title: Levels of High-Density Lipoprotein Cholesterol are Associated With Biomarkers of Inflammation in Patients With Acute Coronary Syndrome.
abstract: Pathologic conditions associated with inflammation show an inverse correlation between high-density lipoprotein cholesterol (HDL-C) and inflammatory biomarker levels. Our aim was to investigate, in patients with acute coronary syndrome (ACS), whether very low HDL-C levels are associated with inflammatory biomarkers. In a cross-sectional study, we included 6,134 patients with ACS; they were classified as having very low (<30 mg/dl), low (30 to 39.9 mg/dl), and normal HDL-C (≥ 40 mg/dl) levels. We analyzed the association of different categories of HDL-C levels with serum levels of inflammatory biomarkers, high-sensitivity C-reactive protein (hs-CRP), albumin, and white blood cell count at admission. Overall, 18.5% of patients had very low HDL-C levels. Patients with very low HDL-C levels, compared to patients with low or normal HDL-C levels, had the highest hs-CRP (median 17.8 [interquartile range 7.2 to 54.5] vs 12.6 [5.6 to 33.9] vs 12.0 [5.4 to 36.9] mg/L, respectively, p <0.001) and the lowest albumin levels (median 3.6 [IQR 3.3 to 4.0] vs 3.8 [3.5 to 4.0] vs 3.8 [3.5 to 4.1] g/dl, respectively, p <0.001). White blood cell count did not differ significantly (p = 0.40). The multivariate analysis showed that albumin ≤ 3.5 g/dl (odds ratio 2.16, 95% confidence interval 1.88 to 2.49, p <0.001) and hs-CRP ≥ 10 mg/L (odds ratio 1.35, 95% confidence interval 1.17 to 1.55, p <0.001) were independent predictors of very low HDL-C levels. Patients with very low HDL-C levels had the highest inhospital mortality rates compared with the other groups. In conclusion, in patients with ACS, hs-CRP and serum albumin were associated independently with very low HDL-C levels.
authors.affiliation: Coronary Care Unit, National Institute of Cardiology, Mexico City, Mexico. Electronic address: hectorglezp@hotmail.com.
authors.forename: Héctor
authors.initials: H
authors.lastname: González-Pacheco
authors.affiliation: Department of Immunology, National Institute of Cardiology, Mexico City, Mexico; Department of Health Care, Metropolitan Autonomous University, Mexico City, Mexico.
authors.forename: Luis M
authors.initials: LM
authors.lastname: Amezcua-Guerra
authors.affiliation: Department of Nephrology, National Institute of Cardiology, Mexico City, Mexico.
authors.forename: Armando
authors.initials: A
authors.lastname: Vazquez-Rangel
authors.affiliation: Coronary Care Unit, National Institute of Cardiology, Mexico City, Mexico.
authors.forename: Carlos
authors.initials: C
authors.lastname: Martínez-Sánchez
authors.affiliation: Department of Molecular Biology, National Institute of Cardiology, Mexico City, Mexico.
authors.forename: Oscar
authors.initials: O
authors.lastname: Pérez-Méndez
authors.affiliation: Department of Cardiology, National Institute of Cardiology, Mexico City, Mexico.
authors.forename: Juan
authors.initials: J
authors.lastname: Verdejo
authors.affiliation: Department of Immunology, National Institute of Cardiology, Mexico City, Mexico; Department of Health Care, Metropolitan Autonomous University, Mexico City, Mexico.
authors.forename: Rafael
authors.initials: R
authors.lastname: Bojalil
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood* / Q000401:mortality; D000210:Acute-Phase Reaction / Q000097:blood; D000368:Aged; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000032:analysis; D008076:Cholesterol, HDL / Q000097:blood*; D003430:Cross-Sectional Studies; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007249:Inflammation / Q000097:blood*; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012709:Serum Albumin / Q000032:analysis
chemical_list: D015415:Biomarkers; D008076:Cholesterol, HDL; D012709:Serum Albumin; D002097:C-Reactive Protein