High-density lipoprotein cholesterol, coronary artery disease, and cardiovascular mortality
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High-density lipoprotein cholesterol, coronary artery disease, and cardiovascular mortality. / Silbernagel, Guenther; Schöttker, Ben; Appelbaum, Sebastian; Scharnagl, Hubert; Kleber, Marcus E; Grammer, Tanja B; Ritsch, Andreas; Mons, Ute; Holleczek, Bernd; Goliasch, Georg; Niessner, Alexander; Boehm, Bernhard O; Schnabel, Renate B; Brenner, Hermann; Blankenberg, Stefan; Landmesser, Ulf; März, Winfried.
in: EUR HEART J, Jahrgang 34, Nr. 46, 12.2013, S. 3563-3571.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - High-density lipoprotein cholesterol, coronary artery disease, and cardiovascular mortality
AU - Silbernagel, Guenther
AU - Schöttker, Ben
AU - Appelbaum, Sebastian
AU - Scharnagl, Hubert
AU - Kleber, Marcus E
AU - Grammer, Tanja B
AU - Ritsch, Andreas
AU - Mons, Ute
AU - Holleczek, Bernd
AU - Goliasch, Georg
AU - Niessner, Alexander
AU - Boehm, Bernhard O
AU - Schnabel, Renate B
AU - Brenner, Hermann
AU - Blankenberg, Stefan
AU - Landmesser, Ulf
AU - März, Winfried
PY - 2013/12
Y1 - 2013/12
N2 - AIMS: High-density lipoprotein (HDL) cholesterol is a strong predictor of cardiovascular mortality. This work aimed to investigate whether the presence of coronary artery disease (CAD) impacts on its predictive value.METHODS AND RESULTS: We studied 3141 participants (2191 males, 950 females) of the LUdwigshafen RIsk and Cardiovascular health (LURIC) study. They had a mean ± standard deviation age of 62.6 ± 10.6 years, body mass index of 27.5 ± 4.1 kg/m², and HDL cholesterol of 38.9 ± 10.8 mg/dL. The cohort consisted of 699 people without CAD, 1515 patients with stable CAD, and 927 patients with unstable CAD. The participants were prospectively followed for cardiovascular mortality over a median (inter-quartile range) period of 9.9 (8.7-10.7) years. A total of 590 participants died from cardiovascular diseases. High-density lipoprotein cholesterol by tertiles was inversely related to cardiovascular mortality in the entire cohort (P = 0.009). There was significant interaction between HDL cholesterol and CAD in predicting the outcome (P = 0.007). In stratified analyses, HDL cholesterol was strongly associated with cardiovascular mortality in people without CAD [3rd vs. 1st tertile: HR (95% CI) = 0.37 (0.18-0.74), P = 0.005], but not in patients with stable [3rd vs. 1st tertile: HR (95% CI) = 0.81 (0.61-1.09), P = 0.159] and unstable [3rd vs. 1st tertile: HR (95% CI) = 0.91 (0.59-1.41), P = 0.675] CAD. These results were replicated by analyses in 3413 participants of the AtheroGene cohort and 5738 participants of the ESTHER cohort, and by a meta-analysis comprising all three cohorts.CONCLUSION: The inverse relationship of HDL cholesterol with cardiovascular mortality is weakened in patients with CAD. The usefulness of considering HDL cholesterol for cardiovascular risk stratification seems limited in such patients.
AB - AIMS: High-density lipoprotein (HDL) cholesterol is a strong predictor of cardiovascular mortality. This work aimed to investigate whether the presence of coronary artery disease (CAD) impacts on its predictive value.METHODS AND RESULTS: We studied 3141 participants (2191 males, 950 females) of the LUdwigshafen RIsk and Cardiovascular health (LURIC) study. They had a mean ± standard deviation age of 62.6 ± 10.6 years, body mass index of 27.5 ± 4.1 kg/m², and HDL cholesterol of 38.9 ± 10.8 mg/dL. The cohort consisted of 699 people without CAD, 1515 patients with stable CAD, and 927 patients with unstable CAD. The participants were prospectively followed for cardiovascular mortality over a median (inter-quartile range) period of 9.9 (8.7-10.7) years. A total of 590 participants died from cardiovascular diseases. High-density lipoprotein cholesterol by tertiles was inversely related to cardiovascular mortality in the entire cohort (P = 0.009). There was significant interaction between HDL cholesterol and CAD in predicting the outcome (P = 0.007). In stratified analyses, HDL cholesterol was strongly associated with cardiovascular mortality in people without CAD [3rd vs. 1st tertile: HR (95% CI) = 0.37 (0.18-0.74), P = 0.005], but not in patients with stable [3rd vs. 1st tertile: HR (95% CI) = 0.81 (0.61-1.09), P = 0.159] and unstable [3rd vs. 1st tertile: HR (95% CI) = 0.91 (0.59-1.41), P = 0.675] CAD. These results were replicated by analyses in 3413 participants of the AtheroGene cohort and 5738 participants of the ESTHER cohort, and by a meta-analysis comprising all three cohorts.CONCLUSION: The inverse relationship of HDL cholesterol with cardiovascular mortality is weakened in patients with CAD. The usefulness of considering HDL cholesterol for cardiovascular risk stratification seems limited in such patients.
KW - Cardiovascular Diseases/blood
KW - Cause of Death
KW - Cholesterol, HDL/metabolism
KW - Cohort Studies
KW - Coronary Artery Disease/blood
KW - Female
KW - Germany/epidemiology
KW - Humans
KW - Male
KW - Middle Aged
KW - Prognosis
KW - Risk Factors
U2 - 10.1093/eurheartj/eht343
DO - 10.1093/eurheartj/eht343
M3 - SCORING: Journal article
C2 - 24014391
VL - 34
SP - 3563
EP - 3571
JO - EUR HEART J
JF - EUR HEART J
SN - 0195-668X
IS - 46
ER -
