- Email: [email protected]
Glycosylated haemoglobin and long-term prognosis in patients with suspected stable angina pectoris without diabetes
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Abstracts / Atherosclerosis 235 (2014) e27–e83
Results: There was a close relationship between the cumulative risk factors and the overall CAC score (p<0.001), with males having more risk factors than females, (3.501.50 vs.2.291.40, p<0.0001). In patients with significant coronary stenosis, the independent predictors of severe CAC (score >400) were diabetes (OR¼1.58, p<0.0001) and hypertension (OR¼1.35, p<0.0001), while the risk factors in patients with no significant luminal stenosis were diabetes (OR¼2.26, p<0.0001), hypercholesterolemia (OR¼1.23, p¼0.03) and smoking (OR¼1.27, p¼0.03). The same risk factors also predicted extensive CAC (score >1000). Conclusion: Although coronary calcification is generally considered a manifestation of atherosclerosis, the impact of conventional risk factors on its formation differs in patients with and without significant luminal stenosis. 71 - Risk factors, epidemiology, prevention and treatment of cardiovascular diseases: Miscellaneous EAS-0936. PRESERVED COGNITIVE FUNCTION SEEMS TO BE PARALLEL WITH GOOD AORTIC DISTENSIBILITY IN ELDERLY INDIVIDUALS: THE IKARIA STUDY C. Chrysohooua, C. Pitsavosa, D. Panagiotakosa, G. Lazarosa, E. Oikonomoua, V. Metaxaa, M. Zaromytidoua, M. Striggoua, J. Skoumasa, C. Stefanadisa a
1st cardiology Clinic, University of Athens, Athens, Greece
Objectives: Background: Aging causes several alterations on cardiovascular system and overall health, including cognitive function, which is recognized as one of the main components of successful living. Among other indices, arterial stiffness, reflecting arterial aging, has been recognized as a marker of subclinical atherosclerosis and a strong predictor of future cardiovascular events. The aim of this work was to evaluate the association between aortic elastic properties and cognitive function in elderly individuals, permanent inhabitants of Ikaria Island, a Greek Island with high longevity rates. Methods: In 535 individuals (756 years, 53% males) Aortic Distensibility (AoD) was non-invasively calculated from the aortic diameters measured with echocardiography and brachial artery pressure using the formula by Stefanadis et al.; cognitive status was evaluated using the Mini Mental State Examination (MMSE). Results: 88% of the elders had normal values of MMSE score (i.e., 24). Elders who achieved MMSE score 24 had higher values of AoD (1.902.06 vs. 1.081.42, p<0.001), as well as were more physically active (85% vs. 69%, p¼0.05), had higher educational status (8.52.8 vs. 62 yrs, p¼0.001), higher creatinine clearance levels (7021 vs. 6323, p¼0.05) and lower pulse pressure (PP) values (6316 vs. 6818, p¼0.06), as compared with those individuals with MMSE<24. Logistic regression analysis showed that for every unit increase in AoD there was a 25% higher likelihood of having MMSE 24 (OR per 1000 mmHg-1¼ 1.25, 95%CI 0.99 - 1.58), after adjustments for age, gender, current smoking, cardiovascular disease, creatinine clearance, hypertension, diabetes mellitus, obesity, physical activity status and education status. Furthermore having PP levels in the upper tertile (>70 mm Hg), increases by 55% the likelihood of having MMSE<24 (OR for above 70 mmHg¼0.45, 95%CI 0.22, 0.92), after the same adjustments were made. Conclusion: Arterial aging seems to affect cognitive function; a finding that states a novel research hypothesis about the pathophysiological mechanisms of mental functioning. 71 - Risk factors, epidemiology, prevention and treatment of cardiovascular diseases: Miscellaneous EAS-0979. GLYCOSYLATED HAEMOGLOBIN AND LONG-TERM PROGNOSIS IN PATIENTS WITH SUSPECTED STABLE ANGINA PECTORIS WITHOUT DIABETES E. Rebnorda, E.R. Pedersenb, E. Strandb, G.F.T. Svingenb, K. Meyerc, H. Schartum-Hansena, K.H. Lølanda, R. Seifertb, P.M. Uelandd, D.W.T. Nilsene, O. Nygårdb
