Cholesterol efflux and collateral circulation in chronic total coronary occlusion: Effect-circ study

Seonhwa Lee, Jung Mi Park, Soo Jin Ann, Moonjong Kang, Eun Jeong Cheon, Dan Bi An, Yu Ri Choi, Chan Joo Lee, Jaewon Oh, Sungha Park, Seok Min Kang, Sang Hak Lee

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)


BACKGROUND: The mechanism through which high-density lipoprotein (HDL) induces cardioprotection is not completely under-stood. We evaluated the correlation between cholesterol efflux capacity (CEC), a functional parameter of HDL, and coronary collateral circulation (CCC). We additionally investigated whether A1BP (apoA1-binding protein) concentration correlates with CEC and CCC. METHODS AND RESULTS: In this case-control study, clinical and angiographic data were collected from 226 patients (mean age, 58 years; male, 72%) with chronic total coronary occlusion. CEC was assessed using a radioisotope and J774 cells, and human A1BP concentration was measured using enzyme-linked immunosorbent assay. Differences between the good and poor CCC groups were compared, and associations between CEC, A1BP, and other variables were evaluated. Predictors of CCC were identified by multivariable logistic regression analysis. The CEC was higher in the good than in the poor CCC group (22.0±4.6% versus 20.2±4.7%; P=0.009). In multivariable analyses including age, sex, HDL-cholesterol levels, age (odds ratio [OR], 0.96; P=0.003), and CEC (OR, 1.10; P=0.004) were identified as the independent predictors of good CCC. These rela-tionships remained significant after additional adjustment for diabetes mellitus, acute coronary syndrome, and Gensini score. The A1BP levels were not significantly correlated with CCC (300 pg/mL and 283 pg/mL in the good CCC and poor CCC groups, respectively, P=0.25) or CEC. CONCLUSIONS: The relationship between higher CEC and good CCC indicates that well-functioning HDL may contribute to CCC and may be cardioprotective; this suggests that a specific function of HDL can have biological and clinical consequences.

Original languageEnglish
Article numbere019060
Pages (from-to)1-10
Number of pages10
JournalJournal of the American Heart Association
Issue number5
Publication statusPublished - 2021

Bibliographical note

Funding Information:
This work was supported by the National Research Foundation of Korea grant funded by the Korean government (grant No. 2019R1F1A1057952).

Publisher Copyright:
© 2021 The Authors.

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine


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