Abstract
BackgroundWe investigated the role of ANGPTL3 and ANGPTL4 in atherosclerosis development and determined whether plasma concentrations of ANGPTL3 and ANGPTL4 are related to the degree of coronary stenosis.MethodsA total of 305 consecutive patients with angina who underwent diagnostic coronary angiography were enrolled in the study between August 2017 and August 2018. The levels of ANGPTL3 and ANGPTL4 were measured by using competitive ELISA kits.ResultsAccording to the degree of coronary artery stenosis, patients were classified into four types: coronary artery stenosis of < 10%, 10-50%, 50-75, and > 75%. The plasma ANGPTL3 level was higher (51.71 ± 52.67 vs. 24.65 ± 10.32 ng/mL, P < 0.001) and that of ANGPTL4 was lower (454.66 ± 269.05 vs. 875.49 ± 961.15 ng/mL, P < 0.001) in the coronary artery stenosis ≥ 10% group than in the < 10% group. ANGPTL3 and ANGPTL4 levels were significantly associated with the severity of coronary vascular stenosis. ROC curve analyses indicated that ANGPTL3 concentrations above 30.5 ng/mL can predict atherosclerosis with a sensitivity of 71.2% and specificity of 75.3%, and that ANGPTL4 levels below 497.5 ng/mL can predict atherosclerosis with a sensitivity of 63.9% and specificity of 74.5%. ANGPTL3 and ANGPTL4 were determined to be independent risk factors for coronary atherosclerosis with odds ratios (ORs) of 0.189 (95% CI 0.097-0.368, P < 0.001) and 3.625 (95% CI 1.873-7.016, P < 0.001), respectively.ConclusionsIncreased ANGPTL3 or decreased ANGPTL4 shows an association with coronary atherosclerosis and, may become a predictor of coronary atherosclerosis in the future.
Highlights
Coronary heart disease (CHD), called coronary artery disease and atherosclerotic heart disease, is the end result of the accumulation of atheromatous plaques within the walls of the coronary arteries, causing myocardial ischemia, hypoxia and even necrosis [1]
In the last ten years, it has been proven that inactivation or variants of the ANGPTL3 gene in humans and mice induce a marked reduction in the levels of plasma triglycerides and cholesterol-carrying lipoproteins, including Very low-density lipoprotein-cholesterol (VLDL-C), low-density lipoprotein-cholesterol (LDL-C) and highdensity lipoprotein-cholesterol (HDL-C) [14,15,16,17]
Does ANGPTL3 or ANGPTL4 represent a better predictive indicator for coronary atherosclerosis? To answer this question, we performed a study of ANGPTL3 and ANGPTL4 in a cohort of patients with angina to clarify the associations of these proteins with coronary atherosclerosis severity
Summary
Compared to the nonstenosis group, the coronary stenosis over 10% group had more elderly patients; males; overweight patients; smokers; patients with diabetes mellitus, hypertension or New York Heart Association (NYHA) class III or IV (2013 ACC/AHA guidelines); and patients using hypoglycemic drugs and antihypertensive drugs. CHD coronary heart diseases, NYHA New York Heart Association (2013 ACC/AHA guidelines), GHb glycosylated hemoglobin, LVEF left ventricular ejection fraction, LVEDP left ventricular end diastolic pressure, BNP B-type natriuretic peptide, apo apolipoprotein, FFA free fatty acid, LDL-C low-density lipoprotein-cholesterol, HDLC high-density lipoprotein-cholesterol, BMI body mass index, ANGPTL angiopoietin-like proteins; group. The level of ANGPTL3 or ANGP TL4 in the different coronary stenosis severity based on sex are shown in Supplementary Table 1, and no statistically significant differences are found between the sexes. Increasing age, sex, higher body mass index, smoking, diabetes, hypertension, elevated ANGPTL3 and decreased ANGP TL4 had a statistically significant association with atherosclerosis development in the univariable analysis. There was no difference in ANGPTL3 or ANGPTL4 between the smoker and nonsmoker groups or between the diabetes and nondiabetes groups
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