title: Low high-density lipoprotein cholesterol and low/normal body mass index are associated with increased mortality in coronary artery disease patients in Taiwan.
abstract: BACKGROUND
  Among patients with coronary artery disease (CAD), high-density lipoprotein cholesterol (HDL-C) is a cardiac protective factor. In contrast, body mass index (BMI) is inversely related to mortality, and this is known as the obesity-mortality paradox. The relationship of HDL-C and BMI to mortality, however, has not been clarified well. The aim of this study was to evaluate the impact of HDL-C and BMI on mortality among CAD patients.
  
  
  RESULTS
  A cohort of 1,114 angiographic CAD patients from the ET-CHD registry during 1997-2003 in Taiwan was studied. The subjects were categorized into 4 groups according to BMI ≥ 25 kg/m(2) (overweight/obese) or BMI <25 kg/m(2) (normal/underweight), and HDL-C higher or lower than the median of 40 mg/dl in men and 45 mg/dl in women. At a mean follow-up of 5.3 years, cardiac and all-cause death were the primary endpoints. On multivariate analysis, low HDL-C predicted higher cardiac and all-cause mortality in normal/underweight patients (hazard ratio [HR], 1.59; 95% confidence interval [CI]: 1.08-2.33; and 1.65, 95% CI: 1.25-2.19, respectively). In contrast, high BMI predicted lower cardiac and all-cause mortality in patients with low HDL-C (HR, 0.78; 95% CI: 0.54-1.14; and 0.66, 95% CI: 0.49-0.88, respectively).
  
  
  CONCLUSIONS
  Among CAD patients in Taiwan, those with low HDL-C and normal/underweight had higher risk of mortality.
authors.affiliation: Department of Public Health, Tzu-Chi University, Hualien, Taiwan.
authors.forename: Gen-Min
authors.initials: GM
authors.lastname: Lin
authors.forename: Yi-Hwei
authors.initials: YH
authors.lastname: Li
authors.forename: Chin-Lon
authors.initials: CL
authors.lastname: Lin
authors.forename: Ji-Hung
authors.initials: JH
authors.lastname: Wang
authors.forename: Chih-Lu
authors.initials: CL
authors.lastname: Han
mesh_terms: D000368:Aged; D015992:Body Mass Index; D008078:Cholesterol, LDL / Q000097:blood*; D003324:Coronary Artery Disease / Q000097:blood* / Q000401:mortality* / Q000473:pathology / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors
chemical_list: D008078:Cholesterol, LDL