title: The anti-oxidative capacity of high-density lipoprotein is reduced in acute coronary syndrome but not in stable coronary artery disease.
abstract: OBJECTIVE
  This study examined an anti-inflammatory property of high-density lipoprotein (HDL) in subjects with acute coronary syndrome (ACS) and stable coronary artery disease (CAD) compared with control subjects.
  
  
  BACKGROUND
  HDL has anti-inflammatory properties in vitro, but its relationship to coronary disease in humans is unclear. The high-density lipoprotein inflammatory index (HII) measures the ability of HDL to mitigate oxidation of low-density lipoprotein; this function may be impaired in ACS and/or CAD.
  
  
  METHODS
  We measured HII in 193 patients undergoing angiography for symptoms of CAD. Control subjects (n = 99) had no angiographic CAD, chronic CAD subjects (n = 51) had ≥ 70% vessel stenosis, and ACS subjects (n = 43) had ≥ 20% vessel stenosis and ischemia or infarction. We also examined HII in a cohort of healthy subjects randomly assigned to a statin or placebo.
  
  
  RESULTS
  Subjects who had ACS had higher HII (less antioxidative capacity) compared with controls (1.57 vs. 1.17, p = 0.005) or those with chronic CAD (1.57 vs. 1.11, p = 0.006). HII was not different in subjects with stable CAD compared with controls. Furthermore, those subjects with higher HII were more likely to have ACS than no CAD (quartile 4 vs. 1, odds ratio [OR]: 1.74, p = 0.008). In a multivariate logistic regression model, HII was associated with ACS after adjusting for traditional cardiac risk factors (OR: 3.8, p = 0.003). There was a small improvement in HII after statin therapy compared with placebo (-14%, p = 0.03).
  
  
  CONCLUSIONS
  HDL has less anti-inflammatory capacity as assessed by HII in the setting of ACS compared with controls or subjects with chronic CAD.
authors: Division of Cardiovascular Medicine, Department of Medicine, Hospital of University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA. parin.patel@post.harvard.edu
authors: Parin J
authors: PJ
authors: Patel
authors: Amit V
authors: AV
authors: Khera
authors: Kashif
authors: K
authors: Jafri
authors: Robert L
authors: RL
authors: Wilensky
authors: Daniel J
authors: DJ
authors: Rader
mesh_terms: D054058:Acute Coronary Syndrome / Q000378:metabolism*; D000368:Aged; D016022:Case-Control Studies; D003324:Coronary Artery Disease / Q000378:metabolism*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000494:pharmacology; D008075:Lipoproteins, HDL / Q000187:drug effects / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008075:Lipoproteins, HDL