Glycoprotein VI as a prognostic biomarker for cardiovascular death in patients with symptomatic coronary artery disease

Background  

Platelets play a critical role in arterial thrombosis, acute coronary syndrome (ACS) and stroke. Platelet collagen receptor glycoprotein VI (GPVI) is associated with acute coronary events and a poor clinical outcome.     

Increased plasma lipid-poor apolipoprotein A-I in patients with coronary artery disease

BACKGROUND: Pre-beta 1-HDL participates in a cyclic process involved in the retrieval of cholesterol from peripheral tissues. Although pre-beta 1-HDL can be measured by two-dimensional electrophoresis or crossed immunoelectrophoresis, these methods are time-consuming and require technical expertise. In this study, we separated plasma lipid-poor apolipoprotein A-I (apo A-I) by high-performance size-exclusion chromatography. METHODS: We measured plasma lipid-poor apo A-I in 20 male patients with coronary artery disease [CAD; mean (SD) age, 64.0 (18) years] and 15 male controls [54.7 (17) years] and in 7 female CAD patients [70.3 (7.7) years] and 9 female controls [65.1 (4.7) years]. RESULTS: Lipid-poor apo A-I was most stable when stored at -80 degrees C in the presence of aprotinin (final concentration, 50 kIU/L). The lipid-poor apo A-I concentration decreased during incubation at 37 degrees C, and this was not prevented by the addition of 2 mmol/L of the lecithin:cholesterol acyltransferase (LCAT) inhibitor 5,5'-dithiobis(2-nitrobenzoic acid). Lipid-poor apo A-I was significantly higher in CAD patients than in controls [38.3 (7.9) mg/L for male CAD patients vs 29.3 (7.3) mg/L for male controls; 43.3 (11) mg/L for female CAD patients vs 27.1 (7.4) mg/L for female controls (P <0.01 for both)]. There were no significant differences in LCAT activity or cholesteryl ester transfer protein (CETP) concentration between patients and controls. Moreover, the plasma lipid-poor apo A-I concentration was not significantly correlated with LCAT or CETP activities. CONCLUSIONS: Although the production of lipid-poor apo A-I in plasma is not fully understood, our results indicate that lipid-poor apo A-I could be used as a marker for arteriosclerosis and demonstrate that it is not identical to the pre-beta1-HDL measured by other methods.     

Correlation of fasting serum apolipoprotein B-48 with coronary artery disease prevalence

Eur J Clin Invest 2012; 42 (9): 992-999 ABSTRACT: Background Postprandial hyperlipidemia partially refers to the postprandial accumulation of chylomicrons and chylomicron remnants (CM-R). Many in vitro studies have shown that CM-R has highly atherogenic properties, but consensus is lacking on whether CM-R accumulation correlates with the development of atherosclerotic cardiovascular diseases. We investigated the correlation between CM-R accumulation and the prevalence of coronary artery disease (CAD). Design Subjects who received a coronary angiography and did not take any lipid-lowering drugs (n?=?189) were enrolled. Subjects with coronary artery stenosis (≥?75%) were diagnosed as CAD. Biochemical markers for glucose and lipid metabolism including fasting apolipoprotein (apo) B-48 concentration were compared between CAD patients (n?=?96) and age-, sex-, and body mass index (BMI)-matched non-CAD subjects without overt coronary stenosis (?4·34?μg/mL, the cut-off value) and other coronary risk factors were found to be associated with a stronger risk of CAD compared with single high fasting apo B-48 levels. Conclusion Fasting serum apo B-48 levels significantly correlated with the prevalence of CAD.     

A prospective evaluation of apolipoprotein M gene T-778C polymorphism in relation to coronary artery disease in Han Chinese

OBJECTIVES: Apolipoprotein M (apoM) is important for the formation of pre-beta-high-density lipoprotein (HDL) and cholesterol efflux in macrophages. It is demonstrated that single-nucleotide polymorphism (SNP) T-778C of apoM gene is related to type 2 diabetes in Han Chinese. In the present study, we investigated the possible association of apoM polymorphism in relation to coronary artery disease (CAD) in Han Chinese. DESIGN AND METHODS: This case-controlled study consisted of 118 CAD patients who were diagnosed angiographically to have at least 30% stenosis, and 255 unrelated subjects who were used as control. ApoM gene polymorphism in the proximal promoter region was analyzed by PCR-RFLP and serum lipid levels were also measured. RESULTS: It is indicated that CAD patients had increased frequency of C allele on apoM T-778C compared to the controls (14.8% vs. 6.9%, P=0.0008). Multivariable logistic regression analysis indicated that odds ratios (ORs) for all subjects with apoM CC+CT genotypes and C allele were 1.9 (95% CI=1.1-2.9, P<0.0001) and 1.9 (95% CI=1.3-3.2, P<0.0001), respectively. The plasma total cholesterol (TC) levels were significantly higher in individuals with CC or CT genotype than those with TT genotype in both CAD patients and controls. CONCLUSIONS: The present findings suggest that the C allele at nucleotide -778 in the apoM gene is a risk factor for genetic susceptibility to CAD and is also associated with TC levels in Han Chinese.     

