Relation between high density lipoprotein cholesterol and coronary atherosclerotic heart disease with multi-vessel lesions

Zhang Ning; Liu Wenxian

doi:10.3760/j.issn.1673-4777.2019.07.003

Abstract：Objective To investigate the relation between high density lipoprotein cholesterol (HDL-C)and coronary atherosclerotic heart disease(CHD) with multi-vessel lesions.Methods A total of 943 patients with uncertain diagnosis of CHD admitted to Beijing Anzhen Hospital,Capital Medical University from January to June 2018 were included;846 patients were diagnosed of CHD by coronary angiography (CHD group);97 patients without CHD were control group.There were 371 cases of single coronary disease,273 cases of double-vessel disease and 202 cases of triple-vessel disease.Baseline data,laboratory indices and Gensini score were compared among control group and CHD patients with different numbers of lesions.Related factors of CHD and multi-vessel lesions were analyzed.Results Ratios of male,smoking history,diabetes history,levels of white blood cell count,serum creatinine,C-reactive protein,B-type brain natriuretic peptide and Gensini score in CHD group were higher than those in control group;the level of HDL-C in CHD group was lower than that in control group [(1.05 ± 0.29) mmol/L vs (1.16 ± 0.27) mmol/L] and the differences were statistically significant (all P ＜ 0.05).Logistic regression showed that Gensini score and diabetes history were risk factors and HDL-C was a protective factor of CHD (odds ratio =0.276,95％ confidence interval:0.102-0.749,P =0.012).In double-vessel and triple-vessel disease groups,age and Gensini score were higher than those in single-vessel disease group;HDL-C level was lower than that in single-vessel disease group [(1.03 ± 0.25),(1.02 ± 0.35) mmol/L vs (1.07 ± 0.27) mmol/L] (all P ＜ 0.05).In triple-vessel disease group,systolic blood pressure and serum B-type brain natriuretic peptide level were higher than those in single-vessel disease group;Gensini score was higher than that in double-vessel disease group;ratios of diabetes history and hypertension history and serum creatinine level were higher than those in single vessel and double-vessel disease groups(all P ＜ 0.05).Logistic regression showed that age,male,Gensini score,diabetes history and hypertension history were risk factors of multi-vessel lesions;HDL-C was a protective factor of multi-vessel lesions(odds ratio =0.299,95％ confidence interval:0.118-0.754,P =0.011).Conclusions Increased HDL-C level suggests low risk of CHD and multi-vessel coronary artery disease.Low HDL-C level is an independent risk factor of CHD and multi-vessel lesions.