- Email: [email protected]
IN VIVO IMAGING OF INFLAMMATION IN THE WALL OF ABDOMINAL AORTIC ANEURYSMS
178 PO41-654
Poster Sessions PO42 Screening for CV risk – imaging PREGNANCY– ASSOCIATED PLASMA PROTEIN-A AND PROFORM OF EOSINOPHILIC MAJOR BASIC PROTEIN IN THE DETECTION OF ACUTE CORONARY SYNDROME
P. Hajek 1 , M. Macek Sr. 2 , M. Hladikova 3 , M. Maly 1 , P. Ostadal 4 , E. Hansvenclova 1 , J. Veselka 1 , A. Krebsova 5 . 1 Department of Cardiology, 2nd Medical School and University Hospital of Charles University Prague, Czech Republic; 2 Institute of Biology and Medical Genetics, 2nd Medical School and University Hospital of Charles University Prague, Czech Republic; 3 Institute of Medical Informatics, 2nd Medical School and University Hospital of Charles University Prague, Czech Republic; 4 Department of Cardiology, 3rd Medical School and University Hospital of Charles University Prague, Czech Republic; 5 Department of Internal Medicine, Cardiology, Virchow Klinikum, Humboldt University, Berlin, Germany Background: Pregnancy-associated plasma protein A (PAPP-A) has been studied as a new biomarker of atherosclerotic plaque instability. The aim of this study was the verification of our previous results suggesting higher diagnostic reliability of PAPP-A/proeosinophilic major basic protein (proMBP) complex than of cardiac troponin I (cTnI) in the earliest phase of acute coronary syndrome (ACS). Methods: Levels of cTnI and PAPP-A/proMBP (measured by Kryptor system) in 246 ACS patients were compared to 47 controls according to the time between the onset of chest pain and admission. In all the treated patients the diagnosis was confirmed by invasive examination. Results: Serum PAPP-A/proMBP levels were increased in 28 unstable angina pectoris pts.(UAP;P=0.0002), in 75 acute myocardial infarction pts. without ST and 139 with ST elevation (NSTEMI/STEMI;P<0.0005). PAPP-A/proMBP levels >95 percentile were more frequent than cTnI (P=0.001) within first six hours of STEMI development. Similar trend was disclosed in NSTEMI pts. After 7 hours cTnI levels have been increasing in STEMI and NSTEMI patients, whereas PAPP/proMBP has been decreasing. ROC analysis confirmed higher diagnostic accuracy of PAPP-A/proMBP in STEMI and NSTEMI (AUC=0.9 and 0.91 respectively) comparing to cTnI (AUC=0.6) within first six hours. The highest specificity/sensitivity PAPP-A/proMBP levels were for UAP, NSTEMI and STEMI in the range of 10.1-14.25 mIU/L. In 64.3% of UAP patients the PAPP-A/proMBP levels were increased in the range of 10-70 mIU/L within first 24 hours. Conclusion: PAPP-A/proMBP is more sensitive than cTnI in the earliest phase of all ACS types as a biomarker of preceeding coronary atherosclerosis progression. PO41-655
ASSOCIATION BETWEEN CRP, LDL AND POSTPRANDIAL GLUCOSE AS RISK FACTORS IN PREVIOUSLY HEALTHY WOMEN
E. Mendoza-Briseno, J. Garcia De Alba, A. Salcedo-Rocha. Unidad de Investigacion Social Epidemiologica y en Servicios de Salud Introduction: Since 2002 the American Heart Association had standardized the inflammation markers as cardiovascular risk predictors, the main promoting factors to develop an atherosclerotic disease are hyperglycemia and low density lipoproteins (LDL) promoting the injure of smooth muscle. Objetive: Establish the association between C reactive protein, LDL and postprandial glucose as cardiovascular risk factors in previously healthy women. Methods: We performed to 650 women 30-60 years without previous chronic disease diagnosis or pregnancy an Oral Glucose Tolerance Test
to identify impaired glucose tolerance and measured HDL, LDL, CRP, HbA1c, weight, height, waist circumference (WC) and BMI, setting statistical significance with the Spearman’s correlation values below 0.05. Results: 100 women were found with impaired glucose tolerance, baseline levels were: glucose 157mg/dl, BMI 32.59kg/m2 , HDL 42.61mg/dl, LDL 112.65mg/dl, CRP 9.45mg, divided in 2 groups according to LDL levels the first >130mg/dl (n=31) finding positive associations between CRP/weight (p=0.010), CRP/BMI (p=0.027) and CRP/WC (p=0.006), in the second group LDL<130mg/dl (n=69) a positive association was found between HDL/age (p=0.013) and HDL/cholesterol (p=0.004). Conclusion: The pro inflammatory markers are raised in women with elevated LDL and postprandial glucose, pointing to a higher atherosclerotic risk and stroke in a preclinical stage, the medical nutrition therapy and physical activity must be used to reduce risk factors prior any drug therapy to stabilize the metabolic profile. PO41-656
