Calcium Index Research Articles

Association of Calcium Index and Myocardial Blood Flow in Non-Obstructive Atherosclerotic Lesion of the Coronary Arteries

Background. Over the past few years, scientific data have demonstrated that patients with non-obstructive coronary artery disease can have high risk for adverse cardiovascular events (ACE) despite the absence of severe coronary obstruction. From this point of view, some patients require special monitoring and treatment; we have to find new methods for stratification of the risk of ACE. Aims to study the association of coronary artery calcification (CCA) with indicators of myocardial blood flow (MBF) and myocardial flow reserve (MFR) in patients with non-obstructive coronary artery disease (CAD). Methods. The study included patients (n = 52) with non-obstructive CAD ( 50%), identified by CCTA. All patients received dynamic myocardial SPECT according to the two-day rest-stress protocol with the radiopharmaceutical agent 99mTc-methoxy-isobutyl-isotnitrile and the pharmacological stress-test (adenosine triphosphate 160 mcg/kg/min) to determine quantitative indicators of MBF and MFR. Depending on the calcium index (CI), three groups of patients were formed: 1 without CCA (CI = 0 Agatston units), 19 patients; 2 Mild CCA (CI = 1100 Agatston units), 21 patients; 3 Moderate CCA (CI = 101400 Agatston units), 12 patients. Results. The study included 52 patients (age 55.0 9.8 years, 36 men). The groups differed statistically significantly (p 0.05) in terms of quantitative scintigraphic parameters: stress-MBF, MFR and MBF. When analyzing the groups in pairs, it was found that stress-MBF and MBF were significantly lower in the group with moderate CCA compared to the group without CCA, and MFR was lower in the group with moderate CCA compared to the groups without CCA and with mild CCA. Correlation analysis revealed significant relationships between CI and scintigraphic parameters: stress-MBF ( = 0.46; p = 0.003), MFR ( = 0.48; p = 0.001), MBF ( = 0.48; p = 0.0008), SSS ( = 0.34; p = 0.02) and SDS ( = 0.28; p = 0.046). Conclusions. Even with non-obstructive CAD, identified by CCTA, there is a decrease in MBF and MFR inversely proportional to the level of CI, which can be considered as an early marker of impaired vasodilation reserve of the vascular wall, which develops in atherosclerosis of the coronary artery.

The relationship of fibroblast growth factor 23 with calcification of the thoracic aorta according to the results of multislice computed tomography in patients with resistant arterial hypertension

Objective: to evaluate the incidence and severity of thoracic aortic calcification, the relationship with endothelial dysfunction and fibroblast growth factor in patients with resistant arterial hypertension.Materials and methods: the study involved 92 patients with resistant hypertension. Daily monitoring of blood pressure (ABPM) was performed, the functional state of the endothelium was assessed in a sample with reactive hyperemia, the calcium index (CI) of the thoracic aorta was determined using MSCT, and the serum level of FGF-23 was determined using enzyme immunoassay.Results: based on ABPM, patients were divided into groups 1st-controlled (n=44) and 2nd-uncontrolled (n=48) resistant AH. In the 2nd group, a more pronounced dysfunction of the endothelium was revealed in the sample with reactive hyperemia and changes in the velocity parameters of blood flow. FGF23 levels and CI were higher in individuals with uncontrolled resistant hypertension. According to the results of correlation-regression analysis, CI was associated with the value of pulse pressure (r=0.49, p=0.007), the duration of hypertension (r=0.68, p=0.04) and the duration of regular antihypertensive therapy (r = −0 .33, p=0.02). FGF- 23 was found to be associated with PA hemodynamic parameters: with Ved (r=0.42, p=0.003), PI (r=0.43, p=0.041) and RI (r=0.46, p=0.025), as well as with CI (r=0.76, p=0.006).Conclusion: patients with uncontrolled resistant hypertension showed a more pronounced decrease in brachial artery EVR and an increase in vascular resistance indices in the test with reactive hyperemia, which was statistically significantly associated with the level of FGF23. In patients with resistant hypertension, excessive calcification of the thoracic aorta was found according to the results of MSCT. Calcium index values are higher in patients with high pulse BP, longer duration of hypertension and high levels of FGF23.

