Abstract 2755: Insulin Resistance and Coronary Artery Calcification measured by Electron Beam Tomography

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Robert Lee ◽  
Fereshteh Hajsadeghi ◽  
Jessica Ramirez ◽  
Behnaz Sarlak ◽  
Ambarish gopal ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Electron Beam ◽  
Coronary Artery ◽  
Coronary Artery Calcification ◽  
Odds Ratio ◽  
Electron Beam Tomography ◽  
C Reactive Protein ◽  
Lipoprotein A ◽  
Reactive Protein ◽  
Increased Risk

Background: Elevation in the ratio of triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) has been suggested as a marker of insulin resistance (IR), conferring an increased risk of atherosclerosis in these patients. The association between TG/HDL-C and coronary artery calcification (CAC) measured by computed tomography has yet to be established. The goal of this study was to examine the relationship between IR, as determined by TG/HDL-C ≥ 3.5, and significant CAC (absolute score ≥ 100). Methods: Fasting lipid levels, homocysteine, C reactive protein and lipoprotein (a) levels of 336 asymptomatic individuals, who also underwent electron beam tomography (EBT), were measured. Results: The mean age of participants was 55 ±10 years. 71.7% were male. 37.4% had hypertension, 52.5% had hypercholesterolemia, 12.4% had diabetes mellitus (DM) and 52.5% had family history of premature CHD. Individuals with IR had higher significant CAC (≥100) than those without IR (70% vs. 27%, P=0.0001). After adjustment for age, gender, hypertension, hypercholesterolemia and DM, multivariate regression analysis demonstrated that individuals with IR had more significant CAC (odds ratio 2.1, 95% CI=1.1–3.9, p=0.01). Further sub-analysis revealed that individuals with IR had significantly higher lipoprotein (a) (Lp(a)) than those without IR (odds ratio 1.31, 95% CI=1.09-.16, p=0.03). No significant differences in C-reactive protein (CRP) and homocysteine were found between the two groups. Conclusion: Insulin resistance, as measured by TG/HDL-C ≥ 3.5, was associated with a significantly higher incidence of accelerated atherosclerosis on EBT (absolute CAC score ≥ 100), independent of age, gender and conventional risk factors. IR was also significantly associated with elevated levels of Lp(a). Further studies regarding the clinical significance of insulin resistance and elevated CAC score, as well as its association with Lp(a), may be warranted.

scholarly journals Plasma F2-Isoprostanes and Coronary Artery Calcification: The CARDIA Study

2005 ◽  
Vol 51 (1) ◽  
pp. 125-131 ◽  
Author(s):  
Myron Gross ◽  
Michael Steffes ◽  
David R Jacobs ◽  
Xinhua Yu ◽  
Linda Lewis ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Early Development ◽  
Coronary Artery Calcification ◽  
Continuous Variable ◽  
Oxidation Products ◽  
Gas Chromatography Mass Spectrometry ◽  
Agatston Score ◽  
Reactive Protein ◽  
Increased Risk ◽  
Coronary Artery Atherosclerosis

Abstract Background: Oxidation of lipids in lipoproteins and cells may initiate and enhance the early development of cardiovascular disease. Method and Results: We assayed F2-isoprostanes, oxidation products of arachidonic acid, by gas chromatography–mass spectrometry in a biracial cohort of 2850 young healthy adult men and women. Coronary artery calcification (CAC), a component of coronary artery atherosclerosis, was detectable in 10% of the cohort and appeared to be in its initial stages (Agatston scores <20 in 47% and <100 in 83% of CAC-positive participants). After adjusting for sex, clinical site, age, and race, the presence of any CAC was 24% more likely among those with high vs low concentrations of F2-isoprostanes [odds ratio (OR) = 1.24 per 92.2 pmol/L (32.7 ng/L; 1 SD of F2-isoprostanes); 95% confidence interval (CI), 1.09–1.41]. The OR was only slightly attenuated [1.18 per 92.2 pmol/L (32.7 ng/L); CI, 1.02–1.38] after further adjustment for body mass index, smoking, serum lipids, C-reactive protein, antioxidant supplementation use, diabetes, and blood pressure. As a continuous variable, the Agatston score increased by 6.9% per 92.2 pmol/L (32.7 ng/L) of F2-isoprostane concentration (P <0.01). Whereas CAC prevalence was lower in women than men, mean (SD), F2-isoprostanes were higher in women {190 (108.9) pmol/L [67.4 (38.6) ng/L]} than in men {140.4 (55.6) pmol/L [49.8 (19.7) ng/L]}. Nevertheless, F2-isoprostanes were associated with an increased risk of CAC in both sexes. Conclusion: This association between increased concentrations of circulating F2-isoprostanes and CAC in young healthy adults supports the hypothesis that oxidative damage is involved in the early development of atherosclerosis.