OSTEOPONTIN LEVEL DOES NOT PREDICT DEVELOPMENT OF ADVERSE CARDIOVASCULAR EVENTS IN ACUTE MYOCARDIAL INFARCTION
K. Okyay 1 , Y. Tavil 2 , G. Tacoy 2 , M. Turfan 2 , N. Sen 2 , O. Gurbahar 3 , B. Boyaci 2 , R. Yalcin 2 , D. Demirkan 2 , A. Cengel 2 . 1 Cardiology Clinic, Corum Government Hospital, Corum, Turkey; 2 Cardiology Department, Gazi University Medical School, Ankara, Turkey; 3 Medical Biochemistry Department, Gazi University Medical School, Ankara, Turkey Background: Osteopontin (OPN), an extracellular matrix protein, has been shown to elevate in plasma in the inflammatory states, including myocardial infarction, and has been proven to modulate inflammation. Aim: We sougt to determine a relationship between plasma OPN level and development of major adverse cardiovascular events (MACE) in the patients diagnosed with acute ST elevation myocardial infarction (STEMI). Methods: Eighty consecutive patients (55±11 years, 12 female and 68 male) were included in the study. Plasma OPN level was assessed at admission and on the third day (the third day OPN value was accepted as the peak value according to the literature). MACE was defined as the presence of the following: death, cardiac arrest, reinfarction, cerebrovascular event, complete AV block requiring pacemaker implantation and decompansated congestive heart failure. Results: The plasma OPN level of the STEMI patients was significantly elevated on the third day (23.8 [16.7-41.3] ng/ml vs 39.2 ng/ml [27.2-56.0], p<0.001) (23.8 [16.7-41.3] ng/ml, p<0.001). The patients who developed MACE during hospitalization (n=15) had similar plasma OPN level on admission and on the third day compared to those of the patients without MACE (p values were 0.41 and 0.58). Conclusion: We have showed for the first time that plasma OPN level was not associated with development of MACE in the setting of the ST elevation myocardial infarction.
PO42 SCREENING FOR CV RISK – IMAGING PO42-657
IN VIVO IMAGING OF INFLAMMATION IN THE WALL OF ABDOMINAL AORTIC ANEURYSMS
M. Truijers 1 , H.A. Kurvers 1 , S.J. Bredie 2 , W.J. Oyen 3 , J.D. Blankensteijn 1 . 1 Department of Surgery, division of Vascular Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands; 2 Department of Medicine, division of Vascular Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands; 3 Department of Nuclear Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands Background and aims: Growth and rupture of an AAA is associated with inflammation of the arterial wall. The non-invasive detection of aneurysm wall inflammation might therefore identify AAA at risk of growth and rupture. We studied the potential of integrated Computer and Positron Emission Tomography (PET/CT) to identify and quantify aneurysm wall inflammation. Methods: 34 patients, 17 AAA and 17 age matched controls, were included. FDG-uptake in the aortic wall was quantified by calculating Standardised Uptake Values (SUV). Results: No significant differences were observed between AAA patients and age matched controls with regard to demographics or risk factors associated with atherosclerosis. The aneurysm wall shows significantly
77th Congress of the European Atherosclerosis Society, April 26–29, 2008, Istanbul, Turkey
Poster Sessions PO42 Screening for CV risk – imaging
179
might be explained as atherosclerotic changes in endothelium may suppress the inflammatory response. PO42-659
CORONARY PERI-STENT REMODELING AFTER DRUG-ELUTING STENT IMPLANTATION IN DIABETIC PATIENTS. A RANDOMIZED SERIAL INTRAVASCULAR ULTRASOUND STUDY
L.O. Jensen 1 , M. Maeng 2 , P. Thayssen 1 , E.H. Christiansen 2 , K.N. Hansen 1 , A. Galloe 3 , H. Kelbaek 4 , J.F. Lassen 2 , L. Thuesen 2 . 1 Department of Cardiology, Odense University Hospital, Odense Denmark; 2 Department of Cardiology, Skejby Hospital, Aarhus Denmark; 3 Department of Cardiology, GentofteHospital, Gentofte Denmark; 4 Department of Cardiology, Rigshospitalet, Copenhagen Denmark
