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MS293 GENDER DIFFERENCES IN ELDERLY PATIENTS WITH SUBCLINICAL ATHEROSCLEROSIS
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Atherosclerosis Supplements 11, no. 2 (2010) 109–222
MS289 COMPARATIVE STUDY OF RISK FACTORS IN YOUNG AND OLDER PATIENTS OF CORONARY ARTERY DISEASE IN A TERTIARY CARE HOSPITAL A. Aggarwal, P. Schroff, S. Dwivedi. Department of Medicine, Preventive Cardiology, University College of Medical Sciences, University of Delhi & GTB Hospital, Delhi, India Objectives: To study conventional coronary risk factors and compare them in young (age 45 years) and older (age > 45 years) patients of coronary artery disease (CAD) to understand their role in particular subgroup along with comparison of carotid intima media thickness (CIMT). Methods: 20 consecutive patients of age 45 years (group I) and 40 consecutive patients of age > 45 years (group II) who suffered CAD for first time were recruited. Detailed history and examination including hypertension, central obesity, dyslipidemia, diabetes mellitus, smoking, family history of premature CAD and CIMT was made. Results: Mean age was 39.6±4.7 years in group I vs 61.2±7.9 years in group II. Majority were males. Major risk factor were dyslipidemia and smoking (95% in group I vs 82.5% in group II and 70% in group I vs 60% in group II, respectively). 40% in group I and 50% in group II had central obesity. In group II it was found out that hypertensive patients were 4.3 times more likely to suffer from CAD. CIMT was significantly higher (0.07±0.014 cms) in older patients compared to young (0.065±0.015 cms). CIMT in younger group approached subclinical atherosclerosis suggesting subclinical atherosclerosis in the younger population. Conclusions: Major burden of CAD can be explained by traditional risk factors only in both groups. Dyslipidemia and smoking were major risk factors and should be aggressively targeted. CIMT can prove to be useful noninvasive tool for early detection of subclinical atherosclerosis. MS290 ARE THE SAME RISK FACTORS INVOLVED IN CAROTID PLAQUE OCCURRENCE AND SIGNIFICANT DOPPLER CAROTID STENOSIS? B. Pojskic1 , A. Macic Dzankovic2 , D. Kolenda3 . 1 Cantonal Hospital Zenica, Zenica, 2 Cardiology, General Hospital ‘Abdulah Nakas’, Sarajevo, 3 General Hospital ‘Nova Bila’, Nova Bila, Bosnia-Herzegovina Introduction and Aim: Risk factors which underlie atherosclerotic process are well known, but there is still a dispute which risk factor is more significant to development of various stages of process itself. The aim of this study is to identify risk factors significant for development of progressive atherosclerosis. Methods and Patients: Randomly selected 239 patients from data basis of carotid doppler examination, age 24−86, average 58. Parameters taken in consideration were age, sex, hypertension, diabetes, cholesterol, HDL, LDL, triglycerides, IMTCCA, carotid stenosis over 50% and plaque without Doppler measured stenosis. Statistic analysis was performed using SPSS 15.0 and STATA 9. Results: There were 118 or 49.4% patients with hypertension and 74 or 31% diabetics. Patients with hypertension showed significant lower HDL, increased IMTCCA and plaque occurrence in comparison with non-hypertensive group. Diabetic patients had significant larger LDL, cholesterol, triglycerides, IMTCCA, lower HDL and higher incidence of plaque occurrence than non-diabetics. Sex was not significant for any of those parameters. Plaque occurrence was significant in correlation with age, cholesterol, HDL, LDL, triglycerides and diabetes (p < 0, 01) and hypertension (p < 0, 05). Stenosis over 50% was connected with advanced age, cholesterol, LDL, triglycerides, IMTCCA (p < 0, 01); correlation with hypertension, diabetes and HDL was not significant. Conclusion: Study has shown that plaque occurrence and stenosis over 50% correlated with advanced age, cholesterol, LDL, triglycerides, IMTCCA. Low HDL, diabetes and hypertension were important risk factors in atherosclerotic process, and correlated with plaque occurrence, but not with stenosis over 50%. MS291 EFFECTS OF ApoE GENE POLYMORPHISM ON ANTHROPOMETRIC AND BIOCHEMICAL PARAMETERS IN MEN E. Stokic1 , I. Djan2 , M. Djan3 , D. Sakaˇc4 . 