P3645Prognosis in relation to high-sensitivity C-reactive protein levels in patients with non-obstructive coronary artery disease

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
H W Zhang ◽  
Y X Cao ◽  
J L Jin ◽  
Y L Guo ◽  
Y Gao ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Obstructive Coronary Artery Disease ◽  
High Sensitivity ◽  
C Reactive Protein ◽  
Development Fund ◽  
Reactive Protein ◽  
Increased Risk ◽  
Hs Crp ◽  
Artery Disease

Abstract Background It has been reported that coronary artery disease (CAD) is characterized by inflammation and non-obstructive CAD (NOCAD) increases the risk of cardiovascular events (CVEs) compared with ones with normal or near-normal coronary arteries (NNCA), even is similar to obstructive CAD (OCAD). We hypothesized that elevated high-sensitivity C-reactive protein (hs-CRP) may be linked to CVEs in those patients with NOCAD. Purpose To investigate the predictive role of hs-CRP in patients with NOCAD. Methods Of 7,746 consecutive patients with angina-like chest pain admissions, 4,662 eligible patients were enrolled who received coronary artery angiography (CAG) and followed up for the CVEs comprising all-cause mortality, myocardial infarction, stroke and late revascularization. According to the results of CAG, the patients were classified as NNCA group (<20% stenosis, n=698, 15.0%), NOCAD group (20–49% stenosis, n=639, 14.3%), and OCAD group (≥50% stenosis, n=3325, 70.7%). They were further subdivided into 3 groups according to baseline hs-CRP levels (<1, 1–3 and >3 mg/L). Proportional hazards models were used to assess the risk of CVEs in all patients enrolled. Results A total of 338 patients (7.3%) experienced CVEs during an average of 13403 person-years follow-up. Patients with NOCAD and OCAD had higher rates of CVEs compared to those with NNCA (p<0.05, respectively). In Cox's models after adjustment of confounders, the risk of CVEs elevated with the increasing degrees of CAD with hazard ratio of 2.01 [95% confidence interval (95% CI): 1.07–3.79, p=0.03] for patients with NOCAD and 2.81 (95% CI: 1.60–4.93, p<0.001) for patients with OCAD compared with the NNCA group. Moreover, elevated hs-CRP levels were associated with the severity of coronary lesions and an elevated increased risk of CVEs in patients with NOCAD and OCAD compared those with NNCA (p<0.05, respectively). Conclusions Patients with NOCAD had indeed worse outcomes and hs-CRP levels were positively in relation to the CVEs in those with NOCAD, which may help to the risk assessment in ones with NOCAD. Acknowledgement/Funding This study was partly supported by Capital Health Development Fund (201614035) and CAMS Innovation Fund for Medical Sciences (2016-I2M-1-011) awarded

scholarly journals Childhood interleukin-6, C-reactive protein and atopic disorders as risk factors for hypomanic symptoms in young adulthood: a longitudinal birth cohort study

