Circulating Soluble Lectin-like Oxidized Low-Density Lipoprotein Receptor-1 (sLOX-1): A Diagnostic Indicator across the Spectrum of Acute Coronary Syndrome.

Sandeep Kumar,Marco Alfonso Perrone,Sridhar Mishra,Rashmi Kushwaha,Akshyaya Pradhan,Uma Shankar Singh,Rishi Sethi,Wahid Ali

doi:10.3390/jcm10235567

Abstract

Background: Cardiac troponin is the best marker to diagnose acute coronary syndrome (ACS). However, early diagnosis using markers for plaque instability may be of significance. Soluble lectin-like oxidized low-density lipoprotein receptor-1 (sLOX-1) plays an important role in the pathogenesis of atherosclerosis plaque rupture and may be a potential biomarker of coronary artery disease (CAD), including ACS. The current study aims to evaluate sLOX-1 levels in the sera of patients with ACS as an independent marker of CAD with other established diagnostic markers and assess its level before and after percutaneous intervention (PCI) in predicting the risk of future recurrence of ACS. Methods: Peripheral blood was obtained from a total of 160 patients, including patients who underwent coronary angiography (n = 18, group I), patients of stable CAD who underwent percutaneous intervention (n = 50, group II), patients of the acute coronary syndrome (n = 64, group III), and healthy controls (n = 28, group IV). A serum sLOX-1 concentration was measured by the enzyme-linked immunosorbent assay (ELISA). Results: The results obtained showed a statistically significant raised level of sLOX-1 in pre/post PCI patients of stable CAD/ACS with male preponderance. The area under the curve for sLOX-1 was 0.925 for cases that are discriminated from controls with sensitivity and specificity of 87.88 and 100%, respectively. SLOX-1 showed 100% sensitivity and specificity in the discrimination of the stable CAD that underwent PCI vs. control with an AUC of 1.00. The recurrence of coronary artery disease was observed in 9 out of 132 (6.8%) cases. The post-interventional sLOX-1 level was significantly different and higher in recurrent cases (p = 0.027) of ACS/CAD. Conclusions: sLOX-1 was a useful biomarker of stable CAD/ACS and has a potential in the risk prediction of a future recurrence of coronary artery disease.

Highlights

Cardiovascular disease remains a major cause of mortality and debility globally, of which coronary artery disease (CAD) accounts for the highest percentage [1], the prognosis of CAD patients has improved with the use of percutaneous coronary intervention (PCI) and new drug therapies
We aim to investigate and compare the pre/post percutaneous intervention (PCI) levels of Soluble lectin-like oxidized low-density lipoprotein receptor-1 (sLOX-1) and other biochemical markers in stable acute coronary syndrome (ACS)/CAD patients, followed up to one year to assess the future recurrence of the disease, and the sLOX-1 and other biochemical markers were measured in the predictor of recurrence of ACS/CAD
Our study showed a statistically significant increase in the pre-treatment levels of sLOX-1 in all the studied groups, with the order of increase being: patients with ACS > patients with stable CAD > patients who only underwent coronary angiography > controls

Summary

Introduction

Cardiovascular disease remains a major cause of mortality and debility globally, of which coronary artery disease (CAD) accounts for the highest percentage [1], the prognosis of CAD patients has improved with the use of percutaneous coronary intervention (PCI) and new drug therapies. CAD patients remain at a higher risk of adverse cardiovascular and cerebrovascular events [1]. The current study aims to evaluate sLOX-1 levels in the sera of patients with ACS as an independent marker of CAD with other established diagnostic markers and assess its level before and after percutaneous intervention (PCI) in predicting the risk of future recurrence of ACS. Methods: Peripheral blood was obtained from a total of 160 patients, including patients who underwent coronary angiography (n = 18, group I), patients of stable CAD who underwent percutaneous intervention (n = 50, group II), patients of the acute coronary syndrome (n = 64, group III), and healthy controls (n = 28, group IV). Results: The results obtained showed a statistically significant raised level of sLOX-1 in pre/post PCI patients of stable CAD/ACS with male preponderance.

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