Institute of Clinical Physiology, CNR, San Cataldo Research Area, Via Moruzzi, 1, 56124 Pisa, Italy.
Fondazione G. Monasterio CNR-Regione Toscana, Via Moruzzi, 1, 56124 Pisa, Italy.
J Geriatr Cardiol. 2014 Mar;11(1):13-9. doi: 10.3969/j.issn.1671-5411.2014.01.008.
Circulating microparticles (MPs) have been reported to be associated with coronary artery disease (CAD). In this study, we explored the relationship between MPs procoagulant activity and characteristics of atherosclerotic plaque detected by 64-slice computed tomography angiography (CTA).
In 127 consecutive patients with CAD but without acute coronary syndrome and who underwent 64-slice CTA, MPs procoagulant activity in plasma (by a thrombin generation test), soluble form of lectin-like oxidized low-density lipoprotein receptor-1 (sLOX-1) and N(epsilon)-(carboxymethyl) lysine (CML) circulating levels (by ELISA) were measured. A quantitative volumetric analysis of the lumen and plaque burden of the vessel wall (soft and calcific components), for the three major coronary vessels, was performed. The patients were classified in three groups according to the presence of calcium volume: non-calcified plaque (NCP) group (calcium volume (%) = 0), moderate calcified plaque (MCP) group (0 < calcium volume (%) < 1), and calcified plaque (CP) group (calcium volume (%) ≥ 1).
MPs procoagulant activity and CML levels were higher in MCP group than in CP or NCP group (P = 0.009 and P = 0.027, respectively). MPs procoagulant activity was positively associated with CML (r = 0.317, P < 0.0001) and sLOX-1 levels (r = 0.216, P = 0.0025).
MPs procoagulant activity was higher in the MCP patient group and correlated positively with sLOX-1 and CML levels, suggesting that it may characterize a state of blood vulnerability that may locally precipitate plaque instability and increase the risk of subsequent major cardiovascular events.
已有研究表明,循环微颗粒(MPs)与冠状动脉疾病(CAD)相关。本研究旨在探讨血浆 MPs 促凝活性与 64 层 CT 血管造影(CTA)检测到的动脉粥样硬化斑块特征之间的关系。
连续纳入 127 例经 64 层 CTA 检查的 CAD 患者(不伴急性冠状动脉综合征),检测其血浆 MPs 促凝活性(采用血栓生成试验)、可溶性凝集素样氧化型低密度脂蛋白受体-1(sLOX-1)和 N(ε)-(羧甲基)赖氨酸(CML)水平(采用 ELISA)。对 3 大冠状动脉的管腔和斑块负荷(软斑块和钙化斑块)进行定量容积分析。根据钙含量体积将患者分为 3 组:无钙斑块组(钙含量体积(%)= 0)、中度钙斑块组(0<钙含量体积(%)<1)和钙斑块组(钙含量体积(%)≥1)。
与 CP 或 NCP 组相比,MCP 组 MPs 促凝活性和 CML 水平更高(P = 0.009 和 P = 0.027)。 MPs 促凝活性与 CML(r = 0.317,P<0.0001)和 sLOX-1 水平(r = 0.216,P = 0.0025)呈正相关。
MCP 患者的 MPs 促凝活性更高,且与 sLOX-1 和 CML 水平呈正相关,提示其可能为血液易损性特征,这可能会局部导致斑块不稳定,增加随后发生主要心血管事件的风险。