Uric acid levels are associated with endothelial dysfunction and severity of coronary atherosclerosis during a first episode of acute coronary syndrome

Diabetes mellitus (DM) is associated with more extensive coronary atherosclerosis and more vulnerable plaque phenotypes. However, DM should not be considered a homogeneous and purely binary entity in terms of risk assessment. We evaluated the impact of prediabetic status on coronary atherosclerosis burden in patients with first-time acute coronary syndrome (ACS) who underwent urgent coronary angiography. The patients were divided into DM, prediabetes, and control groups. The 3-vessel disease (TVD) rates and SYNTAX and Gensini scoring systems for defining atherosclerotic burden were compared. The study was conducted in 469 consecutive patients admitted with a diagnosis of ACS. Of these, 250 patients were admitted at the first occurrence of ACS undergoing diagnostic coronary angiography. SYNTAX and Gensini scores and TVD rates were higher in prediabetic patients than in nondiabetic patients ( P = .004, P = .008, and P = .014, respectively), but similar in prediabetic and diabetic patients ( P = .912, P = .773, and P = 1.000, respectively). Coronary atherosclerosis burden is more advanced in prediabetic patients than in nondiabetic patients and is comparable between prediabetic and diabetic patients at first presentation of ACS. Cardiologists should not miss the opportunity to diagnose prediabetes and DM when patients present with an ACS.

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Abstract 3147: Uric Acid Independently Predicted Acute Coronary Syndrome in a Large Cohort of Ethnic Chinese

Circulation ◽

10.1161/circ.118.suppl_18.s_1103 ◽

2008 ◽

Vol 118 (suppl_18) ◽

Author(s):

Shao-Yuan Chuang ◽

Jonathan Jiunn-Horng Chen ◽

Chih-Cheng Wu ◽

Wen-Harn Pan

Keyword(s):

Body Mass Index ◽

Acute Coronary Syndrome ◽

Uric Acid ◽

Total Cholesterol ◽

Body Mass ◽

Ethnic Chinese ◽

Coronary Syndrome ◽

Group 4 ◽

Group 3 ◽

Group 2

Few studies examine the association between serum uric acid (SUA) and acute coronary syndrome (ACS). We aimed to investigate the association between SUA and ACS in a prospective study of ethnic Chinese. Enrolled were 128569 adults ≥ 20 yrs from 4 MJ Health Checkup Clinics in Taiwan during 1994 –1996, excluding those with heart disease, stroke, renal disease and cancer disease. All physical examination, biochemical test and structured questionnaire were executed in standardized central labs. ACS was defined by main ICD-9 of 410 – 414 from claim data of National Health Insurance for hospitalization and from Death certification registry. Cox proportional hazard model was used to estimate the hazard ratios (HRs) between levels of SUA and ACS events. A total of 2049 subjects (Men: 1239/Women: 810) developed ACS during the period from baseline to Dec.31.2002. Men had higher ACS incidence than women (2.84 vs. 1.61 per 1000 person-years [PY]; p < .0001). Independent risk factors of ACS unfolded from this study included age, male sex, waist circumference, body mass index, triglycerides, total-cholesterol, hypertension, diabetes, uric acid, and current smoking. The crude incidences of ACS were 1.27, 2.06, 3.27 and 4.61 per 1000 PY in that order for four consecutive SUA groups (group1: <5.0 mg/dl; group 2: 5.0 – 6.9 mg/dl; group 3: 7.0 – 8.9 mg/dl; group 4: ≥9.0 mg/dl) (p-value for trend <.0001). Compared to group1, the multi-variate adjusted HRs (95% Confidence intervals) were 1.14 (0.92, 1.42) for group 2, 1.38 (1.10, 1.72) for group 3 and 1.38 (1.10, 1.72) for group 4 among men, and 1.03 (0.87, 1.22), 1.30 (1.05, 1.62) and 1.43 (0.99, 2.05) among women after adjusting for age, systolic/diastolic BP, body mass index, triglycerides, total cholesterol, diabetes, smoking, alcohol drinking, physical activity, and occupation. One standard deviation increase in SUA corresponded to around 30% ACS risk increase in women (HR=1.33; 1.04 –1.70) and 60% in men (HR=1.59; 1.25–2.03). Baseline SUA level independently predicts the development of ACS and should be considered as a potential risk factor of ACS.