a
Department of Heart Disease, Haukeland University Hospital, Bergen, Norway; b Department of Clinical Science, University of Bergen, Bergen, Norway; c Bevital A/S, Bevital A/S, Bergen, Norway; d Section for Pharmacology, Institute of Medicine University of Bergen, Bergen, Norway; e Division of Cardiology, Stavanger University Hospital, Stavanger, Norway Objectives: Particularly low levels of HbA1c among subjects without diabetes have been associated with increased mortality, although findings are conflicting. We wanted to assess the association between HbA1c levels and long-term prognosis in patients with suspected coronary artery disease (CAD), but without diabetes. We specifically aimed to clarify if particularly low HbA1c was associated with increased risk of adverse prognosis. Methods: A prospective cohort of 2519 patients undergoing coronary angiography for suspected stable angina pectoris (SAP) was divided into three categories according to HbA1c (%) levels (<5.0, 5.0 to 5.7 and 5.7 to 6.5). Hazard ratios (HRs) for major coronary events (MCE), fatal coronary events (FCE), cardiovascular disease (CVD) mortality and all-cause mortality were obtained by Cox proportional hazards modeling. Results: Baseline median age was 62 years, 73% were males. The median HbA1c was 5.6%, body mass index (BMI) 26.0 kg/m2 and random plasmaglucose 5.4 mmol/L. After a median follow-up time of 4.9 years there were no statistically significant relationship between HbA1c categories and either outcome. However, when comparing patients within the 1st HbA1c decile (HbA1c <4.45%) against deciles 2-10, the multivariate adjusted HRs (95% CIs) were 1.74 (1.15-2.63); P<0.01 for MCE, 3.44 (1.61-7.35); P<0.01 for FCE, 1.88 (0.97-3.65); P¼0.06 for CVD mortality and 1.53 (0.96-2.45); P¼0.08 for allcause mortality. Conclusion: In suspected SAP patients without diabetes, HbA1c values below the 1st decile were associated with increased risk of MCE and, in particular, with FCE. Future studies should aim to assess the role of low blood glucose levels in acute atherosclerotic complications. 71 - Risk factors, epidemiology, prevention and treatment of cardiovascular diseases: Miscellaneous EAS-1034. ASSOCIATION OF MT2A GENE POLYMORPHISM -209 A/G, RS1610216, WITH DIABETES MELLITUS RELATED TO SMOKING STATUS IN THAI SUBJECT WITH CAD R. Rattanathama, N. Settasatianb, C. Settasatianc, N. Komanasind, U. Kukongwiriyapane, P. Intharapetchf, V. Senthongg, h a Postgraduate Program in Medical Sciences Graduate School, Khon Kaen University, Khon Kaen, Thailand; b Clinical Chemistry Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand; c Pathology Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; d Clinical Microscopy Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand; e Physiology Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; f Queen Sirikit Heart Center of the Northeast Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; g Internal Medicine Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; h Cardiovascular Research Group, Khon Kaen University, Khon Kaen, Thailand
Objectives: Coronary artery disease (CAD) is the leading cause of mortality and morbidity worldwide. The development and progression of atherosclerosis in CAD involve multiple risk factors, including cigarette smoking and diabetes mellitus. Metallothionein (MT) is a metal binding protein involved in oxidative stress one of the smoking related outcome. Polymorphisms of metallothionein 2A gene (MT2A) have also been implicated in the development of type 2 diabetes mellitus (T2DM). The aim of this study was to investigate whether there is an association between MT2A polymorphism and diabetes mellitus (DM) in relation to cigarette smoking in Thai subjects who were under CAD investigation.
