HDL functions and their interaction in patients of Acute Coronary Syndrome: a case control study

Abstract Aim: Recent studies emphasize the importance of HDL function over HDL cholesterol measurement, as an important risk for cardiovascular diseases (CVD). We compared the HDL function of patients with Acute Coronary Syndrome (ACS) and healthy controls. Methods: We measured cholesterol efflux capacity of HDL using THP-1 macrophages labelled with fluorescently tagged (BODIPY) cholesterol. Paraoxonase and arylesterase activity of PON1 enzyme were assessed by spectrophotometric methods. Results: We recruited 151 ACS patients and 110 controls. The HDL function of all patients during acute phase and at six month follow-up was measured. The mean age of the patients and controls was 51.7 and 43.6 years respectively. The mean HDL cholesterol/apolipoprotein A-I levels of patients during acute phase, follow-up and of controls were 40.2 mg/dl/ 112.5 mg/dl, 38.3 mg/dl/ 127.2 and 45.4 mg/dl/ 142.1 mg/dl respectively. The cholesterol efflux capacity of HDL was positively correlated with apolipoprotein A-I levels during acute phase (r = 0.19, p = 0.019), follow-up (r = 0.26, p = 0.007) and of controls (r = 0.3, p = 0.0012) but not with HDL-C levels. Higher levels of CEC, PON 1 activity and apolipoprotein A-I were associated with lower odds of development of ACS. We also observed that combined analysis of two HDL functions could improve the predicted probability of ACS development. Conclusion: ACS is associated with reduced HDL functions which improves at follow-up. The predicted probability of ACS depends upon individual HDL functions and the interactions between them.

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HDL functions and their interaction in patients with ST Elevation Myocardial Infarction: a case control study

10.21203/rs.2.20893/v3 ◽

2020 ◽

Author(s):

Himani Thakkar ◽

Vinnyfred Vincent ◽

Ambuj Roy ◽

Sandeep Singh ◽

Lakshmy Ramakrishnan ◽

...

Keyword(s):

Acute Phase ◽

Cholesterol Efflux ◽

Hdl Cholesterol ◽

Pon1 Activity ◽

Cholesterol Efflux Capacity ◽

Coronary Syndrome ◽

Hdl Function ◽

Apolipoprotein A ◽

The Mean

Abstract Background : Recent studies emphasize the importance of HDL function over HDL cholesterol measurement, as an important risk for cardiovascular diseases (CVD). We compared the HDL function of patients with Acute Coronary Syndrome (ACS) and healthy controls. Methods : We measured cholesterol efflux capacity of HDL using THP-1 macrophages labelled with fluorescently tagged (BODIPY) cholesterol. Paraoxonase and arylesterase activity of PON1 enzyme were assessed by spectrophotometric methods. Results : We recruited 151 ACS patients and 110 controls. The HDL function of all patients during acute phase and at six month follow-up was measured. The mean age of the patients and controls was 51.7 and 43.6 years respectively. The mean HDL cholesterol/apolipoprotein A-I levels (ratio) of patients during acute phase, follow-up and of controls were 40.2 mg/dl/ 112.5 mg/dl (ratio= 0.36), 38.3 mg/dl/ 127.2 mg/dl (ratio= 0.30) and 45.4 mg/dl/ 142.1 mg/dl (ratio=0.32) respectively. The cholesterol efflux capacity (CEC) of HDL was positively correlated with apolipoprotein A-I levels during acute phase (r = 0.19, p = 0.019), follow-up (r = 0.26, p = 0.007) and of controls (r = 0.3, p = 0.0012) but not with HDL-C levels (acute phase: r = 0.07, p = 0.47; follow-up: r = 0.1 , p = 0.2; control: r = 0.02, p = 0.82). Higher levels of cholesterol efflux capacity, PON1 activity and apolipoprotein A-I were associated with lower odds of development of ACS. We also observed that low CEC is associated with higher odds of having ACS if PON1 activity of HDL is also low and vice versa. Conclusion : ACS is associated with reduced HDL functions which improves at follow-up. The predicted probability of ACS depends upon individual HDL functions and the interactions between them.

