scholarly journals Metabolic Biomarker Discovery for Risk of Peripheral Artery Disease Compared With Coronary Artery Disease: Lipoprotein and Metabolite Profiling of 31 657 Individuals From 5 Prospective Cohorts

2021 ◽  
Author(s):  
Emmi Tikkanen ◽  
Vilma Jägerroos ◽  
Michael V. Holmes ◽  
Naveed Sattar ◽  
Mika Ala‐Korpela ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Fatty Acids ◽  
Coronary Artery ◽  
Apolipoprotein B ◽  
Density Lipoprotein ◽  
Peripheral Artery ◽  
Prospective Cohorts ◽  
Artery Disease ◽  
Metabolic Biomarkers

Background Peripheral artery disease (PAD) and coronary artery disease (CAD) represent atherosclerosis in different vascular beds. We used detailed metabolic biomarker profiling to identify common and discordant biomarkers and clarify pathophysiological differences for these vascular diseases. Methods and Results We used 5 prospective cohorts from Finnish population (FINRISK 1997, 2002, 2007, and 2012, and Health 2000; n=31 657; median follow‐up time of 14 years) to estimate associations between >200 metabolic biomarkers and incident PAD and CAD. Metabolic biomarkers were measured with nuclear magnetic resonance, and disease events were obtained from nationwide hospital records. During the follow‐up, 498 incident PAD and 2073 incident CAD events occurred. In age‐ and sex‐adjusted Cox models, apolipoproteins and cholesterol measures were robustly associated with incident CAD (eg, hazard ratio [HR] per SD for higher apolipoprotein B/A‐1 ratio, 1.30; 95% CI, 1.25–1.36), but not with incident PAD (HR per SD for higher apolipoprotein B/A‐1 ratio, 1.04; 95% CI, 0.95–1.14; P heterogeneity <0.001). In contrast, triglyceride levels in low‐density lipoprotein and high‐density lipoprotein were associated with both end points ( P heterogeneity >0.05). Lower proportion of polyunsaturated fatty acids relative to total fatty acids, and higher concentrations of monounsaturated fatty acids, glycolysis‐related metabolites, and inflammatory protein markers were strongly associated with incident PAD, and many of these associations were stronger for PAD than for CAD ( P heterogeneity <0.001). Most differences in metabolic profiles for PAD and CAD remained when adjusting for traditional risk factors. Conclusions The metabolic biomarker profile for future PAD risk is distinct from that of CAD. This may represent pathophysiological differences.

Coronary artery disease risk predicted by plasma concentrations of high-density lipoprotein cholesterol, apolipoprotein AI, apolipoprotein B, and lipoprotein(a) in a general Chinese population

1993 ◽  
Vol 39 (2) ◽  
pp. 209-212 ◽  
Author(s):  
J H Wu ◽  
J T Kao ◽  
M S Wen ◽  
D Wu
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
High Density Lipoprotein ◽  
High Density Lipoprotein Cholesterol ◽  
Apolipoprotein B ◽  
Density Lipoprotein ◽  
Control Group ◽  
Apolipoprotein Ai ◽  
Artery Disease

Abstract We measured lipid and lipoprotein concentrations in blood samples from control subjects and patients with coronary artery disease (CAD) in Taiwan. We found significant differences (P &lt; 0.01) in the concentrations of high-density lipoprotein cholesterol (HDLC), apolipoprotein AI (ApoAI), apolipoprotein B (ApoB), and lipoprotein(a) [Lp(a)]. Concentrations of HDLC &lt; 350 mg/L, ApoAI &lt; 900 mg/L, ApoB &gt; 800 mg/L, and Lp(a) &gt; 200 mg/L occurred, respectively, 2.8, 5.2, 1.7, and 2.3 times more frequently in the patients than in the control group. If one considers HDLC at &lt; 350 mg/L, ApoAI at &lt; 900 mg/L, ApoB at &gt; 800 mg/L, and Lp(a) at &gt; 200 mg/L as separate risk factors for CAD, the ratio of individual patients to control subjects having 4, 3, 2, 1, or 0 risk factors was [symbol: see text] 9.4, 2.1, 0.2, 0.2, respectively. Individuals displaying three or more risk factors were found 15 times more frequently in the CAD group than in the control group. These risk factors may be used clinically for the prediction and prevention of CAD in the general population.

