Key result
Lower HDL-C (51.9 vs. 60.3 mg/dL; P<0.001) and higher CRP (1.02 vs. 0.65 mg/dL; P<0.001) were independently associated with the prevalence of angiographic coronary artery disease.
Cross-Sectional (n=5,641)
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Cohort study reveals HDL-C and CRP independently associate with coronary artery disease in patients undergoing angiography, highlighting HDL-C as a key predictor of disease severity.
BACKGROUND: Although high-density lipoprotein cholesterol (HDL-C) and C-reactive protein (CRP) are well-established predictors for future cardiovascular events, little information is available regarding their correlation with the prevalence and severity of angiographically evaluated coronary artery disease (CAD). MATERIAL AND METHODS: Five thousand six hundred forty-one consecutive patients undergoing coronary angiography for the evaluation of CAD were analysed. Cardiovascular risk factors were assessed by routine blood chemistry and questionnaire. CAD severity was graded by visual estimation of lumen diameter stenosis with significant stenoses defined as lumen diameter reduction of >or= 70%. Coronary angiograms were graded as one-, two- or three-vessel disease, as nonsignificant CAD (lumen irregularities < 70%) or non-CAD. RESULTS: HDL-C (60.3 +/- 18.5 vs. 51.9 +/- 15.3 mg dL(-1); P < 0.001) was higher and CRP was lower (0.65 +/- 1.68 vs. 1.02 +/- 2.38 mg dL(-1); P < 0.001) in non-CAD (n = 1517) compared to overall CAD patients (n = 4124). CAD patients were older (65.2 +/- 10.5 years vs. 59.9 +/- 11.4 years), more often diabetics (19.2% vs. 10.6%) and hypertensives (79.2% vs. 66.0%) and included more smokers (18.8% vs. 16.5%) (all P < 0.005). Low-density lipoprotein cholesterol (124.5 +/- 38.3 vs. 126.0 +/- 36.3 mg dL(-1); P = NS) was similar in overall CAD and non-CAD patients with more statin users (43.4% vs. 27.9%; P < 0.001) among CAD patients. Comparing non-CAD with different CAD severities using analysis of variance, results did not change substantially. In a multivariate analysis, HDL-C and CRP remained independently associated with the prevalence of CAD. In addition, HDL-C is also a potent predictor for the severity of CAD. CONCLUSIONS: In this large consecutive patient cohort, HDL-C and CRP are independently associated with the prevalence of CAD. In this analysis, HDL-C is an even stronger predictor for CAD than some other major classical risk factors.
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Alber et al. (2008) conducted a cross-sectional in Coronary artery disease (n=5,641). High-density lipoprotein cholesterol (HDL-C) and C-reactive protein (CRP) levels vs. Non-CAD vs. CAD severity groups was evaluated on Prevalence and severity of angiographically evaluated coronary artery disease (significant stenosis defined as lumen diameter reduction ≥70%) (p=<0.001). Lower HDL-C (51.9 vs. 60.3 mg/dL; P<0.001) and higher CRP (1.02 vs. 0.65 mg/dL; P<0.001) were independently associated with the prevalence of angiographic coronary artery disease.
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