- Email: [email protected]
FACTOR ANALYSIS OF RISK VARIABLES ASSOCIATED WITH LOW-GRADE INFLAMMATION
114
Poster Sessions PO25 Inflammatory markers
sels was related to increased Lp(a) concentrations, without (p=0.009) and with adjustment (p=0.001) for apo(a) isoforms. However, apo(a) isoforms were not significantly associated with the extent of CAD (p=0.695). Conclusions: This study shows that small apo(a) isoforms are the primary factor associated with the presence of CAD, but they did not influence the extent of the disease. PO24-395
APO E GENOTYPE AS AN INDICATOR FOR THE CHD AND ALZEHEIMER DISEASES IN KOREAN SENIOR SUBJECTS
H. Oh 1 , M. Park 2 , H. Kim 3 , Y. Lim 4 , M. Lee 5 . 1 Family Health and Welfare Center (FHWC), Sungshin Women’s Univ; 2 Division of Clinical Research, Seoul Medical Center Research Institute; 3 Dept. of Food and Nutrition, Sookmyung Women’s University; 4 Dept. of Food and Nutrition, Kyunghee University; 5 Dept. of Food and Nutrition, Sungshin Women’s University Recent studies described the ε4 or ε2 allele of apoE increased risk for CHD and the late-onset Alzheimer’s disease. The goal of this study was to find the association between above diseases and apo E alleles each in the 107 elderly between 50 to 64 years old. We conducted the questionnaire survey (general & diet), anthropometry and blood biochemistry (FBS & lipid profiles, HOMA-IR, apo E genotyping). The frequencies of apo E genotypes were 7.0%, 83.6% and 9.3% for the ε2, ε3 and ε4 allele. FBS was significantly higher in ε4 than that in the others (p<0.01). More than 40% of ε4 group shown the dyslipidemia (High-TG & Low-HDL). The cytokines levels such as IL-1β, IL-6 and TNF-α were not different among three apo E alleles. After the adjusting sex, age & dietary fiber, LDL-c level was significantly higher in ε4 than that in ε2 (p<0.05). According to food intake and the recipe, the elderly with ε4 allele took higher intake frequency of the light-colored vegetable and pan-fried foods than the others. We knew that the elderly with ε4 allele had been restricted the calories intakes with high dietary fiber (33.6±2.5g/d) to maintain the normal level of FBS and LDL-c. Therefore, we found that apoE genotype might be good indicator for combining diseases of CHD and late-onset Alzheimer’s disease. [This study was supported by a grant of the Seoul R&BD Program, Republic of Korea (10526)]. PO24-396
THREE TURKISH SISTERS WITH AUTOSOMAL RECESSIVE HYPERCHOLESTEROLEMIA UNDERGOING LIPID-APHERESIS
E. Steinhagen-Thiessen, U. Kassner, A. Vogt. Lipidclinic, Interdisciplinary Metabolic Center, Charite, Campus Virchow, Berlin, Germany Introduction: In societies allowing marriage of relatives genetic disorders like homozygous familial hypercholesterolemia (FH) are more common. Affected members are at high risk for premature atherosclerosis and regular lipid-apheresis (LA) is the only effective treatment. We are caring for three turkish sisters who presented with phenotypical FH showing massive cutaneous xanthomas. After Hobbs described Autosomal Recessive Hypercholesterolemia (ARH) in 2001 we could prove that this applies to our patients, too. Methods: Since the age of 8, 10, and 10 years respectively LA is performed regularly. Concomitant drug therapy comprises of atorvastatin and ezetimibe. Once a year, high resolution ultrasound the carotids and echocardiography are performed to assess a potenial progression of atherosclerosis. Results: All sisters are tolerating LA and drugs well. The effect of LA on LDL is substantial. Initial LDL-values (566, 852, and 582 mg/dl) are reduced to 166, 188, and 131 mg/dl, respectively (2001) showing a significant ascent due to decreasing compliance (stay-abroad, 383, and 393 mg/dl, 2007). Nevertheless no cardiovascular problems developed. Compliance is a grave problem. Initially the parents had to be convinced repeatedly to assure regular therapy. The growing children and now grown ups currently need remembrance to keep appointments and even so often fail to show up. Conclusion: Treating patients with chronic diseases like ARH which are causing no actual pain but leave the patient with the knowledge of a potential early affection or death, demands not only the delivery of medical care but also the close support to maintain compliance.
