Al-Makhamreh Hanna K, Shaban Ala' E, AlHaddadin Sofia S, AlSharif Abedallatif A, Ghalayni Ruba A, Daoud Lana F, Alshraideh Baha M
Cardiology Department, University of Jordan, Amman, Jordan.
Radiology Department, University of Jordan, Amman, Jordan.
Cardiol Res. 2020 Feb;11(1):50-55. doi: 10.14740/cr992. Epub 2020 Jan 26.
The pathophysiology of coronary artery ectasia (CAE) is under investigated and not well understood. Atherosclerosis is considered as the main etiologic factor for CAE in adults where more than 50% of CAE patients have atherosclerosis. Recently, lipoprotein (a) (Lp(a)) has emerged as a powerful risk factor for atherosclerosis and coronary artery disease (CAD). Serum levels of Lp(a) in patients with CAE have not been investigated. We assumed that Lp(a) may play a role in the pathogenesis of CAE. Principally, our study aims to identify whether Lp(a) is an independent risk factor for CAE.
Our study is a prospective pilot study. Study population was collected prospectively from pool of patients referred for elective cardiac catheterization at Jordan University Hospital (JUH) in the period extending from February 17, 2018 to June 31, 2018. Patients were referred for elective coronary angiography after being interviewed and physically examined by a cardiologist (HA). Patients with known history of CAD or who are already on anti-lipidemic drugs either documented in the medical records or by interviewing patients for history of revascularization were excluded from the study.
Regarding the primary outcome, there was no significant difference in Lp(a) concentrations between normal and ectasia groups in the general sample (median: 17.5mg/dL vs. 20.4 mg/dL, P value = 0.38).
Our study concludes that there is no detected relationship between elevated Lp(a) levels and developing CAE. CAE was more common in patients with low high-density lipoprotein (HDL) level (compared with patients with normal coronaries), higher total cholesterol level (compared with patients with non-obstructive stenosis) and higher hemoglobin A1c (HbA1c).
冠状动脉扩张（CAE）的病理生理学正在研究中，尚未完全明确。动脉粥样硬化被认为是成人CAE的主要病因，超过50%的CAE患者患有动脉粥样硬化。最近，脂蛋白（a）[Lp（a）]已成为动脉粥样硬化和冠状动脉疾病（CAD）的一个强大危险因素。CAE患者的血清Lp（a）水平尚未得到研究。我们推测Lp（a）可能在CAE的发病机制中起作用。主要而言，我们的研究旨在确定Lp（a）是否是CAE的独立危险因素。
我们的研究是一项前瞻性试点研究。研究人群是从2018年2月17日至2018年6月31日期间在约旦大学医院（JUH）接受择期心脏导管插入术的患者库中前瞻性收集的。患者在接受心脏病专家（HA）的访谈和体格检查后被转诊进行择期冠状动脉造影。有CAD已知病史或已服用降脂药物（无论是在病历中记录还是通过询问患者血管重建病史）的患者被排除在研究之外。
关于主要结局，在一般样本中，正常组和扩张组之间的Lp（a）浓度无显著差异（中位数：17.5mg/dL对20.4mg/dL，P值 = 0.38）。
我们的研究得出结论，未检测到Lp（a）水平升高与CAE发生之间的关系。CAE在高密度脂蛋白（HDL）水平低的患者（与冠状动脉正常的患者相比）、总胆固醇水平高的患者（与无阻塞性狭窄的患者相比）和糖化血红蛋白（HbA1c）水平高的患者中更常见。
