scholarly journals THE COMPARISON OF ANKLE BRACHIAL INDEX IN PATIENTS WITH AND WITHOUT ACS IN PROF. DR. R. D. KANDOU HOSPITAL, MANADO

2013 ◽  
Vol 5 (2) ◽  
Author(s):  
Elfan Moeljono ◽  
Iman Y. Suhartono ◽  
Terrance Ransun ◽  
Fonny M. Tedjo ◽  
Agnes L. Panda ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Ankle Brachial Index ◽  
High Sensitivity ◽  
Arterial Disease ◽  
Vascular Medicine ◽  
Chi Square ◽  
Cross Sectional ◽  
Coronary Syndrome ◽  
Increased Risk ◽  
Keywords Ankle

Abstrak: Walaupun merupakan pengukuran sederhana dan non-invasif, ankle brachial index (ABI) menunjukkan sensitifitas dan spesifisitas yang tinggi dalam mendiagnosis penyakit arteri perifer pada nilai ABI ≤0,9. ABI juga merupakan indikator yang kuat untuk mengetahui penyakit aterosklerosis pada area vaskular lainnya. Penelitian ini bertujuan untuk menentukan perbandingan antara ABI pada pasien dengan atau tanpa sindroma koroner akut (SKA). Penelitian ini menggunakan analisis analitik observasional dengan desain potong lintang. Subyek penelitian ialah pasien dengan SKA dan pasien tanpa SKA yang datang ke Departemen Kardiologi dan Pembuluh Darah RSU Prof. Dr. R.D Kandou, Manado bulan September-Desember 2012. Nilai normal ABI yaitu >0,9 dan <1,4, sedangkan ABI <0,9 perlu dipertimbangkan abnormal. Nilai ABI >1,4 dipertimbangkan tidak valid dan diekslusi. Hubungan antara variabel dievaluasi menggunakan SPSS. Hasil penelitian memperlihatkan 33 pasien SKA (72,8% laki-laki) dan 33 pasien tanpa SKA (81,8% laki-laki) sebagai subyek penelitian. Rerata usia pasien SKA 57 tahun dan tanpa SKA 52,3 tahun. Angka kejadian pasien SKA dengan ABI abnormal lebih tinggi, yaitu 82,1% vs 17,9% (P < 0,001). Uji chi-square menunjukkan terdapatnya hubungan antara SKA dan peningkatan risiko ABI abnormal (OR 12, P < 0,05). Simpulan: Sindroma koroner akut berhubungan dengan peningkatan risiko dari ABI abnormal. Kata kunci: Ankle brachial index, sindroma koroner akut.   Abstract: Although the ankle-brachial index (ABI) is a simple and non-invasive measurement, it shows a high sensitivity and specificity in the diagnosis of peripheral arterial disease (PAD) when its value is ≤0.9. Moreover, ABI is a powerful indicator of atherosclerotic diseases in other vascular areas. This study aimed to determine the comparison between ankle brachial indices (ABI) in patients with or  without acute coronary syndrome (ACS). This was an analytical observational study with a cross sectional design. We measured ABI indices in 33 patients with ACS and 33 patients without ACS admitted to the Department of Cardiology and Vascular Medicine, Prof. Dr. R.D. Kandou Hospital, Manado. The normal ABI is >0.9 and <1.4. However, ABI <0.9 was considered as abnormal. On the other hand, ABI >1.4 was considered invalid and then excluded. The association of variables was evaluated by SPSS software. The results showed that there were 33 ACS patients (72.8% male) and 33 patient without ACS (81.8% male). ACS patients were older (57 vs 52.3 years). ACS patients had more prevalent abnormal ABI (82.1% vs 17.9%; P < 0.001). Chi square test showed that ACS was associated with an increased risk of abnormal ABI (OR 12, P < 0.05). Conclusion: ACS was associated with an increased risk of abnormal ABI. Keywords: ankle brachial index, acute coronary syndrome.

scholarly journals A study to assess frequency of peripheral arterial disease in patients presenting with acute coronary syndrome

