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  • Title: HDL-cholesterol concentration and severity of coronary atherosclerosis determined by cine-angiography.
    Author: Naito HK, Greenstreet RL, David JA, Sheldon WL, Shirey EK, Lewis RC, Proudfit WL, Gerrity RG.
    Journal: Artery; 1980; 8(2):101-12. PubMed ID: 7458675.
    Abstract:
    We studied 226 adult male subjects (mean=52yr) who underwent coronary arteriography. Their serum lipid and lipoprotein levels [total cholesterol (TC), triglycerides (TG), HDL-cholesterol (HDL-C), LDL-C, HDL-phospholipid (HDL-P), HDL-TG, HDL-C/TC, HDL-P/TC, LDL-C/TC, LDL-C/HDL-C and LDL-C/HDL-P] were correlated with the severity of coronary artery disease (CAD). Studies showed a slight but statistically significant correlation (linear regression) between CAD and HDL-P/TC (r=-0.24, P < 0.001), HDL-C/TC (r=-0.20, P < 0.002), followed by LDL-C/HDL-P (r=0.19, P < 0.004) and HDL-P (r=-0.18, P < 0.008). HDL-C, LDL-C and TC were significant at the P < 0.05 level; P value of TG was non-significant. Subjects were conveniently grouped based on degree of coronary artery narrowing: normal, mild (1-50%); moderate-severe (51-99%) and very severe (100% occlusion). Of the 11 lipid variables, the best predictor of the stage of the CAD was HDL-P/TC as measured by one-way analysis of variance. This trend was unaltered even after adjustment for covariates. HDL-P, LDL-C/HDL-P and HDL-C/TC were also significant, but the other lipid parameters were not. The study indicates that HDL-C, by itself, is not as effective a predictor of CAD as HDL-P/TC. Also, the small but statistically significant inverse relationship between HDL-P/TC and CAD suggests that a low HDL-P/TC ratio can be considered a risk factor for CAD but not as a dependable clinical diagnostic aid for predicting the severity of CAD on an individual basis.
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