Key result
Patients with acute coronary syndrome exhibited significant HDL subclass remodeling, with higher levels of small-sized pre beta1-HDL and lower levels of large-sized HDL2b compared to patients with stable angina pectoris and normal controls.
Observational (n=321)
No
p-value: p=<0.05
ACS is associated with a remodeling of the HDL subclass distribution profile, characterized by higher levels of small-sized HDL and lower levels of large-sized HDL, which may serve as a novel biomarker for risk stratification.
May support HDL subclass profiling for ACS risk stratification; hypothesis-generating and requires prospective validation before clinical adoption.
BACKGROUND: High-density lipoprotein (HDL) enhances cholesterol efflux from the arterial wall and exhibits potent anti-inflammatory and anti-atherosclerosis (AS) properties. Whether raised HDL levels will clinically benefit patients with acute coronary syndrome (ACS) and the value at which these effects will be apparent, however, is debatable. This study examined the HDL subclass distribution profile in patients with ACS. METHODS: Plasma HDL subclasses were measured in 158 patients with established ACS and quantified by two-dimensional gel electrophoresis and immunoblotting. ACS diagnosis was based on symptoms of cardiac ischemia, electrocardiogram (ECG) abnormalities, speciality cardiac enzyme change along with presence of coronary heart disease (CHD) on coronary angiography. RESULTS: The small-sized preβ1-HDL, HDL3b, and HDL3a levels were significantly higher, and the large-sized HDL2a and HDL2b levels were significantly lower in patients with ACS than in those with stable angina pectoris (SAP) and in normal control subjects. Meanwhile, with an elevation in the low-density lipoprotein cholesterol (LDL-C), fasting plasma glucose (FPG), body mass index (BMI), and blood pressure (BP), and the reduction in the high density lipoprotein cholesterol (HDL-C) levels, the HDL2b contents significantly decreased and the preβ1-HDL contents significantly increased in patients with ACS. The correlation analysis revealed that the apolipoprotein (apo)A-I levels were positively and significantly with all HDL subclasses contents; plasma total cholesterol (TC) and fasting plasma glucose (FPG) levels were inversely associated with HDL2a, and HDL2b. Moreover, the FPG levels were positively related to HDL3c, HDL3b, and HDL3a in ACS patients. CONCLUSION: The HDL subclass distribution profile remodeling was noted in the patients with ACS. Plasma lipoprotein and FPG levels, BP, and BMI play an important role in the HDL subclass metabolism disorder for patients with ACS. The HDL subclass distribution phenotype might be useful as a novel biomarker to assist in the risk stratification of patients with ACS.
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Tian et al. (2014) conducted an observational in Acute Coronary Syndrome (n=321). Acute Coronary Syndrome vs. Stable Angina Pectoris and Normal Controls was evaluated on HDL subclass distribution (p=<0.05). Patients with acute coronary syndrome exhibited significant HDL subclass remodeling, with higher levels of small-sized pre beta1-HDL and lower levels of large-sized HDL2b compared to patients with stable angina pectoris and normal controls.
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