Document Detail


Significance of serum high-density lipoprotein cholesterol levels for diagnosis of coronary stenosis as determined by MDCT in patients with suspected coronary artery disease.
MedLine Citation:
PMID:  20467190     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: Since we previously reported that lower levels of HDL-C may be most useful for predicting coronary artery disease (CAD) as assessed by multi-detector row computed tomography (MDCT), we sought to confirm, among the levels of LDL-C, HDL-C, non-HDL-C (total cholesterol minus HDL-C) and the ratio of LDL-C to HDL-C (LDL-C/HDL-C), which is most closely related to the presence of CAD.
METHODS AND RESULTS: The subjects consisted of 506 consecutive patients with suspected CAD who underwent MDCT with (+) or without (-) statin treatment. The levels of LDL-C in the statin (-) group were similar in categories I, II and III according to the Japan Atherosclerosis Society (JAS) Guidelines 2007, whereas the levels of HDL-C significantly decreased and LDL-C/HDL-C significantly increased as the category number increased. In the statin (-) group, the prevalence of CAD in categories I, II and III was 0, 16 and 33%, respectively (p=0.0018 for trend), in patients with good control of LDL-C levels according to the Guidelines. Multivariate logistic regression analysis was per-formed to examine the association between the presence of CAD and 11 possible factors. Age and HDL-C in the statin (-) group, and HDL-C in the statin (+) group were identified as significant independent variables that correlated with the presence of CAD. Receiver-operating characteristic curve analysis in the statin (-) and statin (+) groups showed a higher area under the curve for HDL-C than for LDL-C, non-HDL-C or LDL-C/HDL-C. In particular, the cut-off levels of HDL-C with the greatest sensitivity and specificity for the diagnosis of CAD in the statin (+) group were 55 mg/dL (sensitivity 0.816, specificity 0.510).
CONCLUSIONS: HDL-C levels are most closely associated with the presence of CAD. In particular, we need to perform coronary CT for suspected CAD patients with lower HDL-C levels under statin treatment.
Authors:
Yuhei Shiga; Shin-ichiro Miura; Ryoko Mitsutake; Akira Kawamura; Yoshinari Uehara; Keijiro Saku
Publication Detail:
Type:  Journal Article     Date:  2010-05-13
Journal Detail:
Title:  Journal of atherosclerosis and thrombosis     Volume:  17     ISSN:  1880-3873     ISO Abbreviation:  J. Atheroscler. Thromb.     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-09-06     Completed Date:  2011-01-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9506298     Medline TA:  J Atheroscler Thromb     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  870-8     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Fukuoka University School of Medicine, Fukuoka, Japan.
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MeSH Terms
Descriptor/Qualifier:
Cholesterol, HDL / blood*
Cholesterol, LDL / blood
Coronary Artery Disease / blood*,  radiography
Coronary Stenosis / blood*,  radiography
Female
Humans
Male
Middle Aged
Risk Factors
Sensitivity and Specificity
Tomography, X-Ray Computed
Chemical
Reg. No./Substance:
0/Cholesterol, HDL; 0/Cholesterol, LDL

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