Tehrani, David MGardin, Julius MYanez, DavidHirsch, Calvin HLloyd-Jones, Donald MStein, Phyllis KWong, Nathan D2024-06-112024-06-112013-120021-91501879-1484https://hdl.handle.net/10161/31171<h4>Background</h4>Inflammatory factors and low HDL-C relate to CHD risk, but whether inflammation attenuates any protective association of high HDL-C is unknown.<h4>Objective</h4>Investigate inflammatory markers' individual and collective impact on the association of HDL-C with incident coronary heart disease (CHD).<h4>Methods</h4>In 3888 older adults without known cardiovascular disease (CVD), we examined if the inflammatory markers C-reactive protein (CRP), interleukin-6 (IL-6), and lipoprotein-associated phospholipase A2 (Lp-PLA₂) modify the relation of HDL-C with CHD. HDL-C, CRP, IL-6, and Lp-PLA₂ values were grouped as using gender-specific tertiles. Also, an inflammation index of z-score sums for CRP, IL-6, and Lp-PLA₂ was categorized into tertiles. We calculated CHD incidence for each HDL-C/inflammation group and performed Cox regression, adjusted for standard CVD risk factors and triglycerides to examine the relationship of combined HDL-C-inflammation groups with incident events.<h4>Results</h4>CHD incidence (per 1000 person years) was higher for higher levels of CRP, IL-6, and the index, and lower for higher levels of HDL-C. Compared to high HDL-C/low-inflammation categories (referent), adjusted HRs for incident CHD were increased for those with high HDL-C and high CRP (HR = 1.50, p < 0.01) or highest IL-6 tertile (HR = 1.40, p < 0.05), but not with highest Lp-PLA₂ tertile. Higher CHD incidence was similarly seen for those with intermediate or low HDL-C accompanied by high CRP, high IL-6, or a high inflammatory index.<h4>Conclusion</h4>The protective relation of high HDL-C for incident CHD appears to be attenuated by greater inflammation.https://creativecommons.org/licenses/by-nc/4.0HumansCardiovascular DiseasesCoronary DiseaseInflammation1-Alkyl-2-acetylglycerophosphocholine EsteraseC-Reactive ProteinInterleukin-6IncidenceProportional Hazards ModelsRisk FactorsProspective StudiesAgedMiddle AgedFemaleMaleCholesterol, HDLBiomarkersWhite PeopleBlack or African AmericanJournal article