**3. Results**

#### *3.1. Baseline Patient Characteristics*

From the Kobe CMI registry between July 2015 and February 2019, we enrolled 264 patients based on the inclusion and exclusion criteria. The baseline patient characteristics and laboratory data are shown in Table 1.



Values are presented as mean ± SD. HbA1c, hemoglobin A1c; TG, triglyceride; TC, total cholesterol; LDL-C, lowdensity lipoprotein cholesterol; HDL-C, high-density lipoprotein cholesterol; CUC, cholesterol uptake capacity; ApoA1, apolipoprotein A1; HDL-PL, high-density lipoprotein phospholipid; HDL-TG, high-density lipoprotein triglyceride; A.U., arbitrary units.

More than 80% of the patients were receiving statin therapy, and achieved a mean LDL-C level of less than 100 mg/dL, which is the goal for secondary prevention of coronary artery disease (CAD) in Japan [25]. The patients in the revascularization (Rev.(+) group had a significantly higher incidence of diabetes than patients without revascularization (Rev.(–)). Conversely, CUC and HDL-PL levels were significantly higher in the Rev.(–) patients than those in the Rev.(+) group. Elaidic acid levels in HDL-PL also tended to be higher in the Rev.(–) group than in the Rev.(+) group, although this trend was not statistically significant (Supplemental Tables S1 and S2).

#### *3.2. The Proportion of Elaidic Acid in HDL-PL Inversely Correlates with CUC*

As a first step towards understanding the effect of TFA in HDL-PL on CUC, we assessed the relationship between CUC and HDL-PL and confirmed that CUC was positively associated with HDL-PL levels (rS = 0.906, *p* < 0.001) (Figure 1A). Though CUC was also positively associated with apoA1 levels (rS = 0.683, *p* < 0.001) (Figure S1A), the value of correlation coefficient was smaller than that of HDL-PL levels, suggesting that the HDL-PL level is an important factor in determining CUC.

**Figure 1.** Correlations between CUC and the following: (**A**) HDL-PL levels (rS = 0.906, *p* < 0.001), (**B**) elaidic acid in HDL PL/HDL-PL ratio (rS = −0.275, *p* < 0.001). CUC, cholesterol uptake capacity; A.U., arbitrary units; HDL-PL, high-density lipoprotein phospholipid.

To analyze the effect of TFA incorporated into HDL-PL on CUC, we evaluated the relationship between CUC and elaidic acid in HDL-PL and found that although there was a positive correlation (Figure S1B); CUC was negatively associated with the proportion of elaidic acid in the HDL-PL/HDL-PL ratio (rS = −0.275, *p* < 0.001) (Figure 1B). By contrast, though oleic acid, a cis analogue of elaidic acid, in HDL-PL also correlated positively with CUC (Figure S1C), no significant relationship was noted between CUC and the proportion of oleic acid in HDL-PL (Figure S1D). These results indicate the possibility that elaidic acid has a negative effect on CUC when incorporated into HDL-PL.
