Coronary artery atherosclerosis in patients with the initial and the early stage of chronic renal failure

AbstractThe recent clinical data indicate that the initial and the early stages of chronic renal failure (CRF) may lead to increased incidence of cardiovascular complications and increased extent of coronary artery disease (CAD). This retrospective study was aimed to determine the effects of coexisting diabetes mellitus type 2 (DM-2) and the extent of atherosclerosis in coronary vessels in patients with mildly reduced kidney function (glomerular filtration rate GFR = 89–60 ml/min) and moderately reduced kidney function (GFR = 59–30 ml/min). The study patients included 53 subjects with creatinine concentration above 120 μmol/l as a cut-off level for the initial stage and compensated CRF. The distributions of coronary artery stenosis were also analysed with respect to DM-2 coexistence and levels of haemoglobin glikolised (HbA1c). The odds ratio of pathological changes in coronary arteries in patients with GFR = 44–30 ml/min, with respect to the number of affected vessels — only one, more than one or more than two — were 7.22, 4.90 and 3.55, respectively. In CRF patients with GFR = 60–89 ml/min the odds ratio of one, more than one and more than two vessels with stenosis and CAD was 1.93, 1.70 and 1.53, respectively. DM-2 was not related to the risk of significant coronary artery stenosis and did not enhance the pre-existing changes in the study setting. Our results demonstrate that the initial and the early stages of CRF were significant risk factors for coronary stenoses and for enhancing the pre-existing changes.

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Apolipoprotein B Immunochemical Heterogeneity in Dialysed Patients with Chronic Renal Failure and Patients with Coronary Artery Stenosis

American Journal of Nephrology ◽

10.1159/000167948 ◽

1989 ◽

Vol 9 (2) ◽

pp. 110-114 ◽

Cited By ~ 5

Author(s):

Richard Reade ◽

Venance Equagoo ◽

Claude Cachera ◽

Patrick Duriez ◽

Michel Dracon ◽

...

Keyword(s):

Renal Failure ◽

Coronary Artery ◽

Chronic Renal Failure ◽

Apolipoprotein B ◽

Coronary Artery Stenosis ◽

Artery Stenosis

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Relationship between Whole Blood Viscosity and Lesion Severity in Coronary Artery Disease

International Journal of Angiology ◽

10.1055/s-0040-1720968 ◽

2021 ◽

Author(s):

Gökhan Ceyhun ◽

Oğuzhan Birdal

Keyword(s):

Coronary Artery ◽

Shear Rate ◽

Confidence Interval ◽

Odds Ratio ◽

Coronary Artery Stenosis ◽

Artery Stenosis ◽

Significant Stenosis ◽

Whole Blood Viscosity ◽

Significant Coronary Artery Stenosis ◽

Coronary Syndrome

Abstract Objective This article investigates the relationship of fractional flow reserve (FFR) with whole blood viscosity (WBV) in patients who were diagnosed with chronic coronary syndrome and significant stenosis in the major coronary arteries and underwent the measurement of FFR. Material and Method In the FFR measurements performed to evaluate the severity of coronary artery stenosis, 160 patients were included in the study and divided into two groups as follows: 80 with significant stenosis and 80 with nonsignificant stenosis. WBVs at low shear rate (LSR) and high shear rate (HSR) were compared between the patients in the significant and nonsignificant coronary artery stenosis groups. Results In the group with FFR < 0.80 and significant coronary artery stenosis, WBV was significantly higher compared with the group with nonsignificant coronary artery stenosis in terms of both HSR (19.33 ± 0.84) and LSR (81.19 ± 14.20) (p < 0.001). In the multivariate logistic regression analysis, HSR and LSR were independent predictors of significant coronary artery stenosis (HSR: odds ratio: 1.67, 95% confidence interval: 1.17–2.64; LSR: odds ratio: 2.46, 95% confidence interval: 2.19–2.78). In the receiver operating characteristic (ROC) curve analysis, when the cutoff value of WBV at LSR was taken as 79.23, it had 58.42% sensitivity and 62.13% specificity for the prediction of significant coronary artery stenosis (area under the ROC curve: 0.628, p < 0.001). Conclusion WBV, an inexpensive biomarker that can be easily calculated prior to coronary angiography, was higher in patients with functionally severe coronary artery stenosis, and thus could be a useful marker in predicting the hemodynamic severity of coronary artery stenosis in patients with chronic coronary syndrome.

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Hyperhomocysteinemia Measured by Immunoassay: A Valid Measure of Coronary Artery Atherosclerosis

Archives of Pathology & Laboratory Medicine ◽

10.5858/2004-128-1263-hmbiav ◽

2004 ◽

Vol 128 (11) ◽

pp. 1263-1266

Author(s):

Michele T. Stauffenberg ◽

Richard A. Lange ◽

L. David Hillis ◽

Joaquin Cigarroa ◽

Rebecca M. Hsu ◽

...

