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BASELINE DATA OF JPPP (THE LARGE RANDOMIZED CONTROLLED TRIAL OF PRIMARY PREVENTION BY ENTERIC COATED LOW-DOSE ASPIRIN IN JAPAN)
220
Publication Only
Conclusion: The present work shows that targeted familyscreening is a highly effective approach to identify persons at high risk for cardiovascular disease. Therefore it could serve as a preventive tool against cardiovascular mortality and morbidity. 22
BASELINE DATA OF JPPP (THE LARGE RANDOMIZED CONTROLLED TRIAL OF PRIMARY PREVENTION BY ENTERIC COATED LOW-DOSE ASPIRIN IN JAPAN)
T. Teramoto 1 , Y. Ikeda 2 , T. Fujita 3 , Y. Goto 4 , S. Oikawa 5 , K. Shimada 6 , S. Uchiyama 7 , N. Yamada 8 , T. Yamazaki 9 . 1 Internal Medicine, Teikyo University School of Medicine; 2 Internal Medicine, Keio University School of Medicine; 3 Department of Internal Medicine, Graduate School of Medicine, University of Tokyo; 4 President of the Japan Physicians Association; 5 Third Department of Internal Medicine, Nippon Medical School; 6 Department of Cardiology, Jichi Medical School; 7 Department of Neurosurgery, Neurological Institute, Tokyo Women’s Medical University; 8 Department of Metabolism, Endocrinology and Atherosclerosis, University of Tsukuba Graduate School of Comprehensive Human Sciences; 9 Department of Clinical Bioinfomatics, Graduate School of Medicine, Faculty of Medicine, University of Tokyo Background and aims: It is important to establish a preventative treatment for atherosclerotic diseases from the point of public health. Though major guidelines in the world including Japan recommend use of aspirin for primary prevention of high-risk patients, these guidelines are founded mainly by the data from secondary prevention. The benefits of aspirin for primary prevention are still controversial. To investigate the risk/benefit balance of primary prevention by enteric-coated low-dose aspirin, we have conducted this study. Methods: JPPP is a multicenter, open-label, centrally-randomized, controlled trial. In total, 15,000 elderly patients with one or more cardio/cerebrovascular (CV) risk factors (aged 60-85 years combined with hypertension, dyslipidemia and/or diabetes mellitus) will be assigned to enteric-coated aspirin (100mg/day) or control, and will be followed for at least 4 years. The primary end point is composite event of CV death, nonfatal stroke and nonfatal MI. Assessment of endpoints will be blinded. Results: The FPFV of JPPP was on March 2005. The enrollment of 14,660 patients was completed on the end of June 2007. We report baseline data of the enrolled patients. Hypertension (HT): 85%, dyslipidemia (DL): 72%, diabetes (DM): 34%. HT & DL w/o DM: 39%, HT & DM w/o DL: 6.8%, HL & DM w/o HT: 4.9%, HT, HL & DM: 20%. The patients who had three risks or more were 80%. Conclusion: We can get the latest epidemiological data of elderly patients in Japan from JPPP. This result was the average elderly patients who take care with the general physicians in Japan.
include the patients with non-obstructive CAD and control subjects with angiographically normal coronary arteries and as high as in patients with obstructive CAD. In conclusion our study findings show that leukocytes may have an important role in the development of CAE independently from atherosclerotic process. 24
METABOLIC SYNDROME IN A HOSPITAL HYPERTENSION UNIT
C. Culebras 2 , L. Lopez y Juan 1 , M. Irurita 1 , E. Bosch 2 , J. Irurita 1 , R. Chirino 3 , L. Suarez 2 , B. Saiz 2 , P. Rossique 2 , R. Guerra 2 , M. Martinez Saavedra 1 , C. Deniz 1 , N. Saez 1 , J. Lopez y Juan 4 , V. Nieto 2 . 1 Dr Negrin Hospital, Las Palmas GC, Spain; 2 Insular Hospital, Las Palmas GC, Spain; 3 Las Palmas de Gran Canaria University, Las Palmas GC, Spain; 4 Primary Care, SERGAS, Lugo, Spain Many countries have limited information on the prevalence of metabolic syndrome. AIM: Assess the prevalence of metabolic syndrome (MS) among hypertensive patients in a Hospital Hypertension Unit (HU), together with cardiovascular risk factors, target organ damage and co-morbidities in an island community with twice the continental prevalence of obesity and diabetes. Method: We enrolled 186 consecutive hypertensive patients attending our HU during 2006. Demographic data were completed with antropometric variables, blood pressure, lipid profile, uric acid, creatinine, microalbuminuria, C reactive protein, left ventricular hypertrophy, comorbidities and treatment. International Diabetes