P1118Impact of serum lipoprotein (a) level on coronary plaque progression and cardiovascular events in statin-treated patients with acute coronary syndrome

Objective: To compare and see the association of serum Lipoprotein (a) levels in younger and older patients suffering from acute coronary syndrome compared to healthy controls Methods: This case control study was conducted in department of cardiology, King Edward Medical University, Lahore from January to December 2015. Total 180 subjects (90 cases and 90 healthy controls, subdivided in 45 young and old in each group ≤/>45 years of age) were included in the study by non-probability purposive sampling. Patients presenting with acute coronary event and angiographically proven coronary vascular disease were considered cases while those with normal coronaries served as controls. Lp(a) was measured after ten hours fasting. Lp(a) >30 nmol/l) were considered as high. Data were entered and analyzed in SPSS 17. Independent sample t-test was used to compare the mean lipoprotein (a) in cases and controls. Results: The mean age of cases and controls was 48.02 ± 10.90 & 45.89±10.09 years respectively. Lipid profile was similar in both cases and controls except triglycerides that were higher in controls (p=0.024). The mean lipoprotein (a) in cases was 47.03 ± 45.47 and in controls was 29.69±23.10 (p-value 0.001). Mean Lp(a) level was significantly high in cases vs controls in young subjects, (50.15±55.62 vs 25.75±15.84, p= 0.006), while in old ones, difference was not statistically significant (43.92±32.69 vs 33.64±28.22, p= 0.114). The frequency of desirable, borderline high, high, and very high Lp(a) levels in cases was 23(25.6%), 12(13.3%), 27(30.0%) and 28(31.1%), while in controls, it was 26(28.9%), 31(34.4%), 17(18.9%) and 16(17.8%), (p-value 0.003). Chi-Square test showed significant association of high Lp(a) with coronary artery disease in younger cases vs controls (P=0.004) with OR 3.65 but not in older (p-value 0.358). Conclusion: Serum lipoprotein(a) is strongly associated with coronary vascular disease especially in patients younger than 45 years of age despite comparable LDL and HDL between cases and controls, making Lp(a) likely independent risk factor for coronary vascular disease. doi: https://doi.org/10.12669/pjms.35.6.377 How to cite this:Hanif S, Akhtar B, Afzal MN. Serum Lipoprotein (a) levels in acute coronary syndrome; Comparison of younger and elderly patients with healthy controls. Pak J Med Sci. 2019;35(6):1718-1723. doi: https://doi.org/10.12669/pjms.35.6.377 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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COMPARISON OF SERUM LIPOPROTEIN (A) LEVEL IN TYPE 2 DM AND NON-DIABETIC PATIENTS WITH ACUTE CORONARY SYNDROME

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/2018/744 ◽

2018 ◽

Vol 7 (29) ◽

pp. 3304-3307

Author(s):

Subhash Chand Meena ◽

Girish Chandra Verma ◽

Meena C. P. ◽

Meena S. R ◽

Abdul Wahid Qureshi ◽

...

Keyword(s):

Acute Coronary Syndrome ◽

Serum Lipoprotein ◽

Diabetic Patients ◽

Lipoprotein A ◽

Coronary Syndrome ◽

Type 2 Dm

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METABOLIC RISK FACTORS AND THE EFFECT OF ALIROCUMAB ON CARDIOVASCULAR EVENTS IN PATIENTS AFTER ACUTE CORONARY SYNDROME: AN ANALYSIS OF THE ODYSSEY OUTCOMES RANDOMIZED CONTROLLED TRIAL

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(21)01509-6 ◽

2021 ◽

Vol 77 (18) ◽

pp. 150

Author(s):

Petr Ostadal ◽

Philippe Gabriel Steg ◽

Yan Poulouin ◽

Deepak Bhatt ◽

Vera Bittner ◽

...

