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hip ratio, in patients with coronary artery disease (which method should be used?)
210
SO?l?iXZ
I666 COMPARISON
OF OBESITY PREVALENCE, BASED ON BODY MASS INDEX, WAIST CIRCUMFERENCE AND WAIST/HIP RATIO, IN PATIENTS WITH CORONARY ARTERY DISEASE (WHICH METHOD SHOULD BE USED?)
K. Sonmez, M. Akcakoyun, A. Akcay, D. Demir, O.H. Elonu, 0. Onat, R.B. Bakal, M. Gencbay, M. Degertekin, F. Turan. Kosuyolu Heart and Research Hospital, Istanbul, Turkey Background:
Various studies have demonstrated obesity as an independent risk factor for coronary artery disease (CAD) in both sexes. Body weight, body mass index (BMI), waist circumference and waist/hip ratio (WHR) are widespread used for the determination of obesity. While BMI reflects obesity in general, waist circumference and WHR indicate central obesity. Objectives: To determine BMI, waist circumference and WHR in cases with angiographically confirmed CAD and in these patients, to compare the obesity degrees according to the ranges determined by International Guidelines Committees for BMI, waist circumference and WHR. Method: Our study group consisted of 617 consecutive cases (516 males, mean age: 75.2&10.8 years) with CAD who underwent their first coronary angiography. between January 2000 and May 2000. Before coronary angiography their heights, weights, waist and hip circumferences and other risk factors were measured. Waist circumferences, BMI, and WHR’ s were compared both as a whole and also within stratified groups as for sexes and age groups categorized in decades above 40 years of age. Results: Overweight cases comprised approximately half of the patients in both sexes. In males the percentages of obese cases with respect to BMIs were 15%, while males with action level 2 waist circumferences were detected to be 20%. Obese male patients whose WHR’ s equal or greather than 0.95 were found to be 5 1%. In female cases corresponding percentages of obesity were estimated to be 32%, 72% and 86% respectively. Conclusion: In terms of these data, the prevalence of obesity in female patients with CAD is significantly higher than their male counterparts. The percentage of obesity within the same group of patients differ significantly in terms of BMI, waist circumference and WHR. The utilisation of BMI for the detection of obesity in cases with CAD can overlook some cases of obesity. Therefore in cases with CAD waist circumference can be the method of choice for the assessment of obesity more precisely.
I667 IS RISK
FACTORS DISTRIBUTION DIFFERS, ACCORDING TO OBESITY DEGREES IN PATIENTS WITH ANGIOGRAPHICALLY CONFIRMED CORONARY ARTERY DISEASE?
K. Sonmez, M. Akcakoyun, A. Akcay, D. Demir, 0. Onat, M. Gencbay, M. Degertekin, F. Turan. Kosuyolu Heart and Research Hospital, Istanbul, Turkey Background:
The main difference that delineates obesity from other coronary risk factors is that besides its being an independent risk factor, it is also associated with other risk factors such as hypertension (HT), hypercholesterolemia, low HDL cholesterol, hypertriglyceridemia, and diabetes mellitus (DM). It has been known that there is a linear correlation between the coronary heart disease (CHD) and obesity. The same linear correlation is true for some other coronary risk factors. Objectives: The purpose of our study was to compare the dispersion of other coronary risk factors in CHD cases with different obesity categories which was defined according to the body mass index (BMI) and waist circumferences and to determine to which extend these cut-off values effect the dispersion of other coronary risk factors. Method: The study group was consisted of 617 consecutive subjects (5 16 male, mean age 57.2&10.8) who underwent an angiography between January 2000 and May 2000 for the first time and in whom significant coronary lesions were detected in our institute. The dispersion of risk factors such as, age, smoking, hypertension (HT), diabetes mellitus (DM), high LDL-C, low HDL-C, Total CXIDL-C ratio, triglyserides, family history of premture CHD were compared within overweight and obese cases defined according to BMI values. The same risk factors are compared within the cases grouped as action level 1 and action level 2 defined by waist circumference. Results: In male patients; smoking was found to be higher in overweight than obese cases (71%vs.56%) (piO.05). In female patients; the only difference was the ratio of Total-CYHDL-C as being greater in obese group than overweight group (p
