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1P-0034 Association of adiponectin and C-reactive protein with the prevalence of coronary artery disease
Monday September 29, 2003: Poster Session Coronary artery disease
26 1P-0032
Evaluating the interrelation between the carotid intima-media thickness and the rate of LV myocardial remodeling after successful thrombolysis
G. Aroutiounov, A. Rozanov. Russian State Medical University, Moscow, Russia Urgency. The high correlation between the carotic intima-media thickness (IMT) and the pronouncement of atherosclerotic process is beyond question. The pronouncement of atherosclerotic processes is the key factor in development of coronary events resulting in myocardial infarction and onset of LV myocardial remodeling. Therefore it would be interesting to trace the interrelation of IMT measured at the moment of completing thrombolysis with pronouncement and progression rate of LV remodeling. Material and Methods: This was an open-label, prospective, parallel group study for evaluation of LV myocardial remodeling rate after myocardial infarction in relation to IMT. We examined 50 male patients aged from 40 to 60 years (mean age 53.1±6.2 years) with the first Q anterior myocardial infarction, 25 patients in the group with initially normal IMT (0.75-0.91 mm) and 25 in the group with IMT more than 0.91 mm). Patients underwent echocardiographic examinations on admission, after 6 and 12 months of therapy including measurement of LV end-diastolic volume (EDV), LV ejection fraction and early to late LV diastolic filling rate ratio. IMT was determined at the moment of thrombolysis completion. Study groups were formed based on this examination. Results: The rate of LV myocardial remodeling was lower in the group with initially normal IMT values than in the group with increased IMT. Difference between EDV values in patients with normal and abnormal IMT values was statistically significant. Baseline IMT N IMT > N
6 months IMT N IMT > N
IMT N
1 year IMT > N
EDV, ml 158±23.5 161±31 162±18.9 172±15.6 168±17.3* 178±18.2* EF, % 45±4.8 43±3.9 52±3.5 51±2.8 50±3.8 48±4.2 Ve/Va 0.74±0.09 0.75±0.07 0.92±0.05 0.87±0.08 0.74±0.06 0.65±0.08
Conclusion: Measurement of IMT in patients at high risk of coronary events may allow prognosis of the extent of LV myocardial remodeling. The rate of LV myocardial remodeling is lower in the group with normal IMT. 1P-0033
Imbalance of sex hormone levels in Japanese men with premature coronary artery disease
K. Kajinami, R. Sato, N. Takekoshi, S. Matsui, S. Kanemitsu, S. Okubo, M. Kitayama, A. Fukuda, H. Akao, H. Okazaki. Kanazawa Medical University, Uchinada, Japan Background: Sex hormones play a key role in atherogenesis, yet the available evidence is inconclusive, partly because of the poor accuracy in measurements. To investigate the potential role of sex hormone in coronary atherosclerosis, we determined the levels of estradiol and testosterone in patients with angiographically proven premature (<65yr) coronary artery disease. Methods: Consecutive male patients (<65yr) receiving CAG for the first time were enrolled: 80 with stable angina and 107 age-matched controls with normal CAG. Blood samples were drawn after overnight fast at the day of CAG. Estradiol levels were determined by high sensitive method (hs-E2). Results: The levels of hs-E2 and free testosterone were slightly different in opposite direction between controls and patient group, but did not reach statistical significance. However, the ratio of these two hormones (free testosterone to hs-E2) of coronary artery disease patients was significantly lower than that of control group. The levels of DHEA-S in patients were significantly lower and FSH was significantly higher, as compared to those of controls, respectively.
