Presence Of Coronary Atherosclerosis Research Articles

Early-onset vs late-onset preeclampsia and risk of coronary atherosclerosis later in life: a clinical follow-up study

BackgroundYounger women with previous preeclampsia have an increased risk of coronary atherosclerosis. It is unknown if this risk is associated with the time of onset of preeclampsia. ObjectivesThe aim of the study was to investigate if women with early-onset preeclampsia have a higher risk of coronary atherosclerosis compared to women with late-onset preeclampsia, independent of other perinatal risk factors. Study DesignA total of 911 women with previous preeclampsia aged 35-55 years participated in a clinical follow-up study, including clinical examination, comprehensive questionnaires, and cardiac computed tomography scan 13 years (range 0-28) after index pregnancy. Early-onset preeclampsia versus late-onset preeclampsia was defined as gestational age at delivery < versus ≥ 34+0 gestational weeks, respectively. The primary outcome of the study was the presence of coronary atherosclerosis on the cardiac computed tomography. A logistic regression analysis was performed to investigate the association between time of onset of preeclampsia, perinatal risk factors and the primary outcome. ResultsWomen with early-onset preeclampsia (N=139) were older (46.2±5.7 vs. 44.4±5.5 years, P<0.001), more likely to have hypertension (51.1% vs. 35.1%, P=<0.001), and had a higher body mass index (27.9±6.3 vs. 26.9±5.5 kg/m2, P=0.051) compared to women with late-onset preeclampsia (N=772) at follow-up. The prevalence of the primary outcome coronary atherosclerosis on the cardiac computed tomography was 28.8% vs. 22.2% (P=0.088) with an adjusted OR=1.74, 95% CI (1.01-3.01), P=0.045 after adjustment for maternal age at index pregnancy, pre-pregnancy body mass index, parity, diabetes in pregnancy, smoking in pregnancy, offspring birth weight and sex, and follow-up length. ConclusionsWomen with early-onset preeclampsia had a slightly higher risk of coronary atherosclerosis compared to women with late-onset preeclampsia. However, based on the current evidence it does not seem indicated to limit screening, diagnostic and preventive measures for cardiovascular disease only to women with early-onset preeclampsia.

Coronary and carotid imaging of atherosclerosis and contributing factors in middle-aged people with long-term cervical and upper thoracic spinal cord injuries.

Cardiovascular disease is a major cause of death in people aging with spinal cord injury (SCI) and is predominantly caused by atherosclerosis; however, knowledge of atherosclerosis in people with SCI is scarce. To describe coronary and carotid atherosclerosis in middle-aged people with long-term cervical and upper thoracic SCI using coronary computed tomography angiography, carotid ultrasound, and cardiovascular disease risk factors and to compare with the general population. Cross-sectional study with matched controls. Outpatient SCI unit in southern Sweden. Participants (n = 25) in the Swedish SPinal Cord Injury Study on Cardiopulmonary and Autonomic Impairment (SPICA) (20% women, mean age 58 years, mean time since injury 28 years, injury levels C2-T6, American Spinal Injury Association Impairment Scale A-C). Non-SCI controls (n = 125; ratio 5:1) from the Swedish CArdioPulmonary bioImage Study (SCAPIS). Not applicable. Presence of coronary atherosclerosis, coronary artery calcium score, carotid plaques, carotid intima media thickness, blood pressure, lipids, Systematic Coronary Risk Evaluation (SCORE), and anthropometry. Coronary and carotid atherosclerotic plaques occurred in 44% of the participants, 67% of the controls exhibited coronary and 59% carotid plaques; odds ratios (OR; 95% confidence interval [CI]): 0.38 (0.13-1.17) and 0.54 (0.22-1.32), respectively. Mean number of segments with coronary atherosclerosis were 1.0 in participants and 2.1 in controls (OR: 0.74 [0.52-1.06]). Coronary artery calcium score > 100 occurred in 4 (18%) of the participants and 23 (21%) of the controls. The participants had significantly lower levels of total and non-high density lipoprotein cholesterol and SCORE than the controls. This is the first comprehensive assessment of atherosclerosis in people with SCI using advanced imaging techniques. The atherosclerotic burden in middle-aged people with long-term cervical and upper thoracic SCI was not increased, whereas SCORE was lower due to lower cholesterol levels. Imaging techniques may be valuable tools for assessment of atherosclerosis in SCI.

