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Abstracts of the 17th Asian Pacific Congress of Cardiology
cholesterol, triglyceride (TG), and high density lipoprotein (HDL) cholesterol at baseline and four weeks after treatment with the statin. Results: The total cholesterol and LDL levels in both groups were significantly decreased four weeks later, and HDL level was significantly increased in both groups, but not TG level in vytorin group. In addition, the change of LDL cholesterol in vytorin group was significantly higher than it in lipitor (52.4% vs 44.1% respectively p < 0.05). The central PWV (cfPWV) and peripheral PWV (cfPWV) in lipitor group was significantly decreased compared with those in vytorin group (p < 0.05). Conclusions: Although co-administration of simvastatin and ezetimibe might show much more lipid lowering effect compared with atorvastatin, only atorvastatin might show pleiotrophic effect for short-term treatment in hypercholesterolemia. P-206 Serum MCP-1 Levels Are Strongly Associated with Higher Ratio of LDL- to HDL-Cholestrol Levels and Lower Estimated GFR Ako Fukami1 , Hisashi Adachi1 , Sho-Ichi Yamagishi2 , Mika Enomoto1 , Maki Otsuka1 , Shunichi Kumagae1 , Yasuki Nanjo1 , Kumiko Furuki1 , Eishi Esaki1 , Eita Kumagai1 , Kyoko Murayama1 , Akira Satoh1 , Yuji Hirai1 , Tsutomu Imaizumi1 . 1 Department of Internal Medicine, Division of Cardio-Vascular Medicine, Kurume University School of Medicine, Japan, 2 Department of Pathophysiology and Therapeutics of Diabetic Vascular Complications, Kurume University School of Medicine, Japan Background: Monocyte chemoattractant protein-1 (MCP-1) has been shown to play a role in the pathogenesis of insulin resistance and atherosclerosis. Recently, it is suggested the ratio of LDL-C to HDL-C (L/H ratio) predicts progression of atherosclerosis. Chronic kidney disease (CKD) is also known as a risk factor for atherosclerotic cardiovascular disease. Objective: We investigated whether serum MCP-1 levels are associated with the risks for atherosclerosis, including L/H ratio and CKD, in a general population. Methods: A total of 860 residents (318 men and 542 women, mean age 65.4±9.8 years) underwent a complete history and physical examination, determination of blood chemistries, including serum levels of MCP-1. Results: Elevated MCP-1 levels were associated with higher levels of WBC (p < 0.05), hsCRP (p < 0.05), g-GTP (p < 0.0001), HbA1c (p < 0.05), BUN (p < 0.0001), Cr (p < 0.0001), Uric acid (p < 0.0001), IMT of carotid arteries (p < 0.0001), and L/H ratio (p < 0.05). Elevated MCP-1 levels were associated with the lower levels of HDL-C (p < 0.05) and estimated GFR (p < 0.0001) by analysis of co-variance adjusted for age and sex. The hierarchical model demonstrated that the serum MCP-1 levels were the highest in the group with higher L/H ratio and lower estimated GFR. Conclusion: The present study demonstrated that serum levels of MCP-1 were strongly associated with higher L/H ratio and CKD, thus being involved in accelerated atherosclerosis in these high-risk patients.
