Key result
Low HDL3-C linked to ~70% higher risk of periprocedural myocardial injury during elective PCI.
Why the study?
Are lower levels of HDL3-C associated with an increased incidence of periprocedural myocardial injury in patients undergoing elective PCI?
Observational (n=129)
No
Are lower levels of HDL3-C associated with an increased incidence of periprocedural myocardial injury in patients undergoing elective PCI?
Lower levels of the HDL3-C subfraction are independently associated with a higher risk of periprocedural myocardial injury during elective PCI.
Low HDL3-C may identify higher periprocedural injury risk during elective PCI; hypothesis-generating pending prospective validation.
BACKGROUND: Periprocedural myocardial injury (PMI) is a major complication of percutaneous coronary intervention (PCI) and is associated with atherosclerotic coronary plaque and worse clinical outcomes. High-density lipoprotein cholesterol (HDL-C) is a protective factor for cardiovascular disease. However, the role of HDL-C subfractions, such as HDL2 cholesterol (HDL2-C) or HDL3 cholesterol (HDL3-C), in cardiovascular disease remains unclear. The purpose of the study was to investigate the relationship between HDL2-C and HDL3-C subfractions and the incidence of PMI in patients who underwent elective PCI. METHODS: We enrolled 129 patients who underwent elective PCI for stable angina pectoris. PMI was defined as an increase in high-sensitivity troponin T levels > 5 times the upper normal limit (> 0.070 ng/mL) at 24 h after PCI. Serum HDL-C subfractions (HDL2-C and HDL3-C) were assessed using ultracentrifugation in patients with and those without PMI. RESULTS: HDL3-C levels were significantly lower in patients with PMI than in those without (15.1 ± 3.0 mg/dL vs. 16.4 ± 2.9 mg/dL, p = 0.016) and had an independent and inverse association with PMI (odds ratio, 0.86; 95% confidence interval, 0.74-0.99; p = 0.038). When divided by the cut-off value of HDL3-C for PMI (14.3 mg/dL), the incidence of PMI was significantly higher in low HDL3-C patients than in high HDL3-C patients (51.2% vs. 30.2%, p = 0.020). CONCLUSIONS: HDL3-C was an independent inverse predictor of PMI in patients who underwent elective PCI.
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Harada et al. (2018) conducted an observational in Stable angina pectoris (n=129). Low HDL3-C vs. High HDL3-C (>14.3 mg/dL) was evaluated on Periprocedural myocardial injury (PMI) (p=0.020). Low HDL3-C levels (≤14.3 mg/dL) were associated with a significantly higher incidence of periprocedural myocardial injury compared to high HDL3-C levels (51.2% vs. 30.2%) in patients undergoing elective percutaneous coronary intervention.
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