Abstract
Monocyte chemotactic protein-1 (MCP-1) plays an important role in the entire atherosclerotic process, from atherogenesis to destabilisation of the atherosclerotic plaque. The purpose of this study is to evaluate the effect of the dietary approaches to stop hypertension (DASH) diet in patients with coronary artery disease on the MCP-1 plasma concentration and to evaluate the potential usefulness of this chemokine as a marker of change in the volume and composition of coronary plaque. Material and method. As part of the dietary intervention to stop coronary atherosclerosis in computed tomography (DISCO-CT) study, patients were randomised to an intervention group (n = 40) in which the DASH diet was introduced, and to a control group (n = 39) with no dietary intervention. In the DASH group, dietary counselling was provided at all follow-up visits within 12 months of the follow-up period. MCP-1 plasma concentration was determined using enzyme-linked immunosorbent assay (ELISA). Coronary plaque analysis was performed using a semi-automated plaque analysis software system (QAngioCT, Medis, The Netherlands). Results. In the DASH group, MCP-1 plasma concentration significantly decreased by 34.1 pg/mL (p = 0.01), while in the control group, the change in MPC-1 was not significant. Significant inverse correlations were revealed for the change in MCP-1 plasma concentration and change in the consumption of vitamin C and dietary fibre both in the DASH (r = −0.519, p = 0.0005; r = −0.353, p = 0.025, respectively) and in the control group (r = −0.488 p = 0.001; r = −0.502, p = 0.001, respectively). In patients with the highest decrease in percent atheroma volume (PAV), a significant positive correlation was observed between the change in MCP-1 plasma concentration and changes in PAV (r = 0.428, p = 0.033) and calcified plaque component (r = 0.468, p = 0.018), while the change in noncalcified plaque component correlated inversely with change in MCP1 (r = −0.459, p = 0.021). Conclusion. Dietary intervention based on the DASH diet model reduces the MCP-1plasma concentration, mostly due to an increased intake of plant-derived, fibre-rich foods and antioxidants. The change in MCP-1 plasma concentration seems to reflect changes in the atheroma volume and proportions between the calcified and non-calcified plaque elements.
Highlights
Inflammation is a central process in the development and destabilisation of atherosclerotic plaques, leading to serious cardiovascular events such as myocardial infarction and stroke [1,2,3]
To the best of our knowledge, this is the first study to assess changes in the level of Monocyte chemotactic protein-1 (MCP-1) chemokine after an intervention related to the use of dietary approaches to stop hypertension (DASH) diet in patients with coronary artery disease (CAD), and the usefulness of this marker in assessing progression or regression of the atherosclerotic plaque
We have proved that an intervention based on the DASH diet model causes a decrease in the plasma concentration of RANTES and CXCL4 chemokines [22]
Summary
Inflammation is a central process in the development and destabilisation of atherosclerotic plaques, leading to serious cardiovascular events such as myocardial infarction and stroke [1,2,3]. Studies indicate that a higher level of circulating MCP-1 is related to a higher stage, phenotype and vulnerability of atherosclerotic plaque [10]. A meta-analysis of seven cohort studies indicates that higher MCP-1 levels are related to a higher long-term cardiovascular mortality in subjects with no evident cardiovascular disease (CVD), [13]. Other studies confirm these observations, suggesting the usefulness of MCP-1, as a risk biomarker, and as a potential therapeutic target in inflammatory and atherosclerotic diseases [14,15]. It has been shown that statins have a significant anti-inflammatory and antiatherogenic effect, at least partially through MCP-1 inhibition [16,17,18]
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