1. Cell-free, high-density lipoprotein-specific phospholipid efflux assay predicts incident cardiovascular disease
- Author
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Sato, Masaki, Neufeld, Edward B., Playford, Martin P., Lei, Yu, Sorokin, Alexander V., Aponte, Angel M., Freeman, Lita A., Gordon, Scott M., Dey, Amit K., Jeiran, Kianoush, Hamasaki, Masato, Sampson, Maureen L., Shamburek, Robert D., Tang, Jingrong, Chen, Marcus Y., Kotani, Kazuhiko, Anderson, Josephine L.C., Dullaart, Robin P.F., Mehta, Nehal N., Tietge, Uwe J.F., and Remaley, Alan T.
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Cholesterol ,Medical research ,Medicine, Experimental ,Coronary heart disease -- Risk factors ,Phospholipids ,Ethylenediaminetetraacetic acid ,Apolipoproteins ,Type 2 diabetes -- Risk factors ,Health care industry - Abstract
BACKGROUND. Cellular cholesterol efflux capacity (CEC) is a better predictor of cardiovascular disease (CVD) events than HDL-cholesterol (HDL-C) but is not suitable as a routine clinical assay. METHODS. We developed an HDL-specific phospholipid efflux (HDL-SPE) assay to assess HDL functionality based on wholeplasma HDL apolipoprotein-mediated solubilization of fluorescent phosphatidylethanolamine from artificial lipid donor particles. We first assessed the association of HDL-SPE with prevalent coronary artery disease (CAD): study I included NIH severe-CAD (n = 50) and non-CAD (n = 50) participants, who were frequency matched for sex, BMI, type 2 diabetes mellitus, and smoking; study II included Japanese CAD (n = 70) and non-CAD (n = 154) participants. We also examined the association of HDL-SPE with incident CVD events in the Prevention of Renal and Vascular End-stage Disease (PREVEND) study comparing 340 patients with 340 controls individually matched for age, sex, smoking, and HDL-C levels. RESULTS. Receiver operating characteristic curves revealed stronger associations of HDL-SPE with prevalent CAD. The AUCs in study I were as follows: HDL-SPE, 0.68; apolipoprotein A-I (apoA-I), 0.62; HDL-C, 0.63; and CEC, 0.52. The AUCs in study II were as follows: HDL-SPE, 0.83; apoA-I, 0.64; and HDL-C, 0.53. Also longitudinally, HDL-SPE was significantly associated with incident CVD events independent of traditional risk factors with ORs below 0.2 per SD increment in the PREVEND study (P < 0.001). CONCLUSION. HDL-SPE could serve as a routine clinical assay for improving CVD risk assessment and drug discovery. TRIAL REGISTRATION. ClinicalTrials.gov NCT01621594. FUNDING. NHLBI Intramural Research Program, NIH (HL006095-06)., Introduction Coronary artery disease (CAD) risk assessment is a critical step for determining the need for lipid-lowering therapy (1). HDL-cholesterol (HDL-C) and total cholesterol are the 2 lipid tests currently [...]
- Published
- 2023
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