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Abstract: TH-PO614

High-Density Lipoprotein Particle Size and Function Predict Cardiovascular Events in Patients With CKD

Session Information

Category: Hypertension and CVD

  • 1501 Hypertension and CVD: Epidemiology‚ Risk Factors‚ and Prevention

Authors

  • Mathew, Anna Vachaparampil, University of Michigan, Ann Arbor, Michigan, United States
  • Han, Yun, University of Michigan, Ann Arbor, Michigan, United States
  • Cheofor, Vetalise Konje, University of Michigan, Ann Arbor, Michigan, United States
  • Guo, Yanhong, University of Michigan, Ann Arbor, Michigan, United States
  • Chen, Y. Eugene, University of Michigan, Ann Arbor, Michigan, United States
  • Gillespie, Brenda W., University of Michigan, Ann Arbor, Michigan, United States
  • Saran, Rajiv, University of Michigan, Ann Arbor, Michigan, United States
  • Pennathur, Subramaniam, University of Michigan, Ann Arbor, Michigan, United States
Background

Chronic Kidney Disease (CKD) is a risk factor for cardiovascular disease (CVD) and 40% of patients with CKD exhibit clinical CVD with greater than 10-fold mortality compared to healthy subjects. Lipoprotein particle size profiles measured with nuclear magnetic resonance spectroscopy and cholesterol efflux capacity (CEC), a metric of high-density lipoprotein (HDL) function predict CVD in the general population. CEC also predicts incident CV events in patients with CKD, but the association of lipoprotein particle size with incident CV events and its link with CEC in CKD patients is unknown.

Methods

We quantified the CEC and lipoprotein particle profile of 325 subjects with stage 3-4 CKD (median follow-up of 2.5 years). To assess the association of lipoprotein particle size with incident CV events, we created Cox regression models controlled for various clinical factors, including age, gender, race, history of CVD, diabetes, systolic blood pressure, C reactive protein, renal function, urine protein, and total cholesterol.

Results

CEC [HR=1.46, p=0.03] was associated with CV events after adjustment for clinical factors. Increased HDL particle size [HR=2.56, p=0.002], Large HDL particles [HR=1.41, p=0.001], and HDL-cholesterol levels [HR=1.04, p=0.001] associate with decreased time to CV events, while a decrease in small VLDL particles [HR=0.97, p=0.02] particles increased the risk of CV events after adjusting for clinical factors.

Conclusion

CEC, HDL cholesterol, and particle size paradoxically were associated with incident CV events in the CKD population adding evidence to the altered HDL metabolism in patients with CKD-associated CVD.

Funding

  • Other NIH Support