Correlation between high density lipoprotein-cholesterol and remodeling index in patients with coronary artery disease: IDEAS (IVUS diagnostic evaluation of atherosclerosis in Singapore)-HDL study

Abstract

Serum level of high density lipoprotein (HDL)-cholesterol is associated with risk of coronary artery disease. We correlated the serum level of cholesterol with coronary artery remodeling index of patients with coronary artery disease. A total of 120 patients with de novo lesions located in native coronary artery were studied. Remodeling index was based on intravascular ultrasound (IVUS) interrogation of the lesions using the static approach, and was defined as external elastic membrane (EEM) area at lesion/average EEM area at proximal and distal reference segments. The average remodeling index was 0.9 (SD: 0.2). The remodeling index was not associated with any of the demographic and coronary risk factors. Stable angina was associated with a low remodeling index. Remodeling index correlated with white blood cell count and HDL-cholesterol, but not with total cholesterol, LDL-cholesterol and triglyceride. In the multiple linear regression analysis, HDL-cholesterol and procedure indication were the only 2 significant predictors of remodeling index. An increase of 1 mg/dL of HDL-cholesterol resulted in a decrease of 0.003 (95% CI: 0.0001, 0.007; P = 0.046) in remodeling index, after adjusting for procedural indications. When stratified according to diabetic status, the negative correlation persisted in non-diabetic (P = 0.023), but not in diabetic, patients (P = 0.707). We found a negative correlation between HDL-cholesterol level and remodeling index. Diabetic status may have an influence on the observed relationship.

Intravascular Ultrasound Analysis to Determine the Relationship between High‐Density Lipoprotein Cholesterol and Lesion Characteristics in Patients with Coronary Artery Disease

“…Indeed, earlier reports have produced conflicting results on the relationship between HDL-C levels and coronary artery remodeling. [25][26][27] In the present study, we observed that remodeling index (0.96 AE 0.18 vs. 0.97 AE 0.18, P ¼ 0.70) and positive remodeling percentage (31.7% vs. 35.0%, P ¼ 0.84) were similar between the low HDL-C and high HDL-C groups. Moreover, a significant correlation between HDL-C levels and remodeling index was not found.…”

“…However, arterial remodeling is a heterogeneous process and the mechanism by which HDL‐C influences arterial remodeling is not well known. Indeed, earlier reports have produced conflicting results on the relationship between HDL‐C levels and coronary artery remodeling . In the present study, we observed that remodeling index (0.96 ± 0.18 vs. 0.97 ± 0.18, P = 0.70) and positive remodeling percentage (31.7% vs. 35.0%, P = 0.84) were similar between the low HDL‐C and high HDL‐C groups.…”

Positive remodeling index by MSCT coronary angiography: A prognostic factor for early detection of plaque rupture and vulnerability

“…Lee et al (16), had reported that HDL-cholesterol level was negatively correlated with coronary remodeling index, implying that coronary arteries tend to develop a positive remodeling pattern as serum level of HDL-cholesterol decreases. When stratified according to diabetic status of the patients, the negative correlation between HDL-cholesterol and the remodeling index was only observed in nondiabetic patients.…”

Angiotensin-(1-7) upregulates expression of adenosine triphosphate-binding cassette transporter A1 and adenosine triphosphate-binding cassette transporter G1 through the Mas receptor through the liver X receptor alpha signalling pathway in THP-1 macrophag

“…The progression of atherosclerosis contributes strongly to the differentiation of monocytes into macrophages, which accumulate cholesterol to form foam cells in the vessel wall . High‐density lipoprotein (HDL) plays a key role in protecting against atherosclerosis, mainly through reverse cholesterol transport (RCT), a process in which excess cholesterol is carried from the arterial wall back to the liver . The RCT pathway is currently considered to be the only mechanism by which the human body clears away excess cholesterol .…”

“…High‐density lipoprotein (HDL) plays a key role in protecting against atherosclerosis, mainly through reverse cholesterol transport (RCT), a process in which excess cholesterol is carried from the arterial wall back to the liver . The RCT pathway is currently considered to be the only mechanism by which the human body clears away excess cholesterol . Adenosine triphosphate‐binding cassette (ABC)A1 and ABCG1, which are members of the ABC transporter superfamily, are considered to mediate the active efflux of cholesterol to lipoprotein acceptors to promote RCT.…”