title: High-density lipoprotein cholesterol level is associated with fibrous cap thickness in acute coronary syndrome.
abstract: BACKGROUND
  Although low high-density lipoprotein cholesterol (HDL-C) level has been reported as an independent risk factor for coronary artery disease, few studies addressed the direct relationship between the presence of thin-cap fibroatheroma (TCFA) that is considered as vulnerable plaque in pathology and HDL-C level. The aim of this study was to investigate whether lesion vulnerability is related to HDL-C level in patients with acute coronary syndrome (ACS).
  
  
  RESULTS
  A total of 261 patients with ACS who underwent optical coherence tomography prior to percutaneous coronary intervention, were enrolled. Patients were divided into a TCFA group (n=124) and a non-TCFA group (n=137). TCFA was defined as a lipid plaque (lipid content in ≥1 quadrant) covered with <70 μm-thickness fibrous caps. There were no differences in patient characteristics and clinical results between the 2 groups except for HDL-C level, low-density lipoprotein cholesterol (LDL-C) level, and high-sensitive C-reactive protein (hs-CRP) level. On multivariate regression analysis, low HDL-C level (β coefficient: 0.302, P<0.001), high LDL-C level (β coefficient: -0.172, P=0.008), hs-CRP level (β coefficient: -0.145, P=0.017), and current smoking (β coefficient: -0.124, P=0.028) were identified as independent contributors to fibrous cap thickness.
  
  
  CONCLUSIONS
  HDL-C is correlated with fibrous cap thickness of the culprit lesion in patients with ACS. HDL-C may be considered as a therapeutic target for plaque stabilization.
authors.affiliation: Department of Cardiovascular Medicine, Wakayama Medical University.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Ozaki
authors.forename: Atsushi
authors.initials: A
authors.lastname: Tanaka
authors.forename: Kenichi
authors.initials: K
authors.lastname: Komukai
authors.forename: Kohei
authors.initials: K
authors.lastname: Ishibashi
authors.forename: Takashi
authors.initials: T
authors.lastname: Tanimoto
authors.forename: Hironori
authors.initials: H
authors.lastname: Kitabata
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Ino
authors.forename: Takashi
authors.initials: T
authors.lastname: Kubo
authors.forename: Toshio
authors.initials: T
authors.lastname: Imanishi
authors.forename: Takashi
authors.initials: T
authors.lastname: Akasaka
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood* / Q000473:pathology*; D000368:Aged; D008076:Cholesterol, HDL / Q000097:blood*; D008078:Cholesterol, LDL / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000097:blood* / Q000473:pathology*; D041623:Tomography, Optical Coherence
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL