Association of the low-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio and body mass index with coronary plaque regression.

Background: The change (Δ) in the low-density lipoprotein cholesterol (LDL-C)/high-density lipoprotein cholesterol (HDL-C) ratio (ΔLDL-C/HDL-C) and obesity are known to play important roles in the progression of coronary atherosclerosis. We hypothesized that a reasonable predictive model of coronary plaque regression could be constructed using ΔLDL-C/HDL-C and the body mass index (BMI).

Objective: The purpose of this study was to establish a predictive model of coronary plaque regression using ΔLDL-C/HDL-C and BMI.

Methods And Results: A 6-month prospective observational study was conducted among 114 patients with coronary artery disease (CAD) who were treated with pravastatin. The plaque volume, as assessed using volumetric intravascular ultrasound, decreased significantly by 9.9% (p < 0.0001 vs baseline). In a multivariate regression analysis with traditional risk factors, ΔLDL-C/HDL-C (β: 0.473, p = 0.0001) and the baseline BMI (β: 0.249, p = 0.004) were identified as independent predictors of the Δplaque volume. The patients were divided using the 50th percentile of the baseline BMI and the 50th percentile of the ΔLDL-C/HDL-C ratio as cutoffs, and a model for predicting coronary atherosclerotic regression was prepared using a combination of the two variables. The Δplaque volumes were -18.3%, -14.1%, -4.8%, and -2.2% for the groups with ΔLDL-C/HDL-C ≤ -22.2% and a BMI ≤ 24.1 kg/m(2), ΔLDL-C/HDL-C ≤ -22.2% and ΔBMI >24.1 kg/m(2), ΔLDL-C/HDL-C > -22.2% and BMI ≤ 24.1 kg/m(2), and ΔLDL-C/HDL-C > -22.2% and BMI >24.1 kg/m(2), respectively (p = 0.003).

Conclusion: A predictive model for coronary plaque regression based on a combination of ΔLDL-C/HDL-C and the baseline BMI may be a useful clinical tool in patients with CAD.