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Simvastatin reduces acute phase response markers
Monday June 26, 2000: Poster Abstracts P: W4 Infections, CHD, and Atherosclerosis
28
0.39; 95% CI 0.16--0.95; p = 0.039) as significant factors associated with ischemic events. In multivariate analysis, only titers of anti-HP IgG antibody (hazard ratio 3.36; 95% CI 1.41-8.01; p = 0.006) were independent predictor of future ischemic events. Condnsions: Elevation of anti-HP IgG antibody titers is a predictor for subsequent ischemic events in CHD patients.
MoP2:W4 ] Association of chlalnydia pneumoniae infection with diabetes mellitus in patients with coronary artery disease Y. Momiyama, R. Hirano, K. Miyazaki, M. Kitagaki, T. Miyagawa, T. Hisada, S. Sawada, A. Yonemura, K. Higashi, T. Shibuya, H. Nakamura, E Ohsuzu. National Defense Medical College, Saitama, Japan
Objective: To elucidate clinical and angiographic characteristics of patients (pts) with coronary artery disease (CAD) who had Chlamydia pneumoniae (CP) infection. Methods: We evaluated clinical and angiographic characteristics and serum IgG antibody to CP in 131 consecutive pts who had cardiac catheterization. The cut off index of IgG titer was measured by enzyme-linked immunosorbent assay, the index > 1.10 being considered positive. Results: Of the 131 pts, 95 had significant CAD (>50% stenosis). The prevalence of CP IgG seropositivity was higher in pts with CAD (46%) than in those without CAD (28%), and CP IgG titer was higher in pts with CAD (1.23 4- 0.76) than in those without CAD (0.86 4- 0.52) (p < 0.01). Of the 95 pts with CAD, 44 were positive for CE Compared between CAD pts positive and those negative for CE we did not find any difference in the prevalence of myocardial infarction and those of eccentric and calcified lesions on coronary arteriograms. Of note was that diabetes mellitus was more prevalent in CAD pts positive for CP than in those negative (50% vs 18%, p < 0.005). Multivariate analysis revealed that CP IgG seropositivity was significantly associated with diabetes in CAD pts, but it was not an independent risk factor for CAD. Conclusion: CP infection was prevalent in pts with CAD, but it was not independently associated with CAD. CP infection was associated with diabetes mellitus which is one of classical risk factors for CAD.
MoP3:W4 [ Chlamydia pneumoniae seropositivity and Carotid Atherosclerosis - A Japanese population-based study N. Maeda, J. Hayashi, Y. Sawayama, C. Shimizu, K. Kashiwagi, H. Nakashima, S. Kashiwagi. Department of General Medicine, Kyushu
University Hospital Fukuoka, Japan Objective: The purpose of this study was to determine the association between Chlamydia pneumoniae (C. pneumoniae) infection and carotid atherosclerosis in a Japanese population-based sample. Methods: In 560 Japanese individuals aged 25 to 85 years (177 men and 383 women, mean age 56.6 4- 13.1 years), we investigated the association between seropositivity to C. pneumoniae infection and carotid atherosclerosis. We measured intima-media thickness (IMT) of the common carotid artery and the presence of carotid plaque by carotid B-mode ultrasound. Plaque was defined as a clearly identified area of focal increased IMT (>1.3 mm). Anti-C. pneumoniae IgA and IgG antibodies were measured by ELISA (HITAZYME C. pneumoniae). Results: The seroprevalence of anti-C, pneumoniae IgG was detected in 43.9%, whereas the seroprevalence of anti-C, pneumoniae IgA was detected in 52.3% of the population. The seroprevalence of anti-C, pneumoniae IgA increased with age, but not anti-C, pneumoniae IgG. There was no difference in seroprevalence levels between men and women. Seropositivity to anti-C. pneumoniae IgA was associated with mean maximum IMT and the presence of carotid plaques, but there were no such associations with anti-C, pneumoniae IgG, by univariate comparison. There was an association between increased carotid plaque and hypertension, diabetes mellitus, smoking, and hyperlipidemia. Conclusions: Seropositivity to anti-C, pneumoniae IgA was associated with carotid atherosclerosis.
