- Email: [email protected]
PP-044 ASSOCIATION OF FIBRINOGEN AND HS-CRP LEVELS IN PATIENTS WITH ANGIOGRAPHICALLY PROVEN CORONARY ARTERY DISEASE
S114
Poster Discussions / International Journal of Cardiology 155S1 (2012) S99–S127
associated with inflammation and with severity of coronary atherosclerosis. We therefore investigated the link between serum vitamin D levels and (i) extent of CAD assessed by the Gensini score and (ii) inflammatory parameters, including C-reactive protein (CRP) and fibrinogen. Methods: We measured 25-hydroxyvitamin D [25(OH)D] and inflammatory markers in 239 patients who underwent coronary angiography, We analyzed the relation between serum levels of 25(OH)D and inflammatory markers and angiographic severity of coronary artery disease (CAD). Gensini lesion severity score was used for the detection of severity of coronary atherosclerosis. Results: Vitamin D insufficiency were very common among the our study population and 83% had levels <30 ng/ml. Gensini score was negatively correlated with serum vitamin D level (r = −0.399, p < 0.001), and positively correlated with age (r = 0.209, p = 0.001), blood pressure (r = 0.379, p < 0.001), diabetes (r = 0.335, p < 0.001), hyperlipidemia (r = 0.150, p = 0.021) and serum CRP level (r = 0.214, p = 0.001). After adjustments for traditional and nontraditional cardiovascular risk factors, vitamin D (B=−0.345, p < 0.001) remained significant predictors of the severity of the coronary artery disease. CRP was significantly higher in the higher gensini group but significance was lost after adjustments for potential confounders. Conclusions: Low serum 25(OH)D levels are associated with the severity of coronary artery stenosis. Further studies are warranted to determine whether vitamin D supplementation could prevent progression of CAD.
PP-044 ASSOCIATION OF FIBRINOGEN AND HS-CRP LEVELS IN PATIENTS WITH ANGIOGRAPHICALLY PROVEN CORONARY ARTERY DISEASE H. Peyman1 , M.R.H. Ahmadi2 , S. Qavam3 , M. Yaghoubi4 , A. Zarian1 , A. Delpisheh4 . 1 Department of Nursing, Ilam University of Medical Sciences, Ilam, Iran; 2 Department of Pathology, Ilam University of Medical Sciences, Ilam-Iran; 3 Department of Cardiology, Ilam University of Medical Sciences, Ilam, Iran; 4 Department of Clinical Epidemiology, Ilam University of Medical Sciences, Ilam, Iran Objective: Inflammation plays a pivotal role in progression of atherosclerosis. Inflammatory Markers such as fibrinogen and hsCRP have been associated with various cardiovascular events. Methods: In the present study 40 patients with positive angiography and hospialised at the Mustafa hospital in Ilam city were randomly recruited in 2010. Diagnosis of Cardiac disease based on American Heart Association’s (AHA) criteria was performed and confirmed with angiography. Demographic and clinical data was collected using a standard questionnaire. Results: Mean age of patients was 58.9±11.2 years and 44.7% were males. The mean blood levels of fibrinogen were 188.9±114.6 g/L (166.5 in males and 207.9 in females). Overall, 67.6% had a fibrinogen level of less than 200 g/L, 30% categorized in 200–400 g/L ranges and 5.4% had a mean level of more than 400 g/L. Fibrinogen level was significantly increased in patient with hyperlipedemia (231.3 vs 156.6, p < 0.001), myocardial infarction (299.4 vs 171.6, p < 0.01), epigastric pain (323.1 vs 162.9, p < 0.001). Increased level of fibrinogen was significantly correlated with LDH and hs-CRP (p < 0.02, r= 0.484 and p < 0.05, r = 0.505 respectively). No similar relationship was found for other risk actors. Conclusions: Combination of fibrinogen and hs-CRP levels provides a better predictive value for cardiac events in patient with proven CAD. Appropriate management of angiographically proven cardiac patients with increased levels of inflammatory biomarkers can reduce fatal and nonfatal cardiovascular events. PP-045 CAROTID-FEMORAL PULSE WAVE VELOCITY IN PATIENTS WITH ISOLATED CORONARY ARTERY ECTASIA: AN OBSERVATIONAL STUDY A. Kırıs¸ 1 , M. Bostan2 , L. Korkmaz3 , M.T. A˘gac¸ 4 , Z. Acar4 , S. ¸ Kaplan1 , 4 1 S. ¸ Celik ¸ . Department of Cardiology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey; 2 Department of Cardiology, Faculty of Medicine, Rize University, Rize, Turkey; 3 Department of Cardiology, Adana Numune Training and Research Hospital, Adana, Turkey; 4 Department of Cardiology, Ahi Evren Cardiovascular and Thoracic Surgery Training and Research Hospital, Trabzon, Turkey
