High-density lipoprotein cholesterol, C-reactive protein, and prevalence and severity of coronary artery disease in 5641 consecutive patients undergoing coronary angiography.

Description

In order to investigate the relationship between HDL cholesterol and C-reactive protein (CRP) levels to severity of coronary artery disease (CAD), Alber et al. performed a cross-sectional analysis in 5,461 consecutive patients who underwent coronary angiography. Patient CAD severity was assessed by visual estimation of lumen diameter stenosis. Patients with an estimated lumen diameter under 70% were considered to have CAD. Compared to the 4,124 patients with CAD, patients without CAD (n=1,517) had higher HDL cholesterol [1.56±0.48 mmol/l vs. 1.34±0.40 mmol/l (60.3±18.5 mg/dl vs. 51.9±15.3 mg/dl)] and lower CRP levels (0.65±1.68 mg/dl vs. 1.02±2.38 mg/dl). HDL cholesterol levels were negatively associated with the number of classical CAD risk factors and with CAD severity, whereas plasma CRP levels were positively associated with the number of classical CAD risk factors and with CAD severity. In a multivariate analysis, HDL cholesterol levels and CRP levels appeared to be independent predictors of the presence of CAD. Although the authors acknowledged that the methods used to estimate CAD were not optimal, they suggested that HDL cholesterol and CRP levels may warrant further consideration in terms of CAD risk prediction.