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HDL cholesterol, triglycerides and characteristics of coronary atherosclerosis in patients with newly diagnosed significant coronary artery disease by CTCA
Affiliations- Department of Intensive Cardiac Therapy, Institute of Cardiology, Warszawa, Poland
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Abstract
Background: Current European Society of Cardiology guidelines indicate specific target low-density lipoprotein cholesterol (LDL-C) levels for different cardiovascular risk categories in terms of prevention. However, the target for high-density lipoprotein cholesterol (HDL-C) and triglycerides have not been established.
Aim: The study aim to investigate the associations between HDL-C, triglycerides and coronary plaques characteristics.
Methods: This is a prospective single-center study with enrolled consecutive patients with newly diagnosed significant (≥1 stenosis ≥50%) CAD on CTCA. Patients had lipids and CTCA analysis, including high-risk plaque (HRP) features: low-attenuation plaque (LAP), napkin-ring sign (NRS), positive remodeling (PR) and spotty calcium (SC), type of plaque (calcified, noncalcified, mixed), and their composition (calcified, fibrous, fibro-fatty, necrotic core).
Results: The study included 300 patients (191 men, 66 [8] years). 66% of them took lipid-lowering therapy. HRP were found in 208 patients. There was no association between LDL-C, plaque composition and HRP presence. There was a negative correlation between HDL-C and fibro-fatty and necrotic core plaque components (P = 0.0002, P = 0.0009). There was a positive correlation between triglycerides and necrotic core (P = 0.038). There were differences in HDL-C and triglycerides in patients with and without NRS (47 vs. 53 mg/dl, P = 0.0002 and 128 vs. 109 mg/dl, P = 0.02). In logistic regression, HDL-C (odds ratio [OR], 0.95; 95% confidence interval [CI], 0.93‒0.98; P <0.001), triglycerides (OR, 1.00; 95% CI, 1.00‒1.01; P = 0.02), and male sex (OR, 3.04; 95% CI, 1.41‒6.52; P = 0.004) were NRS predictors. In multivariable regression only HDL-C (OR, 0.96; 95% CI, 0.93‒0.99; P = 0.02) was an independendent predictor of NRS, despite statin therapy.
Conclusion: Lower HDL-C and higher triglycerides were associated with NRS presence and more necrotic core plaque component in coronary plaques in patients with newly diagnosed CAD.
Abstract
Background: Current European Society of Cardiology guidelines indicate specific target low-density lipoprotein cholesterol (LDL-C) levels for different cardiovascular risk categories in terms of prevention. However, the target for high-density lipoprotein cholesterol (HDL-C) and triglycerides have not been established.
Aim: The study aim to investigate the associations between HDL-C, triglycerides and coronary plaques characteristics.
Methods: This is a prospective single-center study with enrolled consecutive patients with newly diagnosed significant (≥1 stenosis ≥50%) CAD on CTCA. Patients had lipids and CTCA analysis, including high-risk plaque (HRP) features: low-attenuation plaque (LAP), napkin-ring sign (NRS), positive remodeling (PR) and spotty calcium (SC), type of plaque (calcified, noncalcified, mixed), and their composition (calcified, fibrous, fibro-fatty, necrotic core).
Results: The study included 300 patients (191 men, 66 [8] years). 66% of them took lipid-lowering therapy. HRP were found in 208 patients. There was no association between LDL-C, plaque composition and HRP presence. There was a negative correlation between HDL-C and fibro-fatty and necrotic core plaque components (P = 0.0002, P = 0.0009). There was a positive correlation between triglycerides and necrotic core (P = 0.038). There were differences in HDL-C and triglycerides in patients with and without NRS (47 vs. 53 mg/dl, P = 0.0002 and 128 vs. 109 mg/dl, P = 0.02). In logistic regression, HDL-C (odds ratio [OR], 0.95; 95% confidence interval [CI], 0.93‒0.98; P <0.001), triglycerides (OR, 1.00; 95% CI, 1.00‒1.01; P = 0.02), and male sex (OR, 3.04; 95% CI, 1.41‒6.52; P = 0.004) were NRS predictors. In multivariable regression only HDL-C (OR, 0.96; 95% CI, 0.93‒0.99; P = 0.02) was an independendent predictor of NRS, despite statin therapy.
Conclusion: Lower HDL-C and higher triglycerides were associated with NRS presence and more necrotic core plaque component in coronary plaques in patients with newly diagnosed CAD.
Keywords
HDL cholesterol, coronary artery disease, high-risk plaque, cardiovascular prevention, triglycerides
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About this articleTitle
HDL cholesterol, triglycerides and characteristics of coronary atherosclerosis in patients with newly diagnosed significant coronary artery disease by CTCA
Journal
Kardiologia Polska (Polish Heart Journal)
Issue
Article type
Original article
Published online
2022-12-05
Page views
125
Article views/downloads
61
DOI
10.33963/KP.a2022.0279
Pubmed
Keywords
HDL cholesterol
coronary artery disease
high-risk plaque
cardiovascular prevention
triglycerides
Authors
Anna Oleksiak
Cezary Kępka
Cezary Kępka
Karolina Rucińska
Karolina Rucińska
Kamil Marcinkiewicz
Kamil Marcinkiewicz
Marcin Demkow
Marcin Demkow
Mariusz Kruk
Mariusz Kruk
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