PO25 INFLAMMATORY MARKERS PO25-397
INFLAMMATORY MARKERS AND ALL-CAUSE DEATH IN A GENERAL POPULATION
M. Enomoto, H. Adachi, A. Satoh, A. Fukami, M. Otsuka, S. Kumagae, K. Furuki, Y. Nanjo, T. Imaizumi. Department of Internal Medicine, Division of Cardio-Vascular Medicine, Kurume University School of Medicine, Kurume, Japan Background: Accumulating evidence indicates that inflammatory markers such as white blood cell count (WBC), high sensitive-CRP (hs-CRP), fibrinogen (Fib), von Willebrand Factor (vWF), and hematocrit (Hct) predict future cardiovascular events. However, it has been unclear in a general population whether these factors were significant markers for all-cause death. Methods: A total of 1,920 subjects received a health examination in 1999, and they were followed for 7 years. We measured WBC, CRP, hs-CRP, Fib, vWF, and Hct at baseline and examined the relation between these parameters and all-cause death. Results: hs-CRP (p<0.0001), Fib (p<0.0001), and vWF (p=0.0001) were significantly higher in those who died (n=112) than in those who survived (n=1808). WBC, Fib, and Hct were not associated with all-cause death adjusted for age, sex, and confounders by the Cox proportional hazard model. vWF (HR 1.012 [95% CI, 1.005 to 1.019], p=0.0002) and hs-CRP (HR 1.230 [95% CI, 1.057 to 1.432], p=0.006) were positively associated with all-cause death. Conclusion: Our prospective study demonstrated that vWF and hs-CRP were significant predictors of all-cause death in the general population. PO25-398
FACTOR ANALYSIS OF RISK VARIABLES ASSOCIATED WITH LOW-GRADE INFLAMMATION
D. Aronson, O. Avizohar, G. Jacob, Y. Levy, W. Markiewicz. Cardiology, Rambam Medical center, haifa, Israel Background and aims: Chronic subclinical inflammation, manifesting as elevated levels of inflammatory markers such as C-reactive protein (CRP), predicts future atherothrombotic events. Elevated CRP is associated with various intercorrelated conditions including characteristics of the metabolic syndrome, reduced cardiorespiratory fitness, fatty infiltration of the liver, and reduced pulmonary function. Methods: Principal factor analysis was used to investigate clustering of 10 variables associated with elevated CRP using data from 1077 subjects without coronary disease. Components of the metabolic syndrome, uric acid, liver enzymes, pulmonary function tests, smoking status, cardiorespiratory fitness (measured by maximal treadmill test), and high-sensitivity CRP were determined in each subject. Results: Factor analysis identified 3 factors, which explained 54.2% of the total variance in the dataset. Based on factor loadings of ≥0.5, these factors were interpreted as 1) Metabolic factor” including BMI, fasting glucose, HDL cholesterol, triglycerides, systolic blood pressure, uric acid and elevated liver enzymes; 2) "Cardio-respiratory" factor that included fitness level and forced expiratory volume in 1 second (FEV1); and 3) Smoking factor that included cigarette smoking alone. The ability of a multivariable logistic regression model that included the scores of these 3 factors to predict high-risk CRP (≥3 mg/L) was comparable to a model containing the original 10 variables (area under the receiver-operator characteristics curve 0.70 vs. 0.72, respectively). Conclusions: These results suggest that metabolic perturbations, cardiorespiratory fitness, and smoking are separate and largely non-overlapping factors in the pathophysiology of chronic, low-grade inflammation. Importantly, all of these factors are amenable to behavioral interventions. PO25-399
THE ROLE OF PLASMA LEVELS INTERLEUKIN-6 ON MORTALITY IN NON-OBESE PATIENTS WITH NEWLY DIAGNOSED HEART FAILURE, DURING 12-MONTHS OF FOLLOW-UP
I. Kotrogiannis, C. Chrysohoou, C. Vasiliadou, L. Papadimitriou, G. Pounis, P. Aggelopoulos, J. Barbetseas, G. Metallinos, C. Pitsavos, C. Stefanadis. First Cardiology Clinic, School of Medicine, University of Athens, Athens, Greece Background and aims: In this study we aimed to evaluate the relationship
77th Congress of the European Atherosclerosis Society, April 26–29, 2008, Istanbul, Turkey
Poster Sessions PO25 Inflammatory markers
