Significance of the percentage of cholesterol efflux capacity and total cholesterol efflux capacity in patients with or without coronary artery disease

Norimatsu, Kenji; Kuwano, Takashi; Miura, Shin‐ichiro; Shimizu, Tomohiko; Shiga, Yuhei; Suematsu, Yasunori; Miyase, Yuiko; Adachi, Sen; Nakamura, Ayumi; Imaizumi, Satoshi; Iwata, Atsushi; Nishikawa, Hiroaki; Uehara, Yoshio; Saku, Keijiro

doi:10.1007/s00380-016-0837-7

Cited by 20 publications

(16 citation statements)

References 31 publications

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“…Thus, we should consider not only the level of HDL-C but also HDL functionality. We previously reported that the calculated total cholesterol efflux capacity that depended on the HDL-C level was significantly correlated with the presence of CAD at the time of CCTA [23].…”

Section: Discussionmentioning

confidence: 97%

Associations Between High Levels of High-Density Lipoprotein Cholesterol and the Presence and Severity of Coronary Artery Disease in Patients Who Have Undergone Coronary Computed Tomography Angiography

et al. 2020

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Background: Although a recent study in a Japanese cohort indicated that extremely high-density lipoprotein cholesterol (HDL-C, ≥ 90 mg/ dL) had an adverse effect on atherosclerotic cardiovascular disease mortality, we could not conclude that high levels of HDL-C were associated with the presence or severity of coronary artery disease (CAD). Methods: We enrolled 1,016 patients who were clinically suspected to have CAD and who underwent coronary computed tomography angiography (CCTA). The number of significantly stenosed coronary vessels (vessel disease (VD), ≥ 50% coronary stenosis is diagnosed as CAD) and the Gensini score were quantified using CCTA, and the lipid profile was measured. The patients were divided into four groups according to the HDL-C level: < 40 mg/dL (n = 115, low), 40-59 mg/ dL (n = 530, normal), 60-89 mg/dL (n = 335, high) and ≥ 90 mg/dL (n = 36, very-high). Results: The percentage (%) of CAD in the low, normal, high and very-high groups was 69%, 55%, 42% and 25%, respectively (P for trend < 0.01). The Gensini score in the low, normal, high and veryhigh groups was 20 ± 25, 12 ± 16, 8 ± 12 and 4 ± 6, respectively (P for trend < 0.01). The very-high group showed the lowest triglyceride (TG) levels among the four groups. There were no significant differences in the level of low-density lipoprotein cholesterol or % use of statin among the four groups. Finally, the presence of CAD was independently associated with a low level of HDL-C, in addition to age, male, high systolic blood pressure and hemoglobin A1c, but not TG, by a multivariate logistic regression analysis. Conclusions: High levels of HDL-C at the time of CCTA for screening were associated with a reduced presence and severity of CAD.

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Section: Discussionmentioning

confidence: 97%

Associations Between High Levels of High-Density Lipoprotein Cholesterol and the Presence and Severity of Coronary Artery Disease in Patients Who Have Undergone Coronary Computed Tomography Angiography

et al. 2020

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“…After excluding 166 other studies designed as case reports, letters to editor, review articles, in vitro studies, animal studies, 41 articles in full-text article were assessed for eligibility. Finally, 18 articles reporting outcomes of interest were included in the meta-analysis [2,3,7,8,10,[13][14][15][16][17][18][19][20][21][22][23][24][25]. Of them, 12 studies were designed as case-control studies and 6 were cohort studies.…”

Section: Study Selection and Characteristics Of The Included Studiesmentioning

confidence: 99%

“…Eight of them analyzed the association between CEC and the risk of stable CAD or ACS [7,8,16,18,19,[21][22][23]. Four studies reported the prognosis of stable CAD or ACS [2,10,17,25].…”

Section: Study Selection and Characteristics Of The Included Studiesmentioning

confidence: 99%

“…Macrophage-specific cholesterol efflux capacity (CEC) has been reported to be directly associated with the alleviation of murine atherosclerosis [6]. Meanwhile, CEC was confirmed to be reduced in patients with CAD and heart failure [7,8]. CEC is inversely associated with carotid intimamedia thickness in patients with end-stage renal disease, independent of HDL-C concentrations [9].…”

