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2.P.264 A common mutation in methylenetetrahydrofolate reductase: Associations with homocysteine and risk of coronary atherosclerosis
Tuesday 7 October 1997: Posters Risk factors (for cardiovascular diseases) lipoprotein (a), and relation chol/HDL represents precursor in the development and progression of coronary involvement. The aim of our study was to evaluate and compare the level of plasmatic lipids and their fractions with the severity degree of coronary obstruction. Our study comprised 101 subjects, 77 males and 24 females, age from 35 to 75 years x = 55.7 years. The subjects were divided into two groups: one group CAD with positive coronarogram (N = 70), and the other group CAD with negative coronarogram (N = 3 1). By anatomic localization of blood vessel the first group was divided into one-vessel (N = 20), two-vessel (N = 25) and multiple-vessel lesion (N = 24). Blood vessel lumen structure was 70% or more. Lipid status had been determined for each patient. By our study we have pointed to the significant positive correlation between the level of plasmatic lipoproteins (Ape Al, Apo Al/Ape Bl, HDL, cholesterol, chol/HDL, at level p < 0.05) and angiographic findings thus indicating the significant role of low density lipoprotein in pathogenesis of atherosclerosis and development of coronary obstruction.
m2 P 262
The assessment population
LA. Sobenin, A.N. Orekhov. for Atherosclerosis Research,
of risk of myocardii
infarction
Institute of Experimental Ltd., Moscow, Russia
in Moscow
Cardiology,
Institute
Atherosclerotic cardiovascular diseases are the leading causes of death and the most frequent reasons for early invalidity in industrially developed countries. The objective assessment of the overall risk of myocardial infarction in an individual patient is often rather difficult due to the complex interaction and mutual dependence of the risk factors. Generally a single risk factor is insufficient for the early identification of patients in the high risk group. Therefore, we used the programs utilizing the multilogistic function for calculating statistical risk of myocardial infarction in representative group of Moscow inhabitants, namely, Spirit Plus@ generated from the results of PROCAM Study, and Life Style@ generated from the 1991 data revision of original Framingham Study. The total group consisted of 1850 men and 500 women, aged 40-64, free of severe arterial hypertension, diabetes mellitus and cardiovascular diseases at the baseline. The 4-years risk of myocardial infarction was assessed for men with the help of Spirit Plus@ program and accounted for 4.14 f O.ll%, that was 1.19-fold higher than the theoretical average risk for age-matched subjects from European population (p < 0.005, ANOVA, and p < 0.0001, paired t-test). The 5-years and lo-years risk in men calculated by Life Style@ program accounted for 6.71 f 0.11% and 13.79 f 0.19%, respectively. The laner was 1.07-fold higher than the average statistical risk for people of corresponding age (p < 0.0001, ANOVA and paired t-test). In women, the 5-years and lo-years risk levels accounted for 2.58 f 0.11% and 5.88 f 0.23%, respectively. The latter was practically equal to the average statistical risk for women of corresponding age. The results of this study demonstrate that men in Moscow population are at a significantly higher risk of myocardial infarction and thus predisposed to higher incidence of cardiovascular events. The epidemiological program has been started in Moscow to develop the locally adjusted recommendations of primary prevention of atherosclerosis-related cardiovascular diseases.
I 2 P.263
Twenty years lasting interventional risk factors in middle age men
study
of cardiovascular
M. Tom&kov& F. Boudff, .I. ZvtiovB, K. Zvtia, M. Stefek, J. Bultas. UniversiQ and Czech Academy of Sciences, Prague, Czech Republic
Charles
Within the years 1975-1977 a group of 1417 males aged 40-50 years, living in the centre of Prague were screened for the main cardiovascular risk factors. Primary and latter secondary intervention was carried out in them. In a subgroup of 100 subjects body surface potential mapping was obtained to the end of 20 years of follow up in order to identify the presence of coronary artery disease and its degree. Summary: Preliminary data from the first 10 years of risk factor intervention demonstrate more important influence of hypertension (160/90 mmHg) on the cardiovascular morbidity and mortality as compared with the influence of hypercholesterolemia (260 mg%). Heavy smoking (15 cigarettes per dominates with its significance among other risk factors. Conclusion: It seems - after 20 years of the intervention - that population strategy could be appropriate for the management of some risk factors, the individual approach for the others.
