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α1-acid glycoprotein but not C-reactive protein discriminates late restenosis after cartoid endarterectomy
Wednesday June 28,200O: PosterAbstracts P: W20 Triglycerides and CVD
176
IWeP4
Systemic mechanisms disposition to stroke
W19
S.M. Kuznetsova,
1.1. Glazovskaya.
of formation of hereditary
Institute of Gerontology, Kiev, Ukraine
Objective: Study on the state of cerebral hemodynamics and lipid metabolism in subjects with a hereditary disposition to stroke. Methods: Relatives of stroke patients 1st and 2nd kinship degree aged 20-79 years (RSP, n = 210) and control subjects without cerebrovascular pathology in their genealogy (C, n = 150) were examined by ultrasound dopplerography for cerebral hemodynamics, and lipid and lipoproteid contents. Results: There were structural-functional changes of extracranial (ECA) and intracranial sinus carotid arteries in 27% and 12%, respectively, of RSP and only in 10% of C (ECA case). In RSP of all age groups (20 to 79), linear blood flow velocity (LBFV) in ECA and medial cerebral artery was lower compared to C, while at 50-59 years it corresponded to LBFV characteristic of stroke patients (54.0 + 6.7 and 51.2 + 8.8 cm/s, respectively). In RSP, LBFV asymmetry (more than 30%) was highest at 40-49 and 50-59 years, i.e. 25% and 3% (8% and 7% in C). At 50-59 years, marked atherosclerotic changes of cerebral vessels were diagnosed in 25% of RSP (10% in C). Blood cholesterol level exceeded the norm (>6.6 mM/l) in 38% of RSP (in 15.3% of C). After 2&29 years, apoA1 concentration was lower in RSP than in C (1.4 + 0.2 vs. 2.28 + 0.1 mg/ml). Correlation coefficients between apoA1 and HDL contents of stroke patients and their relatives were 0.87 and 0.75. Conclusion: The specifics of cerebral hemodynamics and lipid metabolism should be considered as systemic manifestations of the hereditary disposition to stroke.
IWeP5 W19
al-acid glycoproteh~ but not C-reactive protein discriminates late restenosis after cartoid endarterectomy
B. Millo, H. Kupicz, I. Wiemicki, B. Trojnacka, R. Turowski, P. Gutowski, M. Naruszewicz. Pomeranian Medical University, Szczecin, Poland Objective: To search among acute-phase reactants and lipids for a discriminant of carotid restenosis after carotid endarterectomy. Material and Methods: Patients with internal cartoid stenosis > 70% as assessed by color Doppler USG, and DSA when necessary, underwent endarteroctomy during the past six years. Postoperative assessment (USG/DSA) was done 30 days after surgery, every three months during the first year, and every six months thereafter. Two groups were subsequently formed: with (n = 17, mean age 61.9 f 5.8) or without (n = 16, mean age 59.9 f 9.1) restenosis. Lipids: Total, LDL and HDL cholesterol (Ch, LDL-Ch, HDL-Ch), and triglycerides (Tg) were measured using commercial kits. Acute phase reactants: C-reactive protein (CRP), ot -acid glycoprotein (AAG), prealbumin (PAP), complement C-3 and factor B, were measured with an immunonephelometric method (Array 360 instrument from Beckman). Results: Lipids Ch, LDL-Ch, HDL-Ch and Tg levels were elevated in both groups (Ch: 262.8 f 39.0 mg/dl vs 263.6 f 47.7 mg/dl; LDL-Ch: 168.3 f 39.8 mg/dl vs 170.6 & 44.3 mgAll; HDL-Ch: 42.7 f 14.2 mg/dl vs 38.4 f 12.1 mg/dl; Tg: 206.7 f 157.1 mg/dl vs 280.8 ZIZ215.1 mg/dl - with vs without restenosis). No statisticaJly significant differences were found. Acute phase reactants AAG level was significantly higher in the restenosis group (114.7 f 18.9 mg/dl vs 99.5 f 18.1 mg/dl; p < 0.02). CRP was increased in both groups (4.7 f 3.7 mg/l vs 3.4 f 1.9 mg/l) but without statistical significance. Conclusion: cut-acid glycoprotein seems to be superior to CRP in discriminating patients with late restenosis after cartoid endarteroctomy.