1 Department of Endocrinology, Clinical Center Novi Sad, 2 Department of Endocrinology, Clinical Center Vojvodina, 3 Faculty of Sciences, 4 Institute of Cardiovascular Disease, University of Novi Sad, Novi Sad, Serbia The gene for ApoE is located on chromosome 19q13.2 and three common polymorphisms designated as e2, e3, and e4 code for the three major apoE protein isoforms (E2, E3, and E4). Genetic variation of ApoE is a major determinant of variation in susceptibility to dyslipidemia or coronary heart disease (CHD). In this research we investigated 60 men, 18 to 45 years old for the polymorphism of apoE gene. The study was conducted in a group of 60 male persons in whom, apart from anthropometric measures (weight, height, BMI, waist circumference, fat percentage), biochemical parameters were evaluated (total cholesterol, LDL-, HDL-cholesterol, glucose, insulin, fibrinogen and CRP). Forth exon of ApoE gene was amplified by PCR, and then digested with
Memory Stick Presentations
HhaI endonuclease. Fragments were separated by 4% agarose electrophoresis and genotypes were detected. In analyzed subjects 34 had genotype e3e3 and 17 had genotype e3e4. Rare genotypes were found in three men: e4e4, e2e4 and e2e3. Comparism of all anthropometric and biochemical parameters were performed between e3e3 and e3e4 genotype groups. It was shown that in e3e4 genotype group, following parameters were statistically higher: waist circumfence (105.5±8.8 vs. 99.1±9.9 cm), BMI (29.7±3.2 kg/m2 vs. 25.9±3.08 kg/m2 ), insulin and HOMA IR (7.3±6.0 HOMA IR vs. 3.4±3.8). PCA analysis revealed factors dividing these two groups: waist circumfence, BMI, fat %, IA, insulin and HOMA IR. No difference was detected in cholesterol levels between those groups, but it was shown that larger number of analyzed subjects would reveal also a difference in LDL cholesterol. MS292 PECULIARITIES OF SYSTOLIC, DIASTOLIC, PULSE BP, HEART RATES AND FREQUENCY OF FATAL CARDIOVASCULAR DISEASE IN SIBERIAN POPULATION WITH METABOLIC SYNDROME G. Simonova, O. Glushanina, Y. Nikitin, S. Malutina, L. Scherbakova. Institute of Internal Medicine SB RAMN, Novosibirsk, Russia The analysis of different levels of blood pressure, heart rate and fatal cardiovascular disease (CVD) in a city Siberian population with metabolic syndrome (NCEP ATP III) (age group 45−69 years old, 2003–2005, from international projects HAPIEE). Object: Representative samples of the Novosibirsk’s population for estimation of levels of systolic (SBP), diastolic (DBP), pulse BP (PBP), heart rate (HR) and frequency of fatal of CVD in groups with and without metabolic syndrome (MS) in 9329 subjects. Methods: Population cross − sectionary study. Results: Mean value of SBP − 140.7; DBP − 88,4; PBP − 52.2 mg/hg, HR − 79.7 in persons without MS and 154.1; 96.2; 58.0; 74.4 − in person with MS, appropriately, p < 0.001. SBP, DBP, PBP were significantly above in men without MS than in women. DBP, HR was prevalent in men with MS than in women, but PBP was significantly above in women. Frequency of SBP < 120 mg/hg was 9% in person with MS, but frequency of SBP 120–130 mg/hg was 15%. Frequency of fatal CVD in person with MS was 32%; among women with MS and levels of BP 140–160/90−99 mg/hg frequency of fatal CVD was significantly above than without MS. The conclusion: These results show, that characteristics of SBP, DBP, PBP, HR prevalent in men and women with metabolic syndrome; this fact is negative factor growth of fatal of CVD in the Siberian population. MS293 GENDER DIFFERENCES IN ELDERLY PATIENTS WITH SUBCLINICAL ATHEROSCLEROSIS O. Vittos1,2 , F. Halici1,3 , I. Teodorescu1 . 