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血浆 sLRP-1 水平与急性冠状动脉综合征患者中 Gensini 评分中度至重度狭窄的风险增加独立相关。

Plasma sLRP-1 Level Independently Relates to a Higher Risk of Moderate-Severe Stenosis by Gensini Score in Acute Coronary Syndrome Patients.

机构信息

Department of Cardiology, The Affiliated Hospital of Chengde Medical College.

出版信息

Tohoku J Exp Med. 2023 Aug 23;260(4):329-336. doi: 10.1620/tjem.2023.J044. Epub 2023 Jun 1.

DOI:10.1620/tjem.2023.J044
PMID:37258136
Abstract

Soluble low-density lipoprotein receptor-related protein-1 (sLRP-1) plays a crucial role in facilitating inflammation, lipid accumulation, and atherosclerosis, and the latter factors are involved in the pathology of cardiovascular diseases. This study aimed to explore the ability of plasma sLRP-1 for reflecting stenosis degree in acute coronary syndrome (ACS) patients. sLRP-1 was detected from plasma by enzyme-linked immunosorbent assay in 169 ACS patients and 77 non-ACS subjects (as controls) after admission. Our study illustrated that sLRP-1 was increased in ACS patients versus controls (P < 0.001). Meanwhile, sLRP-1 was positively correlated with body mass index (P = 0.021), white blood cells (P = 0.009), neutrophils (P = 0.002), cardiac troponin I (P = 0.009), and brain natriuretic peptide (P = 0.008) in ACS patients. Notably, sLRP-1 was positively associated with the Gensini score (P = 0.002) and Gensini score stratified stenosis severity (P = 0.004) in ACS patients. After adjustment, sLRP-1 [odds ratio (OR) = 1.333, P = 0.045] independently estimated a higher risk of moderate-severe stenosis, so did numbers of coronary artery lesions (OR = 2.869, P = 0.001), but ejection fraction forecasted a lower risk (OR = 0.880, P = 0.012). Interestingly, a combination of sLRP-1, ejection fraction, and numbers of coronary artery lesions exhibited a good ability to estimate moderate-severe stenosis risk with an area under the curve (95% confidence interval) of 0.845 (0.783-0.906). In summary, increased plasma sLRP-1 represents an aggravated inflammation, impaired cardiac function, and especially a higher stenosis severity in ACS patients.

摘要

可溶性低密度脂蛋白受体相关蛋白-1(sLRP-1)在促进炎症、脂质积累和动脉粥样硬化中发挥着关键作用,而后者是心血管疾病病理的相关因素。本研究旨在探索血浆 sLRP-1 反映急性冠脉综合征(ACS)患者狭窄程度的能力。在入院后,通过酶联免疫吸附试验从 169 例 ACS 患者和 77 例非 ACS 患者(作为对照组)的血浆中检测 sLRP-1。我们的研究表明,ACS 患者的 sLRP-1 高于对照组(P < 0.001)。同时,sLRP-1 与 ACS 患者的体重指数(P = 0.021)、白细胞(P = 0.009)、中性粒细胞(P = 0.002)、心肌肌钙蛋白 I(P = 0.009)和脑钠肽(P = 0.008)呈正相关。值得注意的是,sLRP-1 与 ACS 患者的 Gensini 评分(P = 0.002)和 Gensini 评分分层狭窄严重程度(P = 0.004)呈正相关。调整后,sLRP-1[比值比(OR)= 1.333,P = 0.045]独立预测中重度狭窄的风险更高,冠状动脉病变的数量(OR = 2.869,P = 0.001)也是如此,但射血分数预示着较低的风险(OR = 0.880,P = 0.012)。有趣的是,sLRP-1、射血分数和冠状动脉病变数量的组合能够很好地预测中重度狭窄的风险,曲线下面积(95%置信区间)为 0.845(0.783-0.906)。总之,血浆 sLRP-1 升高表明 ACS 患者炎症加重、心功能受损,尤其是狭窄程度更严重。

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