The relationship between severity of peripheral arterial disease and markers of inflammation

JACC

March 19,2003

Conclusions reductions

When

ABSTRACTS

coadministered

with SIMV,

EZE provided

significant

incremental

- Vascular Disease, Hypertension,

according

in LDL-C and CRP.

and Prevention

to three criteria were 12.2 (Male 8.0, Female

6.6 % (M 5.0, FlO.6)

respectively.

3 17A

15.6), 15.9 (M 11.6, Fl9.2),

In the logistic regression

analysis,

age, female

and

gender,

history of hypertension, diabetes, and stroke, obesity and high level of LDL were independent risk factors contributing to PAOD in criteria A group; age, female gender, history of hypertension,

and diabetes

wers

independent

risk factors

in cnteria

B group;

female gender, history of hypertension, stroke, diabetes, hypercholesterolemia, smoking were independent risk factors in cnteria C group. The plasma fibrinogen in PAOD

pts were

significantly

higher

(p=O.OOl). Platelet aggregation (46.76i23.90 vs 43.50*26.76, Chinese

population

compared

and levels

in all three

groups

rate at 3 minutes was higher in PAOD pts than controls %, P=O.OlZ). Conclusions: The prevalence of PAOD in

is similar to that in western

and increased with advanced levels and platelet aggregation tion for PAOD treatment

to their controls

countries.

It was higher in female

gender

age. PAOD pts had significantly higher plasma fibrinogen rate than controls. The study provides important informa-

and preventox?. 1 l:oo

Lyn Kieltyka.

a86

Peripheral Risk

CONTRIBUTIONS

Srinivasan,

Arterial Disease: Detection

and

University

School of Medicine,

is not well understood.

Bogalusa a.m.

of markers

of inflammation

atherosclerosis, including myocardial infarction rotic burden, as measured by the ankle-brachial the relationship

(PAD) and markers of inflammation. Methods: Blood levels of plasminogen (CRP),

vascular

cell

adhesion

and thrombosis

activator

molecule

predict symptomatic

analyses

Correlattons

Winston-Salem,

New Orleans,

R.

LA, Wake Forest

NC

severity of peripheral inhibitor

(VCAM).

1 (PAI-l),

intracellular

were determined

were used to determine

arterial disease

C-reactive

adhesion

for each factor in relation

the relationship

between

marker

Methods:

This aspect was examined

by applying

the risk equa-

Study.

Age,

gender,

systolic

blood

pressure,

total cholesterol

to HDL

was used to assess the independent

contribution

of risk score, raw,

family history of coronary heart disease, triglycerides, Mean lo-year risk score was lowest for black females

and BMI to carotid IMT. Results: (0.4%) and highest for white males

(2%).

than

As expected,

artery

protein

molecule

1

(ICAM-I). interleukin 6 (IL@, and tumor necrosis factor alpha (TNF) were measured III 110 subjects referred to the vascular laboratory for segmental Doppler pressure measurements.

Rang Tang, M. G. Bond, Sathanur

University,

males

had

higher

risk scores

females

irrespective

of race

(p
and intermittent claudication. Atheroscleindex (Af3l), similarly predicts cardiovas-

between

Heart

Linear regression

Ori -I Preis Joshua A. Beckman, Nader Rifai. Paul M. Ridker, Marie Gerhard-Herman, Brigham & Women’s Hospital, Boston. MA, Children’s Hospital, Boston, MA

cular risk. We Investigated

Tulane

cholesterol ratio, and cigarette smoking habits were used to calculate individual lo-year risk scores. Mean IMT was compared by race- and gender-specific tertiles of risk score.

The Relationship Between Severity of Peripheral Arterial Disease and Markers of Inflammation

Elevations

Elaine M. Urbina,

tons developed by the Framingham Heart Study group to a population-based sample of 517 healthy, young subjects aged 20-37 years (71% white, 39% male) enrolled in the IO:30

Background:

Carsie Nyirenda,

Gerald S. Berenson,

Background: The extent to which multiple cardiovascular risk factors impact intimamedia thickness (IMT) in different segments of the carotid artery in healthy, young adults

Wednesday, April 02,2003, lo:30 a.m.-Noon McCormick Place, Room 5706

886-1

a.m.

The Association Between Carotid Artery Intima-Media Thickness and Framingham Risk Score in Healthy Young Adults: The Bogalusa Heart Study

886-3

ORAL

age,

to ABI. Multivariate levels and severity of

sites.