sels was related to increased Lp(a) concentrations, without (p=0.009) and with adjustment (p=0.001) for apo(a) isoforms. However, apo(a) isoforms were not significantly associated with the extent of CAD (p=0.695). Conclusions: This study shows that small apo(a) isoforms are the primary factor associated with the presence of CAD, but they did not influence the extent of the disease. PO24-395
APO E GENOTYPE AS AN INDICATOR FOR THE CHD AND ALZEHEIMER DISEASES IN KOREAN SENIOR SUBJECTS
H. Oh 1 , M. Park 2 , H. Kim 3 , Y. Lim 4 , M. Lee 5 . 1 Family Health and Welfare Center (FHWC), Sungshin Women’s Univ; 2 Division of Clinical Research, Seoul Medical Center Research Institute; 3 Dept. of Food and Nutrition, Sookmyung Women’s University; 4 Dept. of Food and Nutrition, Kyunghee University; 5 Dept. of Food and Nutrition, Sungshin Women’s University Recent studies described the ε4 or ε2 allele of apoE increased risk for CHD and the late-onset Alzheimer’s disease. The goal of this study was to find the association between above diseases and apo E alleles each in the 107 elderly between 50 to 64 years old. We conducted the questionnaire survey (general & diet), anthropometry and blood biochemistry (FBS & lipid profiles, HOMA-IR, apo E genotyping). The frequencies of apo E genotypes were 7.0%, 83.6% and 9.3% for the ε2, ε3 and ε4 allele. FBS was significantly higher in ε4 than that in the others (p<0.01). More than 40% of ε4 group shown the dyslipidemia (High-TG & Low-HDL). The cytokines levels such as IL-1β, IL-6 and TNF-α were not different among three apo E alleles. After the adjusting sex, age & dietary fiber, LDL-c level was significantly higher in ε4 than that in ε2 (p<0.05). According to food intake and the recipe, the elderly with ε4 allele took higher intake frequency of the light-colored vegetable and pan-fried foods than the others. We knew that the elderly with ε4 allele had been restricted the calories intakes with high dietary fiber (33.6±2.5g/d) to maintain the normal level of FBS and LDL-c. Therefore, we found that apoE genotype might be good indicator for combining diseases of CHD and late-onset Alzheimer’s disease. [This study was supported by a grant of the Seoul R&BD Program, Republic of Korea (10526)]. PO24-396
THREE TURKISH SISTERS WITH AUTOSOMAL RECESSIVE HYPERCHOLESTEROLEMIA UNDERGOING LIPID-APHERESIS
E. Steinhagen-Thiessen, U. Kassner, A. Vogt. Lipidclinic, Interdisciplinary Metabolic Center, Charite, Campus Virchow, Berlin, Germany Introduction: In societies allowing marriage of relatives genetic disorders like homozygous familial hypercholesterolemia (FH) are more common. Affected members are at high risk for premature atherosclerosis and regular lipid-apheresis (LA) is the only effective treatment. We are caring for three turkish sisters who presented with phenotypical FH showing massive cutaneous xanthomas. After Hobbs described Autosomal Recessive Hypercholesterolemia (ARH) in 2001 we could prove that this applies to our patients, too. Methods: Since the age of 8, 10, and 10 years respectively LA is performed regularly. Concomitant drug therapy comprises of atorvastatin and ezetimibe. Once a year, high resolution ultrasound the carotids and echocardiography are performed to assess a potenial progression of atherosclerosis. Results: All sisters are tolerating LA and drugs well. The effect of LA on LDL is substantial. Initial LDL-values (566, 852, and 582 mg/dl) are reduced to 166, 188, and 131 mg/dl, respectively (2001) showing a significant ascent due to decreasing compliance (stay-abroad, 383, and 393 mg/dl, 2007). Nevertheless no cardiovascular problems developed. Compliance is a grave problem. Initially the parents had to be convinced repeatedly to assure regular therapy. The growing children and now grown ups currently need remembrance to keep appointments and even so often fail to show up. Conclusion: Treating patients with chronic diseases like ARH which are causing no actual pain but leave the patient with the knowledge of a potential early affection or death, demands not only the delivery of medical care but also the close support to maintain compliance.
