"If 'Good Cholesterol' Functions Actively, New Blood Vessels Form Well Even When Heart Vessels Are Blocked"

Research by Professor Sanghak Lee's Team at Yonsei University College of Medicine
First Evidence Using 'Human Samples' Beyond Animal Studies

Professor Sanghak Lee's team at Yonsei University College of Medicine (Photo by Severance)

[Asia Economy Reporter Kim Ji-hee] A study has found that people with good functionality of 'HDL,' known as good cholesterol, tend to develop new blood vessels well even when the coronary arteries, the heart's blood vessels, are completely blocked.

The research team led by Professor Lee Sang-hak (Cardiology) and Lecturer Lee Seon-hwa at Yonsei University College of Medicine published these findings in early March in the international journal Journal of the American Heart Association (IF 4.605) under the title "Cholesterol Efflux Capacity and Collateral Circulation in Chronic Total Coronary Occlusion: EFFECT-CIRC Study."

Until now, HDL levels have been known as a factor determining future cardiovascular risk such as myocardial infarction or heart attack. However, reports from foreign studies over the past few years have indicated that ▲HDL levels ▲related genes ▲use of drugs that increase HDL levels have no significant correlation with cardiovascular risk.

Recent studies have newly reported that cardiovascular risk is lower when the function of HDL to remove cholesterol accumulated in vascular cells (cholesterol efflux capacity) and the subsequent removal of this cholesterol from the body (reverse cholesterol transport) are active, rather than the simple HDL level.

Accordingly, the research team investigated how HDL function relates to the degree of new blood vessel development in patients with cardiovascular disease. Among patients visiting the cardiology department at Yonsei University Severance Hospital, 226 patients with chronically and completely blocked coronary arteries were selected, and their HDL function, specifically 'cholesterol efflux capacity,' was measured to analyze its association with the degree of new blood vessel development.

The patients were divided into groups with well-developed new blood vessels and those with absent or poorly developed new vessels to compare differences in HDL function. Additionally, the team checked whether the association remained after statistically adjusting for other clinical characteristics and whether other factors influenced new blood vessel formation.

As a result, the group with good new blood vessel formation showed a cholesterol efflux capacity of 22%, higher than the control group (20.2%). After adjusting for confounding variables, younger age and better HDL function were associated with better new blood vessel formation. Analysis using standard deviation showed that when cholesterol efflux capacity was 1 standard deviation higher, new blood vessel formation improved by 51%.

Professor Lee Sang-hak stated, "The finding that patients with active HDL function have better new blood vessel status suggests that HDL promotes new blood vessel formation and ultimately contributes to cardiovascular protection." He added, "This study confirmed that a specific function of HDL can affect health status through its action in the body, and notably, it is meaningful as it is the first to demonstrate this in human samples beyond cellular or animal studies."

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