Measurement of Cholesterol Function Might Provide Link to Heart Attack Risk in Patients with Psoriasis

WHAT:  Scientists now report a new way to assess cholesterol that shows promise for evaluating the increased heart attack risk observed in patients with psoriasis, a common inflammatory skin disease.  The new technique measures the function of high-density lipoprotein (HDL), known as “good” cholesterol, rather than HDL cholesterol concentration.  The study, conducted by researchers from the National Heart Lung and Blood Institute at the National Institutes of Health (NIH), could broaden the use of the technique.  The study appears in the online issue of the European Heart Journal.

Psoriasis is a common skin disease characterized by itchy patches of thick, scaly skin most commonly on the elbows and knees.  Research has shown psoriasis to be a risk factor for developing atherosclerosis, or hardening of the arteries, which is the major cause of heart attacks.  Recent studies indicate that the level or concentration of HDL may not adequately predict heart disease risk.  A better understanding of how HDL may be involved in atherosclerosis is needed, scientists say.

An emerging technique called HDL-cholesterol efflux capacity (CEC) measures the activity or function of HDL rather than its concentration and may provide a better assessment of a patient’s HDL.  CEC measures the ability of HDL to remove cholesterol from the arterial wall and excrete it from the body.  In the new study, a research group led by NHLBI’s Dr. Nehal N. Mehta studied 101 patients enrolled in a psoriasis study at the Clinical Center of the National Institutes of Health.  Using sophisticated imaging techniques, scientists took detailed pictures of the patients’ coronary arteries and characterized the type of atherosclerotic plaque, a fatty substance that builds up inside the arteries that can lead to heart attacks.  By analyzing the patients’ blood samples, the scientists found that psoriasis patients with poor HDL function, as measured by lower CEC, had higher levels of coronary plaque.  Additionally, this lower CEC was strongly associated with the presence of early, fat-rich coronary plaques which are most often the cause for heart attacks.  Patients with better HDL function measured by higher CEC had lower levels of coronary plaque.  These findings suggest that HDL function plays an important role in early atherosclerosis and may provide additional information about future risk of heart attack, Dr. Mehta and colleagues said.  The CEC technique is currently limited to experimental settings but could provide a useful way to study cholesterol in broader populations in the future, not just psoriasis patients, the scientists said.  

WHO:  Nehal N. Mehta, M.D., M.S.C.E, chief of the Section of Inflammation and Cardiometabolic Diseases in the Cardiopulmonary Branch at NHLBI, is available to comment on the findings and implications of this research.

CONTACT:  For more information or to schedule an interview, please contact the NHLBI Office of Science Policy, Engagement, Education, and Communications at 301-496-4236 or nhlbi_news@nhlbi.nih.gov (link sends e-mail).