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2.P.229 Hyperhomocysteinemia is a risk factor for ischemic heart disease in diabetic patients
Tuesday 7 October 1997: Posters Risk factors (for cardiovascular diseases)
164
disease (H-group: 65.3 yo, M/F = 5/6). Eleven age-matched control patients with acute myocardial infarction were chosen randomly (C- group: 65.2 yo, M/F = 5/Q. All of the patients did not complicate with diabetes mellitus. Results: Serum TSH levels increased (72 to 220 @U/ml) and FT4 and FT3 levels decreased in the H-group. The single vessel disease was diagnosed in 2 patients in the H-group and 3 patients in the C-group, respectively. The double vessel disease was observed in 3 patients in the H-group and 6 in the C-group, and also, 6 in the H-group and 2 in the C-group had the three vessel disease (p = 0.086). The stenotic portion within each major vessel (RCA, LAD and LCX) was calculated in every patient. The incidence of the patients with 1 to 2 stenotic portions was 33.3% in the H-group and 75% in the C-group, while, that of those with 3 to 6 stenotic portions was 66.7% in the H-group and 25% in the C-group. The significant difference (p = 0.038) was shown in these distribution. Furthermore, the stenotic portion distributed from proximal to distal evenly in the H-group. Con&& The hypothyroidism may induce multi-stenotic portions in the RCA, LAD and LCX due to the cluster with dyslipidemia, hypercatecholaminemia, hypometabolism and autoimmune abnormality.
I2.P 229
Hyperhomacysteinemia is a risk factor for ischemic heart disease in diabetic patients
E. Okada, K. Oida, H. Tada, K. Asazuma, M. Kohno, G. Tohda, Third Department of Internal Medicine, Fukui Medical School, Matsuoka-cho, Fukui 910-11, Japan
I. Miyamori.
Both clinical and experimental studies suggest that mild elevation of plasma homocysteine may be an independent risk factor for vascular disease, although the exact mechanism has not been fully elucidated. We studied 74 Japanese patients (51 males and 23 females) who were admitted for routine coronary angiography for investigation of chest pain or suspected CAD. All patients are examined glucose tolerance by 75gOGTT, classified into normal glucose tolerance group (NGT), impaired glucose tolerance group (IGT), and diabetes mellitus group (DM) by WHO criteria. Plasma homocysteine, lipid levels, and other fibrinolytic parameters were measured. Severity of coronary artery stenosis was expressed as CAD score (Gensini score), and patients were classified as having normal vessels or narrowed vessels on basis of a >75% stenosis in one or more of the three major coronary arteries or their branches. Hyperhomccysteinemia was observed in 15 (20%) subjects. Plasma homocysteine levels were higher, and fibrinogen and HbAlc levels were significantly higher in narrowed group than those in normal group, while age, smoking status, BMI, blood pressure, and plasma cholesterol levels were not. Plasma HDL-cholesterol and apolipoprotein A-I levels were significantly lower in narrowed group than those in normal group. Plasma homocysteine levels in all cases (n = 74, p = 0.041) and in DM group (n = 23, p = 0.022) were significantly correlated with CAD score by simple regression. In multiple stepwise linear analysis model, plasma homocysteine and apolipoprotein A-I levels were adjusted to CAD score, while age, smoking status, blood pressure, HbAlc. and BMl were not. These results suggest that hyperhomocysteinemia is an independent risk factor for coronary heart disease in diabetic patients.
2.P.230
Fractional esteritication rate of cholesterol in HDL can predict the particle size of LDL and HDL in CHD patients
T., K. Saku’ , I. Matsuda. University Fukuoka, Japan
Kumamoto
University,
timamoto;
Symposium
14
than that of small HDL. In conclusion, the particle size of both LDL and HDL,
Tbe&fectsofgarliconcardiovascularriskfactors: Double-blinded placebo-controlled study
A.N. Orekhov LV. Andrianova. Institute of Experimental --, Cardiology Research Center; Institute for Atherosclerosis Moscow, Russia
Cardiology, Research Ltd,
The positive influence of garlic on cardiovascular risk factors has been reported. In addition, according to folk medicine, garlic is effective as an antiatherosclerotic agent. Recently we have demonstrated that garlic possesses a direct antiatherosclerotic (therapeutic) and antiatherogenic (preventive) effects in cell culture model in vitro. To assess the effect of garlic on atherosclerosis risk factors, double-blinded placebo-controlled study was performed. Garlic tablet therapy induced statistically significant reduction in serum total cholesterol level along with significant increase in serum HDL cholesterol level, as compared to placebo treatment. Additionally, diastolic blood pressure was reduced by 10% in garlic-treated group of patients. Besides, garlic tablets administration resulted in the enhancement of plasma fibrinolytic activity and inhibition of platelet aggregation. The experiments performed on cell culture model demonstrated, that long-term treatment with garlic powder tablets leads to the :dgniticant reduction or even complete elimination of blood serum atherogenicity. Moreover, after 3 months of the treatment, blood serum gained the ability to reduce cholesterol content in cells cultured from atherosclerotic plaque. Our data demonstrate, that garlic may possess preventive and therapeutic effects on atherosclerosis.
