High-density lipoprotein subclass profile and mortality in patients with coronary artery disease: Results from the GENES study.
BACKGROUND
High-density lipoproteins (HDLs) are highly heterogeneous particles, and the specific contribution of each subclass to the prediction of clinical outcome in coronary artery disease (CAD) remains controversial.


OBJECTIVE
To examine the relationship between HDL subclass profile and mortality in patients with CAD, using a new and rapid electrophoretic quantitative method for the assessment of HDL particle size phenotype.


METHODS
We investigated 403 patients with CAD admitted for cardiovascular examination in the context of evaluation and management of CAD. HDL subclass distribution was analysed using the Quantimetrix Lipoprint®HDL system. Cumulative survival of patients according to lipid variables was determined by the Kaplan-Meier method. The relationship between baseline variables and outcome criteria was assessed using Cox proportional hazards regression analysis.


RESULTS
During follow-up (9.8±3.1 years) the mortality rate was 31.0%; 60.8% of deaths were related to CAD. The concentration of total HDL cholesterol was similar in deceased patients (42±13mg/dL) and alive patients (43±12mg/dL); the concentrations of small, intermediate and large HDL cholesterol subclasses were not significantly different in alive and deceased patients (P=0.17, P=0.34 and P=0.81, respectively). We did not observe any independent associations between overall or cardiovascular mortality and total HDL cholesterol or any HDL subclass. However, heart rate, left ventricular ejection fraction and severity score for coronary atherosclerosis were more associated with mortality than classical cardiovascular risk factors.


CONCLUSIONS
HDL subclass profile is not associated with mortality in patients with CAD. Further investigations linking HDL subclass repartition with prediction of residual cardiovascular risk are required.
Inserm UMR-1048, Institute of Metabolic and Cardiovascular Diseases, 1, avenue Jean-Poulhès, 31432 Toulouse, France; Toulouse University Paul-Sabatier, 31062 Toulouse, France; Department of Cardiology, CHU de Toulouse, 31432 Toulouse, France.
Meyer
M
Elbaz
Inserm UMR-1048, Institute of Metabolic and Cardiovascular Diseases, 1, avenue Jean-Poulhès, 31432 Toulouse, France; Toulouse University Paul-Sabatier, 31062 Toulouse, France.
Julien
J
Faccini
Toulouse University Paul-Sabatier, 31062 Toulouse, France; Inserm UMR-1027, épidémiologie et analyses en santé publique, 31000 Toulouse, France.
Vanina
V
Bongard
Inserm UMR-1048, Institute of Metabolic and Cardiovascular Diseases, 1, avenue Jean-Poulhès, 31432 Toulouse, France; Toulouse University Paul-Sabatier, 31062 Toulouse, France.
Cécile
C
Ingueneau
Toulouse University Paul-Sabatier, 31062 Toulouse, France; Department of Cardiology, CHU de Toulouse, 31432 Toulouse, France; Inserm UMR-1027, épidémiologie et analyses en santé publique, 31000 Toulouse, France.
Dorotea
D
Taraszkiewicz
Inserm UMR-1048, Institute of Metabolic and Cardiovascular Diseases, 1, avenue Jean-Poulhès, 31432 Toulouse, France; Department of Biochemistry, CHU de Toulouse, 31432 Toulouse, France.
Bertrand
B
Perret
Toulouse University Paul-Sabatier, 31062 Toulouse, France; Department of Cardiology, CHU de Toulouse, 31432 Toulouse, France; Inserm UMR-1027, épidémiologie et analyses en santé publique, 31000 Toulouse, France.
Jean
J
Ferrières
Toulouse University Paul-Sabatier, 31062 Toulouse, France; Department of Cardiology, CHU de Toulouse, 31432 Toulouse, France.
Jean-Bernard
JB
Ruidavets
Inserm UMR-1048, Institute of Metabolic and Cardiovascular Diseases, 1, avenue Jean-Poulhès, 31432 Toulouse, France; Toulouse University Paul-Sabatier, 31062 Toulouse, France. Electronic address: cecile.vindis@inserm.fr.
Cécile
C
Vindis
D000368:Aged; D015415:Biomarkers / Q000097:blood; D003324:Coronary Artery Disease / Q000097:blood* / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006801:Humans; D008075:Lipoproteins, HDL / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends
D015415:Biomarkers; D008075:Lipoproteins, HDL
Coronary artery disease; High-density lipoprotein; High-density lipoprotein subclasses; Lipoprotéines de haute densité (HDL); Maladie coronaire; Mortality; Mortalité; Sous-classes de HDL