Federation (IDF) and Adult Treatment Panel (ATP III) criteria were compared. Results: Up to 56% were males, mean age 53 y-o. A total of 68%, met ATP III criteria and 74% IDF; 80% of females and 58% of males had MS. Mean waist circumference was 99.3 cm (females) and 101.1 (males). Diabetes was diagnosed in 24%, dyslipidemia in 63%, obesity in 49%; left ventricular hypertrophy was found in 49.3%. Microalbuminuria was detected in 30.4%, while 40% had cardiac disease and 46% renal disease. Patients with MS were older, had higher systolic pressure, bigger waist perimeter and higher body mass index. MS population had more left ventricular hypertrophy, renal and cardiac diseases were more prevalent (p<0.05), and received more antihypertensive drugs (p<0.05). Conclusions: The prevalence of metabolic syndrome in our University Hospital Hypertension Unit is very high, particularly among females. Metabolic syndrome was associated with more severe hypertension, higher cardiovascular risk and target organ damage. 25
GAMMA-GLUTAMYLTRANSFERASE DEPOSITS IN HUMAN ATHEROSCLEROTIC PLAQUES: POTENTIAL RELATIONSHIPS WITH THE CIRCULATING ENZYME
S. Kocaman, G. Tacoy, A. Sahinarslan, ¸ A. Cengel. Gazi University School of Medicine, Department of Cardiology
M. Franzini 1 , A. Corti 1 , B. Martinelli 1 , A. Del Corso 2 , M. Emdin 3 , G. Parenti 4 , M. Glauber 5 , A. Pompella 1 , A. Paolicchi 1 . 1 Dept. of Experimental Pathology, University of Pisa Medical School; 2 Department of Biology, University of Pisa; 3 Institute of Clinical Physiology, National Research Council-CNR, Pisa; 4 Dept. of Neurosciences, University of Pisa Medical School; 5 Dept. of Cardiac Surgery, Ospedale
Coronary artery ectasia (CAE) is a clinical entity characterized with localized or diffuse dilation of ≥1.5 times normal adjacent segments of vessels. Although the etiopathogenesis is not clearly understood; in some studies it has been shown that CAE may be a form of atherosclerosis and has increased inflammatory properties. Leucocytes have a crucial role in the development of inflamatuar processes. We aimed to investigate possible relationship between leukocytes and coronary ectatic process without coronary artery disease (CAD) and to compare with the inflammatory atherosclerotic process related with leukocytes. Our study population consisted of 371 patients. We divided the patients into three groups. 42 patients with isolated CAE as group I, 279 patients with CAD as group II, 50 control subjects with normal coronary arteries (NCA) as group III were classified. The counts of total leukocytes (7348±1898 and 7569±1619 cell/mm3 vs. 6770±1748 cell/mm3 , p=0.002), neutrophils (4260±2169 and 4529±1380 cell/mm3 vs. 4040±1649 cell/mm3 , p=0.037) and monocytes (630±216 and 583±198 cell/mm3 vs. 480±140 cell/mm3 , p<0.001) were increased significantly in CAE and CAD patients relative to NCA control. Our study results demonstrate that leukocytes, which play important role in inflamation, are increased in patients with isolated CAE. Leukocyte counts in this group were significantly higher than the groups which
Aims: Serum gamma-glutamyltransferase (GGT) activity has been identified as a predictor of complications of coronary atherosclerosis. Human atherosclerotic lesions contain active GGT, which can give rise to pro-oxidant molecular species; thus a direct contribution of GGT to atherosclerosis progression is conceivable. The relationship between plaque and serum GGT is however unclear. Methods and results: Human carotid plaques were analyzed. The characteristics of GGT protein were compared in plaque homogenates and in serum obtained from healthy donors. The methods employed (anion exchange and gel chromatography, western-blot) showed the presence in plaque homogenates of two distinct GGT proteins, one of which comparable with plasma LDL/GGT complexes. In addition, precipitation of beta-lipoproteins from plaque homogenates resulted in removal of GGT activity. RT-PCR indicated in plaques the presence of the GGT mRNA. Analysis of plaque extracts also revealed the presence of enzyme product cysteinyl-glycine both as free and protein-bound form, confirming that GGT-dependent pro-oxidant reactions may occur within the plaque environment. Conclusion: The results obtained suggest the presence in plaques of a GGT protein having serum like features, indicating that a direct
23
RELATIONSHIP BETWEEN TOTAL AND DIFFERENTIAL LEUKOCYTE COUNTS AND ISOLATED CORONARY ARTERY ECTASIA
