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Abstract：
BACKGROUND: Psoriasis is a chronic inflammatory condition associated with coronary artery disease risk. Uptake of oxidized low-density lipoprotein by the lectin-like low-density lipoprotein receptor-1 triggers release of the soluble extracellular domain of the receptor (sLOX-1). We sought to characterize the relationship between sLOX-1, inflammation, and coronary plaque progression in psoriasis.
RESULTS: A total of 327 patients with psoriasis had serum sLOX-1 levels measured at baseline by an ELISA-based assay. Stratification by high-sensitivity C-reactive protein ≥4.0 mg/L (quartile 4), identified 81 participants who had coronary plaque phenotyping at baseline and were followed longitudinally by coronary computed tomography angiography. Subjects within high-sensitivity C-reactive protein quartile 4 were middle-aged (51.47±12.62 years), predominantly men (54.3%) with moderate psoriasis disease severity (6.60 [interquartile range, 3.30-13.40]). In the study cohort, participants with sLOX-1 above the median displayed increased vulnerable coronary plaque features. At baseline, sLOX-1 was associated with total burden (rho=0.296; P=0.01), noncalcified burden (rho=0.286; P=0.02), fibro-fatty burden (rho=0.346; P=0.004), and necrotic burden (rho=0.394; P=0.002). A strong relationship between sLOX-1, noncalcified burden (β=0.19; P=0.03), and fibro-fatty burden (β=0.29; P=0.003) was found in fully adjusted models at baseline and 1- and 4-year follow-up. Finally, coronary plaque features progressed over 1 year regardless of biologic or systemic treatment in subjects with high sLOX-1.
CONCLUSIONS: Patients with psoriasis with both high sLOX-1 and high-sensitivity C-reactive protein levels have increased coronary plaque burden associated with atherosclerotic plaque progression independent of biologic and systemic treatment. Thus, sLOX-1 might be considered as a promising marker in coronary artery disease risk estimation beyond traditional risk factors.
BACKGROUND: URL: https://www.clinicaltrials.gov; Unique identifier: NCT01778569.
RESULTS: A total of 327 patients with psoriasis had serum sLOX-1 levels measured at baseline by an ELISA-based assay. Stratification by high-sensitivity C-reactive protein ≥4.0 mg/L (quartile 4), identified 81 participants who had coronary plaque phenotyping at baseline and were followed longitudinally by coronary computed tomography angiography. Subjects within high-sensitivity C-reactive protein quartile 4 were middle-aged (51.47±12.62 years), predominantly men (54.3%) with moderate psoriasis disease severity (6.60 [interquartile range, 3.30-13.40]). In the study cohort, participants with sLOX-1 above the median displayed increased vulnerable coronary plaque features. At baseline, sLOX-1 was associated with total burden (rho=0.296; P=0.01), noncalcified burden (rho=0.286; P=0.02), fibro-fatty burden (rho=0.346; P=0.004), and necrotic burden (rho=0.394; P=0.002). A strong relationship between sLOX-1, noncalcified burden (β=0.19; P=0.03), and fibro-fatty burden (β=0.29; P=0.003) was found in fully adjusted models at baseline and 1- and 4-year follow-up. Finally, coronary plaque features progressed over 1 year regardless of biologic or systemic treatment in subjects with high sLOX-1.
CONCLUSIONS: Patients with psoriasis with both high sLOX-1 and high-sensitivity C-reactive protein levels have increased coronary plaque burden associated with atherosclerotic plaque progression independent of biologic and systemic treatment. Thus, sLOX-1 might be considered as a promising marker in coronary artery disease risk estimation beyond traditional risk factors.
BACKGROUND: URL: https://www.clinicaltrials.gov; Unique identifier: NCT01778569.
摘要：
背景：银屑病是一种与冠状动脉疾病风险相关的慢性炎症性疾病。凝集素样低密度脂蛋白受体1对氧化低密度脂蛋白的摄取触发了该受体的可溶性胞外域（sLOX-1）的释放。我们试图表征sLOX-1，炎症，和银屑病的冠状动脉斑块进展。
结果：总共327例银屑病患者通过基于ELISA的检测在基线时检测血清sLOX-1水平。按超敏C反应蛋白≥4.0mg/L（四分位数4）进行分层，确定了81名基线时具有冠状动脉斑块表型的参与者,并纵向随访冠状动脉计算机断层扫描血管造影术.高敏C反应蛋白四分位数4内的受试者为中年（51.47±12.62岁），主要是男性（54.3%），患有中度银屑病疾病严重程度（6.60[四分位数范围，3.30-13.40])。在研究队列中，sLOX-1高于中位数的参与者显示冠状动脉易损斑块特征增加.在基线,sLOX-1与总负荷相关(rho=0.296;P=0.01),非钙化负荷(ρ=0.286；P=0.02)，纤维脂肪负荷(rho=0.346；P=0.004)，和坏死负担（rho=0.394；P=0.002）。sLOX-1，非钙化负荷之间有很强的关系(β=0.19；P=0.03)，在基线和1年和4年随访时，在完全校正模型中发现了纤维脂肪负荷（β=0.29;P=0.003）。最后,在高sLOX-1患者中,无论采用生物治疗还是全身治疗,冠状动脉斑块特征均在1年内进展.
结论：同时具有高sLOX-1和高敏C反应蛋白水平的银屑病患者的冠状动脉斑块负荷与动脉粥样硬化斑块进展相关，与生物和全身治疗无关。因此，sLOX-1可能被认为是超越传统危险因素的冠状动脉疾病风险评估的有希望的标志物。
背景：URL：https://www。clinicaltrials.gov；唯一标识符：NCT01778569。
结果：总共327例银屑病患者通过基于ELISA的检测在基线时检测血清sLOX-1水平。按超敏C反应蛋白≥4.0mg/L（四分位数4）进行分层，确定了81名基线时具有冠状动脉斑块表型的参与者,并纵向随访冠状动脉计算机断层扫描血管造影术.高敏C反应蛋白四分位数4内的受试者为中年（51.47±12.62岁），主要是男性（54.3%），患有中度银屑病疾病严重程度（6.60[四分位数范围，3.30-13.40])。在研究队列中，sLOX-1高于中位数的参与者显示冠状动脉易损斑块特征增加.在基线,sLOX-1与总负荷相关(rho=0.296;P=0.01),非钙化负荷(ρ=0.286；P=0.02)，纤维脂肪负荷(rho=0.346；P=0.004)，和坏死负担（rho=0.394；P=0.002）。sLOX-1，非钙化负荷之间有很强的关系(β=0.19；P=0.03)，在基线和1年和4年随访时，在完全校正模型中发现了纤维脂肪负荷（β=0.29;P=0.003）。最后,在高sLOX-1患者中,无论采用生物治疗还是全身治疗,冠状动脉斑块特征均在1年内进展.
结论：同时具有高sLOX-1和高敏C反应蛋白水平的银屑病患者的冠状动脉斑块负荷与动脉粥样硬化斑块进展相关，与生物和全身治疗无关。因此，sLOX-1可能被认为是超越传统危险因素的冠状动脉疾病风险评估的有希望的标志物。
背景：URL：https://www。clinicaltrials.gov；唯一标识符：NCT01778569。
