Relation of Increased Prebeta-1 High-Density Lipoprotein Levels to Risk of Coronary Heart Disease

• Published in: The American journal of cardiology Vol. 108; no. 3; pp. 360 - 366
• Main Authors: Guey, Lin T., PhD, Pullinger, Clive R., PhD, Ishida, Brian Y., PhD, O'Connor, Patricia M., MD, Zellner, Christian, MD, Francone, Omar L., PhD, Laramie, Jason M., PhD, Naya-Vigne, Josefina M., MD, Siradze, Ketevan A., MD, Deedwania, Prakash, MD, Redberg, Rita F., MD, Frost, Philip H., MD, Seymour, Albert B., PhD, Kane, John P., MD, PhD, Malloy, Mary J., MD
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.08.2011; Elsevier; Elsevier Limited
• Subjects: Adult; Aged; Biological and medical sciences; Cardiology; Cardiology. Vascular system; Cardiovascular; Cardiovascular disease; Cholesterol; Cohort Studies; Coronary Disease - blood; Coronary Disease - diagnosis; Coronary Disease - epidemiology; Coronary heart disease; Female; Heart; High-Density Lipoproteins, Pre-beta - blood; Humans; Likelihood Functions; Lipoproteins; Male; Medical sciences; Middle Aged; Myocardial Infarction - blood; Myocardial Infarction - diagnosis; Myocardial Infarction - epidemiology; Predictive Value of Tests; Risk Factors; Cardiovascular disease; Level; Circulatory system; Cardiology; Lipoprotein HDL; Coronary heart disease
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2011.03.054

Preβ-1 high-density lipoprotein (HDL) plays a key role in reverse cholesterol transport by promoting cholesterol efflux. Our aims were (1) to test previous associations between preβ-1 HDL and coronary heart disease (CHD) and (2) to investigate whether preβ-1 HDL levels also are associated with risk of myocardial infarction (MI). Plasma preβ-1 HDL was measured by an ultrafiltration–isotope dilution technique in 1,255 subjects recruited from the University of California–San Francisco Lipid and Cardiovascular Clinics and collaborating cardiologists. Preβ-1 HDL was significantly and positively associated with CHD and MI even after adjustment for established risk factors. Inclusion of preβ-1 HDL in a multivariable model for CHD led to a modest improvement in reclassification of subjects (net reclassification index 0.15, p = 0.01; integrated discrimination improvement 0.003, p = 0.2). In contrast, incorporation of preβ-1 HDL into a risk model of MI alone significantly improved reclassification of subjects (net reclassification index 0.21, p = 0.008; integrated discrimination improvement 0.01, p = 0.02), suggesting that preβ-1 HDL has more discriminatory power for MI than for CHD in our study population. In conclusion, these results confirm previous associations between preβ-1 HDL and CHD in a large well-characterized clinical cohort. Also, this is the first study in which preβ-1 HDL was identified as a novel and independent predictor of MI above and beyond traditional CHD risk factors.