P-207 Impact of Co-Administration of Atorvastatin and Bezafibrate on the Lipoprotein Subclass: Comparison between apoE2/2 and apoE3/3 Masa-aki Kawashiri1 , Junji Kobayashi2 , Atsushi Nohara2 , Hayato Tada1 , Chiaki Nakanishi1 , Masayuki Tsuchida1 , Mutsuko Takata1 , Akihiro Inazu3 , Hiroshi Mabuchi2 , Masakazu Yamagishi1 . 1 Department of Cardiology, Kanazawa University, Japan, 2 Department of Lipidology, Kanazawa University, Japan, 3 Molecular Biochemistry and Molecular Biology Laboratory, Graduate School of Medical Science, Kanazawa University, Japan Background: Type III hyperlipoproteinemia is a rare dyslipidemia (1 in 10,000), the molecular cause of which is the homozygous of the most rare isoform of apolipoprotein (apo) E (apoE2). We examined the effects of AT, BF and their combination in Type III patients. Methods: Hypertriglyceridemic [fasting serum triglyceride >150 mg/dl] patients with apoE 2/2 (n = 6) and apoE 3/3 (n = 8, wild type) were enrolled in an open randomized crossover study consisting of 4 weeks treatment period with AT (10 mg) or BF (400 mg), co-administration of AT and BF, and wash-out period. Serum lipoproteins were separated into 20 subclasses by high-performance liquid chromatography. Results: The changes of cholesterol in lipoprotein subfractions were not different between apoE phenotype. AT significantly decreased cholesterol in all apoB containing lipoprotein subfractions, whereas did not change cholesterol in all HDL subfractions. On the other hand, BF changed cholesterol distribution from small to large sized LDL and large to small sized HDL. Interestingly, co-administration of AT and BF additively modified cholesterol distribution; namely significant decrease of apoB containing lipoprotein cholesterol with shifting from smaller to larger sized LDL and significant increasing HDL cholesterol especially in smaller particles. Conclusion: AT and BF improved atherogenic dyslipidemia in considerably different manners, and co-administraion of AT and BF reinforced the benefits of both drugs particularly in terms of particle size of LDL and HDL. P-208 Double Blind Randomized Cross Over Controlled Clinical Trial of Resveratrol in Hyperlipidemic Patients Bahram Fariborz Farsad1 , Nazanin Zandi1 , Yunes Panahi1 , Farshad Hashemian2 , Abbas Zawarei1 , Ahmad Mohebbi1 , Ali Sadeghpour Taba1 , Kambiz Mozaffari1 . 1 Department of Clinical Pharmacy, Rajaie Heart Center, Iran (Islamic Republic of), 2 IA University, Pharmaceutical Branch, Iran (Islamic Republic of) Background: Resveratrol is a naturally occurring polyphenolic compound in grapes. There has been numerous animal studies showing its beneficial effects on atherosclerosis and dyslipidemia but human effects has rarely been studied. Purpose: To evaluate the clinical efficacy and tolerability of Resveratrol among hyperlipidemic patients and plasma lipid concenteration changes following its administration. Methods: A double blind randomized controlled cross over clinical trial in a tertiary care heart center was performed. We enrolled 200 patients with LDL > 130 mg/dl with no risk factor or LDL > 100 mg/dl if having more than 2 risk factors plus TG > 200 mg/dl. Recruited eligible patients were randomly assigned to receive either one 100 mg capsule of Resveratrol plus 10 mg Atorvastatin or one capsule of placebo plus 10 mg Atorvastatin daily, for three weeks. After a 1-week wash out period of Resveratrol, subjects were given the alternate treatment for an additional 3 weeks.
Abstracts of the 17th Asian Pacific Congress of Cardiology
cholesterol, triglyceride (TG), and high density lipoprotein (HDL) cholesterol at baseline and four weeks after treatment with the statin. Results: The total cholesterol and LDL levels in both groups were significantly decreased four weeks later, and HDL level was significantly increased in both groups, but not TG level in vytorin group. In addition, the change of LDL cholesterol in vytorin group was significantly higher than it in lipitor (52.4% vs 44.1% respectively p < 0.05). The central PWV (cfPWV) and peripheral PWV (cfPWV) in lipitor group was significantly decreased compared with those in vytorin group (p < 0.05). Conclusions: Although co-administration of simvastatin and ezetimibe might show much more lipid lowering effect compared with atorvastatin, only atorvastatin might show pleiotrophic effect for short-term treatment in hypercholesterolemia. P-206 Serum MCP-1 Levels Are Strongly Associated with Higher Ratio of LDL- to HDL-Cholestrol Levels and Lower Estimated GFR Ako Fukami1 , Hisashi Adachi1 , Sho-Ichi Yamagishi2 , Mika Enomoto1 , Maki Otsuka1 , Shunichi Kumagae1 , Yasuki Nanjo1 , Kumiko Furuki1 , Eishi Esaki1 , Eita Kumagai1 , Kyoko Murayama1 , Akira Satoh1 , Yuji Hirai1 , Tsutomu Imaizumi1 . 1 Department of Internal Medicine, Division of Cardio-Vascular Medicine, Kurume University School of Medicine, Japan, 2 Department of Pathophysiology and Therapeutics of Diabetic Vascular Complications, Kurume University School of Medicine, Japan Background: Monocyte chemoattractant protein-1 (MCP-1) has been shown to play a role in the pathogenesis of insulin resistance and atherosclerosis. Recently, it is suggested the ratio of LDL-C to HDL-C (L/H ratio) predicts progression of atherosclerosis. Chronic kidney disease (CKD) is also known as a risk factor for atherosclerotic cardiovascular disease. Objective: We investigated whether serum MCP-1 levels are associated with the risks for atherosclerosis, including L/H ratio and CKD, in a general population. Methods: A total of 860 residents (318 men and 542 women, mean age 65.4±9.8 years) underwent a complete history and physical examination, determination of blood chemistries, including serum levels of MCP-1. Results: Elevated MCP-1 levels were associated with higher levels of WBC (p < 0.05), hsCRP (p < 0.05), g-GTP (p < 0.0001), HbA1c (p < 0.05), BUN (p < 0.0001), Cr (p < 0.0001), Uric acid (p < 0.0001), IMT of carotid arteries (p < 0.0001), and L/H ratio (p < 0.05). Elevated MCP-1 levels were associated with the lower levels of HDL-C (p < 0.05) and estimated GFR (p < 0.0001) by analysis of co-variance adjusted for age and sex. The hierarchical model demonstrated that the serum MCP-1 levels were the highest in the group with higher L/H ratio and lower estimated GFR. Conclusion: The present study demonstrated that serum levels of MCP-1 were strongly associated with higher L/H ratio and CKD, thus being involved in accelerated atherosclerosis in these high-risk patients.
