Serum soluble lectin-like oxidized low-density lipoprotein receptor-1 levels are elevated in acute coronary syndrome - A novel marker for early diagnosis

被引:198
作者
Hayashida, K
Kume, N
Murase, T
Minami, M
Nakagawa, D
Inada, T
Tanaka, M
Ueda, A
Kominami, G
Kambara, H
Kimura, T
Kita, T
机构
[1] Kyoto Univ, Grad Sch Med, Dept Cardiovasc Med, Sakyo Ku, Kyoto 6068507, Japan
[2] Osaka Red Cross Hosp, Ctr Cardiovasc, Osaka, Japan
[3] Shionogi & Co Ltd, Dev Res Labs, Osaka 553, Japan
关键词
angina; atherosclerosis; lipoproteins; myocardial infarction; receptors;
D O I
10.1161/CIRCULATIONAHA.104.468397
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background - Markers of cardiac injury, including troponin-T (TnT), are used to diagnose acute coronary syndrome (ACS); however, markers for plaque instability may be more useful for diagnosing ACS at the earliest stage. Lectin-like oxidized LDL receptor-1 ( LOX-1) appears to play crucial roles in the pathogenesis of atherosclerotic plaque rupture and ACS onset. LOX-1 is released in part as soluble LOX-1 ( sLOX-1) by proteolytic cleavage. Methods and Results - We examined serum sLOX-1 levels in 521 patients, consisting of 427 consecutive patients undergoing coronary angiography, including 80 ACS patients, 173 symptomatic coronary heart disease patients, 122 patients with significant coronary stenosis without ischemia, and 52 patients without apparent coronary atherosclerosis plus 34 patients with noncardiac acute illness and 60 patients with noncardiac chronic illness. Time-dependent changes in sLOX-1 and TnT levels were analyzed in an additional 40 ACS patients. Serum sLOX-1 levels were significantly higher in ACS than the other groups and were associated with ACS as shown by multivariable logistic regression analyses. Given a cutoff value of 1.0 ng/mL, sLOX-1 can discriminate ACS from other groups with 81% and 75% of sensitivity and specificity, respectively. sLOX-1 can also discriminate ACS without ST elevation or abnormal Q waves and ACS without TnT elevation from non-ACS with 91% and 83% of sensitivity, respectively. Peak values of sLOX-1 in ACS were observed earlier than those of TnT. Conclusions - sLOX-1 appears to be a useful marker for early diagnosis of ACS.
引用
收藏
页码:812 / 818
页数:7
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