I2.P.232 1 Lipids, LP(a) and fibrinogen iu acute stroke episodes S.A. Paximadas S.N. Pagoni’, C.E. Pitsavos’, J.N. Skoumas’, N.G. Giotsas’, --9 Y. Hallaq, B. Mermegas, S. Giannakides. Lipid Unit and First Dept. of Internar’ Medicine General Hospital of Athens ELPIS; ‘Lipid Center Cardiology Dept. Hippocration Hospital, Athens University, Greece Lipids, LP((Y) and fibrinogen increased risk for atherosclerosis and are independent risk factors in cardiovascular disease. Materials: 101 patients (47 females and 54 males) age 43-95 (mean 76 f IO) years were studied hospitalised during the last year in our hospitals. 36% had increased blood sugar, 38% had hypertension and 15% had CHD from patients. The over-all mortality was 15%. Methods: Serum levels of lipids, Lp(cr) and fibrinogen from all patients (Group A) compared to 70 random controls (Group B). All results were analyzed in the same laboratory.
Results: GrowA(n= LP@) bWL1 Fibrin. [mgdL] TC [mg/dL] TG [m&IL] HDL ImwdLl
101)
40.8 + 37.6 492 f 165 2lOk46 125 i 65 42.9 h 14.9
Grout B (n = 70)
D
40 * 32.3 314f60 221 f 48 115*37 41.2 3~9.8
NS
Conclusion: The study shows that the lipid and Lp(cx) levels are not elevated in patients with thrombolic-embolism cerebral vascular episodes, while the fibrinogen is increased statistically significant.
’ Fukuoka
Qualitative changes in LDL and HDL are thought to be important for evaluating the risk for coronary heart disease (CHD). Fractional esterification rate of cholesterol in HDL (FBRHDL) can predict the size distribution and physicochemical characteristics of HDL in plasma. We investigated the correlation of FBRHDL with the particle size of LDL (LDL-size) in 111 patients with CHD. The correlations of FBRHDL and LDL-size with conventional lipoprotein parameters were also studied. FERHDL was closely associated with LDL-size (males: r = -0.62, females: r = -0.63, p < 0.001). Plasma levels of TG, HDL-C, HDLz-C and apo B were also associated with LDL-size in male CHD patients (r = -0.53, 0.31, 0.36 and -0.48, p < O.Ol), while plasma TG and apo B were associated with LDL-size in female patients (r = -0.35 and -0.35, p < 0.05). In a stepwise multiple regression analysis, FERHDL alone accounted for 38% and 40% of the variability in LDL-size in male and female CHD patients, respectively. Other parameters accounted for an additional 6-10%. With respect to the relation between FERHDL and HDL subfractions, FERHDL related only to HDL2-C (males: r = -0.64, females: r = -0.65, p -Z O.OOl), suggesting that FBRHDL may predict the presence 1 lth International
(or absence) of larger HDL, rather FERHD; can be useful in predicting even in CHD patients.
17
2.P.233
free radicals generation by grannlocytes of patients with atherosclerosis
Oxygen
L. Pawlicki, W. Pawelski, Department of Physiology Medicar’ University tidi,
J. Blaszczyk, E. Sibiirska, J. Kqdziora, and Department of Internal Diseases Poland
J. Kowalski. Military
According to one the hypotheses of atherosclerotic process pathogenesis oxygen free radicals cause oxidative modification of plasma atherogenic lipoproteins what leads to uncontrolled cumulation of cholesterol esters in macrophage cytoplasm and transformation to foam cells the main element of the early atherogenic changes. Thus it may be assumed that oxygen free radicals generation is higher in patients with atherosclerosis than in healthy subjects. In order to verify this thesis own investigations were performed in patients with various clinical forms of atherosclerosis regarding whole blood granulocytes to be an easy source of oxygen free radicals. Investigations were performed in subjects divided into four groups of clinically healthy
on Atherosclerosis.
