Total cholesterol content of erythrocyte membranes is associated with the severity of coronary artery disease and the therapeutic effect of rosuvastatin

Figures & data

Table I. Demographic and clinical data of the participants at admission.

	SAP (n = 34)	NSTEACS (n = 41)	STEMI (n = 31)	Controls (n = 30)	P value
Age, years	61.9 ± 7.7	60.3 ± 7.9	54.2 ± 8.6	54.6 ± 8.2	0.002^a
Men/women, n	23/11	35/6	26/5	24/6	0.246
BMI, kg/m^2	24.1 ± 2.2	24.1 ± 1.6	24.6 ± 2.2	24.0 ± 2.1	0.803
SBP, mmHg	133.7 ± 14.6	127.7 ± 11.2	126.8 ± 14.1	128.1 ± 10.6	0.279
DBP, mmHg	80.9 ± 9.4	77.2 ± 7.4	80.1 ± 9.2	81.5 ± 8.5	0.355
HR, bpm	65.6 ± 7.0	68.9 ± 8.1	73.5 ± 12.5	67.9 ± 6.0	0.206
EF (%)	68.8 ± 6.5	60.7 ± 6.3	54.2 ± 6.6	68.2 ± 4.0	0.001^a
History of PCI (%)	5	2	3	0	0.725
History of CABG (%)	0	0	0	0	0
Risk factors
Hypertension, n (%)	23 (68%)	27 (66%)	15 (48%)	0	0.211
Diabetes mellitus, n (%)	9 (26%)	11 (27%)	10 (32%)	0	0.844
Dyslipidemia, n (%)	6 (18%)	8 (20%)	5 (16%)	0	0.932
Smoking, n (%)	14 (41%)	25 (61%)	22 (71%)	11 (37%)	0.017^b
Family history, n (%)	7 (21%)	9 (22%)	6 (19%)	0	0.964
Medications
Aspirin, n (%)	21 (62%)	11 (27%)	7 (23%)	0	0.001^b
Clopidogrel, n (%)	3 (9%)	2 (2%)	2 (7%)	0	0.790
Beta-blockers, n (%)	15 (44%)	12 (29%)	6 (19%)	0	0.093
ACE inhibitors, n (%)	9 (26%)	13 (32%)	8 (26%)	0	0.825
ARB, n (%)	7 (21%)	6 (15%)	5 (16%)	0	0.783
CCB, n (%)	12 (35%)	10 (24%)	8 (26%)	0	0.542
Statins, n (%)	16 (47%)	9 (22%)	6 (19%)	0	0.021^b
Nitrates, n (%)	5 (15%)	4 (10%)	2 (7%)	0	0.545
Angiographic analysis					0.612
Non-significant disease	3 (9%)	3 (7%)	2 (7%)	30 (100%)
1-vessel disease	12 (35%)	10 (24%)	9 (29%)	0
2-vessel disease	14 (41%)	15 (37%)	10 (32%)	0
3-vessel disease	5 (15%)	13 (32%)	10 (32%)	0
LMS disease	2 (6%)	5 (12%)	2 (7%)	0	0.552
Biochemistry
Total cholesterol, mmol/L	4.36 ± 0.77	4.29 ± 0.72	4.72 ± 1.02	4.43 ± 0.73	0.335
Triglyceride, mmol/L	1.62 (1.05–2.23)	1.38 (1.07–2.00)	1.63 (1.02–2.25)	1.60 (0.98–2.11)	0.940
HDL cholesterol, mmol/L	1.24 ± 0.24	1.12 ± 0.16	1.08 ± 0.21	1.26 ± 0.27	0.021^a
LDL cholesterol, mmol/L	2.36 ± 0.63	2.32 ± 0.60	2.64 ± 0.86	2.31 ± 0.59	0.346
ApoA-I, mmol/L	1.06 ± 0.17	1.03 ± 0.14	1.02 ± 0.15	1.13 ± 0.21	0.189
ApoB, mmol/L	0.93 ± 0.15	0.95 ± 0.18	0.96 ± 0.19	0.94 ± 0.18	0.958
Lipoprotein (α), mg/L	38.5 (27.3–57.0)	55.9 (31.3–65.6)	51.9 (35.9–80.4)	34.7 (21.6–52.1)	0.018^c
Glucose, mmol/L	4.99 (4.25–6.12)	4.90 (4.40–6.10)	5.30 (4.55–6.34)	4.80 (4.42–5.20)	0.375
Creatinine, μmol/L	74.6 ± 8.5	76.4 ± 9.7	77.7 ± 9.5	73.0 ± 9.8	0.595
Uric acid, μmol/L	338.1 ± 81.9	351.1 ± 50.4	367.1 ± 76.8	334.4 ± 61.7	0.494
Hemoglobin, g/L	132.1 ± 11.4	137.8 ± 11.0	136.3 ± 10.9	136.1 ± 11.0	0.213
hs-CRP, mg/L	3.33 (2.92–3.85)	4.58 (3.36–6.71)	5.77 (4.86–9.43)	3.55 (2.59–4.04)	<0.001^c

Values are expressed as mean ± standard deviation (SD) or median and interquartile range for continuous variables, and as % for categorical variables.

^aOne-way ANOVA.

^bChi-square test.

^cKruskal–Wallis test.