PO42-658
THE EFFECT OF DIAGNOSTIC CORONARY ANGIOGRAPHY ON INFLAMMATUAR MARKERS
A. Hasimi 1 , C. Koz 2 , O. Baysan 2 , M. Yokusoglu 2 , M. Uzun 2 , H. Celebi 2 , E. Isik 2 . 1 Department of Biochemistry and Clinical Biochemistry, Gulhane Military Medical School, Ankara, Turkey; 2 Department of Cardiology, Gulhane Military Medical School, Ankara, Turkey Background: During percutaneous coronary interventions endothelial damage at femoral artery occurs. This damage may activate inflammatory process. We aimed to evaluate the inflammatory status before and after diagnostic coronary angiography. Methods: Eighty consecutive patients without any systemic disease who underwent coronary angiography were enrolled. Before and 8 hours after coronary angiography hsCRP, interleukin 1-beta, and TNF-alpha levels were determined. Results: Of the participants 30 (group 1) had no evidence of coronary atherosclerosis and 50 (group 2) had coronary lesions. Serum levels of inflammatory markers before and after angiography for both groups were illustrated in table 1. Baseline levels of inflammatory markers were not different between groups. There was no significant difference between pre and post procedural values of hsCRP for both groups. However, TNF-alpha values were significantly higher after the angiography for both groups. Interleukin 1-beta was significantly higher after the procedure in group 1, but there was no significant difference pre and post procedure in patients with coronary lesions.
Conclusion: Results of our study imply that coronary angiography causes inflammation especially in patients with normal coronaries. This
PO42-660
ARE CHANGES IN THE ARTERIAL WALL RESPONSIBLE FOR THE DECLINATION OF MENTAL ACTIVITY IN LONGEVOUS INDIVIDUALS?
E. Izcovich, A. Lescano, A. Izcovich, V. Daru, R. Izcovich, R. Ferreyra. Sanatorio Trinidad Mitre, Buenos Aires, Argentina Aims: To find out whether there is diagnostic criteria in the arterial wall that determines if changes in the intima-media thickness (IMT) as manifestation of arterial remodeling, allow to predict the preservation of cognitive activity in longevous patients. Methods: 100 patients of more than 70 years old were included prospectively. Population was classified in 2 groups through the evaluation of cognitive activity by minimental test (MMT). Those who had a score of >25/30, Group 1 and <10/30, Group 2. Patients with intermediate results of the test were excluded. Age, ethnicity, sex and major cardiovascular risk factors were evaluated. The measurement of IMT was performed following the Pignoli and coll. method and the analysis was made off line. The cutting value of IMT used was 0.83 mm. Results: 24 patients were excluded, the remaining were divided into two groups, Group 1: 55 people and Group 2: 22. Risk factors did not show significant differences between groups. Hypertension (p=0.35), Dyslipemia (p=0.71), Smoking (p=0.69) and Diabetes (p=0.22). A significant difference was observed in relation to age (Group 1: 83 years old ± 5 and Group 2: 80±8) where p=0.03. IMT analysis showed a meaningful difference between the two groups: Group 1: 0.8±0.13mm and Group 2: 0.97±0.12mm, p<0.001. Conclusion: Age, sex, ethnicity and cardiovascular risk factors did not proved as fundamental elements in the preservation of intellectual activity, however, the existence of “youthful” IMT values probably related to a genetic pre-conditioning did point out a strong association
77th Congress of the European Atherosclerosis Society, April 26–29, 2008, Istanbul, Turkey
POSTER SESSIONS
more FDG-uptake than the non-dilated aortic wall (2,4±0,4 vs. 2,0± 0,5 respectively; p=0,004). The amount of FDG-uptake is not correlated with maximal aneurysm diameter (r=-0,14 CI; -0,58 < r < 0.36). Conclusions: FDG-uptake is increased in the wall of AAA. The amount of FDG-uptake in the aneurysm is irrespective of maximal diameter. FDG-PET is a promising technique to identify AAA with an increased risk of growth and rupture due to inflammation and provides a new target for future medical therapy.