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HDL functions and their interaction in patients of ST Elevation MI Acute Coronary Syndrome: a case control study

10.21203/rs.2.20893/v2 ◽

2020 ◽

Author(s):

Himani Thakkar ◽

Vinnyfred Vincent ◽

Ambuj Roy ◽

Sandeep Singh ◽

Lakshmy Ramakrishnan ◽

...

Keyword(s):

Acute Phase ◽

Cholesterol Efflux ◽

Hdl Cholesterol ◽

Pon1 Activity ◽

Cholesterol Efflux Capacity ◽

Coronary Syndrome ◽

Hdl Function ◽

Apolipoprotein A ◽

The Mean

Abstract Background: Recent studies emphasize the importance of HDL function over HDL cholesterol measurement, as an important risk for cardiovascular diseases (CVD). We compared the HDL function of patients with Acute Coronary Syndrome (ACS) and healthy controls.Methods: We measured cholesterol efflux capacity of HDL using THP-1 macrophages labelled with fluorescently tagged (BODIPY) cholesterol. Paraoxonase and arylesterase activity of PON1 enzyme were assessed by spectrophotometric methods. Results: We recruited 151 ACS patients and 110 controls. The HDL function of all patients during acute phase and at six month follow-up was measured. The mean age of the patients and controls was 51.7 and 43.6 years respectively. The mean HDL cholesterol/apolipoprotein A-I levels (ratio) of patients during acute phase, follow-up and of controls were 40.2 mg/dl/ 112.5 mg/dl (ratio= 0.36), 38.3 mg/dl/ 127.2 mg/dl (ratio= 0.30) and 45.4 mg/dl/ 142.1 mg/dl (ratio=0.32) respectively. The cholesterol efflux capacity (CEC) of HDL was positively correlated with apolipoprotein A-I levels during acute phase (r = 0.19, p = 0.019), follow-up (r = 0.26, p = 0.007) and of controls (r = 0.3, p = 0.0012) but not with HDL-C levels (acute phase: r = 0.07, p = 0.47; follow-up: r = 0.1 , p = 0.2; control: r = 0.02, p = 0.82). Higher levels of cholesterol efflux capacity, PON1 activity and apolipoprotein A-I were associated with lower odds of development of ACS. We also observed that low CEC is associated with higher odds of having ACS if PON1 activity of HDL is also low and vice versa. Conclusion: ACS is associated with reduced HDL functions which improves at follow-up. The predicted probability of ACS depends upon individual HDL functions and the interactions between them.

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Dysfunctional High-Density Lipoproteins Are Associated With a Greater Incidence of Acute Coronary Syndrome in a Population at High Cardiovascular Risk

Circulation ◽

10.1161/circulationaha.119.041658 ◽

2020 ◽

Vol 141 (6) ◽

pp. 444-453 ◽

Cited By ~ 9

Author(s):

María Trinidad Soria-Florido ◽

Olga Castañer ◽

Camille Lassale ◽

Ramon Estruch ◽

Jordi Salas-Salvadó ◽

...

Keyword(s):

