Table 1. The relationship between HDL-C, CV risk, and mortality.
| Study | Number of participants | Study group | Follow-up (y) | Principle findings |
|---|---|---|---|---|
| Gordon et al. (1989)3 | 1,418 | FHS | 10.3 | - A consistent linear inverse relation of HDL-C levels and CHD event rates. |
| 6,234 | LRCF | 8.5 | - HDLC levels were essentially unrelated to non-CV mortality. | |
| Four prospective American studies | 1,808 | CPPT | 7.7 | |
| 5,792 | MRFIT | 6.7 | ||
| Assmann et al. (1996)11 | 19,698 | Volunteer subjects | 6 | A significant association between HDL-C and the incidence of atherosclerotic CHD (P < 0.001), which remained after adjustment for other risk factors. |
| PROCAM study | 16–65 years | |||
| Wilkins et al. (2014)2 | 11,515 men 12,925 women | Pooled data from 6 community- based cohorts | Men: 139,624 person-years of follow-up | A linear inverse relation has been reported between plasma HDL-C level and incident CHD events with a plateau effect at HDL-C values >90 mg/dl in men and 75 mg/dL in women. |
| 54–60 years | Women: 167,622 person-years of follow up | |||
| Barter et al. (2007)5 | 9,770 | NT study cohort | 5 | HDL-C levels were predictive of major CV events in patients treated with optimal statin therapy. |
| TNT trial | Patients with clinically evident CAD. | |||
| Silbernagel et al. (2013)6 | 3,141 | LURIC | 8.9 ± 3.0 | HDL-C was strongly associated with CV mortality in people without CHD, but not in patients with stable and unstable CHD. |
| 3,413 | AtheroGene | 4.5 ± 2.0 | ||
| 5,738 | ESTHER | 9.1 ± 1.6 | ||
| Angeloni et al. (2013)7 | 1,548 | Patients undergoing elective CABG | 2.7 | Pre-operative higher HDL-C levels were not associated with reduced but rather increased MACE occurrence during follow-up. |
| Voight et al. (2012)8 | 20 studies | A Mendelian randomization study | - Endothelial lipase gene 396Ser allele (2.6% frequency, and associated with high plasma HDL-C levels) was not associated with risk of MI. | |
| 20,913 MI cases | ||||
| 95,407 controls | - 1 SD increase in HDL-C due to genetic score was not associated with risk of MI. | |||
| - However, 1 SD increase in LDL-C due to genetic score was associated with increased risk of MI. | ||||
| Rohatgi et al. (2014)12 | 2,924 | Dallas Heart Study | 9.4 | - Baseline HDL-C level was not associated with CV events in an adjusted analysis. |
| (adults free from CV disease) | ||||
| - Individuals in the highest quartile of cholesterol efflux capacity are associated with a 67% reduction in CV risk compared to those in the lowest quartile. | ||||
| Ridker et al. (2010)9 | 17,802 | JUPITIR trial | HDL-C concentrations are not predictive of residual vascular risk among patients treated with potent statin therapy who attain very low concentrations of LDL-C. |
Notes.
- FHS
- Framingham Heart Study
- LRCF
- Lipid Research Clinics Prevalence Mortality Follow-up Study
- CPPT
- Coronary Primary Prevention Trial
- MRFIT
- Multiple Risk Factor Intervention Trial
- PROCAM
- Prospective Cardiovascular Münster study
- TNT
- Treating to New Targets study
- LURIC
- LUdwigshafen RIsk and Cardiovascular health study
- ESTHER
- Epidemiologische Studie zu Chancen der Verhütung, Früherkennung und optimierten Therapie chronischer Erkrankungen in der älteren Bevölkerung (German)
- MACE
- major adverse cardiovascular events
- MI
- myocardial infarction
- JUPITIR
- Justification for the Use of Statins in Prevention: an Intervention Trial Evaluating Rosuvastatin