Hyperlipidemia is a major risk factor for the development of CAD, with which individuals typically have elevated plasma low-density lipoprotein cholesterol (LDL-C) concentration as well as decreased circulating high-density lipoprotein cholesterol (HDL-C) level ( 5). The disease mainly ensues from atherosclerotic plaques or occlusions of the coronary arteries ( 4). With the rapid development of medical science, the mortality attributable to CAD has been declining for more than 4 decades ( 1) however, the incidence of CAD continues to rise with an estimated incidence of 11 million cases in China in 2017 ( 2) and 605 thousand new heart attacks annually in the United States ( 3), in part because risk factors remain alarmingly high.
Significantly, mediation analysis revealed the mediation interaction of lipid index on GS by MPV, whose effect size reached 20.71 and 20.07% in participants with or without statin medications.Ĭonclusion: The increased risk of dyslipidemia on CAD was partly enhanced by elevated MPV levels, whose mediating effect was around 20%.Ĭoronary artery disease (CAD) is the leading cause of morbidity and mortality worldwide. The combination of lipid index and MPV provided better prediction for high GS than individual lipid index or MPV, as shown by receiver-operating characteristic (ROC) curves (areas under ROC curves were 0.700 and 0.673 in subjects on or not on statin treatment, respectively). The adjusted odds ratios were greater among individuals undergoing statin medications who had high GS and higher MPV levels by elevated lipid index tertiles. Subjects in the highest MPV tertile had higher levels of atherogenic lipid parameters and lipid index ( p < 0.001). Multiple linear regression indicated positive correlation between MPV and GS after adjustment (β = 0.171, p < 0.001). Results: Lipid index increased with elevated GS irrespective of statin status (not on statin: β = 0.100, p < 0.001 on statin: β = 0.082, p < 0.001). The interaction of lipids and MPV in atherosclerosis was evaluated by the mediation analysis. A lipid index was drawn by principal component analysis to weight related lipid parameters including total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), non-HDL-C, apolipoprotein (apo) A1 B. Participants were grouped according to their CAD events, which was defined as stenosis ≥50% in at least one coronary artery, and whose severity was evaluated by the Gensini score (GS). Methods: We prospectively enrolled 5,188 consecutive subjects who underwent coronary angiography between 20. This study aims to assess the mediation effects of mean platelet volume (MPV) in lipids and the severity of CAD.
Evidence proved that platelet activation in dyslipidemia induced CAD, however, their interaction has not been well-established in vivo. Objective: Currently, coronary artery disease (CAD) is regarded as one of the leading global disease burdens. 2Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, China.1Department of Pharmacy, Zhongshan Hospital, Fudan University, Shanghai, China.
Yao Yao 1 †, Xiaoye Li 1 †, Zi Wang 1, Qiuyi Ji 1, Qing Xu 1, Yan Yan 2 * and Qianzhou Lv 1 *
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