Abstract

Background: This study aimed to evaluate changes in markers of calcification and of endothelial dysfunction during the development of calcification and instability of atherosclerotic plaques and to identify associations of calcification factors with the formation of unstable plaques. Methods: We analyzed 44 male patients with coronary atherosclerosis who underwent endarterectomy in coronary arteries during coronary bypass surgery. The endarterectomy material (intima/media) was examined using histological and biochemical methods, and the stability and calcification degree of atherosclerotic plaques were assessed. In homogenates of the tissue samples and in blood, concentrations of osteoprotegerin, osteocalcin, osteopontin, osteonectin, monocyte-chemoattractant protein type 1 (MCP-1), soluble vascular cell adhesion molecule 1 (sVCAM-1), and E-selectin were determined by enzyme immunoassays. Results: Unstable atherosclerotic plaques proved to be calcified more frequently (80.4% of plaques) than stable ones (45.0%). Osteonectin, E-selectin, and sVCAM-1 levels were lower in unstable plaques and plaques with large calcification deposits. Osteocalcin content increased with the increasing size of the calcification deposits in plaque. Blood osteocalcin concentration directly correlated with osteocalcin concentration in atherosclerotic plaques and was higher in the blood of patients with calcified plaques in coronary arteries. Conclusions: The results provide the basis for further research on the suitability of osteocalcin as a potential biomarker of an unstable calcified atherosclerotic plaque in a coronary artery.

Highlights

  • Coronary heart disease (CHD) is one of major causes of high morbidity and mortality worldwide [1]

  • We found that the probability of unstable plaque presence inversely correlates with the plaque content of E-selectin (Exp(B) = 0.924, 95% confidence interval (CI) 0.854–0.999, p = 0.047) and directly correlates with the calcification degree of the atherosclerotic focus

  • Those authors proposed that osteopontin, osteocalcin, and osteonectin are not involved in the initiation stage of the calcification process, but osteopontin and osteocalcin may play a role in the regulation of arterial calcification [14]

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Summary

Introduction

Coronary heart disease (CHD) is one of major causes of high morbidity and mortality worldwide [1]. Even though a higher overall coronary calcification index is a marker of increased cardiovascular risk, Puchner noticed that a low level of local calcium indicates instability of an atherosclerotic plaque, whereas a high calcium concentration with high density may be a marker of plaque stability [4]. This study aimed to evaluate changes in markers of calcification and of endothelial dysfunction during the development of calcification and instability of atherosclerotic plaques and to identify associations of calcification factors with the formation of unstable plaques. Blood osteocalcin concentration directly correlated with osteocalcin concentration in atherosclerotic plaques and was higher in the blood of patients with calcified plaques in coronary arteries. Conclusions: The results provide the basis for further research on the suitability of osteocalcin as a potential biomarker of an unstable calcified atherosclerotic plaque in a coronary artery

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