- Email: [email protected]
17: Fibrinogen, CD40L, CRP and subclinical atherosclerosis
Multiple Risk Factors in Cardiovascular Disease—Abstracts
(hard events), and hard events plus hospitalization for angina or coronary-revascularizations (total CHD events). Results: Over 6 years, 297 participants had CHD events (136 hard events). IL6 and AAI independently predicted CHD events above Framingham Risk Score (FRS) with hazard ratios [HR] for the highest vs. the lowest quartile for IL-6 of 2.03 (95%CI: 1.55-2.85, p for trend<0.001) and of 1.78 (95%CI: 1.29-2.46) for AAI ³0.9 vs. AAI 1.01-1.30. CRP, TNF-a and aPWV had weaker associations with CHD. Results were similar for hard CHD events. C-index for hard/total CHD events increased from 0.62/0.62 for traditional risk factors to 0.64/0.64 for IL-6 addition, 0.65/0.63 for AAI, and 0.66/0.64 for IL6+AAI. In models including IL-6, AAI or both, 8.0 to 12.1% of participants were correctly reclassified. Conclusions: Among older adults, IL-6 and AAI are independently associated with CHD, and modestly improve risk prediction beyond traditional risk factors.
of the thickest plaques present in each of both carotid and femoral bifurcations) Plasma Fb, sCD40L and hsCRP levels were determined.High Fb was associated with presence (p=0.001) and number of plaques (p=0.006), plaque echogenicity (fibrotic plaques) (p<0.001) but not TPT (p=0.14). sCD40L was also associated with number of plaques (p=0.001) and plaque echogenicity (p=0.014) but not with plaque presence (p=0.23). It was, however, associated with TPT (p=0.019). hsCRP levels were not associated with plaque presence, number, echogenicity (MPT) or thickness (TPT). hsCRP levels were not associated with subclinical atherosclerosis as assessed by ultrasound. In contrast, increased Fb and sCD40L levels were associated not only with the presence of plaques but also with plaque echogenicity. Our data suggest that both Fb and sCD40L play a major part in subclinical atherosclerosis formation as shown by presence of plaques and more specifically echolucent, vulnerable plaques.
Funding: National Institute on Aging, NIH
Funding: none
17 FIBRINOGEN, CD40L, CRP AND SUBCLINICAL ATHEROSCLEROSIS A. Panayiotou1, M. Griffin2, T. Tyllis3, D. Bond2, N. Georiou3, A. Nicolaides1,2,3. 1University of Cyprus, Department of Biological Sciences, Nicosia, Cyprus, 2Vascular Screening and Diagnostic Center, London, United Kingdom, 3Vascular Screening and Diagnostic Center, Nicosia, Cyprus Fibrinogen (Fb), soluble CD40L (sCD40L) and high-sensitivity CRP (hsCRP) are inflammatory markers, elevated in the presence of atherosclerotic disease. The aim of the study was to determine whether this is also true for subclinical atherosclerosis. Both common carotid and femoral bifurcations were scanned with ultrasound in 767 volunteers over 40. Three ultrasonic features were considered: (a) number of vessels with plaque; (b) plaque echodensity, as indicated by mean plaque type (MPT) using the Widder classification with type 1 being the most echogenic (stable) and type 5 the most echolucent (unstable) and (c) total plaque thickness (TPT- sum
S8
18 HIGH LEVELS OF PLASMA FIBRINOGEN AT ADMISSION AND DURING HOSPITALIZATION ARE PREDICTIVE OF TARGET VESSEL REVASCULARIZATION FOLLOWING PRIMARY PTCA A. Lupi, S. Ferraro, L. Rossi, M. Santagostino, M. Sansa, R. Rosso, A.S. Bongo. Azienda Ospedaliera Universitaria Maggiore della Carità, Novara, Italy Plasma fibrinogen is a known coronary risk factor in patients (pts) with stable coronary disease, but little is known about the information from fibrinogen in pts with acute myocardial infarction (STEMI) treated by primary PTCA. To this end in 129 consecutive STEMI pts who underwent primary PTCA (106 M, 60.9±12.2 years), plasma samples were obtained at admission, at 12, 24, 48 and 72h following primary PTCA. Fibrinogen plasma citrated levels were evaluated by Clauss method (DADE-Behring). For each pts major adverse coronary events (MACE: myocardial infarction+death+need for urgent revascularization) and target vessel revascularization (TVR) were assessed over a 6 month follow up. 152 coronary lesions (1.2 lesion/pts) were treated, with 175 stents
(hard events), and hard events plus hospitalization for angina or coronary-revascularizations (total CHD events). Results: Over 6 years, 297 participants had CHD events (136 hard events). IL6 and AAI independently predicted CHD events above Framingham Risk Score (FRS) with hazard ratios [HR] for the highest vs. the lowest quartile for IL-6 of 2.03 (95%CI: 1.55-2.85, p for trend<0.001) and of 1.78 (95%CI: 1.29-2.46) for AAI ³0.9 vs. AAI 1.01-1.30. CRP, TNF-a and aPWV had weaker associations with CHD. Results were similar for hard CHD events. C-index for hard/total CHD events increased from 0.62/0.62 for traditional risk factors to 0.64/0.64 for IL-6 addition, 0.65/0.63 for AAI, and 0.66/0.64 for IL6+AAI. In models including IL-6, AAI or both, 8.0 to 12.1% of participants were correctly reclassified. Conclusions: Among older adults, IL-6 and AAI are independently associated with CHD, and modestly improve risk prediction beyond traditional risk factors.