group. In female patients risk factors prevalence was similar in both group. The proportion of regular physical activity did not differ among groups. Conclusion: In patients with CAD, when coronary risk factors such as age, smoking, HT, DM, Hyperlipidemia, low HDL and family history of CAD were considered, the amount of total risk factors doesn’ t differe between overweight and obese cases and between patients with action level 1 and action level 2 waist circumference. These findings indicate the necessity of using the same secondary prevention approach in patients with CAD and different level of obesity. I668 DISTRIBUTION
OF THERAPEUTIC PROCEDURES AND USE OF DRUG THERAPIES IN PATlENTS WITH ANGIOGRAPHICALLY CONFIRMED CORONARY ARTERY DISEASE IN TURKISH PATIENTS (SINGLE CENTRE EXPERIENCE)
K. Sonmez, A. Akcay, M. Akcakoyun, D. Demir, O.H. Elonu, 0. Onat, N.E. Duran, M. Gencbay, M. Degertekin, F. Turan. Kosuyolu Heart and Research Hospital, Istanbul, Turkey Objectives:
The aims of our study were to assess the distribution of interventional and other therapeutic procedures performed on subjects who had proven CAD by angiography in our institution; to determine the groups of therapeutic agents prescribed at the time of discharge; and to compare these with the results of EUROASPIRE II, which examined the prophylactic drug therapy upon discharge of CAD patients in 15 European countries. Methods: Our patients comprises of 617 consecutive subjects (516 male1 female; mean age, 57.2&10.8 years) who underwent their first coronary angiography between January 2000 and May 2000, and who were found to have a greather than 50% lesion in at least one coronary artery. In all patients distribition of risk factors at admission, distribution of therapeutic procedures and the use of drug therapies at the hospital discharge recorded. Results: We found that, 68% of our cases were considered to be eligible for a percutaneous or surgical intervention, while 27% were assessed not as requiring such an intervention and consequently were discharged being prescribed appropriate medications. For the remaining 5% of the subjects, tests for detection of viable myocardium were advised, before deciding upon the proper type of management. At discharge, prescription for antiplatelets, beta-blockers, nitrates, statins, angiotensin-converting enzyme inhibitors (ACE-I), calcium channel blockers and anticoagulants were detected to be 99%, 86%, 86%, 63%, 40%, 16%, and 2% respectively. Conclusion: Compared with the results of EUROASPIRE II study, these data show that, antiplatelet, beta-blocker, ACE-I and statins our subjects received upon discharge were higher, whereas anticoagulant treatment was lower than the averages of the fifteen European countries consisting the EUROASPIRE II study. 16691 A ROLE
OF SCAVENGER RECEPTOR BI (SR-BI), ENDOTHELIAL LIPASE (EL) AND FATTY ACID TRANSLOCASE (FAT)/CD36 IN PUFA SUPPLY AT THE BLOOD-BRAIN BARRIER
A. Sovic U. Panzenboeck, Z. Balazs, D. Goti, A. Hrzenjak, G.M. Kostner, -> W. Sattler. Karl-Franzens-Uniuersify, Institute ofMedical Biochemistry and Medical Molecular Biology, Graz, Austria Polyunsaturated fatty acids (PUFA) comprise 25-30% of the fatty acids in the human brain and are necessary for normal development and function. In principle, cerebral PUFAs can originate from the free fatty acid plasma pool or lipoprotein-associated lipids. Lipoprotein receptors that mediate lipoprotein binding/uptake are expressed at the blood-brain barrier (BBB) and could contribute to the supply of the brain with PUFA originating from lipoprotein lipids. The aim of the present study was to investigate pathways that facilitate uptake of LDL- and HDL-derived phospholipids(PL), subsequent hydrolysis and import of liberated PUFAs by primary porcine brain capillary endothelial cells (pBCEC), an in vitro model of the BBB. Our results indicate that lipoprotein-derived PL are taken up via SR-BI mediated selective uptake. A potential candidate that could catalyze hydrolysis of lipoprotein-derived PL is endothelial lipase (EL), a lipase with high phospholipase activity. EL expression by pBCECs was verified on mRNA and protein level. Treatment of pBCECs with PPAR-agonists and a RXR-agonist significantly upregulated the amount of immunoreactive EL in the cellular supernatants. To elucidate the impact of EL on PL hydrolysis PL-tracer experiments were performed, and revealed hydrolysis of the tracer and liberation of [14C]-20:4 in a time dependent manner. A potential candidate that could mediate FA import in pBCECs is fatty acid translocase (FAT)/CD36. Immunoblotting experiments
73rd EAS Congress
SO?l?iXZ
I666 COMPARISON
OF OBESITY PREVALENCE, BASED ON BODY MASS INDEX, WAIST CIRCUMFERENCE AND WAIST/HIP RATIO, IN PATIENTS WITH CORONARY ARTERY DISEASE (WHICH METHOD SHOULD BE USED?)
