Can dysfunctional HDL explain high coronary artery disease risk in South Asians?

Sunita Dodani, Rajwinderjit Kaur, Srinavasa Reddy, Guy L. Reed, Mohammad Navab, Varghese George

Research output: Contribution to journalArticle

50 Citations (Scopus)

Abstract

Background: Coronary artery disease (CAD) is the leading cause of mortality and morbidity in United States, and South Asian immigrants (SAIs) have a higher risk for CAD compare to Caucasians. Traditional risk factors do not completely explain high risk, and some of the unknown risk factors need to be explored. We assessed dysfunctional pro-inflammatory high density lipoprotein (HDL) in SAIs and assessed its association with sub-clinical CAD using carotid intima-media thickness (IMT) as a surrogate marker for atherosclerosis. Methods: Cross-sectional study on SAIs aged 40-65 years. Sub-clinical CAD was measured using carotid intima media thickness (IMT) as a surrogate marker of atherosclerosis. Dysfunctional or pro-inflammatory HDL was determined by novel cell free assay and HDL inflammatory Index. Results: Dysfunctional HDL was found in the 50% participants, with HDL-inflammatory index of ≥ 1.00, suggesting pro-inflammatory HDL (95% CI, 0.8772-1.4333). The prevalence of sub-clinical CAD using carotid IMT (≥ 0.80 mm) was seen in 41.4% (95% CI, 0.2347-0.5933). On logistic regression analysis, positive carotid IMT was found to be associated with dysfunctional HDL after adjusting for age, family history of cardiovascular disease, and hypertension (p = 0.030). Conclusions: The measurement of HDL level as well as functionality plays an important role in CAD risk assessment. Those SAIs with dysfunctional HDL and without known CAD can be a high risk group requiring treatment with lipid lowering drugs to reduce future risk of CAD. Further large studies are required to explore association of dysfunctional HDL with CAD and identify additional CAD risk caused by dysfunctional HDL.

Original languageEnglish (US)
Pages (from-to)125-132
Number of pages8
JournalInternational Journal of Cardiology
Volume129
Issue number1
DOIs
StatePublished - Sep 16 2008

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HDL Lipoproteins
Coronary Artery Disease
Carotid Intima-Media Thickness
Atherosclerosis
Biomarkers
Cardiovascular Diseases
Cross-Sectional Studies
Logistic Models
Regression Analysis
Hypertension
Morbidity
Lipids
Mortality

Keywords

  • Coronary artery disease
  • Dysfunctional HDL
  • Intima media thickness
  • Risk factors
  • South Asians

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Can dysfunctional HDL explain high coronary artery disease risk in South Asians? / Dodani, Sunita; Kaur, Rajwinderjit; Reddy, Srinavasa; Reed, Guy L.; Navab, Mohammad; George, Varghese.

In: International Journal of Cardiology, Vol. 129, No. 1, 16.09.2008, p. 125-132.

Research output: Contribution to journalArticle

Dodani, Sunita ; Kaur, Rajwinderjit ; Reddy, Srinavasa ; Reed, Guy L. ; Navab, Mohammad ; George, Varghese. / Can dysfunctional HDL explain high coronary artery disease risk in South Asians?. In: International Journal of Cardiology. 2008 ; Vol. 129, No. 1. pp. 125-132.
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abstract = "Background: Coronary artery disease (CAD) is the leading cause of mortality and morbidity in United States, and South Asian immigrants (SAIs) have a higher risk for CAD compare to Caucasians. Traditional risk factors do not completely explain high risk, and some of the unknown risk factors need to be explored. We assessed dysfunctional pro-inflammatory high density lipoprotein (HDL) in SAIs and assessed its association with sub-clinical CAD using carotid intima-media thickness (IMT) as a surrogate marker for atherosclerosis. Methods: Cross-sectional study on SAIs aged 40-65 years. Sub-clinical CAD was measured using carotid intima media thickness (IMT) as a surrogate marker of atherosclerosis. Dysfunctional or pro-inflammatory HDL was determined by novel cell free assay and HDL inflammatory Index. Results: Dysfunctional HDL was found in the 50{\%} participants, with HDL-inflammatory index of ≥ 1.00, suggesting pro-inflammatory HDL (95{\%} CI, 0.8772-1.4333). The prevalence of sub-clinical CAD using carotid IMT (≥ 0.80 mm) was seen in 41.4{\%} (95{\%} CI, 0.2347-0.5933). On logistic regression analysis, positive carotid IMT was found to be associated with dysfunctional HDL after adjusting for age, family history of cardiovascular disease, and hypertension (p = 0.030). Conclusions: The measurement of HDL level as well as functionality plays an important role in CAD risk assessment. Those SAIs with dysfunctional HDL and without known CAD can be a high risk group requiring treatment with lipid lowering drugs to reduce future risk of CAD. Further large studies are required to explore association of dysfunctional HDL with CAD and identify additional CAD risk caused by dysfunctional HDL.",
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AB - Background: Coronary artery disease (CAD) is the leading cause of mortality and morbidity in United States, and South Asian immigrants (SAIs) have a higher risk for CAD compare to Caucasians. Traditional risk factors do not completely explain high risk, and some of the unknown risk factors need to be explored. We assessed dysfunctional pro-inflammatory high density lipoprotein (HDL) in SAIs and assessed its association with sub-clinical CAD using carotid intima-media thickness (IMT) as a surrogate marker for atherosclerosis. Methods: Cross-sectional study on SAIs aged 40-65 years. Sub-clinical CAD was measured using carotid intima media thickness (IMT) as a surrogate marker of atherosclerosis. Dysfunctional or pro-inflammatory HDL was determined by novel cell free assay and HDL inflammatory Index. Results: Dysfunctional HDL was found in the 50% participants, with HDL-inflammatory index of ≥ 1.00, suggesting pro-inflammatory HDL (95% CI, 0.8772-1.4333). The prevalence of sub-clinical CAD using carotid IMT (≥ 0.80 mm) was seen in 41.4% (95% CI, 0.2347-0.5933). On logistic regression analysis, positive carotid IMT was found to be associated with dysfunctional HDL after adjusting for age, family history of cardiovascular disease, and hypertension (p = 0.030). Conclusions: The measurement of HDL level as well as functionality plays an important role in CAD risk assessment. Those SAIs with dysfunctional HDL and without known CAD can be a high risk group requiring treatment with lipid lowering drugs to reduce future risk of CAD. Further large studies are required to explore association of dysfunctional HDL with CAD and identify additional CAD risk caused by dysfunctional HDL.

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