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MS482 SUBCLINICAL ATHEROSCLEROSIS IN PATIENTS WITH PSORIATIC ARTHRITIS: THE IMPACT OF BLOOD PRESSURE
78th EAS Congress
Atherosclerosis Supplements 11, no. 2 (2010) 109–222
analyzes the plasma nitrite and CRP levels in claudicating patients during 12 months of treatment with statins. Methods: A prospective study was made of 60 patients with Fontaine grade II, 30 treated with statins for 12 months from the time of diagnosis and 30 without statins as controls. Measurements were made of plasma high-sensitivity CRP (hsCRP) and nitrites at baseline and after one and twelve months. Results: A significant reduction in nitrite levels was observed after one month of treatment (11.8±7.8 mM vs 5.7±1.8 mM; p = 0.0001). This effect didn’t persist (9.4±8.9 mM; p = 0.27) after one year. hsCRP underwent significant reduction after both one month (13.58±24.00 vs 3.93±3.19; p = 0.02) and one year of treatment (4.59±4.94; p = 0.05). Conclusions: Statin therapy reduces the plasma nitrite and CRP levels in patients with peripheral arterial disease from the first month of treatment. The initial effect upon NO bioavailability is not maintained over time, in contrast to what is seen in the case of the inflammatory process. MS482 SUBCLINICAL ATHEROSCLEROSIS IN PATIENTS WITH PSORIATIC ARTHRITIS: THE IMPACT OF BLOOD PRESSURE M. Puato, M. Zanardo, G. Balbi, M. Zanon, E. Faggin, M. Rattazzi, R. Ramonda, A. Lo Nigro, A. Doria, P. Pauletto. Dipartimento di Medicina Clinica e Sperimentale, Universita` di Padova, Padova, Italy Objective: Increased cardiovascular mortality have been observed in rheumatic diseases. We evaluated vascular remodelling in psoriatic arthritis (PsA) according with hypertensive status by studying non-invasively structural and functional properties of arteries. Method: We studied 41 consecutive patients with PsA (of whom, 48% hypertensives). 40 normotensives healthy subjects (N-C) and 18 hypertensives (HT-C) served as controls. We measured by B-mode ultrasound the carotid intima media thickness (IMT) expressed as mean-IMT (cumulative mean of mean IMT measured in each carotid segment, common, bulb, and internal, bilaterally) and as M-MAX (cumulative mean of maximum IMT). Endothelial function was evaluated by post-occlusion flow-mediated dilation (FMD) of the brachial artery using high-sensitivity ultrasonography. NO-independent vasodilation was evaluated by the response to sublingual glyceril-trinitrate (GTN). Results: PsA had a higher mean-IMT compared to N-C (normotensives PsA 0.69 mm, hypertensives PsA 0.71 vs N-C 0.60 mm, p = 0.005). Hypertensive PsA displayed higher M-MAX (0.91 mm) versus both controls (N-C 0.71 and HT-C 0.77 mm, p = 0.007) and normotensive PsA (0.81 mm, p = 0.026). FMD was lower in PsA than in N-C (normotensives PsA 5.7%, hypertensives PsA 6.1% vs NC 8.9%, p < 0.0005), whereas there was no difference between hypertensive PsA, normotensive PsA, and HT-C. GTN was similar in all groups. Conclusions: Subclinical atherosclerosis is enhanced in PsA compared to N-C. In PsA, the hypertensive status exert an additional effect on M-MAX, a parameter of advanced pro-atherogenic remodelling. FMD was reduced in PsA irrespective of hypertensives status. Thus, PsA per se implies a pro-atherogenic remodelling which is enhanced by hypertensive status. MS483 A NOVEL APPROACH THROUGH ELECTROMAGNETIC FORCES TO ATHEROSCLEROSIS R. Paeizi, E. Barzanouni, M. Bokaiyan. Mashhad University of Medical Sciences, Mashhad, Iran Atherosclerosis is a disease in which deposits of fatty substances such as Low Density Lipoprotein (LDL) particles are formed within the intima of large and medium sized elastic and muscular arteries. The formed plaque causes hardening of the artery walls, reduces arteries flow and it can also completely block blood flow. Although there are several hypotheses that explain the mechanism of atherosclerotic plaque formation and analyze the process mechanical or biochemical approaches, it‘s origin has not been completely understood. Our hypothesis approaches this process through a new point of view. It emphasizes on LDL deposition into the intima layer of a coronary artery which is caused by electromagnetic forces produced by flowing electrically charged blood constituents in neighbouring arteries and produced electrical current of heart. The forces act on flowing LDL particles and deflect them, so increase the susceptibility of LDL deposition into the intima layer. Future investigations may help computerizing simulations of electromagnetic forces in the vasculature to reveal highly atherosclerosis-prone regions. Taken together, the role of electromagnetic forces in coronary arteries atherosclerosis can help us design more efficient prophylactic and therapeutic strategies.