77th Congress of the European Atherosclerosis Society, April 26–29, 2008, Istanbul, Turkey
Publication Only
Conclusion: The present work shows that targeted familyscreening is a highly effective approach to identify persons at high risk for cardiovascular disease. Therefore it could serve as a preventive tool against cardiovascular mortality and morbidity. 22
BASELINE DATA OF JPPP (THE LARGE RANDOMIZED CONTROLLED TRIAL OF PRIMARY PREVENTION BY ENTERIC COATED LOW-DOSE ASPIRIN IN JAPAN)
T. Teramoto 1 , Y. Ikeda 2 , T. Fujita 3 , Y. Goto 4 , S. Oikawa 5 , K. Shimada 6 , S. Uchiyama 7 , N. Yamada 8 , T. Yamazaki 9 . 1 Internal Medicine, Teikyo University School of Medicine; 2 Internal Medicine, Keio University School of Medicine; 3 Department of Internal Medicine, Graduate School of Medicine, University of Tokyo; 4 President of the Japan Physicians Association; 5 Third Department of Internal Medicine, Nippon Medical School; 6 Department of Cardiology, Jichi Medical School; 7 Department of Neurosurgery, Neurological Institute, Tokyo Women’s Medical University; 8 Department of Metabolism, Endocrinology and Atherosclerosis, University of Tsukuba Graduate School of Comprehensive Human Sciences; 9 Department of Clinical Bioinfomatics, Graduate School of Medicine, Faculty of Medicine, University of Tokyo Background and aims: It is important to establish a preventative treatment for atherosclerotic diseases from the point of public health. Though major guidelines in the world including Japan recommend use of aspirin for primary prevention of high-risk patients, these guidelines are founded mainly by the data from secondary prevention. The benefits of aspirin for primary prevention are still controversial. To investigate the risk/benefit balance of primary prevention by enteric-coated low-dose aspirin, we have conducted this study. Methods: JPPP is a multicenter, open-label, centrally-randomized, controlled trial. In total, 15,000 elderly patients with one or more cardio/cerebrovascular (CV) risk factors (aged 60-85 years combined with hypertension, dyslipidemia and/or diabetes mellitus) will be assigned to enteric-coated aspirin (100mg/day) or control, and will be followed for at least 4 years. The primary end point is composite event of CV death, nonfatal stroke and nonfatal MI. Assessment of endpoints will be blinded. Results: The FPFV of JPPP was on March 2005. The enrollment of 14,660 patients was completed on the end of June 2007. We report baseline data of the enrolled patients. Hypertension (HT): 85%, dyslipidemia (DL): 72%, diabetes (DM): 34%. HT & DL w/o DM: 39%, HT & DM w/o DL: 6.8%, HL & DM w/o HT: 4.9%, HT, HL & DM: 20%. The patients who had three risks or more were 80%. Conclusion: We can get the latest epidemiological data of elderly patients in Japan from JPPP. This result was the average elderly patients who take care with the general physicians in Japan.
include the patients with non-obstructive CAD and control subjects with angiographically normal coronary arteries and as high as in patients with obstructive CAD. In conclusion our study findings show that leukocytes may have an important role in the development of CAE independently from atherosclerotic process. 24
METABOLIC SYNDROME IN A HOSPITAL HYPERTENSION UNIT
C. Culebras 2 , L. Lopez y Juan 1 , M. Irurita 1 , E. Bosch 2 , J. Irurita 1 , R. Chirino 3 , L. Suarez 2 , B. Saiz 2 , P. Rossique 2 , R. Guerra 2 , M. Martinez Saavedra 1 , C. Deniz 1 , N. Saez 1 , J. Lopez y Juan 4 , V. Nieto 2 . 1 Dr Negrin Hospital, Las Palmas GC, Spain; 2 Insular Hospital, Las Palmas GC, Spain; 3 Las Palmas de Gran Canaria University, Las Palmas GC, Spain; 4 Primary Care, SERGAS, Lugo, Spain Many countries have limited information on the prevalence of metabolic syndrome. AIM: Assess the prevalence of metabolic syndrome (MS) among hypertensive patients in a Hospital Hypertension Unit (HU), together with cardiovascular risk factors, target organ damage and co-morbidities in an island community with twice the continental prevalence of obesity and diabetes. Method: We enrolled 186 consecutive hypertensive patients attending our HU during 2006. Demographic data were completed with antropometric variables, blood pressure, lipid profile, uric acid, creatinine, microalbuminuria, C reactive protein, left ventricular hypertrophy, comorbidities and treatment. International Diabetes Federation (IDF) and Adult Treatment Panel (ATP III) criteria were compared. Results: Up