Abstract 12827: Serum Levels of High-Density Lipoprotein-Associated Paraoxonase-1 Predict Recurrent Cardiovascular Events After Drug-Eluting Stent Implantation in Patients With Stable Angina Pectoris
Background: It is well established there is an inverse relationship between high-density lipoprotein (HDL) cholesterol and the risk for coronary artery disease, with its antioxidant properties attributed mainly to the HDL-bound enzyme, paraoxonase-1 (PON-1). We reported that plasma levels of myeloperoxidase, a pro-oxidant enzyme released from activated neutrophils that alters the atheroprotective function of HDL to a dysfunctional form, has a significant inverse correlation with PON-1 levels, especially in female patients with stable angina pectoris (SAP) (Atherosclerosis, 231, 308-314, 2013). Drug-eluting stents (DES) reduce the rate of restenosis, although recurrent angina and repeat revascularization remain major limitations. We investigated whether PON-1 levels predict cardiovascular events in patients with SAP undergoing DES implantation.
Methods: Serum PON-1 concentration and activity were measured on admission in 191 SAP patients and 99 control subjects. We also assessed the prognostic significance of serum PON-1 concentrations on admission after DES implantation. Cardiac events were defined as sudden cardiac death, fatal or non-fatal myocardial infarction, and non-fatal events including unstable AP or coronary revascularization.
Results: The serum PON-1 concentrations in SAP patients were significantly lower than those in control subjects (PON-1 concentrations, P<0.0005; PON-arylesterase activity, P<0.0001). Eighty-eight patients (46%) had a cardiac event during the follow-up period (mean 25±15 months). Kaplan-Meier survival analysis showed that the low-PON-1 group (<58.0 μg/mL, median) had a significantly worse outcome than the high-PON-1 group (P=0.0374). Multivariate analysis showed that a low serum PON-1 concentration was the only independent predictor of cardiovascular events (odds ratio, 1.99; 95% confidence interval, 1.17 to 3.41, P=0.012).
Conclusions: These findings suggest that low serum PON-1 levels predict recurrent cardiovascular events in SAP patients undergoing DES implantation.
Author Disclosures: T. Yoshiyama: None. K. Yunoki: None. R. Komatsu: None. K. Haze: None. T. Naruko: None. K. Sugioka: None. M. Nakagawa: None. M. Inaba: None. M. Yoshiyama: None. M. Ueda: None.
- © 2014 by American Heart Association, Inc.