Huang Ching-Hui, Chang Chia-Chu, Huang Ching-Shan, Kuo Chen-Ling, Chen Ching-Pei, Hsia Chien-Hsun, Chang Yung-Ming, Chen Hung-Te, Feng Chih-Chung, Lin Lee-Shin, Yang Po-Ta, Tsai Chen-Dao, Lin Chih-Sheng, Liu Chin-San
Division of Cardiology, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan ; Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan.
PLoS One. 2013 Oct 3;8(10):e74726. doi: 10.1371/journal.pone.0074726. eCollection 2013.
Oxidized low-density lipoproteins (oxLDL) and oxidized low-density lipoprotein autoantibodies (OLAB) have been detected in human plasma and atherosclerotic lesions. OLAB appear to play a role in the clearance of oxLDL from circulation. Higher levels of OLAB appear to be associated with a reduced risk of a wide range of cardiovascular diseases. We investigated the prognostic value of plasma oxLDL and OLAB in patients undergoing primary coronary balloon angioplasty for acute ST-elevation myocardial infarction (STEMI).
Plasma oxLDL and OLAB concentrations were measured in 56 patients with acute STEMI before primary angioplasty, and then 3 days, 7 days and 1 month after the acute event. Follow-up angiography was repeated 6 months later to detect the presence of restensosis (defined as >50% luminal diameter stenosis). The thrombolysis in myocardial infarction (TIMI) risk score was calculated to determine the relationship between OLAB/oxLDL ratio and TIMI risk scores.
Of the 56 patients, 18 (31%) had angiographic evidence of restenosis. Plasma OLAB concentrations were significantly lower in the restenosis group before angioplasty (181±114 vs. 335±257 U/L, p = 0.003), and at day 3 (155±92 vs. 277±185 U/L, p<0.001) and day 7 (177±110 vs. 352±279 U/L, p<0.001) after the acute event. There was no difference in oxLDL concentration between the two groups. The ratio of OLAB/oxLDL positively correlated with TIMI risk scores before angioplasty (p for trend analysis, p = 0.004), at day 3 (p = 0.008) and day 7 (p<0.001) after STEMI.
A relative deficit of OLAB, and hence likely impaired clearance of oxLDL, is associated with the risk of arterial restenosis after primary angioplasty for acute STEMI.
在人血浆和动脉粥样硬化病变中已检测到氧化型低密度脂蛋白（oxLDL）和氧化型低密度脂蛋白自身抗体（OLAB）。OLAB似乎在循环中oxLDL的清除中发挥作用。较高水平的OLAB似乎与多种心血管疾病风险降低相关。我们研究了血浆oxLDL和OLAB在接受急性ST段抬高型心肌梗死（STEMI）初次冠状动脉球囊血管成形术患者中的预后价值。
在56例急性STEMI患者初次血管成形术前，以及急性事件发生后3天、7天和1个月时，测量其血浆oxLDL和OLAB浓度。6个月后重复进行随访血管造影，以检测再狭窄的存在（定义为管腔直径狭窄>50%）。计算心肌梗死溶栓（TIMI）风险评分，以确定OLAB/oxLDL比值与TIMI风险评分之间的关系。
56例患者中，18例（31%）有血管造影证实的再狭窄。再狭窄组血管成形术前血浆OLAB浓度显著较低（181±114 vs. 335±257 U/L，p = 0.003），急性事件后第3天（155±92 vs. 277±185 U/L，p<0.001）和第7天（177±110 vs. 352±279 U/L，p<0.001）也是如此。两组之间oxLDL浓度无差异。血管成形术前（趋势分析p，p = 0.004）、STEMI后第3天（p = 0.008）和第7天（p<0.001），OLAB/oxLDL比值与TIMI风险评分呈正相关。
OLAB相对缺乏，因此可能oxLDL清除受损，与急性STEMI初次血管成形术后动脉再狭窄风险相关。
