1
|
Sivri F, Öztürk Ceyhan B. Increased Plasma Non-High-Density Lipoprotein Levels and Poor Coronary Collateral Circulation in Patients With Stable Coronary Artery Disease. Tex Heart Inst J 2023; 50:493360. [PMID: 37270295 DOI: 10.14503/thij-22-7934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND This study investigated the relationship between coronary collateral circulation (CCC) and non-high-density lipoprotein cholesterol (non-HDL-C) in patients with stable coronary artery disease (CAD). Coronary collateral circulation plays a critical role in supporting blood flow, particularly in the ischemic myocardium. Previous studies show that non-HDL-C plays a more important role in the formation and progression of atherosclerosis than do standard lipid parameters. METHODS A total of 226 patients with stable CAD and stenosis of more than 95% in at least 1 epicardial coronary artery were included in the study. Rentrop classification was used to assign patients into group 1 (n = 85; poor collateral) or 2 (n = 141; good collateral). To adjust for the observed imbalance in baseline covariates between study groups, propensity-score matching was used. Covariates were diabetes, Gensini score, and angiotensin-converting enzyme inhibitor use. RESULTS In the propensity-matched population, the plasma non-HDL-C level (mean [SD], 177.86 [44.0] mg/dL vs 155.6 [46.21] mg/dL; P = .001) was statistically higher in the poor-collateral group. LDL-C (odds ratio [OR], 1.23; 95% CI, 1.11-1.30; P = .01), non-HDL-C (OR, 1.34; 95% CI, 1.20-1.51; P = .01), C-reactive protein (OR, 1.21; 95% CI, 1.11-1.32; P = .03), systemic immune-inflammation index (OR, 1.14; 95% CI, 1.05-1.21; P = .01), and C-reactive protein to albumin ratio (OR, 1.11; 95% CI, 1.06-1.17; P = .01) remained independent predictors of CCC in multivariate logistic regression analysis. CONCLUSION Non-HDL-C was an independent risk factor for developing poor CCC in stable CAD.
Collapse
Affiliation(s)
- Fatih Sivri
- Department of Cardiology, Nazilli State Hospital, Aydin, Turkey
| | - Banu Öztürk Ceyhan
- Department of Endocrinology and Metabolism, Medinova Hospital, Aydin, Turkey
| |
Collapse
|
2
|
Hussain Z, Iqbal J, Liu H, Zhou HD. Exploring the role of lipoprotein(a) in cardiovascular diseases and diabetes in Chinese population. Int J Biol Macromol 2023; 233:123586. [PMID: 36758756 DOI: 10.1016/j.ijbiomac.2023.123586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/31/2023] [Accepted: 02/04/2023] [Indexed: 02/10/2023]
Abstract
A high level of lipoprotein (a) in the plasma has been associated with a variety of cardiovascular diseases and is considered to be an independent predictor of some other diseases. Based on recent studies, the concentration levels of Lp(a) in the Chinese population exhibit a distinctive variation from other populations. In the Chinese population, a high level of Lp(a) indicates a higher incidence of revascularization, platelet aggregation, and thrombogenicity following PCI. Increased risk of atherosclerotic cardiovascular disease (ASCVD) in Chinese population has been linked to higher levels of Lp(a), according to studies. More specifically, it has been found that in Chinese populations, higher levels of Lp(a) were linked to an increased risk of coronary heart disease, severe aortic valve stenosis, deep vein thrombosis in patients with spinal cord injuries, central vein thrombosis in patients receiving hemodialysis, and stroke. Furthermore, new and consistent data retrieved from several clinical trials also suggest that Lp (a) might also play an essential role in some other conditions, including metabolic syndrome, type 2 diabetes and cancers. This review explores the clinical and epidemiological relationships among Lp(a), cardiovascular diseases and diabetes in the Chinese population as well as potential Lp(a) underlying mechanisms in these diseases. However, further research is needed to better understand the role of Lp(a) in cardiovascular diseases and especially diabetes in the Chinese population.
