{"id":{"repo_id":"utswmed","oai_identifier":"oai:utswmed-ir.tdl.org:2152.5/3299"},"canonical_url":"https://search.dev.ndltd.org/etd/utswmed/oai:utswmed-ir.tdl.org:2152.5/3299","repository":{"repo_id":"utswmed","name":"University of Texas Southwestern Medical Center","base_url":"https://utswmed-ir.tdl.org/server/oai/request"},"display":{"title":"HDL Phospholipid and ABCA1-Mediated Cholesterol Efflux Are Reduced in Patients with Very High HDL-C Who Develop Early Coronary Artery Disease","abstract":"BACKGROUND: Plasma levels of high-density lipoprotein cholesterol (HDL-C) are strongly inversely associated with coronary artery disease (CAD), and high HDL-C is generally associated with apparent ‘protection’ from CAD. OBJECTIVE: We identified a number of individuals with high HDL-C levels who develop CAD, a paradoxical phenotype and hypothesized that such individuals may have HDL with altered structure and function, and compared controls with similarly high HDL-C and no coronary disease. METHODS: 55 subjects with HDL-C above the 90th percentile, early CAD, and no major known risk factors for coronary disease were identified. We selected 120 controls without CAD, each matched for race, gender, and HDL-C level. RESULTS: Comparison of HDL particle characteristics between cases and controls demonstrated a significant reduction in HDL phospholipid composition and cholesterol efflux capacity in cases as compared to controls. CONCLUSION: Reduced cholesterol efflux capacity in cases with elevated HDL-C and CAD may explain the development of early coronary artery disease. Cholesterol efflux capacity may in fact be a better predictor of the risk of coronary disease then HDL-C levels alone. The reduction in HDL phospholipid in the cases may help account for impaired cholesterol efflux.","abstract_html":"BACKGROUND: Plasma levels of high-density lipoprotein cholesterol (HDL-C) are strongly inversely associated with coronary artery disease (CAD), and high HDL-C is generally associated with apparent ‘protection’ from CAD. OBJECTIVE: We identified a number of individuals with high HDL-C levels who develop CAD, a paradoxical phenotype and hypothesized that such individuals may have HDL with altered structure and function, and compared controls with similarly high HDL-C and no coronary disease. METHODS: 55 subjects with HDL-C above the 90th percentile, early CAD, and no major known risk factors for coronary disease were identified. We selected 120 controls without CAD, each matched for race, gender, and HDL-C level. RESULTS: Comparison of HDL particle characteristics between cases and controls demonstrated a significant reduction in HDL phospholipid composition and cholesterol efflux capacity in cases as compared to controls. CONCLUSION: Reduced cholesterol efflux capacity in cases with elevated HDL-C and CAD may explain the development of early coronary artery disease. Cholesterol efflux capacity may in fact be a better predictor of the risk of coronary disease then HDL-C levels alone. The reduction in HDL phospholipid in the cases may help account for impaired cholesterol efflux.","abstract_has_math":false,"creators":["Agarwala, Anandita"],"institution":null,"degree_name":null,"degree_level":null,"degree_discipline":null,"degree_department":null,"school":null,"contributors":["Khera, Amit","Hobbs, Helen H.","Grundy, Scott M."],"advisors":[],"committee_chairs":[],"committee_members":[],"year":2016,"date_issued":"2016-06-27T19:56:01Z","date_published":"2016-06-27T19:56:01Z","updated_at":"2026-07-24T05:52:38Z","subjects":["Cholesterol","Coronary Artery Disease","Lipoproteins, HDL"],"languages":["en_US"],"rights":[],"rights_urls":[],"identifier_entries":[{"key":"dc:identifier","label":"Identifier","values":["952355490"],"render_values":[{"text":"952355490","href":null,"code":true}]}]},"links":{"outbound_url":"https://hdl.handle.net/2152.5/3299","outbound_label":"Handle","outbound_source":"dc:identifier"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor","label":"Contributor","values":["Khera, Amit","Hobbs, Helen H.","Grundy, Scott M."]