Methods: We examined acute phase response markers (C-reactive proteins, blood sedimentation rate [BSR], fibrinogen, interleukin-6 [IL-6], serum amyloid A and P) as well as the LPS (4 #g/ml)-induced monocyte expression of TNFct and interleukin-1/3 (IL-1/~) in 57 patients suffering from severe familial heterozygous hypercholesterolemia (FH) and 42 patients suffering from familial combined hyperlipidemia (FCH). Values were obtained before and 4 weeks after dietary councelling, after 1 month simvastatin (S) therapy, as well as after 3 and 6 months (either 20 or 40 mg S as necessary to achieve the consensus goals). Results: S-tberapy but not dietary intervention reduced monocyte TNFa and IL-1/3 significantly, the decrease being more pronounced in FCH as compared to FH. CRP, BSR and IL-6 were significantly decreased (FCH > FH), fibrinogen only borderline (-11%). No change in SAA and SAP was detected. No difference between patients on 20 or 40 mg S was seen. Conclusions: This study demonstrates that S dose-independently shows an antiinflammatory effect via reduction of proinflammatory cytokines expressed by monocytes and acute phase response markers, being apparently more pronounced in FCH.
I MoP5:W4 ] The association between antibody titers to helicobacter I
pylori, chronic coronary heart disease and acute myocardial infarction
N. Sarraf-Zadegan, M. Amid, S. Magsoodloo. Isfahan Cardiovascular
Research Center, lsfahan, Iran Objectives: To study the possible relation between Helicobacter pylori (H. pylori) that may act either acutely (eg. Precipitating plaque rupture) or chronically (eg, promoting plaque growth) and acute myocardial infarction (AMI) or chronic coronary heart disease (CHD). Methods: Two groups of patients and a control group were investigated between May, 1997 to Feb, 1999 at Isfahan Cardiovascular Research Center. The AMI group consisted of 52 consecutive patients (mean age 54.8 -4- 8 years) admitted because of an AMI with a diagnosis based on WHO Criteria. The CHD group consisted of 51 consecutive patients (mean age 52.8 -4- 11 years) admitted for coronary angiography because of chronic symptoms of angina pectoris and had at least single vessel significant lesion > 70% lumen narrowing in the coronary angiography report. The controls were random sample of 55 men and women from the same area as the patients, matched for sex, age and time. The controls underwent diagnostic coronary angiography and none had any lesion to be reported in each of coronary vessels. Serum samples were drawn for measurement of H. Pylori antibodies using Eliza method and fibrinogen using fibrinometric method. Results: AMI patients had significantly higher H. Pylori Ab levels compared to control group with an odds ratio of 4 (95% CI, 1.7 to 7.4; P -- 0.004), The CHD group showed similar findings with adjusted odds Ratio of 3.3 (95% CI, 1.1 to 6; P -- 0.01) while The comparison between AMI and CHD groups showed no significant difference with adjusted OR of 1.1 (95% CI 0.3 to 4 p = 0.08). The prevalence rates for H. Pylori Ab among cases and controls is shown in the following table: Caseand ControlGroups
No.
No, Positive Samplesfor H. Pylori
CrudDate %
(95%CI)
AMIGroup CHDor Coronary Anglo(+)Group Controlor Coronary Anglo(-) Group X2 P=
52 51
15 8
27.5 9.8
(25.5-29.5) (7.8-11.8)
26.8 10.3
(24.8-28.7) (8.3-12.3)
55
3
5.5
(3.5-7.4)
5.1
(3.1-7.1)
2.43 0.08
Adjustedfor SocioeconomicClass % (95%CI)
2.48 0.06
Conclusion: These results do not support the hypothesis that H. Pylori may induce the acute coronary events.
I MoP6:W4 I Randomized double-blind, placebo-controlled study of azithromycin in C. Pneumoniae Positive Postmyocardial Infarction Patients (CROAATS)
I MoP4:W4 ] Simvastatin reduces acute phase response markers H. Sinzinger 1, F. Cbehne I , A. Oguoghol , P. Schmid2. l Wilhelm Auerswald
Atherosclerosis Research Group (ASF) Vienna; 2Rehabilitation Center, Bad Schallerbach, Austria Objective: Inflammation recently gains increasing interest in the process of atherogenesis. The influence of statins on this mechanism is widely unknown.
7.. Reiner 1, M. Bergovec 2 , M. Gjura~in 1, V. Goldner I , J. Halle 3, S. Kranj~evi64 , S. Mihatov5 , T. Zrui6 6, J. Culig6, E. Tedeschi-Reiner5 . For
the CROAATS Study Group; /Univ. Hosp. Rebro," 2Univ. Hosp. Dubrava; 3Gen. Hosp. Sv. Duh; 4Univ. Hosp. Merkur; 5Univ. Hosp. S. Milosrdnice; 6pliva Pharmac. Company, Zagreb, Croatia There is a mounting evidence for an association between Chlamydia pneumo-
Xllth International Symposium on Atherosclerosis, Stockholm, Sweden, June 25-29, 2000
28
0.39; 95% CI 0.16--0.95; p = 0.039) as significant factors associated with ischemic events. In multivariate analysis, only titers of anti-HP IgG antibody (hazard ratio 3.36; 95% CI 1.41-8.01; p = 0.006) were independent predictor of future ischemic events. Condnsions: Elevation of anti-HP IgG antibody titers is a predictor for subsequent ischemic events in CHD patients.