Associations of bone mass and polygenic risk of osteoporosis with indicators of arterial wall condition

Background: The identification of genetic factors that are simultaneously responsible for the predisposition to the development of cardiovascular diseases (CVD) and osteoporosis (OP) is important for the prevention of both conditions.Aim: The aim of this study is to evaluate three genetic risk scales (GRS) that previously showed an association with bone mineral density (BMD) and fracture risk, as well as to study the associations of these GRS with vascular wall pathology.Materials and methods: 250 female outpatients (aged 45 to 69) were enrolled into a cross-sectional study. The intima-media thickness (IMT), the presence and number of atherosclerotic plaques (AP) were studied using duplex scanning. Pulse wave velocity (PWV), augmentation index (AI) were measured by applanation tonometry. Coronary vessels calcium deposits were registered by multispiral computed tomography (MSCT) using the Agatston calcium index (CI). The BMD of the spine, hip neck (HN) and proximal hip (PH) was measured using double energy x-ray absorptiometry. Bone resorption marker type-1 collagen C-terminal telopeptide (CTx) was assessed solid-phase enzyme immunoassay. The genetic study included DNA extraction from whole blood samples. Targeted sequencing was performed on the Nextseq550 sequencer (Illumina, USA). Statistical analysis was carried out using the SAS software package for Windows, version 9.0 (SAS Institute Inc., USA).Results: The chance of detecting low bone mass increased more than 4 times at values of IMT ≥0.9 mm (OR=4.17; 95%CI [1.2–14.4], p<0.02), 2.4 times in the presence of AP in the carotid arteries (OR=2.45; 95%CI [1.12–4.88], p><0.05), by 6.7 times with an Agatstone CI ≥ 100 units (OR=6.68; 95%CI [1.56–28.7], p><0.001), 1.4 times (OR=1.43; 95%CI [0.56–3.68], p><0.438) with a PWV ≥10 m/s, 1.2 times (OR=1.2; 95%CI [0.601–2.43], p><0.60) with increased AI ≥ 27%. According to multivariate linear regression analysis (adjusted for age, duration of postmenopause, marker of bone resorption CTx), a significant association of all GRS with BMD in all parts of the skeleton was revealed. Both univariate and multivariate regression models adjusted for several covariants (age, total cholesterol, systolic blood pressure) showed a reliable association of GRS62 with the presence of plaques and GRS63 — with coronary artery CI. Conclusion: The results of the study demonstrated the association of polygenic genetic risk of GRS-based OP with BMD and vascular wall status indicators in women in the peri and postmenopausal periods.>< 0.02), 2.4 times in the presence of AP in the carotid arteries (OR=2.45; 95%CI [1.12–4.88], p< 0.05), by 6.7 times with an Agatstone CI ≥ 100 units (OR=6.68; 95%CI [1.56–28.7], p< 0.001), 1.4 times (OR=1.43; 95%CI [0.56–3.68], p< 0.438) with a PWV ≥10 m/s, 1.2 times (OR=1.2; 95%CI [0.601–2.43], p<0.60) with increased AI ≥ 27%. According to multivariate linear regression analysis (adjusted for age, duration of postmenopause, marker of bone resorption CTx), a significant association of all GRS with BMD in all parts of the skeleton was revealed. Both univariate and multivariate regression models adjusted for several covariants (age, total cholesterol, systolic blood pressure) showed a reliable association of GRS62 with the presence of plaques and GRS63 — with coronary artery CI.>< 0.60) with increased AI ≥ 27%. According to multivariate linear regression analysis (adjusted for age, duration of postmenopause, marker of bone resorption CTx), a significant association of all GRS with BMD in all parts of the skeleton was revealed. Both univariate and multivariate regression models adjusted for several covariants (age, total cholesterol, systolic blood pressure) showed a reliable association of GRS62 with the presence of plaques and GRS63 — with coronary artery CI.Conclusion: The results of the study demonstrated the association of polygenic genetic risk of GRS-based OP with BMD and vascular wall status indicators in women in the peri and postmenopausal periods.

Calcification of the aortic valve as a possible predictor of paraprosthetic regurgitation after transcatheter aortic valve implantation

