1. Admission Low-Density Lipoprotein Cholesterol Stratified by Circulating CD14++CD16+ Monocytes and Risk for Recurrent Cardiovascular Events Following ST Elevation Myocardial Infarction: Lipid Paradox Revised
- Author
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Jun Miao, Shan Zeng, Qing Yang, Li-Fang Yan, Wen-Jie Ji, Jun-Xiang Liu, Xin Zhou, Shaozhuang Dong, and Xin-Lin Liu
- Subjects
Male ,0301 basic medicine ,medicine.medical_specialty ,Time Factors ,medicine.medical_treatment ,CD14 ,Lipopolysaccharide Receptors ,Pharmaceutical Science ,030204 cardiovascular system & hematology ,CD16 ,GPI-Linked Proteins ,Proof of Concept Study ,Risk Assessment ,Monocytes ,03 medical and health sciences ,Patient Admission ,Percutaneous Coronary Intervention ,0302 clinical medicine ,Recurrence ,Risk Factors ,Internal medicine ,Genetics ,Humans ,Medicine ,cardiovascular diseases ,Genetics (clinical) ,Aged ,business.industry ,Monocyte ,Receptors, IgG ,Hazard ratio ,Percutaneous coronary intervention ,Cholesterol, LDL ,Middle Aged ,Immunity, Innate ,Confidence interval ,Treatment Outcome ,030104 developmental biology ,medicine.anatomical_structure ,Cohort ,Cardiology ,ST Elevation Myocardial Infarction ,Molecular Medicine ,Female ,lipids (amino acids, peptides, and proteins) ,Cardiology and Cardiovascular Medicine ,business ,Biomarkers ,Mace - Abstract
Lower level of low-density lipoprotein cholesterol (LDL-C) is paradoxically associated with increased mortality in ST elevation myocardial infarction (STEMI) patients. The underlying mechanism remains unclear. In a cohort of 220 de novo STEMI patients receiving timely primary percutaneous coronary intervention, admission LDL-C was negatively associated with circulating CD14++CD16+ monocyte counts. Moreover, admission LDL-C 85 mg/dL was associated with increased risk for major adverse cardiovascular events (MACE) during a median follow-up of 2.7 years. After categorizing the patients according to the cutoff values of 85 mg/dL for LDL-C and the median for CD14++CD16+ monocytes, low LDL-C-associated MACE risk was only observed in those with high CD14++CD16+ monocyte counts (low LDL-C/high CD14++CD16+ monocytes vs. low LDL-C/low CD14++CD16+ monocytes: hazard ratio 5.38, 95% confidence interval 1.52 to 19.06, P = 0.009). This work provided the proof-of-principle evidence indicating a role of CD14++CD16+ monocytes in risk stratification of STEMI patients presenting with low LDL-C level. Graphical abstract.
- Published
- 2020