Non-mercaptalbumin is significantly associated with the coronary plaque burden and the severity of coronary artery disease

Abstract

Human non-mercaptalbumin (HNA), oxidized form of serum albumin, has been reported as a useful marker in oxidative stress-related diseases; however, few reports have examined the association between HNA and the severity of coronary artery disease (CAD). The present study evaluated whether the HNA fraction is correlated with coronary artery stenosis in 140 patients considered to have a high risk of CAD or who were suspected of having acute coronary syndrome. The severity of CAD was defined by the number of stenotic coronary vessels and a severity score system (the Gensini score). HNA measurements were performed using our newly established high-performance liquid chromatography methodology. The results had shown that HNA was significantly increased in patients with three-vessel disease, compared with those without CAD or with single-vessel disease (p = 0.025), and was positively correlated with the Gensini score (ρ = 0.421, p < 0.001). A multivariate analysis showed that the number of stenotic vessels was an independent and significant factor associated with HNA (ρ = 1.246, p = 0.012). A logistic regression analysis showed that HNA was a strong predictor of multivessel CAD (odds ratio, 1.12; 95% confidence interval, 1.020-1.229; p = 0.017). These findings indicate that the measurement of HNA could be clinically practical for predicting the severity of coronary artery stenosis.

Figure 1

Associations between HNA and the angiographic severity of CAD as evaluated by the stenotic vessels (A) and the Gensini score (B). In (A), the reported numbers are the average ± standard deviation. The box shows the 1st–3rd quartiles; the bold line shows the 2nd quartiles; the whiskers show the 95th minimum and maximum values; the filled circles are outliers. The width of the box shows the statistical degrees of freedom. The p value is for a 4-group comparison using a one-way analysis of variance. In (B), the bold and dotted lines represent linear regression and the 95% confidence interval, respectively.

Figure 2

(A) Comparison of HNA in patients diagnosed with ACS (n = 82) and those without ACS (n = 56). (B) Comparisons of HNA among groups categorized according to the final diagnosis. N-CAD: without coronary artery disease; S-CAD: stable coronary artery disease; NSTE-ACS: non-ST elevation acute coronary syndrome; STE-ACS: ST elevation acute coronary syndrome.

Figure 3

Impact of diabetes mellitus on HNA in patients with and those without coronary artery stenosis. Among patients without coronary artery stenosis, the HNA level was significantly higher in diabetes patients than in non-diabetic subjects. However, the correlation disappeared among patients who had significant coronary artery stenosis.