Department of Cardiology, Gaziosmanpasa University, Tokat, Turkey.
J Investig Med. 2012 Jun;60(5):808-12. doi: 10.2310/JIM.0b013e31824e980c.
High-density lipoprotein cholesterol (HDL-C) promotes cholesterol efflux from macrophage foam cells in atheroma plaques. In addition, HDL-C has anti-inflammatory and endothelium-protective properties. Despite that the only prerequisite for collateral development is shown to be the degree of coronary artery stenosis, there are significant differences even among patients with a similar degree of coronary artery disease.
We designed this study to investigate a possible association between HDL-C and coronary collateral circulation (CCC).
All study participants had at least one occluded major coronary artery. Demographic, clinical, and laboratory data were obtained from patients' medical records. To classify CCC, we used Rentrop classification. The patients were then classified as having poor CCC (Rentrop grades 0-1) or good CCC (Rentrop grades 2-3). We performed t test and the χ test in comparing groups and multivariate logistics regression analysis to determine the predictors of CCC. The study population consisted of 151 patients (mean age, 63.7 ± 9 years; 76.2% male).
Forty-nine patients had poor CCC and 102 patients had good CCC. The proportion of previous myocardial infarctions, serum triglycerides, and low HDL-C levels were more frequent in the poor CCC group (P = 0.026, P = 0.015, and P < 0.001, respectively). Multivariate logistic regression analysis revealed that low HDL-C is a predictor of CCC (B = 1.456; P < 0.001; odds ratio, 4.3; 95% confidence interval, 1.964-9.369).
We found that low HDL-C frequency was more frequent in the poor CCC group than the good CCC group, and HDL-C was a predictor of CCC.
高密度脂蛋白胆固醇（HDL-C）可促进动脉粥样斑块中巨噬细胞泡沫细胞的胆固醇外流。此外，HDL-C 还具有抗炎和保护血管内皮的特性。尽管仅显示出侧支循环发展的唯一先决条件是冠状动脉狭窄程度，但即使在具有相似程度的冠状动脉疾病的患者中，也存在明显的差异。
我们设计了这项研究，以调查 HDL-C 与冠状动脉侧支循环（CCC）之间可能存在的关联。
所有研究参与者均至少有一条闭塞的主要冠状动脉。从患者的病历中获取人口统计学、临床和实验室数据。为了对 CCC 进行分类，我们使用了 Rentrop 分类。然后根据 Rentrop 分级将患者分为 CCC 较差（Rentrop 分级 0-1）或 CCC 较好（Rentrop 分级 2-3）。我们在比较组时进行 t 检验和 χ 检验，并进行多元逻辑回归分析以确定 CCC 的预测因素。该研究人群包括 151 名患者（平均年龄为 63.7 ± 9 岁，76.2%为男性）。
49 名患者 CCC 较差，102 名患者 CCC 较好。在 CCC 较差的患者中，既往心肌梗死、血清甘油三酯和低 HDL-C 水平的比例更高（P = 0.026、P = 0.015 和 P < 0.001）。多元逻辑回归分析显示，低 HDL-C 是 CCC 的预测因素（B = 1.456；P < 0.001；比值比，4.3；95%置信区间，1.964-9.369）。
我们发现，在 CCC 较差的患者中，低 HDL-C 的频率比 CCC 较好的患者更高，HDL-C 是 CCC 的预测因素。
