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Dysfunctional High-Density Lipoproteins Are Associated With a Greater Incidence of Acute Coronary Syndrome in a Population at High Cardiovascular Risk: A Nested Case-Control Study.

dc.contributor.authorSoria-Florido, María Trinidad
dc.contributor.authorCastañer, Olga
dc.contributor.authorLassale, Camille
dc.contributor.authorEstruch, Ramon
dc.contributor.authorSalas-Salvadó, Jordi
dc.contributor.authorMartínez-González, Miguel Ángel
dc.contributor.authorCorella, Dolores
dc.contributor.authorRos, Emilio
dc.contributor.authorArós, Fernando
dc.contributor.authorElosua, Roberto
dc.contributor.authorLapetra, José
dc.contributor.authorFiol, Miquel
dc.contributor.authorAlonso-Gómez, Angel
dc.contributor.authorGómez-Gracia, Enrique
dc.contributor.authorSerra-Majem, Lluís
dc.contributor.authorPintó, Xavier
dc.contributor.authorBulló, Mònica
dc.contributor.authorRuiz-Canela, Miguel
dc.contributor.authorSorlí, Jose V
dc.contributor.authorHernáez, Álvaro
dc.contributor.authorFitó, Montserrat
dc.date.accessioned2023-02-08T14:39:32Z
dc.date.available2023-02-08T14:39:32Z
dc.date.issued2020-01-16
dc.description.abstractStudies have failed to establish a clear link between high-density lipoprotein (HDL) cholesterol and cardiovascular disease, leading to the hypothesis that the atheroprotective role of HDL lies in its biological activity rather than in its cholesterol content. However, to date, the association between HDL functional characteristics and acute coronary syndrome has not been investigated comprehensively. We conducted a case-control study nested within the PREDIMED (Prevención con Dieta Mediterránea) cohort, originally a randomized trial in which participants followed a Mediterranean or low-fat diet. Incident acute coronary syndrome cases (N=167) were individually matched (1:2) to control patients by sex, age, intervention group, body mass index, and follow-up time. We investigated 2 individual manifestations (myocardial infarction, unstable angina) as secondary outcomes. We measured the following functional characteristics: HDL cholesterol concentration (in plasma); cholesterol efflux capacity; antioxidant ability, measured by the HDL oxidative-inflammatory index; phospholipase A2 activity; and sphingosine-1-phosphate, apolipoproteins A-I and A-IV, serum amyloid A, and complement 3 protein (in apolipoprotein B-depleted plasma). We used conditional logistic regression models adjusted for HDL cholesterol levels and cardiovascular risk factors to estimate odds ratios (ORs) between 1-SD increments in HDL functional characteristics and clinical outcomes. Low values of cholesterol efflux capacity (OR1SD, 0.58; 95% CI, 0.40-0.83) and low levels of sphingosine-1-phosphate (OR1SD, 0.70; 95% CI, 0.52-0.92) and apolipoprotein A-I (OR1SD, 0.58; 95% CI, 0.42-0.79) were associated with higher odds of acute coronary syndrome. Higher HDL oxidative inflammatory index values were marginally linked to acute coronary syndrome risk (OR1SD, 1.27; 95% CI, 0.99-1.63). Low values of cholesterol efflux capacity (OR1SD, 0.33; 95% CI, 0.18-0.61), sphingosine-1-phosphate (OR1SD: 0.60; 95% CI: 0.40-0.89), and apolipoprotein A-I (OR1SD, 0.59; 95% CI, 0.37-0.93) were particularly linked to myocardial infarction, whereas high HDL oxidative-inflammatory index values (OR1SD, 1.53; 95% CI, 1.01-2.33) and low apolipoprotein A-I levels (OR1SD, 0.52; 95% CI, 0.31-0.88) were associated with unstable angina. Low cholesterol efflux capacity values, pro-oxidant/proinflammatory HDL particles, and low HDL levels of sphingosine-1-phosphate and apolipoprotein A-I were associated with increased odds of acute coronary syndrome and its manifestations in individuals at high cardiovascular risk. URL: https://www.controlled-trials.com/ISRCTN35739639. Unique identifier: ISRCTN35739639.
dc.identifier.doi10.1161/CIRCULATIONAHA.119.041658
dc.identifier.essn1524-4539
dc.identifier.pmid31941372
dc.identifier.unpaywallURLhttps://www.ahajournals.org/doi/pdf/10.1161/CIRCULATIONAHA.119.041658
dc.identifier.urihttp://hdl.handle.net/10668/14960
dc.issue.number6
dc.journal.titleCirculation
dc.journal.titleabbreviationCirculation
dc.language.isoen
dc.organizationSevilla
dc.page.number444-453
dc.pubmedtypeJournal Article
dc.pubmedtypeMulticenter Study
dc.pubmedtypeRandomized Controlled Trial
dc.pubmedtypeResearch Support, Non-U.S. Gov't
dc.rights.accessRightsopen access
dc.subjectHDL cholesterol
dc.subjectacute coronary syndrome
dc.subjecthigh-density lipoproteins
dc.subject.meshAcute Coronary Syndrome
dc.subject.meshAged
dc.subject.meshApolipoprotein A-I
dc.subject.meshCase-Control Studies
dc.subject.meshDiet, Mediterranean
dc.subject.meshFemale
dc.subject.meshFollow-Up Studies
dc.subject.meshHumans
dc.subject.meshLipoproteins, HDL
dc.subject.meshLysophospholipids
dc.subject.meshMale
dc.subject.meshMiddle Aged
dc.subject.meshSphingosine
dc.titleDysfunctional High-Density Lipoproteins Are Associated With a Greater Incidence of Acute Coronary Syndrome in a Population at High Cardiovascular Risk: A Nested Case-Control Study.
dc.typeresearch article
dc.type.hasVersionVoR
dc.volume.number141
dspace.entity.typePublication

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