Department of Endocrinology, University of Groningen, University Medical Center Groningen, P.O. Box 30.001, Groningen 9700 RB, The Netherlands.
Department of Pediatrics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Atherosclerosis. 2014 May;234(1):185-92. doi: 10.1016/j.atherosclerosis.2014.02.026. Epub 2014 Mar 11.
The cholesterol esterifying enzyme, lecithin:cholesterol acyltransferase (LCAT), plays a key role in HDL maturation and remodeling. Myeloperoxidase (MPO) may compromise LCAT enzymatic activity. We tested the extent to which plasma LCAT activity is altered in acute myocardial infarction (MI) in conjunction with abnormal MPO levels. We also assessed the impact of LCAT and MPO on newly developed major adverse cardiovascular events (MACE).
Two-hundred one consecutive patients referred for acute chest pain of whom 134 had MI (95 with ST-elevation) participated. Forty-five new MACE were ascertained during 1203 (range 13-1745) days of follow-up among 185 patients. Plasma LCAT activity was measured using an exogenous substrate assay. MPO mass was assayed by chemiluminescent microparticle immunoassay.
Plasma LCAT activity was decreased by 15%, coinciding with 7-fold increased MPO levels in acute MI patients vs. patients with non-cardiac chest pain (p < 0.001 for both; correlation: r = -0.343, p < 0.001). MI at admission was associated independently with both lower plasma LCAT activity and higher MPO (age- and sex-adjusted odds ratio per 1 SD increment: 0.46 (95% CI, 0.31-0.68), p < 0.001 and 7.58 (95% CI, 3.34-17.11), p < 0.001, respectively). In an analysis with LCAT and MPO together these associations were modestly attenuated. MPO mass (hazard ratio: 1.59 (95% CI, 1.15-2.19), p = 0.004), but not LCAT activity (hazard ratio: 0.87 (95% CI, 0.65-1.19), p = 0.39), predicted newly manifest MACE.
In acute MI patients, plasma LCAT activity is decreased coinciding with increased MPO levels. Higher MPO but not lower LCAT activity prospectively predicts adverse cardiac outcome.
胆固醇酯酶，卵磷脂：胆固醇酰基转移酶（LCAT），在 HDL 成熟和重塑中发挥关键作用。髓过氧化物酶（MPO）可能会损害 LCAT 的酶活性。我们测试了急性心肌梗死（MI）患者中 LCAT 活性发生变化的程度，同时伴有异常的 MPO 水平。我们还评估了 LCAT 和 MPO 对新发生的主要不良心血管事件（MACE）的影响。
201 例连续因急性胸痛就诊的患者，其中 134 例为 MI（95 例 ST 段抬高）。185 例患者中有 45 例在 1203 天（范围 13-1745 天）的随访中发生了 45 例新的 MACE。使用外源性底物测定法测量血浆 LCAT 活性。MPO 质量通过化学发光微粒子免疫测定法测定。
与非心源性胸痛患者相比，急性 MI 患者的血浆 LCAT 活性降低了 15%，同时 MPO 水平升高了 7 倍（均为 p<0.001；相关性：r=-0.343，p<0.001）。入院时的 MI 与较低的血浆 LCAT 活性和较高的 MPO 独立相关（每增加 1 SD 增量的年龄和性别调整后的比值比：0.46（95%CI，0.31-0.68），p<0.001 和 7.58（95%CI，3.34-17.11），p<0.001）。在 LCAT 和 MPO 一起的分析中，这些关联略有减弱。MPO 质量（危险比：1.59（95%CI，1.15-2.19），p=0.004），而不是 LCAT 活性（危险比：0.87（95%CI，0.65-1.19），p=0.39），可预测新出现的不良心脏事件。
在急性 MI 患者中，血浆 LCAT 活性降低，同时 MPO 水平升高。较高的 MPO 但不是较低的 LCAT 活性前瞻性地预测不良心脏结局。