Acute Coronary Syndrome ◽

Cardiovascular Risk ◽

Cholesterol Efflux ◽

Hdl Cholesterol ◽

Functional Characteristics ◽

Cholesterol Efflux Capacity ◽

Inflammatory Index ◽

Coronary Syndrome ◽

Apolipoprotein A ◽

Sphingosine 1 Phosphate

Background: Studies have failed to establish a clear link between high-density lipoprotein (HDL) cholesterol and cardiovascular disease, leading to the hypothesis that the atheroprotective role of HDL lies in its biological activity rather than in its cholesterol content. However, to date, the association between HDL functional characteristics and acute coronary syndrome has not been investigated comprehensively. Methods: We conducted a case-control study nested within the PREDIMED (Prevención con Dieta Mediterránea) cohort, originally a randomized trial in which participants followed a Mediterranean or low-fat diet. Incident acute coronary syndrome cases (N=167) were individually matched (1:2) to control patients by sex, age, intervention group, body mass index, and follow-up time. We investigated 2 individual manifestations (myocardial infarction, unstable angina) as secondary outcomes. We measured the following functional characteristics: HDL cholesterol concentration (in plasma); cholesterol efflux capacity; antioxidant ability, measured by the HDL oxidative-inflammatory index; phospholipase A2 activity; and sphingosine-1-phosphate, apolipoproteins A-I and A-IV, serum amyloid A, and complement 3 protein (in apolipoprotein B–depleted plasma). We used conditional logistic regression models adjusted for HDL cholesterol levels and cardiovascular risk factors to estimate odds ratios (ORs) between 1-SD increments in HDL functional characteristics and clinical outcomes. Results: Low values of cholesterol efflux capacity (OR 1SD , 0.58; 95% CI, 0.40–0.83) and low levels of sphingosine-1-phosphate (OR 1SD , 0.70; 95% CI, 0.52–0.92) and apolipoprotein A-I (OR 1SD , 0.58; 95% CI, 0.42–0.79) were associated with higher odds of acute coronary syndrome. Higher HDL oxidative inflammatory index values were marginally linked to acute coronary syndrome risk (OR 1SD , 1.27; 95% CI, 0.99–1.63). Low values of cholesterol efflux capacity (OR 1SD , 0.33; 95% CI, 0.18–0.61), sphingosine-1-phosphate (OR 1SD : 0.60; 95% CI: 0.40–0.89), and apolipoprotein A-I (OR 1SD , 0.59; 95% CI, 0.37–0.93) were particularly linked to myocardial infarction, whereas high HDL oxidative-inflammatory index values (OR 1SD , 1.53; 95% CI, 1.01–2.33) and low apolipoprotein A-I levels (OR 1SD , 0.52; 95% CI, 0.31–0.88) were associated with unstable angina. Conclusions: Low cholesterol efflux capacity values, pro-oxidant/proinflammatory HDL particles, and low HDL levels of sphingosine-1-phosphate and apolipoprotein A-I were associated with increased odds of acute coronary syndrome and its manifestations in individuals at high cardiovascular risk. Clinical Trial Registration: URL: https://www.controlled-trials.com/ISRCTN35739639 . Unique identifier: ISRCTN35739639.

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IMMEDIATE AND 4-YEAR OUTCOME OF PATIENTS WITH ACUTE CORONARY SYNDROME UNDERGOING PERCUTANEOUS CORONARY INTERVENTION FOR LEFT MAIN CORONARY ARTERY DISEASE

10.36106/gjra/4600459 ◽

2021 ◽

pp. 8-11

Author(s):

Saroj Mandal ◽

Sidnath Singh ◽

Kaushik Banerjee ◽

Aditya Verma ◽

Vignesh R.

Keyword(s):

Percutaneous Coronary Intervention ◽

Acute Coronary Syndrome ◽

Coronary Artery ◽

Ejection Fraction ◽

Coronary Intervention ◽

Left Ventricular Ejection ◽

Coronary Syndrome ◽

Percutaneous Coronary ◽

The Mean

Background: The treatment of LMCAD has shifted from coronary artery bypass grafting (CABG) to Percutaneous coronary intervention (PCI). However, data on long-term outcomes of PCI for LMCA disease, especially in patients with acute coronary syndrome (ACS) remains limited and conicting. This study aims to nd the association of the immediate and 4-year mortality in ACS patients with LMCA disease treated by PCI based on ejection fractions at admission. Methods: A retrospective analytical study was conducted. Patients were divided at admission into those with reduced left ventricular ejection fraction and those with preserved ejection fraction. Results: Forty (58.8%) of the patients presented with preserved EF. The mean age of the patients was 71.6±7.1 years. The mean LVEF of the preserved group was 61.6±4.3% and signicantly higher than that of the reduced group. Age and cardiovascular risk factor prole was similar between the two groups. Patients with reduced ejection fraction had signicantly higher levels of serum creatinine and signicantly lower levels of Hb and HDL. Mean hospital stay was signicantly longer for patients with preserved EF. In-hospital deaths were also similar between the two groups. The reduced EF group had a signicantly higher allcause mortality in the 4-year follow-up period. The mean years of follow-up for all participants was 4.2±1.3 years. Conclusion: It was seen that in patients presenting with ACS and undergoing PCI due to LMCAD, LVEF at admission, singly and in in multivariate regression is an important predictor of in hospital and 4-year mortality

