HDL-cholesterol is associated with systemic inflammation in cardiac syndrome X.

AIM: Microvascular inflammation is associated with cardiac syndrome X (CSX). High-density lipoprotein cholesterol (HDL-C) reveals antiatherogenic features with stimulating endothelial NO production, inhibiting oxidative stress and vascular inflammation. We investigated relationship between HDL-C and inflammatory markers in CSX.

METHODS: Hundred patients with CSX and control group of 80 subjects were evaluated. Hematologic indices, lipid levels and C-reactive protein (CRP) levels were studied in patients underwent coronary angiography.

RESULTS: CRP levels were higher in CSX group than control group (4.59 ± 3.82 mg/dL vs. 2.48 ± 1.32 mg/dL, P<0.001). HDL-C was significantly lower in CSX group compared to control group (36.5 ± 4.0 mg/dL vs. 47.5 ± 12.7 mg/dL, P=0.008). White blood cell (WBC) count was higher in CSX group than in control group. Neutrophil-lymphocyte ratio (NLR) was found significantly increased in CSX group as compared to control group. On multivariate linear regression, lower HDL-C was found to be a significant predictor of higher NLR in patients with CSX independent from other clinical and biochemical variables.

CONCLUSION: Lower HDL-C is associated with systemic inflammation in CSX. In patients with typical angina and normal epicardial coronaries,HDL-C and inflammatory markers should be investigated; one of the goals of treatment should be raising HDL-C.