The Changes And Clinical Significance Of Total Cholesterol Content Of Erythrocyte Membranes In Patients With Acute Coronary Syndrome

Background:Most acute coronary syndromes (ACS) are caused by thromboses occurring over ruptured vulnerable plaques. Atherosclerotic plaque vulnerability to rupture depends at least partly on the size of the necrotic lipid core. Previous studies have suggested that cholesterol transported by erythrocytes and deposited into the necrotic core of atheromatous plaques contributes to lipid core growth. A recent clinical study suggests that there is a significant correlation between elevated total cholesterol content of erythrocyte membranes (CEM) levels and ACS.Objective:To investigate the changes and clinical significance of CEM in patients with ACS. We sought to assess whether CEM levels are associated with serum lipids and high sensitivity C-reactive protein (hs-CRP) levels, and explore the pathogenic mechanism of ACS.Metholds:204 subjects with the main complaint of chest pain, according to clinical symptoms and the result of coronary artery angiography,were devided into three different groups.98 had ACS and 45 had stable angina pectoris (SAP).61 individuals with atypical chest pain and normal coronary artery were considered to represent a control group. CEM levels were measured using an enzymatic assay. Serum hs-CRP levels were measured by ELISA. Results:CEM levels in the ACS group (149.50μg/mg, range 120.33 to180.11μg/mg) were significantly higher (p<0.05) compared with the SAP group (79.98μg/mg; range 56.75 to 97.56μg/mg) and control group (76.64μg/mg, range 62.12 to 91.84μg/mg). Multivariable logistic regression analysis revealed a significant independent relation between CEM levels and ACS (OR 24.990,95%CI 5.22 to 119.596, p<0.001). CEM levels were correlated with the number of diseased coronary arteries (r= 0.324, p< 0.05). CEM levels were significantly and positively correlated with serum hs-CRP (r=0.328, p<0.001). CEM levels were positively correlated with serum Triglycerides (TG) (r= 0.191, p<0.05) and lipoprotein a (Lpa) levels (r= 0.224, p<0.05).Conclusions:Our study showed CEM levels were significantly higher in patients with ACS and correlated with serum hs-CRP, TG, Lpa levels and the number of diseased coronary arteries. These findings suggest that CEM may be involved in the pathogenic progression of ACS and a potential role as a marker of atheromatous plaque growth and vulnerability. CEM was a better predictor of ACS than hs-CRP.