of the thickest plaques present in each of both carotid and femoral bifurcations) Plasma Fb, sCD40L and hsCRP levels were determined.High Fb was associated with presence (p=0.001) and number of plaques (p=0.006), plaque echogenicity (fibrotic plaques) (p<0.001) but not TPT (p=0.14). sCD40L was also associated with number of plaques (p=0.001) and plaque echogenicity (p=0.014) but not with plaque presence (p=0.23). It was, however, associated with TPT (p=0.019). hsCRP levels were not associated with plaque presence, number, echogenicity (MPT) or thickness (TPT). hsCRP levels were not associated with subclinical atherosclerosis as assessed by ultrasound. In contrast, increased Fb and sCD40L levels were associated not only with the presence of plaques but also with plaque echogenicity. Our data suggest that both Fb and sCD40L play a major part in subclinical atherosclerosis formation as shown by presence of plaques and more specifically echolucent, vulnerable plaques.
Funding: National Institute on Aging, NIH
Funding: none
17 FIBRINOGEN, CD40L, CRP AND SUBCLINICAL ATHEROSCLEROSIS A. Panayiotou1, M. Griffin2, T. Tyllis3, D. Bond2, N. Georiou3, A. Nicolaides1,2,3. 1University of Cyprus, Department of Biological Sciences, Nicosia, Cyprus, 2Vascular Screening and Diagnostic Center, London, United Kingdom, 3Vascular Screening and Diagnostic Center, Nicosia, Cyprus Fibrinogen (Fb), soluble CD40L (sCD40L) and high-sensitivity CRP (hsCRP) are inflammatory markers, elevated in the presence of atherosclerotic disease. The aim of the study was to determine whether this is also true for subclinical atherosclerosis. Both common carotid and femoral bifurcations were scanned with ultrasound in 767 volunteers over 40. Three ultrasonic features were considered: (a) number of vessels with plaque; (b) plaque echodensity, as indicated by mean plaque type (MPT) using the Widder classification with type 1 being the most echogenic (stable) and type 5 the most echolucent (unstable) and (c) total plaque thickness (TPT- sum
S8
18 HIGH LEVELS OF PLASMA FIBRINOGEN AT ADMISSION AND DURING HOSPITALIZATION ARE PREDICTIVE OF TARGET VESSEL REVASCULARIZATION FOLLOWING PRIMARY PTCA A. Lupi, S. Ferraro, L. Rossi, M. Santagostino, M. Sansa, R. Rosso, A.S. Bongo. Azienda Ospedaliera Universitaria Maggiore della Carità, Novara, Italy Plasma fibrinogen is a known coronary risk factor in patients (pts) with stable coronary disease, but little is known about the information from fibrinogen in pts with acute myocardial infarction (STEMI) treated by primary PTCA. To this end in 129 consecutive STEMI pts who underwent primary PTCA (106 M, 60.9±12.2 years), plasma samples were obtained at admission, at 12, 24, 48 and 72h following primary PTCA. Fibrinogen plasma citrated levels were evaluated by Clauss method (DADE-Behring). For each pts major adverse coronary events (MACE: myocardial infarction+death+need for urgent revascularization) and target vessel revascularization (TVR) were assessed over a 6 month follow up. 152 coronary lesions (1.2 lesion/pts) were treated, with 175 stents