Rs17576 polymorphism of matrix metalloproteinase-9 in predicting coronary artery disease severity and its adverse outcome

Kawasaki disease (KD) is an acute systemic inflammatory illness that occurs predominately in children <5 years of age. The reported incidence varies widely depending on the ethnicity of the population and the method of case ascertainment. Recent reports would suggest the annual incidence is ≈20 to 25 per 100 000 children <5 years of age in North America, with the highest reported incidence of 188 being in Japan, where the disease was first described in 1967.1 The illness is self-limited and of unknown cause, but is complicated by a systemic vasculitis with a predilection for small- to medium-sized arteries, particularly the coronary arteries. The majority of patients will have either transient coronary artery dilation or no coronary artery luminal changes as noted on echocardiography. Long-term prognosis for these patients is considered to be excellent. Coronary artery aneurysms occur in 25% of patients, but the prevalence is reduced to ≈4% for patients treated with intravenous immunoglobulin infusion within 10 days of illness onset. Aneurysms are associated with an intense inflammatory cell infiltrate, destruction of the internal elastic lamina, and smooth muscle cell death. Coronary artery involvement is usually maximal within 6 to 8 weeks after the acute episode. Regression of aneurysms can occur primarily through myointimal proliferation, although the arterial structure and function remains abnormal,2 and there is an important ongoing risk of stenoses and occlusions.3 Long-term cardiology assessment and management is required, and some of these patients may require revascularization procedures or, rarely, cardiac transplantation. KD has become the most prevalent acquired cardiac disease in children in developed countries. Article see p 60 Although coronary artery complications are the predominant cause of morbidity and mortality, other cardiovascular abnormalities can occur. Valvulitis is a less prevalent complication, and there have been case reports of important long-term aortic and …

Objective To explore the association of serum UA level with the severity of coronary artery disease (CAD) assessed by different methods. Methods Five-hundred and fifteen patients with suspected CAD received coronary angiography and were divided into normal group and CAD group; the severity of CAD was assessed based on the SYNTAX score and the number of stenosis. Serum UA levels were compared between the normal and CAD group with different severity. Results The average UA level in high-risk group for SYNTAX score was significantly higher than that of in the normal, low-risk, or moderate-risk group; UA level did not differ significantly among the normal group and univessel disease, twovessel disease, and multi-vessel disease groups. Conclusions CAD patients with hyperuricemia have higher SYNTAX wores than those with normal serum UA level. Uric ac id is independently assoc iated with the severity of CAD. But this association can not he found as the severity of CAD was determined by the number of stenotic vessels. Key words: Uric acid; Coronary artery disease; Risk factor; SYNTAX score

