Dissociation Between Cholesteryl Ester Transfer Protein Mass and Activity in Coronary Artery Disease Patients with Elevated High-Density Lipoprotein Cholesterol: Implications for High-Density Lipoprotein Function and Residual Cardiovascular Risk
ANATOLIAN JOURNAL OF CARDIOLOGY, 2026 (SCI-Expanded, Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Basım Tarihi: 2026
- Doi Numarası: 10.14744/anatoljcardiol.2026.6137
- Dergi Adı: ANATOLIAN JOURNAL OF CARDIOLOGY
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE, Directory of Open Access Journals, TR DİZİN (ULAKBİM), Academic Search Ultimate (EBSCO), Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest)
- Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
- Gazi Üniversitesi Adresli: Evet
Özet
Background: High-density lipoprotein cholesterol (HDL-C) is traditionally viewed as cardioprotective; however, some patients with coronary artery disease (CAD) may present with elevated HDL-C levels, challenging this assumption. This study aimed to investigate the roles of HDL subclasses, apolipoproteins, and cholesteryl ester transfer protein (CETP) activity and mass in patients with CAD with high HDL-C and low-density lipoprotein cholesterol (LDL-C) levels. Methods: A total of 35 patients with CAD and 35 age-and lipid-matched control participants (HDL-C >= 60 mg/dL and LDL-C >= 130 mg/dL) were enrolled. Cholesteryl ester transfer protein mass and activity, apolipoprotein A-I (ApoA-I), ApoA-II, ApoB, and HDL subclasses (HDL2 and HDL3) were measured and compared between groups. Correlation analyses and multivariate logistic regression were performed to assess the relationship between CETP activity and CAD. Results: The CETP activity was significantly higher in patients with CAD compared with control participants (1.08 vs. 0.98 nmol/mu L/h, P = .007), whereas CETP mass, HDL2, and HDL3 levels were similar. The ApoA-I levels were paradoxically higher in patients with CAD (P = .006), with no differences in ApoA-II or ApoB. In multivariate analysis, CETP activity remained independently associated with CAD after adjusting for age and sex (OR 2.03; 95% CI 1.27-3.24; P = .002). Conclusion: In patients with high HDL-C and LDL-C, increased CETP activity-but not mass-was associated with the presence of CAD, suggesting CETP function may contribute to residual cardiovascular risk. Elevated ApoA-I levels in patients with CAD may reflect dysfunctional HDL, emphasizing that HDL quality, rather than quantity, plays a more critical role in atheroprotection. These findings support a functional evaluation of lipoproteins in cardiovascular risk assessment.