Tani Shigemasa, Matsuo Rei, Hirayama Atsushi
Department of Health Planning Center, Nihon University Hospital, 1-6 Kanda-Surugadai, Chiyoda-ku, Tokyo, 101-8309, Japan.
Department of Cardiology, Nihon University Hospital, Tokyo, Japan.
Heart Vessels. 2019 Feb;34(2):368-374. doi: 10.1007/s00380-018-1240-3. Epub 2018 Aug 24.
Interventions targeting the serum eicosapentaenoic acid (EPA)/arachidonic acid (AA) ratio could be useful for the prevention of coronary artery disease (CAD). Few data exist regarding the effects of administration of EPA on the serum levels of soluble thrombomodulin (sTM) as a marker of endothelial damage, or on the relationship between the sTM and EPA/AA ratio in patients with CAD receiving statin treatment. We assigned stable CAD patients already receiving statin therapy to an EPA group (1800 mg/day: n = 50) or control group (n = 50). A significant increase of the sTM level was observed in the EPA group as compared to that in the control group 0.40 (0.10/0.70) FU/mL vs. 0.20 (0/0.40) FU/mL, p = 0.004 at the 6-month follow-up examination. Multivariate regression analysis after adjustments for coronary risk factors and changes of the serum lipid levels identified an increased EPA/AA ratio as an independent predictor of increased serum sTM level (β = 0.244, p = 0.02). The results suggest that an increased sTM level caused by additional administration of EPA to statin might be associated with an increased EPA/AA ratio. The increase of the serum sTM after administration of EPA might reflect an increase of the TM expression on the endothelial surface rather than endothelial damage in CAD patients under statin treatment.Clinical Trial Registration Information UMIN ( http://www.umin.ac.jp/ ), Study ID: UMIN000010452.
针对血清二十碳五烯酸（EPA）/花生四烯酸（AA）比值的干预措施可能有助于预防冠状动脉疾病（CAD）。关于给予EPA对作为内皮损伤标志物的可溶性血栓调节蛋白（sTM）血清水平的影响，或对接受他汀类治疗的CAD患者中sTM与EPA/AA比值之间关系的数据很少。我们将已经接受他汀类治疗的稳定CAD患者分为EPA组（1800毫克/天：n = 50）或对照组（n = 50）。在6个月的随访检查中，与对照组相比，EPA组的sTM水平显著升高，分别为0.40（0.10/0.70）FU/mL和0.20（0/0.40）FU/mL，p = 0.004。在对冠状动脉危险因素和血脂水平变化进行调整后的多变量回归分析中，发现EPA/AA比值升高是血清sTM水平升高的独立预测因素（β = 0.244，p = 0.02）。结果表明，在他汀类药物基础上额外给予EPA导致的sTM水平升高可能与EPA/AA比值升高有关。在接受他汀类治疗的CAD患者中，给予EPA后血清sTM的升高可能反映了内皮表面TM表达的增加，而不是内皮损伤。临床试验注册信息UMIN（http://www.umin.ac.jp/），研究编号：UMIN000010452。