Serum high sensitive C-reactive protein (hs-CRP), adiponectin levels and urine albumin excretion rate (UAER) are probably associated with inflammation and atherosclerosis. The aim of this study was to determine the three markers in coronary artery disease (CAD) subjects with different glucose tolerance status in a Chinese population and further explore the levels of the three markers in these subjects and the possible association of these markers with CAD risk factors and the severity of CAD as well. A total of 242 subjects with angiographically documented CAD were recruited, and then assigned to three groups: the normal glucose tolerance (NGT) + CAD group, including 100 CAD patients with NGT; the impaired glucose tolerance (IGT) + CAD group, 40 CAD patients with IGT; the type 2 diabetes mellitus (T2DM) + CAD group, 102 CAD patients with T2DM. Serum hs-CRP, adiponectin levels as well as UAER were measured in all subjects. Serum hs-CRP levels were increased in the T2DM + CAD group compared with the NGT + CAD group (4.71 +/- 2.59) vs (3.60 +/- 2.46) mg/L, P = 0.037. Serum adiponectin levels were gradually decreased from the NGT + CAD to IGT + CAD to T2DM + CAD groups, (5.99 +/- 1.84), (5.82 +/- 1.72) and (4.65 +/- 1.71) mg/L, P = 0.002 and 0.040 for NGT + CAD and IGT + CAD groups vs T2DM + CAD group, respectively. While the UAER was gradually increased from the NGT + CAD to IGT + CAD to T2DM + CAD groups, (6.42 +/- 2.51), (6.89 +/- 2.94) and (15.03 +/- 4.22) microg/min (P < 0.001) for NGT + CAD and IGT + CAD groups vs T2DM + CAD group. Multiple linear stepwise regression analysis showed that waist-hip ratio (WHR) and low density lipoprotein cholesterol (LDL-C) were the significant determinants of serum hs-CRP levels; triglyceride (TG), high density lipoprotein cholesterol (HDL-C), age, WHR, T2DM, 2-hour serum insulin (2hINS), sex, and apolipoprotein B were the significant determinants of serum adiponectin levels; and systolic blood pressure (SBP), T2DM, and hemoglobin A1c (HbA1c) were the significant determinants of UAER in all subjects (R(2) = 0.070, 0.352, and 0.214, respectively). However, no significant correlation was seen for hs-CRP, adiponectin and UAER with the severity of CAD. Hs-CRP levels were significantly correlated with UAER. There was a trend of increased serum hs-CRP levels from the NGT + CAD to IGT + CAD to T2DM + CAD groups, though it only showed significance in the T2DM + CAD group compared with the NGT + CAD group. Serum adiponectin levels were decreased and UAER was increased from the NGT + CAD to IGT + CAD to T2DM + CAD groups. Increased UAER and serum hs-CRP, and decreased adiponectin levels were associated with traditional CAD risk factors but failed to be correlated with the severity of CAD. Hs-CRP levels were significantly correlated with UAER.

Diabetes is a major global health issue, affecting over 8.5% of adults worldwide and significantly increasing the risk of cardiovascular diseases (CVDs). However, the association between diabetes-related macrovascular complications, such as coronary artery disease (CAD), and pulmonary function remains unclear. The present study was designed to investigate the association between obstructive and restrictive lung patterns and the severity of coronary artery involvement. A cross-sectional study was conducted at Shahid Beheshti Hospital, Qom, Iran, between April 2019 and August 2021. A total of 211 diabetic patients who underwent coronary angiography (CAG) were selected. They were divided into two groups: Sixty-nine patients in group 1 (non-significant CAD) and 142 patients in group 2 (significant CAD). Spirometry was performed to assess forced expiratory volume (FEV), forced vital capacity (FVC), and FEV/FVC ratio, with values adjusted for age and sex in the two groups. Among the 211 participants, 142 (67.3%) exhibited significant coronary artery involvement. Comparative analysis revealed no statistically significant differences in spirometric parameters [forced expiratory volume in one second (FEV1), FVC, FEV1/FVC ratio] between the groups. Notably, advancing age demonstrated a significant negative correlation with both FEF50% (β = -0.32, P < 0.01) and FVC values (β = -0.28, P < 0.05). Multivariate regression analysis identified inverse relationships between age and peak expiratory flow (PEF; β = -0.41, P < 0.001), HbA1C levels and PEF (β = -0.23, P < 0.05). Additionally, sex emerged as a significant modifier of %FEV1/FVC (β = 0.19, P < 0.05), with female participants showing lower ratios. This study failed to find an association between spirometry findings and coronary artery involvement. However, a significant relationship between small airway involvement and glycemic control was observed.

BACKGROUNDPrevious studies reported that the distribution of body fat is an important risk factor for coronary artery diseases (CAD) and abdominal adipose tissue is associated with severe CAD. This study was conducted to evaluate the relationship between body fat distributions, plasma lipids and the severity of CAD in patients with stable angina.METHODSNinety seven patients who underwent coronary angiography for stable angina were allocated into two groups: patients with mild or sever coronary artery involvement. Lipid profile (total cholesterol, LDL, HDL) and triglyceride (TG) and apolipoprotein A and B, were measured for all of the participants and a demographic data questionnaire was filled by the subjects. Participants underwent abdominal computed tomography (CT-Scan) for measurement of adipose tissues that was classified to visceral and superficial and deep subcutaneous fat tissue compartment.RESULTSPatients with severe coronary artery involvement had higher level of apo B (P=0.02). Significant correlation was seen between visceral fat index and TG (P=0.01), HDL-C (P<0.01) in patients with mild coronary involvement and with total cholesterol (P=0.02), LDL-C (P=0.01) and apoB (P<0.01) in patients with severe coronary involvement.No significant relationship was seen among deep cutaneous fat index and lipid profile in both groups.CONCLUSIONOur findings showed that visceral adipose tissue is significantly associated with severe CAD and has a significant correlation with lipid profile as well as Apo B.

