Association between high-density lipoprotein (HDL) levels and severity of coronary artery disease on angiography

Muhammad  Muttahir; Sasha BScN RN Vereecken; Bibi Zahida Kazmi; Muhammad Afnan

Authors

Muhammad Muttahir Medicine and Surgery, Khyber Medical College, Peshawar, Pakistan Author
Sasha BScN RN Vereecken Department of Clinical Science, Saint James School of Medicine, Anguilla Author
Bibi Zahida Kazmi MBBS, Khyber Medical University Institute of Medical Sciences, Kohat, Pakistan Author
Muhammad Afnan MBBS, Khyber Medical University Institute of Medical Sciences, Kohat, Pakistan Author

Keywords:

high-density lipoprotein, coronary artery disease, angiography, hypertension, diabetes, risk stratification

Abstract

Background: This retrospective observational study's goal was to evaluate if high-density lipoprotein (HDL) levels correlate with the degree of coronary artery disease (CAD), as assessed by angiography.

Methodology: The research comprised 160 individuals who had coronary angiography. Data on the
demographics of the patients, as well as their medical information, HDL levels, and angiographic findings were collected using a standardized proforma. The severity of CAD was assessed using the SYNTAX score. Statistical analysis, including independent “t-tests, chi-square tests, and correlation analysis, was performed using SPSS”.

Results: The results revealed a significant association between HDL levels and CAD severity. When
the comparison was done to patients with mild-to-moderate CAD, the ones with severe CAD had considerably lower mean HDL values (p≤0.001). Even after accounting for any confounding variables, there was still a substantial correlation between HDL levels and the severity of CAD. Furthermore, significant associations were found between HDL levels and gender, hypertension, and diabetes, indicating a potential interplay between these factors and HDL in CAD development.

Conclusion: This study provides evidence for the association between lower HDL levels and increased CAD severity. Maintaining optimal HDL levels may have clinical implications for risk stratification and management of CAD. Gender-specific differences and associations with comorbidities such as hypertension and diabetes highlight the need for tailored approaches in CAD prevention and treatment. Prospective research with bigger and more varied populations is necessary to confirm these results and investigate the underlying causes.

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References

Ralapanawa U, Sivakanesan R. Epidemiology and the magnitude of coronary artery disease and acute coronary syndrome: a narrative review. Journal of epidemiology and global health. 2021 Jun;11(2):169.

Sintek M, Zajarias A. Patient evaluation and selection for transcatheter aortic valve replacement: the heart team approach. Progress in cardiovascular diseases. 2014 May 1;56(6):572-82.

Bruce IN, Urowitz MB, Gladman DD, Ibañez D, Steiner G. Risk factors for coronary heart disease in women with systemic lupus erythematosus: the Toronto Risk Factor Study. Arthritis & Rheumatism. 2003 Nov;48(11):3159-67.

Gable DR, Hurel SJ, Humphries SE. Adiponectin and its gene variants as risk factors for insulin resistance, the metabolic syndrome and cardiovascular disease. Atherosclerosis. 2006 Oct 1;188(2):231-44.

Ganjali S, Momtazi AA, Banach M, Kovanen PT, Stein EA, Sahebkar A. HDL abnormalities in familial hypercholesterolemia: Focus on biological functions. Progress in lipid research. 2017 Jul 1;67:16-26.

Frohlich J, Dobiasova M. Fractional esterification rate of cholesterol and ratio of triglycerides to HDL-cholesterol are powerful predictors of positive findings on coronary angiography. Clinical chemistry. 2003 Nov 1;49(11):1873-80.

Chidambaram V, Shanmugavel Geetha H, Kumar A, Majella MG, Sivakumar RK, Voruganti D, Mehta JL, Karakousis PC. Association of lipid levels with COVID-19 infection, disease severity and mortality: a systematic review and meta-analysis. Frontiers in Cardiovascular Medicine. 2022 Mar 24;9:862999.

Liao P, Zeng R, Zhao X, Guo L, Zhang M. Prognostic value of non-high-density lipoprotein cholesterol for mortality in patients with coronary heart disease: a systematic review and meta-analysis. International journal of cardiology. 2017 Jan 15;227:950-5.

Taylor RS, Brown A, Ebrahim S, Jolliffe J, Noorani H, Rees K, Skidmore B, Stone JA, Thompson DR, Oldridge N. Exercise-based rehabilitation for patients with coronary heart disease: systematic review and meta-analysis of randomized controlled trials. The American journal of medicine. 2004 May 15;116(10):682-92.

Liou L, Kaptoge S. Association of small, dense LDL-cholesterol concentration and lipoprotein particle characteristics with coronary heart disease: a systematic review and meta-analysis. PloS one. 2020 Nov 9;15(11):e0241993.

Sacks FM. The role of high-density lipoprotein (HDL) cholesterol in the prevention and treatment of coronary heart disease: expert group recommendations. American Journal of Cardiology. 2002 Jul 15;90(2):139-43.

Vallee A, Lelong H, Lopez-Sublet M, Topouchian J, Safar ME, Blacher J. Association between different lipid parameters and aortic stiffness: clinical and therapeutic implication perspectives. Journal of hypertension. 2019 Nov 1;37(11):2240-6.

Adorni MP, Ronda N, Bernini F, Zimetti F. High density lipoprotein cholesterol efflux capacity and atherosclerosis in cardiovascular disease: pathophysiological aspects and pharmacological perspectives. Cells. 2021 Mar 5;10(3):574.

Lv S, Zhang H, Chen J, Shen Z, Zhu C, Gu Y, Yu X, Zhang D, Wang Y, Ding X, Zhang X. The effect of triglycerides to high-density lipoprotein cholesterol ratio on the reduction of renal function: findings from China health and retirement longitudinal study (CHARLS). Lipids in Health and Disease. 2021 Dec;20(1):1-9

Kim SH, Son KY. Association between lipoprotein cholesterol and future cardiovascular disease and mortality in older adults: a Korean nationwide longitudinal study. Lipids in Health and Disease. 2021 Dec;20(1):1-1.

Lind L, Ingelsson M, Sundstrom J, Ärnlöv J. Impact of risk factors for major cardiovascular diseases: a comparison of life-time observational and Mendelian randomisation findings. Open heart. 2021 Sep 1;8(2):e001735.