2017 ◽  
Vol 4 (5) ◽  
pp. 1276
Author(s):  
Somnath Mukherjee ◽  
Prashant Kumar ◽  
D. P. Sinha
Keyword(s):  
Acute Coronary Syndrome ◽  
Peripheral Arterial Disease ◽  
Past History ◽  
Systolic Dysfunction ◽  
Ankle Brachial Index ◽  
Arterial Disease ◽  
Observation Study ◽  
Cross Sectional ◽  
Coronary Syndrome ◽  
Peripheral Arterial

Background: To determine the frequency of peripheral arterial disease (PAD) in patients presenting with acute coronary syndrome (ACS) and association of PAD with different risk factors of coronary artery disease (CAD) and to look for in hospital outcome of ACS patients with or without PAD.Methods: This cross-sectional observation study was undertaken in the department of cardiology, IPGME&R Hospital, Kolkata from June 2015 to August 2016 to recruit 199 consecutive patients admitted with ACS and were evaluated with detailed clinical history, physical examination, ABI (Ankle Brachial Index) measurement, echocardiography and appropriate blood investigations.Results: Among 199 total ACS patients, STEMI was the predominant mode of presentation (71.86%) and majorities were male. PAD was seen in 26 patients and mean age was 56.68±8.84 years. Factors independently related with PAD in acute coronary syndromes are hypertension (OR- 1.49; 95% CI: 0.615-3.232), diabetes (OR- 2.55;95% CI : 0.9762-6.6665), smoking (OR-2.55; 95% CI: 1.055-6.19), past history of CVA (OR-11.15;95% CI: 1.77-70.32), LV systolic dysfunction (OR-1.388; 95% CI:0.607-3.1742). 2 and 13 patients died within 7 days of admission among 26 ACS-PAD group (7.69%) and 173 ACS-non-PAD group (7.5%) respectively and most of them had STEMI.Conclusions: Significant numbers of ACS patients are having PAD and older age, male sex, diabetes, hypertension, smoking and LV systolic dysfunction were found to be independent predictors for PAD in ACS patients. Early in hospital mortality was seem to be dependent on clinical presentation, not on presence or absence of PAD.

scholarly journals Prevalence of Cardiac Depression and its Related Factors among Patients with Acute Coronary Syndrome

2016 ◽  
Vol 8 (1) ◽  
pp. 30 ◽  
Author(s):  
Amir Hossein Goudarzian ◽  
Hamid Sharif Nia ◽  
Heydar Tavakoli ◽  
Mohammad Ali Soleimani ◽  
Ameneh Yaghoobzadeh ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Depression Scale ◽  
Cross Sectional Study ◽  
Depression Score ◽  
Chi Square ◽  
Related Factors ◽  
Cross Sectional ◽  
Psychological Reactions ◽  
Coronary Syndrome ◽  
Cardiac Depression

Cardiac depression is one of the most common psychological reactions of patients with acute coronary syndrome (ACS). This study aimed to determine the prevalence of cardiac depression and its related factors among patients with ACS. This cross-sectional study was conducted during 2016 in patients with ACS who were admitted to hospitals affiliated to the Mazandaran University of Medical Sciences, Iran. In the present study, 407 patients completed the Cardiac Depression Scale (CDS) within two months (March - June). The data were analyzed by a chi-square test and a general linear model multivariate analysis. According to the results, the mean cardiac depression score in patients with ACS was 109.00 ± 16.49 (CI95: 107.39 to 110.60). Among the participants, 37 (9.1%), 72 (17.7%), and 298 (73.2%) patients had mild, moderate, and severe levels of depression, respectively. Although the two-way ANOVA was not significant, but there was a difference between cardiac depression score of a type of ACS. Given the high prevalence of cardiac depression among these patients, it is necessary to develop measures for routine screening in cardiac treatment units.

The Association Between Serum Procalcitonin Levels and Severity of Coronary Artery Disease Assessed by SYNTAX Score in Patients With Acute Coronary Syndrome

Angiology ◽  
2016 ◽  
Vol 68 (1) ◽  
pp. 40-45 ◽  
Author(s):  
Ahmet Göktuğ Ertem ◽  
Tolga Han Efe ◽  
Çağrı Yayla ◽  
Mehmet Kadri Akboğa ◽  
Burak Açar ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Inflammatory Marker ◽  
High Sensitivity ◽  
Cross Sectional Study ◽  
Syntax Score ◽  
Cross Sectional ◽  
Coronary Syndrome ◽  
Artery Disease

