title: High-Density Lipoprotein (HDL) Phospholipid Content and Cholesterol Efflux Capacity Are Reduced in Patients With Very High HDL Cholesterol and Coronary Disease.
abstract: OBJECTIVE
  Plasma levels of high-density lipoprotein cholesterol (HDL-C) are strongly inversely associated with coronary artery disease (CAD), and high HDL-C is generally associated with reduced risk of CAD. Extremely high HDL-C with CAD is an unusual phenotype, and we hypothesized that the HDL in such individuals may have an altered composition and reduced function when compared with controls with similarly high HDL-C and no CAD.
  
  
  RESULTS
  Fifty-five subjects with very high HDL-C (mean, 86 mg/dL) and onset of CAD at the age of ≈ 60 years with no known risk factors for CAD (cases) were identified through systematic recruitment. A total of 120 control subjects without CAD, matched for race, sex, and HDL-C level (controls), were identified. In all subjects, HDL composition was analyzed and HDL cholesterol efflux capacity was assessed. HDL phospholipid composition was significantly lower in cases (92 ± 37 mg/dL) than in controls (109 ± 43 mg/dL; P=0.0095). HDL cholesterol efflux capacity was significantly lower in cases (1.96 ± 0.39) than in controls (2.11 ± 0.43; P=0.04).
  
  
  CONCLUSIONS
  In people with very high HDL-C, reduced HDL phospholipid content and cholesterol efflux capacity are associated with the paradoxical development of CAD.
authors.affiliation: From the Division of Translational Medicine and Human Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
authors.forename: Anandita P
authors.initials: AP
authors.lastname: Agarwala
authors.affiliation: From the Division of Translational Medicine and Human Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
authors.forename: Amrith
authors.initials: A
authors.lastname: Rodrigues
authors.affiliation: From the Division of Translational Medicine and Human Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
authors.forename: Marjorie
authors.initials: M
authors.lastname: Risman
authors.affiliation: From the Division of Translational Medicine and Human Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
authors.forename: Mary
authors.initials: M
authors.lastname: McCoy
authors.affiliation: From the Division of Translational Medicine and Human Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
authors.forename: Kevin
authors.initials: K
authors.lastname: Trindade
authors.affiliation: From the Division of Translational Medicine and Human Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
authors.forename: Liming
authors.initials: L
authors.lastname: Qu
authors.affiliation: From the Division of Translational Medicine and Human Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
authors.forename: Marina
authors.initials: M
authors.lastname: Cuchel
authors.affiliation: From the Division of Translational Medicine and Human Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Billheimer
authors.affiliation: From the Division of Translational Medicine and Human Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia. rader@mail.med.upenn.edu.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Rader
mesh_terms: D000368:Aged; D002784:Cholesterol / Q000097:blood*; D008076:Cholesterol, HDL / Q000097:blood*; D003324:Coronary Artery Disease / Q000097:blood*; D004951:Esterification; D005260:Female; D006801:Humans; D008075:Lipoproteins, HDL / Q000097:blood*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
chemical_list: D008076:Cholesterol, HDL; D008075:Lipoproteins, HDL; C026277:very high density lipoproteins; D002784:Cholesterol
keywords: ABC transporters; coronary artery disease; high-density lipoprotein cholesterol
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