ArticleJournal of the American College of Cardiology2016
Beyond Coronary Calcification, Family History, and C-Reactive Protein: Cholesterol Efflux Capacity and Cardiovascular Risk Prediction.
Article in Journal of the American College of Cardiology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 48 papers, 3 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
48 citing papers in PubMed, 3 syntheses or guidelines pooled it, 76 citations in OpenAlex.
- A Systematic Review and Meta-Analysis of Advanced Biomarkers for Predicting Incident Cardiovascular Disease among Asymptomatic Middle-Aged Adults.International journal of molecular sciences · 2022Pooled it
- Cholesterol Efflux Capacity and Its Association With Adverse Cardiovascular Events: A Systematic Review and Meta-Analysis.Frontiers in cardiovascular medicine · 2021Pooled it
- High-density lipoprotein cholesterol efflux capacity is inversely associated with cardiovascular risk: a systematic review and meta-analysis.Lipids in health and disease · 2017Pooled it
- Virgin Olive Oil Phenolic Compounds Modulate the HDL Lipidome in Hypercholesterolaemic Subjects: A Lipidomic Analysis of the VOHF Study.Molecular nutrition & food research · 2021Trial
- Prolonged bedrest reduces plasma high-density lipoprotein levels linked to markedly suppressed cholesterol efflux capacity.Scientific reports · 2020Trial
- Determinants of HDL Cholesterol Efflux Capacity after Virgin Olive Oil Ingestion: Interrelationships with Fluidity of HDL Monolayer.Molecular nutrition & food research · 2017Trial
- Apolipoprotein A-I exchange is impaired in metabolic syndrome patients asymptomatic for diabetes and cardiovascular disease.PloS one · 2017Trial
- Early Emergence of HDL Oxidation Across the Body Mass Index Spectrum in Patients with Suspected Coronary Artery Disease.International journal of molecular sciences · 2026Article
- Reduced antioxidant high-density lipoprotein function in heart failure with preserved ejection fraction.Clinical research in cardiology : official journal of the German Cardiac Society · 2026Observational
- Oxidized high-density lipoprotein associates with cardiometabolic dysfunction in coronary artery disease and acute coronary syndrome.Journal of internal medicine · 2025Article
- High-density lipoproteins, Part 1. Epidemiology, antiatherogenic effects, and therapies designed to increase their serum levels.American journal of preventive cardiology · 2025Review
- HDL Function Versus Small Dense LDL: Cardiovascular Benefits and Implications.Journal of clinical medicine · 2025Review
- Reduced high-density lipoprotein antioxidant function in patients with coronary artery disease and acute coronary syndrome.JCI insight · 2025Article
- Reverse cholesterol transport: current assay methods, alterations with disease and response to therapeutic intervention.Frontiers in cardiovascular medicine · 2025Review
- Research progress of Ganoderma lucidum polysaccharide in prevention and treatment of Atherosclerosis.Heliyon · 2024Review
- Ethnic Disparities in the Risk Factors, Morbidity, and Mortality of Cardiovascular Disease in People With Diabetes.Journal of the Endocrine Society · 2024Review
- Oxidized high-density lipoprotein associates with atrial fibrillation.Heart rhythm · 2024Article
- Parental cardiometabolic multimorbidity and subsequent cardiovascular incidence in middle-aged adults: A prospective cohort study.SSM - population health · 2024Article
- Metabolomic Profiling of Cholesterol Efflux Capacity in a Multiethnic Population: Insights From MESA.Arteriosclerosis, thrombosis, and vascular biology · 2023Article
- HDL Cholesterol Efflux and the Complement System Are Linked in Systemic Lupus Erythematosus.Journal of clinical medicine · 2023Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundCholesterol efflux capacity (CEC), which is a key step in the reverse cholesterol transport pathway, is independently associated with atherosclerotic cardiovascular disease (ASCVD). However, whether it predicts ASCVD beyond validated novel risk markers is unknown.
objectivesThis study assessed if CEC improved ACSVD risk prediction beyond using coronary artery calcium (CAC), family history (FH), and high-sensitivity C-reactive protein (hs-CRP).
methodsCEC, CAC, self-reported FH, and hs-CRP were assessed among participants without baseline ASCVD who were enrolled in the Dallas Heart Study (DHS). ASCVD was defined as a first nonfatal myocardial infarction (MI) or stroke, coronary revascularization, or cardiovascular death, assessed over a median 9.4 years. Risk prediction was assessed using various modeling techniques and improvements in the c-statistic, the integrated discrimination index (IDI), and the net reclassification index (NRI).
resultsThe mean age of the population (N = 1,972) was 45 years, 52% had CAC (>0), 31% had FH, and 58% had elevated hs-CRP (≥2 mg/l). CEC greater than the median was associated with a 50% reduced incidence of ASCVD in those with CAC (5.4% vs. 10.5%; p = 0.003), FH (5.8% vs. 10%; p = 0.05), and elevated hs-CRP (3.8% vs. 7.9%; p = 0.004). CEC improved all metrics of discrimination and reclassification when added to CAC (c-statistic, p = 0.004; IDI, p = 0.02; NRI: 0.38; 95% confidence interval [CI]: 0.13 to 0.53), FH (c-statistic, p = 0.006; IDI, p = 0.008; NRI: 0.38; 95% CI: 0.13 to 0.55), or elevated hs-CRP (c-statistic p = 0.008; IDI p = 0.02; NRI: 0.36; 95% CI 0.12 to 0.52).
conclusionsCEC improves ASCVD risk prediction beyond using CAC, FH, and hs-CRP and warrants consideration as a novel ASCVD risk marker.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.