Further evaluation of plasma sphingomyelin levels as a risk factor for coronary artery disease.
BACKGROUND
Sphingomyelin (SM) is the major phospholipid in cell membranes and in lipoproteins. In human plasma, SM is mainly found in atherogenic lipoproteins; thus, high levels of SM may promote atherogenesis.


METHODS
We investigated in a median follow up of 6.0 years the association of SM with the incidence of a combined endpoint (myocardial infarction and cardiovascular death) in stable and unstable patients, and its relation to other marker of atherosclerosis in 1,102 patients with angiographically documented CAD and 444 healthy controls.


CONCLUSIONS
Logistic regression analysis showed that SM categorized by median was associated with an elevated risk for CAD (HR 3.2, 95%CI 2.5-4.0, p < 0.05). SM levels were correlated with apoB (r = 0.34) and triglyceride levels (r = 0.31). In patients with stable angina (n = 614), SM categorized by median was not related to incidence of a combined endpoint (cardiovascular death and myocardial infarction) (p = 0.844 by Log-rank test). However, in patients with acute coronary syndrome (n = 488), elevated SM was related to the combined endpoint (p < 0.05 by Log-rank test), also in a multivariate Cox regression analysis including potential confounders (HR 1.8, 95%CI 1.0-3.3, p < 0.05).


CONCLUSIONS
The results of our study reveal that 1) human plasma SM levels are a risk factor for CAD; 2) the pro-atherogenic property of plasma SM might be related to metabolism of apoB-containing or triglyceride-rich lipoproteins; and 3) plasma SM levels are a predictor for outcome of patients with acute coronary syndrome.
Schlitt
Axel
A
Department of Anatomy and Cell Biology and Scientific Computing Center, State University of New York, Downstate Medical Center, Brooklyn, USA. axel.schlitt@medizin.uni-halle.de
Blankenberg
Stefan
S
Yan
Daoguang
D
von Gizycki
Hans
H
Buerke
Michael
M
Werdan
Karl
K
Bickel
Christoph
C
Lackner
Karl J
KJ
Meyer
Juergen
J
Rupprecht
Hans J
HJ
Jiang
Xian-Cheng
XC