Hs-E2 (pg/ml) Progesterone (ng/ml) F-testosterone (pg/ml) DHEA-S (ng/ml) LH (IU/L) FSH (IU/L) FT/Hs-E2
Control
Stable CAD
7.6±4.0 0.71±0.25 14.0±5.0 1217±711 6.4±6.0 11.1±10.3 2.3±1.2
7.9±4.7 0.66±0.24 13.1±4.6 950±633** 7.1±5.0 14.1±13.5** 1.9±1.0*
1P-0034
Association of adiponectin and C-reactive protein with the prevalence of coronary artery disease
M. Kumada 1 , S. Kihara 1 , S. Sumitsuji 2 , T. Kawamoto 3 , S. Matsumoto 4 , N. Ouchi 1 , Y. Arita 5 , Y. Okamoto 1 , I. Shimomura 1 , H. Hiraoka 1 , T. Nakamura 1 , T. Funahashi 1 , Y. Matsuzawa 5 . 1 Department of Internal Medicine and Molecular Science, Graduate School of Medicine, Osaka University; 2 Department of Cardiology, Rinku General Medical Center; 3 Department of Cardiology, National Hospital Kure Medical Center; 4 Department of Cardiology, Toyonaka Municipal Hospital; 5 Sumitomo Hospital, Japan Objectives: Adiponectin is an adipocyte-derived plasma protein which has potential anti-inflammatory and anti-atherogenic properties. On the other hand, high-sensitive C-reactive protein (hs-CRP) is a well-known inflammatory marker and a risk factor for coronary artery disease (CAD). This study was designed to investigate whether hypoadiponectinemia can be associated with the prevalence of CAD and hs-CRP levels. Methods: The consecutive 225 male patients were enrolled from inpatients who underwent coronary angiography. Voluntary blood donors (n=225) matched for age served as controls. Plasma adiponectin and hs-CRP levels were measured with ELISA and analyzed statistically with other CAD risk factors. Human adipose tissue samples wrere obtained from the subjects who underwent the elective abdominal surgery. CRP and adiponectin mRNA levels were measured with quantitative real-time PCR. Results: Plasma adiponectin levels in the CAD patients were significantly lower than those in the control subjects, and the hs-CRP levels were significantly higher in the CAD patients compared with control subjects. Multiple logistic regression analysis revealed that hypoadiponectinemia was significantly and independently associated with CAD prevalence (P<0.01). The multivariate-adjusted odds ratio revealed that the plasma adiponectin level of 4.0µg/ml was the cut-off point of hypoadiponectinemia based on the CAD prevalence. In addition, we found the expression of CRP mRNA in human adipose tissue for the first time. A significant inverse correlation was observed between the CRP and adiponectin mRNA levels in human adipose tissue (P<0.01). Conclusions: Hypoadiponectinemia (<4.0µg/ml) had a significant 2-fold increase in CAD prevalence, and adiponectin were negatively correlated with CRP in both plasma and adipose tissue. 1P-0035
Taq1B polymorphism of the cholesteryl ester transfer protein gene and CETP activity in members of families with a history of ischaemic heart disease
T. Wesolowska, G. Adler, K. Chelstowski, A. Ciechanowicz, B. Torbus-Lisiecka, M. Naruszewicz. Chair of Clinical Biochemistry and Laboratory Diagnostics, Pomeranian Medical University, Szczecin, Poland Taq1B polymorphism of the cholesteryl ester transfer protein (CETP) gene appears to influence CETP activity, as well as plasma levels of high density lipoproteins (HDL-C) and apolipoprotein A1 which are recognized markers of premature atherosclerosis. We have studied for the first time in Poland the distribution of CETP gene B1 and B2 alleles in relation to the lipid profile and apolipoprotein levels in 38 young parents and their 70 offsprings from families with a history of ischaemic heart disease. No significant effect of Taq1B CETP gene polymorphism on CETP activity was observed. However, the B2 allele may exert an anti-atherogenic effect in young males. Tobacco smoking and B1 allele predispose to lower HDL-C levels and higher CETP activities associated with an atherogenic phenotype of HDL and LDL fractions in males. Multivariate analysis revealed that CETP activity in sons was determined by paternal CETP activity, triglyceride levels, LDL-C/HDL-C ratio, BMI, body fat percentage and water content (R=0.631; p<0.00015). CETP activity in daughters was determined by maternal total cholesterol, apolipoprotein B and triglyceride levels (R=0.570; p<0.004). Correlation analysis of CETP activity, lipid levels and body weight in offspring and their parents suggests a genetic background of the metabolic disorders and predisposition to lipid abnormalities in offspring with a family history of cardiovascular disease.