2.P.264
Symposium
A common mutation in methylenetetrahydrafok& reductase: Associations with homocysteine and risk of coronary atherosclerosis
P. Verhoef’ , F.J. Kohl , L.A.J. Kluijtmans’, H.J. Blom*, H. Refsum3, P.M. Ueland3, H.A.C.M. Kruyssen4. ‘Department of Epidemiology and Public Health, Agricultural University, Wageningen; 2 University Hospital, Nijmegen; 4Zuiderziekenhuis Hospital Rotterdam, The Netherlands: 3 University of Bergen, Norway Purpose: To assess whether the 677C-+T mutation of methylenetetrahydrofolate reductase (MTHFR), a crucial enzyme in homocysteine metabolism, is associated with increased risk of coronary atherosclerosis, and whether folate status modifies the association. Methods: Data were collected from males and females, aged 25 to 65 years, with severe coronary atherosclerosis (cases, n = 131) or virtually no coronary narrowing (coronary controls, n = 87), and a population-based control group (n = 100). Results: Frequency of homozygosity for the mutation (+/+) was 10.0% in cases, 11 5% in coronary controls and 7.0% in population-based controls. In the overall group (as well as in the three subgroups), plasma fasting tHcy levels were higher in +/+ subjects than in homozygous normal subjects (-/-), whereas heterozygous subjects (+/-) had intermediate levels (&& = 0.001). The +/+ subjects with erythrocyte folate levels ~790 mnol/L (population median) had a 77% (95% confidence interval [CI], 27% to 144%) higher geometric mean fasting tHcy (21.4 @mol/L) than those with higher erythrocyte folate (12.1 kmol/L). The odds ratio (OR) of coronary atherosclerosis for +/+ subjects, with + & and - f subjects as reference, using combined controls, was 1.1 (95% CI, 0.5-2.4). The ORs were 2.2 (0.7 to 6.8) and 0.6 (0.2 to 1.7)
Lrl
2 P 265
J3ffects of andrugenic anabolic steroids apolipoproteins and lipoprotein(a)
B.H.R. Wolffenbuttel, Maastricht University, Netherlands
(AAS)
on
F. Hartgens, G. Rietjens, H.A. Keizer, H. Kuipers. and Centre for Doping Affairs Rotterdam, The
Previous studies suggested detrimental effects of high doses of AAS on cardiovascular risk factors. As part of a long-term study, we studied the changes of apolipoproteins (apo) and lipoprotein(a), Lp(a), in 14 male competitive body-builders (age 31 f 6 yrs), who used self-administration of AAS for 8 or 14 weeks in addition to their usual strength training. Results were compared with 15 subjects (age 33 f 5 yrs) who trained without using AAS. Also, we assessed whether lipoproteins had normalized 6 weeks after cessation of AAS use. At the start, all subjects had normal fasting serum lipids. In AAS users, who used several compounds at the same time in varying dosages (weekly use 3-10 x the maximal therapeutic dose), total cholesterol (C) and triglycerides (enzymatic methods) did not change significantly; HDL-C fell from 1.11 & 0.31 to 0.46 f 0.23 mmol!l (p < O.OOl), and LDL-C (Friedewald formula) increased from 2.73 f 0.64 to 3.66 f 1.05 mmol/l (p < 0.01); apoA1 decreased from 1.44 f 0.29 to 0.79 f 0.32 fl, while apoB (immunoturbidimetry, Roche) increased from 0.98 f 0.14 to 1.32 f 0.29 g/l (both p < 0.001). Also, Lp(a) (RIA, Pharmacia) fell greatly, from a median concentration of 82 (range 16-1243) to 10 (range 8-281) UiI (p c 0.001). No changes occurred in the subjects who performed strength training without the use of AAS. Six weeks after cessation of AAS administration, HDL-C, apoA1 and Lp(a) were still decreased in comparison with baseline levels (0.89 f 0.40 mmolA, 1.16 f 0.42 g/l, and 30 (range 9-991) U/l, resp., all p < 0.05). We conclude that, although AAS belong to the few compounds which may reduce elevated levels of Lp(a), their long-term use is accompanied with an increased atherogenic lipid profile, which persists more than 6 weeks after cessation of use.
