血浆神经酰胺与ST段抬高型心肌梗死患者的冠状动脉粥样硬化负担相关。

Plasma ceramides are associated with coronary atherosclerotic burden in patients with ST-segment elevation myocardial infarction.

作者信息

Pan Weili, Li Longyan, Sun Meng, Wang Chao, Fang Shaohong, Yu Bo

机构信息

Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, Province Heilongjiang, China; The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, Province Heilongjiang, China.

Department of Cardiology, People's Liberation Army Joint Logistics Support Unit 962 Hospital, Harbin, Province Heilongjiang, China.

出版信息

Int J Cardiol. 2020 Dec 1;320:155-160. doi: 10.1016/j.ijcard.2020.08.010. Epub 2020 Aug 12.

DOI:10.1016/j.ijcard.2020.08.010

PMID:32800902

Abstract

BACKGROUND

Plasma ceramides (Cer), a subset of bioactive lipids, have mechanistic links to atherosclerotic coronary artery disease (CAD) pathogenesis and are related to major adverse cardiovascular events (MACEs).

OBJECTIVES

This study aimed to explore the associations between plasma Cer and atherosclerotic burden evaluated by Synergy Between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) score.

METHODS AND RESULTS

A retrospective series of 248 ST-segment elevation myocardial infarction (STEMI) patients undergoing interventional procedures and plasma ceramides measurement were enrolled. Rapid resolution liquid chromatography coupled with quadrupole time-of-flight mass spectrometry (RRLC-Q-TOF/MS) was used to evaluate plasma Cer concentrations. SYNTAX score was automatically calculated on the SYNTAX website (http://www.syntaxscore.com/). Patients with STEMI had higher plasma MACEs-related ceramide levels than normal donors (p < .001). Pearson correlation analysis showed positive correlations between SYNTAX score and Cer(d18:1/16:0) (r = 0.176, p = .006), Cer(d18:1/18:0) (r = 0.290, p < .001), Cer(d18:1/24:1) (r = 0.209, p = .001) and Cer(d18:1/24:0) (r = 0.134, p = .036). Adjustments for all traditional risks, higher Cer(d18:1/16:0) level (per SD increase, β (95%CI) =10.681 (1.912-19.923), p = .032), Cer(d18:1/18:0) level (per SD increase, β (95%CI) =38.830 (15.444-62.126), p = .001), Cer(d18:1/24:1) level (per SD increase, β (95%CI) =6.122 (1.640-10.605), p = .008) (except for and Cer(d18:1/24:0) level (per SD increase, β (95%CI) =0.999 (-0.508-2.506), p = .193)) were independently associated with higher levels of SYNTAX score.

CONCLUSIONS

Elevated plasma levels of Cer (d18:1/16:0), Cer(d18:1/18:0) and Cer(d18:1/24:1)) are independent predictors for a high atherosclerotic burden in patients with STEMI. Our findings provide evidence supporting proatherogenic roles of Cer.

摘要

背景

血浆神经酰胺（Cer）是生物活性脂质的一个子集，与动脉粥样硬化性冠状动脉疾病（CAD）的发病机制存在机制联系，并与主要不良心血管事件（MACE）相关。

目的

本研究旨在探讨血浆Cer与通过紫杉醇药物洗脱支架与心脏外科手术协同作用（SYNTAX）评分评估的动脉粥样硬化负担之间的关联。

方法与结果

纳入了248例接受介入手术并进行血浆神经酰胺测量的ST段抬高型心肌梗死（STEMI）患者的回顾性系列研究。采用快速分辨率液相色谱联用四极杆飞行时间质谱（RRLC-Q-TOF/MS）评估血浆Cer浓度。SYNTAX评分在SYNTAX网站（http://www.syntaxscore.com/）上自动计算。STEMI患者血浆中与MACE相关的神经酰胺水平高于正常供体（p <.001）。Pearson相关性分析显示SYNTAX评分与Cer（d18:1/16:0）（r = 0.176，p = 0.006）、Cer（d18:1/18:0）（r = 0.290，p <.001）、Cer（d18:1/24:1）（r = 0.209，p = 0.001）和Cer（d18:1/24:0）（r = 0.134，p = 0.036）之间呈正相关。在对所有传统风险进行调整后，较高的Cer（d18:1/16:0）水平（每增加1个标准差，β（95%CI）=10.681（1.912 - 19.923），p = 0.032）、Cer（d18:1/18:0）水平（每增加1个标准差，β（95%CI）=38.830（15.444 - 62.126），p = 0.001）、Cer（d18:1/24:1）水平（每增加1个标准差，β（95%CI）=6.122（1.640 - 10.605），p = 0.008）（除Cer（d18:1/24:0）水平（每增加1个标准差，β（95%CI）=0.999（-0.508 - 2.506），p = 0.193）外）均与较高的SYNTAX评分水平独立相关。