Abstract 13756: Low Levels of High-Density Lipoprotein Cholesterol are Associated With the Presence of Unstable Coronary Plaques in Patients With Coronary Artery Disease
Background: Low high-density lipoprotein cholesterol (HDL-C) is associated with an increased risk of cardiovascular events. Previous intravascular ultrasound (IVUS) studies have suggested a significant association between lesion characteristics and cardiovascular events. This study utilized gray-scale IVUS to explore the relationship between HDL-C levels and culprit lesion characteristics in patients with coronary artery disease.
Methods: According to HDL-C levels, 120 patients who underwent IVUS for native, de novo coronary lesions before any intervention were divided into low HDL-C group (<40 mg/dl, n=60) or high HDL-C group (≥40 mg/dl, n=60). Quantitative and qualitative IVUS analyses were performed to compare lesion characteristics between the 2 groups.
Results: Quantitative IVUS measurements did not show significant differences between groups. HDL-C level was not significantly correlated with the remodeling index (r=0.03, p=0.78). However, attenuated plaque (defined as hypoechoic plaque with deep ultrasound attenuation) was more frequent in the low HDL-C group (48.3% vs. 28.3%, p=0.02). A greater percentage of attenuated plaque was found in this group as well (32.5±21.3% vs. 21.0±11.0%, p=0.02). Moreover, when categorized into 4 groups according to HDL-C levels, the proportion of attenuated plaque (64.7% in group with <30 mg/dl, 41.9% in group with 30-39 mg/dl, 36.4% in group with 40-59 mg/dl, and 6.3% in group with ≥60 mg/dl; p=0.001 for trend) was significantly different among groups. On multivariate analysis, only HDL-C and male gender were independently associated with the presence of attenuated plaque at the culprit lesions.
Conclusions: Patients with low levels of HDL-C are at increased risk of having unstable coronary atherosclerotic plaques.
- © 2013 by American Heart Association, Inc.