Plasma PAF-acetylhydrolase in patients with coronary artery disease: results of a cross-sectional analysis
Plasma PAF-acetylhydrolase in patients with coronary artery disease: results of a cross-sectional analysis
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DOI：
10.1194/jlr.m300086-jlr200
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发表时间：
2003-07-01
影响因子：
6.5
通讯作者：
Ninio, E
中科院分区：
文献类型：
--
作者：
Blankenberg, S;Stengel, D;Ninio, E
炎症是动脉粥样硬化发生和持续的基础。血浆脂蛋白转运具有潜在抗炎活性的血小板活化因子乙酰水解酶（PAF-AH）。我们的目的是确定PAF-AH活性是否与炎症标志物和冠状动脉疾病（CAD）相关。在496例CAD患者和477例对照者的血浆中测定了PAF-AH活性和一组炎症介质; 276例稳定型心绞痛患者和220例急性冠状动脉综合征（ACS）患者。PAF-AH活性最高四分位数的个体与第一四分位数的个体相比，CAD风险增加1.8倍[95%置信区间（CI），1.01 - 3.2; P = 0.048]（根据临床和代谢因素调整）。当排除接受他汀类和血管紧张素转换酶抑制剂治疗的个体时，PAF-AH活性最高四分位数的个体显示CAD风险增加3.9倍（95%CI，2.0 - 7.7; P < 0.0001）。稳定型心绞痛和急性冠脉综合征患者血浆PAF-AH活性在男性（P < 0.0001）和女性（P < 0.001）与对照组比较均逐渐升高。PAF AH水平与常见炎症标志物之间无相关性。这项研究和以前的研究提出了一个重要的问题，即PAF-AH是否只是一个危险的标志物或直接促进动脉粥样硬化。
Inflammation underlies both onset and perpetuation of atherosclerosis. Plasma lipoproteins transport the platelet-activating factor-acetylhydrolase (PAF-AH) with potentially anti-inflammatory activities. Our aim was to determine whether PAF-AH activity was associated with inflammatory markers and with coronary artery disease (CAD). PAF-AH activity and a panel of inflammatory mediators were measured in plasma of 496 patients with CAD and in 477 controls; 276 patients presented with stable angina pectoris and 220 with acute coronary syndrome (ACS). Individuals within the highest quartile of PAF-AH activity had an 1.8-fold increase in CAD risk [95% confidence interval (CI), 1.01 to 3.2; P = 0.048] compared with those in the first quartile (adjusted for clinical and metabolic factors). When excluding individuals receiving statin and angiotensin-converting enzyme-inhibitor medication, individuals within the highest quartile of PAF-AH activity revealed a 3.9-fold increase in CAD risk (95% CI, 2.0 to 7.7; P < 0.0001). In these subjects, the plasma PAF-AH activity increased gradually in stable angina and in ACS both in men (P < 0.0001) and in women (P < 0.001), as compared with controls. No correlation was found between PAF AH levels and those of common markers of inflammation. This study and the previous ones raise the important issue of whether PAF-AH is simply a marker of risk or directly promotes atherosclerosis.