Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan.
Int J Cardiol. 2010 Jul 23;142(3):250-6. doi: 10.1016/j.ijcard.2008.12.216. Epub 2009 Apr 28.
Previous studies demonstrated the inverse association of adiponectin with coronary artery disease (CAD) especially in men with acute coronary syndrome, however their association with in vivo plaque vulnerability in stable CAD, which may be reflected by the thin-cap fibroatheroma (TCFA) prevalence, remains unknown.
In 50 men with stable CAD, we identified TCFA with multi-vessel examination of combined use of virtual histology intravascular ultrasound (VH-IVUS) and optical coherence tomography (OCT). The definition of TCFA was described as follows; necrotic-core rich lesion (% necrotic-core >10%) without evidence of an overlying fibrous component and % plaque-volume >40% in at least 3 consecutive frames by VH-IVUS, and the thinnest fibrous-cap thickness <65 microm by OCT. The patients were divided into two groups, patients with TCFA and without TCFA, and plasma adiponectin level was compared between the groups.
Among 50 patients, we could observe 116 vessels (2.32+/-0.47 vessel/patient). At least one TCFA was identified in 20 patients. Patients with TCFA had significantly lower plasma adiponectin levels than patients without TCFA (P<0.0001). Furthermore, the plasma adiponectin levels in patients with multi-vessel TCFA were significantly lower than those in patients with single-vessel TCFA (P=0.049). Multivariate logistic regression analysis revealed that plasma adiponectin was the strongest predictive factor of the presence of TCFA (P=0.0007).
Low plasma adiponectin was associated with the presence of TCFA in men with stable CAD. This finding suggests that, in these subjects, it may be a biomarker that can be used to stratify "vulnerable patients" into risk categories.
先前的研究表明脂联素与冠状动脉疾病（CAD）呈负相关，尤其是在急性冠状动脉综合征的男性中，但脂联素与稳定型 CAD 中体内斑块易损性的关系尚不清楚，这种易损性可能反映在薄帽纤维粥样斑块（TCFA）的患病率上。
在 50 名患有稳定型 CAD 的男性中，我们通过多血管联合应用虚拟组织学血管内超声（VH-IVUS）和光学相干断层扫描（OCT）来识别 TCFA。TCFA 的定义如下：VH-IVUS 至少在 3 个连续帧上显示无纤维覆盖的富含坏死核心的病变（%坏死核心＞10%）和斑块体积%＞40%，OCT 显示最薄的纤维帽厚度＜65μm。将患者分为 TCFA 组和非 TCFA 组，比较两组患者的血浆脂联素水平。
在 50 名患者中，我们可以观察到 116 个血管（2.32±0.47 个/患者）。20 名患者中至少有一个 TCFA。TCFA 患者的血浆脂联素水平明显低于非 TCFA 患者（P＜0.0001）。此外，多血管 TCFA 患者的血浆脂联素水平明显低于单血管 TCFA 患者（P=0.049）。多变量逻辑回归分析显示，血浆脂联素是 TCFA 存在的最强预测因子（P=0.0007）。
在患有稳定型 CAD 的男性中，低血浆脂联素与 TCFA 的存在相关。这一发现表明，在这些患者中，它可能是一种生物标志物，可用于将“易损患者”分层为风险类别。
