Lack of Association between High-Density Lipoprotein Cholesterol and Angiographic Coronary Lesion Severity in Chinese Patients with Low Background Low-Density Lipoprotein Cholesterol.
BACKGROUND
The atheroprotective role of high-density lipoprotein (HDL-C) particles as measured by HDL-C level in coronary arterial disease (CAD) remains unsettled. The aim of our study was to ascertain whether HDL-C was associated with the development and severity of coronary artery disease in Chinese patients who underwent coronary angiogram with low background Low-density lipoprotein (LDL-C) levels, which has not been previously investigated.


METHODS
Between March 1995 and May 2000, 566 consecutive patients (408 males, 66.7 ± 11.3 years of age) with background LDL-C less than 100 mg/dl who underwent coronary artery angiography at our cath lab for suspected CAD were retrospectively recruited into the study. The severity of coronary lesions was measured by conventional coronary angiography and modified Gensini scores.


RESULTS
In those subjects with significant coronary lesions, there were more males and conventional CAD risk factors of diabetes mellitus, smoking, and chronic renal disease. They were also older compared to those in the control group. However, total cholesterol, LDL-C, HDL-C, triglyceride levels and use of statins were similar in both groups. In those subjects with significant coronary lesions, there was no difference in conventional coronary lesion severity or modified Gensini score between the quartered HDL-C subgroups. Furthermore, there was no significant correlation between serum HDL-C level and modified Gensini scores. In linear regression analysis, HDL-C was not an independent predictor for modified Gensini scores. Furthermore, HDL-C was also not an independent risk factor for the presence of significant coronary lesions in low LDL-C patients in logistic regression analysis.


CONCLUSIONS
In Chinese patients with low background LDL-C, serum HDL-C was not associated with development of CAD or lesion severity in patients with suspected CAD. Therefore, HDL-C did not appear to be atheroprotective in these patients.


BACKGROUND
Coronary artery disease; Gensini score; High-density lipoprotein cholesterol.
Cardiovascular Center, Taichung Veterans General Hospital, Taichun; ; Institute of Clinical Medicine, Cardiovascular Research Center, and Department of Medicine, National Yang Ming University School of Medicine, Taipei;
Chieh-Shou
CS
Su
Cardiovascular Center, Taichung Veterans General Hospital, Taichun;
Kuan-Ju
KJ
Chen
Department of Internal Medicine, Division of Endocrinology and Metabolism, Taichung Veterans General Hospital; ; Department of Medicine, Chung Shan Medical University; ; Institute of Medical Technology, National Chung Hsing University, Taichung; ; College of Medicine, National Yang Ming University School of Medicine, Taipei;
Wayne Huey-Herng
WH
Sheu
Department of Anesthesiology, Taichung Veterans General Hospital;
Ya-Ling
YL
Yang
Cardiovascular Center, Taichung Veterans General Hospital, Taichun; ; Institute of Clinical Medicine, Cardiovascular Research Center, and Department of Medicine, National Yang Ming University School of Medicine, Taipei;
Tsun-Jui
TJ
Liu
Cardiovascular Center, Taichung Veterans General Hospital, Taichun; ; Institute of Clinical Medicine, Cardiovascular Research Center, and Department of Medicine, National Yang Ming University School of Medicine, Taipei;
Wei-Chun
WC
Chang
Cardiovascular Center, Taichung Veterans General Hospital, Taichun; ; Department of Medicine, Chung Shan Medical University; ; Department of Medicine, China Medical University, Taichung Taiwan.
Kuo-Yang
KY
Wang
Cardiovascular Center, Taichung Veterans General Hospital, Taichun; ; Institute of Clinical Medicine, Cardiovascular Research Center, and Department of Medicine, National Yang Ming University School of Medicine, Taipei;
Wen-Lieng
WL
Lee