代谢综合征与冠心病的载脂蛋白E基因多态性

目的:探讨代谢综合征(metabolicsyndrome,MS)与冠心病(coronaryarterydisease,CHD)的载脂蛋白E(apolipoproteinE,ApoE)基因多态性之间的关联。方法:将203例原发性高血压、糖尿病或原发性高血压合并糖尿病的患者分为代谢综合征组(按WHO定义,MS+,n=96)和非代谢综合征组(MS-,n=107);冠心病组(CHD+,n=84)和非冠心病组(CHD-,n=119);代谢综合征合并冠心病(MS++CHD,n=55)及代谢综合征非合并冠心病组(MS+,n=39)。采用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)确定特定ApoE片段基因型,应用荧光标记自动测序法测定PCR产物,确认单核苷酸多态性(singlenucleotidepolymorphisms,SNPs)位点。结果:(1)MS组ApoEε4等位基因频率高于对照组(15.6%vs8.9%,P=0.038);(2)CHD组ε4等位基因频率显著高于对照组(16.8%vs8.8%,P=0.017);(3)MS+CHD组ε4等位基因频率显著高于对照组(21.8%vs7.3%,P=0.006);与...     

Association of apolipoprotein E polymorphism, low-density lipoprotein cholesterol, and coronary artery disease

We determined the frequencies of genetic apolipoprotein E isoforms in 570 survivors of myocardial infarction, all with demonstrable coronary heart disease, as compared with 624 healthy persons. In controls, E-4/E-3 heterozygosity was associated with total cholesterol concentrations of 1985 (SD 364) mg/L and low-density lipoprotein (LDL)-cholesterol concentrations of 1306 (SD 332) mg/L. Significantly lower values, 1811 (SD 312) mg/L and 1121 (SD 274) mg/L, respectively, were observed for E-3/E-2 heterozygous persons. In survivors of myocardial infarction, the respective values were significantly higher than in controls, differing between E-4/E-3 and E-3/E-2 heterozygous patients by 233 and 220 mg/L, respectively. Moreover, E-4/E-3 heterozygosity was accompanied by earlier age of myocardial infarction (48.8 +/- 7.4 years) as compared with E-3/E-2 heterozygosity (53.4 +/- 6.9 years) and E-3/E-3 homozygosity (51.2 +/- 7.7 years). Evidently, apolipoprotein E polymorphism can contribute to total and LDL-cholesterol concentrations in serum, thereby affecting risk of coronary heart disease and myocardial infarction.     

Remnant like particles as a risk factor for coronary artery disease

Plasma triglyceride(TG) has now emerged as an independent risk factor for coronary artery disease(CAD). In contrast to LDL, TG-rich lipoproteins are heterogenous in size and apolipoprotein composition. Remnant is proatherogenic TG-rich lipoproteins, thereby drawing much research interest of how to isolate and quantify remnants. Remnant like particles(RLP) was developed by using immunoaffinity gels coupled to anti-apoA-I and anti-apoB-100 antibodies. RLP has been shown to be positively correlated with coronary vasocontraction to acetylcholine in CAD patients, suggesting that RLP causes endothelial dysfunction. Further study revealed that CAD patient with relatively high RLP-C levels had a significantly poor prognosis as compared to low RLP-C counterpart. Both Framingham heart study and VA-HIT also found RLP-C as a significant risk factor for CAD. In conclusions, RLP-C is a reasonable indicator for proatherogenic remnants, thus considered as a new risk factor for CAD.     

