Association of soluble tumour necrosis factor-related apoptosis-inducing ligand levels with coronary plaque burden and composition

作者：Deftereos Spyridon; Giannopoulos Georgios^*; Kossyvakis Charalampos; Kaoukis Andreas; Raisakis Konstantinos; Panagopoulou Vasiliki; Miliou Antigoni; Theodorakis Andreas; Driva Metaxia; Pyrgakis Vlasios; Stefanadis Christodoulos; Cleman Michael W

来源：Heart, 2012, 98(3): 214-218.

DOI：10.1136/heartjnl-2011-300339

Background Evidence shows that the soluble tumour necrosis factor-related apoptosis-inducing ligand (sTRAIL) may play a protective role against atherosclerosis. This study sought to investigate the potential association of sTRAIL levels with intravascular ultrasound (IVUS) and virtual histology characteristics of coronary plaques. %26lt;br%26gt;Methods Patients with stable angina or positive for ischaemia non-invasive test were submitted to left cardiac catheterisation. Coronary blood samples were collected and sTRAIL was measured. Coronary arteries with at least one 50% or greater stenosis were studied with IVUS. %26lt;br%26gt;Results 56 coronary arteries were studied with significant coronary artery disease. Plaque volume per unit of arterial length was 63 +/- 65 mm(3)/cm in arteries at the lower quartile of sTRAIL concentration versus 30 +/- 64 mm(3)/cm at the upper quartile (p%26lt;0.001; 95% CI of the difference 19.7 to 46.3 mm(3)/cm). The necrotic core and fibrofatty content of atheromatous plaques were inversely associated with sTRAIL (p%26lt;0.001). Thin-cap fibroatheromas (TCFA) were discovered in 16 of the 56 arterial segments. The mean sTRAIL concentration in these segments was 56.8 +/- 7.5 pg/ml versus 99.9 +/- 5.7 pg/ml in those without TCFA (p%26lt;0.001; 95% CI of the difference 22.7 to 63.5 pg/ml). The association of sTRAIL with the presence of TCFA remained significant in the logistic multivariate analysis (p=0.009). %26lt;br%26gt;Conclusion According to the findings of the present study, in addition to coronary artery disease burden, the sTRAIL concentration is also related to the composition of atheromatous plaques. A significant association is demonstrated between low sTRAIL levels and the presence of TCFA, the IVUS-virtual histology prototype of the vulnerable plaque.

• 出版日期2012-2