The SYNTAX score (SX score) is a useful score for assessing the severity of coronary artery disease (CAD). Previous studies have demonstrated a close relationship between SX score and inflammation. Procalcitonin (PCT) is an early inflammatory marker, especially during sepsis. Thus, in this study, we aimed to investigate the relationship between SX score and serum PCT levels. A total of 545 patients were enrolled in this prospective cross-sectional study and were divided into 2 subgroups, according to their SX score. Serum PCT and high-sensitivity C-reactive protein levels were measured. Serum PCT levels were higher in the high SX score group compared to the low–intermediate SX score group ( P < .001). Serum PCT levels were an independent predictor of a high SX score in patients with acute coronary syndrome ( P = .001). As patients with a higher SX score had increased serum PCT levels on admission, serum PCT may be useful for identifying patients with severe CAD.

scholarly journals FREQUENCY, DISTRIBUTION AND DETERMINANTS OF DIABETES MELLITUS IN ADULT ACUTE CORONARY SYNDROME POPULATION OF D.I.KHAN DIVISION, PAKISTAN

2019 ◽  
Vol 17 (4) ◽  
pp. 131-143 ◽  
Author(s):  
Muhammad Marwat ◽  
Iftikhar Ahmad ◽  
Fariha Ashiq ◽  
Sania Ali ◽  
Sher Zamir ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Frequency Distribution ◽  
Goodness Of Fit ◽  
Age Groups ◽  
Cross Sectional Study ◽  
Age Group ◽  
Chi Square ◽  
Cross Sectional ◽  
Coronary Syndrome ◽  
Chi Square Test

Background: Global Health Estimates 2015 has shown IHD as second leading global cause of death and 3rd leading global cause for DALYs for 2015. The objectives of this study were to determine frequency, distribution and determinants of DM in adult acute coronary syndrome (ACS) population of D.I.Khan Division, Pakistan. Materials & Methods: This cross-sectional study was conducted in Departments of Ophthalmology & Community Medicine, Gomal Medical College, D.I.Khan, from February 1, 2017 to April 30, 2017. 331 cases were selected with margin of error 4.511%, 90%CL and 25% prevalence of DM in 73,438 adults assumed to have IHD. All indoor adult patients of ACS were eligible. Sex, age groups, and residence and presence of DM were variables. Frequency and distribution were analyzed by count and percentage. Hypotheses for distribution were substantiated by chi-square goodness-of-fit and of association by chi-square test of association. Results: Out of 331 patients with ACS, 225 (68.0%) were men and 106 (32.0%) women, 221 (66.8%) ≤60 years and 110 (33.2%) >60 years, and 210 (63.4%) urban and 121 (35.6%) rural. Frequency of DM was 79/331 (23.87%). Out of 79 patients with DM, men were 44 (13.29%), women 35 (10.57%), age group ≤60 years 57 (17.22%), >60 years 22 (6.65%), urban 53 (16.01%) and rural 60 (7.85%). Our prevalence of DM was lower than expected (p=.00214), our distribution by sex was similar to expected (p=.4993) while our distribution for age groups (p=.01209) and residence (p=.00005) were not similar to expected. Presence of DM was associated to sex (p=.011) but not to age groups (p=.0304) and residence (p=.5241). Conclusion: Prevalence of DM in adult ACS population of D.I.Khan Division, Pakistan was found lower than expected. The prevalence was more in men than women, more in younger age group (≤60 years) than older age group (>60 years) and more in urban than rural population. Our prevalence of DM was lower than expected, our distribution by sex was similar to expected while our distribution for age groups and residence were not similar to expected. The presence of DM was associated to sex but not to age groups and residence.

