Abstract 15426: HDL Functionality Could be a Novel Marker for Predicting Restenosis after Stent Implantation
Objective: The HDL cholesterol (HDL-C) level shows a strong inverse association with the incidence of cardiovascular disease. HDL provides cardiovascular protection mainly by promoting reverse cholesterol transport. We hypothesized that the cholesterol efflux capacity and the anti-oxidative capacity of HDL could be used to predict restenosis after stent implantation.
Methods: The participants included FU-Registry patients who were successfully implanted with a drug-eluting stent or bare-metal stent at Fukuoka University Hospital. Follow-up coronary angiography was performed 6-8 months after stenting. We examined HDL cholesterol efflux capacity with an ex vivo system that used J774 macrophages and apolipoprotein B-depleted plasma from the study participants. The anti-oxidative capacity of HDL was determined by 2 different cell-free assay systems using 2',7'-dichlorofluorescin-diacetate (DCFH-DA) and dihydrorhodamine 123 (DHR). In-stent percent diameter stenosis (%DS) was determined at the time of stent implantation (Baseline) and at follow-up coronary angiography (F-up) by quantitative coronary angiogram (QCA). In-stent late loss was also determined by QCA at F-up.
Results: There was a weak correlation between the HDL-C level and the efflux capacity at F-up (r= 0.27, p=0.06). Cholesterol efflux capacity (Baseline), but not the HDL-C or LDL-C level (Baseline), showed inverse associations with Δ%DS (Δ%DS=%DS at F-up minus %DS at Baseline) (efflux capacity; r= -0.38, p=0.006, HDL-C; r= 0.05, p=0.71, and LDL-C; r= -0.07, p= 0.60) and In-stent late loss (efflux capacity; r=-0.36, p=0.01, HDL-C; r= 0.13, p=0.34, and LDL-C; r= 0.06, p= 0.65). Cholesterol efflux capacity (F-up), but not the HDL-C or LDL-C level (F-up), was also significantly correlated with In-stent late loss (efflux capacity; r=-0.32, p=0.03, HDL-C; r=-0.08, p= 0.55, LDL-C; r= -0.14, p= 0.29). Interestingly, the anti-oxidative activity of HDL as determined by two different cell-free assay systems using DCFH-DA and DHR was not associated with Δ%DS or in-stent late loss.
Conclusions: The cholesterol efflux capacity of HDL, but not the anti-oxidative capacity of HDL, could be a novel marker for predicting restenosis after stent implantation.
- © 2012 by American Heart Association, Inc.