1. Impact of small dense low-density lipoprotein cholesterol and triglyceride-rich lipoproteins on plaque rupture with ST-segment elevation myocardial infarction
- Author
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Taito Arai, Teruo Sekimoto, Shinji Koba, Hiroyoshi Mori, Naoki Matsukawa, Rikuo Sakai, Yuya Yokota, Shunya Sato, Hideaki Tanaka, Ryota Masaki, Yosuke Oishi, Kunihiro Ogura, Ken Arai, Kosuke Nomura, Koshiro Sakai, Hiroaki Tsujita, Seita Kondo, Shigeto Tsukamoto, Hiroshi Suzuki, and Toshiro Shinke
- Subjects
Cholesterol ,Nutrition and Dietetics ,Lipoproteins ,Endocrinology, Diabetes and Metabolism ,Internal Medicine ,Humans ,ST Elevation Myocardial Infarction ,Cholesterol, LDL ,Cardiology and Cardiovascular Medicine ,Plaque, Atherosclerotic ,Triglycerides - Abstract
Plaque rupture (PR), characterized by a disruption of the fibrous cap of lipid-rich plaques, is the major etiology of ST-segment elevation myocardial infarction (STEMI). Dyslipidemia is a well-known risk factor for PR. Nonetheless, the impact of detailed atherogenic lipid profiles, including small dense low-density lipoprotein cholesterol (sd-LDL-C) and triglyceride-rich lipoproteins (TRLs), on PR has not yet been investigated.To elucidate the impact of sd-LDL-C and TRL levels on PR in patients with STEMI using optical coherence tomography (OCT).A total of 106 consecutive statin-naive patients with STEMI were enrolled. The PR in culprit lesions was assessed on pre-intervention OCT images, and serum samples were collected immediately before coronary angiography. Sd-LDL-C was directly measured using a homogeneous assay. TRL-cholesterol (TRL-C) was estimated by subtracting the LDL-C level from the non-high-density lipoprotein cholesterol level. Clinical characteristics and lipid profiles were compared between the PR and intact fibrous cap (IFC).No difference in LDL-C levels was observed between the PR (n=64) and IFC (n=42) groups (120.0 mg/dL vs. 129.5 mg/dL, p=0.97); however, sd-LDL-C levels were significantly higher in the PR group (38.9 mg/dL vs. 32.4 mg/dL, p=0.04). Similarly, the PR group had higher TRL-C (24.0 mg/dL vs. 18.0 mg/dL, p=0.01) and triglyceride (130.0 mg/dL vs. 100.3 mg/dL, p=0.03) levels than the IFC group. Multivariate logistic regression analysis showed that sd-LDL-C was an independent factor determining PR (odds ratio, 1.53 per 10 mg/dL; p=0.04).Only sd-LDL-C levels were significantly associated with PR in culprit lesions in patients with STEMI.
- Published
- 2022