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Correlation between Serum High Sensitivity C-reactive Protein Level and Severity of Coronary Atherosclerosis Assessed by Angiographic Gensini Score in Patients with Acute Coronary Syndrome

Journal of Cardiovascular Medicine and Surgery ◽

10.21088/jcms.2454.7123.4218.5 ◽

2018 ◽

Vol 4 (2) ◽

pp. 100-107

Author(s):

Mayank Jain ◽

◽

Priyanka Kiyawat ◽

Surbhi Kiyawat ◽

◽

...

Keyword(s):

Acute Coronary Syndrome ◽

Protein Level ◽

Coronary Atherosclerosis ◽

High Sensitivity ◽

Gensini Score ◽

C Reactive Protein ◽

Reactive Protein ◽

Coronary Syndrome

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Clot properties and endothelial dysfunction as a predictor of poor prognosis in patients with acute coronary syndrome

Atherosclerosis ◽

10.1016/j.atherosclerosis.2020.10.734 ◽

2020 ◽

Vol 315 ◽

pp. e233

Author(s):

P. Savvinova ◽

A. Kalinskaya ◽

E. Vasilieva ◽

A. Shpektor

Keyword(s):

Acute Coronary Syndrome ◽

Endothelial Dysfunction ◽

Poor Prognosis ◽

Coronary Syndrome

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The Impact of Chronic Repetitive Leg Ischemia on Left Ventricular Function and Severity of Coronary Atherosclerosis in Patients with Acute Coronary Syndrome

Medical Principles and Practice ◽

10.1159/000481866 ◽

2017 ◽

Vol 26 (5) ◽

pp. 447-450

Author(s):

Mutlu Gungor ◽

Erkan Yildirim

Keyword(s):

Acute Coronary Syndrome ◽

Left Ventricular Function ◽

Ventricular Function ◽

Coronary Atherosclerosis ◽

Left Ventricular ◽

Coronary Syndrome ◽

The Impact ◽

Leg Ischemia

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Microencapsulated Pomegranate Reverts High-Density Lipoprotein (HDL)-Induced Endothelial Dysfunction and Reduces Postprandial Triglyceridemia in Women with Acute Coronary Syndrome

Nutrients ◽

10.3390/nu11081710 ◽

2019 ◽

Vol 11 (8) ◽

pp. 1710 ◽

Cited By ~ 2

Author(s):

Diego Estrada-Luna ◽

Elizabeth Carreón-Torres ◽

Rocío Bautista-Pérez ◽

Gabriel Betanzos-Cabrera ◽

Alan Dorantes-Morales ◽

...

Keyword(s):

Acute Coronary Syndrome ◽

Endothelial Dysfunction ◽

Endothelial Function ◽

Lipid Profile ◽

High Density ◽

Paraoxonase 1 ◽

Pon1 Activity ◽

Plasma Samples ◽

Postprandial Period ◽

Coronary Syndrome

(1) Background: the composition of high-density lipoproteins (HDL) becomes altered during the postprandial state, probably affecting their functionality vis-à-vis the endothelium. Since acute coronary syndrome (ACS) in women is frequently associated with endothelial dysfunction, it is likely that HDL are unable to improve artery vasodilation in these patients. Therefore, we characterized HDL from women with ACS in fasting and postprandial conditions. We also determined whether microencapsulated pomegranate (MiPo) reverts the HDL abnormalities, since previous studies have suggested that this fruit improves HDL functionality. (2) Methods: Eleven women with a history of ACS were supplemented daily with 20 g of MiPo, for 30 days. Plasma samples were obtained during fasting and at different times, after a lipid load test to determine the lipid profile and paraoxonase–1 (PON1) activity. HDL were isolated by sequential ultracentrifugation to determine their size distribution and to assess their effect on endothelial function, by using an in vitro model of rat aorta rings. (3) Results: MiPo improved the lipid profile and increased PON1 activity, as previously reported, with fresh pomegranate juice. After supplementation with MiPo, the incremental area under the curve of triglycerides decreased to half of the initial values. The HDL distribution shifted from large HDL to intermediate and small-size particles during the postprandial period in the basal conditions, whereas such a shift was no longer observed after MiPo supplementation. Consistently, HDL isolated from postprandial plasma samples hindered the vasodilation of aorta rings, and this endothelial dysfunction was reverted after MiPo consumption. (4) Conclusions: MiPo exhibited the same beneficial effects on the lipid profile and PON1 activity as the previously reported fresh pomegranate. In addition, MiPo supplementation reverted the negative effects of HDL on endothelial function generated during the postprandial period in women with ACS.

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