Figure 1. Correlation graph of vitamin D with C-reactive protein. Table 1. Multiple regression models of Gensini score b (P)
Vitamin D, ng/ml Age Gender Hypertension Diabetes mellitus Hyperlipidemia Smoking GFR CRP (mg/liter) Fibrinogen (mg/dl)
Unadjusted
Model 1
Model 2
Model 3
−0.39 (<0.001)
−0.343 (<0.001) 0.061 (0.258) 0.158 (0.003) 0.293 (<0.001) 0.245 (<0.001) 0.130 (0.014) 0.039 (0.458)
−0.358 (<0.001)
−0.345 (<0.001)
0.010 (0.851) 0.128 (0.014) 0.268 (<0.001) 0.227 (<0.001) 0.115 (0.024) 0.026 (0.657) −0.227 (<0.001)
0.014 (0.788) 0.127 (0.016) 0.270 (<0.001) 0.219 (<0.001) 0.115 (0.024) 0.026 (0.616) −0.218 (<0.001) 0.092 (0.071) 0.011 (0.834)
Objective: Carotid-femoral pulse wave velocity (PWV) has emerged as an important independent predictor of cardiovascular events. It is the current “gold-standard” measure of arterial stiffness and increased PWV is recognized as an indicator of atherosclerosis. The relationship between isolated coronary artery ectasia (CAE) and carotid-femoral PWV has not been well-described. The objective of this study was to assess this relation. Methods: Thirthy-four patients with isolated CAE and 24 control subjects with angiographically normal coronary arteries were enrolled in this study. The patients who have any visible coronary stenosis were excluded from the study. The carotid-femoral PWV was measured by applanation tonometry. Multivariable regression analysis was performed for the evaluation of the relations of parameters. Results: The baseline clinical and laboratory parameters of the both groups were similar. Patients with isolated CAE had significantly higher carotid-femoral PWV compared to control subjects (10.5±2.4 vs 9.2±1.7 m/s, p = 0.02). In multivariable analysis, age (b = 0.23, p = 0.04), number of ectatic vessel (b = 0.24, p = 0.03), and systolic blood pressure (b = 0.52, p = 0.001) were found independently related to PWV.
Poster Discussions / International Journal of Cardiology 155S1 (2012) S99–S127
associated with inflammation and with severity of coronary atherosclerosis. We therefore investigated the link between serum vitamin D levels and (i) extent of CAD assessed by the Gensini score and (ii) inflammatory parameters, including C-reactive protein (CRP) and fibrinogen. Methods: We measured 25-hydroxyvitamin D [25(OH)D] and inflammatory markers in 239 patients who underwent coronary angiography, We analyzed the relation between serum levels of 25(OH)D and inflammatory markers and angiographic severity of coronary artery disease (CAD). Gensini lesion severity score was used for the detection of severity of coronary atherosclerosis. Results: Vitamin D insufficiency were very common among the our study population and 83% had levels <30 ng/ml. Gensini score was negatively correlated with serum vitamin D level (r = −0.399, p < 0.001), and positively correlated with age (r = 0.209, p = 0.001), blood pressure (r = 0.379, p < 0.001), diabetes (r = 0.335, p < 0.001), hyperlipidemia (r = 0.150, p = 0.021) and serum CRP level (r = 0.214, p = 0.001). After adjustments for traditional and nontraditional cardiovascular risk factors, vitamin D (B=−0.345, p < 0.001) remained significant predictors of the severity of the coronary artery disease. CRP was significantly higher in the higher gensini group but significance was lost after adjustments for potential confounders. Conclusions: Low serum 25(OH)D levels are associated with the severity of coronary artery stenosis. Further studies are warranted to determine whether vitamin D supplementation could prevent progression of CAD.