I2 P 266 T. Wesolowska --, Atherosclerosis Higher
11th International
171
on Atherosclerosis
Serum angiotensin convertase activity in men after myacardial infarction and their healthy sons M. Naruszewicz, K. Klimek, B. Torbus-Lisiecka. Centerfor Research, Pomeranian Medical Academy, Szczecin, Poland
angiotensin Paris,
convertase October
activity 1997
(ACE)
predisposes
to the development
m2 P 262
The assessment population
LA. Sobenin, A.N. Orekhov. for Atherosclerosis Research,
of risk of myocardii
infarction
Institute of Experimental Ltd., Moscow, Russia
in Moscow
Cardiology,
Institute
Atherosclerotic cardiovascular diseases are the leading causes of death and the most frequent reasons for early invalidity in industrially developed countries. The objective assessment of the overall risk of myocardial infarction in an individual patient is often rather difficult due to the complex interaction and mutual dependence of the risk factors. Generally a single risk factor is insufficient for the early identification of patients in the high risk group. Therefore, we used the programs utilizing the multilogistic function for calculating statistical risk of myocardial infarction in representative group of Moscow inhabitants, namely, Spirit Plus@ generated from the results of PROCAM Study, and Life Style@ generated from the 1991 data revision of original Framingham Study. The total group consisted of 1850 men and 500 women, aged 40-64, free of severe arterial hypertension, diabetes mellitus and cardiovascular diseases at the baseline. The 4-years risk of myocardial infarction was assessed for men with the help of Spirit Plus@ program and accounted for 4.14 f O.ll%, that was 1.19-fold higher than the theoretical average risk for age-matched subjects from European population (p < 0.005, ANOVA, and p < 0.0001, paired t-test). The 5-years and lo-years risk in men calculated by Life Style@ program accounted for 6.71 f 0.11% and 13.79 f 0.19%, respectively. The laner was 1.07-fold higher than the average statistical risk for people of corresponding age (p < 0.0001, ANOVA and paired t-test). In women, the 5-years and lo-years risk levels accounted for 2.58 f 0.11% and 5.88 f 0.23%, respectively. The latter was practically equal to the average statistical risk for women of corresponding age. The results of this study demonstrate that men in Moscow population are at a significantly higher risk of myocardial infarction and thus predisposed to higher incidence of cardiovascular events. The epidemiological program has been started in Moscow to develop the locally adjusted recommendations of primary prevention of atherosclerosis-related cardiovascular diseases.
I 2 P.263
Twenty years lasting interventional risk factors in middle age men
study
of cardiovascular
M. Tom&kov& F. Boudff, .I. ZvtiovB, K. Zvtia, M. Stefek, J. Bultas. UniversiQ and Czech Academy of Sciences, Prague, Czech Republic
Charles
Within the years 1975-1977 a group of 1417 males aged 40-50 years, living in the centre of Prague were screened for the main cardiovascular risk factors. Primary and latter secondary intervention was carried out in them. In a subgroup of 100 subjects body surface potential mapping was obtained to the end of 20 years of follow up in order to identify the presence of coronary artery disease and its degree. Summary: Preliminary data from the first 10 years of risk factor intervention demonstrate more important influence of hypertension (160/90 mmHg) on the cardiovascular morbidity and mortality as compared with the influence of hypercholesterolemia (260 mg%). Heavy smoking (15 cigarettes per dominates with its significance among other risk factors. Conclusion: It seems - after 20 years of the intervention - that population strategy could be appropriate for the management of some risk factors, the individual approach for the others.