(* p<0.05, **p<0.01)
Conclusion: Hs-E2 measurement demonstrated the significant imbalance of sex hormones in male patients with premature and stable coronary artery disease. XIIIth International Symposium on Atherosclerosis, September 28–October 2, 2003, Kyoto, Japan
26 1P-0032
Evaluating the interrelation between the carotid intima-media thickness and the rate of LV myocardial remodeling after successful thrombolysis
G. Aroutiounov, A. Rozanov. Russian State Medical University, Moscow, Russia Urgency. The high correlation between the carotic intima-media thickness (IMT) and the pronouncement of atherosclerotic process is beyond question. The pronouncement of atherosclerotic processes is the key factor in development of coronary events resulting in myocardial infarction and onset of LV myocardial remodeling. Therefore it would be interesting to trace the interrelation of IMT measured at the moment of completing thrombolysis with pronouncement and progression rate of LV remodeling. Material and Methods: This was an open-label, prospective, parallel group study for evaluation of LV myocardial remodeling rate after myocardial infarction in relation to IMT. We examined 50 male patients aged from 40 to 60 years (mean age 53.1±6.2 years) with the first Q anterior myocardial infarction, 25 patients in the group with initially normal IMT (0.75-0.91 mm) and 25 in the group with IMT more than 0.91 mm). Patients underwent echocardiographic examinations on admission, after 6 and 12 months of therapy including measurement of LV end-diastolic volume (EDV), LV ejection fraction and early to late LV diastolic filling rate ratio. IMT was determined at the moment of thrombolysis completion. Study groups were formed based on this examination. Results: The rate of LV myocardial remodeling was lower in the group with initially normal IMT values than in the group with increased IMT. Difference between EDV values in patients with normal and abnormal IMT values was statistically significant. Baseline IMT N IMT > N
6 months IMT N IMT > N
IMT N
1 year IMT > N
EDV, ml 158±23.5 161±31 162±18.9 172±15.6 168±17.3* 178±18.2* EF, % 45±4.8 43±3.9 52±3.5 51±2.8 50±3.8 48±4.2 Ve/Va 0.74±0.09 0.75±0.07 0.92±0.05 0.87±0.08 0.74±0.06 0.65±0.08
Conclusion: Measurement of IMT in patients at high risk of coronary events may allow prognosis of the extent of LV myocardial remodeling. The rate of LV myocardial remodeling is lower in the group with normal IMT. 1P-0033
Imbalance of sex hormone levels in Japanese men with premature coronary artery disease
K. Kajinami, R. Sato, N. Takekoshi, S. Matsui, S. Kanemitsu, S. Okubo, M. Kitayama, A. Fukuda, H. Akao, H. Okazaki. Kanazawa Medical University, Uchinada, Japan Background: Sex hormones play a key role in atherogenesis, yet the available evidence is inconclusive, partly because of the poor accuracy in measurements. To investigate the potential role of sex hormone in coronary atherosclerosis, we determined the levels of estradiol and testosterone in patients with angiographically proven premature (<65yr) coronary artery disease. Methods: Consecutive male patients (<65yr) receiving CAG for the first time were enrolled: 80 with stable angina and 107 age-matched controls with normal CAG. Blood samples were drawn after overnight fast at the day of CAG. Estradiol levels were determined by high sensitive method (hs-E2). Results: The levels of hs-E2 and free testosterone were slightly different in opposite direction between controls and patient group, but did not reach statistical significance. However, the ratio of these two hormones (free testosterone to hs-E2) of coronary artery disease patients was significantly lower than that of control group. The levels of DHEA-S in patients were significantly lower and FSH was significantly higher, as compared to those of controls, respectively.