PP-044 ASSOCIATION OF FIBRINOGEN AND HS-CRP LEVELS IN PATIENTS WITH ANGIOGRAPHICALLY PROVEN CORONARY ARTERY DISEASE H. Peyman1 , M.R.H. Ahmadi2 , S. Qavam3 , M. Yaghoubi4 , A. Zarian1 , A. Delpisheh4 . 1 Department of Nursing, Ilam University of Medical Sciences, Ilam, Iran; 2 Department of Pathology, Ilam University of Medical Sciences, Ilam-Iran; 3 Department of Cardiology, Ilam University of Medical Sciences, Ilam, Iran; 4 Department of Clinical Epidemiology, Ilam University of Medical Sciences, Ilam, Iran Objective: Inflammation plays a pivotal role in progression of atherosclerosis. Inflammatory Markers such as fibrinogen and hsCRP have been associated with various cardiovascular events. Methods: In the present study 40 patients with positive angiography and hospialised at the Mustafa hospital in Ilam city were randomly recruited in 2010. Diagnosis of Cardiac disease based on American Heart Association’s (AHA) criteria was performed and confirmed with angiography. Demographic and clinical data was collected using a standard questionnaire. Results: Mean age of patients was 58.9±11.2 years and 44.7% were males. The mean blood levels of fibrinogen were 188.9±114.6 g/L (166.5 in males and 207.9 in females). Overall, 67.6% had a fibrinogen level of less than 200 g/L, 30% categorized in 200–400 g/L ranges and 5.4% had a mean level of more than 400 g/L. Fibrinogen level was significantly increased in patient with hyperlipedemia (231.3 vs 156.6, p < 0.001), myocardial infarction (299.4 vs 171.6, p < 0.01), epigastric pain (323.1 vs 162.9, p < 0.001). Increased level of fibrinogen was significantly correlated with LDH and hs-CRP (p < 0.02, r= 0.484 and p < 0.05, r = 0.505 respectively). No similar relationship was found for other risk actors. Conclusions: Combination of fibrinogen and hs-CRP levels provides a better predictive value for cardiac events in patient with proven CAD. Appropriate management of angiographically proven cardiac patients with increased levels of inflammatory biomarkers can reduce fatal and nonfatal cardiovascular events. PP-045 CAROTID-FEMORAL PULSE WAVE VELOCITY IN PATIENTS WITH ISOLATED CORONARY ARTERY ECTASIA: AN OBSERVATIONAL STUDY A. Kırıs¸ 1 , M. Bostan2 , L. Korkmaz3 , M.T. A˘gac¸ 4 , Z. Acar4 , S. ¸ Kaplan1 , 4 1 S. ¸ Celik ¸ . Department of Cardiology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey; 2 Department of Cardiology, Faculty of Medicine, Rize University, Rize, Turkey; 3 Department of Cardiology, Adana Numune Training and Research Hospital, Adana, Turkey; 4 Department of Cardiology, Ahi Evren Cardiovascular and Thoracic Surgery Training and Research Hospital, Trabzon, Turkey
Figure 1. Correlation graph of vitamin D with C-reactive protein. Table 1. Multiple regression models of Gensini score b (P)
Vitamin D, ng/ml Age Gender Hypertension Diabetes mellitus Hyperlipidemia Smoking GFR CRP (mg/liter) Fibrinogen (mg/dl)
Unadjusted
Model 1
Model 2
Model 3
−0.39 (<0.001)
−0.343 (<0.001) 0.061 (0.258) 0.158 (0.003) 0.293 (<0.001) 0.245 (<0.001) 0.130 (0.014) 0.039 (0.458)
−0.358 (<0.001)
−0.345 (<0.001)
0.010 (0.851) 0.128 (0.014) 0.268 (<0.001) 0.227 (<0.001) 0.115 (0.024) 0.026 (0.657) −0.227 (<0.001)
0.014 (0.788) 0.127 (0.016) 0.270 (<0.001) 0.219 (<0.001) 0.115 (0.024) 0.026 (0.616) −0.218 (<0.001) 0.092 (0.071) 0.011 (0.834)
Objective: Carotid-femoral pulse wave velocity (PWV) has emerged as an important independent predictor of cardiovascular events. It is the current “gold-standard” measure of arterial stiffness and increased PWV is recognized as an indicator of atherosclerosis. The relationship between isolated coronary artery ectasia (CAE) and carotid-femoral PWV has not been well-described. The objective of this study was to assess this relation. Methods: Thirthy-four patients with isolated CAE and 24 control subjects with angiographically normal coronary arteries were enrolled in this study. The patients who have any visible coronary stenosis were excluded from the study. The carotid-femoral PWV was measured by applanation tonometry. Multivariable regression analysis was performed for the evaluation of the relations of parameters. Results: The baseline clinical and laboratory parameters of the both groups were similar. Patients with isolated CAE had significantly higher carotid-femoral PWV compared to control subjects (10.5±2.4 vs 9.2±1.7 m/s, p = 0.02). In multivariable analysis, age (b = 0.23, p = 0.04), number of ectatic vessel (b = 0.24, p = 0.03), and systolic blood pressure (b = 0.52, p = 0.001) were found independently related to PWV.