P-207 Impact of Co-Administration of Atorvastatin and Bezafibrate on the Lipoprotein Subclass: Comparison between apoE2/2 and apoE3/3 Masa-aki Kawashiri1 , Junji Kobayashi2 , Atsushi Nohara2 , Hayato Tada1 , Chiaki Nakanishi1 , Masayuki Tsuchida1 , Mutsuko Takata1 , Akihiro Inazu3 , Hiroshi Mabuchi2 , Masakazu Yamagishi1 . 1 Department of Cardiology, Kanazawa University, Japan, 2 Department of Lipidology, Kanazawa University, Japan, 3 Molecular Biochemistry and Molecular Biology Laboratory, Graduate School of Medical Science, Kanazawa University, Japan Background: Type III hyperlipoproteinemia is a rare dyslipidemia (1 in 10,000), the molecular cause of which is the homozygous of the most rare isoform of apolipoprotein (apo) E (apoE2). We examined the effects of AT, BF and their combination in Type III patients. Methods: Hypertriglyceridemic [fasting serum triglyceride >150 mg/dl] patients with apoE 2/2 (n = 6) and apoE 3/3 (n = 8, wild type) were enrolled in an open randomized crossover study consisting of 4 weeks treatment period with AT (10 mg) or BF (400 mg), co-administration of AT and BF, and wash-out period. Serum lipoproteins were separated into 20 subclasses by high-performance liquid chromatography. Results: The changes of cholesterol in lipoprotein subfractions were not different between apoE phenotype. AT significantly decreased cholesterol in all apoB containing lipoprotein subfractions, whereas did not change cholesterol in all HDL subfractions. On the other hand, BF changed cholesterol distribution from small to large sized LDL and large to small sized HDL. Interestingly, co-administration of AT and BF additively modified cholesterol distribution; namely significant decrease of apoB containing lipoprotein cholesterol with shifting from smaller to larger sized LDL and significant increasing HDL cholesterol especially in smaller particles. Conclusion: AT and BF improved atherogenic dyslipidemia in considerably different manners, and co-administraion of AT and BF reinforced the benefits of both drugs particularly in terms of particle size of LDL and HDL. P-208 Double Blind Randomized Cross Over Controlled Clinical Trial of Resveratrol in Hyperlipidemic Patients Bahram Fariborz Farsad1 , Nazanin Zandi1 , Yunes Panahi1 , Farshad Hashemian2 , Abbas Zawarei1 , Ahmad Mohebbi1 , Ali Sadeghpour Taba1 , Kambiz Mozaffari1 . 1 Department of Clinical Pharmacy, Rajaie Heart Center, Iran (Islamic Republic of), 2 IA University, Pharmaceutical Branch, Iran (Islamic Republic of) Background: Resveratrol is a naturally occurring polyphenolic compound in grapes. There has been numerous animal studies showing its beneficial effects on atherosclerosis and dyslipidemia but human effects has rarely been studied. Purpose: To evaluate the clinical efficacy and tolerability of Resveratrol among hyperlipidemic patients and plasma lipid concenteration changes following its administration. Methods: A double blind randomized controlled cross over clinical trial in a tertiary care heart center was performed. We enrolled 200 patients with LDL > 130 mg/dl with no risk factor or LDL > 100 mg/dl if having more than 2 risk factors plus TG > 200 mg/dl. Recruited eligible patients were randomly assigned to receive either one 100 mg capsule of Resveratrol plus 10 mg Atorvastatin or one capsule of placebo plus 10 mg Atorvastatin daily, for three weeks. After a 1-week wash out period of Resveratrol, subjects were given the alternate treatment for an additional 3 weeks.