Introduction. The development of paraprosthetic regurgitation after transcatheter aortic valve implantation (TAVI) in patients with critical aortic stenosis is an actual problem, which predictors are not well understood. One of the main reasons is calcification of the aortic valve, which does not allow the aortic valve prosthesis to fully expand.Objective – to identify a possible relationship between the severity of aortic valve calcification and the degree of paraprosthetic regurgitation after TAVI.Materials and methods. The study included 23 patients with critical symptomatic aortic stenosis and high risk factors for EuroScore II and STS. The single center study is a retrospective analysis of aortic valve calcification measured by preoperative multislice computed tomography. Calcification (calcium index) of the aortic valve was quantified according to the Agatson method. Paraprosthetic regurgitation was evaluated by transthoracic echocardiography according to the ACC/AHA recommendations. The observation period was 12 months. Results. There female patients predominated in the study group (n=15, 65 %). The mean value of the calcium index (CI) of the aortic valve was 5179.7±2334.1 Agatson units. Intraoperatively, half of the patients (n=12, 52 %) after implantation of aortic valve prosthesis had paraprosthetic regurgitation of more than II degree, which required postdilation. The calcium index in this group of patients was significantly higher (6088.3±2274.4, p=0.049). After implantation of an aortal valve prosthesis, paraprosthetic regurgitation of I–II degrees was observed in 16 patients (70 %) with a CI of 5902.1±2191.9, in 7 patients (30 %) with a CI of 3528.7±1537.2 paraprosthetic regurgitation was absent (p=0.021). In the postoperative period (12 months), no lethal outcomes were detected in the study group. Paraprosthetic regurgitation of I–II degrees was detected in 14 patients with a CI of 5676.6±2275, paraprosthetic regurgitation was absent in 9 patients with a CI of 4406.9±2338.3 (p=0.21).Conclusion. Patients with severe calcification of the aortic valve have an increased risk of developing significant paraprosthetic regurgitation and the use of more aggressive intervention techniques.

Relationship of visceral obesity and coronary calcinosis in ischemic heart disease

To assess the relationship between the prevalence of visceral obesity (VO) and the severity of coronary calcification (CC) in patients with verified coronary artery disease (CAD). 125 patients with CAD were examined. Assessment of the morphometric characteristics of visceral adipose tissue (VAT) and CC was perform using multislice computed tomography (MSCT). The calcium index (CI) of the coronary arteries (CA) was determine by the Agatston method. Statistical analysis was perform using Statistica 10.0. VO was detect in 82 (65.6%) patients with CAD. In the presence of VO, higher CC values were observed in the projection of the envelope (p=0.00014), right coronary (p=0.00002) arteries, total CI (p=0.0003), and the prevalence of massive CC. Correlation analysis showed the relationship between the area of VAT and the CC of all the studied localizations. According to the ROC analysis, VO is a significant predictor of massive CC (area under the ROC curve AUC 0.72, 95% CI 0.560.89), in contrast to body mass index BMI (AUC 0.56, 95% CI 0.310.82). The index of the ratio of VAT to subcutaneous adipose tissue (VAT/SAT), but not BMI, had a direct correlation with CC. Morphology of VAT may be a significant diagnostic sign of massive CC in patients with CAD, as a factor affecting treatment and prognosis.

Oral Calcium Supplements Associate With Serial Coronary Calcification: Insights From Intravascular Ultrasound

ObjectivesThis study sought to evaluate and assess the extent of serial coronary artery calcification in response to oral calcium supplementation. BackgroundOral calcium supplements are frequently used despite their cardiovascular safety remaining controversial. Their effects on serial coronary calcification are not well established. MethodsIn a post hoc patient-level analysis of 9 prospective randomized trials using serial coronary intravascular ultrasound, changes in serial percentage of atheroma volume (PAV) and calcium indices (CaI) were compared in matched segments of patients coronary artery disease who were receiving concomitant calcium supplements (n = 447) and in those who did not receive supplements (n = 4,700) during an 18- to 24-month trial period. ResultsPatients (mean age 58 ± 9 years; 73% were men; 43% received concomitant high-intensity statins) demonstrated overall annualized changes in PAV and CaI with a mean of −0.02 ± 1.9% (p = 0.44) and a median of 0.02 (interquartile range: 0.00 to 0.06) (p < 0.001) from baseline, respectively. Following propensity-weighted mixed modeling adjusting for treatment and a range of demographic, clinical, ultrasonic, and laboratory parameters (including but not limited to sex, race, baseline, and annualized change in PAV, baseline CaI, concomitant high-intensity statins, diabetes mellitus, renal function), there were no significant between-group differences in annualized changes in PAV (least-squares mean: 0.09; 95% confidence interval [CI]: −0.20 to 0.37 vs. 0.01; 95% CI: −0.27 to 0.29; p = 0.092) according to calcium supplement intake. Per a multivariable logistic regression model accounting for the range of covariates described, calcium supplementation independently associated with an increase in annualized CaI (odds ratio: 1.15; 95% CI: 1.05 to 1.26; p = 0.004). ConclusionsOral calcium supplementation may increase calcium deposition in the coronary vasculature independent of changes in atheroma volume. The impact of these changes on plaque stability and cardiovascular outcomes requires further investigation.