207
MS484 EPICARDIAL ADIPOSE TISSUE FATTY ACID BINDING PROTEIN 4 EXPRESSION IS CORRELATED WITH EXTENSION OF CORONARY ATHEROSCLEROSIS IN PATIENTS WITH METABOLIC SYNDROME 1 4 5 S. Gormez ¨ , A. Demirkan2 , F. Atalar3 , B. Caynak ¸ , D. Gunay ¨ , B. Akpınar4 , 3 8 1 ¨ , V. Aytekin6 , N. Yazıcıoglu ˘ 7 , A.S. Buy ¨ ukdevrim ¨ . Cardiology U. Ozbek Department, Florence Nightingale Hospital, Istanbul, Turkey, 2 Department of Genetic Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands, 3 Department of Genetics, Istanbul University, Institute for Experimental Medical Research, 4 Department of Cardiovascular Surgery, Istanbul Bilim University, Faculty of Medicine, 5 Department of Biochemistry, Florence Nightingale Hospital, 6 Department of Cardiology, Istanbul Bilim University, Faculty of Medicine, 7 Department of Cardiology, Florence Nightingale Hospital, 8 Turkish Diabetes Consortium, Istanbul, Turkey Objective: Fatty acid binding proteins are a group of cytosolic lipid carriers that coordinate inflammatory and metabolic responses in cells. Adipocyte fatty-acidbinding protein 4 (FABP4) is a member of adipokines family and expressed in adipocytes and macrophages. It has been shown a strong pathophysiological association between FABP4 and metabolic syndrome (MS), diabetes and atherosclerosis. In this study, we investigated the association between FABP4 and the extent of coronary atherosclerosis in patients with MS. Methods: Between November 2007 and January 2009, 37 patients with MS who were to undergo coronary bypass surgery due to coronary artery disease in our institution were enrolled prospectively to our study. Phenotypic parametres of the study group are presented in Table 1. MS patiens fit the criteria depicted by ATPIII. Patients with pregnancy, chronic renal and hepatic insufficiency, cancer, endocrine and severe psychiatric disease were excluded from the study. Coronary angiography was performed on all of the study patients. The extent of coronary atherosclerosis was assessed by using Sullivan’s scoring system. Relative gene expressions (arbitrary unit) of FABP4 in study group was evaluated in epicardial, pericardial and subcutaneous adipose tissue by using quantitative RT-PCR method. Results: The expression of FABP4 in epicardial adipose tissue was positively correlated with the Sullivan’s score (r: 0.53, p = 0.002). Contrarily, there were no correlation between pericardial and subcutaneous adipose tissue FABP4 expression and Sullivan’s score (r: −0.15, p = 0.40, r: −0.03, p = 0.88, respectively). Conclusion: FABP4 expression in epicardial adipose tissue may be responsible for the coronary atherosclerosis in patients with MS. MS485 PARAMETERS AFFECTING PROGNOSIS OF PATIENTS WITH ACUTE MYOCARDIAL INFARCTION. AN AMI REGISTRY A. Gotsis, I.-A. Kerasidou, A. Gagalis, A. Risggits, D. Theodoridis, A. Koutsogianni, L. Borghi, P. Bozia, M. Konstantarakis, A. Panagiotidou. Cardiology, General Hospital of Komotini, Komotin´ı, Greece Objectives: The aim of this registry was to study the epidemiological and clinical characteristics of AMI (according AHA-WHF-ESC statement), in order to both prevent AMI and treat patients effectively. The aim of this study is to identify the parameters that affect positively prognosis of patients hospitalized with AMI. Methods: We studied 724 patients (506 men, aged 66.6 and 216 women, aged 73.3 years old) hospitalized from January 2005 up to December 2007 with discharge diagnosis of AMI. A detailed medical history was taken emphasizing to risk factors. Statistical analysis was performed by using SPSS 10.0. The methods used were x2 , Mann–Whitney test and Binary Logistic Regression. Results: Older patients (p < 0.001), women (p = 0.008), patients with previous stroke (p = 0.024) and patients who did not receive GP IIb–IIIa inhibitors (p < 0.001) had increased mortality. Hyperlipidaemic patients (p = 0.059) and patients with STEMI (p = 0.065) have a trend to appear increased mortality, but these risk factors do not affect statistically significant patients’ survival after AMI. Based to the results mentioned above, there was an effort to create an algorithm of mortality prediction for patients with AMI by using Binary Logistic Regression. As a result, male sex (p = 0.013, OP = 2.215) and luck of previous stroke (p = 0.019, OP = 2.473) appear to be independent factors of positive prognosis. Conclusions: Older patients, women, patients with previous stroke and patients who did not receive GP IIb–IIIa inhibitors during hospitalization had worse prognosis. According to our algorithm of mortality prediction after AMI, men and patients without previous stroke medical history have positive prognosis.
