High-density lipoprotein cholesterol, triglycerides, and characteristics of coronary atherosclerosis in patients with significant coronary artery disease newly diagnosed by computed tomography coronary angiography

Background: The Current European Society of Cardiology guidelines indicate specific target low-density lipoprotein cholesterol (LDL-C) levels for different cardiovascular risk categories in terms of prevention. However, the target for high-density lipoprotein cholesterol (HDL-C) and triglycerides has not been established.Aim: The study aims to investigate the associations between HDL-C, triglycerides, and coronary plaque characteristics.Methods: This was a prospective single-center study with enrolled consecutive patients with newly diagnosed significant (>= 1 stenosis >= 50%) CAD on computed tomography coronary angiography (CTCA). Patients had lipids and CTCA analysis, including high-risk plaque (HRP) features: low-atten-uation plaque (LAP), napkin-ring sign (NRS), positive remodeling (PR), and spotty calcium (SC), type of the plaque (calcified, noncalcified, mixed), and their composition (calcified, fibrous, fibro-fatty, necrotic core).Results: The study included 300 patients (191 men, 66 [8] years). Sixty-six percent of them had lipid-lowering therapy. HRP was found in 208 patients. There was no association between LDL-C, plaque composition, and HRP presence. There was a negative correlation between HDL-C, fibro-fatty and necrotic core plaque components (P= 0.0002, P= 0.0009). There was a positive correlation be-tween triglycerides and necrotic core (P= 0.038). There were differences in HDL-C and triglycerides in patients with and without NRS (47 vs. 53 mg/dl, P = 0.0002 and 128 vs. 109 mg/dl, P = 0.02). In logistic regression, HDL-C (odds ratio [OR], 0.95; 95% confidence interval [CI], 0.93-0.98; P <0.001), triglycerides (OR, 1.00; 95% CI, 1.00-1.01;P= 0.02), and male sex (OR, 3.04; 95% CI, 1.41-6.52; P= 0.004) were NRS predictors. In multivariable regression, only HDL-C (OR, 0.96; 95% CI, 0.93-0.99; P= 0.02) was an independent predictor of NRS.Conclusion: Lower HDL-C and higher triglycerides were associated with NRS presence and more necrotic core plaque components in coronary plaques in patients with newly diagnosed CAD.

Automated summary

This study aims to investigate the associations between HDL-C, triglycerides, and coronary plaque characteristics. The study found that lower HDL-C levels and higher triglycerides levels were associated with more necrotic core plaque components and the presence of fibro-fatty plaques in coronary plaques in patients with newly diagnosed CAD.