Prevalence and risk factors of angina pectoris and its association with coronary atherosclerosis in a general population, a cross-sectional study

Abstract Background Angina pectoris (AP) is a common clinical presentation with low association to significant coronary artery disease (CAD) in selected cohorts, though yet associated with an elevated risk of major cardiovascular adverse events. Current knowledge on AP prevalence is not up to date since contemporary cross-sectional population-based studies using symptom evaluation are sparse and epidemiological studies often use administrative data from routine health care. Also, there is a lack of studies in the general population examining the association between AP and presence of coronary atherosclerosis. Purpose To assess the prevalence of AP, the relationship to CAD, and risk factors associated to the conditions in a population-based, middle-aged Swedish cohort. Methods Data were based on the Swedish CArdioPulmonary bioImage Study (SCAPIS), in which 30,154 men and women aged 50–64 years were recruited from the general population between 2013 and 2018. Exposure variables included information from blood sampling, physiological examinations, coronary computed tomographic angiography (CCTA) and an extensive questionnaire, including WHO Rose questionnaire on AP. Participants that completed the Rose questionnaire were included and categorized as having Rose angina or No angina. Subjects with a valid CCTA were further assessed regarding correlation between having Rose angina and degree of CAD, categorized as obstructive (&amp;gt;50% occlusion, O-CAD), non-obstructive (&amp;lt;50% occlusion, NO-CAD) or normal coronary angiography (Normal CA). Associations between risk factor exposures and outcomes were analysed in both cohorts using bivariate logistic regression. Results The main cohort consisted of N=28,974 individuals, of which n=1025 fulfilled the criteria of Rose angina, giving a prevalence of 3.5%. Out of these, N=24,602 subjects constituted the CCTA-cohort. Coronary atherosclerosis was significantly more common in individuals having Rose angina compared with those with No angina, (p≤0.001; O-CAD 11.8% vs 5.4%, NO-CAD 38.9% vs 37.0%, Normal CA 49.4% vs 57.7%). Factors associated with Rose angina were birthplace outside of Sweden, low educational level, unemployment, poor economic status, symptoms of depression, and high degree of general stress (Table). Physical inactivity, and current or previous cardiopulmonary diseases only marginally attenuated the associations. These findings were consistent in the sub-population of Rose angina with NO-CAD or Normal CA. Conclusion Rose Questionnaire AP was common in a Swedish general population, with a greater association to coronary atherosclerosis at CCTA compared with asymptomatic individuals. O-CAD was though uncommon. Risk factors associated with AP were sociodemographic and psychological, irrespective of degree of CAD. Funding Acknowledgement Type of funding sources: Foundation. Main funding source(s): SCAPIS has been funded mainly from the Swedish Heart- and Lung foundation and Knut och Alice Wallenberg foundation.

Comparison of Framingham risk score and atherogenic indices as a predictor of atherosclerosis in patients with myocardial bridge in left anterior descending artery

Background Myocardial bridge (MB) is generally considered as a benign condition, but it may trigger atherosclerosis, especially in the adjacent proximal coronary artery segment. In this study, we aimed to investigate whether the Framingham risk score (FRS) or atherogenic indices are risk factors for coronary atherosclerosis in patients with MB in the left anterior descending coronary artery (LAD). Methods We performed a retrospective study evaluating 155 patients who have MB in LAD. The patients were evaluated in two groups according to the presence of atherosclerosis (74 patients in atherosclerotic group vs. 81 patients in non-atherosclerotic group). Baseline characteristics, FRS and atherogenic indices were reviewed between groups. Significant independent risk factors for coronary atherosclerosis were investigated by logistic regression analysis. Results Patients in atherosclerotic group were significantly older (58.15 ± 10.04 vs. 50.22 ± 9.27 years, p < .001) and 74.3% of the patients were male. While the mean FRS in the atherosclerotic group was 21.20 ± 8.81, it was 12.79 ± 8.61 in the non-atherosclerotic group (p < .001). Among the atherogenic indices, only LDL-c/HDL-c ratio was significantly higher in the atherosclerotic group (3.49 ± 1.2 vs. 3.11 ± 0.98, p:.033). Multivariable analysis showed that age (OR: 1.08, 95% CI 1.03–1.13, p < .001) and FRS (OR: 1.06, 95% CI 1.01–1.11, p:.012) were independently associated with the presence of atherosclerotic lesion. Conclusions FRS is an easily applicable predictor in clinical practice that indicates the presence of coronary atherosclerosis in patients with MB in LAD.