ACE = angiotensin-converting enzyme; ApoA-I = apolipoprotein A-I; ApoB = apolipoprotein B; ARB = angiotonin II receptor blocker; BMI = body mass index; CABG = coronary artery bypass graft; CCB = calcium antagonists; DBP = diastolic blood pressure; EF = ejection fraction; HDL = high-density lipoprotein; HR = heart rate; hs-CRP = high-sensitivity C-reactive protein; LDL = low-density lipoprotein; LMS = left main stem; NSTEACS = non-ST-segment elevation acute coronary syndrome; PCI = percutaneous coronary intervention; SAP = stable angina pectoris; SBP = systolic blood pressure; STEMI = ST-segment elevation myocardial infarction.

Table II. Characteristics of all participants classified according to the quartile of CEM levels.

	Quartile of CEM level (μg/mg), groups I - IV 3.
	≤77.6 (n = 34)	77.6–111.1 (n = 34)	111.1–141.6 (n = 34)	>141.6 (n = 34)
Age, years	57.1 ± 9.3	59.0 ± 8.4	57.4 ± 7.8	58.4 ± 9.2
Men/women, n	27/7	26/8	27/7	28/6
BMI, kg/m^2	24.2 ± 2.5	24.1 ± 1.7	24.0 ± 1.9	24.3 ± 1.8
Hypertension, n (%)	17 (50%)	17 (50%)	16 (47%)	21 (62%)
Diabetes mellitus, n (%)	5 (15%)	6 (18%)	11 (32%)	9 (26%)
Dyslipidemia, n (%)	4 (12%)	6 (18%)	9 (26%)	2 (6%)
Smoking, n (%)	14 (41%)	14 (41%)	20 (59%)	22 (65%)
Family history, n (%)	3 (9%)	3 (9%)	7 (21%)	9 (26%)
Total cholesterol, mmol/L	4.18 ± 0.72	4.37 ± 0.66	4.60 ± 0.91	4.63 ± 0.94
Triglyceride, mmol/L	1.29 (0.96–2.41)	1.52 (0.94–2.03)	1.68 (1.18–2.17)	1.52 (1.08–2.18)
HDL cholesterol, mmol/L	1.15 ± 0.29	1.14 ± 0.20	1.11 ± 0.18	1.12 ± 0.22
LDL cholesterol, mmol/L	2.07 ± 0.56	2.40 ± 0.55	2.67 ± 0.78^b	2.50 ± 0.71^a
ApoA-I, mmol/L	1.07 ± 0.19	1.10 ± 0.14	1.04 ± 0.15	1.03 ± 0.19
ApoB, mmol/L	0.89 ± 0.18	0.95 ± 0.15	1.00 ± 0.17	0.91 ± 0.20
Lipoprotein (α), mg/L	27.2 (20.5–41.4)	43.8 (32.0–58.3)^b	54.6 (32.7–78.4)^c	58.1 (42.5–69.3)^c
Glucose, mmol/L	4.65 (4.40–5.76)	4.85 (4.71–6.06)	4.95 (4.45–6.06)	5.47 (4.40–6.88)
Creatinine, μmol/L	74.4 ± 9.7	76.9 ± 14.5	69.4 ± 10.4	77.3 ± 13.2
Uric acid, μmol/L	336.2 ± 65.9	333.2 ± 62.2	331.8 ± 51.9	334.3 ± 81.9
Hemoglobin, g/L	134.6 ± 10.8	137.7 ± 13.8	134.7 ± 10.4	143.3 ± 19.8
hs-CRP, mg/L	2.87 (2.05–3.17)	3.49 (3.21–3.83)^c	4.76 (3.82–5.48)^c	8.21 (5.71–9.60)^c
Gensini score	3 (0–16.6)	18.5 (6.9–41.9)^c	42 (24.3–56.0)^c	70.3 (48.4–99.0)^c

Values are expressed as mean ± standard deviation (SD) or median and interquartile range for continuous variables, and as % for categorical variables. P values were calculated using chi-square test, one-way ANOVA, or Kruskal–Wallis test.

^a P < 0.05; ^b P < 0.01; ^c P < 0.001, compared with the CEM level ≤77.6 μg/mg group.

ApoA-I = apolipoprotein A-I; ApoB = apolipoprotein B; BMI = body mass index; HDL = high-density lipoprotein; hs-CRP = high-sensitivity C-reactive protein; LDL = low-density lipoprotein.

Figure 1. A: Gensini score in patients within different groups according to the quartile of CEM level. Horizontal line in the box plots represents the median value; the boxed area is the interquartile range, and the whiskers indicate minimum and maximum. B: CEM levels in controls and patients with stable angina pectoris (SAP), non-ST-segment elevation acute coronary syndrome (NSTEACS), and ST-segment elevation myocardial infarction (STEMI). CEM = total cholesterol content of erythrocyte membrane.

Figure 2. A: CEM levels in patients with coronary artery disease (CAD) on admission and at 6 months. B: The proportion of CEM reduction in patients in the low-dose group and high-dose group. ΔCEM = CEM_adm − CEM_{6 months}; adm = admission; CEM = total cholesterol content of erythrocyte membrane.

Figure 3. Correlation between CEM levels and coronary angiographic Gensini score in patients with coronary artery disease (CAD). CEM = total cholesterol content of erythrocyte membrane.