Background: Patients with diabetes mellitus have less favorable outcomes after percutaneous coronary intervention (PCI) than non-diabetics. Remodeling may take place in the coronary artery vessel wall behind the stent (peri-stent) after PCI. The objective was to evaluate peri-stent remodeling with intravascular ultrasound (IVUS) after implantation of sirolimus-eluting (Cypher) and paclitaxel-eluting (Taxus) stents in diabetic patients. Methods: 95 diabetic patients were randomized to Cypher or Taxus stent implantation. IVUS was performed after the percutaneous coronary intervention and at eight-month follow-up. At the follow-up IVUS was available in 74 patients (Cypher=40; Taxus=34). Results: Neointimal hyperplasia (NIH) volume and volume obstruction were significantly reduced in the Cypher group as compared to the Taxus group [NIH volume: Median (interquartile range): 0.0 mm3 (0.0 to 0.0) vs. 8.0 mm3 (0.1 to 33.0), p<0.001 and volume obstruction: 0.0% (0.0 to 0.0) vs. 7.5% (0.1 to 27.0), p<0.001]. Increase of peri-stent external elastic membrane (EEM) volume was more pronounced in the Taxus group (from 292.4±132.6 to 309.5±146.8 mm3 ) than in the Cypher group (from 274.4±137.2 to 275.4±140.1 mm3 ) (p=0.005). Plaque volume outside the stent increased in the Taxus group (from 152.5±73.7 to 166.1±85.1 mm3 ) but was unchanged in the Cypher group (from 153.5±75.5 to 151.5±75.8 mm3 ) (p=0.002). Six patients had late acquired incomplete stent apposition (Cypher: n=4 (10.0%), Taxus: n=2 (6.1%): p=0.683). Conclusion: In diabetic patients the Cypher stent inhibited NIH formation more effectively than the Taxus stent. Further, Taxus stent implantation was associated with increased peri-stent EEM volume and plaque growth outside the stent.
Poster Sessions PO42 Screening for CV risk – imaging PREGNANCY– ASSOCIATED PLASMA PROTEIN-A AND PROFORM OF EOSINOPHILIC MAJOR BASIC PROTEIN IN THE DETECTION OF ACUTE CORONARY SYNDROME
P. Hajek 1 , M. Macek Sr. 2 , M. Hladikova 3 , M. Maly 1 , P. Ostadal 4 , E. Hansvenclova 1 , J. Veselka 1 , A. Krebsova 5 . 1 Department of Cardiology, 2nd Medical School and University Hospital of Charles University Prague, Czech Republic; 2 Institute of Biology and Medical Genetics, 2nd Medical School and University Hospital of Charles University Prague, Czech Republic; 3 Institute of Medical Informatics, 2nd Medical School and University Hospital of Charles University Prague, Czech Republic; 4 Department of Cardiology, 3rd Medical School and University Hospital of Charles University Prague, Czech Republic; 5 Department of Internal Medicine, Cardiology, Virchow Klinikum, Humboldt University, Berlin, Germany Background: Pregnancy-associated plasma protein A (PAPP-A) has been studied as a new biomarker of atherosclerotic plaque instability. The aim of this study was the verification of our previous results suggesting higher diagnostic reliability of PAPP-A/proeosinophilic major basic protein (proMBP) complex than of cardiac troponin I (cTnI) in the earliest phase of acute coronary syndrome (ACS). Methods: Levels of cTnI and PAPP-A/proMBP (measured by Kryptor system) in 246 ACS patients were compared to 47 controls according to the time between the onset of chest pain and admission. In all the treated patients the diagnosis was confirmed by invasive examination. Results: Serum PAPP-A/proMBP levels were increased in 28 unstable angina pectoris pts.(UAP;P=0.0002), in 75 acute myocardial infarction pts. without ST and 139 with ST elevation (NSTEMI/STEMI;P<0.0005). PAPP-A/proMBP levels >95 percentile were more frequent than cTnI (P=0.001) within first six hours of STEMI development. Similar trend was disclosed in NSTEMI pts. After 7 hours cTnI levels have been increasing in STEMI and NSTEMI patients, whereas PAPP/proMBP has been decreasing. ROC analysis confirmed higher diagnostic accuracy of PAPP-A/proMBP in STEMI and NSTEMI (AUC=0.9 and 0.91 respectively) comparing to cTnI (AUC=0.6) within first six hours. The highest specificity/sensitivity PAPP-A/proMBP levels were for UAP, NSTEMI and STEMI in the range of 10.1-14.25 mIU/L. In 64.3% of UAP patients the PAPP-A/proMBP levels were increased in the range of 10-70 mIU/L within first 24 hours. Conclusion: PAPP-A/proMBP is more sensitive than cTnI in the earliest phase of all ACS types as a biomarker of preceeding coronary atherosclerosis progression. PO41-655