2.P.264
Symposium
A common mutation in methylenetetrahydrafok& reductase: Associations with homocysteine and risk of coronary atherosclerosis
P. Verhoef’ , F.J. Kohl , L.A.J. Kluijtmans’, H.J. Blom*, H. Refsum3, P.M. Ueland3, H.A.C.M. Kruyssen4. ‘Department of Epidemiology and Public Health, Agricultural University, Wageningen; 2 University Hospital, Nijmegen; 4Zuiderziekenhuis Hospital Rotterdam, The Netherlands: 3 University of Bergen, Norway Purpose: To assess whether the 677C-+T mutation of methylenetetrahydrofolate reductase (MTHFR), a crucial enzyme in homocysteine metabolism, is associated with increased risk of coronary atherosclerosis, and whether folate status modifies the association. Methods: Data were collected from males and females, aged 25 to 65 years, with severe coronary atherosclerosis (cases, n = 131) or virtually no coronary narrowing (coronary controls, n = 87), and a population-based control group (n = 100). Results: Frequency of homozygosity for the mutation (+/+) was 10.0% in cases, 11 5% in coronary controls and 7.0% in population-based controls. In the overall group (as well as in the three subgroups), plasma fasting tHcy levels were higher in +/+ subjects than in homozygous normal subjects (-/-), whereas heterozygous subjects (+/-) had intermediate levels (&& = 0.001). The +/+ subjects with erythrocyte folate levels ~790 mnol/L (population median) had a 77% (95% confidence interval [CI], 27% to 144%) higher geometric mean fasting tHcy (21.4 @mol/L) than those with higher erythrocyte folate (12.1 kmol/L). The odds ratio (OR) of coronary atherosclerosis for +/+ subjects, with + & and - f subjects as reference, using combined controls, was 1.1 (95% CI, 0.5-2.4). The ORs were 2.2 (0.7 to 6.8) and 0.6 (0.2 to 1.7)
Lrl
2 P 265
J3ffects of andrugenic anabolic steroids apolipoproteins and lipoprotein(a)
B.H.R. Wolffenbuttel, Maastricht University, Netherlands
(AAS)
on
F. Hartgens, G. Rietjens, H.A. Keizer, H. Kuipers. and Centre for Doping Affairs Rotterdam, The
Previous studies suggested detrimental effects of high doses of AAS on cardiovascular risk factors. As part of a long-term study, we studied the changes of apolipoproteins (apo) and lipoprotein(a), Lp(a), in 14 male competitive body-builders (age 31 f 6 yrs), who used self-administration of AAS for 8 or 14 weeks in addition to their usual strength training. Results were compared with 15 subjects (age 33 f 5 yrs) who trained without using AAS. Also, we assessed whether lipoproteins had normalized 6 weeks after cessation of AAS use. At the start, all subjects had normal fasting serum lipids. In AAS users, who used several compounds at the same time in varying dosages (weekly use 3-10 x the maximal therapeutic dose), total cholesterol (C) and triglycerides (enzymatic methods) did not change significantly; HDL-C fell from 1.11 & 0.31 to 0.46 f 0.23 mmol!l (p < O.OOl), and LDL-C (Friedewald formula) increased from 2.73 f 0.64 to 3.66 f 1.05 mmol/l (p < 0.01); apoA1 decreased from 1.44 f 0.29 to 0.79 f 0.32 fl, while apoB (immunoturbidimetry, Roche) increased from 0.98 f 0.14 to 1.32 f 0.29 g/l (both p < 0.001). Also, Lp(a) (RIA, Pharmacia) fell greatly, from a median concentration of 82 (range 16-1243) to 10 (range 8-281) UiI (p c 0.001). No changes occurred in the subjects who performed strength training without the use of AAS. Six weeks after cessation of AAS administration, HDL-C, apoA1 and Lp(a) were still decreased in comparison with baseline levels (0.89 f 0.40 mmolA, 1.16 f 0.42 g/l, and 30 (range 9-991) U/l, resp., all p < 0.05). We conclude that, although AAS belong to the few compounds which may reduce elevated levels of Lp(a), their long-term use is accompanied with an increased atherogenic lipid profile, which persists more than 6 weeks after cessation of use.
I2 P 266 T. Wesolowska --, Atherosclerosis Higher
11th International
171
on Atherosclerosis
Serum angiotensin convertase activity in men after myacardial infarction and their healthy sons M. Naruszewicz, K. Klimek, B. Torbus-Lisiecka. Centerfor Research, Pomeranian Medical Academy, Szczecin, Poland
angiotensin Paris,
convertase October
activity 1997
(ACE)
predisposes
to the development