Atherosclerosis Supplements 11, no. 2 (2010) 109–222
analyzes the plasma nitrite and CRP levels in claudicating patients during 12 months of treatment with statins. Methods: A prospective study was made of 60 patients with Fontaine grade II, 30 treated with statins for 12 months from the time of diagnosis and 30 without statins as controls. Measurements were made of plasma high-sensitivity CRP (hsCRP) and nitrites at baseline and after one and twelve months. Results: A significant reduction in nitrite levels was observed after one month of treatment (11.8±7.8 mM vs 5.7±1.8 mM; p = 0.0001). This effect didn’t persist (9.4±8.9 mM; p = 0.27) after one year. hsCRP underwent significant reduction after both one month (13.58±24.00 vs 3.93±3.19; p = 0.02) and one year of treatment (4.59±4.94; p = 0.05). Conclusions: Statin therapy reduces the plasma nitrite and CRP levels in patients with peripheral arterial disease from the first month of treatment. The initial effect upon NO bioavailability is not maintained over time, in contrast to what is seen in the case of the inflammatory process. MS482 SUBCLINICAL ATHEROSCLEROSIS IN PATIENTS WITH PSORIATIC ARTHRITIS: THE IMPACT OF BLOOD PRESSURE M. Puato, M. Zanardo, G. Balbi, M. Zanon, E. Faggin, M. Rattazzi, R. Ramonda, A. Lo Nigro, A. Doria, P. Pauletto. Dipartimento di Medicina Clinica e Sperimentale, Universita` di Padova, Padova, Italy Objective: Increased cardiovascular mortality have been observed in rheumatic diseases. We evaluated vascular remodelling in psoriatic arthritis (PsA) according with hypertensive status by studying non-invasively structural and functional properties of arteries. Method: We studied 41 consecutive patients with PsA (of whom, 48% hypertensives). 40 normotensives healthy subjects (N-C) and 18 hypertensives (HT-C) served as controls. We measured by B-mode ultrasound the carotid intima media thickness (IMT) expressed as mean-IMT (cumulative mean of mean IMT measured in each carotid segment, common, bulb, and internal, bilaterally) and as M-MAX (cumulative mean of maximum IMT). Endothelial function was evaluated by post-occlusion flow-mediated dilation (FMD) of the brachial artery using high-sensitivity ultrasonography. NO-independent vasodilation was evaluated by the response to sublingual glyceril-trinitrate (GTN). Results: PsA had a higher mean-IMT compared to N-C (normotensives PsA 0.69 mm, hypertensives PsA 0.71 vs N-C 0.60 mm, p = 0.005). Hypertensive PsA displayed higher M-MAX (0.91 mm) versus both controls (N-C 0.71 and HT-C 0.77 mm, p = 0.007) and normotensive PsA (0.81 mm, p = 0.026). FMD was lower in PsA than in N-C (normotensives PsA 5.7%, hypertensives PsA 6.1% vs NC 8.9%, p < 0.0005), whereas there was no difference between hypertensive PsA, normotensive PsA, and HT-C. GTN was similar in all groups. Conclusions: Subclinical atherosclerosis is enhanced in PsA compared to N-C. In PsA, the hypertensive status exert an additional effect on M-MAX, a parameter of advanced pro-atherogenic remodelling. FMD was reduced in PsA irrespective of hypertensives status. Thus, PsA per se implies a pro-atherogenic remodelling which is enhanced by hypertensive status. MS483 A NOVEL APPROACH THROUGH ELECTROMAGNETIC FORCES TO ATHEROSCLEROSIS R. Paeizi, E. Barzanouni, M. Bokaiyan. Mashhad University of Medical Sciences, Mashhad, Iran Atherosclerosis is a disease in which deposits of fatty substances such as Low Density Lipoprotein (LDL) particles are formed within the intima of large and medium sized elastic and muscular arteries. The formed plaque causes hardening of the artery walls, reduces arteries flow and it can also completely block blood flow. Although there are several hypotheses that explain the mechanism of atherosclerotic plaque formation and analyze the process mechanical or biochemical approaches, it‘s origin has not been completely understood. Our hypothesis approaches this process through a new point of view. It emphasizes on LDL deposition into the intima layer of a coronary artery which is caused by electromagnetic forces produced by flowing electrically charged blood constituents in neighbouring arteries and produced electrical current of heart. The forces act on flowing LDL particles and deflect them, so increase the susceptibility of LDL deposition into the intima layer. Future investigations may help computerizing simulations of electromagnetic forces in the vasculature to reveal highly atherosclerosis-prone regions. Taken together, the role of electromagnetic forces in coronary arteries atherosclerosis can help us design more efficient prophylactic and therapeutic strategies.