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Complex lipid-lowering treatment options in patients with a history of acute coronary syndrome

Orvosi Hetilap ◽

10.1556/oh.2011.29036 ◽

2011 ◽

Vol 152 (8) ◽

pp. 296-302 ◽

Cited By ~ 1

Author(s):

Győző Dani ◽

László Márk ◽

András Katona

Keyword(s):

Acute Coronary Syndrome ◽

Serum Lipid ◽

Ldl Cholesterol ◽

Hdl Cholesterol ◽

Lipid Lowering ◽

Coronary Syndrome ◽

Target Values ◽

History Of ◽

Lipid Parameters

Authors aimed to assess how target values in serum lipid concentrations (LDL- and HDL-cholesterol, triglyceride) can be achieved in patients with a history of acute coronary syndrome during follow up in an outpatient cardiology clinic. Methods: 201 patients with a history of acute coronary syndrome were included and were followed up between January 1 and May 31, 2007.Authors analyzed serum lipid parameters of the patients and the lipid-lowering medications at the time of the first meeting and during follow up lasting two years. Results: During the enrollment visit only 26.4% of the patients had serum LDL cholesterol at target level, whereas high triglycerides and low HDL cholesterol levels were observed in 40.3% and 33.3% of the patients, respectively. Only 22 patients (10.9%) achieved the target levels in all three lipid parameters. Of the 201 patients, 179 patients participated in the follow up, and data obtained from these patients were analyzed. There was a positive trend toward better lipid parameters; 42.5% of the patients reached the desired LDL-cholesterol target value and 17.3% of the patients had HDL-cholesterol and triglycerides target values. Conclusions: These findings are consistent with those published in the literature. Beside the currently used therapeutic options for achieving optimal LDL-cholesterol, efforts should be made to reduce the so-called “residual cardiovascular risk” with the use of a widespread application of combination therapy. Orv. Hetil., 2011, 152, 296–302.

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Early vascular healing of ultra-thin strut polymer-free sirolimus-eluting stents in acute coronary syndrome: USUI-ACS study

10.21203/rs.3.rs-1060996/v1 ◽

2021 ◽

Author(s):

Yutaka Matsuhiro ◽

Yasuyuki Egami ◽

Naotaka Okamoto ◽

Masaya Kusuda ◽

Takashige Sakio ◽

...

Keyword(s):

Percutaneous Coronary Intervention ◽

Acute Coronary Syndrome ◽

Neointimal Hyperplasia ◽

Coronary Intervention ◽

Median Percentage ◽

Coronary Syndrome ◽

Percutaneous Coronary ◽

The Mean ◽

Sirolimus Eluting Stent

Abstract Purpose:Ultra-thin strut polymer-free sirolimus eluting stent (UPF-SES) have two novel characteristics, ultra-thin strut and polymer-free coating, which have the potential to achieve early re-endotherialization. However, a little is known whether early vascular healing of UPF-SES can be achieved in patients with acute coronary syndrome (ACS).The aim of this study was to evaluate the vascular healing after an implantation of UPF-SES in patients with ACS using optical coherence tomography (OCT) at 3 months after the stent implantation. Methods:From September 2020 and January 2021, a total of 31 consecutive patients presenting with ACS who underwent OCT examinations at the initial percutaneous coronary intervention (PCI) and 3-month follow-up were enrolled in the USUI-ACS study. The endpoints of this study were neointimal strut coverage, malapposition, and mean neointimal hyperplasia (NIH) thickness at 3-month follow-up.Results:Over a mean follow-up of 91 days after the initial PCI, the follow-up OCT was examined. The median percentage of covered struts was 98.4% and malapposed struts 0%, and the mean NIH thickness was 60μm.Conclusions:UPF-SES exhibited an excellent early vascular healing at 3-months in patients with ACS.

