Study to Evaluate the Effect of Rosuvastatin on Intravascular Ultrasound-Derived Coronary Atheroma Burden (ASTEROID), rosuvastatin at a dose of 40 mg/d for 24 months regressed coronary atherosclerosis by intravascular ultrasound and quantitative coronary angiography [230]. In a similar fashion, elevation in HDL-C was significantly related to atherosclerotic plaque regression in patients with coronary artery disease after six months of pravastatin therapy, as revealed by multiple regression analysis [231]. The beneficial effect of this statin on coronary atherosclerosis was correlated with both a reduction in LDL-C and an increment in HDL-C [230].…”

The role of monocytosis and neutrophilia in atherosclerosis

“…In humans, a direct correlation between the high‐cholesterol levels and increased counts of peripheral mononuclear phagocytes was also found therefore reflecting the stimulating contribution of lipids on the levels of monocytes and neutrophils in the circulation . Treatment with lipid‐lowering agents caused decrease in levels of both neutrophils and monocytes thereby suggesting for the positive link between hypercholesterolaemia and pro‐atherogenic monocytosis/neutrophilia.…”