Complexity of lower extremity peripheral artery disease reflects the complexity of coronary artery disease

Vascular ◽  
2014 ◽  
Vol 23 (4) ◽  
pp. 366-373 ◽  
Author(s):  
Ahmet Çağrı Aykan ◽  
Engin Hatem ◽  
Can Yücel Karabay ◽  
İlker Gül ◽  
Tayyar Gökdeniz ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Peripheral Artery Disease ◽  
Low Density Lipoprotein ◽  
Computer Software ◽  
Density Lipoprotein ◽  
Multivariate Regression Analysis ◽  
Syntax Score ◽  
Peripheral Artery ◽  
Artery Disease

We investigated the relationship between peripheral artery disease complexity and coronary artery disease complexity in patients with peripheral artery disease. A total of 449 patients were enrolled. SYNTAX score, a marker of coronary artery disease complexity, was assessed by dedicated computer software and complexity of peripheral artery disease was determined by Trans Atlantic Inter-Society Consensus II classification. The SYNTAX score of patients with minimal peripheral artery disease, Trans Atlantic Inter-Society Consensus A, Trans Atlantic Inter-Society Consensus B, Trans Atlantic Inter-Society Consensus C and Trans Atlantic Inter-Society Consensus D were 5 (11), 12.5 (13.25), 20 (14), 20.5 (19) and 27.5 (19), respectively (values in brackets represent the interquartile range). SYNTAX score and Trans Atlantic Inter-Society Consensus class was moderately correlated (r = 0.495, p < 0.001). In multivariate regression analysis male sex (B = 0.169, p < 0.001, CI95% = 0.270–0.735), Log10 SYNTAX score (B = 0.282, p < 0.001, CI95% = 0.431–0.782), Log10 creatinine (B = 0.081, p = 0.036, CI95% = 0.043–1.239), low-density lipoprotein (B = 0.114, p = 0.003, CI95% = 0.001–0.006) and high-density lipoprotein (B = −0.360, p < 0.001, CI95% = −0.063 to −0.041) were the independent predictors of Trans Atlantic Inter-Society Consensus II class. We have shown that patients with complex peripheral artery disease had complex coronary artery disease.

scholarly journals The Clinical Outcomes Based on the Achievement of Low-Density Lipoprotein Cholesterol Targets after ST Elevation Myocardial Infarction

2019 ◽  
Vol 9 (1) ◽  
pp. 79
Author(s):  
Wei-Chieh Lee ◽  
Chih-Yuan Fang ◽  
Chien-Jen Chen ◽  
Cheng-Hsu Yang ◽  
Chiung-Jen Wu ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Left Main Coronary Artery ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Left Main ◽  
Main Coronary Artery Disease ◽  
Group 2 ◽  
Artery Disease

The clinical outcome of patients with ST elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI), with or without achievement of low-density lipoprotein cholesterol (LDL-C) targets, has rarely been investigated. This study was performed to investigate the comparison of clinical outcome in STEMI patients with or without achievement LDL-C targets (below 70 mg/dL and/or ≥50% reduction). Between November 2013 and December 2016, 689 STEMI patients underwent primary PCI in our hospital. Patients who were deceased, lost to follow-up, had no follow-up lipid profile, or had no side effects after statin use were excluded. A total of 343 patients were classified into group 1 (with LDL-C target achievement) and 172 patients were classified into group 2 (without LDL-C target achievement). Between the two groups, a higher prevalence of left main coronary artery disease, smaller pre-PCI stenosis, and a larger pre-PCI minimal luminal diameter were noted in group 2. The incidence of post-MI angina (8.7% vs. 6.4%; p = 0.393), target vessel revascularization (2.3% vs. 3.5%; p = 0.566), and recurrent MI (1.5% vs. 1.2%; p = 1.000), showed similar results between the two groups during a one-year follow-up period. Initial LDL-C levels ≥130 mg/dL, left main coronary artery disease, and absence of diabetes mellitus were positively associated with non-achievement of LDL-C targets. After STEMI, 66.6% of patients could achieve LDL-C targets one year later. However, such patients did not show better clinical outcomes. Non-DM, initial LDL-C levels ≥130 mg/dL, and left main coronary artery disease were related to non-achievement of LDL-C targets.

