Abstract 11009: Serum Cholesterol Efflux Capacity is an Independent Predictor of All-cause and Cardiovascular Mortality in Patients With Coronary Artery Disease

Abstract

Objective To investigate the association between serum cholesterol efflux capacity and all-cause and cardiovascular mortality in patients with coronary artery disease. Design Prospective cohort study. Setting Guangdong Coronary Artery Disease Cohort, established in 2008-2011. Participants 1 765 patients with coronary artery disease were followed-up for a median of 3.9 years. Main outcome measures Primary outcome was the association of baseline serum cholesterol efflux capacity with the risks of all-cause and cardiovascular mortality. Results: During 6 778 person-years of follow-up, 170 deaths were registered, 126 of which were caused by cardiovascular diseases. After multivariate adjustment for factors related to cardiovascular diseases, the hazard ratios (95% confidence intervals) across quartiles of serum cholesterol efflux capacity were 1.00, 0.75 (0.51-1.10), 0.51 (0.33-0.81) and 0.43 (0.25-0.73) for all-cause mortality ( P = 0.003), and 1.00, 0.76 (0.49-1.18), 0.37 (0.21-0.65), and 0.25 (0.12-0.52) for cardiovascular mortality ( P < 0.001). Adding serum cholesterol efflux capacity to a model containing traditional cardiovascular risk factors significantly increases its discriminatory power and predictive ability for all-cause (area under receiver operating characteristic curve 0.68 versus 0.61, P < 0.001; net reclassification improvement 14.5%, P = 0.001) and cardiovascular (area under receiver operating characteristic curve 0.71 versus 0.63, P < 0.001; net reclassification improvement 18.4%, P < 0.001) death, respectively. Conclusions: Serum cholesterol efflux capacity may serve as an independent measure for predicting all-cause and cardiovascular mortality in patients with coronary artery disease.