OBJECTIVES: Lipid profile control is a key measure in order to reduce the incidence of future cardiac events in the setting of coronary artery disease. We aim to determine which lipid profile parameter has greater influence on atheroma size using intravascular ultrasound analysis of moderate lesions. METHODS: We performed intravascular ultrasound analysis in a consecutive series of 31 patients presenting 35 moderate lesions, measuring the cross-sectional area (CSA) of vessel, lumen, plaque & media (P&M) and plaque burden at the minimal lumen area. RESULTS: Mean age was 64 ± 11 years, with 75% men and 22% diabetics. An inverse relationship was observed between high-density lipoprotein cholesterol (HDL-cholesterol) levels and P&M area (r = -0.40, P = 0.02). Total cholesterol, low-density lipoprotein cholesterol (LDL-cholesterol) or triglycerides were not related to atheroma size. Multivariate regression revealed that among cardiovascular risk factors, ejection fraction, lipid profile and anti-ischemic drugs, only HDL-cholesterol (Coefficient = -0.58; P = 0.001) and left ventricular ejection fraction (Coefficient = -0.40; P = 0.02) were independent predictors of plaque burden. Patients with HDL-cholesterol > 50 mg/dl presented smaller P&M area (4.9 ± 3.5 mm² vs. 8.84 ± 3.4 mm²; P = 0.03), and vessel area (9.4 ± 3.2 mm² vs. 13.9 ± 3.7 mm²; P = 0.01) when compared to patients with HDL-cholesterol < 50 mg/dL. CONCLUSIONS: In this study, serum HDL-cholesterol level was the single independent predictor of coronary plaque burden at minimal lumen area of moderate lesions evaluated by intravascular ultrasound.
Lipids; Coronary disease; Arteriosclerosis; Ultrasonography, interventional
