Association of the Low-Density Lipoprotein Cholesterol/High-Density Lipoprotein Cholesterol Ratio and Body Mass Index with Coronary Plaque Regression

Background: The change (Delta) in the low-density lipoprotein cholesterol (LDL-C)/high-density lipoprotein cholesterol (HDL-C) ratio (Delta LDL-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 Delta LDL-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 Delta LDL-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, Delta LDL-C/HDL-C (beta: 0.473, p = 0.0001) and the baseline BMI (beta: 0.249, p = 0.004) were identified as independent predictors of the Delta plaque volume. The patients were divided using the 50th percentile of the baseline BMI and the 50th percentile of the Delta LDL-C/HDL-C ratio as cutoffs, and a model for predicting coronary atherosclerotic regression was prepared using a combination of the two variables. The Delta plaque volumes were -18.3%, -14.1%, -4.8%, and -2.2% for the groups with Delta LDL-C/HDL-C <= -22.2% and a BMI <= 24.1 kg/m(2), Delta LDL-C/HDL-C <= -22.2% and Delta BMI >24.1 kg/m(2), Delta LDL-C/HDL-C > -22.2% and BMI <= 24.1 kg/m(2), and Delta LDL-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 Delta LDL-C/HDL-C and the baseline BMI may be a useful clinical tool in patients with CAD.