The Anti-Oxidative Capacity of High-Density Lipoprotein Is Reduced in Acute Coronary Syndrome But Not in Stable Coronary Artery Disease

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY

卷:58

Article

Patel, Parin J.^1,2  Khera, Amit V.^1,3,4  Jafri, Kashif¹  Wilensky, Robert L.^2,3  Rader, Daniel J.^1,2,3,4 

[1] Univ Penn, Sch Med, Philadelphia, PA 19104 USA

[2] Hosp Univ Penn, Dept Med, Div Cardiovasc Med, Philadelphia, PA 19104 USA

[3] Cardiovasc Inst, Philadelphia, PA USA

[4] Inst Translat Med & Therapeut, Philadelphia, PA USA

关键词: acute coronary syndrome(s);    coronary artery disease;    HDL function;    HDL inflammatory index;    oxidized LDL;   

DOI  :  10.1016/j.jacc.2011.08.030

来源: Elsevier

【 摘 要 】

Objectives This study examined an anti-inflammatory property of high-density lipoprotein (HDL) in subjects with acute coronary syndrome (ACS) and stable coronary artery disease (CAD) compared with control subjects. Background HDL has anti-inflammatory properties in vitro, but its relationship to coronary disease in humans is unclear. The high-density lipoprotein inflammatory index (HII) measures the ability of HDL to mitigate oxidation of low-density lipoprotein; this function may be impaired in ACS and/or CAD. Methods We measured HII in 193 patients undergoing angiography for symptoms of CAD. Control subjects (n = 99) had no angiographic CAD, chronic CAD subjects (n = 51) had >= 70% vessel stenosis, and ACS subjects (n = 43) had >= 20% vessel stenosis and ischemia or infarction. We also examined HII in a cohort of healthy subjects randomly assigned to a statin or placebo. Results Subjects who had ACS had higher HII (less antioxidative capacity) compared with controls (1.57 vs. 1.17, p = 0.005) or those with chronic CAD (1.57 vs. 1.11, p = 0.006). HII was not different in subjects with stable CAD compared with controls. Furthermore, those subjects with higher HII were more likely to have ACS than no CAD (quartile 4 vs. 1, odds ratio [OR]: 1.74, p = 0.008). In a multivariate logistic regression model, HII was associated with ACS after adjusting for traditional cardiac risk factors (OR: 3.8, p = 0.003). There was a small improvement in HII after statin therapy compared with placebo (-14%, p = 0.03). Conclusions HDL has less anti-inflammatory capacity as assessed by HII in the setting of ACS compared with controls or subjects with chronic CAD. (J Am Coll Cardiol 2011;58:2068-75) (C) 2011 by the American College of Cardiology Foundation

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