title: Low paraoxonase 1 arylesterase activity and high von Willebrand factor levels are associated with severe coronary atherosclerosis in patients with non-diabetic stable coronary artery disease.
abstract: BACKGROUND
  Paraoxonase 1 (PON1) activity and von Willebrand factor (VWF) release are associated with lesion initiation in atherosclerosis. Diabetes can complicate coronary artery disease (CAD) due to the production of advanced glycation end products. This study evaluated PON1 activity and VWF levels in non-post-acute coronary syndrome, stable CAD (SCAD) patients without diabetes.
  
  
  METHODS
  Non-diabetic SCAD patients and patients experiencing acute stress periods were selected (n=130). Forty-seven cases with normal coronary angiography and 50 healthy individuals served as controls. The non-diabetic SCAD group was then stratified into single-vessel lesions, multiple-vessel lesions, and mild or severe luminal stenosis according to the number and the degree of luminal stenoses. Serum PON1 paraoxonase and arylesterase activities, and plasma VWF levels were measured, as well as serum total cholesterol, total triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and apolipoprotein A1. PON1 arylesterase activity was detected with an ordinary chemistry system using a novel phenylacetate derivative.
  
  
  RESULTS
  Both PON1 paraoxonase and arylesterase were lower in the non-diabetic SCAD group, but VWF levels were higher (versus controls, all P<0.001). PON1 paraoxonase activity (OR=0.991), PON1 arylesterase activity (OR=0.981), and VWF (OR 2.854) influenced SCAD in multiple logistic regression. Decreased PON1 arylesterase activity and increased VWF levels were associated with severe atherosclerosis in non-diabetic SCAD patients. We also observed a slight negative correlation between VWF and PON1 paraoxonase/arylesterase.
  
  
  CONCLUSIONS
  PON1 and VWF are detectable markers that may predict the severity of stenoses, ideally facilitating a non-diabetic SCAD diagnosis before the sudden onset of life-threatening symptoms.
authors.affiliation: Department of Clinical Laboratories, Ninth People's Hospital Affiliated to Shanghai Jiaotong University, School of Medicine, Shanghai, China (mainland).
authors.forename: Jieying
authors.initials: J
authors.lastname: Ding
authors.affiliation: Department of Cardiology, Ninth People's Hospital Affiliated to Shanghai Jiaotong University, School of Medicine, Shanghai, China (mainland).
authors.forename: Qizhi
authors.initials: Q
authors.lastname: Chen
authors.affiliation: Department of Clinical Laboratories, Ninth People's Hospital Affiliated to Shanghai Jiaotong University, School of Medicine, Shanghai, China (mainland).
authors.forename: Xing
authors.initials: X
authors.lastname: Zhuang
authors.affiliation: Department of Clinical Laboratories, Ninth People's Hospital Affiliated to Shanghai Jiaotong University, School of Medicine, Shanghai, China (mainland).
authors.forename: Zhilei
authors.initials: Z
authors.lastname: Feng
authors.affiliation: Department of Gastroenterology, Zhongshan Hospital, Fudan University, Shanghai, China (mainland).
authors.forename: Lili
authors.initials: L
authors.lastname: Xu
authors.affiliation: Department of Clinical Laboratories, Ninth People's Hospital Affiliated to Shanghai Jiaotong University, School of Medicine, Shanghai, China (mainland).
authors.forename: Fuxiang
authors.initials: F
authors.lastname: Chen
mesh_terms: D000368:Aged; D043303:Aryldialkylphosphatase / Q000097:blood*; D016022:Case-Control Studies; D003324:Coronary Artery Disease / Q000097:blood* / Q000150:complications* / Q000201:enzymology; D023921:Coronary Stenosis / Q000097:blood / Q000150:complications; D003920:Diabetes Mellitus / Q000097:blood*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012372:ROC Curve; D015203:Reproducibility of Results; D014841:von Willebrand Factor / Q000378:metabolism*
chemical_list: D014841:von Willebrand Factor; D043303:Aryldialkylphosphatase; C468406:PON1 protein, human