Cholesterol Efflux Capacity and Cardiovascular Disease: The Ludwigshafen Risk and Cardiovascular Health (LURIC) Study
(1) Background and Aims: Efforts to reduce coronary artery disease (CAD) by raising high-density lipoprotein (HDL) cholesterol (HDL-C) have not been uniformly successful. A more important factor than HDL-C may be cellular cholesterol efflux mediated by HDL, which has been shown to be associated with...
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| Format: | Article |
| Language: | English |
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MDPI AG
2020-11-01
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| Series: | Biomedicines |
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| Online Access: | https://www.mdpi.com/2227-9059/8/11/524 |
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| author | Andreas Ritsch Angela Duerr Patrick Kahler Monika Hunjadi Tatjana Stojakovic Guenther Silbernagel Hubert Scharnagl Marcus E. Kleber Winfried März |
| author_facet | Andreas Ritsch Angela Duerr Patrick Kahler Monika Hunjadi Tatjana Stojakovic Guenther Silbernagel Hubert Scharnagl Marcus E. Kleber Winfried März |
| author_sort | Andreas Ritsch |
| collection | DOAJ |
| description | (1) Background and Aims: Efforts to reduce coronary artery disease (CAD) by raising high-density lipoprotein (HDL) cholesterol (HDL-C) have not been uniformly successful. A more important factor than HDL-C may be cellular cholesterol efflux mediated by HDL, which has been shown to be associated with CAD. In this report, we analyzed the influence of cardiovascular biomarkers and risk factors on cholesterol efflux in a prospective observational study of patients referred to coronary angiography. (2) Methods: HDL-mediated efflux capacity was determined for 2468 participants of the Ludwigshafen Risk and Cardiovascular Health (LURIC) study who were referred to coronary angiography at baseline between 1997 and 2000. Median follow-up time was 9.9 years. Primary and secondary endpoints were cardiovascular and all-cause mortality, respectively. (3) Results: Cholesterol efflux strongly correlated with HDL-related markers including HDL cholesterol, HDL phospholipids, and apolipoproteins AI and AII, as well as HDL particle concentration, which was not seen for low density lipoprotein (LDL) markers including LDL cholesterol and apoB. Cholesterol efflux was associated negatively with C-reactive protein (CRP), fibrinogen, interleukin-6 (IL-6), and serum amyloid A. Cardiovascular mortality was higher in patients in the lowest cholesterol efflux quartile. This association was weakened, but not fully abolished, after adjustment for HDL cholesterol. (4) Conclusions: We demonstrate that cholesterol efflux was associated with HDL-composition as well as inflammatory burden in patients referred for coronary angiography, and that this inversely predicts cardiovascular mortality independently of HDL cholesterol. |
| first_indexed | 2024-03-10T14:40:16Z |
| format | Article |
| id | doaj.art-c800fb2e8e3c4f9c932fb97229b5806f |
| institution | Directory Open Access Journal |
| issn | 2227-9059 |
| language | English |
| last_indexed | 2024-03-10T14:40:16Z |
| publishDate | 2020-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Biomedicines |
| spelling | doaj.art-c800fb2e8e3c4f9c932fb97229b5806f2023-11-20T21:50:49ZengMDPI AGBiomedicines2227-90592020-11-0181152410.3390/biomedicines8110524Cholesterol Efflux Capacity and Cardiovascular Disease: The Ludwigshafen Risk and Cardiovascular Health (LURIC) StudyAndreas Ritsch0Angela Duerr1Patrick Kahler2Monika Hunjadi3Tatjana Stojakovic4Guenther Silbernagel5Hubert Scharnagl6Marcus E. Kleber7Winfried März8Department of Internal Medicine, Medical University of Innsbruck, 6020 Innsbruck, AustriaDepartment of Internal Medicine, Medical University of Innsbruck, 6020 Innsbruck, AustriaDepartment of Internal Medicine, Medical University of Innsbruck, 6020 Innsbruck, AustriaDepartment of Internal Medicine, Medical University of Innsbruck, 6020 Innsbruck, AustriaClinical Institute of Medical and Chemical Laboratory Diagnostics, University Hospital Graz, 8036 Graz, AustriaDivision of Angiology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, AustriaClinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, 8036 Graz, AustriaVth Department of Medicine, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, GermanyClinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, 8036 Graz, Austria(1) Background and Aims: Efforts to reduce coronary artery disease (CAD) by raising high-density lipoprotein (HDL) cholesterol (HDL-C) have not been uniformly successful. A more important factor than HDL-C may be cellular cholesterol efflux mediated by HDL, which has been shown to be associated with CAD. In this report, we analyzed the influence of cardiovascular biomarkers and risk factors on cholesterol efflux in a prospective observational study of patients referred to coronary angiography. (2) Methods: HDL-mediated efflux capacity was determined for 2468 participants of the Ludwigshafen Risk and Cardiovascular Health (LURIC) study who were referred to coronary angiography at baseline between 1997 and 2000. Median follow-up time was 9.9 years. Primary and secondary endpoints were cardiovascular and all-cause mortality, respectively. (3) Results: Cholesterol efflux strongly correlated with HDL-related markers including HDL cholesterol, HDL phospholipids, and apolipoproteins AI and AII, as well as HDL particle concentration, which was not seen for low density lipoprotein (LDL) markers including LDL cholesterol and apoB. Cholesterol efflux was associated negatively with C-reactive protein (CRP), fibrinogen, interleukin-6 (IL-6), and serum amyloid A. Cardiovascular mortality was higher in patients in the lowest cholesterol efflux quartile. This association was weakened, but not fully abolished, after adjustment for HDL cholesterol. (4) Conclusions: We demonstrate that cholesterol efflux was associated with HDL-composition as well as inflammatory burden in patients referred for coronary angiography, and that this inversely predicts cardiovascular mortality independently of HDL cholesterol.https://www.mdpi.com/2227-9059/8/11/524high-density lipoproteincholesterol efflux capacitycardiovascular riskmortalitydysfunctional HDL |
| spellingShingle | Andreas Ritsch Angela Duerr Patrick Kahler Monika Hunjadi Tatjana Stojakovic Guenther Silbernagel Hubert Scharnagl Marcus E. Kleber Winfried März Cholesterol Efflux Capacity and Cardiovascular Disease: The Ludwigshafen Risk and Cardiovascular Health (LURIC) Study Biomedicines high-density lipoprotein cholesterol efflux capacity cardiovascular risk mortality dysfunctional HDL |
| title | Cholesterol Efflux Capacity and Cardiovascular Disease: The Ludwigshafen Risk and Cardiovascular Health (LURIC) Study |
| title_full | Cholesterol Efflux Capacity and Cardiovascular Disease: The Ludwigshafen Risk and Cardiovascular Health (LURIC) Study |
| title_fullStr | Cholesterol Efflux Capacity and Cardiovascular Disease: The Ludwigshafen Risk and Cardiovascular Health (LURIC) Study |
| title_full_unstemmed | Cholesterol Efflux Capacity and Cardiovascular Disease: The Ludwigshafen Risk and Cardiovascular Health (LURIC) Study |
| title_short | Cholesterol Efflux Capacity and Cardiovascular Disease: The Ludwigshafen Risk and Cardiovascular Health (LURIC) Study |
| title_sort | cholesterol efflux capacity and cardiovascular disease the ludwigshafen risk and cardiovascular health luric study |
| topic | high-density lipoprotein cholesterol efflux capacity cardiovascular risk mortality dysfunctional HDL |
| url | https://www.mdpi.com/2227-9059/8/11/524 |
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