P1771Soluble urokinase plasminogen activator receptor and vulnerable plaque: high suPAR is associated with larger coronary plaque necrotic core and dense calcium in non-obstructive coronary artery disease

2017 ◽  
Vol 38 (suppl_1) ◽  
Author(s):  
S. Lee ◽  
P. Sandesara ◽  
P. Eshtehardi ◽  
S. Hayek ◽  
A.S. Tahhan ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Plasminogen Activator ◽  
Vulnerable Plaque ◽  
Obstructive Coronary Artery Disease ◽  
Coronary Plaque ◽  
Necrotic Core ◽  
Urokinase Plasminogen Activator Receptor ◽  
Plasminogen Activator Receptor ◽  
Artery Disease

P6436Soluble urokinase plasminogen activator receptor and functionally relevant coronary artery disease: a prospective cohort study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
J E Walter ◽  
M Amrein ◽  
L Koechlin ◽  
J Du Fay De Lavallaz ◽  
T Zimmermann ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Plasminogen Activator ◽  
Cardiovascular Death ◽  
Urokinase Plasminogen Activator Receptor ◽  
Spearman's Rho ◽  
Spearman’S Rho ◽  
Plasminogen Activator Receptor ◽  
Artery Disease ◽  
Multivariable Adjustment

Abstract Background The urokinase system is pivotal in the pathogenesis of atherosclerosis. Therefore, soluble urokinase plasminogen activator receptor (suPAR) concentrations may help in the detection of functionally relevant coronary artery disease (fCAD). Purpose To evaluate suPAR as diagnostic marker for fCAD. Methods Among consecutive patients with symptoms suggestive of fCAD, fCAD was adjudicated blinded to suPAR concentrations in two domains: first, diagnosis of fCAD according to myocardial perfusion single photon emission tomography (MPI-SPECT) and coronary angiography; second, fCAD according to cardiovascular death, non-fatal acute myocardial infarction (AMI) and all-cause death during 2-year follow-up. Results Among 968 patients, symptoms were adjudicated to be causally related to fCAD in 26% (255/968). SuPAR concentrations were higher in patients with fCAD as compared to those without (3.45 ng/mL versus 3.20 ng/mL, p=0.007), but overall had only low diagnostic accuracy (area under the curve [AUC]: 0.56, 95% CI 0.52–0.60) and were not independent predictors of fCAD after multivariable adjustment. Circulating suPAR concentrations were modestly correlated with high-sensitivity cardiac troponin (hs-cTn) T (Spearman's rho 0.393, p<0.001), NT-proBNP (Spearman's rho 0.327, p<0.001) and age (Spearman's rho 0.364, p<0.001), but only weakly correlated with the extent of coronary atherosclerosis as quantified by perfusion defects (Spearman's rho 0.123, p<0.001). Prognostically, suPAR concentrations had moderate-to-high accuracy in the prediction of cardiovascular death (AUC 0.72, 95% CI 0.62–0.81) and all-cause death (AUC 0.72, 95% CI 0.65–0.79) at 2-years, and remained a significant predictor for all-cause death after multivariable adjustment (p=0.001). SuPAR concentrations did not predict non-fatal AMI. Conclusions SuPAR is an independent predictor of death, but not helpful in the detection of fCAD. Acknowledgement/Funding European Union, Swiss National Science Foundation, the Swiss Heart Foundation, the Cardiovascular Research Foundation Basel, the University of Basel,

Clinical implications of coronary artery morphology of patients with ischemia and non-obstructive coronary artery disease (INOCA) -An intracoronary OCT study-

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
K Nishimiya ◽  
A Suda ◽  
K Hao ◽  
J Takahashi ◽  
Y Matsumoto ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Obstructive Coronary Artery Disease ◽  
Morphological Characteristics ◽  
Provocation Test ◽  
Coronary Plaque ◽  
Vasa Vasorum ◽  
Imaging Evaluation ◽  
Artery Disease