Methods: We undertook an open forced-titration dose-response study of increasing doses of mF (67, 134 & 201 mg/d) on PP Tg values, in 38 patients (pts) with fasting Tg > 250 mg/dl. Determinations of lipids following an oral fat load (1 g/kg) were performed on four occasions: after a 4-wk NCEP Step 1 diet and after each 4-wk treatment with ml? Results: A linear cumulative dose-effect was demonstrated on fasting values: Tg: 450 f 235 to 196 f 83 mg/dl; TC: 234 f 49 to 208 f 40 mg/dl; HDL: 38 f 13 to 44 z!= 14 mg/dl; Apo B: 144 f 43 to 126 f 40 mg/dl; TC/HDL-C ratio: 6.8 f 2.6 to 5.2 f 2.0 (n = 33 pts, all p c 0.05). PP determinations (n = 28 pts without any missing data) revealed a similar dose-related reduction of Tg Cmax (p < 0.0001; ANOVA), and the median Tg Tmax was reduced from 6 to 4.5 hrs @ < O.OOfll; sign test). (See figure).
Two pts discontinued prematurely due to adverse events: one with increased transaminases (t3 x UNL) on 67 mg/d, and one with constipation. Conclusions: mF dose-dependently reduces PP Tg, and favorably alters other plasma lipid risk factors for CHD in hypertriglyceridemic pts.
1WeP2:20
syndrome abnormalities
( WePl:20
TRIGLYCERIDES
AND CVD
1 Effect of increasing doses of micronized fenolibrate on post-praudial triglycerides and fasting plasma lipids and lipoproteins in hypertriglycerklemic patients
W. Insulli, D.J. Rader*, J. Hsia3, C.E. Rhoads’, D. Stafford’, R.L. Boyett4, D. Crimet' ‘Baylor College of Medicine, Houston; 2 University of Pennsylvania, Philadelphia; ‘George Washington University, Washington; 4Fournier Research Inc., Fairfield, USA; ‘Laboratoires Foumier SA, Daix, France Objective: To evaluate increasing doses of micronized fenofibrate (mF) on post-prandial (PP) triglycerides (Tg) identified as a predictor of Coronary Heart Disease (CHD).
and metabolic in adolescents
A. Hemandez-One’ , R. Posadas-Sanchez*, J. Zamora-Gonzalez* , G. Cardoso-Saldaha* , L. Yamamoto-Kimura3, C. Posadas-Romero2. ‘Institute Mexican0 de1 Segum Social; 2Departamento de Endocrinologt’a de1 Institute National de Cardiologia ‘lgnacio CMvez”; “Departamento de Salud Publica, Facultad de Medicina, VNAM, Mexico City Mexico Objective: To examine the association of hypertriglyceridemia with the metabolic syndrome coronary risk factors in adolescents. Methods: Sampling design: Of 889 junior high school students, 455 were stratified as non-obese (NOB) (2”d quartile of BMI) and obese (OB) (4th quartiles of BMI); as hypertriglyceridemic (HTG) (Tg ? 150 mg/dl) and normotriglyceridemic (NTG) (Tg < 150 mg/dl); and as boys and girls. Risk factors: Anthropometry and blood pressure were measured. Lipids, lipoproteins, apolipoprotein A-I and B, insulin and glucose were quantified in a venous blood sample after a 1Zhour fast. Results: We studied 171 boys and 284 girls with a mean age of 13.6 & 1. OB HTG had higher prevalence of HDL-C < 35, fasting insulin 2 ~75, and waist circumference 2 ~75. Both OB and NOB HTG had higher proportion of small LDL particles (estimated as LDL-C/apoB < ~25). Multiple regression analysis showed that Tg explained insulin (10.4%). waist circumference (1.1%) and HDL-C (14.2%) in boys; and insulin (1.2%). LDL size (8.9%) and HDL-C (4.8%) in girls. Conclwious: Our results confirm that in the adolescent population, HTG when accompanied with OB is associated with a higher prevalence of metabolic syndrome risk factors. However, Tg can independently explain, some of these factors.
IWeP3.20 P: W20
1 Association of hypertriglyceridemla
An enzyme-linked bmmmow-bent assay for the measurement of activated factor XII in human plasma
David J. Pritchard, Sine D. Creagmile, Marc T. Green, David J. Craig, Rachel J. Sham&n, Robert P. Ford. Shield Diagnostics, Dundee, Scotland, UK Background: Factor XII is activated to FXIIa on the surface of triglyceride-rich lipoproteins and it has been reported that FXIIa is associated with cardiovascular risk. The aim of this study was to investigate the characteristics of an ELISA for the measurement of FXIIa. Method: Citrated plasma samples were collected from a total of 339 apparently healthy asymptomatic volunteers. The age range of this population was 18-68 years, and comprised a 50% male to female distribution. Results: The mean FXIIa value of this asymptomatic population was 1.53 @ml f 0.73 @ml. The range of the values obtained was 0.03-4.8 n&ml. The within assay imprecision was ~5% and between assay imprecision < 12%. The lower limit of detection of the assay was 0.11 @ml. Within-day, within-person variation of XIIa levels was assessed by taking 7 titrated blood