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Impaired High‐Density Lipoprotein Function in Patients With Heart Failure

Journal of the American Heart Association ◽

10.1161/jaha.120.019123 ◽

2021 ◽

Author(s):

Johanna E. Emmens ◽

Congzhuo Jia ◽

Leong L. Ng ◽

Dirk J. van Veldhuisen ◽

Kenneth Dickstein ◽

...

Keyword(s):

Heart Failure ◽

Cholesterol Efflux ◽

Density Lipoprotein ◽

Hdl Cholesterol ◽

Cholesterol Concentration ◽

Hdl Function ◽

Patients With Heart Failure ◽

Hdl Functionality ◽

Anti Inflammatory

Background We recently showed that, in patients with heart failure, lower high‐density lipoprotein (HDL) cholesterol concentration was a strong predictor of death or hospitalization for heart failure. In a follow‐up study, we suggested that this association could be partly explained by HDL proteome composition. However, whether the emerging concept of HDL function contributes to the prognosis of patients with heart failure has not been addressed. Methods and Results We measured 3 key protective HDL function metrics, namely, cholesterol efflux, antioxidative capacity, and anti‐inflammatory capacity, at baseline and after 9 months in 446 randomly selected patients with heart failure from BIOSTAT‐CHF (A Systems Biology Study to Tailored Treatment in Chronic Heart Failure). Additionally, the relationship between HDL functionality and HDL proteome composition was determined in 86 patients with heart failure. From baseline to 9 months, HDL cholesterol concentrations were unchanged, but HDL cholesterol efflux and anti‐inflammatory capacity declined (both P <0.001). In contrast, antioxidative capacity increased ( P <0.001). Higher HDL cholesterol efflux was associated with lower mortality after adjusting for BIOSTAT‐CHF risk models and log HDL cholesterol (hazard ratio, 0.81; 95% CI, 0.71–0.92; P =0.001). Other functionality measures were not associated with outcome. Several HDL proteins correlated with HDL functionality, mainly with cholesterol efflux. Apolipoprotein A1 emerged as the main protein associated with all 3 HDL functionality measures. Conclusions Better HDL cholesterol efflux at baseline was associated with lower mortality during follow‐up, independent of HDL cholesterol. HDL cholesterol efflux and anti‐inflammatory capacity declined during follow‐up in patients with heart failure. Measures of HDL function may provide clinical information in addition to HDL cholesterol concentration in patients with heart failure.

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Serum cholesterol efflux capacity is associated with coronary plaque progression in patients with coronary heart disease

European Heart Journal ◽

10.1093/eurheartj/ehab724.1389 ◽

2021 ◽

Vol 42 (Supplement_1) ◽

Author(s):

X Q Wang ◽

S Feng ◽

X Y Shu ◽

C D Yang ◽

R Y Zhang

Keyword(s):

Coronary Heart Disease ◽

Heart Disease ◽

Coronary Angiography ◽

Cholesterol Efflux ◽

Hdl Cholesterol ◽

Coronary Plaque ◽

Plaque Progression ◽

Cholesterol Efflux Capacity ◽

Hdl Function

Abstract Background Coronary plaque progression is a major risk factor of adverse cardiac events in patients with coronary heart disease (CHD). Emerging evidence showed that attenuated high-density lipoprotein (HDL) function measured by cholesterol efflux capacity (CEC) was associated with development of atherosclerosis independent of HDL cholesterol level. In this study, we sought to investigate whether CEC is a predictor for coronary plaque progression in CHD patients. Methods We consecutively enrolled CHD patients from January 2017 to August 2019 in our Hospital who underwent elective percutaneous coronary intervention and had at least one non-target coronary lesion. Follow-up coronary angiography were performed at around 12 months. Fluorescence-labeled cholesterol and J774 macrophages were used to measure the CEC of ApoB-depleted serum sample from all patients. Quantitative coronary angiography (QCA) was performed both at baseline and follow-up to analyze the plaque progression. Results A total of 430 CHD patients with 586 non-target coronary lesions were included in the final analysis. During a mean follow-up time of 381.04±59.52 days, patients with decreased CEC presented more severe plaque progression (net luminal loss in highest to lowest CEC quartile: 0.22±0.42mm vs 0.20±0.41mm vs 0.13±0.36mm vs 0.11±0.34mm, p=0.035). In multivariate analysis, baseline CEC was independently associated with coronary plaque progression after adjustment for traditional risk factors including HDL cholesterol and ApoA-I, no matter treated as categorical variable (OR: 0.382 [95% CI 0.180–0.781] for highest to lowest quartile) or continuous variable (OR: 0.522 [95% CI 0.373–0.714] for per SD increase]. Furthermore, CEC demonstrated a better power in predicting coronary plaque progression compared with HDL cholesterol concentration (AUC=0.644 vs 0.514). Conclusions This study suggests that HDL function reflected by serum CEC is an independent predictor for coronary plaque progression in CHD patients. FUNDunding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): National Natural Science Foundation of China, Shanghai Municipal Commission of Health and Family Planning

