Sattler Katherine, Lehmann Isa, Gräler Markus, Bröcker-Preuss Martina, Erbel Raimund, Heusch Gerd, Levkau Bodo
Institute for Pathophysiology, University Duisburg-Essen, Essen, Germany.
Cell Physiol Biochem. 2014;34(1):172-84. doi: 10.1159/000362993. Epub 2014 Jun 16.
We have recently demonstrated a reduction in HDL-bound sphingosine 1-phosphate (S1P) in patients with stable coronary artery disease (CAD). In the current study, we tested whether HDL-associated S1P is predictive for the degree of coronary stenosis, restenosis and overall CAD severity on follow up in patients undergoing elective percutaneous coronary intervention (PCI).
Coronary angiography of patients with CAD (n=59) undergoing elective PCI and presenting for a follow up after 6 months (n=48) was graded for disease severity defined clinically as 1- or multi-vessel disease. Target lesion stenosis was quantified by quantitative coronary angiography (QCA). S1P in plasma and isolated HDL were measured by mass spectrometry in the initial samples and in 32 available follow up samples.
HDL-bound S1P levels remained stable over time and correlated closely at first visit and follow up. While not associated with the extent of target lesion stenosis or restenosis, HDL-bound S1P correlated negatively with the overall severity of CAD and discriminated 1-vessel-disease from multi-vessel disease. Furthermore, low HDL-bound S1P was predictive for CAD extent.
In stable CAD, HDL-bound S1P does not predict the degree of stenosis or restenosis of the target lesion but constitutes a marker of clinically defined disease burden.
我们最近证明，稳定型冠状动脉疾病（CAD）患者中与高密度脂蛋白（HDL）结合的1-磷酸鞘氨醇（S1P）有所减少。在本研究中，我们测试了HDL相关的S1P是否可预测接受择期经皮冠状动脉介入治疗（PCI）患者随访时的冠状动脉狭窄程度、再狭窄情况及CAD总体严重程度。
对59例接受择期PCI的CAD患者进行冠状动脉造影，并对6个月后前来随访的48例患者进行疾病严重程度分级，临床上将其定义为单支或多支血管病变。通过定量冠状动脉造影（QCA）对靶病变狭窄进行量化。在初始样本及32份可获得的随访样本中，采用质谱法测定血浆和分离出的HDL中的S1P。
HDL结合的S1P水平随时间保持稳定，在首次就诊和随访时密切相关。虽然与靶病变狭窄或再狭窄程度无关，但HDL结合的S1P与CAD的总体严重程度呈负相关，且可区分单支血管病变和多支血管病变。此外，低HDL结合的S1P可预测CAD范围。
在稳定型CAD中，HDL结合的S1P不能预测靶病变的狭窄程度或再狭窄情况，但可作为临床定义的疾病负担的标志物。