The relationships of serum circNIPSNAP3A and circHIPK3 with metabolic disorders, atherosclerosis and severity of coronary artery disease (CAD) remain to be clarified. Three hundred and thirty-eight subjects were categorized into normal coronary artery, atherosclerosis and CAD groups. Clinical data including anthropometric indexes, medical history, and physiological and biochemical parameters were collected. Serum circNIPSNAP3A and circHIPK3 were determined by quantitative real-time PCR. CAD severity was evaluated by clinical manifestation, electrocardiogram and coronary angiography. Both CAD and atherosclerosis groups had a higher serum level of circNIPSNAP3A than the normal coronary artery group (P < 0.05 for all). The subjects with a high percentage (> 66th percentile) of circNIPSNAP3A had higher mean levels of triglycerides, uric acid and homocysteine, and lower mean levels of high-density lipoprotein cholesterol and apolipoprotein AI than those with a low percentage (< 33rd percentile) of circNIPSNAP3A. Notably, circNIPSNAP3A is significantly and independently associated with CAD, and subjects with a high percentage of circNIPSNAP3A had more diseased coronary branches and a higher incidence of acute coronary syndrome than those with a low percentage of circNIPSNAP3A. Regarding circHIPK3, subjects with a medium or high percentage of circHIPK3 had a lower mean level of apolipoprotein AI than those with a low percentage of circHIPK3, but no significant differences in the incidence and severity of CAD among the < 33rd, 33rd-66th, and > 66th percentiles of circHIPK3 were detected. Serum circNIPSNAP3A is related to cardiovascular risk factors and CAD severity, and may be a potential prognostic marker and/or therapeutic target for CAD.

Background: Hypertension is a well-known risk factor towards the development of Coronary Artery Disease (CAD). However, the extent to which the presence of hypertension affects the severity of CAD is not yet fully studied. This study hopes to lightly touch on the link between hypertension and the severity of CAD. Objective: The objective of this study is to analyze the association between the presence of hypertension as a risk factor with the severity of CAD, roughly represented by the number of coronary vessels involved identified through coronary angiography. Method: We studied several prevalent risk factorsin 228 patients admitted for elective coronary angiography. We identified hypertension amongst other risk factors such as, diabetes, smoking habit, family history, and dyslipidemia using the angiography report. The number of coronary vessel involvement were classified as, Minor CAD without any significant vessel stenosis, CAD 1-Vessel Disease (VD), CAD 2-VD, and CAD 3-VD; excluding any involvement of the Left Main Coronary Artery. Results: Of the 228 patients, 129 (55.6%) patients were present with hypertension. Patients who were present with hypertension, as compared with those without, independently increased the odds of an increased number of coronary vessel involvement in a proportional-odds logistic regression model (Odds Ratio, 1.65; 95% CI 1.02–2.67; p-value <0.05) across four categories. Conclusion: Hypertension is a significant risk factor in every level of CAD represented by the increased number of coronary vessels involved. This result may indicate that hypertension not only plays a part in the development of, but also influences the severity of CAD.