Evaluating Mortality Rate and Associated Parameters in Patients with Acute Coronary Syndrome

2020 ◽  
Vol 20 (3) ◽  
pp. 221-226
Author(s):  
Alireza Gheini ◽  
Ali Pooria ◽  
Afsoun Pourya
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Acute Coronary Syndrome ◽  
Mortality Rate ◽  
Winter Season ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Killip Class ◽  
Coronary Syndrome ◽  
Increased Risk

Background: Acute coronary syndrome (ACS) is one of the leading causes of mortality worldwide and is characterized by unstable angina or acute myocardial infarction. The aim of this study is to evaluate the clinical characteristics of patients who died of ACS. Methods: In this cross-sectional study, 1000 patients presenting ACS were included. Data and records of these patients were evaluated for parameters such as; deceased status, age, gender, diagnosis, ECG, common complaints, associated risk factors, Killip class, pulse, blood pressure, geographic setup (urban or rural), complications and season in which the disease was presented. Statistical analysis was performed on the data obtained using SPSS-win software. Results: The mortality rate among ACS patients in our study was 7.1%. Of these patients, AMI was the most prevalent diagnosis and chest pain was the most common complaint. Furthermore, low blood pressure, advanced age, increased pulse rate and fall/winter season were associated with the increased risk of mortality. ST deviation was the most seen ECG finding and most of the mortalities were within the 24 hours of admission. Conclusion: Our study reports risk factors associated with mortality in ACS patients. Advanced and timely therapeutic measurements are likely to reduce the incidence of mortality in these patients.

scholarly journals Application of Cardiac Troponin in Cardiovascular Diseases Other Than Acute Coronary Syndrome

2017 ◽  
Vol 63 (1) ◽  
pp. 223-235 ◽  
Author(s):  
Kai M Eggers ◽  
Bertil Lindahl
Keyword(s):  
Heart Failure ◽  
Acute Coronary Syndrome ◽  
Takotsubo Cardiomyopathy ◽  
Cardiac Troponin ◽  
High Sensitivity ◽  
Prognostic Information ◽  
Coronary Syndrome ◽  
Prognostic Assessment ◽  
Increased Risk ◽  
Pulmonary Arterial

Abstract BACKGROUND Increased cardiac troponin concentrations in acute coronary syndrome (ACS) identify patients with ongoing cardiomyocyte necrosis who are at increased risk. However, with the use of more precise assays, cardiac troponin increases are commonly noted in other cardiovascular conditions as well. This has generated interest in the use of cardiac troponin for prognostic assessment and clinical management of these patients. In this review, we have summarized the data from studies investigating the implications of cardiac troponin concentrations in various acute and chronic conditions beyond ACS, i.e., heart failure, myocarditis, Takotsubo cardiomyopathy, aortic dissection, supraventricular arrhythmias, valve disease, pulmonary arterial hypertension, stroke, and in the perioperative setting. CONTENT Cardiac troponin concentrations are often detectable and frankly increased in non-ACS conditions, in particular when measured with high-sensitivity (hs) assays. With the exception of myocarditis and Takotsubo cardiomyopathy, cardiac troponin concentrations carry strong prognostic information, mainly with respect to mortality, or incipient and/or worsening heart failure. Studies investigating the prognostic benefit associated with cardiac troponin–guided treatments however, are almost lacking and the potential role of cardiac troponin in the management of non-ACS conditions is not defined. SUMMARY Increased cardiac troponin indicates increased risk for adverse outcome in patients with various cardiovascular conditions beyond ACS. Routine measurement of cardiac troponin concentrations can however, not be generally recommended unless there is a suspicion of ACS. Nonetheless, any finding of an increased cardiac troponin concentration in a patient without ACS should at least prompt the search for possible underlying conditions and these should be managed meticulously according to current guidelines to improve outcome.

scholarly journals Prevalence of peripheral arterial disease among patients with acute coronary syndrome, a sample of Iraqi patients in Al-Yarmook Teaching Hospital 2016

2021 ◽  
Vol 63 (2) ◽  
pp. 50-56
Author(s):  
Osama A. Altaei ◽  
Abbass N. Al-Sharifi
Keyword(s):  
Acute Coronary Syndrome ◽  
Peripheral Arterial Disease ◽  
Previous History ◽  
Ankle Brachial Index ◽  
Arterial Disease ◽  
Leg Pain ◽  
P Value ◽  
Coronary Syndrome ◽  
History Of ◽  
Peripheral Arterial

