Association between the High-density Lipoprotein Cholesterol Efflux Capacity and the Long-term Prognosis in Patients with Coronary Artery Disease: A Meta-analysis
Itaru Hisauchi, Tetsuya Ishikawa, Kota Yamada, Tomoaki Ukaji, Masatoshi Shimura, Yohei Tamura, Yuki Kondo, Taro Takeyama, Kahoko Mori, M. Arai, Yuichi Hori, Shiro Nakahara, Yuji Itabashi, Sayuki Kobayashi, Isao Taguchi
Abstract
AIM: We aimed to determine whether baseline high-density lipoprotein (HDL) cholesterol efflux capacity (CEC) at the time of coronary angiography (CAG) could serve as a prognostic marker for future major adverse cardiovascular events (MACE) in patients with coronary artery disease (CAD) through a systematic review and meta-analysis. METHODS: The MEDLINE, Cochrane, and Embase databases were used for data collection. As of April 2024, 2,871 studies have been identified. Clinical studies comparing MACEs over an observational interval exceeding 12 months in patients with angiographically defined CAD with estimated hazard ratios (HRs) of MACEs in the higher or top-quartile HDL-CEC (H-HDL-CEC) group compared with the lower or bottom-quartile HDL-CEC (L-HDL-CEC) group, after adjusting for six confounding variables, including HDL-C, were included. HRs of 1) overall cardiovascular outcomes, composite of cardiovascular mortality, myocardial infarction, any coronary revascularization, and all-cause mortality (Model-1), and 2) cardiovascular outcomes excluding all-cause mortality from Model-1 (Model-2), compared between the L-HDL-CEC and H-HDL-CEC groups, were estimated using a random-effects model, respectively. RESULTS: =64% [p=0.04]). CONCLUSION: This is the first systematic review and meta-analysis to demonstrate a significant inverse relationship between the baseline HDL-CECs on CAG and long-term MACEs in CAD patients.