Association of cholesterol uptake capacity, a novel indicator for HDL functionality, and coronary plaque properties: An optical coherence tomography-based observational study

•Cholesterol uptake capacity (CUC) is a novel indicator for HDL functionality.•We investigated the relationship between CUC and coronary plaque properties by OCT.•CUC was inversely related with lipid-rich plaque burden and macrophage accumulation.•Neither of serum HDL cholesterol nor apoA1 levels showed a similar relationship. Cholesterol efflux from atherosclerotic lesion is a key function of high-density lipoprotein (HDL). Recently, we established a simple, high-throughput, cell-free assay to evaluate the capacity of HDL to accept additional cholesterol, which is herein referred to as “cholesterol uptake capacity (CUC)”. To clarify the cross-sectional relationship between CUC and coronary plaque properties. We enrolled 135 patients to measure CUC and assess the morphological features of angiographic stenosis by optical coherence tomography (OCT). We estimated the extent of the lipid-rich plaque by multiplying the mean lipid arc by lipid length (lipid index). The extent of the OCT-detected macrophage accumulation in the target plaque was semi-quantitatively estimated using a grading system. Lipid-rich plaque lesions were identified in 125 patients (92.6%). CUC was inversely associated with the lipid index (R = −0.348, P