Hs-E2 (pg/ml) Progesterone (ng/ml) F-testosterone (pg/ml) DHEA-S (ng/ml) LH (IU/L) FSH (IU/L) FT/Hs-E2
Control
Stable CAD
7.6±4.0 0.71±0.25 14.0±5.0 1217±711 6.4±6.0 11.1±10.3 2.3±1.2
7.9±4.7 0.66±0.24 13.1±4.6 950±633** 7.1±5.0 14.1±13.5** 1.9±1.0*
1P-0034
Association of adiponectin and C-reactive protein with the prevalence of coronary artery disease
M. Kumada 1 , S. Kihara 1 , S. Sumitsuji 2 , T. Kawamoto 3 , S. Matsumoto 4 , N. Ouchi 1 , Y. Arita 5 , Y. Okamoto 1 , I. Shimomura 1 , H. Hiraoka 1 , T. Nakamura 1 , T. Funahashi 1 , Y. Matsuzawa 5 . 1 Department of Internal Medicine and Molecular Science, Graduate School of Medicine, Osaka University; 2 Department of Cardiology, Rinku General Medical Center; 3 Department of Cardiology, National Hospital Kure Medical Center; 4 Department of Cardiology, Toyonaka Municipal Hospital; 5 Sumitomo Hospital, Japan Objectives: Adiponectin is an adipocyte-derived plasma protein which has potential anti-inflammatory and anti-atherogenic properties. On the other hand, high-sensitive C-reactive protein (hs-CRP) is a well-known inflammatory marker and a risk factor for coronary artery disease (CAD). This study was designed to investigate whether hypoadiponectinemia can be associated with the prevalence of CAD and hs-CRP levels. Methods: The consecutive 225 male patients were enrolled from inpatients who underwent coronary angiography. Voluntary blood donors (n=225) matched for age served as controls. Plasma adiponectin and hs-CRP levels were measured with ELISA and analyzed statistically with other CAD risk factors. Human adipose tissue samples wrere obtained from the subjects who underwent the elective abdominal surgery. CRP and adiponectin mRNA levels were measured with quantitative real-time PCR. Results: Plasma adiponectin levels in the CAD patients were significantly lower than those in the control subjects, and the hs-CRP levels were significantly higher in the CAD patients compared with control subjects. Multiple logistic regression analysis revealed that hypoadiponectinemia was significantly and independently associated with CAD prevalence (P<0.01). The multivariate-adjusted odds ratio revealed that the plasma adiponectin level of 4.0µg/ml was the cut-off point of hypoadiponectinemia based on the CAD prevalence. In addition, we found the expression of CRP mRNA in human adipose tissue for the first time. A significant inverse correlation was observed between the CRP and adiponectin mRNA levels in human adipose tissue (P<0.01). Conclusions: Hypoadiponectinemia (<4.0µg/ml) had a significant 2-fold increase in CAD prevalence, and adiponectin were negatively correlated with CRP in both plasma and adipose tissue. 1P-0035
Taq1B polymorphism of the cholesteryl ester transfer protein gene and CETP activity in members of families with a history of ischaemic heart disease
T. Wesolowska, G. Adler, K. Chelstowski, A. Ciechanowicz, B. Torbus-Lisiecka, M. Naruszewicz. Chair of Clinical Biochemistry and Laboratory Diagnostics, Pomeranian Medical University, Szczecin, Poland Taq1B polymorphism of the cholesteryl ester transfer protein (CETP) gene appears to influence CETP activity, as well as plasma levels of high density lipoproteins (HDL-C) and apolipoprotein A1 which are recognized markers of premature atherosclerosis. We have studied for the first time in Poland the distribution of CETP gene B1 and B2 alleles in relation to the lipid profile and apolipoprotein levels in 38 young parents and their 70 offsprings from families with a history of ischaemic heart disease. No significant effect of Taq1B CETP gene polymorphism on CETP activity was observed. However, the B2 allele may exert an anti-atherogenic effect in young males. Tobacco smoking and B1 allele predispose to lower HDL-C levels and higher CETP activities associated with an atherogenic phenotype of HDL and LDL fractions in males. Multivariate analysis revealed that CETP activity in sons was determined by paternal CETP activity, triglyceride levels, LDL-C/HDL-C ratio, BMI, body fat percentage and water content (R=0.631; p<0.00015). CETP activity in daughters was determined by maternal total cholesterol, apolipoprotein B and triglyceride levels (R=0.570; p<0.004). Correlation analysis of CETP activity, lipid levels and body weight in offspring and their parents suggests a genetic background of the metabolic disorders and predisposition to lipid abnormalities in offspring with a family history of cardiovascular disease.
(* p<0.05, **p<0.01)
Conclusion: Hs-E2 measurement demonstrated the significant imbalance of sex hormones in male patients with premature and stable coronary artery disease. XIIIth International Symposium on Atherosclerosis, September 28–October 2, 2003, Kyoto, Japan