PurposeTo investigate the relationship between the ratio (GHR) of fasting blood glucose (FBG) to high-density lipoprotein cholesterol (HDL-C) and the degree of coronary artery stenosis.Patients and MethodsThis retrospective cross-sectional study enrolled 1313 eligible participants who underwent coronary arteriography (CAG) or coronary computed tomography angiography (CCTA) between January 1, 2022, and May 31, 2023, from the electronic medical record system of Liaoning Province Benxi Central Hospital. Participants were divided into two groups: a Coronary Artery Disease (CAD) group (n = 1071) and a non-CAD group (n = 242). Patients in the CAD group were further categorized into three groups based on their GS: a low GS group (GS ≤ 32, n = 404), a medium GS group (32 < GS ≤ 66, n = 313), and a high GS group (GS > 66, n = 354). Logistic regression analysis was used to determine the association between GHR and CAD, as well as severe CAD. Receiver operating characteristic (ROC) curves were constructed to analyze the predictive value of GHR for CAD and severe CAD.ResultsThe median GHR in the CAD group was significantly higher than that in the non-CAD group (5.980 vs 4.871, P = 0.000). GHR was positively correlated with GS and the number of coronary artery lesions. Logistic regression analysis indicated that GHR was an independent predictor of CAD and severe CAD. ROC analysis showed that GHR had predictive value for CAD and severe CAD. The areas under the curve (AUC) were 0.672 and 0.591, respectively, both of which were statistically significant (P = 0.000). Combining GHD with other risk factors to construct a new diagnostic model significantly improved the AUC.ConclusionGHR is associated with the degree of coronary artery stenosis and can predict CAD and its severity.

The relationship of plasma lipid and apolipoprotein (apo) concentrations and plasma insulin response to oral glucose load to angiographically determined coronary artery disease (CAD) was investigated in 65 normolipidemic (plasma cholesterol less than 230 mg/dl and plasma triglyceride less than 150 mg/dl) males. According to the results of coronary angiography, the patients were divided into 2 groups: patients with normal coronary artery, NCA group (n = 21); and patients with coronary artery disease, CAD group (n = 44). No significant differences in concentrations of plasma cholesterol and triglyceride were observed between the CAD and NCA groups. In the CAD group cumulative lifetime tobacco consumption was higher and high density lipoprotein (HDL) cholesterol concentration was lower than those in the NCA group. The variables that correlated with the severity of CAD, defined by the number of lesions and percent stenosis, were levels of plasma apo A-I and apo B. Prevalence of subjects with reduced oral glucose tolerance did not differ between 2 groups. However, hyperinsulinemic response to oral glucose load was present in the CAD group. HDL-cholesterol concentration, the sum of plasma insulin levels and the magnitude of the early insulin response during oral glucose challenge were accurate predictors of the presence of but not the severity of CAD. Multivariate analysis of the data confirmed the independent effect of plasma levels of apo A-I and apo B on the severity of CAD. The present data indicated that plasma levels of apo A-I and apo B were powerful discriminators in the normolipidemic CAD patients and that a high insulin response might be an indicator of enhanced susceptibility to the distinct coronary atherosclerosis.

New investigations suggest a pivotal role of brain-derived neurotrophic factor (BDNF) in cardiovascular homeostasis. However, no data could indicate the association between BDNF methylation status and the risk of coronary artery disease (CAD). The aim of the present study was to assess the association of BDNF methylation status and its serum level with the severity of CAD. According to the angiography report, a total of 84 non-diabetic CAD patients with at least 50% stenosis in one of the major coronary arteries were selected as the CAD group. For comparison, 62 angiographically proven non-CAD participants were selected as control. Additionally, subjects were categorized according to the Gensini Scoring system. Blood sample was used for genomic DNA isolation. Methylation status of the BDNF gene in exonic region was determined using the MS-PCR method and serum BDNF levels were measured with ELISA. BDNF gene methylation was significantly higher in the CAD group than in the non-CAD group. After adjustment for confounding factors, BDNF gene hypermethylation increases the risk of CAD in the total population (OR = 2.769; 95% CI, 1.033-7.423; P = 0.043). BDNF gene hypermethylation was higher in patients with severe CAD than patients with mild CAD. Additionally, the serum BDNF level was not different from non-diabetic CAD and control groups. Our findings indicate that BDNF hypermethylation was associated with an increased risk of CAD, which may help identify subjects being at the risk of developing CAD. In addition, BDNF hypermethylation shows a significant correlation with the severity of CAD.