},{"key":"dc:creator","label":"Author","values":["Agarwala, Anandita"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date","label":"Dc Date","values":["2016-06-27T19:56:01Z","2014-05","2014-04-15","May 2014","2016-06-27T19:48:21Z"]},{"key":"dc:type","label":"Dc Type","values":["Thesis","text"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["Cholesterol","Coronary Artery Disease","Lipoproteins, HDL"]}]},{"id":"language_rights","label":"Language and Rights","entries":[{"key":"dc:language","label":"Dc Language","values":["en_US"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier","label":"Identifier","values":["https://hdl.handle.net/2152.5/3299","952355490"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description","label":"Description","values":["BACKGROUND: Plasma levels of high-density lipoprotein cholesterol (HDL-C) are strongly inversely associated with coronary artery disease (CAD), and high HDL-C is generally associated with apparent ‘protection’ from CAD. OBJECTIVE: We identified a number of individuals with high HDL-C levels who develop CAD, a paradoxical phenotype and hypothesized that such individuals may have HDL with altered structure and function, and compared controls with similarly high HDL-C and no coronary disease. METHODS: 55 subjects with HDL-C above the 90th percentile, early CAD, and no major known risk factors for coronary disease were identified. We selected 120 controls without CAD, each matched for race, gender, and HDL-C level. RESULTS: Comparison of HDL particle characteristics between cases and controls demonstrated a significant reduction in HDL phospholipid composition and cholesterol efflux capacity in cases as compared to controls. CONCLUSION: Reduced cholesterol efflux capacity in cases with elevated HDL-C and CAD may explain the development of early coronary artery disease. Cholesterol efflux capacity may in fact be a better predictor of the risk of coronary disease then HDL-C levels alone. The reduction in HDL phospholipid in the cases may help account for impaired cholesterol efflux."]},{"key":"dc:format","label":"Dc Format","values":["application/pdf"]},{"key":"dc:title","label":"Title","values":["HDL Phospholipid and ABCA1-Mediated Cholesterol Efflux Are Reduced in Patients with Very High HDL-C Who Develop Early Coronary Artery Disease"]}]}],"canonical_facts":{"dc:contributor":["Khera, Amit","Hobbs, Helen H.","Grundy, Scott M."],"dc:creator":["Agarwala, Anandita"],"dc:date":["2016-06-27T19:56:01Z","2014-05","2014-04-15","May 2014","2016-06-27T19:48:21Z"],"dc:description":["BACKGROUND: Plasma levels of high-density lipoprotein cholesterol (HDL-C) are strongly inversely associated with coronary artery disease (CAD), and high HDL-C is generally associated with apparent ‘protection’ from CAD. OBJECTIVE: We identified a number of individuals with high HDL-C levels who develop CAD, a paradoxical phenotype and hypothesized that such individuals may have HDL with altered structure and function, and compared controls with similarly high HDL-C and no coronary disease. METHODS: 55 subjects with HDL-C above the 90th percentile, early CAD, and no major known risk factors for coronary disease were identified. We selected 120 controls without CAD, each matched for race, gender, and HDL-C level. RESULTS: Comparison of HDL particle characteristics between cases and controls demonstrated a significant reduction in HDL phospholipid composition and cholesterol efflux capacity in cases as compared to controls. CONCLUSION: Reduced cholesterol efflux capacity in cases with elevated HDL-C and CAD may explain the development of early coronary artery disease. Cholesterol efflux capacity may in fact be a better predictor of the risk of coronary disease then HDL-C levels alone. The reduction in HDL phospholipid in the cases may help account for impaired cholesterol efflux."],"dc:format":["application/pdf"],"dc:identifier":["https://hdl.handle.net/2152.5/3299","952355490"],"dc:language":["en_US"],"dc:subject":["Cholesterol","Coronary Artery Disease","Lipoproteins, HDL"],"dc:title":["HDL Phospholipid and ABCA1-Mediated Cholesterol Efflux Are Reduced in Patients with Very High HDL-C Who Develop Early Coronary Artery Disease"],"dc:type":["Thesis","text"]},"updated_at":"2026-07-24T05:52:38Z"}