B-type natriuretic peptide and extent of lesion on coronary angiography in stable coronary artery disease

Introduction: The role of the immune and inflammatory pathways in patients with coronary artery disease (CAD) is important but not complete understood. The aim of this study was to evaluate concentrations of the interleukins 17 (IL 17) according to severity of coronary stenosis in patients with stable CAD Hypothesis: There is no association between severity of coronary stenosis and IL 17 in patients with stable CAD. Methods: This is a cross-sectional, prospective, analytical study, conducted from january to september, 2013. We included 40 patients (P) with stable CAD, CCS III or IV, ischemic myocardial scintigraphy, who had not been subjected to any kind of myocardial revascularization and with coronary stenosis ≥ 50% according to current coronary angiography. There were 20 healthy volunteers (C), to take up comparison of concentrations of IL 17. Interleukins were evaluated in serum of patients and after 48 hours of cells in culture with and without stimulus. IL 17 A concentrations were expressed in pg / ml. Coronary stenosis were classified as severe (> 70%) [SS] and intermediate (50 - 69%) [MS] according to coronary angiography. Results: Stenosis ≥ 50% were found in the anterior descending artery in 31 patients, in the left circumflex artery in 19 patients, and in the right coronary artery in 24 patients. No cases of stenosis were observed in the left main. Eighteen patients (45%) had single-artery disease, 8 patients (20%) had two-artery disease, and 14 patients (35%) had multiarterial disease. The comparison between the groups showed: IL 17: Serum: P with SS = 3.91 (3.91 -- 72.27) vs P with MS = 3.91 (3.91 -- 3.91) vs C = 3.91 (3.91 -- 28.8), p = 0.53; culture 48 hours without stimulus: P with SS = 3.91 (3.91 -- 3.91) vs P with MS = 3.91 (3.91 -- 86.8) vs C = 3.91 (3.91 -- 53.3), p = 0.55; culture 48 hours with stimulus: P with SS = 241.8 (3.91 -- 2200) vs P with MS = 217.5 (3.91 -- 1346) vs C = 154.3 (3.91 -- 1353), p = 0.7. Conclusions: There were no differences in concentrations of IL 17 according to severity of coronary stenosis, does not matter in serum or cell in culture. In conclusion, there was no association between severity of coronary stenosis and IL 17 in patients with stable CAD

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Abstract 162: Single Nucleotide Polymorphism of the B-Type Natriuretic Peptide Helps Predict the Presence of Significant Coronary Artery Disease

Circulation Research ◽

10.1161/res.115.suppl_1.162 ◽

2014 ◽

Vol 115 (suppl_1) ◽

Author(s):

Terry Y Li ◽

M. Y Tse ◽

Nicole M Ventura ◽

Marie-France Hetu ◽

Amer M Johri ◽

...

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Coronary Angiography ◽

Natriuretic Peptide ◽

Genetic Screening ◽

Odds Ratio ◽

Single Nucleotide ◽

Artery Disease ◽

Peptide Gene ◽

Significant Disease

Early detection and diagnosis of coronary artery disease (CAD) is crucial in reducing the morbidity and mortality. The clinical standard for detecting CAD is by angiography which is associated with rare but important clinical risks. Recent studies have shown that up to 40% of patients referred for angiography do not have significant disease. This discrepancy between referral and diagnosis may be improved by the utilization of genetic screening. A single nucleotide polymorphisms (SNP) of the B-type natriuretic peptide gene (NPPB), rs198389, was previously found to be associated with several cardiovascular diseases. Our objective was to determine whether detection of genetic variation could contribute to better selection of patients referred for angiography. We hypothesized that an SNP analysis of the NPPB gene may help differentiate patients with significant disease from those with non-significant CAD. Ninety-three patients referred for coronary angiography at the Kingston General Hospital Cardiac Catheterization Lab were consented for genetic screening. Blood samples were collected during angiography procedure. Genomic DNA was isolated from leukocytes, and screened for SNPs using a real-time PCR-based TaqMan SNP Assay. We found that more males were referred for coronary angiography than females: 69% versus 31%. Two out of ten males (20%) were found to have no or minimal CAD. In contrast, 48% of females were found to have non-significant CAD. Older age (≥ 69 years) was deemed to be a significant predictor of CAD in the total recruited population (odds ratio of 3.4), but no age difference was found between healthy and diseased females. Additionally, a mutation of the B-type natriuretic peptide gene (NPPB) was found to be a significant predictor of CAD in the younger population (< 69 years), with an odds ratio of 5.9. We found a significant difference between patterns of CAD development in males and females, suggesting that different diagnostic criteria should be used depending upon gender. Moreover, younger individuals with two copies of the major allele for the NPPB SNP were more likely to develop CAD, making this SNP a potential factor in the prediction of CAD in younger population.

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