1 Medical Association ‘Marie Curie’, 2 Medcenter, Cardiology Dept, 3 Geriatrics, Medcenter, Bucharest, Romania Aim: Subclinical atherosclerosis is increasing with age and is related to other cardiovascular and metabolic risk factors. All of these increase the prevalence of cardiovascular diseases in elderly people with major consequence on morbidity and mortality regardless of age. Material and Methods: 150 outpatients (age range 55−75 years) were admitted in our medical center (53.3% women and 46.6% men). They were globally evaluated and a comprehensive anamnesis was done. Clinical and laboratory evaluations were also done including electrocardiography, B-mode and Doppler ultrasonography and anthropometric tests were performed. Descriptive statistical data, independent t-test and a model of multiple regression were performed. P value less than 0.05 was considered significant (SPSS-10). Results: Subclinical atherosclerosis was found at 37.55% in women and in 28.55% in men. A high prevalence of metabolic disease was diagnosed at both gender with a predominance in women (54%). There were found positive correlations between body mass index, age and HDL-cholesterol (p < 0.01) and subclinical atherosclerosis in women and serum uric acid, glycemia, tryglicerides (p < 0.05) and subclinical atherosclerosis in men. Age, BMI and HDL-cholesterol were found as independent predictors for asymptomatic/subclinical atherosclerosis. Significant gender differences were noticed questioning about the overlap of gender role on cardiovascular risk factors and subclinical cardiovascular pathology. MS294 MOST IMPORTANT CARDIOVASCULAR RISK FACTORS IN PROGNOSIS OF PATIENTS WITH MYOCARDIAL INFARCTION − 5 YEAR FOLLOW UP STUDY T. Emami Meybodi1 , M. Emami2 , M. Hasan Lotfi3 , S. Mahdiye Namayande3 , S. Mahmood Sad3 . 1 Cardiovascular Research Center, 2 Afshar Heart Center, 3 Yazd University of Medical Science, Yazd, Iran Introduction: Cardiovascular diseases are increasingly recognized as a major cause of morbidity and mortality in almost all countries. Myocardial infarction (MI) is usually accompanied by pain, increased enzyme values and ECG signs. Obviously, there are many distinct risk factors that can increase its incidence.
Atherosclerosis Supplements 11, no. 2 (2010) 109–222
MS289 COMPARATIVE STUDY OF RISK FACTORS IN YOUNG AND OLDER PATIENTS OF CORONARY ARTERY DISEASE IN A TERTIARY CARE HOSPITAL A. Aggarwal, P. Schroff, S. Dwivedi. Department of Medicine, Preventive Cardiology, University College of Medical Sciences, University of Delhi & GTB Hospital, Delhi, India Objectives: To study conventional coronary risk factors and compare them in young (age 45 years) and older (age > 45 years) patients of coronary artery disease (CAD) to understand their role in particular subgroup along with comparison of carotid intima media thickness (CIMT). Methods: 20 consecutive patients of age 45 years (group I) and 40 consecutive patients of age > 45 years (group II) who suffered CAD for first time were recruited. Detailed history and examination including hypertension, central obesity, dyslipidemia, diabetes mellitus, smoking, family history of premature CAD and CIMT was made. Results: Mean age was 39.6±4.7 years in group I vs 61.2±7.9 years in group II. Majority were males. Major risk factor were dyslipidemia and smoking (95% in group I vs 82.5% in group II and 70% in group I vs 60% in group II, respectively). 40% in group I and 50% in group II had central obesity. In group II it was found out that hypertensive patients were 4.3 times more likely to suffer from CAD. CIMT was significantly higher (0.07±0.014 cms) in older patients compared to young (0.065±0.015 cms). CIMT in younger group approached subclinical atherosclerosis suggesting subclinical atherosclerosis in the younger population. Conclusions: Major burden of CAD can be explained by traditional risk factors only in both groups. Dyslipidemia and smoking were major risk factors and should be aggressively targeted. CIMT can prove to be useful noninvasive tool for early detection of subclinical atherosclerosis. MS290 ARE THE SAME RISK FACTORS INVOLVED IN CAROTID PLAQUE OCCURRENCE AND SIGNIFICANT DOPPLER CAROTID STENOSIS? B. Pojskic1 , A. Macic Dzankovic2 , D. Kolenda3 . 