to 56% were males, mean age 53 y-o. A total of 68%, met ATP III criteria and 74% IDF; 80% of females and 58% of males had MS. Mean waist circumference was 99.3 cm (females) and 101.1 (males). Diabetes was diagnosed in 24%, dyslipidemia in 63%, obesity in 49%; left ventricular hypertrophy was found in 49.3%. Microalbuminuria was detected in 30.4%, while 40% had cardiac disease and 46% renal disease. Patients with MS were older, had higher systolic pressure, bigger waist perimeter and higher body mass index. MS population had more left ventricular hypertrophy, renal and cardiac diseases were more prevalent (p<0.05), and received more antihypertensive drugs (p<0.05). Conclusions: The prevalence of metabolic syndrome in our University Hospital Hypertension Unit is very high, particularly among females. Metabolic syndrome was associated with more severe hypertension, higher cardiovascular risk and target organ damage. 25
GAMMA-GLUTAMYLTRANSFERASE DEPOSITS IN HUMAN ATHEROSCLEROTIC PLAQUES: POTENTIAL RELATIONSHIPS WITH THE CIRCULATING ENZYME
S. Kocaman, G. Tacoy, A. Sahinarslan, ¸ A. Cengel. Gazi University School of Medicine, Department of Cardiology
M. Franzini 1 , A. Corti 1 , B. Martinelli 1 , A. Del Corso 2 , M. Emdin 3 , G. Parenti 4 , M. Glauber 5 , A. Pompella 1 , A. Paolicchi 1 . 1 Dept. of Experimental Pathology, University of Pisa Medical School; 2 Department of Biology, University of Pisa; 3 Institute of Clinical Physiology, National Research Council-CNR, Pisa; 4 Dept. of Neurosciences, University of Pisa Medical School; 5 Dept. of Cardiac Surgery, Ospedale
Coronary artery ectasia (CAE) is a clinical entity characterized with localized or diffuse dilation of ≥1.5 times normal adjacent segments of vessels. Although the etiopathogenesis is not clearly understood; in some studies it has been shown that CAE may be a form of atherosclerosis and has increased inflammatory properties. Leucocytes have a crucial role in the development of inflamatuar processes. We aimed to investigate possible relationship between leukocytes and coronary ectatic process without coronary artery disease (CAD) and to compare with the inflammatory atherosclerotic process related with leukocytes. Our study population consisted of 371 patients. We divided the patients into three groups. 42 patients with isolated CAE as group I, 279 patients with CAD as group II, 50 control subjects with normal coronary arteries (NCA) as group III were classified. The counts of total leukocytes (7348±1898 and 7569±1619 cell/mm3 vs. 6770±1748 cell/mm3 , p=0.002), neutrophils (4260±2169 and 4529±1380 cell/mm3 vs. 4040±1649 cell/mm3 , p=0.037) and monocytes (630±216 and 583±198 cell/mm3 vs. 480±140 cell/mm3 , p<0.001) were increased significantly in CAE and CAD patients relative to NCA control. Our study results demonstrate that leukocytes, which play important role in inflamation, are increased in patients with isolated CAE. Leukocyte counts in this group were significantly higher than the groups which
Aims: Serum gamma-glutamyltransferase (GGT) activity has been identified as a predictor of complications of coronary atherosclerosis. Human atherosclerotic lesions contain active GGT, which can give rise to pro-oxidant molecular species; thus a direct contribution of GGT to atherosclerosis progression is conceivable. The relationship between plaque and serum GGT is however unclear. Methods and results: Human carotid plaques were analyzed. The characteristics of GGT protein were compared in plaque homogenates and in serum obtained from healthy donors. The methods employed (anion exchange and gel chromatography, western-blot) showed the presence in plaque homogenates of two distinct GGT proteins, one of which comparable with plasma LDL/GGT complexes. In addition, precipitation of beta-lipoproteins from plaque homogenates resulted in removal of GGT activity. RT-PCR indicated in plaques the presence of the GGT mRNA. Analysis of plaque extracts also revealed the presence of enzyme product cysteinyl-glycine both as free and protein-bound form, confirming that GGT-dependent pro-oxidant reactions may occur within the plaque environment. Conclusion: The results obtained suggest the presence in plaques of a GGT protein having serum like features, indicating that a direct
23
RELATIONSHIP BETWEEN TOTAL AND DIFFERENTIAL LEUKOCYTE COUNTS AND ISOLATED CORONARY ARTERY ECTASIA
77th Congress of the European Atherosclerosis Society, April 26–29, 2008, Istanbul, Turkey