Type A aortic dissection (TAAD) involves a tear in the intimal layer of the thoracic aorta proximal to the left subclavian artery, and hence, carries a high risk of mortality and morbidity and requires urgent intervention. This dissection can extend into the main coronary arteries. Coronary artery involvement in TAAD can either be due to retrograde extension of the dissection flap into the coronaries or compression and/or blockage of these vessels by the dissection flap, possibly causing myocardial ischemia. Due to the emergent nature of TAAD, coronary involvement is often missed during diagnosis, thereby delaying the required intervention. The main scope of this review is to summarize the literature on the incidence, mechanism, diagnosis, and treatment of coronary artery involvement in TAAD. A comprehensive literature search was performed using multiple electronic databases, including PubMed, Ovid, Scopus and Embase, to identify and extract relevant studies. Incidence of coronary artery involvement in TAAD was seldom reported in the literature, however, some studies have described patients diagnosed either preoperatively, intraoperatively following aortic clamping, or even during autopsy. Among the few studies that reported on this matter, the treatment choice for coronary involvement in TAAD was varied, with the majority revascularizing the coronary arteries using coronary artery bypass grafting or direct local repair of the vessels. It is well-established that coronary artery involvement in TAAD adds to the already high mortality and morbidity associated with this disease. Lastly, the right main coronary artery was often more implicated than the left. This review reiterates the significance of an accurate diagnosis and timely and effective interventions to improve prognosis. Finally, further large cohort studies and longer trials are needed to reach a definitive consensus on the best approach for coronary involvement in TAAD.

SAT0289 Serum Soluble HLA E: A Biomarker of Disease Activity and Coronary Arteritis in Takayasu Arteritis

Objectives: Patients with Peripheral artery disease (PAD) have similar cardiovascular morbidity and mortality as those with established coronary artery disease (CAD). Thus the recommended LDL goal is &lt; 100 mg/dl for both CAD and PAD patients. This study assesses the degree of lipid control and statin drug use in CAD and PAD patients in current clinical practice. Methods: We did a retrospective chart review of patients with a diagnosis of PAD, CAD and both PAD and CAD seen at our institution between Jan 2009 to March 2012. Demographic data, lipid levels and statin use were compared between CAD, PAD and PAD &amp; CAD groups. To enable comparison of the doses of various statins, we used statin potency unit where 1 potency unit = 10mg of Simvastatin. Results: There were a total of 11498 subjects in the chart review (CAD-9879, PAD-623, both PAD &amp; CAD -996). PAD patients were younger with more females &amp; lower BMI compared to CAD and both PAD &amp; CAD groups (Table 1). Mean LDL level in the PAD group was 93.4±35.5 mg/dL, CAD group was 82.7±33.1 mg/dL and both PAD &amp; CAD group was 80.5±31.0 mg/dL. Although all groups had a mean LDL of &lt; 100mg/dL, significantly fewer number of PAD patients achieved target LDL &lt;100 mg/dl and LDL &lt;70 mg/dl, as compared to CAD and combined group (Table 1). The PAD group had significantly higher mean total cholesterol and mean LDL levels as compared to the CAD group and combined PAD &amp; CAD group (Table 1). The mean HDL and mean triglyceride (TG) levels in PAD group were significantly higher than the CAD and combined PAD &amp; CAD group. The PAD patients had significantly greater use of less potent statins than the CAD and PAD &amp; CAD groups which was not compensated for by a higher mean dose of the lower potency statins (Table 1). PAD patients were receiving significantly lower mean potency unit of statins as compared to PAD and combined CAD and PAD group (Table 1). Conclusion: Even though both PAD and CAD groups had mean LDL &lt; 100mg/dL, we found that lipid control assessed by absolute mean lipid levels were significantly better in patients with CAD and combined PAD &amp; CAD group. Thus, our study indicates that physicians tend to be more aggressive with lipid control in patients with a diagnosis of CAD when compared to patients with PAD alone.

Background and objectiveStudies showed that atherosclerosis is a systemic disease. Parameters representing peripheral artery atherosclerosis, such as decreased ankle-brachial index (ABI), and increased carotid artery intima-media thickness (CIMT), are well...

Background:Coronary artery involvement (CAI) is a special but not rare type in Takayasu arteritis (TAK) [1, 2]. Granzyme B (GzmB) is a multifunctional protease in the immune system and coronary...