Collapse
Affiliation(s)
- Zubair Hussain
- State Key Laboratory of Esophageal Cancer Prevention and Treatment, Zhengzhou University, 450000, Zhengzhou, China; Department of Pathophysiology, Academy of Medical Science, College of Medicine, Zhengzhou University, 450000, Zhengzhou, China; China-US (Henan) Hormel Cancer Institute, 450000, Zhengzhou, China
| | - Junaid Iqbal
- National Clinical Research Center for Metabolic Diseases, Hunan Provincial Key Laboratory for Metabolic Bone Diseases, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - Hongcai Liu
- Institute of Systems Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100005, China; Suzhou Institute of Systems Medicine, Suzhou 215123, China
| | - Hou-De Zhou
- National Clinical Research Center for Metabolic Diseases, Hunan Provincial Key Laboratory for Metabolic Bone Diseases, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha 410011, China.
| |
Collapse
|
3
|
Li J. Lipoprotein(a) and Atherosclerotic Cardiovascular Diseases: Evidence from Chinese Population. CARDIOLOGY DISCOVERY 2023; 3:40-47. [DOI: 10.1097/cd9.0000000000000059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
Abstract
Cardiovascular disease (CVD) is the leading cause of mortality worldwide. Multiple factors are involved in CVD, and emerging data indicate that lipoprotein(a) (Lp(a)) may be associated with atherosclerotic cardiovascular disease (ASCVD) independent of other traditional risk factors. Lp(a) has been identified as a novel therapeutic target. Previous studies on the influence of Lp(a) in CVD have mainly used in western populations. In this review, the association of plasma Lp(a) concentration with ASCVD was summarized, with regards to epidemiological, population-based observational, and pathological studies in Chinese populations. Lp(a) mutations and copy number variations in Chinese populations are also explored. Finally, the impact of plasma Lp(a) levels on patients with type 2 diabetes mellitus, cancer, and familial hypercholesterolemia are discussed.
Collapse
Affiliation(s)
- Jianjun Li
- Cardiometabolic Center, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing 100037, China
| |
Collapse
|
4
|
Shen Y, Wang XQ, Dai Y, Wang YX, Zhang RY, Lu L, Ding FH, Shen WF. Diabetic dyslipidemia impairs coronary collateral formation: An update. Front Cardiovasc Med 2022; 9:956086. [PMID: 36072863 PMCID: PMC9441638 DOI: 10.3389/fcvm.2022.956086] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 08/01/2022] [Indexed: 11/13/2022] Open
Abstract
Coronary collateralization is substantially impaired in patients with type 2 diabetes and occlusive coronary artery disease, which leads to aggravated myocardial ischemia and a more dismal prognosis. In a diabetic setting, altered serum lipid profiles and profound glycoxidative modification of lipoprotein particles induce endothelial dysfunction, blunt endothelial progenitor cell response, and severely hamper growth and maturation of collateral vessels. The impact of dyslipidemia and lipid-lowering treatments on coronary collateral formation has become a topic of heightened interest. In this review, we summarized the association of triglyceride-based integrative indexes, hypercholesterolemia, increased Lp(a) with its glycoxidative modification, as well as quantity and quality abnormalities of high-density lipoprotein with impaired collateral formation. We also analyzed the influence of innovative lipid-modifying strategies on coronary collateral development. Therefore, clinical management of diabetic dyslipidemia should take into account of its effect on coronary collateralization in patients with occlusive coronary artery disease.