КАЛЬЦИНОЗ КОРОНАРНЫХ АРТЕРИЙ У РЕЦИПИЕНТОВ ТРАНСПЛАНТАТА ПЕЧЕНИ

To study the dynamics of changes in the calcium index (CI) as a cardiovascular risk factor in patients with terminal liver diseases.

Coronary calcinosis and psychological distress association, by the data from ESSE-RF study in Kemerovskaya Region

Aim. To evaluate the association of coronary arteries calcinosis with personality type D, by ESSE-RF (Epidemiology of cardiovascular diseases and risk factors in various regions of Russian Federation) trial data in Kemerovskaya Oblast.Material and methods. The study has been done under the framework of ESSE-RF trial. Standard protocol was updated with personality type assessment by DS-14 questionnaire. All patients underwent quantitative assessment of coronary calcinosis with multispiral computed tomography. The data package was analyzed with Agatstone method. Two groups of patients collected: group 1 (n=231) with type D personality, and group 2 with non-D (n=1379).Results. With the evaluation of calcium index (CaI) there were significant differences in groups: 689,3+53,7 in type D patients and 546,5+47 with none (p=0,048). Moderate and severe CaI was higher in type D patients — 10,3% and 12,5% vs 5,8% and 2,9%, respectively (p=0,043 and p=0,011). Highest differences in CaI in the left coronary artery, exactly in the left anterior descending, were 189,1+12,5 in type D vs 155,6+16,7 in non-type D (p=0,011), and circumflex artery — 121,7+30,6 vs 63,8+21,7 (p=0,032). With the logistic regression, the most influencing on moderate and severe CaI were age — hazard ratio (HR) 1,07-2,14 (p=0,023), diabetes — HR 1,32; 95% CI 1,09-1,62 (p=0,032), type D personality — HR 1,42; 95% CI 1,12-1,82 (p=0,023), coronary heart disease — HR 1,12; 95% CI 1,01-1,21 (p=0,034). By the multifactorial analysis, as independent predictors of moderate and severe CI remained such parameters as coronary heart disease — HR 1,24 95% CI 1,01-1,53 (р=0,04), diabetes — HR 1,28; 95% CI 1,80-3,24 (р=0,02) and type D — HR 1,49; 95% CI 2,01-2,29 (р=0,01).Conclusion. Screening for the influence of type D personality is worthy in persons with subclinical coronary arteries lesion to conduct on-time preventive events.

Coronary Calcium Score Using Multi-Slice Computed Tomography

Coronary atherosclerosis and coronary artery disease (CAD) are the most common causes of death and disability in the most of industrialized countries. The problem of early diagnosis of CAD detection is extremely relevant all over the world. Preclinical identification of patients with risk factors of CAD is one of the most important goal in routine clinical practice. Multislice computed tomography (MSCT) of the heart with the determination of the calcium index (CI) is a noninvasive screening of coronary arteries assessment. The severity of coronary calcification has a close relationship with the severity of coronary atherosclerosis and the risk of acute coronary events according to numerous studies. Initially, studies targeted on assessment of coronary calcification and determination of normative parameters were performed using electron-beam scanners (EBS). Subsequently multislice computed tomography (MSCT) replaced the electronic beam tomography (EBCT). The results of studies that performed with EBS have become the basis for a methodology of coronary calcification assessment with MSCT. The reproducibility of coronary calcium score is important for assessment of atherosclerosis for dynamic monitoring. The inter- observer and intra-observer reproducibility of this method is quite high, the reproducibility according to repeated studies of the same patient is lower. In recent years, a new generation of volumetric CT- scanners has been introduced into clinical practice. Reducing the radiation dose for coronary calcium screening to the minimum values (less than 1 mSv) is one of the important advantages of volumetric computed tomography. Currently, new studies are needed to assess the reproducibility of coronary calcium index calculation using a new generation of volumetric CT-scanners.

