ArticleAnatolian journal of cardiology2026
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.
Article in Anatolian journal of cardiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundHigh-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.
methodsA 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.
resultsThe CETP activity was significantly higher in patients with CAD compared with control participants (1.08 vs. 0.98 nmol/μL/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).
conclusionIn 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 con-tribute 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.
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