速度向量成像技术评价冠心病患者颈动脉病变

目的探讨速度向量成像技术分析冠心病患者颈动脉壁的运动速度、应变率及扭转运动。方法根据冠状动脉造影,将71例受检者分为冠心病组45例及正常组26例。在速度向量成像模式下,分别取左颈总动脉距颈内外动脉分叉处1．5cm及2．5cm处两个短轴切面,勾画动脉内膜,分析颈动脉壁的运动速度及应变率,并计算其扭转角度。结果45例冠心病患者左颈总动脉各壁运动速度及应变率大于正常组（P〈0．05）。冠心病组颈动脉壁的扭转角度与正常组无统计学差异（P〉0．05）。结论利用速度向量成像技术测量患者颈动脉壁的运动速度及应变率,可以评估冠心病患者的血管病变,并有望成为预测冠心病的新指标。     

Evaluation of coronary artery disease in patients having noncardiac surgery

Perioperative myocardial infarction and cardiac death are feared complications of noncardiac surgery. Preoperative risk assessment begins with clinical variables. There is no formula for determining who needs further evaluation. In selected patients, thallium scintigraphy or coronary arteriography is needed to define preoperative risk.     

Effect of apolipoprotein E genotypes on incidence and development of coronary stenosis in Iranian patients with coronary artery disease

Background: Apolipoprotein (apo) E polymorphism plays a significant role in the development of coronary disease, but their involvement in coronary artery stenosis (CAS) is controversial. Therefore, the purpose of this study was to investigate the effects of this polymorphism on atherosclerosis, and severity and extent of CAS in unrelated Iranian population. Methods: DNA was isolated from 390 study participants and APOE genotypes were determined utilizing the polymerase chain reaction and restriction fragment length polymorphism. Results: The APOE‐ε4 and ‐ε2 allele frequencies were significantly higher in the CAS patients than in the control group (P<0.05). The association of Apo E polymorphism with the severity of stenosis was evaluated, which is according to the result that apolipoprotein E alleles were not significantly different when compared with the severity of stenosis (χ²=0.84, P>0.05). Conclusion: Our results suggest that APOE‐ε4 is a risk factor for stenosis but does not has any effect on the severity of this disease. J. Clin. Lab. Anal. 25:43–46, 2011. © 2011 Wiley‐Liss, Inc.     

Evaluation of C-reactive protein, a sensitive marker of inflammation, as a risk factor for stable coronary artery disease.

OBJECTIVES: Multiple lines of investigations have converged to suggest a prominent role for inflammation in coronary artery disease (CAD). The association of CRP level with active CAD is well documented. The relation, however, between levels of CRP and the presence and extent of stable CAD has seldom been studied in the developing countries. We investigated the association between serum concentration of C-reactive protein (CRP) and angiographically documented coronary artery disease (CAD) in a population of 450 individuals. DESIGN AND METHODS: Ultrasensitive immunoassay was used to measure CRP levels in 284 patients with CAD and 166 control healthy subjects. The association of CRP levels with severity of disease as indicated by > or = 50% stenosis in one vessel (n = 79), two vessels (n = 74), or three vessels (n = 131) was also investigated. RESULTS: CRP levels were greater in the patients with CAD (2.14 (0.88--3.38) vs. 1.45 (0.70--2.55) mg/L, p < 0.0001) than in the respective control subjects. Multiple logistic regression analysis showed CRP as an independent discriminating risk factor for CAD (odds ratio, 3.46, p < 0.001). Significant correlation was identified between CRP levels and severity of CAD (p < 0.0001). Prediction models that incorporated CRP in addition to other established coronary risk factors were significantly better at predicting risk than the models based on the other risk factors alone. CRP level was also an independent predictor of CAD in a subpopulation with normal levels of low density lipoprotein cholesterol (LDL-C < or = 3.4 mmol/L, p < 0.009). CONCLUSIONS: Our findings suggest that CRP has a strong association with stable CAD, as such, the measurement of CRP may improve the coronary risk assessment in Iranian CAD patients.     

Association between apolipoprotein E polymorphism and coronary artery disease in the Kermanshah population in Iran

OBJECTIVE: Coronary artery disease (CAD) is the major cause of death in developing countries, such as Iran. The apolipoprotein E gene (APOE) is considered an important genetic determinant of CAD. In this study, the relationship between APOE polymorphism with lipid variation in CAD patients in Kermanshah, Iran was investigated. METHODS: This case-control study consisted of 115 CAD patients who angiographically had at least 30% stenosis and 135 unrelated controls. APOE polymorphism was detected by PCR-RFLP and serum lipid level was measured enzymatically. RESULTS: The APOE-epsilon4 and -epsilon2 allele frequencies were significantly higher in the CAD patients than in the control group (P < 0.001). The CAD patients with epsilon3/epsilon4 genotype had also higher TC (P < 0.001) and LDL-C (P < 0.01) and lower HDL-C (P < 0.03) levels than that of the control group. CONCLUSIONS: APOE-epsilon4 allele is a risk factor for CAD, so that carriers of this allele with high levels of LDL-C may be susceptible to CAD and myocardial infarction.