Division of Cardiology, Department of Medicine, Showa University School of Medicine.
J Atheroscler Thromb. 2018 Feb 1;25(2):153-169. doi: 10.5551/jat.41095. Epub 2017 Aug 30.
We evaluated whether exercised-based cardiac rehabilitation (CR) can ameliorate the HDL function, i.e., cholesterol efflux capacity (CEC) and paraoxonase-1 activity in patients with acute coronary syndrome (ACS).
This study is a retrospective analysis of stored serum from patients with ACS following successful percutaneous coronary intervention. The CEC, measured by a cell-based ex vivo assay using apolipoprotein B-depleted serum and H-cholesterol labeled macrophages and arylesterase activity (AREA) at the onset or early phase of ACS, and the follow-up periods were compared between 69 patients who completed the five-month outpatient CR program (CR group) and 15 patients who did not participate and/or dropped out from CR program (non-CR group).
Apolipoprotein A-I (apoA-I) and CEC significantly increased by 4.0% and 9.4%, respectively, in the CR group, whereas HDL-cholesterol and AREA were not changed during the follow-up periods in both groups. Among CR patients, the CEC significantly increased, irrespective of the different statin treatment, while HDL-cholesterol and apoA-I significantly increased in patients treated with rosuvastatin or pitavastatin. Although CEC and AREA were significantly correlated each other, there is a discordance between CEC and AREA for their correlations with other biomarkers. Both CEC and AREA were significantly correlated with apoA-I rather than HDL-cholesterol. Changes in CEC and those in AREA were significantly correlated with those in apoA-I (rho=0.328, p=0.002, and rho=0.428, p＜0.0001, respectively) greater than those in HDL-cholesterol (rho=0.312, p= 0.0042,and rho=0.343, p=0.003, respectively).
CR can improve HDL function, and it is beneficial for secondary prevention.
我们评估了基于运动的心脏康复（CR）是否可以改善急性冠状动脉综合征（ACS）患者的高密度脂蛋白（HDL）功能，即胆固醇流出能力（CEC）和对氧磷酶-1 活性。
这是一项回顾性分析，使用了经皮冠状动脉介入治疗后成功的 ACS 患者的储存血清。通过使用载脂蛋白 B 耗尽的血清和 H-胆固醇标记的巨噬细胞的体外细胞测定，测量 CEC，并用 arylesterase 活性（AREA）在 ACS 的发病或早期阶段进行评估，比较了 69 例完成五个月门诊 CR 计划（CR 组）和 15 例未参加和/或退出 CR 计划（非 CR 组）的患者。
CR 组中载脂蛋白 A-I（apoA-I）和 CEC 分别增加了 4.0%和 9.4%，而两组的 HDL-胆固醇和 AREA 在随访期间均未发生变化。在 CR 患者中，CEC 显著增加，而不论他汀类药物的不同治疗，而 HDL-胆固醇和 apoA-I 显著增加，在接受瑞舒伐他汀或匹伐他汀治疗的患者中。尽管 CEC 和 AREA 彼此显著相关，但 CEC 和 AREA 与其他生物标志物的相关性存在差异。CEC 和 AREA 与 apoA-I 显著相关，而与 HDL-胆固醇不相关。CEC 和 AREA 的变化与 apoA-I 的变化显著相关（rho=0.328，p=0.002 和 rho=0.428，p＜0.0001），大于与 HDL-胆固醇的变化（rho=0.312，p=0.0042 和 rho=0.343，p=0.003）。
CR 可以改善 HDL 功能，有利于二级预防。
