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|Type:||Artigo de periódico|
|Title:||Hdl Levels And Oxidizability During Myocardial Infarction Are Associated With Reduced Endothelial-mediated Vasodilation And Nitric Oxide Bioavailability|
Quinaglia e Silva J.C.
de Faria E.C.
|Abstract:||Objective: Acute phase response modifies high-density lipoprotein (HDL) into a dysfunctional particle that may favor oxidative/inflammatory stress and eNOS dysfunction. The present study investigated the impact of this phenomenon on patients presenting ST-elevation myocardial infarction (STEMI). Methods: Plasma was obtained from 180 consecutive patients within the first 24-h of onset of STEMI symptoms (D1) and after 5 days (D5). Nitrate/nitrite (NOx) and lipoproteins were isolated by gradient ultracentrifugation. The oxidizability of low-density lipoprotein incubated with HDL (HDLaoxLDL) and the HDL self-oxidizability (HDLautox) were measured after CuSO4 co-incubation. Anti-inflammatory activity of HDL was estimated by VCAM-1 secretion by human umbilical vein endothelial cells after incubation with TNF-α. Flow-mediated dilation (FMD) was assessed at the 30th day (D30) after STEMI. Results: Among patients in the first tertile of admission HDL-Cholesterol (<33mg/dL), the increment of NOx from D1 to D5 [6.7(2; 13) vs. 3.2(-3; 10) vs. 3.5(-3; 12); p=0.001] and the FMD adjusted for multiple covariates [8.4(5; 11) vs 6.1(3; 10) vs. 5.2(3; 10); p=0.001] were higher than in those in the second (33-42mg/dL) or third (>42mg/dL) tertiles, respectively. From D1 to D5, there was a decrease in HDL size (-6.3±0.3%; p<0.001) and particle number (-22.0±0.6%; p<0.001) as well as an increase in both HDLaoxLDL (33%(23); p<0.001) and HDLautox (65%(25); p<0.001). VCAM-1 secretion after TNF-a stimulation was reduced after co-incubation with HDL from healthy volunteers (-24%(33); p=0.009), from MI patients at D1 (-23%(37); p=0.015) and at D30 (-22%(24); p=0.042) but not at D5 (p=0.28). Conclusion: During STEMI, high HDL-cholesterol is associated with a greater decline in endothelial function. In parallel, structural and functional changes in HDL occur reducing its anti-inflammatory and anti-oxidant properties.|
|Editor:||Elsevier Ireland Ltd|
|Appears in Collections:||Unicamp - Artigos e Outros Documentos|
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