- Email: [email protected]
Plasma urokinase as predictor of recurrent angina after coronary angioplasty
Alabakovska
66
~LDL
AND HDL SUBCLASS DISTRIBUTION IN PATIENTS WITH END-STAGE RENAL DISEASES
S.B. Alabakovska, B.B. Todorova, D.D. Labudovie, K.N. Tosheska.
Department of Medical Biochemistry, Skopje, Macedonia The aim of the study was to examine the alterations in LDL and HDL subclass distribution in ESRD patients compared with a control group and to investigate the relationship of LDL particle size to the other plasma lipoproteins levels. Plasma lipids, LDL and HDL subclasses were determined in 63 hemodialysis patients (HI)), 42 predialysis patients and 345 control subjects. Lipoprotein subclasses were separated by polyacrylamide 3 0 1 % gradient gel electrophoresis. In predialysis group, 88% subjects had small LDL particles compared with 58,5% of hemodialysis patients and 16,5% of control subjects. Mean LDL size particle diameter was significantly smaller in HI) and predialysis patients in comparison with controls (p<0,0005, p<0,0001; respectively). Significant inverse correlation between LDL particle size and trigliceride level was observed for both patient groups. Decreased levels of the largest HDL2b subclass was found in both predialysis (16,5%) and in HD patients (30%) as compared with controls (50%), and increased levels of the small HDL3a subclass was found only in predialysis group (21%) in comparison with controls (4,5%). Alterations in LDL and HDL subclass distribution towards smaller particles is the main lipid abnormality associated with atherogensis found in ESRD. ESRD is associated with reduced levels of HDL2b subclass and increased levels of HDL3c subclass, which occurs in coronary artery disease (CAD) as well. ~
STATIN TREATMENT ASSESSED BY MAGNETIC RESONANCE
J.P. Albert±n±1, H. Laouenan2, P. Valensi 2, L. Le Moyee 2. ISMBH, Hrpital
Avicenne, Bobigny; 2Pfizer, Paris, France In this study NMR analysis was used to look for some pleiotropic effects of statins. Among the 1300 patients of the COAST study, 60 men with a ~>45% LDL-eholesterol lowering under statin treatment were included. These patients were treated by atorvastatin l0 mg (30 patients) or simvastatin 20 mg (30 patients). Thirty-one of them had CHD and 29 patients had ~>2 risk factors. Sera at baseline and after 45-day treatment, were analyzed by 1H-NMR at 500 MHz. Spectra analysis produced 6 lipid components (met6 to metll). At baseline, CT, TG, HDL-C and LDL-C and the Principal Component Analysis (PCA) profile were similar in both groups. After treatment with atorvastatin or simvastatin at dose of similar efficacy, the changes in CT, TG, HDL-C and LDL-C were similar between the two treatments groups. In the whole series of 60 patients, the PCA and cluster analysis demonstrated that met7 and metl l components decreased and met9 component increased. After treatment, two clusters were separated by metl0 and metS, this separation being explained only by CHD history (ANOVA, P<0.03): CHD was associated with a met8 decrease and a metl0 increase. This was eonfirmed in atorvastatin group, but not in simvastatin group. This study shows that NMR spectroscopy may provide evidence for subtle lipid profile changes with statins. Moreover, these changes seem to differ with CHD status and according to the statins; atorvastatin may have beneficial effects in those with CHD: decrease in the triglycerides-rich lipoproteins (met8 component) and increase in the triglycerides-poor lipoproteins (metl0 component).