Abstract Introduction Ischemia and non-obstructive coronary artery disease (INOCA), including microvascular spasm (MVS) and epicardial spasm, has recently attracted much attention, for which in vivo imaging evaluation for coronary artery morphology is warranted for better understanding of this disorder. Besides the improved diagnostic accuracy of optical coherence tomography (OCT) for coronary plaques, we have recently demonstrated its capability for in vivo visualization of coronary adventitial vasa vasorum (VV) and the enhanced VV formation in patients with epicardial spasm. Purpose We aimed to examine OCT-delineated morphological characteristics in patients with INOCA in vivo. Methods A total of 335 consecutive INOCA patients, who underwent pharmacological spasm provocation tests, lactate sampling, and OCT imaging over the entire length of the left anterior descending (LAD) coronary arteries, were enrolled at our institute over 68 months from April 2013. They were classified into 4 groups; control with non-cardiac chest pain, MVS, diffuse spasm (DS), or focal spasm (FS) (Fig. 1A). MVS was diagnosed when negative lactate extraction ratio (coronary orifice &lt; coronary sinus) was detected despite the absence of epicardial spasm during the spasm provocation test. DS was defined as epicardial spasm induced in more than 2 coronary segments in LAD, and FS as epicardial spasm in one segment. Quantitative analyses for adventitial inflammation and atherosclerotic changes were performed by calculating VV density and %area stenosis (AS) on OCT (Fig. 1B, E). Furthermore, index of microcirculatory resistance (IMR), a marker of microvascular disorder with a cut-off value of ≥25, was measured during intravenous infusion of adenosine, which was then correlated with VV densities in the MVS and DS groups. Coronary plaque with a necrotic core was classified as fibroatheroma (FA), and the number of OCT frames with internal VV (IVV) in the atheroma was counted. Results VV density was significantly higher in MVS as compared with the controls (Fig. 1B). DS was most prevalent in INOCA (Fig. 1A) with highest VV density (Fig. 1B). Patients with IMR≥25 were predominantly distributed with a gradual increase in the MVS, DS, and FS groups, but none in the controls (Fig. 1C). Importantly, there was a significant positive correlation between VV densities and IMR in the MVS and DS groups (Fig. 1D). In addition, FS had the largest plaque size and showed the highest prevalence of FA and IVV (Fig. 1E–G). Conclusions These results indicate that MVS and DS are characterized by vasomotion abnormalities associated with adventitial inflammation and microvascular disorder, while FS by vulnerable atherosclerotic phenotype, suggesting that OCT may be useful for screening high-risk populations in INOCA. Figure 1 Funding Acknowledgement Type of funding source: None

scholarly journals Correlation between monocyte chemoattractant protein-1/chemokine (C-C motif) ligand 2 and coronary plaque characteristics

2020 ◽  
Vol 245 (15) ◽  
pp. 1335-1343
Author(s):  
Meng Li ◽  
Yan Chen ◽  
Yan Zhang ◽  
Danna Li ◽  
Jun Liu
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Signaling Pathway ◽  
Fibrous Tissue ◽  
Coronary Plaque ◽  
Necrotic Core ◽  
High Expression ◽  
Vulnerable Plaques ◽  
Receptor Signaling Pathway ◽  
Artery Disease