PO25 INFLAMMATORY MARKERS PO25-397
INFLAMMATORY MARKERS AND ALL-CAUSE DEATH IN A GENERAL POPULATION
M. Enomoto, H. Adachi, A. Satoh, A. Fukami, M. Otsuka, S. Kumagae, K. Furuki, Y. Nanjo, T. Imaizumi. Department of Internal Medicine, Division of Cardio-Vascular Medicine, Kurume University School of Medicine, Kurume, Japan Background: Accumulating evidence indicates that inflammatory markers such as white blood cell count (WBC), high sensitive-CRP (hs-CRP), fibrinogen (Fib), von Willebrand Factor (vWF), and hematocrit (Hct) predict future cardiovascular events. However, it has been unclear in a general population whether these factors were significant markers for all-cause death. Methods: A total of 1,920 subjects received a health examination in 1999, and they were followed for 7 years. We measured WBC, CRP, hs-CRP, Fib, vWF, and Hct at baseline and examined the relation between these parameters and all-cause death. Results: hs-CRP (p<0.0001), Fib (p<0.0001), and vWF (p=0.0001) were significantly higher in those who died (n=112) than in those who survived (n=1808). WBC, Fib, and Hct were not associated with all-cause death adjusted for age, sex, and confounders by the Cox proportional hazard model. vWF (HR 1.012 [95% CI, 1.005 to 1.019], p=0.0002) and hs-CRP (HR 1.230 [95% CI, 1.057 to 1.432], p=0.006) were positively associated with all-cause death. Conclusion: Our prospective study demonstrated that vWF and hs-CRP were significant predictors of all-cause death in the general population. PO25-398
FACTOR ANALYSIS OF RISK VARIABLES ASSOCIATED WITH LOW-GRADE INFLAMMATION
D. Aronson, O. Avizohar, G. Jacob, Y. Levy, W. Markiewicz. Cardiology, Rambam Medical center, haifa, Israel Background and aims: Chronic subclinical inflammation, manifesting as elevated levels of inflammatory markers such as C-reactive protein (CRP), predicts future atherothrombotic events. Elevated CRP is associated with various intercorrelated conditions including characteristics of the metabolic syndrome, reduced cardiorespiratory fitness, fatty infiltration of the liver, and reduced pulmonary function. Methods: Principal factor analysis was used to investigate clustering of 10 variables associated with elevated CRP using data from 1077 subjects without coronary disease. Components of the metabolic syndrome, uric acid, liver enzymes, pulmonary function tests, smoking status, cardiorespiratory fitness (measured by maximal treadmill test), and high-sensitivity CRP were determined in each subject. Results: Factor analysis identified 3 factors, which explained 54.2% of the total variance in the dataset. Based on factor loadings of ≥0.5, these factors were interpreted as 1) Metabolic factor” including BMI, fasting glucose, HDL cholesterol, triglycerides, systolic blood pressure, uric acid and elevated liver enzymes; 2) "Cardio-respiratory" factor that included fitness level and forced expiratory volume in 1 second (FEV1); and 3) Smoking factor that included cigarette smoking alone. The ability of a multivariable logistic regression model that included the scores of these 3 factors to predict high-risk CRP (≥3 mg/L) was comparable to a model containing the original 10 variables (area under the receiver-operator characteristics curve 0.70 vs. 0.72, respectively). Conclusions: These results suggest that metabolic perturbations, cardiorespiratory fitness, and smoking are separate and largely non-overlapping factors in the pathophysiology of chronic, low-grade inflammation. Importantly, all of these factors are amenable to behavioral interventions. PO25-399
THE ROLE OF PLASMA LEVELS INTERLEUKIN-6 ON MORTALITY IN NON-OBESE PATIENTS WITH NEWLY DIAGNOSED HEART FAILURE, DURING 12-MONTHS OF FOLLOW-UP
I. Kotrogiannis, C. Chrysohoou, C. Vasiliadou, L. Papadimitriou, G. Pounis, P. Aggelopoulos, J. Barbetseas, G. Metallinos, C. Pitsavos, C. Stefanadis. First Cardiology Clinic, School of Medicine, University of Athens, Athens, Greece Background and aims: In this study we aimed to evaluate the relationship
77th Congress of the European Atherosclerosis Society, April 26–29, 2008, Istanbul, Turkey