Circulating β-d-Glucan as a Marker of Subclinical Coronary Plaque in Antiretroviral Therapy-Treated People With Human Immunodeficiency Virus.

BackgroundDespite antiretroviral therapy (ART), people with human immunodeficiency virus (PWH) have increased risk of inflammatory comorbidities, including cardiovascular diseases. Gut epithelial damage, and translocation of bacterial lipopolysaccharide (LPS) or fungal β-d-glucan (BDG) drive inflammation in ART-treated PWH. In this study, we investigated whether markers of gut damage and microbial translocation were associated with cardiovascular risk in asymptomatic ART-treated PWH.MethodsWe cross-sectionally analyzed plasma from 93 ART-treated PWH and 52 uninfected controls older than 40 years of age from the Canadian HIV and Aging Cohort. Participants were cardiovascular disease free and underwent a cardiac computed tomography (CT) to measure total coronary atherosclerotic plaque volume (TPV). Levels of bacterial LPS and gut damage markers REG3α and I-FABP were measured by enzyme-linked immunosorbent assay. Fungal BDG levels were analyzed using the Fungitell assay.Resultsβ-d-glucan levels but not LPS were significantly elevated in ART-treated PWH with coronary artery plaque (P = .0007). Moreover, BDG but not LPS levels correlated with TPV (r = 0.26, P = .01). Intestinal fatty acid binding protein (I-FABP) but not REG3α levels correlated with TPV (r = 0.23, P = .03). However, BDG and LPS levels were not elevated in uninfected controls with plaque. In multivariable models, elevated BDG levels were independently associated with the presence of coronary atherosclerosis in PWH but not in uninfected controls.ConclusionsTranslocation of fungal BDG was associated with coronary atherosclerosis assessed by CT-scan imaging in ART-treated PWH, suggesting a human immunodeficiency virus-specific pathway leading to cardiovascular disease. Further investigation is needed to appraise causality of this association. Translocation of fungal products may represent a therapeutic target to prevent cardiovascular disease in ART-treated PWH.Plasma levels of the fungal product β-D-Glucan, but not the bacterial product lipopolysaccharide, are associated with the presence and the size of subclinical coronary atherosclerosis plaque in people living with HIV taking antiretroviral therapy, independently of classical cardiovascular risk factors.

ГЕНДЕРНЫЕ ОСОБЕННОСТИ МАРКЕРОВ ПОВРЕЖДЕНИЯ ЭНДОТЕЛИЯ, ОКИСЛИТЕЛЬНОГО И КЛЕТОЧНОГО СТРЕССА У КОМОРБИДНЫХ БОЛЬНЫХ ИБС

The main morbidity and mortality in the world is caused by cardiovascular diseases. In the structure of CVD, the largest percentage is coronary heart disease. The main cause of CHD is atherosclerosis. To date, it is believed that the prognosis of patients with stable coronary heart disease is primarily due to the severity of coronary atherosclerosis. But do not forget about the presence of comorbid pathology in patients, which is becoming increasingly relevant and has an impact on the quality of life of such patients. In addition, it is necessary to keep in mind the gender characteristics of the development of CHD and the adherence of patients with CHD to the treatment and diagnosis of their disease, depending on gender. The aim of the study was to study the gender characteristics of coronary atherosclerosis, changes in markers of endothelial damage, oxidative and cellular stress in comorbid CHD patients. The material for the study was a survey of 336 patients diagnosed with coronary heart disease, verified by standardized validated criteria and clinical and functional methods. The presence of coronary atherosclerosis in patients was confirmed by coronary angiography using the Judkins method. The severity of coronary atherosclerosis was determined based on the Gensini index. Gender differences in indicators of oxidative stress, cellular stress, inflammation and endothelial dysfunction were revealed. Analysis of the relationship between sex and the studied indicators revealed significant positive associations with the Gensini index and male sex, as well as with markers of oxidative stress; and significant negative associations with superoxide dismutase activity, as well as heat shock proteins 70.

