FEATURES OF THE COURSE OF STABLE CORONARY ARTERY DISEASE WITH BORDERLINE CORONARY ARTERY STENOSES DEPENDING ON THE EPICARDIAL FAT THICKNESS

Abstract

HighlightsPatients with stable coronary artery disease, borderline coronary artery stenoses (BCAS) and increased thickness of epicardial adipose tissue (EAT) are characterized by development of cardiovascular diseases (CVD) at a younger age and higher levels of proinflammatory markers compared to patients without increased thickness of EAT (in case of comparable obesity class, diabetes type, angina grade and apolipoprotein B levels). Aim. To study the features of the course of stable coronary artery disease with borderline coronary artery stenoses (BCAS) depending on the epicardial fat thickness.Methods. 201 patients with stable angina of 1–3 grade with BCAS (50–70%) were included in the study. The 1st group consisted of 57 (28,4%) patients with high EAT levels, the 2nd group consisted of 144 (71,6%) patients without normal EAT levels. The results of biochemical blood tests and systemic inflammation markers (high-sensitivity C-reactive protein, IL 1, 6, 8, 10, TNF-a, cystatin С, MMP-9, NTproBNP) concentration were evaluated. The epicardial fat thickness was determined by echocardiography. All patients underwent coronary angiography.Results. The general EAT thickness was at 6.00 [5.00; 6.50] mm in the 1st group and at 3.00 [2.30; 4.00] mm in the 2nd group (p<0.001). Hypertension (p<0.001), CAD (p<0.001), and myocardial infarction in particular (p = 0.003) were detected at a younger age in the 1st group. There were no significant differences in terms of prevalence of obesity, diabetes mellitus, angina grade and type of prescribed medication. Patients in the 1st group showed higher levels of NTproBNP (p = 0.002) and hsCRP (p = 0.027). Moreover, patients in the 1st group had a higher Apo-A1 levels (p = 0.023) and a lower Apo B/Apo-A1 ratio (p = 0.019). Proinflammatory cytokine levels were comparable, however anti-inflammatory cytokine IL-10 levels (р =0.005) and the frequency of elevated IL-10 levels (p<0.001) were lower in the 1st group. Higher cystatin C levels and the frequency of elevated cystatin C levels (p<0.001) were observed more often in patients with high EAT levels.Conclusion. Patients with stable CAD, borderline coronary artery stenoses and high EAT levels can be characterized by cardiovascular diseases detected at a younger age and higher levels of proinflammatory markers compared with patients with normal EAT levels in case of comparable obesity class, diabetes mellitus, angina grade, and Apo B levels.