Section: Introductionmentioning

confidence: 99%

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Roles of cholesterol efflux capacity in the occurrence and prognosis coronary artery disease

Ren

et al. 2019

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Background The association between cholesterol efflux capacity (CEC) with the occurrence and prognosis of coronary artery disease (CAD) remains unrevealed. In our study, a systematic review was performed to quantitively analyze the association between CEC and the risk of CAD and follow-up endpoint events of the patients with CAD.Methods A systematic search of electronic databases (PubMed, EMBASE, OVID, Web of Science and Cochrane Library) for studies published until September 2019 was performed. Cohort, case-control studies, and randomized controlled trials that examined the effect of CEC on risk and prognosis of CAD were included.Results Eighteen studies involving a total of 12615 subjects that met the inclusion criteria were included. Among them, 14 studies reported the CEC levels in control and CAD group and 8 of them analyzed the association of CEC with risk of CAD. Four studies reported the prognosis of CAD or acute coronary syndrome (ACS). From the pooled analyses, significantly decreased CEC level was shown in patients with stable CAD in comparison with the control. It was also true in subgroup analysis of the patients with ACS. The decreased CEC was significantly associated with increased risk of CAD (OR=0.65, 95% CI: 0.55-0.75, P<0.001). Decreased CEC level predicted higher all-cause (OR= 0.39, 95% CI: 0.20-0.77, P=0.007) and cardiovascular related mortality (OR= 0.34, 95% CI: 0.13-0.90, P=0.03) risk in patients with CAD. However, CEC levels failed to predict the occurrence of stroke and myocardial infraction in patients with CAD.Conclusions Decreased cholesterol efflux capacity is an independent risk factor for the occurrence of CAD patients, and its level predicts all-cause and cardiovascular related mortality risk in patients with CAD. Prospective studies should further investigate whether CEC control might improve outcomes in CAD patients.

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“…The cholesterol efflux capacity (CEC) of HDL is modified in CVD [ 22 – 26 ] , metabolic syndrome [ 27 ] , and during acute inflammation [ 28 ] . How distinct CEC and HDL-C are as biomarkers of disease has been debated, with some studies observing reduced CEC independent of changes in HDL-C [ 22 - 23 , 25 , 28 – 30 ] , while others find that CEC and HDL-C changes correlate [ 24 , 26 - 27 ] . Possible mechanisms to explain diminished CEC in most of these studies is increased HDL-associated serum amyloid A (SAA) [ 28 ] and reduced HDL-associated paraoxonase 1 (PON-1) [ 26 ] in inflammatory states, which will be discussed below.…”

Section: Changes In Hdl Cholesterol Efflux Capacitymentioning

confidence: 99%

The pleiotropic vasoprotective functions of high density lipoproteins (HDL)

et al. 2018

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The pleiotropic functions of circulating high density lipoprotein (HDL) on peripheral vascular health are well established. HDL plays a pivotal role in reverse cholesterol transport and is also known to suppress inflammation, endothelial activation and apoptosis in peripheral vessels. Although not expressed in the central nervous system, HDL has nevertheless emerged as a potential resilience factor for dementia in multiple epidemiological studies. Animal model data specifically support a role for HDL in attenuating the accumulation of β-amyloid within cerebral vessels concomitant with reduced neuroinflammation and improved cognitive performance. As the vascular contributions to dementia are increasingly appreciated, this review seeks to summarize recent literature focused on the vasoprotective properties of HDL that may extend to cerebral vessels, discuss potential roles of HDL in dementia relative to brain-derived lipoproteins, identify gaps in current knowledge, and highlight new opportunities for research and discovery.

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Significance of the percentage of cholesterol efflux capacity and total cholesterol efflux capacity in patients with or without coronary artery disease

Cited by 20 publications

References 31 publications

Associations Between High Levels of High-Density Lipoprotein Cholesterol and the Presence and Severity of Coronary Artery Disease in Patients Who Have Undergone Coronary Computed Tomography Angiography

Associations Between High Levels of High-Density Lipoprotein Cholesterol and the Presence and Severity of Coronary Artery Disease in Patients Who Have Undergone Coronary Computed Tomography Angiography

Roles of cholesterol efflux capacity in the occurrence and prognosis coronary artery disease

The pleiotropic vasoprotective functions of high density lipoproteins (HDL)

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