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

Abstract

Introduction: Numerous studies suggest that total cholesterol content of erythrocyte membranes (CEM) might play a critical role in atherosclerotic plaque progression and instability. However, the exact role of CEM in atherosclerosis remains obscure. Our study was designed to investigate the association between CEM and the severity of coronary artery disease (CAD), and to assess the effect of rosuvastatin on CEM levels.

Methods: CEM levels were assessed in 136 participants, including acute coronary syndrome (ACS) (non-ST-segment elevation ACS (NSTEACS) and ST-segment elevation myocardial infarction (STEMI)), stable angina pectoris (SAP), and controls. The Gensini score was used to estimate the severity of CAD. Additionally, 54 patients with CAD were medicated with rosuvastatin, 5 or 10 mg once daily, and then checked at 6 months.

Results: The highest level of CEM was found in the STEMI group, followed by the NSTEACS, the SAP, and the control groups. Gensini score in group IV (CEM > 141.6 μg/mg) was markedly higher compared with group I (CEM ≤77.6 μg/mg). Gensini scores in group II (77.6 < CEM ≤111.1 μg/mg) and group III (111.1 < CEM ≤141.6 μg/mg) were also higher than in group I (all P < 0.001). Furthermore, a positive correlation was found between CEM levels and Gensini score (r = 0.714, P < 0.001). CEM levels were dose-dependently reduced by rosuvastatin therapy.

Conclusions: CEM levels are positively associated with the severity of CAD, meaning that CEM might contribute to the development of CAD. Importantly, rosuvastatin could decrease CEM levels in patients with CAD and might effectively help to attenuate the progression of CAD.

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. ▵CEM = 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.