Guo Xiaoxiao, Yuan Su, Liu Yongtai, Zeng Yong, Xie Hongzhi, Liu Zhenyu, Zhang Shuyang, Fang Quan, Wang Jing, Shen Zhujun
Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
Department of Anesthesiology and Critical Care, State Key Laboratory of Cardiovascular Diseases, National Center for Cardiovascular Diseases, Fuwai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
Atherosclerosis. 2016 Aug;251:355-360. doi: 10.1016/j.atherosclerosis.2016.05.020. Epub 2016 May 12.
Immunoglobulin E (IgE), a key element of allergic reactions, was considered to be involved in the development of atherosclerosis and the pathogenesis of myocardial ischemia. This study was designed to test whether total serum IgE levels were associated with the atherosclerosis severity of coronary artery disease (CAD).
Total serum IgE concentrations were measured in 708 consecutive patients who were presented to our center for coronary angiography. Atherosclerosis severity of CAD was assessed by the number of diseased vessels showing ≥50% diameter stenosis and quantified by Gensini score.
Patients with CAD (N = 562) had higher serum IgE levels than those without CAD (N = 146) [55.90 (19.10-156.00) vs. 26.90 (11.80-62.10) KU/L, p = 0.003]. Furthermore, the serum IgE levels were significantly increased in patients with multivessel disease (MVD) compared to those with single-vessel disease [61.80 (23.20-159.00) vs. 32.45(14.15-94.38) KU/L, p = 0.003]. After adjustment for traditional cardiovascular risk factors, a high serum IgE level was an independent predictor for an increased risk of MVD (OR 1.003; 95% CI 1.001-1.004; p = 0.041). Receiver-operating characteristic curve analysis demonstrated that serum IgE levels improved the predictive capability of traditional risk factors for MVD (area under the curve with and without IgE: 0.734 and 0.713, respectively, p < 0.001). Meanwhile, there was a significant linear relationship between Gensini score and the serum IgE level quartiles (p for linear trend <0.001).
Increased total serum IgE levels are associated with MVD and contribute to discriminating CAD severity independently of traditional cardiovascular risk factors.
免疫球蛋白E（IgE）是过敏反应的关键要素，被认为参与动脉粥样硬化的发展及心肌缺血的发病机制。本研究旨在检测血清总IgE水平是否与冠状动脉疾病（CAD）的动脉粥样硬化严重程度相关。
对连续708例因冠状动脉造影前来本中心就诊的患者测定血清总IgE浓度。CAD的动脉粥样硬化严重程度通过直径狭窄≥50%的病变血管数量进行评估，并采用Gensini评分进行量化。
CAD患者（N = 562）的血清IgE水平高于无CAD患者（N = 146）[55.90（19.10 - 156.00）对比26.90（11.80 - 62.10）KU/L，p = 0.003]。此外，与单支血管病变患者相比，多支血管病变（MVD）患者的血清IgE水平显著升高[61.80（23.20 - 159.00）对比32.45（14.15 - 94.38）KU/L，p = 0.003]。在对传统心血管危险因素进行校正后，高血清IgE水平是MVD风险增加的独立预测因素（OR 1.003；95% CI 1.001 - 1.004；p = 0.041）。受试者工作特征曲线分析表明，血清IgE水平提高了传统危险因素对MVD的预测能力（有和无IgE时曲线下面积分别为0.734和0.713，p < 0.001）。同时，Gensini评分与血清IgE水平四分位数之间存在显著的线性关系（线性趋势p < 0.001）。
血清总IgE水平升高与MVD相关，且有助于独立于传统心血管危险因素来鉴别CAD的严重程度。
