Significance of serum high-density lipoprotein cholesterol levels for diagnosis of coronary stenosis as determined by MDCT in patients with suspected coronary artery disease

Aim: since we previously reported that lower levels of hdl-c may be most useful for predicting coronary artery disease (cad) as assessed by multi-detector row computed tomography (mdct),we sought to confirm,among the levels of ldl-c,hdl-c,non-hdl-c (total cholesterol minus hdl-c) and the ratio of ldl-c to hdl-c (ldl-c/hdl-c),which is most closely related to the presence of cad. methods and results: the subjects consisted of 506 consecutive patients with suspected cad who underwent mdct with (+) or without (-) statin treatment. the levels of ldl-c in the statin (-) group were similar in categories i,ii and iii according to the japan atherosclerosis society (jas) guidelines 2007,whereas the levels of hdl-c significantly decreased and ldl-c/hdl-c significantly increased as the category number ncreased. in the statin (-) group,the prevalence of cad in categories i,ii and iii was 0,16 and 33%,respectively (p = 0.0018 for trend),in patients with good control of ldl-c levels according to the guidelines. multivariate logistic regression analysis was performed to examine the association between the presence of cad and 11 possible factors. age and hdl-c in the statin (-) group,and hdl-c in the statin (+) group were identified as significant independent variables that correlated with the presence of cad. receiver-operating characteristic curve analysis in the statin (-) and statin (+) groups showed a higher area under the curve for hdl-c than for ldl-c,non-hdl-c or ldl-c/hdl-c. in particular,the cut-off levels of hdl-c with the greatest sensitivity and specificity for the diagnosis of cad in the statin (+) group were 55 mg/dl (sensitivity 0.816,specificity 0.510). & conclusions: hdl-c levels are most closely associated with the presence of cad. in particular,we need to perform coronary ct for suspected cad patients with lower hdl-c levels under statin treatment.