Lipoprotein subfraction LDL-5 and the presence of coronary atherosclerosis

Abstract Background Coronary artery disease (CAD) has high mortality rates and is a frequent cause of death globally. Serum lipids play a pivotal role in the development of atherosclerosis, and elevated levels of total cholesterol, low density lipoprotein (LDL) cholesterol, and triglycerides are well known risk factors of cardiovascular disease (CVD). However, there are limitations in the ability to predict CVD risk, which has led to an increased clinical interest in identifying novel risk markers. With the advances in lipidomic technology, lipoprotein subfractions may provide additional information that is missing in today's evaluation of CVD risk. Lipoprotein subfractions differ in size and density, and recent studies suggest that high density of small LDL particles provide a greater risk for CVD. Purpose To investigate whether lipoprotein subfractions are associated with the presence and extent of coronary atherosclerosis. Methods Fasting serum samples from 60 participants with suspected stable CAD were collected before scheduled coronary angiography, and analysed by nuclear magnetic resonance (NMR). The presence and extent of atherosclerosis were quantified by the Gensini Score. Participants were classified into one of three Gensini groups based on severity (&amp;lt;20.5, normal; 20.6–30, non-significant CAD; &amp;gt;30.1, significant CAD). Results A three-way ANOVA, adjusted for statin-use and sex, revealed statistically significant differences (p&amp;lt;0.005) in LDL-5 particle number, LDL-5 triglycerides, and LDL-5 phospholipids between the Gensini groups. In addition, significant differences (p&amp;lt;0.005) were found in the ratios apolipoprotein A/apolipoprotein B and LDL cholesterol/HDL cholesterol between the Gensini groups. All significant variables, identified by the three-way ANOVA, displayed the highest levels in the Gensini group with significant CAD. Conclusion Despite no difference in the traditional clinical measurements (total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides), NMR-lipidomics revealed significant differences in LDL-5 between the Gensini groups. Interestingly, our results reveal that those with significant CAD have a higher density of small LDL subfractions. Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): Norwegian Health Association, The Liaison Committee for Education, Research and Innovation in Central Norway

P4425The exercise-induced troponin I elevation is highly correlated with power output during exercise in recreational cyclists with coronary atherosclerosis

Abstract Background Following strenuous exercise there is an increase cardiac Troponins (cTn) elevation considered being a physiological response. During prolonged strenuous physical activity, high work-loads may induce demand myocardial ischemia due to an oxygen demand/supply mismatch in susceptible subjects, causing an excessive cTn elevation. Purpose This study aimed to assess the relationship between exercise-induced cTnI elevation and direct measurement of work performed during prolonged strenuous exercise in subjects with and without atherosclerotic CAD. Methods Work during a 91 km mountain bike race was quantified by Stages™ power meters. Power (Watt) and heart rate data were stored in Garmin™ Forerunner 935 monitors. Coronary computed tomography angiography was performed after the race. Blood pressure was measured 4 times during the race. Blood samples (hs-cTnI from Abbot Diagnostics) were obtained one day prior to the race and at 3 and 24 h after the race. Data are presented as mean±SD or median (25th and 75th percentile). Results 40 subjects (10 women) were included in the final analysis. 15 Participants (4 women) had atherosclerosis, none had obstructive CAD. These participants were significantly older (55±8 years vs. 46±8 years p=0.007) and had higher training volumes (METS: 69 (64–102) hrs/week) compared with normal subjects (METS: 51 (33–88) hrs/week) (p=0.03). Baseline cTnI was higher (p=0.04) in the atherosclerotic group (4.5 (3.4–8.8) ng/L) compared with normals (2.6 (1.6–4.8) ng/L). There were no differences in baseline blood pressure, peak VO2 max, heart rate or BMI. There was no significant difference in race duration between normals (3.9 (3.5–4.5) hrs) and subjects with atherosclerosis (4.1 (3.6–4.5) hrs). During the race there were no differences in peak power or peak Watt/kg. cTnI increased after the race in all participants, but there were no differences between groups: 3h: atherosclerosis: 89 (27–131) ng/L vs. normal 77 (36–104) ng/L, 24h: atherosclerosis: 13 (6.3–23.7) ng/L vs. normal: 17 (12–37) ng/L. There were no significant difference between the groups in average power during the race: atherosclerosis: 167±50 Watt vs. 174 (±50) Watt or ratio: 2.0±0.49 Watt/kg vs 2.2±0.58 Watt/kg during the race. Maximal systolic and diastolic blood pressures during the race were higher (p=0.002) in the atherosclerotic group: SBP: 241±14 mmHg vs. 219±26 mmHg, DBP: 107±8 vs 95±8 mmHg. In atherosclerotic subjects cTnI both at 3h and 24 h were highly correlated (p&lt;0.001) with Watt/kg ratio during the race in contrast to no correlations in the normal group (Figure). Conclusions Our findings suggest that the presence of coronary atherosclerosis, even in the absences of significant stenosis, alters the relationship between workload and the troponin response. This indicates different release kinetics in exercise-induced cTn in participants with and without CAD, with prolonged elevation in cTnI in CAD subjects exceeding the highest work-intensities. Acknowledgement/Funding Grant Western Norway Health service, Grant ConocoPhillips, Grant Simon Fougner Hartmanns Familyfund

