Very low high-density lipoprotein-cholesterol and long-term mortality

Abstract Background High-density lipoprotein-cholesterol (HDL-C) has anti-atherogenic, anti-inflammatory, anti-oxidative, anti-apoptotic, and vasodilatory properties. While a linear inverse relationship between HDL-C levels all-cause mortality is established, recent observational studies suggest U-shaped association outcome. Purpose We tested the hypothesis that both low high associate with long-term mortality. Methods The present analysis based on longitudinal ECAD registry of consecutive patients undergoing coronary angiography at West German Heart Vascular Center 2004 2019. was quantified hospital admission using standardized enzymatic methods. incidence death due to any cause evaluated during follow-up. Cox regression used determine incident mortality, adjusting for age, sex, systolic blood pressure, low-density lipoprotein cholesterol, smoking status, family history premature cardiovascular disease. In addition as continuous variable, HDL-groups (<10th percentile, 10th-<25th 25th-<50th 50th-<75th 75th-90th ≥90thpercentile) determined <10th percentile reference. Results Among 17,433 patients, mean age 65.9±12.6 years 70.1% were men. Mean 48.7±16.2 mg/dL. During follow-up 3.38±2.10 years, 2,401 (13.8%) died. multivariable analysis, higher independently associated lower [hazard ratio (95% confidence interval): 0.83 (0.76, 0.91) per 1 standard deviation change in HDL-C, p<0.001]. Associations equally male [0.83 (0,74, 0.93), p=0.001] female [0.85 (0.73, 1.00), p=0.0496]. Using <10thpercentile reference (<31mg/dl), all other groups showed stable effect sizes below 1.0 without signs increasing morality probability [0.50 (0.44, 0.58), p<0.001; 0.41 (0.36, 0.46), 0.37 (0.32, 0.42), 0.36 0.31), 0.40 (0.34, 0.47), p<0.001 31–37 mg/dL, 38–45 46–56 57–69 ≥70mg/dl, respectively]. Conclusions large cohort invasive angiography, only very increased found no prognosis. FUNDunding Acknowledgement Type funding sources: Foundation. Main source(s): Iryna Dykun supported by Research Foundation (DY 149/2-1)Stefanie Hendricks Universitätsmedizin Essen Clinician Scientist Academy (UMEA)