K. Sonmez, M. Akcakoyun, A. Akcay, D. Demir, O.H. Elonu, 0. Onat, R.B. Bakal, M. Gencbay, M. Degertekin, F. Turan. Kosuyolu Heart and Research Hospital, Istanbul, Turkey Background:
Various studies have demonstrated obesity as an independent risk factor for coronary artery disease (CAD) in both sexes. Body weight, body mass index (BMI), waist circumference and waist/hip ratio (WHR) are widespread used for the determination of obesity. While BMI reflects obesity in general, waist circumference and WHR indicate central obesity. Objectives: To determine BMI, waist circumference and WHR in cases with angiographically confirmed CAD and in these patients, to compare the obesity degrees according to the ranges determined by International Guidelines Committees for BMI, waist circumference and WHR. Method: Our study group consisted of 617 consecutive cases (516 males, mean age: 75.2&10.8 years) with CAD who underwent their first coronary angiography. between January 2000 and May 2000. Before coronary angiography their heights, weights, waist and hip circumferences and other risk factors were measured. Waist circumferences, BMI, and WHR’ s were compared both as a whole and also within stratified groups as for sexes and age groups categorized in decades above 40 years of age. Results: Overweight cases comprised approximately half of the patients in both sexes. In males the percentages of obese cases with respect to BMIs were 15%, while males with action level 2 waist circumferences were detected to be 20%. Obese male patients whose WHR’ s equal or greather than 0.95 were found to be 5 1%. In female cases corresponding percentages of obesity were estimated to be 32%, 72% and 86% respectively. Conclusion: In terms of these data, the prevalence of obesity in female patients with CAD is significantly higher than their male counterparts. The percentage of obesity within the same group of patients differ significantly in terms of BMI, waist circumference and WHR. The utilisation of BMI for the detection of obesity in cases with CAD can overlook some cases of obesity. Therefore in cases with CAD waist circumference can be the method of choice for the assessment of obesity more precisely.
I667 IS RISK
FACTORS DISTRIBUTION DIFFERS, ACCORDING TO OBESITY DEGREES IN PATIENTS WITH ANGIOGRAPHICALLY CONFIRMED CORONARY ARTERY DISEASE?
K. Sonmez, M. Akcakoyun, A. Akcay, D. Demir, 0. Onat, M. Gencbay, M. Degertekin, F. Turan. Kosuyolu Heart and Research Hospital, Istanbul, Turkey Background:
The main difference that delineates obesity from other coronary risk factors is that besides its being an independent risk factor, it is also associated with other risk factors such as hypertension (HT), hypercholesterolemia, low HDL cholesterol, hypertriglyceridemia, and diabetes mellitus (DM). It has been known that there is a linear correlation between the coronary heart disease (CHD) and obesity. The same linear correlation is true for some other coronary risk factors. Objectives: The purpose of our study was to compare the dispersion of other coronary risk factors in CHD cases with different obesity categories which was defined according to the body mass index (BMI) and waist circumferences and to determine to which extend these cut-off values effect the dispersion of other coronary risk factors. Method: The study group was consisted of 617 consecutive subjects (5 16 male, mean age 57.2&10.8) who underwent an angiography between January 2000 and May 2000 for the first time and in whom significant coronary lesions were detected in our institute. The dispersion of risk factors such as, age, smoking, hypertension (HT), diabetes mellitus (DM), high LDL-C, low HDL-C, Total CXIDL-C ratio, triglyserides, family history of premture CHD were compared within overweight and obese cases defined according to BMI values. The same risk factors are compared within the cases grouped as action level 1 and action level 2 defined by waist circumference. Results: In male patients; smoking was found to be higher in overweight than obese cases (71%vs.56%) (piO.05). In female patients; the only difference was the ratio of Total-CYHDL-C as being greater in obese group than overweight group (p