Risk

tertile

as

bottom,

middle,

top

(p

for

trend):

0.64,0.67,0.69(pc0.0001); 0.66,0.66,0.70(p~0.001).

carotid bulb 0.81,0.66,0.91(p Results of multivanate analyses

was positively

with IMT of all three carotid segments

associated

the Framingham risk score contributed 9% of the variance and 3% for the comnwn and internal carotid, respectively, more susceptible

to multiple

elusion: These findings arterial wall and support tors beginning

risk factors and related

underscore the adverse the necessity of focusing

common

carotid

c 0.0001); internal carotid indicated that the risk score (p
in carotid bulb IMT versus 5% suggests that thts site may be

early atherosclerotic

changes&u+

effects of multiple risk factors on the on multiple rather than single risk fac-

early in life.

PAD. Results:

Inflammatory

markers,

including

CRP, IL6, TNF, and VCAM. correlated

with bur-

den of PAD(table), while a marker of thrombosis (PAI-1) did not. In multivariate analysis, low ABI was significantly associated with Increasing levels of CRP (adjusted RZ = 674, p

II:15

Potential Limitation of Resting Ankle-Brachial Index Measurement: Post-Exercise Ankle-Brachial Index and All-Cause Mortality

886-4

c.001). Conclusion: In subjects with PAD, levels of inflammatory with severity of lower extremity atherosclerosis. These nlstic

relationship

patients

between

atherosclerotic

with lower extremity

burden

markers significantly associated data suggest a possible mecha-

and

magnitude

of inflammation

in

Mobeen

A. Sheikh, Ahmed

Linda Graham,

arterial disease.

Background CarrelatIon

p value

A. Latif, Mutaphasahim

The Cleveland Peripheral

Clinic Foundation,

arterial disease

(PAD)

Shaaroui, Cleveland, IS a strong

John R. Bartholomew, OH independent

Marker

Pearson

TNF

-26

c.001

CRP

-.32

,001

IL-6

-.29

,002

sized that these patients may represent a high-mortality risk group. Methods Patients undergoing ABI measurement with exercise during

VCAM

-.22

,025

included

ABI may be normal

a.m.

Background:

In order to determine

ease (PAOD)

in Chinese

population,

Hospital

of PLA. Beijing,

People’s

Republic

we conducted

of peripheral

arterial

an epidemiology

occlusive

dis-

study on elderly

res-

idents lived in the District of Wanshoulu, Beijing. Thew plasma fibrinogen levels, platelet aggregation rates, and other risk factors were analyzed. Methods: A total of 2,124 elderly subjects

(aged 60-95) were randomly

selected

from the area. Three diagnostic

crite-

ria for PAOD were used in this study: A) Presence of intermittent claudication (IQ; b) Ankle-arm index (AAI) a.9: and C) AAla. with clinical symptoms. Risk factors, and dietary analysis

habits

which

might

contribute

using three diagnostic

this multivariate

regression

rates were compared their age, gender

analysis.

between

normalized

to PAOD,

were analyzed

criteria respectwely. Plasma

PAOD patients controls.

Stepwise

fibrinogen (diagnosed

Results:

with logistic

selection

by three different

The prevalence

regression

was also used in

levels and platelet of PAOD

of car-

aggregation criteria) and diagnosed

The difference

in mortality

abnormal

between

after exercise.

patients

We hypothe-

1990.1997

were

who had an ABI of 2

0.65 bilaterally both at rest and after exercise and those who had normal ABI bilaterally al rest but < 0.65 in either lower extremity after symptom/protocol limited treadmill exercise Mortality

data were obtained

from the Social Security

Death Index.

Results A total of 2502 patients were assessed (mean age 66.2 yrs SDe10.7, males),

2055 patients

who had ABI>

controls

and 447 patients

0.85 both at rest and with exercise

had abnormal

ABlsa

after exercise.

60.5% constituted the

Survival analysis dem-

onstrated a significant difference between the 2 groups [log rank chi square = 4.14, pcO.051. Additional adjustments for the presence of risk factors (smoking, hypertension, hyperlipidemia,

the prevalence

at rest but may only become

for analysis.

were assessed.

The Prevalence and Risk Factors of Peripheral Arterial Occlusive Disease in the Elderly Chinese PopulationWanshoulu Study

Jie Wang, Xiaovina Lf, Yao He, The General of China

marker

diovascular morbidity and mortality. The prevalence of PAD in most epidemiological studies is based on abnormal resting ABI measurements. In some cases however the

10:45 888-2

a.m.

diabetes,

prior stroke and prior coronary

artery disease)

did not change