Abstracts / Atherosclerosis 235 (2014) e27–e83
Results: There was a close relationship between the cumulative risk factors and the overall CAC score (p<0.001), with males having more risk factors than females, (3.501.50 vs.2.291.40, p<0.0001). In patients with significant coronary stenosis, the independent predictors of severe CAC (score >400) were diabetes (OR¼1.58, p<0.0001) and hypertension (OR¼1.35, p<0.0001), while the risk factors in patients with no significant luminal stenosis were diabetes (OR¼2.26, p<0.0001), hypercholesterolemia (OR¼1.23, p¼0.03) and smoking (OR¼1.27, p¼0.03). The same risk factors also predicted extensive CAC (score >1000). Conclusion: Although coronary calcification is generally considered a manifestation of atherosclerosis, the impact of conventional risk factors on its formation differs in patients with and without significant luminal stenosis. 71 - Risk factors, epidemiology, prevention and treatment of cardiovascular diseases: Miscellaneous EAS-0936. PRESERVED COGNITIVE FUNCTION SEEMS TO BE PARALLEL WITH GOOD AORTIC DISTENSIBILITY IN ELDERLY INDIVIDUALS: THE IKARIA STUDY C. Chrysohooua, C. Pitsavosa, D. Panagiotakosa, G. Lazarosa, E. Oikonomoua, V. Metaxaa, M. Zaromytidoua, M. Striggoua, J. Skoumasa, C. Stefanadisa a
1st cardiology Clinic, University of Athens, Athens, Greece
Objectives: Background: Aging causes several alterations on cardiovascular system and overall health, including cognitive function, which is recognized as one of the main components of successful living. Among other indices, arterial stiffness, reflecting arterial aging, has been recognized as a marker of subclinical atherosclerosis and a strong predictor of future cardiovascular events. The aim of this work was to evaluate the association between aortic elastic properties and cognitive function in elderly individuals, permanent inhabitants of Ikaria Island, a Greek Island with high longevity rates. Methods: In 535 individuals (756 years, 53% males) Aortic Distensibility (AoD) was non-invasively calculated from the aortic diameters measured with echocardiography and brachial artery pressure using the formula by Stefanadis et al.; cognitive status was evaluated using the Mini Mental State Examination (MMSE). Results: 88% of the elders had normal values of MMSE score (i.e., 24). Elders who achieved MMSE score 24 had higher values of AoD (1.902.06 vs. 1.081.42, p<0.001), as well as were more physically active (85% vs. 69%, p¼0.05), had higher educational status (8.52.8 vs. 62 yrs, p¼0.001), higher creatinine clearance levels (7021 vs. 6323, p¼0.05) and lower pulse pressure (PP) values (6316 vs. 6818, p¼0.06), as compared with those individuals with MMSE<24. Logistic regression analysis showed that for every unit increase in AoD there was a 25% higher likelihood of having MMSE 24 (OR per 1000 mmHg-1¼ 1.25, 95%CI 0.99 - 1.58), after adjustments for age, gender, current smoking, cardiovascular disease, creatinine clearance, hypertension, diabetes mellitus, obesity, physical activity status and education status. Furthermore having PP levels in the upper tertile (>70 mm Hg), increases by 55% the likelihood of having MMSE<24 (OR for above 70 mmHg¼0.45, 95%CI 0.22, 0.92), after the same adjustments were made. Conclusion: Arterial aging seems to affect cognitive function; a finding that states a novel research hypothesis about the pathophysiological mechanisms of mental functioning. 71 - Risk factors, epidemiology, prevention and treatment of cardiovascular diseases: Miscellaneous EAS-0979. GLYCOSYLATED HAEMOGLOBIN AND LONG-TERM PROGNOSIS IN PATIENTS WITH SUSPECTED STABLE ANGINA PECTORIS WITHOUT DIABETES E. Rebnorda, E.R. Pedersenb, E. Strandb, G.F.T. Svingenb, K. Meyerc, H. Schartum-Hansena, K.H. Lølanda, R. Seifertb, P.M. Uelandd, D.W.T. Nilsene, O. Nygårdb