Collapse
Affiliation(s)
- Ying Shen
- Department of Cardiovascular Medicine, School of Medicine, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Xiao Qun Wang
- Department of Cardiovascular Medicine, School of Medicine, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Yang Dai
- Department of Cardiovascular Medicine, School of Medicine, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Yi Xuan Wang
- Department of Cardiovascular Medicine, School of Medicine, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Rui Yan Zhang
- Department of Cardiovascular Medicine, School of Medicine, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Clinical Research Center for Interventional Medicine, Shanghai, China
| | - Lin Lu
- Department of Cardiovascular Medicine, School of Medicine, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China
- Institute of Cardiovascular Disease, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Feng Hua Ding
- Department of Cardiovascular Medicine, School of Medicine, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China
- *Correspondence: Feng Hua Ding,
| | - Wei Feng Shen
- Department of Cardiovascular Medicine, School of Medicine, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China
- Institute of Cardiovascular Disease, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Wei Feng Shen,
| |
Collapse
|
5
|
Wu B, Zhao H, Liu C, Lu H, Liu R, Long J, Zhang Z, Zeng F. Association of lipoprotein (a) and in-hospital outcomes in patients with acute coronary syndrome undergoing percutaneous coronary intervention. Postgrad Med 2020; 133:195-201. [PMID: 33131368 DOI: 10.1080/00325481.2020.1845517] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Objective: The current study was to evaluate the association of Lipoprotein (a) [Lp(a)] and in-hospital outcomes in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI).Methods: ACS patients undergoing PCI were retrospectively enrolled. Based on Lp(a) level, patients were divided into low (<30 mg/dL) and high (≥30 mg/dL) Lp(a) groups.Results: Compared to those with low Lp(a), patients with high Lp(a) had larger numbers of coronary arteries ≥70% stenosis and had longer coronary artery lesion (P < 0.05). After adjustment for covariates, high Lp(a) remained associated with higher odds of having coronary artery ≥70% stenosis, type C coronary lesion and pre-PCI TIMI flow grade 1/0. Patients with high Lp(a) had a higher unadjusted odds of acute stent thrombosis (odds ratio [OR] 1.10 and 95% confidence interval [CI] 1.01-2.27), congestive heart failure (OR 1.24 and 95% CI 1.15-2.38) and composite in-hospital outcomes (OR 1.28 and 95% CI 1.18-2.42). After adjustment for covariates, patients with high Lp(a) still had a higher odds of congestive heart failure (OR 1.08 and 95% CI 1.01-1.78) and composite in-hospital outcomes (OR 1.12 and 95% CI 1.04-1.81).Conclusion: In ACS patients undergoing PCI, compared to those with low Lp(a), patients with high Lp(a) had more severe coronary artery lesion, higher risk of congestive heart failure and composite in-hospital outcomes.
Collapse
Affiliation(s)
| | | | | | - Hao Lu
- Department of Cardiology, Fuwai Hospital Chinese Academy Science of Medical Science, Shenzhen, Guangdong, China
| | | | | | | | | |
Collapse
|
6
|
Huoxin Pill Attenuates Cardiac Inflammation by Suppression of TLR4/NF- κB in Acute Myocardial Ischemia Injury Rats. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:7905902. [PMID: 32695212 PMCID: PMC7368223 DOI: 10.1155/2020/7905902] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 05/04/2020] [Accepted: 05/29/2020] [Indexed: 01/11/2023]
Abstract
Huoxin Pill (HXP), a traditional Chinese medicine, has been prescribed widely in the treatment of coronary heart disease, angina pectoris, and other diseases. However, the possible protective mechanisms of HXP on myocardial ischemia remain unclear. In the current study, we investigated the effects and potential mechanism of HXP on myocardial ischemia and cardiac inflammation and the activation of TLR4/NF-κB pathway. Determination of electrocardiogram, echocardiography, and heart weight index (HWI) indicated that HXP treatment obviously attenuated the elevation of ST-segment, end-diastolic volume, and HWI in the AMI rat model. Enzyme-linked immunosorbent assay (ELISA) demonstrated that Huoxin Pill treatment significantly decreased the levels of CTnT, CK-MB, MDA, IL-6, and TNF-α, while it increased SOD content in serum of the AMI rat model. Moreover, hematoxylin and eosin (HE) and immunohistochemistry (IHC) staining revealed that HXP treatment alleviated pathological change, infiltration of inflammatory cells, levels of IL-6 and TNF-α, and expression of TLR4 and p-NF-κB in cardiac tissues of the AMI rat model. In conclusion, HXP treatment significantly improves cardiac function and attenuates cardiac inflammation by suppressing the activation of TLR4/NF-κB pathway in the ISO-induced AMI rat model. This study provides insights into the potential of HXP on prevention and treatment of AMI.
Collapse
|