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

Minerva Med. 2015 Jun;106(3):133-41. Epub 2014 Jul 16.


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.

Publication types

  • Observational Study

MeSH terms

  • Biomarkers / blood
  • Cholesterol, HDL / blood*
  • Female
  • Humans
  • Inflammation / blood*
  • Inflammation / complications*
  • Male
  • Microvascular Angina / blood*
  • Microvascular Angina / complications*
  • Middle Aged
  • Retrospective Studies


  • Biomarkers
  • Cholesterol, HDL