Is it possible to predict the complexity of peripheral artery disease with atherogenic index?

Vascular ◽  
2020 ◽  
Vol 28 (5) ◽  
pp. 513-519
Author(s):  
Engin Mesut ◽  
Aydın Cihan ◽  
Guvenc Orhan
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Peripheral Artery Disease ◽  
Multivariate Logistic Regression Analysis ◽  
Density Lipoprotein ◽  
Atherogenic Index ◽  
Peripheral Artery ◽  
Group 2 ◽  
Artery Disease ◽  
Group 1

Objectives Lower extremity peripheral artery disease develops mainly due to atherosclerosis and occurs as a result of the systemic atherosclerotic process. Increased triglyceride (TG) and decreased high density lipoprotein cholesterol (HDL-C) values increase atherosclerosis risk. With regard to this information, TG/HDL-C ratio is used as the atherogenic index. The aim of the present study was to evaluate the role of TG/HDL-C ratio to predict the complexity of disease in patients with peripheral artery disease. Methods Patients who were diagnosed with peripheral artery disease and admitted to our clinic between August 2013 and August 2019 were included in this study retrospectively. Patients were divided into two groups based on angiographic evaluations with TransAtlantic Inter-Society Consensus-II classification. Those with TASC A-B lesions were included in Group 1 and those with TASC C-D lesions constituted Group 2. Results The mean ages of Group 1 ( n = 314) and Group 2 ( n = 98) patients were 56.1 ± 9.3 and 58.4.1 ± 8.1 years, respectively. The frequency of male gender and coronary artery disease was significantly higher in Group 2 ( p = 0.043, p = 0.001, respectively). In Group 2, triglyceride and TG/HDL-C ratios were significantly high, while HDL-C was significantly low ( p = 0.022, p < 0.001, p = 0.010, respectively). The multivariate logistic regression analysis performed to evaluate the parameters in predicting the angiographic complexity of peripheral artery disease showed that coronary artery disease (OR: 1.009 CI 95%: 1.003–1.021 p = 0.016) and TG/HDL-C ratio (OR: 5.385 CI 95%: 2.553–9.357 p = 0.001) were independent predictors for complexity. ROC analysis revealed that the cut-off value of TG/HDL-C was 2.9 (AUC = 0.670, p < 0.001) with 75.5% sensitivity and 56.7% specificity. Conclusions It is possible to predict the angiographic complexity of peripheral artery disease with TG/HDL-C ratio, also known as atherogenic index, which is easily obtained by routine biochemical parameters.

scholarly journals Metabolic biomarkers for peripheral artery disease compared with coronary artery disease: Lipoprotein and metabolite profiling of 31,657 individuals from five prospective cohorts

2020 ◽  
Author(s):  
Emmi Tikkanen ◽  
Vilma Jägerroos ◽  
Rodosthenis Rodosthenous ◽  
Michael Holmes ◽  
Naveed Sattar ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Peripheral Artery Disease ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Vascular Diseases ◽  
Peripheral Artery ◽  
Ldl Particles ◽  
Increased Risk ◽  
Artery Disease

Background: Peripheral artery disease (PAD) and coronary artery disease (CAD) represent atherosclerosis in different vascular beds. We conducted detailed metabolic profiling to identify biomarkers for the risk of developing PAD and compared with risk of CAD to explore common and unique risk factors for these different vascular diseases. Methods: We measured blood biomarkers using nuclear magnetic resonance metabolomics in five Finnish prospective general-population cohorts (FINRISK 1997, 2002, 2007, 2012, and Health 2000 studies, n = 31,657). We used Cox modelling to estimate associations between biomarkers and incident symptomatic PAD and CAD (498 and 2073 events, respectively) during median follow-up time of 14 years. Results: The pattern of biomarker associations for incident PAD deviated from that for CAD. Apolipoproteins and cholesterol measures were robustly associated with incident CAD (for example, age- and sex-adjusted hazard ratio per SD for higher apolipoprotein B/A 1 ratio: 1.30; 95% confidence interval 1.25-1.36), but not with incident PAD (1.04; 0.95-1.14; Pheterogeneity < 0.001). Low-density lipoprotein (LDL) particle concentrations were also associated with incident CAD (e.g. small LDL particles: 1.24; 1.19-1.29) but not with PAD (1.07; 0.98-1.17; Pheterogeneity < 0.001). In contrast, more consistent associations of smaller LDL particle size and higher triglyceride levels in LDL and HDL particles with increased risk for both CAD and PAD events were seen (Pheterogeneity > 0.05). Many non-traditional biomarkers, including fatty acids, amino acids, inflammation- and glycolysis-related metabolites were associated with future PAD events. Lower levels of linoleic acid, an omega-6 fatty acid, and higher concentrations of glucose, lactate, pyruvate, glycerol and glycoprotein acetyls were more strongly associated with incident PAD as compared to CAD (Pheterogeneity < 0.001). The differences in metabolic biomarker associations for PAD and CAD remained when adjusting for body mass index, smoking, prevalent diabetes, and medications. Conclusions: The metabolic biomarker profile for future PAD risk is largely distinct from that of CAD. This may represent pathophysiological differences and may facilitate risk prediction.

