A serum amyloid A and LDL complex as a new prognostic marker in stable coronary artery disease

被引:78
作者
Ogasawara, K
Mashiba, S
Wada, Y
Sahara, M
Uchida, K
Aizawa, T
Kodama, T
机构
[1] Cardiovasc Inst, Minato Ku, Tokyo 1060032, Japan
[2] Ikagaku Co Ltd, Tokyo, Japan
[3] Univ Tokyo, Dept Mol Biol & Med 35, Adv Sci & Technol Res Ctr, Tokyo, Japan
关键词
atherosclerosis; coronary disease; inflammation; prognosis;
D O I
10.1016/j.atherosclerosis.2004.01.030
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Although some reports have indicated that acute phase proteins such as C-reactive protein (CRP) and serum amyloid A (SAA) can predict the prognosis in patients with acute coronary syndrome, the value of these markers in patients with stable coronary artery disease (CAD) still remains obscure. Therefore, our aim was to determine the prognostic value of inflammatory markers in patients with stable coronary artery disease. Methods and results: We conducted a prospective cohort study in 140 consecutive patients with stable coronary artery disease who had at least one coronary stenosis more than 50% in diameter seen on diagnostic coronary angiography (CAG). We determined serum levels of the SAA/LDL complex as a new marker in addition to CRP and SAA. Serum levels of the SAA/LDL complex were measured by a sandwich enzyme-linked immunosorbent assay (ELISA). End-points were defined as cardiac death, myocardial infarction, cerebral infarction, and coronary revascularization. End-point events occurred in 21 patients (2 death from myocardial infarction, 2 cerebral infarction, and 17 revascularization). Age (year) (OR = 1.14, CI: 1.05-1.25), diabetes mellitus (OR = 3.50, CI: 1.08-11.40), triglyceride (10 mg/dl) (OR = 1.12, CI: 1.01-1.23) and SAA/LDL complex (10 mug/ml) (OR = 2.32, CI: 1.05-4.70) were independently related to the events. A reconstitution experiment suggested that the SAA/LDL complex is derived by oxidative interaction between SAA and lipoproteins. Conclusions: The SAA/LDL complex reflects intravascular inflammation directly and can be a new marker more sensitive than CRP or SAA for prediction of prognosis in patients with stable coronary artery disease. (C) 2004 Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:349 / 356
页数:8
相关论文
共 28 条
[11]   CLEAVAGE OF STRUCTURAL PROTEINS DURING ASSEMBLY OF HEAD OF BACTERIOPHAGE-T4 [J].
LAEMMLI, UK .
NATURE, 1970, 227 (5259) :680-+
[12]   THE PROGNOSTIC VALUE OF C-REACTIVE PROTEIN AND SERUM AMYLOID-A PROTEIN IN SEVERE UNSTABLE ANGINA [J].
LIUZZO, G ;
BIASUCCI, LM ;
GALLIMORE, JR ;
GRILLO, RL ;
REBUZZI, AG ;
PEPYS, MB ;
MASERI, A .
NEW ENGLAND JOURNAL OF MEDICINE, 1994, 331 (07) :417-424
[13]   Increased immunolocalization of paraoxonase, clusterin, and apolipoprotein A-I in the human artery wall with the progression of atherosclerosis [J].
Mackness, B ;
Hunt, R ;
Durrington, PN ;
Mackness, MI .
ARTERIOSCLEROSIS THROMBOSIS AND VASCULAR BIOLOGY, 1997, 17 (07) :1233-1238
[14]   SERUM AMYLOID-A (SAA) - AN ACUTE-PHASE PROTEIN AND APOLIPOPROTEIN [J].
MALLE, E ;
STEINMETZ, A ;
RAYNES, JG .
ATHEROSCLEROSIS, 1993, 102 (02) :131-146
[15]  
MARHAUG G, 1982, CLIN EXP IMMUNOL, V50, P382
[16]   In vivo complex formation of oxidized α1-antitrypsin and LDL [J].
Mashiba, S ;
Wada, Y ;
Takeya, M ;
Sugiyama, A ;
Hamakubo, T ;
Nakamura, A ;
Noguchi, N ;
Niki, E ;
Izumi, A ;
Kobayashi, M ;
Uchida, K ;
Kodama, T .
ARTERIOSCLEROSIS THROMBOSIS AND VASCULAR BIOLOGY, 2001, 21 (11) :1801-1808
[17]   Serum amyloid A predicts early mortality in acute coronary syndromes: A TIMI 11A substudy [J].
Morrow, DA ;
Rifai, N ;
Antman, EM ;
Weiner, DL ;
McCabe, CH ;
Cannon, CP ;
Braunwald, E .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2000, 35 (02) :358-362
[18]   Inflammation and long-term mortality after non-ST elevation acute coronary syndrome treated with a very early invasive strategy in 1042 consecutive patients [J].
Mueller, C ;
Buettner, HJ ;
Hodgson, JM ;
Marsch, S ;
Perruchoud, AP ;
Roskamm, H ;
Neumann, FJ .
CIRCULATION, 2002, 105 (12) :1412-1415
[19]  
RICKER PM, 2000, NEW ENGL J MED, V342, P836
[20]   Measurement of C-reactive protein for the targeting of statin therapy in the primary prevention of acute coronary events [J].
Ridker, PM ;
Rifai, N ;
Clearfield, M ;
Downs, JR ;
Weis, SE ;
Miles, JS ;
Gotto, AM .
NEW ENGLAND JOURNAL OF MEDICINE, 2001, 344 (26) :1959-1965