Paris,
October
1997
164
disease (H-group: 65.3 yo, M/F = 5/6). Eleven age-matched control patients with acute myocardial infarction were chosen randomly (C- group: 65.2 yo, M/F = 5/Q. All of the patients did not complicate with diabetes mellitus. Results: Serum TSH levels increased (72 to 220 @U/ml) and FT4 and FT3 levels decreased in the H-group. The single vessel disease was diagnosed in 2 patients in the H-group and 3 patients in the C-group, respectively. The double vessel disease was observed in 3 patients in the H-group and 6 in the C-group, and also, 6 in the H-group and 2 in the C-group had the three vessel disease (p = 0.086). The stenotic portion within each major vessel (RCA, LAD and LCX) was calculated in every patient. The incidence of the patients with 1 to 2 stenotic portions was 33.3% in the H-group and 75% in the C-group, while, that of those with 3 to 6 stenotic portions was 66.7% in the H-group and 25% in the C-group. The significant difference (p = 0.038) was shown in these distribution. Furthermore, the stenotic portion distributed from proximal to distal evenly in the H-group. Con&& The hypothyroidism may induce multi-stenotic portions in the RCA, LAD and LCX due to the cluster with dyslipidemia, hypercatecholaminemia, hypometabolism and autoimmune abnormality.
I2.P 229
Hyperhomacysteinemia is a risk factor for ischemic heart disease in diabetic patients
E. Okada, K. Oida, H. Tada, K. Asazuma, M. Kohno, G. Tohda, Third Department of Internal Medicine, Fukui Medical School, Matsuoka-cho, Fukui 910-11, Japan
I. Miyamori.
Both clinical and experimental studies suggest that mild elevation of plasma homocysteine may be an independent risk factor for vascular disease, although the exact mechanism has not been fully elucidated. We studied 74 Japanese patients (51 males and 23 females) who were admitted for routine coronary angiography for investigation of chest pain or suspected CAD. All patients are examined glucose tolerance by 75gOGTT, classified into normal glucose tolerance group (NGT), impaired glucose tolerance group (IGT), and diabetes mellitus group (DM) by WHO criteria. Plasma homocysteine, lipid levels, and other fibrinolytic parameters were measured. Severity of coronary artery stenosis was expressed as CAD score (Gensini score), and patients were classified as having normal vessels or narrowed vessels on basis of a >75% stenosis in one or more of the three major coronary arteries or their branches. Hyperhomccysteinemia was observed in 15 (20%) subjects. Plasma homocysteine levels were higher, and fibrinogen and HbAlc levels were significantly higher in narrowed group than those in normal group, while age, smoking status, BMI, blood pressure, and plasma cholesterol levels were not. Plasma HDL-cholesterol and apolipoprotein A-I levels were significantly lower in narrowed group than those in normal group. Plasma homocysteine levels in all cases (n = 74, p = 0.041) and in DM group (n = 23, p = 0.022) were significantly correlated with CAD score by simple regression. In multiple stepwise linear analysis model, plasma homocysteine and apolipoprotein A-I levels were adjusted to CAD score, while age, smoking status, blood pressure, HbAlc. and BMl were not. These results suggest that hyperhomocysteinemia is an independent risk factor for coronary heart disease in diabetic patients.
2.P.230
Fractional esteritication rate of cholesterol in HDL can predict the particle size of LDL and HDL in CHD patients
T., K. Saku’ , I. Matsuda. University Fukuoka, Japan
Kumamoto
University,
timamoto;
Symposium
14
than that of small HDL. In conclusion, the particle size of both LDL and HDL,
Tbe&fectsofgarliconcardiovascularriskfactors: Double-blinded placebo-controlled study
A.N. Orekhov LV. Andrianova. Institute of Experimental --, Cardiology Research Center; Institute for Atherosclerosis Moscow, Russia
Cardiology, Research Ltd,
The positive influence of garlic on cardiovascular risk factors has been reported. In addition, according to folk medicine, garlic is effective as an antiatherosclerotic agent. Recently we have demonstrated that garlic possesses a direct antiatherosclerotic (therapeutic) and antiatherogenic (preventive) effects in cell culture model in vitro. To assess the effect of garlic on atherosclerosis risk factors, double-blinded placebo-controlled study was performed. Garlic tablet therapy induced statistically significant reduction in serum total cholesterol level along with significant increase in serum HDL cholesterol level, as compared to placebo treatment. Additionally, diastolic blood pressure was reduced by 10% in garlic-treated group of patients. Besides, garlic tablets administration resulted in the enhancement of plasma fibrinolytic activity and inhibition of platelet aggregation. The experiments performed on cell culture model demonstrated, that long-term treatment with garlic powder tablets leads to the :dgniticant reduction or even complete elimination of blood serum atherogenicity. Moreover, after 3 months of the treatment, blood serum gained the ability to reduce cholesterol content in cells cultured from atherosclerotic plaque. Our data demonstrate, that garlic may possess preventive and therapeutic effects on atherosclerosis.