P2627Diffuse coronary artery disease and effect of implantable cardioverter-defibrillators in patients with non-ischaemic systolic heart failure

Abstract Background Implantable defibrillators reduce mortality in patients with ischaemic heart failure. The recent Danish Study to Assess the Efficacy of Implantable Cardioverter Defibrillators in Patients With Non-Ischaemic Systolic Heart Failure on Mortality (DANISH) found no overall effect on all-cause mortality with ICD implantation. Coronary artery disease (CAD) as the cause of heart failure had to be ruled out prior to inclusion into DANISH, but patients could have diffuse atherosclerosis, one- or two-vessel disease on the qualifying coronary angiogram if the investigator did not find that the degree of CAD could explain the severely reduced left ventricular ejection fraction. It is unknown if concomitant coronary atherosclerosis is related to outcome in patients with non-ischaemic cardiomyopathy and whether the effect of implanting an ICD is different in patients with non-ischaemic cardiomyopathy and coronary atherosclerosis. Purpose The aim of this study was to investigate the association between coronary atherosclerosis and all-cause mortality in patients with non-ischaemic systolic heart failure and the effect of ICD implantation in these patients. Methods Of the 1116 patients from the DANISH study, 838 patients with available coronary angiography data were included in this subgroup analysis. Patients were considered to have coronary atherosclerosis if the invasive cardiologist described diffuse atherosclerosis or coronary stenosis. We used cox regression to assess the relationship between coronary atherosclerosis and mortality and between ICD implantation and mortality in patients with and without coronary atherosclerosis. Data are presented as hazard ratios with 95% confidence intervals. Results Of the 838 patients, 266 (32%) had coronary atherosclerosis, 216 (81%) of whom were reported as having atherosclerosis without stenoses. Patients with coronary atherosclerosis were significantly older (median age 67 years vs 61 years), more often male (77% vs 70%) and had a higher prevalence of diabetes (30% vs 17%). In univariable analysis, coronary atherosclerosis was a significant predictor of all-cause mortality (HR, 1.41; 95% CI, 1.04–1.91; P=0.03). However, the association between coronary atherosclerosis and all-cause mortality disappeared when adjusting for age, gender and diabetes (HR 1.02, 0.75–1.41, P=0.88). Adjusted hazard ratios are shown in Figure 1. There was no association between ICD treatment and all-cause mortality in patients with or without coronary atherosclerosis (HR 0.94; 0.58–1.52; P=0.79 vs HR 0.82; 0.56–1.20; P=0.30), P for interaction=0.67. Figure 1 Conclusions In patients with non-ischaemic systolic heart failure, the concomitant presence of coronary atherosclerosis was associated with increased mortality. However, this association was not independent of other risk factors. ICD implantation was not associated with mortality risk in patients either with or without concomitant coronary atherosclerosis. Acknowledgement/Funding TrygFonden (Copenhagen, DK), Medtronic (US) and St. Jude Medical (US)

Association of ABO group types to overweight and obesity: Based on six years of experience in two centers in Sulaimani governorate, Kurdistan Region/Iraq