1 Cantonal Hospital Zenica, Zenica, 2 Cardiology, General Hospital ‘Abdulah Nakas’, Sarajevo, 3 General Hospital ‘Nova Bila’, Nova Bila, Bosnia-Herzegovina Introduction and Aim: Risk factors which underlie atherosclerotic process are well known, but there is still a dispute which risk factor is more significant to development of various stages of process itself. The aim of this study is to identify risk factors significant for development of progressive atherosclerosis. Methods and Patients: Randomly selected 239 patients from data basis of carotid doppler examination, age 24−86, average 58. Parameters taken in consideration were age, sex, hypertension, diabetes, cholesterol, HDL, LDL, triglycerides, IMTCCA, carotid stenosis over 50% and plaque without Doppler measured stenosis. Statistic analysis was performed using SPSS 15.0 and STATA 9. Results: There were 118 or 49.4% patients with hypertension and 74 or 31% diabetics. Patients with hypertension showed significant lower HDL, increased IMTCCA and plaque occurrence in comparison with non-hypertensive group. Diabetic patients had significant larger LDL, cholesterol, triglycerides, IMTCCA, lower HDL and higher incidence of plaque occurrence than non-diabetics. Sex was not significant for any of those parameters. Plaque occurrence was significant in correlation with age, cholesterol, HDL, LDL, triglycerides and diabetes (p < 0, 01) and hypertension (p < 0, 05). Stenosis over 50% was connected with advanced age, cholesterol, LDL, triglycerides, IMTCCA (p < 0, 01); correlation with hypertension, diabetes and HDL was not significant. Conclusion: Study has shown that plaque occurrence and stenosis over 50% correlated with advanced age, cholesterol, LDL, triglycerides, IMTCCA. Low HDL, diabetes and hypertension were important risk factors in atherosclerotic process, and correlated with plaque occurrence, but not with stenosis over 50%. MS291 EFFECTS OF ApoE GENE POLYMORPHISM ON ANTHROPOMETRIC AND BIOCHEMICAL PARAMETERS IN MEN E. Stokic1 , I. Djan2 , M. Djan3 , D. Sakaˇc4 . 1 Department of Endocrinology, Clinical Center Novi Sad, 2 Department of Endocrinology, Clinical Center Vojvodina, 3 Faculty of Sciences, 4 Institute of Cardiovascular Disease, University of Novi Sad, Novi Sad, Serbia The gene for ApoE is located on chromosome 19q13.2 and three common polymorphisms designated as e2, e3, and e4 code for the three major apoE protein isoforms (E2, E3, and E4). Genetic variation of ApoE is a major determinant of variation in susceptibility to dyslipidemia or coronary heart disease (CHD). In this research we investigated 60 men, 18 to 45 years old for the polymorphism of apoE gene. The study was conducted in a group of 60 male persons in whom, apart from anthropometric measures (weight, height, BMI, waist circumference, fat percentage), biochemical parameters were evaluated (total cholesterol, LDL-, HDL-cholesterol, glucose, insulin, fibrinogen and CRP). Forth exon of ApoE gene was amplified by PCR, and then digested with
Memory Stick Presentations
HhaI endonuclease. Fragments were separated by 4% agarose electrophoresis and genotypes were detected. In analyzed subjects 34 had genotype e3e3 and 17 had genotype e3e4. Rare genotypes were found in three men: e4e4, e2e4 and e2e3. Comparism of all anthropometric and biochemical parameters were performed between e3e3 and e3e4 genotype groups. It was shown that in e3e4 genotype group, following parameters were statistically higher: waist circumfence (105.5±8.8 vs. 99.1±9.9 cm), BMI (29.7±3.2 kg/m2 vs. 25.9±3.08 kg/m2 ), insulin and HOMA IR (7.3±6.0 HOMA IR vs. 3.4±3.8). PCA analysis revealed factors dividing these two groups: waist circumfence, BMI, fat %, IA, insulin and HOMA IR. No difference was detected in cholesterol levels between those groups, but it was shown that larger number of analyzed subjects would reveal also a difference in LDL cholesterol. MS292 