Paraoxonase-1 and symptomatic status in carotid artery disease.Ann Vasc Surg 2019AV
Paraoxonase-1 (PON-1) is a high-density-lipoprotein associated hydrolase that appears to have a protective action against atherosclerosis. The aim of our study is to identify whether PON-1 levels may be associated with the manifestation of symptoms in patients with carotid artery stenosis.
We studied all patients who underwent carotid endarterectomy in the Vascular Surgery Department of Laikon Hospital, Athens, Greece, from July 2012 to July 2014. Medical history was recorded and PON-1 glucose, total cholesterol, high-density lipoprotein cholesterol, low-density-lipoprotein cholesterol and triglycerides levels were measured. Variables were compared between symptomatic and asymptomatic patients. A receiver operating characteristic (ROC) curve was constructed in order to evaluate accuracy of PON-1 to predict symptoms.
74 patients were included, 41 were asymptomatic and mean age was 68.5 years. The 2 groups appear to differ significantly with regards to the PON-1 levels, with the symptomatic group showing lower levels (5.3±1.19 vs 4.6±1.36 ng/ml; p=0.025). ROC analysis demonstrated an area under the curve of 0.654 (p=0.023).
Reduced PON-1 levels showed a significant association with symptomatic status, which was independent of other traditional cardiovascular factors. Further studies are required to prospectively assess the role of PON-1 in predicting cerebrovascular events in patients with carotid artery disease.