BackgroundMany studies have supported a number of associations between ABO blood type and certain diseases, including pancreatic cancer, venous thromboembolism, and myocardial infarction in the presence of coronary atherosclerosis, sexual maturity, breast cancer, cancer, infections, Diabetes mellitus, cardiovascular diseases, hypertension, peptic ulcers, intelligence and socioeconomic class, personality, suicide, BMI and obesity. ObjectivesTo find any relation of the ABO blood groups to overweight and obesity. Patients, materials, and methodsA prospective randomized study including 885 overweight or obese patients from a total of 896 patients, they were consulting for advice, diet and or drugs and various bariatric operations. This was conducted over the period of 6 years from February 1st, 2012 to March 1st, 2018.The patients were arranged in 2 groups.1. Group A: 885 overweight or obese patients.2. Group B: 20011 blood donors. ResultsRegarding the frequency of ABO blood groups among the overweight and obese patients, group O was the most common (n = 361, 40.80%), as it is in the population sample (n = 7563, 37.80%). Although group A and B were comparable, patients in group AB composes (11.41%) of the overweight and obese patients, while the prevalence of group AB is (07.36%) in the population sample, there is statistically important positive relation between overweight and obesity to ABO group type AB, r = 0.98), (P < 0.001). ConclusionIn the ABO blood group system, group AB was more susceptible to develop overweight and obesity in Kurd race.

Coronary tortuosity is negatively correlated with coronary atherosclerosis.

ObjectiveThe impact of coronary tortuosity on coronary atherosclerosis remains unclear. This study was performed to determine to the relationship between coronary tortuosity and the presence of coronary atherosclerosis.MethodsTortuosity and the presence of coronary atherosclerosis in the main coronary arteries were evaluated. The coronary artery was divided into non-tortuous and tortuous segments. The incidence of coronary atherosclerosis between the two segments was compared.ResultsThe prevalence of coronary atherosclerotic stenosis was significantly lower in the tortuous than non-tortuous segment.ConclusionThe prevalence of coronary atherosclerotic stenosis is lower in the coronary tortuous than non-tortuous segment, indicating that coronary tortuosity might be considered a protective factor for atherosclerosis.

Dr. Tam, et al, reply.

We thank Haroon, et al for their comments1. Their study demonstrated suboptimal performances of established cardiovascular (CV) risk scores in identifying asymptomatic coronary artery disease as confirmed by coronary computed tomography angiography (CCTA) among patients with psoriatic arthritis (PsA). The results were in line with our study based on carotid subclinical atherosclerosis2. However, they found that a multiplication factor of 1.5 accurately categorizes PsA patients as having a high risk of CV diseases, presumably based on the presence of coronary atherosclerosis. To address whether this also applies to our cohort of patients with PsA, we have performed posthoc … Address correspondence to Dr. L.S. Tam, Department of Medicine and Therapeutics, The Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong. E-mail: lstam{at}cuhk.edu.hk

Balance of Fatty Acids and Their Correlations with Parameters of Lipid Metabolism and Markers of Inflammation in Men with Coronary Atherosclerosis.

We studied the balance of fatty acids and their correlation with parameters of lipid metabolism and inflammation markers in men with coronary atherosclerosis. In the blood of patients and healthy men, the content of myristic (C14:0), pentadecanoic (C15:0), palmitic (C16:0), stearic (C18:0), arachidic (C20:0) and docosanic (C22:0), TNFα, IL-1β, IL-6, IL-8, C-reactive protein, cholesterol, triglycerides, HDL, and LPO intensity were measured. In patients with coronary atherosclerosis, increased concentrations of saturated fatty acids, triglycerides, LPO products, IL-6, IL-8, and C-reactive protein were found. Correlation analysis revealed multiple correlations between the studied fatty acids, correlation of C16:0, C18:0, and C20:0 with inflammation markers, C14:0, C16:0, and C18:0 with triglyceride level, C16:0, C18:0, and C20:0 with cholesterol. The contents of C14:0, C15:0, C16:0, and C18:0 correlated with the presence of coronary atherosclerosis. Lipid metabolism disturbances in coronary atherosclerosis were accompanied by changes in not only lipid spectrum and inflammation markers, but also fatty acids balance.

Inverse association between hyperthymic affective temperament and coronary atherosclerosis: A coronary computed tomography angiography study

