Can Cholesterol Efflux Capacity Predict All-Cause Mortality in Patients with PAD?

Cholesterol efflux capacity (CEC) does not predict mortality in peripheral artery disease (PAD), according to a study published in the journal Diagnostics. 

“Cholesterol efflux is an important mechanism by which high-density lipoproteins (HDLs) protect against cardiovascular disease. As peripheral artery disease (PAD) is associated with high mortality rates, mainly due to cardiovascular causes, we investigated whether CEC of apolipoprotein B (apoB)-depleted plasma, a widely used surrogate of HDL function, may serve as a predictive marker for mortality in this patient population,” the researchers wrote.

In this prospective single-center study, apoB-containing lipoproteins were precipitated from plasma of 95 patients with PAD and incubated with J744-macrophages. These macrophages were loaded with radiolabeled cholesterol. CEC was defined in this study as the fractional radiolabel released during 4 h of incubation.

Results: Baseline CEC was lower in PAD patients that currently smoked (p = 0.015) and had a history of myocardial infarction (p = 0.011). Moreover, CEC showed a significant correlation with HDL-cholesterol (p = 0.003) and apolipoprotein A-I levels (p = 0.001) as well as the ankle-brachial index (ABI, p = 0.018). However, CEC did not differ between survivors and non-survivors. Neither revealed Kaplan-Meier and Cox regression analyses any significant association of CEC with all-cause mortality rates.

The researchers concluded that: “Taken together, CEC is associated with ABI but does not predict all-cause mortality in patients with PAD.”