Abstract Background: A significant proportion of patients with ischemic heart disease have been associated with peripheral arterial disease, yet it is still underestimated by our health system as many of patients are asymptomatic and this condition remains under diagnosed and therefore undertreated. Objective: To study prevalence of peripheral arterial disease of the lower limbs in patient with acute coronary syndrome and its association with certain risk factors. Method: A cross sectional descriptive study was conducted in the coronary care unit at Al-Yarmouk Teaching Hospital from the 1st of January 2016 to the 1st of November 2016 where hundred and fifty (150) patients enrolled to the coronary care unit with approved acute coronary syndrome, had been evaluated for peripheral arterial disease by assessing Demographic, risk factors and clinical features of the patients, including age groups, gender, hypertension, diabetes mellitus, smoking, dyslipidemia, family history. of coronary artery disease, previous history of cerebrovascular accident, body mass index, leg pain, measurement of ankle brachial index using hand held continuous wave Doppler device. Results: in 150 acute coronary syndrome patients were included male were (70.7%) , peripheral arterial disease was found in 31.2% through measuring ankle brachial index, 51% of those patients were asymptomatic and 29.8% with atypical leg pain and 12.8% with intermittent leg pain and 6.4% had pain at rest. And ankle brachial index in the 150 patients with acute coronary syndrome were 68.8% normal (ankle brachial index =1.4-0.91) and 21.3% (ankle brachial index =0.9-0.71) and 7.3 %( ankle brachial index =0.69-0.41) and 2.6% (ankle brachial index ≤0.40).  Factors independently related to peripheral arterial disease were old age (>60 years) which constitutes 51% and p value was 0.013, and smoking which constitutes 46.8% and P value was 0.04, and dyslipidemia which constitutes 74% and P value was 0.03, and finally previous history of cerebrovascular accident which constitutes 21.2% and P value was 0.0018. Conclusion: The prevalence of peripheral arterial disease in patients presenting with acute coronary syndrome is considerable and significant, the majority of patients were asymptomatic, it is associated with increased cardiovascular risk. Factors like aging, hypertension, diabetes mellitus, smoking, previous history of cerebrovascular accident, and dyslipidemia were strong predictors of peripheral arterial disease.   Key word: peripheral arterial disease , acute coronary syndrome, hypertension, diabetes mellitus.

scholarly journals Correlation Abnormal Ankle-Brachial Index and Multivessel Coronary Artery Disease in Acute Coronary Syndrome Patients

2017 ◽  
Vol 9 (1) ◽  
pp. 29
Author(s):  
Idar Mappangara ◽  
Magma Purnawan Putra ◽  
Khalid Saleh
Keyword(s):  
Coronary Artery Disease ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Ankle Brachial Index ◽  
High Sensitivity ◽  
Binary Logistic Regression Model ◽  
Old Patients ◽  
Coronary Syndrome ◽  
St Elevation ◽  
Artery Disease

BACKGROUND: Many studies showed the association between peripheral artery disease (PAD) and coronary artery disease (CAD). The anklebrachial index (ABI) was a simple, noninvasive, and not expensive test that showed high sensitivity and specificity in the diagnosis of PAD. Previous studies showed PAD correlation with the number of coronary artery lesions and higher complexity of the lesions. These correlations might contribute to worse cardiovascular outcomes, especially acute coronary syndrome (ACS) cases. Aim of this study is to evaluate the correlation abnormal ABI with the risk of ACS patients to have multivessel coronary artery lesions.METHODS: This was a retrospective analytical casec ontrol study. The data were taken from Dr. Wahidin Sudirohusodo Hospital medical records from November 2015 to February 2016. The inclusion criteria were (>18 years old) patients with ACS who had underwent ABI examination and coronary angiography.RESULTS: The prevalence of patients with ST-elevation myocardial infarction (STEMI) was lower than non-ST elevation ACS (NSTE-ACS). The prevalence of patients with abnormal ABI was 43.3% and patients with multivessel CAD was 65%. Male patients dominated the ACS population with 73.3%, about half of patients were smoking, and 86.7% had dyslipidemia. Patients with abnormal ABI and multivessel disease had greater number than patients with normal ABI (p=0.025). Analysis with binary logistic regression model showed abnormal ABI(odd ratio [OR] 4.83; p=0.021) and male sex (OR 19.35; p=0.010) were associated with greater risk of multivessel CAD.CONCLUSION: An abnormal ABI is associated with greater risk of multivessel CAD in ACS patients.KEYWORDS: ankle-brachial index, multivessel, coronary, acute coronary syndrome

scholarly journals Hypertension and Risk of Acute Coronary Syndrome (ACS) in Patients with ACS: A Study on 926 patients with ACS

