Abstract 622: High-density Lipoprotein Cholesterol Efflux Does Not Predict Cardiovascular Risk in Hemodialysis Patients

• Published in: Arteriosclerosis, thrombosis, and vascular biology Vol. 36; no. suppl_1
• Main Authors: Ebtehaj, Sanam, Kopecky, Chantal, Genser, Bernd, Drechsler, Christiane, Krane, Vera, Antlanger, Marlies, J. Kovarik, Johannes, C. Kaltenecker, Christopher, Parvizi, Mojtaba, Wanner, Christoph, Weichhart, Thomas, Säemann, Marcus D, Tietge, Uwe J
• Format: Journal Article
• Language: English
• Published: 01.05.2016
• ISSN: 1079-5642; 1524-4636
• DOI: 10.1161/atvb.36.suppl_1.622

Abstract only The cardioprotective effect of HDL (High-Density Lipoprotein) is largely determined by its cholesterol efflux capacity, which was shown to correlate inversely with atherosclerotic cardiovascular disease in populations with normal kidney function. Patients with end-stage renal disease suffer an exceptionally high cardiovascular risk not fully explained by traditional risk factors. Here, we investigated in a post-hoc analysis in 1147 patients with type 2 diabetes mellitus on hemodialysis participating in the 4D Study (The German Diabetes Dialysis Study), if the HDL cholesterol efflux capacity is predictive of cardiovascular risk. Efflux capacity was quantified by incubating human macrophage foam cells with apolipoprotein B-depleted serum. During a median follow-up of 4.1 years n=423 patients reached the combined primary endpoint (composite of cardiac death, nonfatal myocardial infarction and stroke), n=410 experienced cardiac events and n=561 died (all-cause mortality). Strikingly, in Cox regression analysis we found no association of efflux capacity with the combined primary endpoint (hazard ratio [HR], 0.96; 95% confidence interval [CI], 0.88 – 1.06, p =0.417), cardiac events (HR, 0.92; CI, 0.83-1.02; p =0.108) or all-cause mortality (HR 0.96; 95% CI, 0.88-1.05; p =0.390). In conclusion, HDL cholesterol efflux capacity is not a prognostic cardiovascular risk marker in diabetic patients on hemodialysis.