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Cardiac magnetic resonance features of acute myocarditis presenting as acute coronary syndrome

European Heart Journal ◽

10.1093/ehjci/ehaa946.2949 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

L Szabo ◽

A Bagonyi ◽

Z.S Dohy ◽

C.S Czimbalmos ◽

A Toth ◽

...

Keyword(s):

Acute Coronary Syndrome ◽

Logistic Regression ◽

Acute Phase ◽

Circumferential Strain ◽

Acute Myocarditis ◽

Clinical Signs ◽

Funding Source ◽

Research Development ◽

Coronary Syndrome

Abstract Background Clinical presentation of myocarditis varies, one specific form of myocarditis appears with the clinical signs of acute coronary syndrome (ACS). Cardiac magnetic resonance (CMR) is an important method for assessing ventricular function and morphology, additionally provides accurate tissue specific and functional information of the heart. Aims Our aim was to investigate the characteristics, and prognosis of myocarditis presenting with ACS symptoms. Methods 113 patients with the clinical signs of ACS but nonobstructed coronary arteries in whom the CMR revealed acute myocarditis were included in our study. CMR was performed in acute phase and at 3–6-month follow-up. Left ventricular (LV) volumes, mass and strain parameters expressing myocardial deformity were determined. Additional images were taken to represent tissue specific information. Relationships between laboratory and CMR parameters were investigated. Parameters predicting changes in LV ejection fraction (LVEF) were analyzed by logistic regression. Results A total of 113 patients with myocarditis (98 males, 31±11 years) underwent acute and follow-up CMR. Sixty two patients reported fever or infection before the beginning of their complaints, most commonly gastroenteritis (33%) and pharyngitis (32%). The creatinine kinase MB value measured in the acute phase showed positive correlation with the extent of necrosis, and the global longitudinal- and circumferential strain. The extent of the LV necrosis showed negative correlation with LVEF and positive correlation with global circumferential strain (GCS) (p<0.05). On the control CMR examination LVEF and all global strain values improved, fibrosis persisted in 82% of cases but shrank (15±11 vs 5±4 g) and LV mass decreased (p<0.01) compared to the acute phase. Compared to the acute phase, 21% of the patients had lower LVEF on the follow-up CMR. Lower initial LVEF, worse acute GCS, and greater LV necrosis were independent predictors of LVEF reduction in the logistic regression model. During a median follow-up of 6-years of patients treated at our clinic (n=39) no patient suffered cardiac death, heart failure, or documented ventricular arrhythmia but 21% of them had recurrent myocarditis. Conclusion Myocarditis mimicking ACS affects predominantly young men and shows functional improvement and good prognosis on follow-up, but it may reoccur in some cases. The reduction of LV function on control CMR may be predicted by worse initial LVEF, GCS, and a larger LV scar. Strain, LGE in acute phase and follow-up Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): Project no. NVKP_16-1-2016-0017 has been implemented with the support provided from the National Research, Development and Innovation Fund of Hungary, financed under the NVKP_16 funding scheme. This project was supported by a grant from the National Research, Development and Innovation Office (NKFIH) of Hungary (K 120277).

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