Abstract 15530: Omega-3 Fatty acids Supplementation Attenuates the Progression of Microalbuminuria in Diabetics With Coronary Artery Disease

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Dharshan K Lakshminarayan ◽  
Tarec K Elajami ◽  
Michael Soliman ◽  
Abdulhamied Alfaddagh ◽  
Francine K Welty
Keyword(s):  
Coronary Artery Disease ◽  
Fatty Acids ◽  
Coronary Artery ◽  
Diabetic Patients ◽  
Omega 3 Fatty Acids ◽  
Omega 3 ◽  
Artery Disease ◽  
Stable Cad ◽  
One Year

Introduction: Microalbuminuria is a marker of generalized endothelial dysfunction, a key step in the pathogenesis of coronary artery disease (CAD). It is also an independent predictor of cardiovascular morbidity and mortality. Angiotensin converting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB) therapy is considered a standard of care to attenuate progression of albuminuria in diabetic patients. Hypothesis: Omega-3 fatty acids (FAs) supplementation will attenuate progression of microalbuminuria in diabetic subjects with stable CAD. Method: In our study, 262 subjects with stable CAD were randomized to 3.6 g of omega-3 FAs (1.86 g of eicosapentaenoic acid + 1.5 g of docosahexaenoic acid) per day or no omega-3 FA (control) for one year. Urine microalbumin to creatinine ratio (urine MCR mg/g) was calculated as a measure of microalbuminuria at baseline and one year follow-up. Results: Mean age was 63.3 ± 7.6 yrs, 17% were women, 30% had diabetes, and 74% were on ACEI or ARB therapy. At one year follow-up in non-diabetics, there was no significant difference in the % change in urine MCR between the omega-3 FAs and control groups (see table). In contrast in diabetics, those not receiving omega-3 FAs had a significant 72.3% increase in urine MCR whereas those receiving omega-3 FAs had no change (table). In subgroup analysis, diabetics on an ACEI or ARB receiving omega-3 FAs had no change in urine MCR whereas those not receiving omega-3 FAs had a 64.2% increase at one year follow-up. Conclusions: Omega-3 FAs attenuated worsening of urine MCR in diabetics with CAD compared to diabetics not receiving omega-3 FAs over a one year period. Our results suggest that a combination of omega-3 FAs and ACEI or ARB is better in attenuating the progression of microalbuminuria than ACEI or ARB alone in diabetics with CAD. This suggests that omega-3 FAs may provide additional benefit when added to ACEI/ARB in diabetics with CAD.

Monoclonal antibodies can precipitate low-density lipoprotein. II. Radioimmunoassays with single and combined monoclonal antibodies for determining apolipoprotein B in serum of patients with coronary artery disease.

1985 ◽  
Vol 31 (10) ◽  
pp. 1659-1663 ◽  
Author(s):  
S Marcovina ◽  
B A Kottke ◽  
S J Mao
Keyword(s):  
Coronary Artery Disease ◽  
Monoclonal Antibody ◽  
Monoclonal Antibodies ◽  
Coronary Artery ◽  
Apolipoprotein B ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Low Density ◽  
Apo B ◽  
Artery Disease

