Imaizumi Satoshi, Miura Shin-Ichiro, Takata Kohei, Takamiya Yosuke, Kuwano Takashi, Sugihara Makoto, Ike Amane, Iwata Atsushi, Nishikawa Hiroaki, Saku Keijiro
Department of Cardiology, Fukuoka University School of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan.
Department of Molecular Cardiovascular Therapeutics, Fukuoka University School of Medicine, Fukuoka, Japan.
Heart Vessels. 2016 Aug;31(8):1257-65. doi: 10.1007/s00380-015-0738-1. Epub 2015 Sep 4.
The measurement of high-density lipoprotein (HDL) functionality could be useful for identifying patients who have an increased risk of coronary restenosis after stent implantation. In the present study, we elucidates whether HDL functionality can predict restenosis. The participants included 48 consecutive patients who had stable angina and were successfully implanted with a drug-eluting stent (DES) or bare-metal stent. Follow-up coronary angiography was performed after 6-8 months of stenting. Cholesterol efflux and the anti-inflammatory capacity of HDL were measured before stenting (at baseline) and at follow-up. The mean age was 64 ± 11 years and the body mass index was 24 ± 3 kg/m(2). While HDL cholesterol (HDL-C) significantly increased from baseline to follow-up, there was no significant association between HDL-C level at baseline and in-stent late loss. Cholesterol efflux capacity was significantly increased from baseline to follow-up. The efflux capacity at baseline was negatively correlated with in-stent late loss, whereas the anti-oxidative activity of HDL at baseline was not associated with in-stent late loss. We analyzed the predictors of in-stent late loss using independent variables (efflux capacity and anti-oxidative capacity at baseline in addition to age, gender, HDL-C and low-density lipoprotein cholesterol at baseline, hypertension, diabetes mellitus, smoking, lesion length and DES implantation, history of myocardial infarction and prior percutaneous coronary intervention) by a multiple regression analysis. The efflux capacity at baseline was only independently associated with in-stent late loss. In conclusion, cholesterol efflux capacity at baseline could predict coronary restenosis in patients with successful stent implantation.
测量高密度脂蛋白（HDL）功能可能有助于识别支架植入术后发生冠状动脉再狭窄风险增加的患者。在本研究中，我们阐明了HDL功能是否能够预测再狭窄。研究对象包括48例连续入选的稳定型心绞痛患者，这些患者成功植入了药物洗脱支架（DES）或裸金属支架。在支架植入6 - 8个月后进行随访冠状动脉造影。在支架植入前（基线时）和随访时测量HDL的胆固醇流出和抗炎能力。平均年龄为64±11岁，体重指数为24±3kg/m²。虽然从基线到随访时HDL胆固醇（HDL-C）显著升高，但基线时HDL-C水平与支架内晚期丢失之间无显著相关性。从基线到随访，胆固醇流出能力显著增加。基线时的流出能力与支架内晚期丢失呈负相关，而基线时HDL的抗氧化活性与支架内晚期丢失无关。我们使用自变量（除了年龄、性别、基线时的HDL-C和低密度脂蛋白胆固醇、高血压、糖尿病、吸烟、病变长度和DES植入、心肌梗死病史和既往经皮冠状动脉介入治疗外，还包括基线时的流出能力和抗氧化能力）通过多元回归分析来分析支架内晚期丢失的预测因素。基线时的流出能力仅与支架内晚期丢失独立相关。总之，基线时的胆固醇流出能力可以预测成功植入支架患者的冠状动脉再狭窄。