2019 ◽  
Vol 10 (1) ◽  
pp. 22-26
Author(s):  
Mostafa Madmoli ◽  
Masoomeh Saeidilandi ◽  
Raha Latifinasab ◽  
Shekofeh Fatehimoghaddam ◽  
Fariba Mobarez ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
World Health ◽  
Chi Square ◽  
Cross Sectional ◽  
Coronary Syndrome ◽  
High Prevalence ◽  
Chi Square Test ◽  
History Of ◽  
Health Organization ◽  
The Relationship

Introduction: According to the World Health Organization (WHO), 1 billion people have been affected by hypertension (HTN). Since the role of HTN and its effects on patients with ACS is still unclear, the aim of this study was to determine whether HTN is a risk factor for patients with acute coronary syndrome admitted to ShahidZadeh hospital in Behbahan. Materials and Methods: This is a retrospective cross-sectional descriptive study. In this study, 926 cases of patients with acs with or history of the disease who were referred to ShahidZadeh Hospital in Behbahan during 2016-2017 were studied. The required information was collected through a researcher checklist from the records. Data were then entered into SPSS software version 18. Data were analyzed by descriptive statistics and Chi-square and Chi-square test at a significant level of P <0.05. Results: 926 patients with ACS with an average age of 59.15 ± 15.5 were included in this study. In this study there was no significant correlation between gender and history of HTN (p = 0.17). Among the qualitative demographic variables, only the relationship between marital status and history of HTN was significant. There was a significant relationship between history of HTN with history of MI, history of angina, history of smoking and history of family history of cardiovascular problems (P <0.05). Conclusion: Considering the high prevalence of cardiovascular problems and the relationship between HTN and cardiovascular problems, especially acute coronary syndrome in this study, it is necessary to provide training and prevention to prevent further cardiovascular disease through Educational class, mass media and cyberspace and improve the level of knowledge of these patients and reduce cardiovascular risk factors.  

Opposite effects of CX3CR1 receptor polymorphisms V249I and T280M on the development of acute coronary syndrome

2005 ◽  
Vol 93 (05) ◽  
pp. 949-954 ◽  
Author(s):  
Arvand Haschemi ◽  
Georg Endler ◽  
Gerlinde Zorn ◽  
Cornelia Weyand ◽  
Gerald Maurer ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
High Sensitivity ◽  
Elevated Risk ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Coronary Syndrome ◽  
Increased Risk ◽  
Inflammatory Activation ◽  
Soluble Ligand ◽  
Artery Disease

SummarySeveral lines of evidence suggest that the chemokine fractalkine (FKN) and its receptor CX3CR1 contribute to the accumulation of leukocytes in the atherosclerotic plaque. The M280 allele of the CX3CR1T280M polymorphism modulates leukocyte recruitment and is associated with lower prevalence of cardiovascular disease. The influence of V249I, another CX3CR1 poly-morphism, is discussed controversially. We investigated the association of the alleles M280 and I249 of CX3CR1 with coronary artery disease (CAD) and with acute coronary syndrome (ACS). Additionally, we assessed their association with the soluble ligand FKN and inflammatory activation measured by high-sensitivity C-reactive protein (hsCRP). The genotypes of the V249I and T280M polymorphisms were determined in 1152 patients with suspected CAD. 720 (62.5%) individuals showed significant CAD with an ACS prevalence of 59.3%. Using multivariate regression, we found a harmful influence of I249 (adjusted OR=1.8, P<0.03) and a protective effect of M280 (adjusted OR=0.6, P<0.04) on the occurrence of ACS in patients with CAD. Correspondingly, patients with I249 but without M280 (17%) were at elevated risk of ACS (OR=1.6, P<0.04). During ACS these patients (carrying only I249) had significantly higher circulating concentrations of FKN and high sensitivity C-reactive protein (1.9– and 1.6-fold). We found no association of the I249 or the M280 allele with the occurrence of CAD. In conclusion, I249 and M280 have opposite effects on the occurrence of ACS. The presence of I249 not“balanced” by M280 confers an elevated risk of ACS. A FKN-mediated enhanced inflammatory activation might explain this increased risk.

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