title: Impaired antioxidant HDL function is associated with premature myocardial infarction.
abstract: BACKGROUND
  There is growing evidence that the predictive value of HDL cholesterol levels for cardiovascular risk stratification is limited in patients with coronary artery disease (CAD). HDL function seems to be a more sensitive surrogate of cardiovascular risk estimation than simple serum levels. Therefore, we aimed to assess whether impaired antioxidant HDL function is involved in the development of premature acute myocardial infarction (AMI).
  
  
  METHODS
  In this multicentre case-control study, we compared the antioxidant function of HDL, measured by the HDL inflammatory index (HII), and HDL particle size in 184 patients comprising 92 patients with AMI at a very young age (≤40 years of age) and 92 age- and gender-matched controls.
  
  
  RESULTS
  Antioxidant capacities of HDL were significantly impaired in the acute phase of AMI (HII of 1·50 [IQR 1·10-1·74] vs. 0·56 [IQR 0·41-0·86] in controls, P < 0·001 as well as in the chronic stable phase 1 year after the event (HII of 0·85 [IQR 0·72-1·03] vs. 0·56 [IQR 0·41-0·86], P < 0·001) compared to controls. Moreover, HDL function in the stable phase remained significantly associated with premature MI in adjusted logistic regression analysis with an OR of 2·24 per SD increase of HII (95% CI 1·28-3·91; P = 0·005). Analyses of HDL size revealed a significant correlation between all HDL subfractions and HDL function in controls, whereas this correlation was lost for large and intermediate HDL in AMI patients.
  
  
  CONCLUSIONS
  Impaired antioxidant function of HDL is independently associated with the development of premature AMI. The maintenance of HDL function might evolve into a significant therapeutic target, especially in patients with premature CAD.
authors.affiliation: Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria.
authors.forename: Klaus
authors.initials: K
authors.lastname: Distelmaier
authors.affiliation: Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria.
authors.forename: Franz
authors.initials: F
authors.lastname: Wiesbauer
authors.affiliation: Department of Internal Medicine I - Cardiology, Linz General Hospital, Johannes Kepler University School of Medicine, Linz, Austria.
authors.forename: Hermann
authors.initials: H
authors.lastname: Blessberger
authors.affiliation: Department of Internal Medicine II, University of Bratislava, Bratislava, Slovakia.
authors.forename: Stanislav
authors.initials: S
authors.lastname: Oravec
authors.affiliation: Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria.
authors.forename: Lore
authors.initials: L
authors.lastname: Schrutka
authors.affiliation: Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria.
authors.forename: Christina
authors.initials: C
authors.lastname: Binder
authors.affiliation: Krankenanstalten Dr. Dostal, Vienna, Austria.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Dostal
authors.affiliation: Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria.
authors.forename: Martin
authors.initials: M
authors.lastname: Schillinger
authors.affiliation: Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria.|Ludwig Boltzmann Cluster for Cardiovascular Research, Vienna, Austria.|Core Facilities, Medical University of Vienna, Vienna, Austria.
authors.forename: Johann
authors.initials: J
authors.lastname: Wojta
authors.affiliation: Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria.
authors.forename: Irene M
authors.initials: IM
authors.lastname: Lang
authors.affiliation: Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria.
authors.forename: Gerald
authors.initials: G
authors.lastname: Maurer
authors.affiliation: Third Medical Department, Cardiology and Intensive Care Medicine, Wilhelminenhospital, Vienna, Austria.
authors.forename: Kurt
authors.initials: K
authors.lastname: Huber
authors.affiliation: Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria.
authors.forename: Georg
authors.initials: G
authors.lastname: Goliasch
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000975:Antioxidants / Q000378:metabolism / Q000502:physiology*; D016022:Case-Control Studies; D008076:Cholesterol, HDL / Q000378:metabolism / Q000502:physiology*; D003324:Coronary Artery Disease / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology*; D012307:Risk Factors; D055815:Young Adult
chemical_list: D000975:Antioxidants; D008076:Cholesterol, HDL
keywords: Acute myocardial infarction; antioxidant function; high-density lipoprotein; premature coronary artery disease