ASSOCIATION BETWEEN CRP, LDL AND POSTPRANDIAL GLUCOSE AS RISK FACTORS IN PREVIOUSLY HEALTHY WOMEN
E. Mendoza-Briseno, J. Garcia De Alba, A. Salcedo-Rocha. Unidad de Investigacion Social Epidemiologica y en Servicios de Salud Introduction: Since 2002 the American Heart Association had standardized the inflammation markers as cardiovascular risk predictors, the main promoting factors to develop an atherosclerotic disease are hyperglycemia and low density lipoproteins (LDL) promoting the injure of smooth muscle. Objetive: Establish the association between C reactive protein, LDL and postprandial glucose as cardiovascular risk factors in previously healthy women. Methods: We performed to 650 women 30-60 years without previous chronic disease diagnosis or pregnancy an Oral Glucose Tolerance Test
to identify impaired glucose tolerance and measured HDL, LDL, CRP, HbA1c, weight, height, waist circumference (WC) and BMI, setting statistical significance with the Spearman’s correlation values below 0.05. Results: 100 women were found with impaired glucose tolerance, baseline levels were: glucose 157mg/dl, BMI 32.59kg/m2 , HDL 42.61mg/dl, LDL 112.65mg/dl, CRP 9.45mg, divided in 2 groups according to LDL levels the first >130mg/dl (n=31) finding positive associations between CRP/weight (p=0.010), CRP/BMI (p=0.027) and CRP/WC (p=0.006), in the second group LDL<130mg/dl (n=69) a positive association was found between HDL/age (p=0.013) and HDL/cholesterol (p=0.004). Conclusion: The pro inflammatory markers are raised in women with elevated LDL and postprandial glucose, pointing to a higher atherosclerotic risk and stroke in a preclinical stage, the medical nutrition therapy and physical activity must be used to reduce risk factors prior any drug therapy to stabilize the metabolic profile. PO41-656
OSTEOPONTIN LEVEL DOES NOT PREDICT DEVELOPMENT OF ADVERSE CARDIOVASCULAR EVENTS IN ACUTE MYOCARDIAL INFARCTION
K. Okyay 1 , Y. Tavil 2 , G. Tacoy 2 , M. Turfan 2 , N. Sen 2 , O. Gurbahar 3 , B. Boyaci 2 , R. Yalcin 2 , D. Demirkan 2 , A. Cengel 2 . 1 Cardiology Clinic, Corum Government Hospital, Corum, Turkey; 2 Cardiology Department, Gazi University Medical School, Ankara, Turkey; 3 Medical Biochemistry Department, Gazi University Medical School, Ankara, Turkey Background: Osteopontin (OPN), an extracellular matrix protein, has been shown to elevate in plasma in the inflammatory states, including myocardial infarction, and has been proven to modulate inflammation. Aim: We sougt to determine a relationship between plasma OPN level and development of major adverse cardiovascular events (MACE) in the patients diagnosed with acute ST elevation myocardial infarction (STEMI). Methods: Eighty consecutive patients (55±11 years, 12 female and 68 male) were included in the study. Plasma OPN level was assessed at admission and on the third day (the third day OPN value was accepted as the peak value according to the literature). MACE was defined as the presence of the following: death, cardiac arrest, reinfarction, cerebrovascular event, complete AV block requiring pacemaker implantation and decompansated congestive heart failure. Results: The plasma OPN level of the STEMI patients was significantly elevated on the third day (23.8 [16.7-41.3] ng/ml vs 39.2 ng/ml [27.2-56.0], p<0.001) (23.8 [16.7-41.3] ng/ml, p<0.001). The patients who developed MACE during hospitalization (n=15) had similar plasma OPN level on admission and on the third day compared to those of the patients without MACE (p values were 0.41 and 0.58). Conclusion: We have showed for the first time that plasma OPN level was not associated with development of MACE in the setting of the ST elevation myocardial infarction.
