Increased plasma lipoprotein-associated phospholipase A2 levels are associated with coronary slow flow

Yao-dong Ding,Hua Shen,Yu-qiang Pei,Qian Ma,Rui Wang,Jia-xing Yang,Hai-long Ge,Shuo Zhang,Xiao-li Liu,Yin-xin Zhao

doi:10.1186/s12872-020-01463-8

Abstract

ObjectiveCoronary slow flow (CSF) is characterized by delayed opacification of distal epicardial coronary arteries without significant coronary stenosis. In addition, The changes of lipoprotein-associated phospholipase A2 (Lp-PLA2) as a significant predictive factor for CSF remain controversial. The study aims to investigate the association between plasma Lp-PLA2 and CSF.MethodsIn this retrospective study, 170 consecutive patients who underwent coronary angiography were enrolled in Beijing Anzhen Hospital from January 2017 to September 2019, and were divided into CSF group and normal control groups. According to coronary blood flow rate measured by the thrombolysis in myocardial infarction frame count (TFC) method, CSF was defined as TFC > 27. Serum Lp-PLA2 levels were measured in an enzyme-linked immunosorbent assay.ResultsLp-PLA2 levels were higher in the CSF group than in the control group (288.6 ± 50.3 versus 141.9 ± 49.7, P < 0.001) and were significantly correlated with the mean coronary artery thrombolysis in myocardial infarction (TIMI) frame count (r = 0.790, P<0.001). Logistic regression analysis showed that high Lp-PLA2 was independently associated with CSF after adjustment for conventional risk factors (OR = 1.040, CI = 1.022–1.059, P<0.001). Male sex (OR = 2.192, CI = 1.161–4.140, P = 0.016) and hypertension (OR = 1.965, CI = 1.034–3.736, P = 0.039) were also CSF risk factors. Receiver-operating characteristic curve (ROC) analysis showed that Lp-PLA2 levels can predict CSF severity; the predictive power was higher than the other risk factors.ConclusionOur study demonstrated that patients with CSF had higher circulating levels of Lp-PLA2 than normal controls. After adjustment for potential confounders, increased Lp-PLA2 was independently associated with presence of CSF.

Highlights

A vast majority of evidence has indicated that many inflammatory mediators such as interleukin-1, interleukin-10, and the lymphocyte to monocyte ratio, are associated with the pathogenesis of Coronary slow flow (CSF), indicating the presence of a proinflammatory process occurring as a result of the phenomenon [6,7,8]
body mass index (BMI) Body mass index, FBG Fasting blood glucose, HbA1c Glycosylated hemoglobin A1c, SBP Systolic blood pressure, DBP Diastolic blood pressure, low-density lipoprotein (LDL)-c Low density lipoprotein cholesterol, high density lipoprotein (HDL)-c High density lipoprotein cholesterol, TC total cholesterol, TG triglyceride, Hs-CRP hyper-sensitive C-reactive protein, WBC white blood cell oblique projection with an angle of 20–25°, and the right coronary artery (RCA) was imaged as the positive projection with an angle of 30°
Except for TGs, TC, and high-density lipoprotein cholesterol (HDL-c), the two groups showed no significant differences in most laboratory tests

Summary

Methods

Study patients The retrospective study was carried out from January 2017 to September 2019 at Anzhen Hospital. Coronary angiography protocols CSF was defined according to the thrombolysis in myocardial infarction (TIMI) frame count (TFC) method. BMI Body mass index, FBG Fasting blood glucose, HbA1c Glycosylated hemoglobin A1c, SBP Systolic blood pressure, DBP Diastolic blood pressure, LDL-c Low density lipoprotein cholesterol, HDL-c High density lipoprotein cholesterol, TC total cholesterol, TG triglyceride, Hs-CRP hyper-sensitive C-reactive protein, WBC white blood cell oblique projection with an angle of 20–25°, and the RCA was imaged as the positive projection with an angle of 30°. According to Gibson et al, any frame count over 27 is considered abnormal and indicates significant CSF [17]. LCX left circumflex coronary artery, LAD left anterior descending coronary artery, RCA right coronary artery, TIMI thrombolysis in myocardial infarction and percentages, and continuous variables were expressed as the mean and standard deviation. A P value< 0.05 (two tailed) was considered significant

Results

Conclusion

Discussion

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