Serum soluble lectin-like oxidized low-density lipoprotein receptor-1 levels are elevated in acute coronary syndrome - A novel marker for early diagnosis
Serum soluble lectin-like oxidized low-density lipoprotein receptor-1 levels are elevated in acute coronary syndrome - A novel marker for early diagnosis
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DOI：
10.1161/circulationaha.104.468397
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发表时间：
2005-08-09
期刊：
影响因子：
37.8
通讯作者：
Kita, T
中科院分区：
文献类型：
--
作者：
Hayashida, K;Kume, N;Kita, T
心肌损伤的标志物，包括肌钙蛋白T（TnT），被用于诊断急性冠脉综合征（ACS）;然而，斑块不稳定性的标志物可能对ACS的早期诊断更有用。凝集素样氧化低密度脂蛋白受体-1（LOX-1）在动脉粥样硬化斑块破裂和ACS发病中起重要作用。方法和结果-我们检测了521名患者的血清sLOX-1水平，包括427名进行冠状动脉造影的连续患者，包括80名ACS患者，173名有症状的冠心病患者，122名无缺血的显著冠状动脉狭窄患者，无明显冠状动脉粥样硬化者52例，非心源性急性疾病34例，非心源性慢性疾病60例。在另外40例ACS患者中分析了sLOX-1和TnT水平的时间依赖性变化。多因素Logistic回归分析显示，ACS患者血清sLOX-1水平显著高于其他组，且与ACS相关。如果sLOX-1的临界值为1.0 ng/mL，则可以将ACS与其他组区分开来，其敏感性和特异性分别为81%和75%。sLOX-1还可以区分无ST段抬高或异常Q波的ACS和无TnT升高的ACS与非ACS，敏感性分别为91%和83%。结论sLOX-1是ACS早期诊断的一个有用指标。
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.