~
PLASMAUROKINASE AS
PREDICTOR OF RECURRENT ANGINA AFTER CORONARY ANGIOPLASTY
I. Alekseeva, Y. Parfyonova, A. Lyakishev, A. Dobrovolsky, Z. Gabbasov, V. Naumov. Cardiology Research Centre, Moscow, Russia Angina recurrence after successful coronary angioplasty (CA) remains a major clinical problem. The main causes of this are restenosis of dilated arteries as a form of accelerated atherosclerosis and the progression of atherosclerotic lesion of coronary arteries, with thrombus formation as a principle mechanism underlying both of them. In our study we evaluated the predictive value of some markers of the coagulation-fibrinolysis system for angina recurrence after successful CA. We measured pre-procedural and follow-up plasma levels of fibrinogen, urokinase plasminogen activator antigen (uPA), plasminogen activator inhibitor-1 activity (PAI-l-act), tissue plasminogen activator activity (tPA-act) and ADP-induced platelet aggregation in 53 patients with stable angina who underwent successful CA for singlevessel coronary disease. All patients were followed up for angina recurrence for 1 year after CA. The Cox proportional hazards model was used to assess
the association of variables with angina recurrence rate. At the end of the follow-up, 16 patients had angina recurrence. No significant differences in plasma level of fibrinogen, tPA-act and ADP-induced platelet aggregation at all time points were found between study groups. Preprocedural, 3 and 6 months PAI-l-act levels were increased in the group with compared to the group without angina recurrence (23.3±8.5 vs. 13.9±7.7; 22.3±7.2 vs. 15.5±7.5; 25.0±7.9 vs. 15.7±7.9 IU/ml, respectively, p<0,05), uPA antigen levels were significantly higher in patients with recurrent angina at all the time periods studied. From clinical variables only the duration of stable angina more than 1 year before CA (p=0.017) by univariate analysis was a predictor of recurrent angina. According to stepwise multivariate analysis only the level of plasma uPA antigen was shown to be significant independent predictor of angina recurrence (p-0.004). Conclusion: In our study only uPA antigen level was an independent predictor of recurrent angina within 1 year after successful CA. ~
ASSOCIATION BETWEEN SERUM HOMOCYSTEINE AND CORONARY HEART DISEASE IN A FINNISH HIGH-RISK MALE POPULATION
G. Alfthan 1, P. Jousilahti1, J.T. Salonen2, J. Tuomilehto 1. JNational Public Health Institute, Helsinki," 2Research Institute of Public Health, University of Kuopio, Finland The association between serum homocysteine and coronary heart disease (CHD) risk was studied in a nested case-control study design. Cases and controls were ascertained from a random population sample of men aged 35 59 years at baseline who participated in a cardiovascular risk factor survey in Eastern Finland in 1972. A frozen serum sample was available for 113 men, who developed a fatal or non-fatal CHD event until the end of 1997. The controls comprised of 174 for age group matched men, who remained free from an acute CHD event. Serum total homoeysteine was determined by HPLC using fluorometry. The m e a n i S D serum homocysteine concentration was 13.4±3.5 ~tmol/1 for cases, and 13.2±4.4 ~tmol/1 for controls. The odds ratio for CHD in the highest, as compared to the other quartiles, was 1.93 (95% CI 1.07-3.50) including the eovariates age, serum cholesterol, smoking, systolic blood pressure, diabetes and body mass index in the logistic regression model. Among the cases, the mean serum cholesterol was 7.4 mmoV1 and 65% of them were smokers. Thus, a mild hyperhomocysteinemia contributed to the risk of CHD in this population with an exceptionally high risk for CHD. ~1"~ MEMBRANE PROTECTIVE EFFECT OF PRESTARIUM IN HYPERTENSIVES W I T H HEART FAILURE I.G. Alizade, N.T. Karaeva. Hospital of Ministry of Internal Affairs, Baku,
Azerbaijan Prestarium (perindopril) is widely use in the treatment of essential hypertension and heart failure (HF). The aim of our study was to assess the possible membrane protective effect of prestarium in essential hypertensive patients with HF. Methods: Prestarium was given in a dose 4 8 mg/day. Cell membrane lipid profile - platelet membrane cholesterol (CH) content, phospholipid (PH) spectrum (phosphatidylcholine (PC), lysophosphatidylcholine (LPC); lipid peroxides products levels dienes conjugates (DC) and malonic dialdehyde (MD) and ADP-induced aggregation were determined in fiftysix hypertensive patients with HF (mean age 55.1±1.6 years). Effect of prestarium was estimated after five week treatment. Results: Dynamic investigation of parameters after prestarium therapy in hypertensive patients with HF revealed that the expressive ant±hypertensive effect of prestarium (significant diminution of BP in 86% of patients) accompanied significant decrease of CH content (p<0.05), and DC, MD levels (p<0.01). LPC, PH and ADP- induced aggregation had tendency to lowering. Conclusion: The membrane protective effect of prestarium may be beneficial in prevention of atherosclerosis in hypertensive patients with HF. ~0--~ THE ACUTE EFFECTS OF INSULIN ON CHYLOMICRON METABOLISM IN VISCERALLY OBESE AND LEAN MEN E.M. Allister 1, A.R James 1, J.C.L. Mamo 1, RH.R. Barrett 2, M. Soares 1, G.E Watts 2. I Curtin University," 2University of Western Australia, Perth,
WA, Australia Obese subjects exhibit raised concentrations of chylomicron (CM) and CM-remnants in circulation. Therefore, this stud5, aimed to investigate
73rd EAS Congress
66
~LDL
AND HDL SUBCLASS DISTRIBUTION IN PATIENTS WITH END-STAGE RENAL DISEASES
S.B. Alabakovska, B.B. Todorova, D.D. Labudovie, K.N. Tosheska.