MoP2:W4 ] Association of chlalnydia pneumoniae infection with diabetes mellitus in patients with coronary artery disease Y. Momiyama, R. Hirano, K. Miyazaki, M. Kitagaki, T. Miyagawa, T. Hisada, S. Sawada, A. Yonemura, K. Higashi, T. Shibuya, H. Nakamura, E Ohsuzu. National Defense Medical College, Saitama, Japan
Objective: To elucidate clinical and angiographic characteristics of patients (pts) with coronary artery disease (CAD) who had Chlamydia pneumoniae (CP) infection. Methods: We evaluated clinical and angiographic characteristics and serum IgG antibody to CP in 131 consecutive pts who had cardiac catheterization. The cut off index of IgG titer was measured by enzyme-linked immunosorbent assay, the index > 1.10 being considered positive. Results: Of the 131 pts, 95 had significant CAD (>50% stenosis). The prevalence of CP IgG seropositivity was higher in pts with CAD (46%) than in those without CAD (28%), and CP IgG titer was higher in pts with CAD (1.23 4- 0.76) than in those without CAD (0.86 4- 0.52) (p < 0.01). Of the 95 pts with CAD, 44 were positive for CE Compared between CAD pts positive and those negative for CE we did not find any difference in the prevalence of myocardial infarction and those of eccentric and calcified lesions on coronary arteriograms. Of note was that diabetes mellitus was more prevalent in CAD pts positive for CP than in those negative (50% vs 18%, p < 0.005). Multivariate analysis revealed that CP IgG seropositivity was significantly associated with diabetes in CAD pts, but it was not an independent risk factor for CAD. Conclusion: CP infection was prevalent in pts with CAD, but it was not independently associated with CAD. CP infection was associated with diabetes mellitus which is one of classical risk factors for CAD.
MoP3:W4 [ Chlamydia pneumoniae seropositivity and Carotid Atherosclerosis - A Japanese population-based study N. Maeda, J. Hayashi, Y. Sawayama, C. Shimizu, K. Kashiwagi, H. Nakashima, S. Kashiwagi. Department of General Medicine, Kyushu
University Hospital Fukuoka, Japan Objective: The purpose of this study was to determine the association between Chlamydia pneumoniae (C. pneumoniae) infection and carotid atherosclerosis in a Japanese population-based sample. Methods: In 560 Japanese individuals aged 25 to 85 years (177 men and 383 women, mean age 56.6 4- 13.1 years), we investigated the association between seropositivity to C. pneumoniae infection and carotid atherosclerosis. We measured intima-media thickness (IMT) of the common carotid artery and the presence of carotid plaque by carotid B-mode ultrasound. Plaque was defined as a clearly identified area of focal increased IMT (>1.3 mm). Anti-C. pneumoniae IgA and IgG antibodies were measured by ELISA (HITAZYME C. pneumoniae). Results: The seroprevalence of anti-C, pneumoniae IgG was detected in 43.9%, whereas the seroprevalence of anti-C, pneumoniae IgA was detected in 52.3% of the population. The seroprevalence of anti-C, pneumoniae IgA increased with age, but not anti-C, pneumoniae IgG. There was no difference in seroprevalence levels between men and women. Seropositivity to anti-C. pneumoniae IgA was associated with mean maximum IMT and the presence of carotid plaques, but there were no such associations with anti-C, pneumoniae IgG, by univariate comparison. There was an association between increased carotid plaque and hypertension, diabetes mellitus, smoking, and hyperlipidemia. Conclusions: Seropositivity to anti-C, pneumoniae IgA was associated with carotid atherosclerosis.