a
Department of Heart Disease, Haukeland University Hospital, Bergen, Norway; b Department of Clinical Science, University of Bergen, Bergen, Norway; c Bevital A/S, Bevital A/S, Bergen, Norway; d Section for Pharmacology, Institute of Medicine University of Bergen, Bergen, Norway; e Division of Cardiology, Stavanger University Hospital, Stavanger, Norway Objectives: Particularly low levels of HbA1c among subjects without diabetes have been associated with increased mortality, although findings are conflicting. We wanted to assess the association between HbA1c levels and long-term prognosis in patients with suspected coronary artery disease (CAD), but without diabetes. We specifically aimed to clarify if particularly low HbA1c was associated with increased risk of adverse prognosis. Methods: A prospective cohort of 2519 patients undergoing coronary angiography for suspected stable angina pectoris (SAP) was divided into three categories according to HbA1c (%) levels (<5.0, 5.0 to 5.7 and 5.7 to 6.5). Hazard ratios (HRs) for major coronary events (MCE), fatal coronary events (FCE), cardiovascular disease (CVD) mortality and all-cause mortality were obtained by Cox proportional hazards modeling. Results: Baseline median age was 62 years, 73% were males. The median HbA1c was 5.6%, body mass index (BMI) 26.0 kg/m2 and random plasmaglucose 5.4 mmol/L. After a median follow-up time of 4.9 years there were no statistically significant relationship between HbA1c categories and either outcome. However, when comparing patients within the 1st HbA1c decile (HbA1c <4.45%) against deciles 2-10, the multivariate adjusted HRs (95% CIs) were 1.74 (1.15-2.63); P<0.01 for MCE, 3.44 (1.61-7.35); P<0.01 for FCE, 1.88 (0.97-3.65); P¼0.06 for CVD mortality and 1.53 (0.96-2.45); P¼0.08 for allcause mortality. Conclusion: In suspected SAP patients without diabetes, HbA1c values below the 1st decile were associated with increased risk of MCE and, in particular, with FCE. Future studies should aim to assess the role of low blood glucose levels in acute atherosclerotic complications. 71 - Risk factors, epidemiology, prevention and treatment of cardiovascular diseases: Miscellaneous EAS-1034. ASSOCIATION OF MT2A GENE POLYMORPHISM -209 A/G, RS1610216, WITH DIABETES MELLITUS RELATED TO SMOKING STATUS IN THAI SUBJECT WITH CAD R. Rattanathama, N. Settasatianb, C. Settasatianc, N. Komanasind, U. Kukongwiriyapane, P. Intharapetchf, V. Senthongg, h a Postgraduate Program in Medical Sciences Graduate School, Khon Kaen University, Khon Kaen, Thailand; b Clinical Chemistry Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand; c Pathology Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; d Clinical Microscopy Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand; e Physiology Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; f Queen Sirikit Heart Center of the Northeast Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; g Internal Medicine Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; h Cardiovascular Research Group, Khon Kaen University, Khon Kaen, Thailand
Objectives: Coronary artery disease (CAD) is the leading cause of mortality and morbidity worldwide. The development and progression of atherosclerosis in CAD involve multiple risk factors, including cigarette smoking and diabetes mellitus. Metallothionein (MT) is a metal binding protein involved in oxidative stress one of the smoking related outcome. Polymorphisms of metallothionein 2A gene (MT2A) have also been implicated in the development of type 2 diabetes mellitus (T2DM). The aim of this study was to investigate whether there is an association between MT2A polymorphism and diabetes mellitus (DM) in relation to cigarette smoking in Thai subjects who were under CAD investigation.