Publication: Indoleamine 2,3 dioxygenase (IDO) level as a marker for significant coronary artery disease
Issued Date
2021-12-01
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ISSN
14712261
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2-s2.0-85111298700
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Mahidol University
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SCOPUS
Bibliographic Citation
BMC Cardiovascular Disorders. Vol.21, No.1 (2021)
Suggested Citation
Nattawut Wongpraparut, Ploy Pengchata, Sudarat Piyophirapong, Pariya Panchavinnin, Rungtiwa Pongakasira, Noppadol Arechep, Kanda Kasetsinsombat, Kittipong Maneechotesuwan Indoleamine 2,3 dioxygenase (IDO) level as a marker for significant coronary artery disease. BMC Cardiovascular Disorders. Vol.21, No.1 (2021). doi:10.1186/s12872-021-02140-0 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/77554
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Title
Indoleamine 2,3 dioxygenase (IDO) level as a marker for significant coronary artery disease
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Abstract
Background: Indoleamine 2,3 dioxygenase (IDO), the rate-limiting enzyme in the kynurenine (Kyn) pathway of tryptophan (Trp) degradation, is modulated by inflammation, and is regarded as a key molecule driving immunotolerance and immunosuppressive mechanisms. Little is known about IDO activity in patients with active coronary artery disease (CAD). Methods: We prospectively enrolled patients who were scheduled to undergo coronary angiography. Measurement of IDO, high-sensitivity troponin T (hs-TnT), and high-sensitivity C-reactive protein (hs-CRP) levels was performed at baseline, and IDO activity was monitored at the 6-month follow-up. Results: Three hundred and five patients were enrolled. Ninety-eight patients (32.1%) presented with recent acute coronary syndrome (ACS). Significant difference in IDO, kynurenine, and hs-TnT between patients with and without significant CAD was observed. Baseline IDO activity, kynurenine level, and hs-TnT level were all significantly higher in significant CAD patients with 3-vessel, 2-vessel, and 1-vessel involvement than in those with insignificant CAD [(0.17, 0.13, and 0.16 vs. 0.03, respectively; p = 0.003), (5.89, 4.58, and 5.24 vs. 2.74 µM/g, respectively; p = 0.011), and (18.27, 12.22, and 12.86 vs. 10.89 mg/dL, respectively; p < 0.001)]. One-year mortality was 3.9%. When we compared between patients who survived and patients who died, we found a significantly lower prevalence of left main (LM) disease by coronary angiogram (6.1% vs. 33.3%, p = 0.007), and also a trend toward higher baseline kynurenine (5.07 vs. 0.79 µM/g, p = 0.082) and higher IDO (0.15 vs. 0.02, p = 0.081) in patients who survived. Conclusion: Immunometabolic response mediated via IDO function was enhanced in patients with CAD, and correlated with the extent and severity of disease. Patients with LM disease had higher 1-year mortality. Lower level of IDO, as suggested by inadequate IDO response, demonstrated a trend toward predicting 1-year mortality. Trial registration TCTR Trial registration number TCTR20200626001. Date of registration 26 June 2020. “Retrospectively registered”.