ObjectiveA bidirectional relationship exists between psychiatric disorders and cardiovascular diseases, however less is known with regards to personality traits. Accumulating data suggest that affective temperaments are both associated with psychiatric and somatic diseases. The aim of our study was to evaluate the associations between different affective temperaments and the presence of coronary atherosclerosis. Methods200 consecutive patients referred to coronary computed tomography angiography (CCTA) due to suspected coronary artery disease (CAD) were included in our study. Medical history and demographic parameters were recorded and all patients completed the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire (TEMPS-A) and the Beck Depression Inventory (BDI). The presence of coronary artery disease was evaluated based on the CCTA images. Results39 patients were free of any coronary atherosclerosis (CCTA-) and 161 had coronary atherosclerosis (CCTA+). Hyperthymic affective temperament score was higher in CCTA- subjects as compared to CCTA+ (13.1±3.0 vs 11.5±4.6, p=0.010, respectively). Hyperthymic affective temperament score showed a significant independent, inverse relationship with coronary atherosclerosis (OR: 0.91 CI: 0.82–0.99, p=0.04). ConclusionOur results suggest that hyperthymic affective temperament is independently associated with the absence of CAD. It requires further research to delineate the mechanism mediating the effect of hyperthymia on better coronary artery health and establishing potential biochemical or behavioral factors, both of which could be exploited for prevention and treatment purposes. But it is plausible, that the evaluation of affective temperaments have importance both in relation with psychiatric and cardiovascular disorders.

Population-based Cohort Study in Outcome of Phased Progression of Atherosclerosis in China (PERSUADE): objective, rationale and design.

The coronary artery calcification score and pericardial fat volume have recently been reported to be strongly associated with the severity and presence of coronary atherosclerosis. However, no studies have explored the outcome of phased progression of atherosclerosis by non-contrast computed tomography in asymptomatic people in China. The population-based cohort study in outcome of phased progression of atherosclerosis in China (PERSUADE), an observational, longitudinal and prospective cohort study in a target population of healthy subjects based in Jidong Oilfield (China), prospectively analyzes the outcome of phased progression of atherosclerosis by non-contrast computed tomography in healthy population. The results of this study are expected to be of value for utilizing noninvasive imaging combine with traditional cardiovascular risk factors to create a risk stratification and find pertinent biomarkers associated with the outcome of phased progression of atherosclerosis in healthy people, thereby could help to establish a more personalized treatment of clinical practice.

Abstract 233: Genetic Evidence for Overlap in the Pathogenesis of Peripheral Artery Disease and Coronary Artery Disease

Introduction: Peripheral artery disease (PAD) is thought to share atherosclerotic biologic mechanisms and traditional risk factors with coronary artery disease (CAD). Although significant progress has been made in identifying genetic contributors to CAD, genetic factors underlying PAD remain largely uncharacterized. The aim of our study was to evaluate the shared genetic architecture between PAD and CAD. Hypothesis: DNA sequence variants associated with CAD risk are also associated with PAD. Methods: We analyzed the electronic health records from 239,621 U.S. Veterans of European ancestry with available imputed genetic data from the VA Million Veteran Program. Within this cohort we identified 16,364 participants with PAD, and 67,636 with CAD. We constructed additive weighted genetic risk scores (GRS) of 57 DNA sequence variants previously associated with CAD at genome-wide significance. We standardized the GRS to have a mean of zero and standard deviation (SD) of 1, and assessed the strength of its association with PAD through logistic regression. Models were adjusted for age, sex, and 7 principal components of ancestry. In a mediation analysis, we then included CAD status in the model to examine if these genetic associations remained significant after accounting for a CAD diagnosis. Results: The CAD GRS was significantly associated with clinical CAD [OR = 1.22 per SD increase in GRS, (95%CI: 1.21 -1.23, Z-Score = 44.5, P &lt; 2 x10 -16 )]. The CAD GRS was also significantly associated with PAD [OR = 1.12 per SD increase in GRS, (95%CI: 1.10-1.14, Z-Score = 14.5, P &lt; 2x10 -16 )]. This magnitude of association was attenuated when further adjusting for CAD in the regression model but remained strongly significant [OR = 1.05 per SD increase in GRS, (95%CI: 1.03-1.07, Z-Score = 6.2, P = 5.6x10 -10 )]. Conclusions: In the largest single cohort of CAD and PAD cases worldwide, we found that a genetic risk score of DNA sequence variants associated with risk for CAD are also associated with risk of PAD, even after accounting for the presence of coronary atherosclerosis. These data suggest significant overlap in the mechanisms underlying development of atherosclerosis within both the peripheral and coronary arterial beds.