XIIth International Symposium on Atherosclerosis,
Stockholm,
Sweden,
June 25-29, 2000
176
IWeP4
Systemic mechanisms disposition to stroke
W19
S.M. Kuznetsova,
1.1. Glazovskaya.
of formation of hereditary
Institute of Gerontology, Kiev, Ukraine
Objective: Study on the state of cerebral hemodynamics and lipid metabolism in subjects with a hereditary disposition to stroke. Methods: Relatives of stroke patients 1st and 2nd kinship degree aged 20-79 years (RSP, n = 210) and control subjects without cerebrovascular pathology in their genealogy (C, n = 150) were examined by ultrasound dopplerography for cerebral hemodynamics, and lipid and lipoproteid contents. Results: There were structural-functional changes of extracranial (ECA) and intracranial sinus carotid arteries in 27% and 12%, respectively, of RSP and only in 10% of C (ECA case). In RSP of all age groups (20 to 79), linear blood flow velocity (LBFV) in ECA and medial cerebral artery was lower compared to C, while at 50-59 years it corresponded to LBFV characteristic of stroke patients (54.0 + 6.7 and 51.2 + 8.8 cm/s, respectively). In RSP, LBFV asymmetry (more than 30%) was highest at 40-49 and 50-59 years, i.e. 25% and 3% (8% and 7% in C). At 50-59 years, marked atherosclerotic changes of cerebral vessels were diagnosed in 25% of RSP (10% in C). Blood cholesterol level exceeded the norm (>6.6 mM/l) in 38% of RSP (in 15.3% of C). After 2&29 years, apoA1 concentration was lower in RSP than in C (1.4 + 0.2 vs. 2.28 + 0.1 mg/ml). Correlation coefficients between apoA1 and HDL contents of stroke patients and their relatives were 0.87 and 0.75. Conclusion: The specifics of cerebral hemodynamics and lipid metabolism should be considered as systemic manifestations of the hereditary disposition to stroke.
IWeP5 W19
al-acid glycoproteh~ but not C-reactive protein discriminates late restenosis after cartoid endarterectomy
B. Millo, H. Kupicz, I. Wiemicki, B. Trojnacka, R. Turowski, P. Gutowski, M. Naruszewicz. Pomeranian Medical University, Szczecin, Poland Objective: To search among acute-phase reactants and lipids for a discriminant of carotid restenosis after carotid endarterectomy. Material and Methods: Patients with internal cartoid stenosis > 70% as assessed by color Doppler USG, and DSA when necessary, underwent endarteroctomy during the past six years. Postoperative assessment (USG/DSA) was done 30 days after surgery, every three months during the first year, and every six months thereafter. Two groups were subsequently formed: with (n = 17, mean age 61.9 f 5.8) or without (n = 16, mean age 59.9 f 9.1) restenosis. Lipids: Total, LDL and HDL cholesterol (Ch, LDL-Ch, HDL-Ch), and triglycerides (Tg) were measured using commercial kits. Acute phase reactants: C-reactive protein (CRP), ot -acid glycoprotein (AAG), prealbumin (PAP), complement C-3 and factor B, were measured with an immunonephelometric method (Array 360 instrument from Beckman). Results: Lipids Ch, LDL-Ch, HDL-Ch and Tg levels were elevated in both groups (Ch: 262.8 f 39.0 mg/dl vs 263.6 f 47.7 mg/dl; LDL-Ch: 168.3 f 39.8 mg/dl vs 170.6 & 44.3 mgAll; HDL-Ch: 42.7 f 14.2 mg/dl vs 38.4 f 12.1 mg/dl; Tg: 206.7 f 157.1 mg/dl vs 280.8 ZIZ215.1 mg/dl - with vs without restenosis). No statisticaJly significant differences were found. Acute phase reactants AAG level was significantly higher in the restenosis group (114.7 f 18.9 mg/dl vs 99.5 f 18.1 mg/dl; p < 0.02). CRP was increased in both groups (4.7 f 3.7 mg/l vs 3.4 f 1.9 mg/l) but without statistical significance. Conclusion: cut-acid glycoprotein seems to be superior to CRP in discriminating patients with late restenosis after cartoid endarteroctomy.
Methods: We undertook an open forced-titration dose-response study of increasing doses of mF (67, 134 & 201 mg/d) on PP Tg values, in 38 patients (pts) with fasting Tg > 250 mg/dl. Determinations of lipids following an oral fat load (1 g/kg) were performed on four occasions: after a 4-wk NCEP Step 1 diet and after each 4-wk treatment with ml? Results: A linear cumulative dose-effect was demonstrated on fasting values: Tg: 450 f 235 to 196 f 83 mg/dl; TC: 234 f 49 to 208 f 40 mg/dl; HDL: 38 f 13 to 44 z!= 14 mg/dl; Apo B: 144 f 43 to 126 f 40 mg/dl; TC/HDL-C ratio: 6.8 f 2.6 to 5.2 f 2.0 (n = 33 pts, all p c 0.05). PP determinations (n = 28 pts without any missing data) revealed a similar dose-related reduction of Tg Cmax (p < 0.0001; ANOVA), and the median Tg Tmax was reduced from 6 to 4.5 hrs @ < O.OOfll; sign test). (See figure).
