High HDL cholesterol protects against revascularization in men with CHD
MedWire News: High levels of high-density lipoprotein (HDL) cholesterol may be protective against revascularization among men with statin-treated coronary heart disease (CHD) who are at low-density lipoprotein (LDL) cholesterol target, say researchers.
"We found an inverse association between HDL cholesterol levels >41.0 mg/dl and the need for revascularization procedures in male CHD patients treated with statins and who had achieved target LDL cholesterol levels <100 mg/dl," write Avishay Elis (Meir Medical Center, Kfar Saba, Israel) and co-authors in the journal Clinical Cardiology.
The team explains that low levels of HDL cholesterol are a strong independent predictor for cardiovascular disease (CVD) morbidity and mortality at all LDL cholesterol concentrations. "Nevertheless, it is not clear whether this association always exists in statin-treated patients who achieve low LDL cholesterol levels."
To address this, Elis and team retrospectively examined the association between HDL cholesterol levels and revascularization procedures (percutaneous coronary intervention or coronary artery bypass graft) in 909 men (mean age 68 years) who were receiving statins (≥6 purchases/year) and who had LDL cholesterol levels less than 100 mg/dl (2.59 mmol/l) from January 1998 through June 2008.
In total, 307 (33.8%) patients required one or more revascularization procedures during the follow-up period (range 1 month to 7.5 years).
When the researchers divided the patients into quintiles based on their mean HDL cholesterol levels, they found that those in the highest quintile (>41.0 mg/dl [1.06 mmol/l]) underwent significantly fewer revascularization procedures than those in the lowest quintile (≤26.4 mg/dl [0.68 mmol/l]), at 16.6% versus 40.8%, respectively.
This significant effect was not influenced by any other variable, note Elis et al.
"This finding also correlates with the National Cholesterol Education Program (NCEP) III definition of low HDL cholesterol level in males as <40 mg/dl and the previous finding of HDL cholesterol levels as an independent predictor for CVD morbidity and mortality," they say.
The team concludes: "Possible additional benefits of using agents to raise HDL cholesterol levels should be investigated."
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By Nikki Withers