title: Relationship of high-density lipoprotein cholesterol with periprocedural myocardial injury following elective percutaneous coronary intervention in patients with low-density lipoprotein cholesterol below 70 mg/dL.
abstract: BACKGROUND
  Recent data showed inconsistent association of high-density lipoprotein cholesterol (HDL-C) with cardiovascular risk in patients with different levels of low-density lipoprotein cholesterol (LDL-C) or intensive statin therapy. This study sought to determine the relationship of HDL-C with periprocedural myocardial injury following elective percutaneous coronary intervention (PCI) across a range of LDL-C levels, especially in patients with LDL-C <70 mg/dL.
  
  
  RESULTS
  We enrolled 2529 consecutive patients with normal preprocedural cardiac troponin I (cTnI) who underwent elective PCI. The association between preprocedural HDL-C and periprocedural myocardial injury was evaluated across LDL-C levels, especially in patients with LDL-C <70 mg/dL. The HDL-C level was not predictive of periprocedural myocardial injury across the entire study cohort. However, among patients with LDL-C <70 mg/dL, a 1 mg/dL increase in HDL-C was associated with a 3% reduced risk for postprocedural cTnI above 1×upper limit of normal (ULN) (odds ratio: 0.97; 95% CI: 0.95 to 0.99; P=0.004), a 3% reduced risk for postprocedural cTnI above 3×ULN odds ratio: 0.97; 95% CI: 0.95 to 0.99; P=0.022), and a 3% reduced risk for postprocedural cTnI above 5×ULN (odds ratio: 0.97; 95% CI: 0.95 to 0.99; P=0.017). The relation between plasma HDL-C level and risk of postprocedural cTnI elevation above 1×ULN, 3×ULN, and 5×ULN was modified by LDL-C level (all P for interaction <0.05).
  
  
  CONCLUSIONS
  Higher HDL-C levels were associated with reduced risk of periprocedural myocardial injury only in patients with LDL-C <70 mg/dL.
authors.affiliation: Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, XiCheng District, Beijing, China (X.L.L., Y.L.G., C.G.Z., R.X.X., P.Q., N.Q.W., L.X.J., B.X., R.L.G., J.J.L.).
authors.forename: Xiao-Lin
authors.initials: XL
authors.lastname: Li
authors.affiliation: Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, XiCheng District, Beijing, China (X.L.L., Y.L.G., C.G.Z., R.X.X., P.Q., N.Q.W., L.X.J., B.X., R.L.G., J.J.L.).
authors.forename: Yuan-Lin
authors.initials: YL
authors.lastname: Guo
authors.affiliation: Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, XiCheng District, Beijing, China (X.L.L., Y.L.G., C.G.Z., R.X.X., P.Q., N.Q.W., L.X.J., B.X., R.L.G., J.J.L.).
authors.forename: Cheng-Gang
authors.initials: CG
authors.lastname: Zhu
authors.affiliation: Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, XiCheng District, Beijing, China (X.L.L., Y.L.G., C.G.Z., R.X.X., P.Q., N.Q.W., L.X.J., B.X., R.L.G., J.J.L.).
authors.forename: Rui-Xia
authors.initials: RX
authors.lastname: Xu
authors.affiliation: Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, XiCheng District, Beijing, China (X.L.L., Y.L.G., C.G.Z., R.X.X., P.Q., N.Q.W., L.X.J., B.X., R.L.G., J.J.L.).
authors.forename: Ping
authors.initials: P
authors.lastname: Qing
authors.affiliation: Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, XiCheng District, Beijing, China (X.L.L., Y.L.G., C.G.Z., R.X.X., P.Q., N.Q.W., L.X.J., B.X., R.L.G., J.J.L.).
authors.forename: Na-Qiong
authors.initials: NQ
authors.lastname: Wu
authors.affiliation: Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, XiCheng District, Beijing, China (X.L.L., Y.L.G., C.G.Z., R.X.X., P.Q., N.Q.W., L.X.J., B.X., R.L.G., J.J.L.).
authors.forename: Li-Xin
authors.initials: LX
authors.lastname: Jiang
authors.affiliation: Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, XiCheng District, Beijing, China (X.L.L., Y.L.G., C.G.Z., R.X.X., P.Q., N.Q.W., L.X.J., B.X., R.L.G., J.J.L.).
authors.forename: Bo
authors.initials: B
authors.lastname: Xu
authors.affiliation: Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, XiCheng District, Beijing, China (X.L.L., Y.L.G., C.G.Z., R.X.X., P.Q., N.Q.W., L.X.J., B.X., R.L.G., J.J.L.).
authors.forename: Run-Lin
authors.initials: RL
authors.lastname: Gao
authors.affiliation: Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, XiCheng District, Beijing, China (X.L.L., Y.L.G., C.G.Z., R.X.X., P.Q., N.Q.W., L.X.J., B.X., R.L.G., J.J.L.).
authors.forename: Jian-Jun
authors.initials: JJ
authors.lastname: Li
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood*; D008078:Cholesterol, LDL / Q000097:blood*; D015331:Cohort Studies; D017023:Coronary Angiography / Q000379:methods; D023921:Coronary Stenosis / Q000097:blood / Q000000981:diagnostic imaging / Q000601:surgery*; D017558:Elective Surgical Procedures / Q000379:methods; D004562:Electrocardiography / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000401:mortality / Q000503:physiopathology; D016017:Odds Ratio; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000379:methods*; D019990:Perioperative Care; D011379:Prognosis; D012044:Regression Analysis; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL
keywords: high‐density lipoprotein cholesterol; low‐density lipoprotein cholesterol; percutaneous coronary intervention; periprocedural myocardial injury