Serum soluble lectin-like oxidized low-density lipoprotein receptor-1 levels are elevated in acute coronary syndrome: a novel marker for early diagnosis.
BACKGROUND
Markers of cardiac injury, including troponin-T (TnT), are used to diagnose acute coronary syndrome (ACS); however, markers for plaque instability may be more useful for diagnosing ACS at the earliest stage. Lectin-like oxidized LDL receptor-1 (LOX-1) appears to play crucial roles in the pathogenesis of atherosclerotic plaque rupture and ACS onset. LOX-1 is released in part as soluble LOX-1 (sLOX-1) by proteolytic cleavage.


RESULTS
We examined serum sLOX-1 levels in 521 patients, consisting of 427 consecutive patients undergoing coronary angiography, including 80 ACS patients, 173 symptomatic coronary heart disease patients, 122 patients with significant coronary stenosis without ischemia, and 52 patients without apparent coronary atherosclerosis plus 34 patients with noncardiac acute illness and 60 patients with noncardiac chronic illness. Time-dependent changes in sLOX-1 and TnT levels were analyzed in an additional 40 ACS patients. Serum sLOX-1 levels were significantly higher in ACS than the other groups and were associated with ACS as shown by multivariable logistic regression analyses. Given a cutoff value of 1.0 ng/mL, sLOX-1 can discriminate ACS from other groups with 81% and 75% of sensitivity and specificity, respectively. sLOX-1 can also discriminate ACS without ST elevation or abnormal Q waves and ACS without TnT elevation from non-ACS with 91% and 83% of sensitivity, respectively. Peak values of sLOX-1 in ACS were observed earlier than those of TnT.


CONCLUSIONS
sLOX-1 appears to be a useful marker for early diagnosis of ACS.
Hayashida
Kazutaka
K
Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto 606-8507, Japan.
Kume
Noriaki
N
Murase
Takatoshi
T
Minami
Manabu
M
Nakagawa
Daisuke
D
Inada
Tsukasa
T
Tanaka
Masaru
M
Ueda
Akira
A
Kominami
Goro
G
Kambara
Hirofumi
H
Kimura
Takeshi
T
Kita
Toru
T
D000208:Acute Disease; D000368:Aged; D015415:Biomarkers / Q000097:blood; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood; D003327:Coronary Disease / Q000097:blood* / Q000175:diagnosis*; D005260:Female; D006801:Humans; D037102:Lectins / Q000097:blood; D008297:Male; D008875:Middle Aged; D051127:Scavenger Receptors, Class E / Q000097:blood*
D015415:Biomarkers; D037102:Lectins; C495137:OLR1 protein, human; D051127:Scavenger Receptors, Class E