Abstract 15126: Hdl Phospholipid is Associated With Coronary Artery Disease (cad) in Individuals With Hdl-c Above the 90th Percentile Who Develop Cad
Plasma levels of high-density lipoprotein cholesterol (HDL-C) are strongly inversely associated with coronary artery disease (CAD), and high HDL-C is generally associated with apparent ‘protection’ from CAD. A minority of individuals with very high HDL-C levels also develops CAD, a paradoxical phenotype. We hypothesize that such individuals may have HDL with altered structure and/ or function, and compared these individuals (cases) to individuals with very high HDL-C without CAD (controls).
We identified 55 subjects with HDL-C above the 90th percentile, early CAD, and no major risk factors for coronary disease. We selected 2 controls without CAD per case, each matched for race, gender, and HDL-C level. Controls were selected to be the same age or no more than 10 years older than the cases. Studies to assess HDL size distribution, cholesterol efflux capacity, and lecithin-cholesterol acyltransferase (LCAT) activity in cases and controls were conducted. Characteristics of cases and controls are shown in the table below.
There was no significant difference in apolipoprotein composition of HDL-C, however there was a significant reduction in the HDL phospholipid amount in cases. Interestingly, there was no significant difference in HDL particle size, plasma LCAT activity, or plasma cholesterol efflux capacity.
These findings suggest that HDL phospholipid may be associated with an increased risk of coronary disease in subjects with very high HDL-C.
- © 2013 by American Heart Association, Inc.