Abstract 12756: High-density Lipoprotein Cholesterol Level is Associated With Fibrous-cap Thickness in Patients With Acute Coronary Syndrome

Abstract

Background: While low high-density lipoprotein cholesterol (HDL-C) level has been reported as an independent risk factor for coronary heart disease, few studies addressed a relationship between HDL-C levels and morphological features of vulnerable plaque. The aim of this study was to investigate whether the presence of thin-cap fibroatheroma (TCFA) was related to HDL-C levels in patients with acute coronary syndrome (ACS).

Methods: We enrolled 211 patients with ACS who underwent optical coherence tomography (OCT) prior to percutaneous coronary intervention. Patients were divided into a TCFA group (n=102) and a non-TCFA group (n=109) according to the OCT findings of the culprit lesion. TCFA was defined as a plaque with lipid content in ≥2 quadrant and the thinnest part of the fibrous cap measuring <70 µm.

Results: There were no differences in patient’s characteristics between the two groups except for HDL-C levels (TCFA 40.7 ± 10.5 mg/dl vs. non-TCFA 46.9 ± 12.3 mg/dl, p<0.001), low-density lipoprotein cholesterol (LDL-C) levels (TCFA 121.4 ± 32.2 mg/dl vs. non-TCFA 110.9 ± 29.2 mg/dl, p=0.014), and high-sensitive C-reactive protein (hs-CRP) levels (TCFA 0.20 [0.10 to 0.36] mg/dl vs. non-TCFA 0.15 [0.10 to 0.28] mg/dl, p=0.010). Multivariate regression analysis demonstrated that HDL-C levels (β coefficient: 0.340, p<0.001), LDL-C levels (β coefficient: -0.165, p=0.012), hs-CRP levels (β coefficient: -0.139, p=0.035), and current smoking (β coefficient: -0.178, p=0.007) were independent contributors for fibrous-cap thickness.

Conclusions: Our results suggest that HDL-C is independently related to the fibrous-cap thickness in patients with ACS. HDL-C would contribute to cap thickening, resulting in plaque stabilization.