Combination of Visual and Metabolic Markers in Assessment of Probability of Presence and Severity of Atherosclerosis of Coronary Arteries

to assess possibilities of the use of biochemical markers combined with data of methods of imaging of arterial atherosclerotic lesions for evaluation of risk of presence and severity of coronary atherosclerosis. We enrolled into this study patients (n=205, 136 men, 69 women, age 33-85 years, 94% on statin therapy) who underwent coronary angiography and carotid artery ultrasound dopplerography. Examination included determination of parameters of lipid profile and carbohydrate metabolism, markers of inflammation and metabolism of visceral adipose tissue. The severity of carotid artery atherosclerosis was estimated using mean common carotid artery intima-media thickness and atherosclerotic plaques presence. Severity of coronary atherosclerosis was evaluated using Gensini score. We found association between a number of biomarkers and severity of coronary artery involvement. Presence of coronary atherosclerosis (Gensini score >0) was associated with male sex, carotid artery stenosis >45%, and adiponectin level <8.0 pg/ml. Overt coronary atherosclerosis (Gensini score more or equal 35) significantly correlated with intima-media thickness more or equal 0.9 mm, C-reactive protein level >3.0 mg/l and adiponectin level <8.0 pg/ml.

Is galectin-3 a biomarker, a player—or both—in the presence of coronary atherosclerosis?

Atherosclerosis is a complex process mediated by leukocytes, macrophages and various inflammatory markers. Galectin-3 is secreted by activated macrophages and is involved in cardiac fibrosis, cardiac remodeling, and inflammation. The...

Decreased Renal Function Is a Risk Factor for Subclinical Coronary Atherosclerosis in Korean Postmenopausal Women.

ObjectivesDecreased renal function is associated with increased cardiovascular risk. Our study was planned to verify the association of decreased renal function and subclinical coronary atherosclerosis in postmenopausal women.MethodsWe performed a retrospective review of 251 Korean postmenopausal women who visited the health promotion center for a routine health checkup. Estimated glomerular filtration rate (eGFR) was used to show renal function, which was estimated by calculated using the Cockcroft-Gault (CG) and the modification of diet in renal disease (MDRD) formulas. Coronary atherosclerosis was assessed by 64-row multidetector computed tomography.ResultsWomen with reduced eGFR (< 60 mL/minute/1.73 m2) had significantly higher brachial-ankle pulse wave velocity (baPWV) than women with normal eGFR (≥ 60 mL/minute/1.73 m2). The eGFR was negatively correlated with baPWV (r = -0.352, P < 0.001), significantly. The eGFR was lower in women with coronary atherosclerosis than in normal control women, markedly. Reduced eGFR was significantly associated with the presence of coronary atherosclerosis (odds ratio [OR] = 7.528, 95% confidence interval [CI] = 2.728-20.772, P < 0.001).ConclusionsDecreased eGFR was closely associated with increased arterial stiffness and coronary atherosclerosis in postmenopausal women. Evaluating subclinical atherosclerosis by screening the renal function in postmenopausal women may be helpful screening high risk group and considering starting menopausal hormone therapy before atherosclerosis development.

Serum Thyroid Stimulating Hormone Levels Are Associated with the Presence of Coronary Atherosclerosis in Healthy Postmenopausal Women.

ObjectivesMenopause is a natural aging process causing estrogen deficiency, accelerating atherogenic processes including dyslipidemia. Prevalence of thyroid dysfunction is also high in postmenopausal women, and it is known to elevate the risk of cardiovascular disease (CVD). Therefore, we are to study on the associations in between serum thyroid stimulating hormone (TSH) and prevalence of CVD in postmenopausal women who have normal thyroid function.MethodsWe performed a retrospective review of 247 Korean postmenopausal women who visited the health promotion center from January, 2007 to December, 2009. Postmenopausal women with normal serum TSH were included in the study. Coronary atherosclerosis was assessed by 64-row multidetector computed tomography.ResultsIn multiple linear regression analysis, serum TSH was associated with serum triglyceride (TG) (β = 0.146, P = 0.023). In multiple logistic regression analysis, increasing age and serum TSH were associated with an increased risk of coronary atherosclerosis in euthyroid postmenopausal women (odds ratio [OR] = 1.107 [1.024-1.197], P = 0.011 and OR = 1.303 [1.024-1.658], P = 0.031, respectively).ConclusionsIt revealed that significant predictor of serum TSH was serum TG, and increasing age and TSH were found to have associations with an increased risk of coronary atherosclerosis in euthyroid postmenopausal women. Screening and assessing risks for CVD in healthy postmenopausal women would be helpful before atherosclerosis develops.