Department of Medical Biochemistry, Skopje, Macedonia The aim of the study was to examine the alterations in LDL and HDL subclass distribution in ESRD patients compared with a control group and to investigate the relationship of LDL particle size to the other plasma lipoproteins levels. Plasma lipids, LDL and HDL subclasses were determined in 63 hemodialysis patients (HI)), 42 predialysis patients and 345 control subjects. Lipoprotein subclasses were separated by polyacrylamide 3 0 1 % gradient gel electrophoresis. In predialysis group, 88% subjects had small LDL particles compared with 58,5% of hemodialysis patients and 16,5% of control subjects. Mean LDL size particle diameter was significantly smaller in HI) and predialysis patients in comparison with controls (p<0,0005, p<0,0001; respectively). Significant inverse correlation between LDL particle size and trigliceride level was observed for both patient groups. Decreased levels of the largest HDL2b subclass was found in both predialysis (16,5%) and in HD patients (30%) as compared with controls (50%), and increased levels of the small HDL3a subclass was found only in predialysis group (21%) in comparison with controls (4,5%). Alterations in LDL and HDL subclass distribution towards smaller particles is the main lipid abnormality associated with atherogensis found in ESRD. ESRD is associated with reduced levels of HDL2b subclass and increased levels of HDL3c subclass, which occurs in coronary artery disease (CAD) as well. ~
STATIN TREATMENT ASSESSED BY MAGNETIC RESONANCE
J.P. Albert±n±1, H. Laouenan2, P. Valensi 2, L. Le Moyee 2. ISMBH, Hrpital
Avicenne, Bobigny; 2Pfizer, Paris, France In this study NMR analysis was used to look for some pleiotropic effects of statins. Among the 1300 patients of the COAST study, 60 men with a ~>45% LDL-eholesterol lowering under statin treatment were included. These patients were treated by atorvastatin l0 mg (30 patients) or simvastatin 20 mg (30 patients). Thirty-one of them had CHD and 29 patients had ~>2 risk factors. Sera at baseline and after 45-day treatment, were analyzed by 1H-NMR at 500 MHz. Spectra analysis produced 6 lipid components (met6 to metll). At baseline, CT, TG, HDL-C and LDL-C and the Principal Component Analysis (PCA) profile were similar in both groups. After treatment with atorvastatin or simvastatin at dose of similar efficacy, the changes in CT, TG, HDL-C and LDL-C were similar between the two treatments groups. In the whole series of 60 patients, the PCA and cluster analysis demonstrated that met7 and metl l components decreased and met9 component increased. After treatment, two clusters were separated by metl0 and metS, this separation being explained only by CHD history (ANOVA, P<0.03): CHD was associated with a met8 decrease and a metl0 increase. This was eonfirmed in atorvastatin group, but not in simvastatin group. This study shows that NMR spectroscopy may provide evidence for subtle lipid profile changes with statins. Moreover, these changes seem to differ with CHD status and according to the statins; atorvastatin may have beneficial effects in those with CHD: decrease in the triglycerides-rich lipoproteins (met8 component) and increase in the triglycerides-poor lipoproteins (metl0 component).