PO42 SCREENING FOR CV RISK – IMAGING PO42-657
IN VIVO IMAGING OF INFLAMMATION IN THE WALL OF ABDOMINAL AORTIC ANEURYSMS
M. Truijers 1 , H.A. Kurvers 1 , S.J. Bredie 2 , W.J. Oyen 3 , J.D. Blankensteijn 1 . 1 Department of Surgery, division of Vascular Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands; 2 Department of Medicine, division of Vascular Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands; 3 Department of Nuclear Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands Background and aims: Growth and rupture of an AAA is associated with inflammation of the arterial wall. The non-invasive detection of aneurysm wall inflammation might therefore identify AAA at risk of growth and rupture. We studied the potential of integrated Computer and Positron Emission Tomography (PET/CT) to identify and quantify aneurysm wall inflammation. Methods: 34 patients, 17 AAA and 17 age matched controls, were included. FDG-uptake in the aortic wall was quantified by calculating Standardised Uptake Values (SUV). Results: No significant differences were observed between AAA patients and age matched controls with regard to demographics or risk factors associated with atherosclerosis. The aneurysm wall shows significantly
77th Congress of the European Atherosclerosis Society, April 26–29, 2008, Istanbul, Turkey
Poster Sessions PO42 Screening for CV risk – imaging
179
might be explained as atherosclerotic changes in endothelium may suppress the inflammatory response. PO42-659
CORONARY PERI-STENT REMODELING AFTER DRUG-ELUTING STENT IMPLANTATION IN DIABETIC PATIENTS. A RANDOMIZED SERIAL INTRAVASCULAR ULTRASOUND STUDY
L.O. Jensen 1 , M. Maeng 2 , P. Thayssen 1 , E.H. Christiansen 2 , K.N. Hansen 1 , A. Galloe 3 , H. Kelbaek 4 , J.F. Lassen 2 , L. Thuesen 2 . 1 Department of Cardiology, Odense University Hospital, Odense Denmark; 2 Department of Cardiology, Skejby Hospital, Aarhus Denmark; 3 Department of Cardiology, GentofteHospital, Gentofte Denmark; 4 Department of Cardiology, Rigshospitalet, Copenhagen Denmark
PO42-658
THE EFFECT OF DIAGNOSTIC CORONARY ANGIOGRAPHY ON INFLAMMATUAR MARKERS
A. Hasimi 1 , C. Koz 2 , O. Baysan 2 , M. Yokusoglu 2 , M. Uzun 2 , H. Celebi 2 , E. Isik 2 . 1 Department of Biochemistry and Clinical Biochemistry, Gulhane Military Medical School, Ankara, Turkey; 2 Department of Cardiology, Gulhane Military Medical School, Ankara, Turkey Background: During percutaneous coronary interventions endothelial damage at femoral artery occurs. This damage may activate inflammatory process. We aimed to evaluate the inflammatory status before and after diagnostic coronary angiography. Methods: Eighty consecutive patients without any systemic disease who underwent coronary angiography were enrolled. Before and 8 hours after coronary angiography hsCRP, interleukin 1-beta, and TNF-alpha levels were determined. Results: Of the participants 30 (group 1) had no evidence of coronary atherosclerosis and 50 (group 2) had coronary lesions. Serum levels of inflammatory markers before and after angiography for both groups were illustrated in table 1. Baseline levels of inflammatory markers were not different between groups. There was no significant difference between pre and post procedural values of hsCRP for both groups. However, TNF-alpha values were significantly higher after the angiography for both groups. Interleukin 1-beta was significantly higher after the procedure in group 1, but there was no significant difference pre and post procedure in patients with coronary lesions.
Conclusion: Results of our study imply that coronary angiography causes inflammation especially in patients with normal coronaries. This
PO42-660
ARE CHANGES IN THE ARTERIAL WALL RESPONSIBLE FOR THE DECLINATION OF MENTAL ACTIVITY IN LONGEVOUS INDIVIDUALS?
