학술논문
Apolipoproteins and lipoprotein(a) as factors modulating fibrin clot properties in patients with severe aortic stenosis.
Document Type
Academic Journal
Author
Siudut J; Institute of Cardiology, Jagiellonian University Medical College, 31-202, Krakow, Poland; Krakow Center for Medical Research and Technologies, John Paul II Hospital, 31-202, Krakow, Poland.; Natorska J; Institute of Cardiology, Jagiellonian University Medical College, 31-202, Krakow, Poland; Krakow Center for Medical Research and Technologies, John Paul II Hospital, 31-202, Krakow, Poland.; Wypasek E; Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Krakow University, 30-705, Krakow, Poland.; Wiewiórka Ł; Department of Interventional Cardiology, John Paul II Hospital, 31-202, Krakow, Poland.; Ostrowska-Kaim E; Department of Interventional Cardiology, John Paul II Hospital, 31-202, Krakow, Poland.; Wiśniowska-Śmiałek S; Department of Cardiac and Vascular Diseases, John Paul II Hospital, 31-202, Krakow, Poland.; Plens K; KCRI, 30-055, Krakow, Poland.; Musialek P; Institute of Cardiology, Jagiellonian University Medical College, 31-202, Krakow, Poland; Department of Cardiac and Vascular Diseases, John Paul II Hospital, 31-202, Krakow, Poland.; Legutko J; Institute of Cardiology, Jagiellonian University Medical College, 31-202, Krakow, Poland; Department of Interventional Cardiology, John Paul II Hospital, 31-202, Krakow, Poland.; Undas A; Institute of Cardiology, Jagiellonian University Medical College, 31-202, Krakow, Poland; Krakow Center for Medical Research and Technologies, John Paul II Hospital, 31-202, Krakow, Poland. Electronic address: mmundas@cyf-kr.edu.pl.
Source
Publisher: Elsevier Country of Publication: Ireland NLM ID: 0242543 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1879-1484 (Electronic) Linking ISSN: 00219150 NLM ISO Abbreviation: Atherosclerosis Subsets: MEDLINE
Subject
Language
English
Abstract
Background and Aims: Large amounts of clot-bound lipoproteins were reported in proteomic analysis of plasma clot but their impact on fibrin clot properties is unknown. We investigated a contribution of lipid profile and apolipoproteins (apo) to the prothrombotic plasma fibrin clot phenotype in patients with aortic stenosis (AS).
Methods: In 138 patients with isolated severe AS, we determined serum apoA-I, A-II, B, C-II, C-III, E, oxidized low-density lipoprotein (OxLDL) and lipoprotein(a) concentrations. Plasma fibrin clot permeability (Ks), maximal absorbance (MaxAbsCLT2018 and MaxAbs Lys50 ), and fibrinolytic capacity were studied using 3 plasma-based lysis assays (CLT2018, CLT, and Lys50), and compared with well-matched patients without AS (control group).
Results: After adjustment for confounding factors, including statin use, only low-density lipoprotein cholesterol (LDL-C) and apoB levels were inversely associated with Ks. Triglycerides, apoC-II, and C-III were associated with MaxAbsCLT2018 and MaxAbs Lys50 , explaining 56-64% of their variability. CLT2018 and CLT showed associations with total cholesterol, LDL-C, triglycerides, and OxLDL as well as with apoB, C-II, C-III, and E. ApoA-I, C-II, and C-III but not serum lipids were associated with Lys50. Only CLT2018 was associated with lipoprotein(a). ApoC-III, B, A-I, and E along with estimated glomerular filtration rate and OxLDL predicted hypofibrinolysis in multiple regression analysis. AS patients had higher lipoprotein(a) (+34.9%) and apoA-I (+25.9%) levels and less compact fibrin clots (-13.3% lower MaxAbs CLT2018 , -53.2% lower MaxAbs Lys50 , and +28.3% higher Ks) displaying higher susceptibility to lysis (-17.9% lower Lys50) in comparison with control group.
Conclusions: Apolipoproteins and OxLDL contribute to prothrombotic fibrin clot phenotype in severe AS. Moreover, apolipoproteins better than serum lipids predicted hypofibrinolysis, which provides additional argument for a role of elevated lipoproteins in the prothrombotic state.
(Copyright © 2022 Elsevier B.V. All rights reserved.)
Methods: In 138 patients with isolated severe AS, we determined serum apoA-I, A-II, B, C-II, C-III, E, oxidized low-density lipoprotein (OxLDL) and lipoprotein(a) concentrations. Plasma fibrin clot permeability (Ks), maximal absorbance (MaxAbs
Results: After adjustment for confounding factors, including statin use, only low-density lipoprotein cholesterol (LDL-C) and apoB levels were inversely associated with Ks. Triglycerides, apoC-II, and C-III were associated with MaxAbs
Conclusions: Apolipoproteins and OxLDL contribute to prothrombotic fibrin clot phenotype in severe AS. Moreover, apolipoproteins better than serum lipids predicted hypofibrinolysis, which provides additional argument for a role of elevated lipoproteins in the prothrombotic state.
(Copyright © 2022 Elsevier B.V. All rights reserved.)