2016 ◽  
Vol 47 (1) ◽  
pp. 23-33 ◽  
Author(s):  
J. F. Hayes ◽  
G. M. Khandaker ◽  
J. Anderson ◽  
D. Mackay ◽  
S. Zammit ◽  
...  
Keyword(s):  
Birth Cohort ◽  
Young Adulthood ◽  
Interleukin 6 ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Inflammatory Marker ◽  
Birth Cohort Study ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Increased Risk

BackgroundThere are no existing longitudinal studies of inflammatory markers and atopic disorders in childhood and risk of hypomanic symptoms in adulthood. This study examined if childhood: (1) serum interleukin-6 (IL-6) and C-reactive protein (CRP); and (2) asthma and/or eczema are associated with features of hypomania in young adulthood.MethodParticipants in the Avon Longitudinal Study of Parents and Children, a prospective general population UK birth cohort, had non-fasting blood samples for IL-6 and CRP measurement at the age of 9 years (n = 4645), and parents answered a question about doctor-diagnosed atopic illness before the age of 10 years (n = 7809). These participants completed the Hypomania Checklist at age 22 years (n = 3361).ResultsAfter adjusting for age, sex, ethnicity, socio-economic status, past psychological and behavioural problems, body mass index and maternal postnatal depression, participants in the top third of IL-6 values at 9 years, compared with the bottom third, had an increased risk of hypomanic symptoms by age 22 years [adjusted odds ratio 1.77, 95% confidence interval (CI) 1.10–2.85, p < 0.001]. Higher IL-6 levels in childhood were associated with adult hypomania features in a dose–response fashion. After further adjustment for depression at the age of 18 years this association remained (adjusted odds ratio 1.70, 95% CI 1.03–2.81, p = 0.038). There was no evidence of an association of hypomanic symptoms with CRP levels, asthma or eczema in childhood.ConclusionsHigher levels of systemic inflammatory marker IL-6 in childhood were associated with hypomanic symptoms in young adulthood, suggesting that inflammation may play a role in the pathophysiology of mania. Inflammatory pathways may be suitable targets for the prevention and intervention for bipolar disorder.

scholarly journals Residual Cardiovascular Risk at Low LDL: Remnants, Lipoprotein(a), and Inflammation

2020 ◽  
Author(s):  
Ron C Hoogeveen ◽  
Christie M Ballantyne
Keyword(s):  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Residual Risk ◽  
Atherosclerotic Cardiovascular Disease ◽  
C Reactive Protein ◽  
Residual Cardiovascular Risk ◽  
Lipoprotein A ◽  
Reactive Protein ◽  
Increased Risk ◽  
Ascvd Risk

Abstract Background Current guidelines target low-density lipoprotein cholesterol (LDL-C) concentrations to reduce atherosclerotic cardiovascular disease (ASCVD) risk, and yet clinical trials demonstrate persistent residual ASCVD risk despite aggressive LDL-C lowering. Content Non–LDL-C lipid parameters, most notably triglycerides, triglyceride-rich lipoproteins (TGRLs), and lipoprotein(a), and C-reactive protein as a measure of inflammation are increasingly recognized as associated with residual risk after LDL-C lowering. Eicosapentaenoic acid in statin-treated patients with high triglycerides reduced both triglycerides and ASCVD events. Reducing TGRLs is believed to have beneficial effects on inflammation and atherosclerosis. High lipoprotein(a) concentrations increase ASCVD risk even in individuals with LDL-C &lt; 70 mg/dL. Although statins do not generally lower lipoprotein(a), proprotein convertase subtilisin/kexin type 9 inhibitors reduce lipoprotein(a) and cardiovascular outcomes, and newer approaches are in development. Persistent increases in C-reactive protein after intensive lipid therapy have been consistently associated with increased risk for ASCVD events. Summary We review the evidence that biochemical assays to measure TGRLs, lipoprotein(a), and C-reactive protein are associated with residual risk in patients treated to low concentrations of LDL-C. Growing evidence supports a causal role for TGRLs, lipoprotein(a), and inflammation in ASCVD; novel therapies that target TGRLs, lipoprotein(a), and inflammation are in development to reduce residual ASCVD risk.

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