The relationship between the high-density lipoprotein (HDL)-associated sphingosine-1-phosphate (S1P) and coronary in-stent restenosis

Abstract

BackgroundHigh-density lipoprotein (HDL)-associated sphingosine-1-phosphate (S1P) contributed to several beneficial effects in the cardiovascular system. We explored the relationship between the HDL-S1P concentrations and coronary in-stent restenosis (ISR). MethodsFifty consecutive patients with ISR and 50 normal control subjects were included. The serum S1P, HDL-S1P and clinical data were collected to explore the relationships between these parameters and ISR. ResultsThe patients with ISR had significantly lower concentrations of serum S1P (96.10±26.33 vs. 113.40±32.72; P=0.004) and HDL-S1P (32.81±10.02 vs. 42.72±11.75; P<0.001). All included patients were divided into four quartiles based on their concentrations of HDL-S1P: Quartile 1 (18.63–28.51ng/ml), Quartile 2 (28.62–37.28ng/ml), Quartile 3 (37.35–45.27ng/ml), and Quartile 4 (45.59–79.36ng/ml). The rates of ISR were 84%, 48%, 40% and 28%, respectively. The patients in Quartile 1 exhibited significantly higher rates of ISR compared with the other groups (P=0.001). A multivariate stepwise logistic regression analysis indicated that HDL-S1P (OR=0.846, 95% CI=0.767–0.932, P=0.001) was an independent predictor of ISR. An ROC analysis indicated that HDL-S1P=30.37ng/ml and had a 90% sensitivity and a 52% specificity in predicting ISR. ConclusionsHDL-S1P is an independent predictor of ISR, and patients with higher concentrations of HDL-S1P have a low risk of ISR.