Keyword(s):

Risk Factors ◽

Randomized Controlled Trial ◽

Acute Coronary Syndrome ◽

Cardiovascular Events ◽

Controlled Trial ◽

Metabolic Risk Factors ◽

Metabolic Risk ◽

Coronary Syndrome ◽

Randomized Controlled

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Bone marrow-derived NGFR+ cells regulate arterial remodeling and those poor mobilizations in peripheral blood in acute coronary syndrome predicts plaque progression at the non-targeted lesion

European Heart Journal ◽

10.1093/ehjci/ehaa946.1679 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

S Takashima ◽

S Usui ◽

S Matsuura ◽

C Goten ◽

O Inoue ◽

...

Keyword(s):

Bone Marrow ◽

Acute Coronary Syndrome ◽

Peripheral Blood ◽

Funding Source ◽

Arterial Remodeling ◽

Plaque Progression ◽

Wild Type ◽

Plaque Volume ◽

Coronary Syndrome

Abstract Background In our previous 5-year cohort study, we demonstrated that low gene expression of nerve growth factor receptor (NGFR) in peripheral leucocytes in acute coronary syndrome (ACS) predicted repetitive coronary interventions at the de novo lesions. An NGFR-positive cell has been demonstrated to reside in bone marrow (BM) stromal fraction and to be increased in peripheral blood mononuclear cell (MNCs) fraction in patients with ischemic heart disease. Purpose To investigate whether the BM-NGFR+ cell is associated with arterial remodeling and the relationship between the levels of peripheral NGFR+ cells after ACS and coronary plaque progression in an experimental and prospective clinical study. Methods and results In an experimental study, 8-week-old C57B6/J wild type male mice were subjected to irradiation with 9.6 Gy and transplantation with BM (BMT) isolated from GFP-transgenic NGFR wild type (WT) or knock-out (KO) mice at day 1. Four weeks after BMT, the right carotid artery was ligated for 4 weeks. Induced neointimal area was increased (p<0.05), where cells under apoptosis were decreased (p<0.05) in NGFR-KO-BMT group compared to WT-BMT group (n=4). NGFR+ cells were not detected in wild type sham-operated artery, whereas in the ligated artery in WT-BMT group NGFR+ cells assembled in the developed neointima and exclusively presented double positive with GFP, but absent in NGFR-KO-BMT group (p<0.05, n=4). In a clinical study, thirty patients with ACS who underwent primary percutaneous coronary intervention (PCI) were enrolled. The peripheral blood sample was collected on days 0, 3 and 7, and 9 months follow-up and the number of NGFR+MNCs were measured by flowcytometric analysis. The plaque volume at non-targeted coronary lesion (non-TL:>5 mm proximal or distal to the implanted stents) were quantitatively analysed using gray-scale intravascular ultrasound (IVUS) and Q-IVUS™ software at the acute phase and 9 months follow-up. The number of NGFR+MNCs in peripheral blood was 1.5-fold increased at day 3 (0.064±0.056%) compared to day 0 (0.042±0.030%) (p<0.05). The change in normalized total plaque volume (TAVN) at non-TL at 9 months was negatively correlated with the number of NGFR+MNCs at day 0 (r=−0.51), day 3 (r=−0.51) and 9 months (r=−0.59) after ACS (p<0.05). Multiple regression analysis showed that NGFR+MNCs at day 0 (β=−0.48, p=0.01) and CRP (β=−0.53, P<0.01) are independent factors associating with TAVN change at non-TL at 9 months, regardless of LDL-cholesterol control level. ROC analysis revealed that NGFR+MNCs <0.049 at day 0 predicted the increase of TAVN with AUC 0.78; sensitivity 0.82 and specificity 0.67. Conclusions Bone marrow-derived peripheral NGFR+ cells negatively regulate arterial remodeling through appropriate apoptosis of neointimal cells and the peripheral level of NGFR+ cells in ACS predicts plaque progression at the non-targeted lesion. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): KAKENHI

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