In this work, our primary objective was to examine the interrelationship among the serum level of chemokine (C-C motif) ligand 2 (CCL2) and plaque characteristics in coronary culprit lesions. The clinical data of 116 coronary heart disease patients who were hospitalized in the Department of Cardiology of Henan Province People's Hospital from February 2015 to June 2017 were retrospectively analyzed. The study population was subdivided according to the concentration of CCL2 into low CCL2 group and high CCL2 group. The levels of blood lipid, creatinine, and uric acid were measured, and patients underwent coronary angiography. The characteristics of the culprit lesions were detected by intravascular ultrasound, and the correlation between the serum markers and the characteristics of coronary artery plaque was analyzed. Moreover, the coronary artery disease dataset from the Gene Expression Omnibus database was downloaded and the genes regulated were analyzed by CCL2 using gene set enrichment analysis (GSEA). Patients with high CCL2 group had higher LDL-C level and L/H ratio, and lower HDL-C level than the low CCL2 group. Compared with low-level CCL2 group, coronary plaque in the high CCL2 group had higher eccentric plaque and plaque rupture, and thin cap fibroatheromas, fibrofatty and necrotic core and lower fibrous tissue. CCL2 was positively correlated with the percentage of fibrofatty and necrotic core, and negatively correlated with the percentage of fibrous tissue. Furthermore, GSEA analysis showed that samples with high CCL2 expression were enriched for genes involved in different pathways, such as cell adhesion molecules and Nod-like receptor signaling pathway. The CCL2 level was correlated with vulnerable plaques of coronary artery and had certain value in detecting vulnerable plaques. These results indicated that CCL2 could be regarded as a clinical prognostic biomarker for coronary artery disease. Impact statement Vulnerable plaques are plaques which are susceptible to rupture or thrombosis and trigger a series of adverse events such as coronary disorders. CCL2 is a soluble basic protein belonging to the CC subfamily. Previous studies have been investigated on the correlation between inflammatory factors and clinical events, but there are few studies on the correlation between CCL2 and plaque characteristics. Our study found that the high expression of CCL2 is involved in multiple processes in the genesis and progression of coronary artery disease, and would be a potential clinical prognostic indicator. In addition, high expression of CCL2 may be related to gene pathways such as Nod-like receptor signaling pathway, suggesting that CCL2 is involved in the inflammatory response and immune process of coronary artery disease.

P6416Lower serum syndecan-1 level is associated with higher prevalence of vulnerable plaque in patients with coronary artery disease

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
T Nemoto ◽  
Y Minami ◽  
M Yamaoka-Tojo ◽  
T Sato ◽  
Y Muramatsu ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Vulnerable Plaque ◽  
Coronary Intervention ◽  
Coronary Plaque ◽  
Endothelial Glycocalyx ◽  
Total Occlusion ◽  
Significant Difference ◽  
Lipid Rich Plaque ◽  
Artery Disease

Abstract Introduction Syndecan-1 is a component of endothelial glycocalyx which maintains vascular integrity. Thus, it may be impaied in patients with coronary artery disease (CAD). Purpose To assess the association between serum syndecan-1 level and the severity and vulnerability of CAD. Methods A total of 259 consecutive patients with stable angina requiring percutaneous coronary intervention (PCI) were prospectively enrolled. Patients were classified into 2 groups according to the median syndecan-1 value (Lower syndecan-1 group [syndecan-1 <99.0], n=130; Higher syndecan-1 group [syndecan-1 ≥99.0], n=129). Severity of CAD and focal plaque vulnerability in target lesion was evaluated using findings of angiography and optical coherence tomography (OCT), respectively. Thin-cap fibroatheroma (TCFA) was defined as a lipid-rich plaque covered with thin fibrous cap (<65 μm). Results There was no significant difference in baseline clinical characteristics between the lower syndecan-1 group and the higher syndecan-1 group other than the prevalence of family history of ischemic heart disease (19 vs. 32%, p=0.022) and prior PCI history (45 vs. 60%, p=0.015). The prevalence of multivessel disease (70 vs. 68%, p=0.627), left main disease (4 vs. 5%, p=0.748) and chronic total occlusion (15 vs. 15%, p=0.959) was comparable between the 2 groups. On the other hand, the prevalence of lipid-rich plaque (40 vs. 19%, p=0.004) and TCFA (20 vs. 6%, p=0.006) was significantly higher in the lower syndecan-1 groupthan the higher syndecan-1 group (Figure). The lower syndecan-1 was independently associated with the higher prevalence of lipid-rich plaque (Table). Table 1. Multivariate analysis for lipid-rich plaque Odds ratio 95% CI pvalue Lower syndecan-1 2.981 1.448–6.411 0.003 Dyslipidemia 1.693 0.738–4.142 0.218 Chronic kidney disease 1.354 0.669–2.765 0.400 Smoking 0.975 0.453–2.154 0.951 Diabetes mellitus 0.819 0.400–1.661 0.580 Conclusions Lower syndecan-1 level was associated with higher prevalence of vulnerable plaque in patients with CAD. Serum syndecan-1 may have a potential as a marker for the presence of vulnerable coronary plaque.

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