Two pts discontinued prematurely due to adverse events: one with increased transaminases (t3 x UNL) on 67 mg/d, and one with constipation. Conclusions: mF dose-dependently reduces PP Tg, and favorably alters other plasma lipid risk factors for CHD in hypertriglyceridemic pts.
1WeP2:20
syndrome abnormalities
( WePl:20
TRIGLYCERIDES
AND CVD
1 Effect of increasing doses of micronized fenolibrate on post-praudial triglycerides and fasting plasma lipids and lipoproteins in hypertriglycerklemic patients
W. Insulli, D.J. Rader*, J. Hsia3, C.E. Rhoads’, D. Stafford’, R.L. Boyett4, D. Crimet' ‘Baylor College of Medicine, Houston; 2 University of Pennsylvania, Philadelphia; ‘George Washington University, Washington; 4Fournier Research Inc., Fairfield, USA; ‘Laboratoires Foumier SA, Daix, France Objective: To evaluate increasing doses of micronized fenofibrate (mF) on post-prandial (PP) triglycerides (Tg) identified as a predictor of Coronary Heart Disease (CHD).
and metabolic in adolescents
A. Hemandez-One’ , R. Posadas-Sanchez*, J. Zamora-Gonzalez* , G. Cardoso-Saldaha* , L. Yamamoto-Kimura3, C. Posadas-Romero2. ‘Institute Mexican0 de1 Segum Social; 2Departamento de Endocrinologt’a de1 Institute National de Cardiologia ‘lgnacio CMvez”; “Departamento de Salud Publica, Facultad de Medicina, VNAM, Mexico City Mexico Objective: To examine the association of hypertriglyceridemia with the metabolic syndrome coronary risk factors in adolescents. Methods: Sampling design: Of 889 junior high school students, 455 were stratified as non-obese (NOB) (2”d quartile of BMI) and obese (OB) (4th quartiles of BMI); as hypertriglyceridemic (HTG) (Tg ? 150 mg/dl) and normotriglyceridemic (NTG) (Tg < 150 mg/dl); and as boys and girls. Risk factors: Anthropometry and blood pressure were measured. Lipids, lipoproteins, apolipoprotein A-I and B, insulin and glucose were quantified in a venous blood sample after a 1Zhour fast. Results: We studied 171 boys and 284 girls with a mean age of 13.6 & 1. OB HTG had higher prevalence of HDL-C < 35, fasting insulin 2 ~75, and waist circumference 2 ~75. Both OB and NOB HTG had higher proportion of small LDL particles (estimated as LDL-C/apoB < ~25). Multiple regression analysis showed that Tg explained insulin (10.4%). waist circumference (1.1%) and HDL-C (14.2%) in boys; and insulin (1.2%). LDL size (8.9%) and HDL-C (4.8%) in girls. Conclwious: Our results confirm that in the adolescent population, HTG when accompanied with OB is associated with a higher prevalence of metabolic syndrome risk factors. However, Tg can independently explain, some of these factors.
IWeP3.20 P: W20
1 Association of hypertriglyceridemla
An enzyme-linked bmmmow-bent assay for the measurement of activated factor XII in human plasma
David J. Pritchard, Sine D. Creagmile, Marc T. Green, David J. Craig, Rachel J. Sham&n, Robert P. Ford. Shield Diagnostics, Dundee, Scotland, UK Background: Factor XII is activated to FXIIa on the surface of triglyceride-rich lipoproteins and it has been reported that FXIIa is associated with cardiovascular risk. The aim of this study was to investigate the characteristics of an ELISA for the measurement of FXIIa. Method: Citrated plasma samples were collected from a total of 339 apparently healthy asymptomatic volunteers. The age range of this population was 18-68 years, and comprised a 50% male to female distribution. Results: The mean FXIIa value of this asymptomatic population was 1.53 @ml f 0.73 @ml. The range of the values obtained was 0.03-4.8 n&ml. The within assay imprecision was ~5% and between assay imprecision < 12%. The lower limit of detection of the assay was 0.11 @ml. Within-day, within-person variation of XIIa levels was assessed by taking 7 titrated blood
XIIth International Symposium on Atherosclerosis,
Stockholm,
Sweden,
June 25-29, 2000