group. In female patients risk factors prevalence was similar in both group. The proportion of regular physical activity did not differ among groups. Conclusion: In patients with CAD, when coronary risk factors such as age, smoking, HT, DM, Hyperlipidemia, low HDL and family history of CAD were considered, the amount of total risk factors doesn’ t differe between overweight and obese cases and between patients with action level 1 and action level 2 waist circumference. These findings indicate the necessity of using the same secondary prevention approach in patients with CAD and different level of obesity. I668 DISTRIBUTION
OF THERAPEUTIC PROCEDURES AND USE OF DRUG THERAPIES IN PATlENTS WITH ANGIOGRAPHICALLY CONFIRMED CORONARY ARTERY DISEASE IN TURKISH PATIENTS (SINGLE CENTRE EXPERIENCE)
K. Sonmez, A. Akcay, M. Akcakoyun, D. Demir, O.H. Elonu, 0. Onat, N.E. Duran, M. Gencbay, M. Degertekin, F. Turan. Kosuyolu Heart and Research Hospital, Istanbul, Turkey Objectives:
The aims of our study were to assess the distribution of interventional and other therapeutic procedures performed on subjects who had proven CAD by angiography in our institution; to determine the groups of therapeutic agents prescribed at the time of discharge; and to compare these with the results of EUROASPIRE II, which examined the prophylactic drug therapy upon discharge of CAD patients in 15 European countries. Methods: Our patients comprises of 617 consecutive subjects (516 male1 female; mean age, 57.2&10.8 years) who underwent their first coronary angiography between January 2000 and May 2000, and who were found to have a greather than 50% lesion in at least one coronary artery. In all patients distribition of risk factors at admission, distribution of therapeutic procedures and the use of drug therapies at the hospital discharge recorded. Results: We found that, 68% of our cases were considered to be eligible for a percutaneous or surgical intervention, while 27% were assessed not as requiring such an intervention and consequently were discharged being prescribed appropriate medications. For the remaining 5% of the subjects, tests for detection of viable myocardium were advised, before deciding upon the proper type of management. At discharge, prescription for antiplatelets, beta-blockers, nitrates, statins, angiotensin-converting enzyme inhibitors (ACE-I), calcium channel blockers and anticoagulants were detected to be 99%, 86%, 86%, 63%, 40%, 16%, and 2% respectively. Conclusion: Compared with the results of EUROASPIRE II study, these data show that, antiplatelet, beta-blocker, ACE-I and statins our subjects received upon discharge were higher, whereas anticoagulant treatment was lower than the averages of the fifteen European countries consisting the EUROASPIRE II study. 16691 A ROLE
OF SCAVENGER RECEPTOR BI (SR-BI), ENDOTHELIAL LIPASE (EL) AND FATTY ACID TRANSLOCASE (FAT)/CD36 IN PUFA SUPPLY AT THE BLOOD-BRAIN BARRIER
A. Sovic U. Panzenboeck, Z. Balazs, D. Goti, A. Hrzenjak, G.M. Kostner, -> W. Sattler. Karl-Franzens-Uniuersify, Institute ofMedical Biochemistry and Medical Molecular Biology, Graz, Austria Polyunsaturated fatty acids (PUFA) comprise 25-30% of the fatty acids in the human brain and are necessary for normal development and function. In principle, cerebral PUFAs can originate from the free fatty acid plasma pool or lipoprotein-associated lipids. Lipoprotein receptors that mediate lipoprotein binding/uptake are expressed at the blood-brain barrier (BBB) and could contribute to the supply of the brain with PUFA originating from lipoprotein lipids. The aim of the present study was to investigate pathways that facilitate uptake of LDL- and HDL-derived phospholipids(PL), subsequent hydrolysis and import of liberated PUFAs by primary porcine brain capillary endothelial cells (pBCEC), an in vitro model of the BBB. Our results indicate that lipoprotein-derived PL are taken up via SR-BI mediated selective uptake. A potential candidate that could catalyze hydrolysis of lipoprotein-derived PL is endothelial lipase (EL), a lipase with high phospholipase activity. EL expression by pBCECs was verified on mRNA and protein level. Treatment of pBCECs with PPAR-agonists and a RXR-agonist significantly upregulated the amount of immunoreactive EL in the cellular supernatants. To elucidate the impact of EL on PL hydrolysis PL-tracer experiments were performed, and revealed hydrolysis of the tracer and liberation of [14C]-20:4 in a time dependent manner. A potential candidate that could mediate FA import in pBCECs is fatty acid translocase (FAT)/CD36. Immunoblotting experiments
73rd EAS Congress