~
PLASMAUROKINASE AS
PREDICTOR OF RECURRENT ANGINA AFTER CORONARY ANGIOPLASTY
I. Alekseeva, Y. Parfyonova, A. Lyakishev, A. Dobrovolsky, Z. Gabbasov, V. Naumov. Cardiology Research Centre, Moscow, Russia Angina recurrence after successful coronary angioplasty (CA) remains a major clinical problem. The main causes of this are restenosis of dilated arteries as a form of accelerated atherosclerosis and the progression of atherosclerotic lesion of coronary arteries, with thrombus formation as a principle mechanism underlying both of them. In our study we evaluated the predictive value of some markers of the coagulation-fibrinolysis system for angina recurrence after successful CA. We measured pre-procedural and follow-up plasma levels of fibrinogen, urokinase plasminogen activator antigen (uPA), plasminogen activator inhibitor-1 activity (PAI-l-act), tissue plasminogen activator activity (tPA-act) and ADP-induced platelet aggregation in 53 patients with stable angina who underwent successful CA for singlevessel coronary disease. All patients were followed up for angina recurrence for 1 year after CA. The Cox proportional hazards model was used to assess
the association of variables with angina recurrence rate. At the end of the follow-up, 16 patients had angina recurrence. No significant differences in plasma level of fibrinogen, tPA-act and ADP-induced platelet aggregation at all time points were found between study groups. Preprocedural, 3 and 6 months PAI-l-act levels were increased in the group with compared to the group without angina recurrence (23.3±8.5 vs. 13.9±7.7; 22.3±7.2 vs. 15.5±7.5; 25.0±7.9 vs. 15.7±7.9 IU/ml, respectively, p<0,05), uPA antigen levels were significantly higher in patients with recurrent angina at all the time periods studied. From clinical variables only the duration of stable angina more than 1 year before CA (p=0.017) by univariate analysis was a predictor of recurrent angina. According to stepwise multivariate analysis only the level of plasma uPA antigen was shown to be significant independent predictor of angina recurrence (p-0.004). Conclusion: In our study only uPA antigen level was an independent predictor of recurrent angina within 1 year after successful CA. ~
ASSOCIATION BETWEEN SERUM HOMOCYSTEINE AND CORONARY HEART DISEASE IN A FINNISH HIGH-RISK MALE POPULATION
G. Alfthan 1, P. Jousilahti1, J.T. Salonen2, J. Tuomilehto 1. JNational Public Health Institute, Helsinki," 2Research Institute of Public Health, University of Kuopio, Finland The association between serum homocysteine and coronary heart disease (CHD) risk was studied in a nested case-control study design. Cases and controls were ascertained from a random population sample of men aged 35 59 years at baseline who participated in a cardiovascular risk factor survey in Eastern Finland in 1972. A frozen serum sample was available for 113 men, who developed a fatal or non-fatal CHD event until the end of 1997. The controls comprised of 174 for age group matched men, who remained free from an acute CHD event. Serum total homoeysteine was determined by HPLC using fluorometry. The m e a n i S D serum homocysteine concentration was 13.4±3.5 ~tmol/1 for cases, and 13.2±4.4 ~tmol/1 for controls. The odds ratio for CHD in the highest, as compared to the other quartiles, was 1.93 (95% CI 1.07-3.50) including the eovariates age, serum cholesterol, smoking, systolic blood pressure, diabetes and body mass index in the logistic regression model. Among the cases, the mean serum cholesterol was 7.4 mmoV1 and 65% of them were smokers. Thus, a mild hyperhomocysteinemia contributed to the risk of CHD in this population with an exceptionally high risk for CHD. ~1"~ MEMBRANE PROTECTIVE EFFECT OF PRESTARIUM IN HYPERTENSIVES W I T H HEART FAILURE I.G. Alizade, N.T. Karaeva. Hospital of Ministry of Internal Affairs, Baku,
Azerbaijan Prestarium (perindopril) is widely use in the treatment of essential hypertension and heart failure (HF). The aim of our study was to assess the possible membrane protective effect of prestarium in essential hypertensive patients with HF. Methods: Prestarium was given in a dose 4 8 mg/day. Cell membrane lipid profile - platelet membrane cholesterol (CH) content, phospholipid (PH) spectrum (phosphatidylcholine (PC), lysophosphatidylcholine (LPC); lipid peroxides products levels dienes conjugates (DC) and malonic dialdehyde (MD) and ADP-induced aggregation were determined in fiftysix hypertensive patients with HF (mean age 55.1±1.6 years). Effect of prestarium was estimated after five week treatment. Results: Dynamic investigation of parameters after prestarium therapy in hypertensive patients with HF revealed that the expressive ant±hypertensive effect of prestarium (significant diminution of BP in 86% of patients) accompanied significant decrease of CH content (p<0.05), and DC, MD levels (p<0.01). LPC, PH and ADP- induced aggregation had tendency to lowering. Conclusion: The membrane protective effect of prestarium may be beneficial in prevention of atherosclerosis in hypertensive patients with HF. ~0--~ THE ACUTE EFFECTS OF INSULIN ON CHYLOMICRON METABOLISM IN VISCERALLY OBESE AND LEAN MEN E.M. Allister 1, A.R James 1, J.C.L. Mamo 1, RH.R. Barrett 2, M. Soares 1, G.E Watts 2. I Curtin University," 2University of Western Australia, Perth,
WA, Australia Obese subjects exhibit raised concentrations of chylomicron (CM) and CM-remnants in circulation. Therefore, this stud5, aimed to investigate
73rd EAS Congress