Nishino Masami, Mori Naoki, Yoshimura Takahiro, Nakamura Daisuke, Lee Yasuharu, Taniike Masayuki, Makino Nobuhiko, Kato Hiroyasu, Egami Yasuyuki, Shutta Ryu, Tanouchi Jun, Yamada Yoshio
Division of Cardiology, Osaka Rosai Hospital, 1179-3 Nagasone-cho, Sakai, Osaka, 591-8025, Japan,
Heart Vessels. 2014 Mar;29(2):186-90. doi: 10.1007/s00380-013-0346-x. Epub 2013 Apr 4.
It has been reported that a major cause of coronary vasospastic angina (VSA) is endothelial dysfunction of the coronary artery. On the other hand, some studies showed that serum uric acid and lipoprotein(a) are correlated with endothelial dysfunction. Thus, we examined whether uric acid and lipoprotein(a), are correlated with VSA. Four hundred forty-one patients with suspected VSA who underwent a coronary angiogram with acetylcholine provocation (ACh test) during an 8-year period were enrolled. We divided them into a VSA group, who showed coronary spasm by the ACh test, and an atypical chest pain (ACP) group, who showed negative ACh test. We compared serum markers between the two groups, including low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, high-sensitivity C-reactive protein (hs-CRP), lipoprotein(a), fibrinogen, total plasminogen activator inhibitor-1, and uric acid. Uric acid, hs-CRP, and lipoprotein(a) were significantly higher in the VSA group than in the ACP group (all P < 0.05) while there were no significant differences in the other parameters. Multivariate analyses identified uric acid and lipoprotein(a) as significant independent markers for VSA. Uric acid and lipoprotein(a) are correlated with VSA, and medical intervention to decrease uric acid and lipoprotein(a) might be effective in controlling VSA.
据报道，冠状动脉痉挛性心绞痛（VSA）的一个主要原因是冠状动脉内皮功能障碍。另一方面，一些研究表明，血清尿酸和脂蛋白（a）与内皮功能障碍相关。因此，我们研究了尿酸和脂蛋白（a）是否与VSA相关。纳入了441例疑似VSA患者，这些患者在8年期间接受了乙酰胆碱激发试验（ACh试验）的冠状动脉造影。我们将他们分为VSA组（通过ACh试验显示冠状动脉痉挛）和非典型胸痛（ACP）组（ACh试验为阴性）。我们比较了两组之间的血清标志物，包括低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、高敏C反应蛋白（hs-CRP）、脂蛋白（a）、纤维蛋白原、总纤溶酶原激活物抑制剂-1和尿酸。VSA组的尿酸、hs-CRP和脂蛋白（a）显著高于ACP组（所有P<0.05），而其他参数无显著差异。多变量分析确定尿酸和脂蛋白（a）是VSA的重要独立标志物。尿酸和脂蛋白（a）与VSA相关，降低尿酸和脂蛋白（a）的医学干预可能对控制VSA有效。
