Highlights
- •Functional read-outs of HDL represent an emerging topic.
- •We tested 3 different atheroprotective properties of HDL in patients with acute MI.
- •Efflux and anti-inflammatory function decreased in MI independent of HDL-C.
- •Antioxidative properties of HDL were unaltered.
- •Myeloperoxidase might be a major factor mediating impaired HDL function in MI.
Background
High-density lipoproteins (HDLs) protect against the development of atherosclerotic
cardiovascular disease. HDL function represents an emerging concept in cardiovascular
research.
Objective
This study investigated the association between HDL functionality and acute myocardial
infarction (MI) independent of HDL-cholesterol plasma levels.
Methods
Participants (non-ST-segment elevation MI, non-STEMI, n = 41; STEMI, n = 37; non-MI
patients, n = 33) from a prospective follow-up study enrolling patients with acute
chest pain were matched for age and plasma HDL cholesterol. The in vitro capacity of HDL to (1) mediate cholesterol efflux from macrophage foam cells, (2)
prevent low-density lipoprotein oxidation, and (3) inhibit TNF-α-induced vascular
adhesion molecule-1 expression in endothelial cells was determined.
Results
STEMI-HDL displayed reduced cholesterol efflux (P < .001) and anti-inflammatory functionality (P = .001), whereas the antioxidative properties were unaltered. Cholesterol efflux
correlated with the anti-inflammatory HDL activity (P < .001). Not C-reactive protein levels, a marker of systemic inflammation, but specifically
plasma myeloperoxidase levels were independently associated with impaired HDL function
(efflux: P = .022; anti-inflammation: P < .001). Subjects in the higher risk quartile of efflux (odds ratio [OR], 5.66; 95%
confidence interval [CI], 1.26–25.00; P = .024) as well as anti-inflammatory functionality of HDL (OR, 5.53; 95% CI, 1.83–16.73;
P = .002) had a higher OR for MI vs those in the three lower risk quartiles combined.
Conclusion
Independent of plasma HDL cholesterol levels, 2 of 3 antiatherogenic HDL functionalities
tested were significantly impaired in STEMI patients, namely cholesterol efflux and
anti-inflammatory properties. Increased myeloperoxidase levels might represent a major
contributing mechanism for decreased HDL functionality in MI patients.
Keywords
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Article info
Publication history
Published online: August 18, 2016
Accepted:
August 8,
2016
Received:
February 8,
2016
Identification
Copyright
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