Warfarin Use Is Associated With Progressive Coronary Arterial Calcification: Insights From Serial Intravascular Ultrasound

ObjectivesThis study compared serial changes in coronary percent atheroma volume (PAV) and calcium index (CaI) in patients with coronary artery disease who were treated with and without warfarin. BackgroundWarfarin blocks the synthesis and activity of matrix Gla protein, a vitamin K–dependent inhibitor of arterial calcification. The longitudinal impact of warfarin on serial coronary artery calcification in vivo in humans is unknown. MethodsIn a post hoc patient-level analysis of 8 prospective randomized trials using serial coronary intravascular ultrasound examinations, this study compared changes in PAV and CaI in matched arterial segments in patients with coronary artery disease who were treated with (n = 171) and without (n = 4,129) warfarin during an 18- to 24-month period. ResultsPatients (mean age 57.9 ± 9.2 years; male 73%; prior and concomitant 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statin) use, 73% and 97%, respectively) demonstrated overall increases in PAV of 0.41 ± 0.07% (p = 0.001 compared with baseline) and in CaI (median) of 0.04 (interquartile range [IQR]: 0.00 to 0.11; p < 0.001 compared with baseline). Following propensity-weighted adjustment for clinical trial and a range of clinical, ultrasonic, and laboratory parameters, there was no significant difference in the annualized change in PAV in the presence and absence of warfarin treatment (0.33 ± 0.05% vs. 0.25 ± 0.05%; p = 0.17). A significantly greater annualized increase in CaI was observed in warfarin-treated compared with non–warfarin-treated patients (median 0.03; IQR: 0.0 to 0.08 vs. median 0.02; IQR: 0.0 to 0.06; p < 0.001). In a sensitivity analysis evaluating a 1:1 matched cohort (n = 164 per group), significantly greater annualized changes in CaI were also observed in warfarin-treated compared with non–warfarin-treated patients. In a multivariate model, warfarin was independently associated with an increasing CaI (odds ratio: 1.16; 95% confidence interval: 1.05 to 1.28; p = 0.003). ConclusionsWarfarin therapy is associated with progressive coronary atheroma calcification independent of changes in atheroma volume. The impact of these changes on plaque stability and cardiovascular outcomes requires further investigation.

Abstract 17525: Warfarin Promotes Progressive Coronary Arterial Calcification: Insights From Serial Intravascular Ultrasound

Background: Warfarin blocks the synthesis and activity of matrix Gla protein (MGP), a vitamin K-dependent inhibitor of arterial calcification. The impact of warfarin on coronary arterial calcification in vivo is unknown. This study compared serial changes in coronary percent atheroma volume (PAV) and calcium index (CaI) in patients treated with and without warfarin. Hypothesis: Serial changes in coronary CaI are greater in warfarin-treated patients compared with those not on warfarin, independent of changes in PAV Methods: In a patient-level analysis of 8 prospective randomized trials using serial coronary intravascular ultrasound, we compared changes in PAV and CaI in matched arterial segments in patients with coronary artery disease treated with (n=171) and without (n=4129) warfarin during an 18-24-month period. Results: Patients (age 57.9±9.2 yrs; male 73%; prior and concomitant statin use: 73 and 97% respectively) demonstrated an overall increase in PAV by 0.18±0.06% (p=0.003 compared with baseline) and CaI [median (IQR)] by 0.04 (0.00, 0.11) (p &lt;0.001 compared with baseline). Following propensity-weighted adjustment for clinical trial, clinical characteristics and laboratory parameters, there was no difference in annualized ΔPAV in the presence and absence of warfarin treatment (0.08±0.05 vs. 0.13±0.04%, p=0.41). Following adjustment for PAV, a greater annualized increase in CaI was observed in warfarin treated patients [median (IQR) 0.03 (0.0-0.08) vs. no-warfarin: 0.02 (0.0-0.06) p&lt;0.001)]. In a sensitivity analysis evaluating a 1:1 matched cohort (n=164 per group), significantly greater annualized changes in CaI were also observed in warfarin-treated patients. In a multivariable model, warfarin independently associated with an increasing CaI [Odds Ratio (95% confidence interval) 1.12 (1.01, 1.24), p=0.027]. Conclusion: Warfarin therapy associates with progressive coronary atheroma calcification, independent of changes in atheroma volume. The impact of these changes on plaque stability and cardiovascular outcomes require further investigation.

