Bliden Kevin P, Chaudhary Rahul, Lopez Luis R, Damrongwatanasuk Rongras, Guyer Kirk, Gesheff Martin G, Franzese Christopher J, Kaza Himabindu, Tantry Udaya S, Gurbel Paul A
Inova Center for Thrombosis Research and Drug Development, Inova Heart and Vascular Institute, Fairfax, Virginia.
Division of Medicine, Johns Hopkins University/Sinai Hospital of Baltimore, Baltimore, Maryland.
Am J Cardiol. 2016 Sep 1;118(5):673-8. doi: 10.1016/j.amjcard.2016.06.023. Epub 2016 Jun 15.
Oxidized low-density lipoprotein (oxLDL) and β2-glycoprotein I (β2GPI) have been identified in human atherosclerotic lesions and when complexed have been implicated as a pro-atherothrombotic antigen. We examined the association of free oxLDL and oxLDL-β2GPI complex in patients with coronary artery disease who underwent elective cardiac catheterization. Serum was collected from patients with suspected coronary artery disease immediately before elective cardiac catheterization who were either treated (n = 385) or not treated (n = 150) with statins and from healthy volunteers (n = 134). OxLDL and oxLDL-β2GPI complex levels were determined by enzyme-linked immunosorbent assay. Disease severity was defined angiographically as none-minimal (<20%), moderate (20% to 75%), and severe (>75%) luminal diameter obstruction of any major coronary vessel. Both oxLDL and oxLDL-β2GPI complex were lower in patients on statins (p <0.001). In statin-naive patients, oxLDL-β2GPI complex, but not free oxLDL, was associated with severe coronary artery disease (p = 0.036). However, no association was observed in patients on statins. LDL4 and triglycerides increased with oxLDL-β2GPI complex quartiles (p = 0.001). OxLDL-β2GPI complex (>0.32 U/ml) was predictive of severe atherosclerosis by receiver-operating characteristic curve analysis in statin-naive patients (area under the curve 0.66, p = 0.002). In conclusion, oxLDL-β2GPI appears more predictive of coronary artery disease severity than oxLDL alone in statin-naive patients.
氧化型低密度脂蛋白（oxLDL）和β2-糖蛋白I（β2GPI）已在人类动脉粥样硬化病变中被发现，二者复合时被认为是一种促动脉粥样硬化血栓形成抗原。我们研究了接受择期心脏导管插入术的冠心病患者中游离oxLDL和oxLDL-β2GPI复合物之间的关联。在择期心脏导管插入术即将进行前，从疑似冠心病患者中采集血清，这些患者接受过他汀类药物治疗（n = 385）或未接受过治疗（n = 150），同时也从健康志愿者（n = 134）中采集血清。通过酶联免疫吸附测定法测定oxLDL和oxLDL-β2GPI复合物水平。疾病严重程度通过血管造影术定义为无-轻度（<20%）、中度（20%至75%）和重度（>75%）任何主要冠状动脉管腔直径阻塞。服用他汀类药物的患者中oxLDL和oxLDL-β2GPI复合物水平均较低（p<0.001）。在未服用他汀类药物的患者中，oxLDL-β2GPI复合物而非游离oxLDL与严重冠状动脉疾病相关（p = 0.036）。然而，在服用他汀类药物的患者中未观察到关联。低密度脂蛋白4和甘油三酯随oxLDL-β2GPI复合物四分位数增加（p = 0.001）。通过受试者工作特征曲线分析，在未服用他汀类药物的患者中，oxLDL-β2GPI复合物（>0.32 U/ml）可预测严重动脉粥样硬化（曲线下面积0.66，p = 0.002）。总之，在未服用他汀类药物的患者中，oxLDL-β2GPI似乎比单独的oxLDL更能预测冠状动脉疾病的严重程度。