PECULIARITIES OF SYSTOLIC, DIASTOLIC, PULSE BP, HEART RATES AND FREQUENCY OF FATAL CARDIOVASCULAR DISEASE IN SIBERIAN POPULATION WITH METABOLIC SYNDROME G. Simonova, O. Glushanina, Y. Nikitin, S. Malutina, L. Scherbakova. Institute of Internal Medicine SB RAMN, Novosibirsk, Russia The analysis of different levels of blood pressure, heart rate and fatal cardiovascular disease (CVD) in a city Siberian population with metabolic syndrome (NCEP ATP III) (age group 45−69 years old, 2003–2005, from international projects HAPIEE). Object: Representative samples of the Novosibirsk’s population for estimation of levels of systolic (SBP), diastolic (DBP), pulse BP (PBP), heart rate (HR) and frequency of fatal of CVD in groups with and without metabolic syndrome (MS) in 9329 subjects. Methods: Population cross − sectionary study. Results: Mean value of SBP − 140.7; DBP − 88,4; PBP − 52.2 mg/hg, HR − 79.7 in persons without MS and 154.1; 96.2; 58.0; 74.4 − in person with MS, appropriately, p < 0.001. SBP, DBP, PBP were significantly above in men without MS than in women. DBP, HR was prevalent in men with MS than in women, but PBP was significantly above in women. Frequency of SBP < 120 mg/hg was 9% in person with MS, but frequency of SBP 120–130 mg/hg was 15%. Frequency of fatal CVD in person with MS was 32%; among women with MS and levels of BP 140–160/90−99 mg/hg frequency of fatal CVD was significantly above than without MS. The conclusion: These results show, that characteristics of SBP, DBP, PBP, HR prevalent in men and women with metabolic syndrome; this fact is negative factor growth of fatal of CVD in the Siberian population. MS293 GENDER DIFFERENCES IN ELDERLY PATIENTS WITH SUBCLINICAL ATHEROSCLEROSIS O. Vittos1,2 , F. Halici1,3 , I. Teodorescu1 . 1 Medical Association ‘Marie Curie’, 2 Medcenter, Cardiology Dept, 3 Geriatrics, Medcenter, Bucharest, Romania Aim: Subclinical atherosclerosis is increasing with age and is related to other cardiovascular and metabolic risk factors. All of these increase the prevalence of cardiovascular diseases in elderly people with major consequence on morbidity and mortality regardless of age. Material and Methods: 150 outpatients (age range 55−75 years) were admitted in our medical center (53.3% women and 46.6% men). They were globally evaluated and a comprehensive anamnesis was done. Clinical and laboratory evaluations were also done including electrocardiography, B-mode and Doppler ultrasonography and anthropometric tests were performed. Descriptive statistical data, independent t-test and a model of multiple regression were performed. P value less than 0.05 was considered significant (SPSS-10). Results: Subclinical atherosclerosis was found at 37.55% in women and in 28.55% in men. A high prevalence of metabolic disease was diagnosed at both gender with a predominance in women (54%). There were found positive correlations between body mass index, age and HDL-cholesterol (p < 0.01) and subclinical atherosclerosis in women and serum uric acid, glycemia, tryglicerides (p < 0.05) and subclinical atherosclerosis in men. Age, BMI and HDL-cholesterol were found as independent predictors for asymptomatic/subclinical atherosclerosis. Significant gender differences were noticed questioning about the overlap of gender role on cardiovascular risk factors and subclinical cardiovascular pathology. MS294 MOST IMPORTANT CARDIOVASCULAR RISK FACTORS IN PROGNOSIS OF PATIENTS WITH MYOCARDIAL INFARCTION − 5 YEAR FOLLOW UP STUDY T. Emami Meybodi1 , M. Emami2 , M. Hasan Lotfi3 , S. Mahdiye Namayande3 , S. Mahmood Sad3 . 1 Cardiovascular Research Center, 2 Afshar Heart Center, 3 Yazd University of Medical Science, Yazd, Iran Introduction: Cardiovascular diseases are increasingly recognized as a major cause of morbidity and mortality in almost all countries. Myocardial infarction (MI) is usually accompanied by pain, increased enzyme values and ECG signs. Obviously, there are many distinct risk factors that can increase its incidence.