Keyword(s):

Cardiovascular Disease ◽

Coronary Artery ◽

Coronary Angiography ◽

High Performance ◽

Coronary Artery Stenosis ◽

Artery Stenosis ◽

Valid Measure ◽

Atherosclerotic Burden ◽

Coronary Artery Atherosclerosis ◽

Folate And Vitamin B12

Abstract Context.—Homocysteine is emerging as a novel marker of atherothrombosis. Its role as an independent risk factor for cardiovascular disease is generally accepted. There is scanty data correlating homocysteine levels measured by immunoassay with cardiovascular disease. We previously validated a fluorescence polarization immunoassay for measuring homocysteine, which compared favorably with high performance liquid chromatography. Objective.—To determine if homocysteine levels measured by immunoassay correlate with extent of atherosclerotic burden, as represented by degree of coronary artery stenosis determined by coronary angiography. Design.—Fasting plasma samples were obtained from patients undergoing coronary angiography (N = 165). Homocysteine levels were measured by immunoassay and coronary artery stenosis was determined by coronary angiography. Results.—Median coronary artery stenosis for the 3 homocysteine subgroups, less than 1.35, 1.35 to 6.75, and greater than 6.75 mg/L (<10, 10–15, and >15 μmol/L), was 75%, 90%, and 99%, respectively (P = .01 for trend). Also, folate and vitamin B12 levels decreased with increasing homocysteine levels (P = .01 and .04, respectively, for trend). Spearman's correlation showed a significant association between homocysteine level and coronary artery stenosis (r = 0.20; P = .009). When men and women were examined separately, the correlation was significant only for women (r = 0.30; P = .01). Conclusion.—Homocysteine levels, as measured by immunoassay, show a positive correlation with cardiovascular disease in women. Thus, this is a valid measure of atherosclerotic burden and, therefore, a reliable addition to the established laboratory repertoire for the assessment of cardiovascular disease.

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Circulating ANGPTL3 and ANGPTL4 levels predict coronary artery atherosclerosis severity

Lipids in Health and Disease ◽

10.1186/s12944-021-01580-z ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Ting Sun ◽

Wanlin Zhan ◽

Lijiang Wei ◽

Zuojun Xu ◽

Li Fan ◽

...

Keyword(s):

Coronary Artery ◽

Coronary Atherosclerosis ◽

Coronary Artery Stenosis ◽

Plasma Concentrations ◽

Artery Stenosis ◽

Coronary Artery Atherosclerosis ◽

Vascular Stenosis ◽

Independent Risk Factors ◽

Atherosclerosis Development ◽

Diagnostic Coronary Angiography

Abstract Background We investigated the role of ANGPTL3 and ANGPTL4 in atherosclerosis development and determined whether plasma concentrations of ANGPTL3 and ANGPTL4 are related to the degree of coronary stenosis. Methods A total of 305 consecutive patients with angina who underwent diagnostic coronary angiography were enrolled in the study between August 2017 and August 2018. The levels of ANGPTL3 and ANGPTL4 were measured by using competitive ELISA kits. Results According to the degree of coronary artery stenosis, patients were classified into four types: coronary artery stenosis of < 10%, 10-50%, 50-75, and > 75%. The plasma ANGPTL3 level was higher (51.71 ± 52.67 vs. 24.65 ± 10.32 ng/mL, P < 0.001) and that of ANGPTL4 was lower (454.66 ± 269.05 vs. 875.49 ± 961.15 ng/mL, P < 0.001) in the coronary artery stenosis ≥ 10% group than in the < 10% group. ANGPTL3 and ANGPTL4 levels were significantly associated with the severity of coronary vascular stenosis. ROC curve analyses indicated that ANGPTL3 concentrations above 30.5 ng/mL can predict atherosclerosis with a sensitivity of 71.2% and specificity of 75.3%, and that ANGPTL4 levels below 497.5 ng/mL can predict atherosclerosis with a sensitivity of 63.9% and specificity of 74.5%. ANGPTL3 and ANGPTL4 were determined to be independent risk factors for coronary atherosclerosis with odds ratios (ORs) of 0.189 (95% CI 0.097-0.368, P < 0.001) and 3.625 (95% CI 1.873-7.016, P < 0.001), respectively. Conclusions Increased ANGPTL3 or decreased ANGPTL4 shows an association with coronary atherosclerosis and, may become a predictor of coronary atherosclerosis in the future.

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Carotid intima-media thickness, 25-OH vitamin D, homocysteine and subclinical coronary artery atherosclerosis in patients with type 1 diabetes mellitus

Archives of Biological Sciences ◽

10.2298/abs190706048m ◽

2019 ◽

Vol 71 (4) ◽

pp. 655-663

Author(s):

Gordana Milic ◽

Jasna Gacic ◽

Ana Mladenovic-Markovic ◽

Ivan Soldatovic ◽

Dragan Matic ◽

...

