Tani Shigemasa, Nagao Ken, Kawamorita Tsuyoshi, Hirayama Atsushi
Department of Cardiology, Nihon University Surugadai Hospital, Tokyo, Japan.
Coron Artery Dis. 2011 May;22(3):125-30. doi: 10.1097/MCA.0b013e328341baa9.
The relationship between the serum levels of atherosclerosis-related apolipoprotein (apo) and the risk of coronary spastic angina remains unknown.
This study consists of 111 patients who were admitted to our facility with the chief complaint of chest pain, in whom coronary angiography showed no significant organic stenosis. The patients were divided into two groups according to the result of the acetylcholine test: the spasm group with a positive test result (n=71) and the nonspasm group with a negative test result (n=40). The serum apoA-I level in the spasm group was significantly lower than that in the nonspasm group (128±22 vs. 141±21 mg/dl, P=0.003). However, no significant differences in the serum levels of apoA-II, apoB, apoC-III, apoE, or the apoB/apoA-I ratio were observed between the two groups. In a multi-logistic regression analysis conducted using the traditional risk factors as covariates, current smoking, male sex, and a low serum apoA-I level were identified as variables that were independently related to the risk of coronary vasospasm. The plaque volume in the spasm group was larger than that in the nonspasm group [median (interquartile) 40.6% (31.3/45.7) vs. 13.1% (10.4/23.7), P<0.0001]. Furthermore, the plaque volume was negatively correlated with the serum levels of apoA-I (r=-0.333, P=0.015), but not to those of any other.
These results showed that low serum levels of apoA-I may play a crucial role in the pathogenesis of coronary spastic angina.
