Association of soluble tumour necrosis factor-related apoptosis-inducing ligand levels with coronary plaque burden and composition. Issue 3 (1st October 2011)

• Record Type: Journal Article
• Authors: Deftereos, Spyridon; Giannopoulos, Georgios; Kossyvakis, Charalampos; Kaoukis, Andreas; Raisakis, Konstantinos; Panagopoulou, Vasiliki; Miliou, Antigoni; Theodorakis, Andreas; Driva, Metaxia; Pyrgakis, Vlasios; Stefanadis, Christodoulos; Cleman, Michael W
• Is Part Of: Heart. Volume 98:Issue 3(2012)
• Page Start: 214
• Page End: 218
• Publication Date: 2011-10-01
• Subjects: Apoptosis -- arrhythmias -- atherosclerosis -- cardiac resynchronisation therapy -- cardiomyopathy hypertrophic -- chest pain clinic -- clinical heart failure -- contrast echocardiography -- coronary artery disease (CAD) -- coronary intervention (PCI) -- EBM -- fractional flow reserve -- gender -- genetics -- implantable cardioverter defibrillator (ICD) -- intravascular ultrasound -- magnetic resonance imaging -- NSTEMI -- radionuclide imaging -- stable angina -- STEMI -- sudden cardiac death -- thin-cap fibroatheroma -- TRAIL -- virtual histology; Heart -- Diseases -- Treatment -- Periodicals; Cardiology -- Periodicals; 616.12
• DOI: 10.1136/heartjnl-2011-300339
• Languages: English
• ISSNs: 1355-6037

Abstract

Abstract : Background: Evidence shows that the soluble tumour necrosis factor-related apoptosis-inducing ligand (sTRAIL) may play a protective role against atherosclerosis. This study sought to investigate the potential association of sTRAIL levels with intravascular ultrasound (IVUS) and virtual histology characteristics of coronary plaques. Methods: Patients with stable angina or positive for ischaemia non-invasive test were submitted to left cardiac catheterisation. Coronary blood samples were collected and sTRAIL was measured. Coronary arteries with at least one 50% or greater stenosis were studied with IVUS. Results: 56 coronary arteries were studied with significant coronary artery disease. Plaque volume per unit of arterial length was 63±5 mm 3 /cm in arteries at the lower quartile of sTRAIL concentration versus 30±4 mm 3 /cm at the upper quartile (p<0.001; 95% CI of the difference 19.7 to 46.3 mm 3 /cm). The necrotic core and fibrofatty content of atheromatous plaques were inversely associated with sTRAIL (p<0.001). Thin-cap fibroatheromas (TCFA) were discovered in 16 of the 56 arterial segments. The mean sTRAIL concentration in these segments was 56.8±7.5 pg/ml versus 99.9±5.7 pg/ml in those without TCFA (p<0.001; 95% CI of the difference 22.7 to 63.5 pg/ml). The association of sTRAIL with the presence of TCFA remained significant in the logistic multivariate analysis (p=0.009). Conclusion: According to the findings of the present study, in addition to coronary artery disease burden, the sTRAIL concentration is also related to the composition of atheromatous plaques. A significant association is demonstrated between low sTRAIL levels and the presence of TCFA, the IVUS–virtual histology prototype of the vulnerable plaque.