The apolipoprotein B/A1 ratio is associated with reactive oxygen metabolites and endothelial dysfunction in statin-treated patients with coronary artery disease.

AIM: The prognostic significance of the apolipoprotein B/A1 (ApoB/A1) ratio in statintreated patients with coronary artery disease (CAD) is unknown. We aimed to evaluate the association of the ApoB/A1 ratio with oxidative stress and endothelial dysfunction in these patients. METHODS: We enrolled 62 consecutive statin-treated patients who underwent percutaneous coronary intervention (PCI). Their lipid profiles, diacron-reactive oxygen metabolites (d-ROMs), as a marker of oxidative stress, flow-mediated dilatation (FMD), as a marker of vascular endothelial function, and C-reactive protein (CRP) levels, as a marker of inflammation, were measured. RESULTS: Our study population comprised 44 men and 18 women (mean age, 70.5 ± 2.5 years). The ApoB/A1 ratio was positively correlated with the results of the d-ROMs test (p=0.004, r=0.36) and CRP level (p=0.02, r=0.30) and negatively correlated with the %FMD (p=0.005, r=-0.40). A multivariate logistic regression analysis showed that the most powerful predictive factor for the d-ROMs was the ApoB/A1 ratio (p=0.026). We therefore divided patients into two groups according to the cutoff point reported by the INTERHEART study: a low ApoB/A1 ratio (<0.641, n=26) and a high ApoB/A1 ratio (>0.641, n=36). The patients with a high ApoB/A1 ratio had higher levels of d-ROMs and CRP, and tended to have a lower %FMD. CONCLUSION: The ApoB/A1 ratio was associated with the d-ROMs, a marker of oxidative stress, endothelial dysfunction and inflammation, and could be useful as a residual atherosclerotic risk marker to help prevent CAD in statin-treated patients.

Significance of the neutrophil myeloperoxidase index in patients with atherosclerotic diseases.

The pattern of changes in the neutrophil myeloperoxidase (MPO) levels in various atherosclerotic conditions was analyzed by assessing the mean myeloperoxidase index (MPXI), which is calculated during the routine complete blood count (CBC) performed using the flow-cytochemistry blood autoanalyzer ADVIA120/2120 (Siemens), and plasma MPO concentrations. MPXI values of ischemic heart disease (IHD) patients did not differ from those of healthy volunteers. However, MPXI values of IHD patients with arteriosclerosis obliterans (ASO) (-6.1 ± 1.8) were significantly lower than those of IHD patients without ASO (0.8 ± 0.5). In contrast, the MPO values in IHD patients with ASO were significantly elevated. In subjects without IHD, while the MPXI values in mild cases of ASO (Fontaine's stages I/II, 3.4 ± 0.8) were significantly higher than those of healthy volunteers (0.4 ± 0.4), the values of those with severe ASO (stages III/IV, 0.3 ± 0.8) were significantly lower than those of mild cases. However, when ASO patients developed IHD, the MPXI values dramatically decreased (stages I/II, -7.3 ± 1.9; stages III/IV, -5.2 ± 1.6). These results indicate that MPXI is elevated in mild, but not in severe, ASO cases, and that MPXI decreases dramatically when ASO patients develop IHD. MPXI may constitute an informative independent biomarker for diagnosis and follow-up of IHD complicated by ASO.

Gelatin gel as a carrier of platelet-derived growth factors.

Currently, patient's own growth factors from platelet-rich plasma and platelet-rich fibrin have been clinically used for repair and regeneration of defective tissues. In platelet-rich plasma and platelet-rich fibrin, fibrin gel is formed from blood fibrinogen and functions as a carrier for growth factors. In this study, the growth factors were extracted from the platelet-rich fibrin and incorporated into a gelatin gel by mixing the platelet-rich fibrin extract and gelatin solution before cross-linking with glutaraldehyde. About 70% of TGF-ß1 was found to be released in vitro from the gelatin gel containing the platelet-rich fibrin extract into phosphate-buffered saline (-) in 7 days. The gelatin gel containing basic fibroblast growth factor, prepared as a comparison, showed a similar release profile. The gelatin gels were slowly degraded with time after subcutaneous implantation on the back of rats, and the gel containing the platelet-rich fibrin extract strongly induced neovascularization and granulation tissue formation around the implantation site compared to the gel only and the gel containing basic fibroblast growth factor, platelet-rich plasma, or platelet-rich fibrin. The gelatin gel containing the platelet-rich fibrin extract was attempted as wound dressing on a full-thickness skin defect model. After 2 weeks of application, the gel was found to be more effective in acceleration of wound healing than the commonly used platelet-rich plasma.