Impact of Statins on Serial Coronary Calcification During Atheroma Progression and Regression

BackgroundStatins can regress coronary atheroma and lower clinical events. Although pre-clinical studies suggest procalcific effects of statins in vitro, it remains unclear if statins can modulate coronary atheroma calcification in vivo. ObjectivesThis study compared changes in coronary atheroma volume and calcium indices (CaI) in patients receiving high-intensity statin therapy (HIST), low-intensity statin therapy (LIST), and no-statin therapy. MethodsIn a post-hoc patient-level analysis of 8 prospective randomized trials using serial coronary intravascular ultrasound, serial changes in coronary percent atheroma volume (PAV) and CaI were measured across matched coronary segments in patients with coronary artery disease. ResultsFollowing propensity-weighted adjustment for differences in baseline and changes in clinical, laboratory, and ultrasonic characteristics, HIST (n = 1,545) associated with PAV regression from baseline (−0.6 ± 0.1%; p < 0.001), whereas both LIST (n = 1,726) and no-statin therapy (n = 224) associated with PAV progression (+0.8 ± 0.1% and +1.0 ± 0.1%; p < 0.001, respectively; p < 0.001 for both HIST vs. LIST and HIST vs. no-statin; p = 0.35 for LIST vs. no-statin). Significant increases in CaI from baseline were noted across all groups (median [interquartile range] HIST, +0.044 [0.0–0.12]; LIST, +0.038 [0.0–0.11]; no-statin, +0.020 [0.0–0.10]; p < 0.001 for all), which could relate to statin intensity (p = 0.03 for LIST vs. no-statin; p = 0.007 for HIST vs. no-statin; p = 0.18 for HIST vs. LIST). No correlations were found between changes in CaI and on-treatment levels of atherogenic and antiatherogenic lipoproteins, and C-reactive protein, in either of the HIST groups or the no-statin group. ConclusionsIndependent of their plaque-regressive effects, statins promote coronary atheroma calcification. These findings provide insight as to how statins may stabilize plaque beyond their effects on plaque regression.

Nonglycemic effects of incretins in patients with long-term type 1 diabetes mellitus and chronic kidney disease

To investigate the nonglycemic effects of incretins in patients with type 1 diabetes mellitus (DM1) of long duration (for more than 20 years) and chronic kidney disease. Seventy-five patients with varying degrees of diabetic nephropathy (DN) and without this condition, including patients receiving renal replacement therapy with programmed hemodialysis and those who had undergone kidney transplantation were examined. The levels of phosphorus-calcium metabolic indicators (calcium, phosphorus, parathyroid hormone, vitamin D, and fibroblast growth factor 23 (FGF-23)), the cardiac damage marker atrial natriuretic peptide, the proinflammatory markers monocyte chemoattractant protein 1 (MCP-1) and C-reactive protein (CRP) and the fibrotic marker transforming growth factor-β, as well as those of glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic peptide (GIP) were estimated in addition to conventional examination methods. All the patients underwent cardiac multislice spiral computed tomography, by calculating the Agatston index (calcium index (CI)) reflecting the degree of coronary artery calcification. The investigation revealed no relationship of GLP-1 and GIP levels to the presence and degree of DN in the patients of the study groups. GLP-1 was noted to be inversely related to patient age, indicating the diminished secretion of this peptide in older people. There was evidence that GLP-1 positively affected blood lipid composition (total cholesterol: r=-0,320; p<0.05) and the magnitude of coronary artery calcification (CI: r=-0.308; p<0.05). GIP showed a differently directed effect on the proinflammatory factors: fibrinogen (r=-0.264; p<0.05), CRP (r=-0.626; p<0.05), and FGF-23 (r=-0.341; p<0.05). The investigation has demonstrated the nonglycemic effects of incretins that favorably affect the pathogenetic processes underlying the late complications of DM1. The findings point to the potential efficacy of incretin-based drugs in preventing and treating the late complications of DM, which necessitates the conduction of larger investigations.

SAT0230 Atherosclerosis of coronary arteries and coronary heart disease in patients with systemic lupus erythematosus (autopsy and intravital findings)

ObjectivesTo study frequency and character of atherosclerotic damage of coronary arteries (CA) and associated coronary heart disease (CHD) in patients (pts) with systemic lupus erythematosus (SLE); to suggest a rational...

Detection of Adulteration in Grated Cheese by Using Calcium, Phosphorus, Magnesium, and Lactose Indices

Abstract Calcium, phosphorus, and magnesium levels and calcium/phosphorus and calcium/magnesium ratios were determined for 74 authentic cheeses. Lactose was determined for 40 authentic grating cheeses. Phosphorus was measured by an AOAC method, calcium and magnesium by a modified AOAC atomic absorption method, and lactose by liquid chromatography. The average calcium/phosphorus and calcium/magnesium ratios were 1.55 and 23.3, respectively, and were used with lactose data as criteria for evaluating grated cheese adulteration.