IMPACT OF HIGH SERUM HIGH DENSITY LIPOPROTEIN (HDL) LEVEL AND CORONARY ENDOTHELIAL FUNCTION

• Sunwon Kim, 
• Seung-Woon Rha, 
• Amro Elnagar, 
• Byoung Geol Choi, 
• sung il Im, 
• Jin Oh Na, 
• Seongwoo Han,
• Cheol Ung Choi, 
• Hong Euy Lim, 
• Jin Won Kim, 
• Eung Ju Kim, 
• Hong-Seog Seo, 
• Chang Gyu Park, 
• Dong Joo Oh

• Cardiovascular Center, Korea University Guro Hospital, Seoul, South Korea

Background

Serum concentration of high density lipoprotein (HDL) more than 60mg/dL was known to have cardioprotective effect. We investigated whether high serum HDL have beneficial effect on coronary endothelial function as assessed by acetylcholine (Ach) provocation test.

Methods

Among angina patients (pts) who underwent coronary angiography with Ach provocation test, a total of 1300 pts were enrolled. Ach provocation test was performed by incremental dosage (20, 50, 100μg). Vasoconstriction more than 70% by visual assessment was considered as positive provocation test. Angiographic parameters were compared between low HDL group (< 60mg/dL, n=994) and high HDL group (≥ 60mg/dL, n=306)

Results

Baseline characteristics were similar between the two groups except male gender, smoking, and aspirin use were higher in the low HDL group. High HDL group showed significantly lower incidence of (+) provocation test results, severe vasoconstriction (> 70%) on the QCA measurement and multivessel involvement as compared with low HDL group (Table). These statistical differences were continued to be significant after adjustment of baseline differences.

Conclusions

According to our study, high serum HDL level (≥ 60mg/dL) was associated with less incidence of (+) provocation test, less severe vasoconstriction and multivessel involvemenet. High HDL at baseline may play an important role in coronary artery vasoreactivity, may preserve coronary endothelial function and afford cardioprotection.

Copyright © 2012 Published by Elsevier Inc. All rights reserved.