Very High High-Density Lipoprotein Cholesterol Levels and Cardiovascular Mortality

• Type of Material: Article
• Authors: Chang Liu, Emory University; Devinder Dhindsa, Emory University; Zakaria Almuwaqqat, Emory University; Yan Sun, Emory University; Arshed Quyyumi, Emory University
• Language: English
• Date: 2022-12-23
• Publisher: EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2022 Published by Elsevier Inc.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.amjcard.2022.10.050
• Title of Journal or Parent Work: AMERICAN JOURNAL OF CARDIOLOGY
• Volume: 188
• Start Page: 120
• End Page: 121
• Grant/Funding Information: A.A.Q. has been supported by NIH grants 4R61HL138657-04, U54AG062334-01, 1P30DK111024-03S1, 15SFCRN23910003, 5P01HL086773-09, 1R01HL141205-01, 5P01HL101398-05, 1P20HL113451-04, 3RF1AG051633-01S2, and American Heart Association grant 15SFCRN23910003. D.S.D has been supported by the Abraham J. & Phyllis Katz Foundation (Atlanta, GA). This research has been conducted using the UK Biobank Resource under Application Number “34031”.
• Keywords: Life Sciences & Biomedicine; Science & Technology; Cardiovascular System & Cardiology; Cardiac & Cardiovascular Systems
• Research Categories: Health Sciences, Medicine and Surgery

Abstract

Our study was conducted using the UK Biobank data with 227,951 women and thus includes proportionately far fewer women compared to 5.7 million cohort studied by Yang et al1. Our data also agree with observations in the South Korean cohort that the nadir of risk in women was in the 80–100mg/dL subset of high-density lipoprotein cholesterol (HDL-C) levels. The number of women with HDL-C > 100 mg/dL (n=3074, 1.3% of women) and the number of all-cause deaths (n=89) and cardiovascular death events (n=15) in this subset were also small. Although we did not have sufficient power to demonstrate statistically higher risk in this subset, in comparison with the women with HDL-C levels between 80 and 99 mg/dL, the U-shaped association was observed at the extremely high HDL-C levels, where risk appears to be higher, using both the continuous data analysis in Figure 1 and categorical analysis in Figure 2. For example, the fully adjusted hazard ratio for cardiovascular death in the subset of women with HDL-C > 100 mg/dL was 1.14 (0.65, 2.00), p=0.7, compared to women with HDL-C levels between 80 and 99 mg/dL. In this regard, our findings agree with the observations by Yang et al.