Prevention & lipidsCase-control study
Dysfunctional High-Density Lipoproteins Are Associated With a Greater Incidence of Acute Coronary Syndrome in a Population at High Cardiovascular Risk
- Nested case-control study
- nested within the PREDIMED randomised trial cohort
- individually matched 1:2
Authors' conclusion
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.
Study context
- Population
- Individuals at high CV risk in the PREDIMED cohort (Mediterranean or low-fat diet)matched 1:2
- Comparison
- High-density lipoprotein (HDL) functional characteristics in ACS cases vs matched controls
- Casesn = 167
- Outcome
- Incident ACS
Main finding
As reported in the abstract
ACS, OR per 1-SD increment (adjusted for HDL-C and CV risk factors)
- Cholesterol efflux capacity
- OR1SD 0.58 (95% CI 0.40–0.83)
- Sphingosine-1-phosphate
- OR1SD 0.70 (95% CI 0.52–0.92)
- Apolipoprotein A-I
- OR1SD 0.58 (95% CI 0.42–0.79)
- HDL oxidative-inflammatory index · marginally linked
- OR1SD 1.27 (95% CI 0.99–1.63)
Observational data: associations, not effects.
Secondary outcomes
| Outcome | OR1SD (95% CI) |
|---|---|
| MI, OR per 1-SD increment — Cholesterol efflux capacity | 0.33 (0.18–0.61) |
| MI, OR per 1-SD increment — Sphingosine-1-phosphate | 0.60 (0.40–0.89) |
| MI, OR per 1-SD increment — Apolipoprotein A-I | 0.59 (0.37–0.93) |
| Unstable angina, OR per 1-SD increment — HDL oxidative-inflammatory index | 1.53 (1.01–2.33) |
| Unstable angina, OR per 1-SD increment — Apolipoprotein A-I | 0.52 (0.31–0.88) |
Original publication
Dysfunctional High-Density Lipoproteins Are Associated With a Greater Incidence of Acute Coronary Syndrome in a Population at High Cardiovascular Risk. Circulation. Published 16 January 2020. doi:10.1161/circulationaha.119.041658
Summarised from the published abstract; every number is checked against it