Lipids and Atherosclerosis Unit, Internal Medicine Unit, Reina Sofia University Hospital, 14004 Cordoba, Spain; Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Cordoba, Spain; Department of Medical and Surgical Sciences, University of Cordoba, 14004 Cordoba, Spain; CIBER Fisiopatologia de la Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain.
Lipids and Atherosclerosis Unit, Internal Medicine Unit, Reina Sofia University Hospital, 14004 Cordoba, Spain; Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Cordoba, Spain.
Clin Chim Acta. 2022 Aug 1;533:89-95. doi: 10.1016/j.cca.2022.06.002. Epub 2022 Jun 11.
The extent of atherosclerotic coronary heart disease (CHD) is associated with its prognosis, thus discovering potential biomarkers related to worse outcomes could prove valuable. The present work aims to investigate whether lipoprotein subfractions are associated with angiographic CHD severity.
Patients from the CORDIOPREV study exhibiting coronary lesions in angiography were classified into two groups (single-vessel coronary disease (SVD) or multivessel coronary disease (MVD)). High-throughput nuclear magnetic resonance (NMR) spectroscopy determined lipoprotein subfractions concentration and composition.
SVD patients showed a higher concentration of medium and small HDL particles compared with MVD patients. For medium HDL, total lipids, phospholipids, total cholesterol, cholesteryl esters and free cholesterol reflected HDL particle concentration, whereas, for small HDL, total lipids, phospholipids, and free cholesterol mirrored lipoprotein particle concentration. Among traditional cardiovascular risk factors, age, hypertension and T2D were independently associated with angiography severity. In multivariate logistic regression models, medium and small HDL particles remained inversely associated with angiography severity (OR 0.77 (95% CI: 0.64-0.91); OR 0.78 (95% CI: 0.67-0.91), respectively) after adjusting with covariates.
In CHD patients mostly on statin treatment, angiography severity is inversely related to small and medium HDL subclasses concentration measured by NMR. These particles are also independent predictors of the presence of MVD, and its use increased the prediction of this entity over traditional risk factors.
动脉粥样硬化性冠心病（CHD）的严重程度与其预后相关，因此发现与不良结局相关的潜在生物标志物可能具有重要价值。本研究旨在探讨脂蛋白亚组份与血管造影 CHD 严重程度的关系。
在 CORDIOPREV 研究中，对血管造影显示有冠状动脉病变的患者进行分组（单支血管性冠心病（SVD）或多支血管性冠心病（MVD））。采用高通量核磁共振（NMR）光谱法测定脂蛋白亚组份浓度和组成。
与 MVD 患者相比，SVD 患者的中、小 HDL 颗粒浓度更高。对于中 HDL，总脂质、磷脂、总胆固醇、胆固醇酯和游离胆固醇反映了 HDL 颗粒浓度，而对于小 HDL，总脂质、磷脂和游离胆固醇反映了脂蛋白颗粒浓度。在传统心血管危险因素中，年龄、高血压和 T2D 与血管造影严重程度独立相关。在多变量逻辑回归模型中，在校正了协变量后，中、小 HDL 颗粒与血管造影严重程度呈负相关（OR 0.77（95%CI：0.64-0.91）；OR 0.78（95%CI：0.67-0.91））。
在接受他汀类药物治疗的 CHD 患者中，血管造影严重程度与通过 NMR 测量的小和中 HDL 亚组份浓度呈负相关。这些颗粒也是 MVD 的独立预测因子，其使用增加了传统危险因素对该实体的预测能力。
