Relationship between Increased Plasma Levels of Legumain and Properties of Coronary Atherosclerotic Plaque

Deng, Yunpeng; Fan, Yudong; Wu, Di; Zhang, Zilong; Zhang, Miaomiao; Huang, Zhiping; Gao, Yuxia

doi:10.36660/abc.20230395

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Original Article • Arq. Bras. Cardiol. 120 (11) • Oct 2023 • https://doi.org/10.36660/abc.20230395 linkcopy

Relationship between Increased Plasma Levels of Legumain and Properties of Coronary Atherosclerotic Plaque

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Background Many clinical studies have confirmed that legumain is closely related to atherosclerosis. Unfortunately, different conclusions have been reached, and analyses and studies on atherosclerotic plaque characteristics in patients with increased plasma levels of legumain are still lacking.

Objectives This study aimed to investigate the correlation between legumain and coronary atherosclerotic plaque characteristics.

Methods A total of 81 patients with coronary atherosclerotic heart disease (CHD), including 43 patients with unstable angina (UA) and 38 patients with stable angina (SA), were screened by coronary angiography. Intravascular ultrasound (IVUS) was performed to evaluate the characteristics of coronary atherosclerotic plaques, and plasma legumain levels were also measured. Values of p < 0.05 were considered significant.

Results Legumain concentration was significantly higher in the two CHD subgroups than in the control group (all p<0.001). Legumain concentrations in the UA group were significantly higher than in the SA group (p=0.001). The plaque area, remodeling index (RI), and eccentricity index (EI) in the UA group were significantly higher than those in the SA group (p<0.001, p=0.001, p=0.001, respectively). There was a significant positive correlation between legumain levels and RI and EI in both UA and SA patients (all p<0.05).

Conclusions High plasma levels of legumain were closely related to the occurrence and severity of CHD, and the lesions tended to be unstable. Legumain is expected to be a potential inflammatory biomarker for the diagnosis of CHD and the early identification of unstable coronary lesions.

Coronary Artery Disease; Atherosclerosis; Biomarkers

Central Illustration

: Relationship between Increased Plasma Levels of Legumain and Properties of Coronary Atherosclerotic Plaque

Characteristic	UA(n=43)	SA(n=38)	Control(n=37)	p
Age, yrs	67.0(57.0,71.0)	67.0(52.8,73.0)	66.0(56.0,73.0)	0.624
Male, n(%)	22(51.2)	16(42.1)	18(48.6)	0.707
BMI (kg/m²)	23.40(20.70,27.10)	24.35(20.23,26.33)	25.00(22.60,26.95)	0.361
Hypertension, n (%)	22(51.2)	16(42.1)	16(43.2)	0.669
Diabetes mellitus, n (%)	20(46.5)	12(31.6)	9(24.3)	0.102
Smoking, n (%)	18(41.9)	17(44.7)	15(40.5)	0.931
Drinking, n (%)	21(48.8)	14(36.8)	14(37.8)	0.473
LDL-C (mmol/L)	2.72±0.98	2.53±0.87	2.18±0.73	0.024
HDL-C (mmol/L)	1.04(0.86,1.41)	1.02(0.85,1.24)	0.98(0.77,1.11)	0.431
Homocystein(μmol/L)	13.04(11.23,16.44)	14.10(12.17,16.85)	13.98(11.76,15.71)	0.480
hs-CRP (mg/L)	1.03(0.66,1.78)	1.03(0.59,1.59)	0.98(0.57,1.92)	0.856
Fasting glucose (mmol/L)	6.12(5.57,7.56)	5.91(5.23,7.14)	6.02(5.17,7.21)	0.483
Triglyceride (mmol/L)	1.98(1.30,2.40)	1.87(1.38,2.67)	1.47(1.22,2.14)	0.342
Cholesterol (mmol/L) Statin user, n (%)	4.15(3.59,5.01)29(67.4)	3.99(3.64,5.18)27(71.1)	3.99(3.59,4.73)15(40.5)	0.873 0.012

Variables	UA(n=43)	SA(n=38)	p
Lesion length, mm	31.77±8.80	31.60±7.86	0.930
MLD, mm	1.47(1.33,1.67)	1.44(1.31,1.67)	0.716
MLA, mm²	2.66(2.38,2.95)	2.62(2.09,3.02)	0.936
Plaque area, mm²	13.25±2.19	11.06±1.95	0.000
Plaque burden,%	76.66(71.12,81.29)	73.61(69.44,78.77)	0.195
Remodeling index Positive remodeling [n (%)]	0.99±0.15 17(39.5)	0.89±0.12 4(10.5)	0.001 0.003
Negative remodeling [n (%)] Eccentricity index Eccentric lesion [n (%)]	16(37.2) 0.68±0.11 39(90.7)	26(68.4) 0.60±0.13 28(73.7)	0.005 0.003 0.043
Concentric lesion [n (%)]	4(9.3)	10(26.3)	0.043

	Odds ratio	(95%CI)	p value
UA
Legumain concentration	1.198	1.058-1.356	0.004
Coronary plaque area	1.652	1.150-2.375	0.007

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[TFN1001] Continuous variables are presented as means ± SD, median (interquartile range). Categorical variables were expressed as frequencies and percentages. UA: unstable angina; SA: stable angina; BMI: body index mass; LDL-C: low-density lipoprotein cholesterol; HDL-C: high-density lipoprotein cholesterol; hs-CRP: high-sensitivity C-reactive protein.