Methods: We examined acute phase response markers (C-reactive proteins, blood sedimentation rate [BSR], fibrinogen, interleukin-6 [IL-6], serum amyloid A and P) as well as the LPS (4 #g/ml)-induced monocyte expression of TNFct and interleukin-1/3 (IL-1/~) in 57 patients suffering from severe familial heterozygous hypercholesterolemia (FH) and 42 patients suffering from familial combined hyperlipidemia (FCH). Values were obtained before and 4 weeks after dietary councelling, after 1 month simvastatin (S) therapy, as well as after 3 and 6 months (either 20 or 40 mg S as necessary to achieve the consensus goals). Results: S-tberapy but not dietary intervention reduced monocyte TNFa and IL-1/3 significantly, the decrease being more pronounced in FCH as compared to FH. CRP, BSR and IL-6 were significantly decreased (FCH > FH), fibrinogen only borderline (-11%). No change in SAA and SAP was detected. No difference between patients on 20 or 40 mg S was seen. Conclusions: This study demonstrates that S dose-independently shows an antiinflammatory effect via reduction of proinflammatory cytokines expressed by monocytes and acute phase response markers, being apparently more pronounced in FCH.
I MoP5:W4 ] The association between antibody titers to helicobacter I
pylori, chronic coronary heart disease and acute myocardial infarction
N. Sarraf-Zadegan, M. Amid, S. Magsoodloo. Isfahan Cardiovascular
Research Center, lsfahan, Iran Objectives: To study the possible relation between Helicobacter pylori (H. pylori) that may act either acutely (eg. Precipitating plaque rupture) or chronically (eg, promoting plaque growth) and acute myocardial infarction (AMI) or chronic coronary heart disease (CHD). Methods: Two groups of patients and a control group were investigated between May, 1997 to Feb, 1999 at Isfahan Cardiovascular Research Center. The AMI group consisted of 52 consecutive patients (mean age 54.8 -4- 8 years) admitted because of an AMI with a diagnosis based on WHO Criteria. The CHD group consisted of 51 consecutive patients (mean age 52.8 -4- 11 years) admitted for coronary angiography because of chronic symptoms of angina pectoris and had at least single vessel significant lesion > 70% lumen narrowing in the coronary angiography report. The controls were random sample of 55 men and women from the same area as the patients, matched for sex, age and time. The controls underwent diagnostic coronary angiography and none had any lesion to be reported in each of coronary vessels. Serum samples were drawn for measurement of H. Pylori antibodies using Eliza method and fibrinogen using fibrinometric method. Results: AMI patients had significantly higher H. Pylori Ab levels compared to control group with an odds ratio of 4 (95% CI, 1.7 to 7.4; P -- 0.004), The CHD group showed similar findings with adjusted odds Ratio of 3.3 (95% CI, 1.1 to 6; P -- 0.01) while The comparison between AMI and CHD groups showed no significant difference with adjusted OR of 1.1 (95% CI 0.3 to 4 p = 0.08). The prevalence rates for H. Pylori Ab among cases and controls is shown in the following table: Caseand ControlGroups
No.
No, Positive Samplesfor H. Pylori
CrudDate %
(95%CI)
AMIGroup CHDor Coronary Anglo(+)Group Controlor Coronary Anglo(-) Group X2 P=
52 51
15 8
27.5 9.8
(25.5-29.5) (7.8-11.8)
26.8 10.3
(24.8-28.7) (8.3-12.3)
55
3
5.5
(3.5-7.4)
5.1
(3.1-7.1)
2.43 0.08
Adjustedfor SocioeconomicClass % (95%CI)
2.48 0.06
Conclusion: These results do not support the hypothesis that H. Pylori may induce the acute coronary events.
I MoP6:W4 I Randomized double-blind, placebo-controlled study of azithromycin in C. Pneumoniae Positive Postmyocardial Infarction Patients (CROAATS)
I MoP4:W4 ] Simvastatin reduces acute phase response markers H. Sinzinger 1, F. Cbehne I , A. Oguoghol , P. Schmid2. l Wilhelm Auerswald
Atherosclerosis Research Group (ASF) Vienna; 2Rehabilitation Center, Bad Schallerbach, Austria Objective: Inflammation recently gains increasing interest in the process of atherogenesis. The influence of statins on this mechanism is widely unknown.
7.. Reiner 1, M. Bergovec 2 , M. Gjura~in 1, V. Goldner I , J. Halle 3, S. Kranj~evi64 , S. Mihatov5 , T. Zrui6 6, J. Culig6, E. Tedeschi-Reiner5 . For
the CROAATS Study Group; /Univ. Hosp. Rebro," 2Univ. Hosp. Dubrava; 3Gen. Hosp. Sv. Duh; 4Univ. Hosp. Merkur; 5Univ. Hosp. S. Milosrdnice; 6pliva Pharmac. Company, Zagreb, Croatia There is a mounting evidence for an association between Chlamydia pneumo-
Xllth International Symposium on Atherosclerosis, Stockholm, Sweden, June 25-29, 2000