I2.P.232 1 Lipids, LP(a) and fibrinogen iu acute stroke episodes S.A. Paximadas S.N. Pagoni’, C.E. Pitsavos’, J.N. Skoumas’, N.G. Giotsas’, --9 Y. Hallaq, B. Mermegas, S. Giannakides. Lipid Unit and First Dept. of Internar’ Medicine General Hospital of Athens ELPIS; ‘Lipid Center Cardiology Dept. Hippocration Hospital, Athens University, Greece Lipids, LP((Y) and fibrinogen increased risk for atherosclerosis and are independent risk factors in cardiovascular disease. Materials: 101 patients (47 females and 54 males) age 43-95 (mean 76 f IO) years were studied hospitalised during the last year in our hospitals. 36% had increased blood sugar, 38% had hypertension and 15% had CHD from patients. The over-all mortality was 15%. Methods: Serum levels of lipids, Lp(cr) and fibrinogen from all patients (Group A) compared to 70 random controls (Group B). All results were analyzed in the same laboratory.
Results: GrowA(n= LP@) bWL1 Fibrin. [mgdL] TC [mg/dL] TG [m&IL] HDL ImwdLl
101)
40.8 + 37.6 492 f 165 2lOk46 125 i 65 42.9 h 14.9
Grout B (n = 70)
D
40 * 32.3 314f60 221 f 48 115*37 41.2 3~9.8
NS
Conclusion: The study shows that the lipid and Lp(cx) levels are not elevated in patients with thrombolic-embolism cerebral vascular episodes, while the fibrinogen is increased statistically significant.
’ Fukuoka
Qualitative changes in LDL and HDL are thought to be important for evaluating the risk for coronary heart disease (CHD). Fractional esterification rate of cholesterol in HDL (FBRHDL) can predict the size distribution and physicochemical characteristics of HDL in plasma. We investigated the correlation of FBRHDL with the particle size of LDL (LDL-size) in 111 patients with CHD. The correlations of FBRHDL and LDL-size with conventional lipoprotein parameters were also studied. FERHDL was closely associated with LDL-size (males: r = -0.62, females: r = -0.63, p < 0.001). Plasma levels of TG, HDL-C, HDLz-C and apo B were also associated with LDL-size in male CHD patients (r = -0.53, 0.31, 0.36 and -0.48, p < O.Ol), while plasma TG and apo B were associated with LDL-size in female patients (r = -0.35 and -0.35, p < 0.05). In a stepwise multiple regression analysis, FERHDL alone accounted for 38% and 40% of the variability in LDL-size in male and female CHD patients, respectively. Other parameters accounted for an additional 6-10%. With respect to the relation between FERHDL and HDL subfractions, FERHDL related only to HDL2-C (males: r = -0.64, females: r = -0.65, p -Z O.OOl), suggesting that FBRHDL may predict the presence 1 lth International
(or absence) of larger HDL, rather FERHD; can be useful in predicting even in CHD patients.
17
2.P.233
free radicals generation by grannlocytes of patients with atherosclerosis
Oxygen
L. Pawlicki, W. Pawelski, Department of Physiology Medicar’ University tidi,
J. Blaszczyk, E. Sibiirska, J. Kqdziora, and Department of Internal Diseases Poland
J. Kowalski. Military
According to one the hypotheses of atherosclerotic process pathogenesis oxygen free radicals cause oxidative modification of plasma atherogenic lipoproteins what leads to uncontrolled cumulation of cholesterol esters in macrophage cytoplasm and transformation to foam cells the main element of the early atherogenic changes. Thus it may be assumed that oxygen free radicals generation is higher in patients with atherosclerosis than in healthy subjects. In order to verify this thesis own investigations were performed in patients with various clinical forms of atherosclerosis regarding whole blood granulocytes to be an easy source of oxygen free radicals. Investigations were performed in subjects divided into four groups of clinically healthy
on Atherosclerosis.
Paris,
October
1997