207
MS484 EPICARDIAL ADIPOSE TISSUE FATTY ACID BINDING PROTEIN 4 EXPRESSION IS CORRELATED WITH EXTENSION OF CORONARY ATHEROSCLEROSIS IN PATIENTS WITH METABOLIC SYNDROME 1 4 5 S. Gormez ¨ , A. Demirkan2 , F. Atalar3 , B. Caynak ¸ , D. Gunay ¨ , B. Akpınar4 , 3 8 1 ¨ , V. Aytekin6 , N. Yazıcıoglu ˘ 7 , A.S. Buy ¨ ukdevrim ¨ . Cardiology U. Ozbek Department, Florence Nightingale Hospital, Istanbul, Turkey, 2 Department of Genetic Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands, 3 Department of Genetics, Istanbul University, Institute for Experimental Medical Research, 4 Department of Cardiovascular Surgery, Istanbul Bilim University, Faculty of Medicine, 5 Department of Biochemistry, Florence Nightingale Hospital, 6 Department of Cardiology, Istanbul Bilim University, Faculty of Medicine, 7 Department of Cardiology, Florence Nightingale Hospital, 8 Turkish Diabetes Consortium, Istanbul, Turkey Objective: Fatty acid binding proteins are a group of cytosolic lipid carriers that coordinate inflammatory and metabolic responses in cells. Adipocyte fatty-acidbinding protein 4 (FABP4) is a member of adipokines family and expressed in adipocytes and macrophages. It has been shown a strong pathophysiological association between FABP4 and metabolic syndrome (MS), diabetes and atherosclerosis. In this study, we investigated the association between FABP4 and the extent of coronary atherosclerosis in patients with MS. Methods: Between November 2007 and January 2009, 37 patients with MS who were to undergo coronary bypass surgery due to coronary artery disease in our institution were enrolled prospectively to our study. Phenotypic parametres of the study group are presented in Table 1. MS patiens fit the criteria depicted by ATPIII. Patients with pregnancy, chronic renal and hepatic insufficiency, cancer, endocrine and severe psychiatric disease were excluded from the study. Coronary angiography was performed on all of the study patients. The extent of coronary atherosclerosis was assessed by using Sullivan’s scoring system. Relative gene expressions (arbitrary unit) of FABP4 in study group was evaluated in epicardial, pericardial and subcutaneous adipose tissue by using quantitative RT-PCR method. Results: The expression of FABP4 in epicardial adipose tissue was positively correlated with the Sullivan’s score (r: 0.53, p = 0.002). Contrarily, there were no correlation between pericardial and subcutaneous adipose tissue FABP4 expression and Sullivan’s score (r: −0.15, p = 0.40, r: −0.03, p = 0.88, respectively). Conclusion: FABP4 expression in epicardial adipose tissue may be responsible for the coronary atherosclerosis in patients with MS. MS485 PARAMETERS AFFECTING PROGNOSIS OF PATIENTS WITH ACUTE MYOCARDIAL INFARCTION. AN AMI REGISTRY A. Gotsis, I.-A. Kerasidou, A. Gagalis, A. Risggits, D. Theodoridis, A. Koutsogianni, L. Borghi, P. Bozia, M. Konstantarakis, A. Panagiotidou. Cardiology, General Hospital of Komotini, Komotin´ı, Greece Objectives: The aim of this registry was to study the epidemiological and clinical characteristics of AMI (according AHA-WHF-ESC statement), in order to both prevent AMI and treat patients effectively. The aim of this study is to identify the parameters that affect positively prognosis of patients hospitalized with AMI. Methods: We studied 724 patients (506 men, aged 66.6 and 216 women, aged 73.3 years old) hospitalized from January 2005 up to December 2007 with discharge diagnosis of AMI. A detailed medical history was taken emphasizing to risk factors. Statistical analysis was performed by using SPSS 10.0. The methods used were x2 , Mann–Whitney test and Binary Logistic Regression. Results: Older patients (p < 0.001), women (p = 0.008), patients with previous stroke (p = 0.024) and patients who did not receive GP IIb–IIIa inhibitors (p < 0.001) had increased mortality. Hyperlipidaemic patients (p = 0.059) and patients with STEMI (p = 0.065) have a trend to appear increased mortality, but these risk factors do not affect statistically significant patients’ survival after AMI. Based to the results mentioned above, there was an effort to create an algorithm of mortality prediction for patients with AMI by using Binary Logistic Regression. As a result, male sex (p = 0.013, OP = 2.215) and luck of previous stroke (p = 0.019, OP = 2.473) appear to be independent factors of positive prognosis. Conclusions: Older patients, women, patients with previous stroke and patients who did not receive GP IIb–IIIa inhibitors during hospitalization had worse prognosis. According to our algorithm of mortality prediction after AMI, men and patients without previous stroke medical history have positive prognosis.