Abstract 17352: Impaired HDL Metabolism is Associated with More Vulnerable Coronary Plaque Phenotype as Assessed by Intravascular Ultrasound with Radiofrequency Backscatter Analysis (IVUS-VH)
Background: Adequate maturation of smaller, cholesterol-poor HDL particles to larger, cholesterol-rich HDL particles is critical for reverse cholesterol transport to counteract atherosclerosis. HDL-subclass profile has been associated with angiographic coronary disease but not as defined by IVUS-VH.
Methods: 40 patients prospectively had IVUS-VH using 20 mHz probe with standard pullback (0.5 mm/s). Plaque volume, fibrous tissue (FI), fibro-fatty (FF), necrotic core (NC) and dense calcium (DC) were quantified. HDL-C was measured by standard enzymatic methods, apolipoprotein (apo) B, apoA-I and Lp-PLA2 by immuno-turbidometry and HDL subclasses by two-dimensional native-gel electrophoresis, immunoblotting, and image analysis (2dPAGE). Relationship between biomarkers and plaque parameters were assessed by linear correlation.
Results: Higher HDL-C levels were associated with less plaque volume and NC and higher apoA-I levels were associated with less NC and DC. In general, the larger, more mature HDL particles (α-1 and α-2) were associated with less plaque and NC volume; the smaller, less mature HDL particles (α-3 and α-4) were associated with more plaque and NC volume. Higher Lp-PLA2 levels -an inflammatory marker- were associated with more NC.
Conclusions: This is the first validation using IVUS-VH and 2dPAGE that indicates that impaired HDL metabolism/remodeling is associated with more vulnerable coronary plaque phenotype.
- © 2010 by American Heart Association, Inc.