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Association between ceramides and coronary artery stenosis in patients with coronary artery disease
Chenchen Tu1, Lan Xie2, Zhenjie Wang3
1Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Rd, Chaoyang District, Beijing, 100029, China.
Insights
Plasma ceramide levels, particularly the ratio of Cer (d18:1/24:1) to Cer (d18:1/24:0), are linked to coronary artery stenosis severity. This finding aids in predicting acute coronary syndrome (ACS) risk.
Area of Science:
- Cardiovascular Medicine
- Biochemistry
- Clinical Diagnostics
Background:
- Coronary artery stenosis is a primary cause of heart disease, including acute coronary syndrome (ACS).
- Ceramide species have been implicated in ACS and major adverse cardiovascular and cerebrovascular events (MACE).
- Limited research exists on the correlation between plasma ceramide levels and coronary artery stenosis severity or disease onset.
Purpose of the Study:
- To investigate the association between specific plasma ceramide species and the severity of coronary artery stenosis.
- To explore the relationship between plasma ceramides, coronary artery stenosis, and the occurrence of acute coronary syndrome.
Main Methods:
- Recruited 553 patients with suspected or confirmed coronary artery disease (CAD) undergoing angiography.
- Measured four plasma ceramide species (Cer (d18:1/16:0), Cer (d18:1/18:0), Cer (d18:1/24:1), Cer (d18:1/24:0)) using LC-MS/MS.
- Calculated ceramide ratios as indices and employed multiple logistic regression to develop a prognostic model for ACS risk.
Main Results:
- A high ratio of Cer (d18:1/24:1) to Cer (d18:1/24:0), female gender, elevated HbA1c%, and diagnoses of unstable angina (UAP) or acute myocardial infarction (AMI) were associated with more severe coronary artery stenosis.
- A prognostic model was developed with an area under the curve (AUC) of 0.732 (95% CI: 0.642-0.822) for predicting ACS risk after adjusting for clinical factors.
Conclusions:
- The severity of coronary artery stenosis correlates with a high Cer (d18:1/24:1) to Cer (d18:1/24:0) ratio, female gender, HbA1c%, and AMI.
- The established prognostic model demonstrates good discrimination for ACS risk.
- Further research is warranted to assess the long-term predictive value of ceramides for MACE.
Background:
Coronary artery stenosis induces heart diseases including acute coronary syndrome (ACS). Some studies reported the ceramide species are associated with the ACS and major adverse cardia and cerebrovascular events (MACE). However, few studies investigated the association between plasma ceramide levels and the severity of stenosis, together with the onset of diseases. This aim of the present study was to investigate the association betweencertain ceramide species, coronary artery stenosis and acute coronary syndrome.
Methods:
Five hundred fifty-three patients with definite or suspected CAD were recruited and received angiography. Subjects were assigned into 4 groups according to the severity of coronary artery stenosis. The measurements of 4 plasma ceramide species, namely, Cer (d18:1/16:0), Cer (d18:1/18:0), Cer (d18:1/24:1), Cer (d18:1/24:0) were carried out by Liquid chromatography-tandem mass spectrometry (LC-MS/MS) and the ratio of Cer (d18:1/16:0), Cer (d18:1/18:0) and Cer (d18:1/24:1) to Cer (18:1/24:0), respectively, were calculated as index to evaluate the association between plasma ceramides levels and coronary artery stenosis. Multiple logistic regression analysis was used to establish the prognostic model for the prediction of ACS risk.
Results:
After the adjustment by multiple clinical risk factors including age, gender, pre-existing myocardial/cerebral infarction, hemoglobin A1c% (HbA1c%), smoking and the diagnosis during index hospitalization, multiple logistic regression analysis showed that the high ratio of Cer (d18:1/24:1) to Cer (d18:1/24:0), female gender, HbA1c%, unstable angina (UAP) and acute myocardial infarction (AMI) diagnosis (compared with atherosclerosis) during index hospitalization were associated with more severe coronary artery stenosis. Furthermore, the prognostic model was established after adjustment of risk factors and the area under curve (AUC) of receiver operating characteristics (ROC) for the prognostic model was 0.732 and 95% CI was 0.642-0.822.
Conclusion:
The severity of coronary artery stenosis is associated with high ratio of Cer (d18:1/24:1) to Cer (d18:1/24:0), female gender, HbA1c% and AMI. Although the reported prognostic model showed a good discrimination, further investigation on long term MACE is needed to evaluate the role of ceramide for the prediction of MACE risk.
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