E. Izcovich, A. Lescano, A. Izcovich, V. Daru, R. Izcovich, R. Ferreyra. Sanatorio Trinidad Mitre, Buenos Aires, Argentina Aims: To find out whether there is diagnostic criteria in the arterial wall that determines if changes in the intima-media thickness (IMT) as manifestation of arterial remodeling, allow to predict the preservation of cognitive activity in longevous patients. Methods: 100 patients of more than 70 years old were included prospectively. Population was classified in 2 groups through the evaluation of cognitive activity by minimental test (MMT). Those who had a score of >25/30, Group 1 and <10/30, Group 2. Patients with intermediate results of the test were excluded. Age, ethnicity, sex and major cardiovascular risk factors were evaluated. The measurement of IMT was performed following the Pignoli and coll. method and the analysis was made off line. The cutting value of IMT used was 0.83 mm. Results: 24 patients were excluded, the remaining were divided into two groups, Group 1: 55 people and Group 2: 22. Risk factors did not show significant differences between groups. Hypertension (p=0.35), Dyslipemia (p=0.71), Smoking (p=0.69) and Diabetes (p=0.22). A significant difference was observed in relation to age (Group 1: 83 years old ± 5 and Group 2: 80±8) where p=0.03. IMT analysis showed a meaningful difference between the two groups: Group 1: 0.8±0.13mm and Group 2: 0.97±0.12mm, p<0.001. Conclusion: Age, sex, ethnicity and cardiovascular risk factors did not proved as fundamental elements in the preservation of intellectual activity, however, the existence of “youthful” IMT values probably related to a genetic pre-conditioning did point out a strong association
77th Congress of the European Atherosclerosis Society, April 26–29, 2008, Istanbul, Turkey
POSTER SESSIONS
more FDG-uptake than the non-dilated aortic wall (2,4±0,4 vs. 2,0± 0,5 respectively; p=0,004). The amount of FDG-uptake is not correlated with maximal aneurysm diameter (r=-0,14 CI; -0,58 < r < 0.36). Conclusions: FDG-uptake is increased in the wall of AAA. The amount of FDG-uptake in the aneurysm is irrespective of maximal diameter. FDG-PET is a promising technique to identify AAA with an increased risk of growth and rupture due to inflammation and provides a new target for future medical therapy.
Background: Patients with diabetes mellitus have less favorable outcomes after percutaneous coronary intervention (PCI) than non-diabetics. Remodeling may take place in the coronary artery vessel wall behind the stent (peri-stent) after PCI. The objective was to evaluate peri-stent remodeling with intravascular ultrasound (IVUS) after implantation of sirolimus-eluting (Cypher) and paclitaxel-eluting (Taxus) stents in diabetic patients. Methods: 95 diabetic patients were randomized to Cypher or Taxus stent implantation. IVUS was performed after the percutaneous coronary intervention and at eight-month follow-up. At the follow-up IVUS was available in 74 patients (Cypher=40; Taxus=34). Results: Neointimal hyperplasia (NIH) volume and volume obstruction were significantly reduced in the Cypher group as compared to the Taxus group [NIH volume: Median (interquartile range): 0.0 mm3 (0.0 to 0.0) vs. 8.0 mm3 (0.1 to 33.0), p<0.001 and volume obstruction: 0.0% (0.0 to 0.0) vs. 7.5% (0.1 to 27.0), p<0.001]. Increase of peri-stent external elastic membrane (EEM) volume was more pronounced in the Taxus group (from 292.4±132.6 to 309.5±146.8 mm3 ) than in the Cypher group (from 274.4±137.2 to 275.4±140.1 mm3 ) (p=0.005). Plaque volume outside the stent increased in the Taxus group (from 152.5±73.7 to 166.1±85.1 mm3 ) but was unchanged in the Cypher group (from 153.5±75.5 to 151.5±75.8 mm3 ) (p=0.002). Six patients had late acquired incomplete stent apposition (Cypher: n=4 (10.0%), Taxus: n=2 (6.1%): p=0.683). Conclusion: In diabetic patients the Cypher stent inhibited NIH formation more effectively than the Taxus stent. Further, Taxus stent implantation was associated with increased peri-stent EEM volume and plaque growth outside the stent.