Abstract We have established four lines of monoclonal antibodies against human low-density lipoproteins (LDL) that, mixed in equal proportions, can precipitate LDL in gel and so can be used for apolipoprotein (apo) B determination in plasma. One monoclonal antibody (clone A), with a relatively low binding affinity to LDL (ka = 0.6 X 10(9) L/mol) and recognizing only two species of apo B, significantly underestimated the concentration of apo B in 74 patients with and 27 without coronary artery disease (CAD). High-affinity monoclonal antibody C (Ka = 3.8 X 10(9) L/mol), which recognized all four apo B species, gave the same value for apo B as determined with the mixture of monoclonal antibodies. The latter results (by radioimmunoassay, y) correlated well with those by radial immunodiffusion (chi): y = 0.994 chi + 0.003 (r = 0.987). The CAD patients showed an increased concentration of apo B as compared to the angiographically documented CAD-negative patients. Except for the values determined by clone B (p = 0.07), the increase was statistically significant (p = 0.002-0.018) for values determined by use of the other clones or their mixture.

scholarly journals The LDL-C/HDL-C ratio and 4-year risk of coronary artery disease: a retrospective study

2020 ◽  
Author(s):  
shaohui zhang ◽  
Yongliang Zhao ◽  
Xiangting Li ◽  
Wen Dai ◽  
Xueying Chen ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Independent Predictor ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Syntax Score ◽  
Artery Disease

Abstract BackgroundNumerous studies have demonstrated that the low-density lipoprotein cholesterol/high-density lipoprotein cholesterol (LDL-C/HDL-C) ratio can reflect the positive correlation index LDL-C and the negative index HDL-C of coronary artery disease (CAD) at the same time, which is increasingly considered as a novel marker to evaluate the risk of CAD. However, whether the short-term evaluation effect of the LDL-C/HDL-C ratio can be maintained during long-term follow-up is unclear. In addition, it is not clear whether the value of LDL-C/HDL-C ratio in the risk assessment of major adverse cardiac events (MACE) varies with different treatments. Our aim of the study was to investigate the link between LDL-C/HDL-C ratio and long-term risk of CAD and find out whether the LDL-C/HDL-C ratio could effectively evaluate the occurrence of MACE in CAD patients under different treatments. MethodsFrom May 2013 to November 2015, a total of 2409 patients who underwent coronary angiography (CAG) with or without revascularization therapy were enrolled in this study. They were divided into two groups based on the LDL-C/HDL-C ratio and three groups based on the treatments: medical therapy alone (MTA), percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG).ResultsIn total, 1784 patients (74.1%) were followed for health outcome and 625 patients (25.9%) experienced a MACE event. The median follow-up time was 4.27 years (1560 days). The patients with a higher LDL-C/HDL-C ratio (≥ 2.33) also had a significantly higher incidence of MACE (HR: 1.47, 95% CI: 1.25 to 1.72, p < 0.001). The cumulative incidence of rehospitalization for UA (HR: 1.53, 95% CI: 1.27 to 1.84, p < 0.001) and rehospitalization for HF (HR: 3.70, 95% CI: 1.22 to 22.25, p = 0.021) were significantly higher in high group than in low group. There were no significant differences in MI (HR: 1.25, 95% CI: 0.63 to 2.48, P = 0.521), TLR (HR: 0.98, 95% CI: 0.62 to 1.55, p = 0.947), Stroke (HR: 1.65, 95% CI: 0.64 to 4.25, p = 0.301) and 4-year all-cause death (HR: 1.45, 95% CI: 0.58 to 3.61, p = 0.423). Kaplan-Meier cumulative curve showed that patients with higher LDL-C/HDL-C ratio had a significantly lower MACE-free survival (p < 0.001). Multivariate Cox regression analysis demonstrated that LDL-C/HDL-C ratio (HR: 1.34, 95% CI: 1.14 to 1.60, p < 0.001) together with age, smoking, hypertension, diabetes mellitus, Syntax score and TG were independent predictors of 4-year MACE in the total CAD population (all p < 0.05). Further subgroup analysis showed that age, smoking, Syntax score, TG and LDL-C/HDL-C ratio were the independent predictors of MACE in MAT group (all p < 0.05); However, Syntax score and diabetes mellitus were the only independent predictor of MACE in PCI group and the CABG group, respectively (both p < 0.05). ConclusionsIn this study, we found that LDL-C/HDL-C ratio was an independent predictor of 4-year MACE in the total CAD population. The value of LDL-C/HDL-C ratio in assessing MACE risk varied among CAD patients with different treatments.

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