LAUSR

BACKGROUND Plasma ceramides (Cer), a subset of bioactive lipids, have mechanistic links to atherosclerotic coronary artery disease (CAD) pathogenesis and are related to major adverse cardiovascular events (MACEs). OBJECTIVES This study aimed to explore the associations between plasma Cer and atherosclerotic burden evaluated by Synergy Between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) score. METHODS AND RESULTS A retrospective series of 248 ST-segment elevation myocardial infarction (STEMI) patients undergoing interventional procedures and plasma ceramides measurement were enrolled. Rapid resolution liquid chromatography coupled with quadrupole time-of-flight mass spectrometry (RRLC-Q-TOF/MS) was used to evaluate plasma Cer concentrations. SYNTAX score was automatically calculated on the SYNTAX website (http://www.syntaxscore.com/). Patients with STEMI had higher plasma MACEs-related ceramide levels than normal donors (p < .001). Pearson correlation analysis showed positive correlations between SYNTAX score and Cer(d18:1/16:0) (r = 0.176, p = .006), Cer(d18:1/18:0) (r = 0.290, p < .001), Cer(d18:1/24:1) (r = 0.209, p = .001) and Cer(d18:1/24:0) (r = 0.134, p = .036). Adjustments for all traditional risks, higher Cer(d18:1/16:0) level (per SD increase, β (95%CI) =10.681 (1.912-19.923), p = .032), Cer(d18:1/18:0) level (per SD increase, β (95%CI) =38.830 (15.444-62.126), p = .001), Cer(d18:1/24:1) level (per SD increase, β (95%CI) =6.122 (1.640-10.605), p = .008) (except for and Cer(d18:1/24:0) level (per SD increase, β (95%CI) =0.999 (-0.508-2.506), p = .193)) were independently associated with higher levels of SYNTAX score. CONCLUSIONS Elevated plasma levels of Cer (d18:1/16:0), Cer(d18:1/18:0) and Cer(d18:1/24:1)) are independent predictors for a high atherosclerotic burden in patients with STEMI. Our findings provide evidence supporting proatherogenic roles of Cer.