Association Between High-Density Lipoprotein Cholesterol Levels and Adverse Cardiovascular Outcomes in High-risk Populations

• DOI: 10.1001/jamacardio.2022.0912
• Publication Date: 2022-05-18T15:06:22Z
• Authors: Chang Liu; Devinder Dhindsa; Zakaria Almuwaqqat; Yi-An Ko; Anurag Mehta; Ayman A. Alkhoder; Zahran Alras; Shivang Rajan Desai; Krishan Jignesh P...; Ananya Hooda; Mohamad Wehbe; Laurence S. Sperling; Yan V. Sun; Arshed A. Quyyumi
• Keywords: Cohort Studies; Male; Cholesterol; Risk Factors; Cholesterol, HDL; Humans; Female; Coronary Artery Disease; Prospective Studies; Middle Aged; 16. Peace & justice; Aged; 3. Good health

Previous studies have shown lower cardiovascular risk with higher high-density lipoprotein cholesterol (HDL-C) levels. However, recent data in the general population increased of adverse outcomes at very high HDL-C concentrations.To study association between levels (>80 mg/dL) and mortality patients coronary artery disease (CAD) to investigate known genotypes level outcomes.This prospective, multicenter, cohort study, conducted from 2006 present UK 2003 Atlanta, Georgia, recruited CAD Biobank (UKB) Emory Cardiovascular (EmCAB), respectively. Patients without confirmed were excluded study. Data analyses May 10, 2020, April 28, 2021.High mg/dL).The primary outcome was all-cause death. The secondary death.A total 14 478 participants (mean [SD] age, 62.1 [5.8] years; 11 034 men [76.2%]) UKB 5467 63.8 [12.3] 3632 [66.4%]) EmCAB included Over a median follow-up 8.9 (IQR, 8.0-9.7) years 6.7 4.0-10.8) EmCAB, U-shaped observed those both low compared midrange values. Very associated death (hazard ratio [HR], 1.96; 95% CI, 1.42-2.71; P < .001) (HR, 1.71; 1.09-2.68; = .02) range 40 60 mg/dL after adjustment for confounding factors. These results replicated EmCAB. associations persisted genetic score within UKB. Sensitivity demonstrated that group among than women 2.63; 1.75-3.95; .001 vs HR, 1.39; 0.82-2.35; .23).Results this suggest are paradoxically individuals CAD. This independent common polymorphisms