Abstract 18369: Cholesteryl Ester Transfer Protein Activity is Associated with Oxidative Stress Markers During Acute Phase of Myocardial Infarction

Abstract

Cholesteryl ester transfer protein (CETP) action enriches HDL particles with triglycerides, depletes HDL by cholesterol esters, consequently reducing size of HDL and increasing catabolism of apolipoprotein AI (Apo AI). The HDL phenotype induced by enhanced CETP activity is considered pro-atherogenic. But recent findings have linked increased CETP activity in sepsis-related acute stress to reduced inflammatory response and there is no information regarding CETP activity impact in acute coronary syndromes (ACS). We evaluated the association between CETP activity and oxidative stress and inflammatory response in patients with myocardial infaction (MI). Consecutive patients (n=38) with ST-elevation MI (STEMI) were selected from the Brasilia Heart Study for this investigation. Plasma CETP activity, HDL cholesterol, triglycerides, C-reactive protein (CRP), interleukin-2 (IL2), interleukin-10 (IL10), tumor necrosis factor α (TNFα) and isoprostane (iso-PGF 2α ) levels were measured in the first 24 hours and at the fifth day after MI onset. Patients were divided in two groups, according to CETP median (6 nmol/mL/h) at admission: M1 (CETP activity ≤ median) and M2 (CETP activity > median). On admission, no difference was found between the groups in plasma HDLc (p=0.5), triglycerides (p=0.1), CRP (p=0.5), IL2 (p=0.9), IL10 (p=0.6), TNFα (p=0.2) and isoprostane (p=0.7) levels. On fifth day, both groups experienced similar reductions in CETP activity [M1: -38%(-100;30); M2: -43% (-75;8); p=0.303]. On an analysis of the change between admission and fifth day, there was a major increase in triglycerides (p<0.01) in M2 group [11% (-18;32)] against M1 [3.3% (-49;16)], and also a major increase in isoprostane (p<0.01) in M2 [9.1% (-30;74)] versus M1 [5.7% (-20;37)]. However, there was no significant change in HDLc (p=0.2), CRP (p=0.5), TNFα (p=0.2), IL2 (p=0.1), IL10 (p=0.9) levels between M1 and M2 groups. This is the first study that observed a marked reduction in CETP activity following STEMI. And also, the findings indicate that higher CETP activity at admission is associated with increased triglycerides and isoprostane, a marker of oxidative stress. Such information contributes for the understanding of CETP role during acute phase of ACS.