Keyword(s):

Vitamin D ◽

Type 1 Diabetes ◽

Coronary Artery ◽

Coronary Atherosclerosis ◽

Coronary Artery Stenosis ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Artery Stenosis ◽

Coronary Artery Atherosclerosis

Individuals with type 1 diabetes have an increased risk of premature atherosclerosis. The aim of this study was to evaluate the possible predictive significance of elevated plasma total homocysteine (tHcy), lower serum 25-hydroxy vitamin D (25(OH)D) concentrations and increased carotid intima-media thickness (CIMT) for the development of coronary atherosclerosis in patients with type 1 diabetes mellitus (T1D) and no previous history of ischemic heart disease. The study included 73 patients previously diagnosed with T1D. The patients were divided into groups with and without non-obstructive moderate coronary artery stenosis. Coronary artery stenosis was examined using coronary multidetector computed tomographic angiography (MDCTA); CIMT was measured by B-mode ultrasound. The patients with moderate stenosis had significantly higher HbA1c (p<0.001), elevated tHcy (p<0.001), increased CIMTmax. (p<0.001) but lower 25(OH)D (p<0.001) in comparison to patients without detectable coronary atherosclerosis. Homocysteine (AUCHcy=0.955; p<0.001), vitamin D (AUCvit D=0.792; p<0.001) and CIMT max (AUCCIMT=0.743; p<0.001) (AUC or area under the curve) appear to be adequate markers for detecting stenosis of coronary arteries using receiver operating characteristic (ROC) curve analysis. Multivariate logistic regression analysis showed that serum homocysteine was the only significant predictor of moderate coronary artery stenosis. Our study implies that tHcy can be used as a reliable predictor of coronary artery atherosclerosis in patients with T1D. 25(OH)D and CIMT can also be used, but with lower diagnostic accuracy.

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Discovery of plasma biomarkers for predicting the severity of coronary artery atherosclerosis by quantitative proteomics

BMJ Open Diabetes Research & Care ◽

10.1136/bmjdrc-2019-001152 ◽

2020 ◽

Vol 8 (1) ◽

pp. e001152 ◽

Cited By ~ 1

Author(s):

Eu Jeong Ku ◽

Kyung-Cho Cho ◽

Cheong Lim ◽

Jeong Won Kang ◽

Jae Won Oh ◽

...

Keyword(s):

Coronary Artery ◽

Coronary Artery Stenosis ◽

Binding Protein ◽

Artery Stenosis ◽

Tandem Mass ◽

Reaction Monitoring ◽

Discovery Cohort ◽

Coronary Artery Atherosclerosis ◽

Patients With Diabetes ◽

Severe Coronary Artery

IntroductionCardiovascular disease (CVD) in patients with diabetes is the leading cause of death. Finding early biomarkers for detecting asymptomatic patients with CVD can improve survival. Recently, plasma proteomics—targeted selected reaction monitoring/multiple reaction monitoring analyses (MRM)—has emerged as highly specific and sensitive tools compared with classic ELISA methods. The objective was to identify differentially regulated proteins according to the severity of the coronary artery atherosclerosis.Research design and methodsA discovery cohort, a verification cohort and a validation cohort consisted of 18, 53, and 228 subjects, respectively. The grade of coronary artery stenosis was defined as a percentage of luminal stenosis of the major coronary arteries. Participants were divided into six groups, depending on the presence of diabetes and the grade of coronary artery stenosis. Two mass spectrometric approaches were employed: (1) conventional shotgun liquid chromatography tandem mass spectrometry for a discovery and (2) quantitative MRM for verification and validation. An analysis of the covariance was used to examine the biomarkers’ predictivity beyond conventional cardiovascular risks.ResultsA total of 1349 different proteins were identified from a discovery cohort. We selected 52 proteins based on the tandem mass tag quantitative analysis then summarized as follows: chemokine (C-X-C motif) ligand 7 (CXCL7), apolipoprotein C-II (APOC2), human lipopolysaccharide-binding protein (LBP) and dedicator of cytokinesis 2 (DOCK2) in diabetes; CXCL7, APOC2, LBP, complement 4A (C4A), vitamin D-binding protein (VTDB) and laminin β1 subunit in non-diabetes. Analysis of covariance showed that APOC2, DOCK2, CXCL7 and VTDB were upregulated and C4A was downregulated in patients with diabetes showing severe coronary artery stenosis. LBP and VTDB were downregulated in patients without diabetes, showing severe coronary artery stenosis.ConclusionWe identified significant associations between circulating APOC2, C4A, CXCL7, DOCK2, LBP and VTDB levels and the degree of coronary artery stenosis using the MRM technique.

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