High-density lipoprotein cholesterol (HDL-C) is shown to be an independent protective factor against coronary artery diseases (CAD). Yet there are limited studies focusing on the association between HDL-C and coronary artery bypass graft (CABG) surgery outcomes. Low levels of HDL-C are associated with higher incidence of adverse outcomes in patients undergoing CABG. This registry-based study included 17,772 patients who underwent elective isolated CABG between 2007 and 2017. Patients were classified into low and desirable HDL-C groups based on their serum HDL-C levels at admission and were followed for one-year post-surgery. The study population included 13,321 patients with low HDL-C and 4,451 with desirable HDL-C. proportional hazard Cox models were performed to evaluate the association between HDL-C levels and incidence of mortality as well as major adverse cardiovascular and cerebrovascular events (MACCE), while adjusting for potential confounders. Moreover, participants were stratified based on sex and the association was also investigated in each subgroup separately. No significant difference was found between the groups regarding incidence of both mortality and MACCE, after adjusting with Inverse Probability Weighting (IPW) [HR (95%CI): 0.84 (0.46–1.53), p-value:0.575 and HR (95% CI): 0.91 (0.56–1.50), p-value:0.733, respectively]. According to the sex-based subgroup analysis, no significant association was observed after adjustment with IPW analysis. However, as we examined the association between the interaction of HDL-C levels, sex and cardiovascular outcomes, we found a significant association (HR;1.19 (95%CI: 1.04–1.45); p = 0.030). HDL-C level was not associated with either mortality or MACCE during one year after CABG procedure. Sex-based analysis showed that in males, HDL-C is significantly more protective against these outcomes, compared to females. Further studies are necessary to elucidate the exact mechanisms mediating such association.

中文翻译：

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高密度脂蛋白胆固醇与冠状动脉旁路移植术后不良后果之间的性别相关性

高密度脂蛋白胆固醇（HDL-C）被证明是预防冠状动脉疾病（CAD）的独立保护因素。然而，关注 HDL-C 与冠状动脉搭桥术 (CABG) 手术结果之间关系的研究有限。 HDL-C 水平低与接受 CABG 的患者不良结果发生率较高相关。这项基于登记的研究纳入了 2007 年至 2017 年间接受选择性孤立 CABG 的 17,772 名患者。根据患者入院时的血清 HDL-C 水平将患者分为低 HDL-C 组和理想 HDL-C 组，并在术后随访一年。研究人群包括 13,321 名 HDL-C 水平较低的患者和 4,451 名 HDL-C 水平理想的患者。采用比例风险 Cox 模型评估 HDL-C 水平与死亡率以及主要不良心脑血管事件 (MACCE) 发生率之间的关联，同时调整潜在的混杂因素。此外，参与者根据性别进行分层，并且还在每个亚组中单独调查了这种关联。在用逆概率加权 (IPW) 调整后，各组之间的死亡率和 MACCE 发生率没有显着差异 [HR (95%CI)：0.84 (0.46–1.53)，p 值：0.575 和 HR (95% CI)：0.91 (0.56–1.50)，p 值：0.733，分别]。根据基于性别的亚组分析，IPW 分析调整后未观察到显着关联。然而，当我们检查 HDL-C 水平、性别和心血管结局之间的相互作用时，我们发现了显着的关联 (HR;1.19 (95%CI: 1.04–1.45); p = 0.030)。 CABG 手术后一年内 HDL-C 水平与死亡率或 MACCE 无关。基于性别的分析表明，与女性相比，男性的 HDL-C 对这些结果的保护作用明显更强。需要进一步的研究来阐明介导这种关联的确切机制。