Plasma N-ε-(carboxymethyl)lysine levels are associated with the extent of vessel injury after coronary arterial stenting
Plasma N-ε-(carboxymethyl)lysine levels are associated with the extent of vessel injury after coronary arterial stenting
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DOI：
10.1097/mca.0b013e3282fec058
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发表时间：
2008-08-01
影响因子：
1.8
通讯作者：
Mazzone, Annamaria
中科院分区：
文献类型：
--
作者：
Basta, Giuseppina;Berti, Sergio;Mazzone, Annamaria
目的在动物模型中，晚期糖基化终产物及其配体（包括N-羧甲基赖氨酸（CML））的组织受体增加与球囊损伤后内膜增生密切相关。在接受经皮冠状动脉介入治疗与支架植入术的患者中，我们研究了是否血浆CML水平和晚期糖基化终末产物（sHBG）受体的可溶性形式的变化在poststenting follow-up.Methods我们研究了81例成功接受经皮冠状动脉介入治疗的冠心病患者。结果CML水平在支架植入后第1天显著升高，并在第180天持续升高（P=0.013），而血清CRP水平在第180天显著升高（P = 0.011）。在1天和180天随访时，多支血管治疗患者的CML水平均显著高于单支血管治疗患者。此外，CML值与随访1天和180天时的支架面积范围呈正相关（分别为r=0.278，P=0.022和r=0.315，P=0.012）。Logistic回归分析显示，仅支架面积的大小预测180 d随访时的不良临床事件（P=0.03，OR =14.25，CI =1.25-162.2）。慢性粒细胞白血病的持续上升可能会放大支架置入引发的炎症现象，从而导致冠状动脉疾病的进展。
Objective In animal models, increased tissue receptor for advanced glycation end products and its ligands, including N-epsilon-(carboxymethyl)lysine (CML), are critically implicated in postprocedural intimal hyperplasia after balloon injury. In patients undergoing percutaneous coronary interventions with stenting, we investigated whether plasma levels of CML and the soluble form of receptor for advanced glycation end products (sRAGE) changed during poststenting follow-up.Methods We studied 81 patients with coronary artery disease who underwent successful percutaneous coronary interventions. Plasma levels of CML and sRAGE were measured before intervention, and at I day and 180 days of follow-up.Results CML levels increased significantly at day 1 after stenting and persisted at an elevated level at 180 days (P=0.013), whereas sRAGE levels increased significantly at 180 days (P=0.011). CML levels were significantly higher in multivessel-treated patients than in single-vessel-treated patients both at 1 day and 180 days of follow-up. In addition, CML values were positively associated with the extent of stent area at 1 day and 180 days of follow-up (r=0.278, P=0.022 and r=0.315, P=0.012, respectively). In logistic regression analysis, only the extent of stent area predicted adverse clinical events at 180-day follow-up (P=0.03, odds ratio=14.25, confidence interval=1.25-162.2).Conclusion This study supports the hypothesis that increased circulating levels of CML occurred in the presence of vascular injury. This persistent rise of CML could amplify an inflammatory phenomenon triggered by stent placement and thus contributes to coronary artery disease progression.