title: Prognostic Usefulness of Serum Cholesterol Efflux Capacity in Patients With Coronary Artery Disease.
abstract: Cholesterol efflux capacity has been shown to have an inverse relation with coronary artery disease (CAD) and may overcome the limitations of high-density lipoprotein (HDL) cholesterol levels as a predictor for CAD risks. We investigated the predictive value of cholesterol efflux capacity for the prognosis of CAD. Serum cholesterol efflux capacity in 313 patients newly diagnosed with CAD by coronary angiography was measured, and all patients completed a 3-year follow-up. The primary clinical end points were nonfatal myocardial infarction, nonfatal stroke, and cardiovascular mortality. The secondary clinical end points were class IV heart failure requiring hospitalization and coronary artery revascularization. Cholesterol efflux capacity was lower in patients with CAD compared with control group, and decreased cholesterol efflux capacity was associated with an increased risk of acute coronary syndrome (odds ratios, 0.25; 95% confidence interval, 0.14 to 0.46; p <0.01). There was no association between cholesterol efflux capacity and serum HDL cholesterol levels. Follow-up data showed that patients with CAD with lower cholesterol efflux capacity had higher primary clinical end point events (26 of 158 vs 8 of 155, p <0.01). Cox regression and Kaplan-Meier analysis further showed that a decreased cholesterol efflux capacity was associated with an increased risk of the primary end point events regardless of adjustment. There was no association between cholesterol efflux capacity and the secondary end point events. In conclusion, the results provide the important clinical evidence that cholesterol efflux capacity is a predictive index for plaque stability and the prognosis of CAD, independent of HDL cholesterol levels.
authors.affiliation: Department of Cardiology, The Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China; Department of Cardiology, The First Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China.
authors.forename: Jianhua
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Cardiology, The First Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China.
authors.forename: Jia
authors.initials: J
authors.lastname: Xu
authors.affiliation: Department of Cardiology, The Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China. Electronic address: wangjf_sysu@126.com.
authors.forename: Jingfeng
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Biochemistry and Physiology, Faculty of Health and Medical Sciences, School of Biosciences and Medicine, University of Surrey, Guildford, UK.
authors.forename: Changhao
authors.initials: C
authors.lastname: Wu
authors.affiliation: Department of Cardiology, The First Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China. Electronic address: anyi_xuyan@hotmail.com.
authors.forename: Yan
authors.initials: Y
authors.lastname: Xu
authors.affiliation: Department of Cardiology, The First Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China.
authors.forename: Yueguo
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Cardiology, The First Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China.
authors.forename: Fengfeng
authors.initials: F
authors.lastname: Deng
authors.affiliation: Department of Cardiology, The First Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China.
authors.forename: Zhe
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Department of Cardiology, The First Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China.
authors.forename: Xuhua
authors.initials: X
authors.lastname: Chen
authors.affiliation: Department of Cardiology, The First Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China.
authors.forename: Mengzuo
authors.initials: M
authors.lastname: Wu
authors.affiliation: Department of Cardiology, The Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China.
authors.forename: Yangxin
authors.initials: Y
authors.lastname: Chen
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D002784:Cholesterol / Q000097:blood*; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood* / Q000000981:diagnostic imaging; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; D002784:Cholesterol