Low HDL-C predicts risk and PCI outcomes in the Han Chinese population

Background: High-density lipoprotein cholesterol (HDL-C) can predict the occurrence and prognosis of coronary heart disease (CHD) in the Western population; however, the role of HDL-C in Chinese populations is unclear. Thus, we investigated the predictive value of HDL-C on the risk and clinical outcomes of CHD in the Han Chinese population. Methods: In a case-control study, plasma HDL-C levels of CHD patients and controls were evaluated to analyse the diagnostic value of HDL-C on CHD. In a prospective cohort study, the predictive value of HDL-C on the development of major adverse cardiovascular events (MACE) was determined in CHD patients who underwent a percutaneous coronary intervention (PCI). Results: In the case-control study, HDL-C levels were significantly lower in patients with CHD (n = 375) compared to the controls (n = 328, P < 0.05). There were more male patients in the CHD group than in the control group. Logistic regression analysis showed that, relative to other lipid parameters, the relationship between HDL-C levels and CHD showed the strongest association. A stratified analysis showed that gender did not affect the relationship between HDL-C levels and CHD. The prospective cohort study found that in the low HDL-C subgroup of CHD patients (n = 249) who underwent PCI, 62 (24.9%) patients experienced a MACE during the 120-week follow-up period. However, only 15 (6.8%) patients experienced a MACE in the high HDL-C subgroup (n = 219; P < 0.05). Kaplan-Meier analysis revealed that the MACE rate and death rate were significantly higher in the low HDL-C subgroup than in their counterparts with high HDL-C levels (P < 0.05). The Cox regression analysis showed that HDL-C was an independent predictor of a MACE during the follow-up period (hazard ratio = 0.395, P = 0.005). Conclusions: Low HDL-C was the most powerful lipid parameter for predicting the risk and the clinical outcome of CHD in the Han Chinese population.