open access

Vol 66, No 11 (2008)
Other
Published online: 2008-11-27
Submitted: 2012-12-28
Get Citation

Original article
Novel atherogenesis markers for identification of patients with a multivessel coronary artery disease

Radosław Kręcki, Jarosław Drożdż, Piotr Szcześniak, Daria Orszulak-Michalak, Maria Krzemińska-Pakuła
Kardiol Pol 2008;66(11):1173-1180.

open access

Vol 66, No 11 (2008)
Other
Published online: 2008-11-27
Submitted: 2012-12-28

Abstract


Background: Patients with advanced coronary artery disease (CAD) have an unfovourable prognosis. Therefore, early identification of this high-risk group is important.
Aim: To asses the utility of clinical, electrographic and echocardiographic parameters, supported by novel atherogenesis markers, to identify patients with triple vessel coronary artery disease (CAD).
Methods: The study group comprised 37 patients (29 males, mean age 64±8 years) suffering from multivessel CAD and a control group of 16 patients (8 males, mean age 60±10 years), in whom – despite typical stenocardial symptoms, positive exercise stress test and segmental contractility disturbances – coronary angiography did not reveal any haemodynamically significant CAD. Apart from coronary angiography, each patient had additionally an entire test panel performed assessing both the disease severity and the presence of other systemic dysfunction. Mean Gensini score in the study group was 91.9±43.8, including proximal Gensini score 52.6±45.6 and distal one 39.4±29.7.
Results: Patients with triple vessel disease had a long history of angina (mean 84 months), of whom 30 (81%) experienced at least Q-wave myocardial infarction (MI). ECG changes typical for ischaemia were observed more often than in the control group. Also in patients with triple vessel disease echocardiography showed more escalated segmental contractility disorders, and left ventricular ejection fraction in this group was significantly lower than in the control group (44 vs. 55%, p <0.001). There were significant differences between CAD patients and control groups with respect to serum levels of: adiponectin (10.5±4.2 vs. 17.6±3 µg/ml, p=0.001), resistin (13.7±6.1 vs. 7.2±2.4 ng/ml, p=0.007), TNF-α (4.2±2.9 vs. 2.1±1.1 pg/ml, p=0.02) and IL-8 (18.4±4.1 vs. 12.2±4.1 pg/ml, p=0.008). Significant differences were also noted in lipid profile (total cholesterol: 201±47.1 vs. 183±18 mg/dl, NS; HDL cholesterol: 45±8.5 vs. 54±11 mg/dl, p=0.005; LDL cholesterol: 126.1±46.9 vs. 102±29 mg/dl, p=0.004), NT-proBNP [516 (174-1426) vs. 187 (39-573) pg/ml, p=0.02] and fasting blood glucose levels (97±14 vs. 94±11 mg/dl, p=0.03). Significantly lower serum adiponectin levels were observed in men and tobacco smokers.
Conclusions: Medical history, supported by interpretation of selected, routine imaging studies and novel biochemical markers, such as adiponectin, resistin, TNF-α, IL-8 or NT-proBNP, seem to be the key factors when assessing the risk of presence of advanced coronary artery atherosclerosis.

Abstract


Background: Patients with advanced coronary artery disease (CAD) have an unfovourable prognosis. Therefore, early identification of this high-risk group is important.
Aim: To asses the utility of clinical, electrographic and echocardiographic parameters, supported by novel atherogenesis markers, to identify patients with triple vessel coronary artery disease (CAD).
Methods: The study group comprised 37 patients (29 males, mean age 64±8 years) suffering from multivessel CAD and a control group of 16 patients (8 males, mean age 60±10 years), in whom – despite typical stenocardial symptoms, positive exercise stress test and segmental contractility disturbances – coronary angiography did not reveal any haemodynamically significant CAD. Apart from coronary angiography, each patient had additionally an entire test panel performed assessing both the disease severity and the presence of other systemic dysfunction. Mean Gensini score in the study group was 91.9±43.8, including proximal Gensini score 52.6±45.6 and distal one 39.4±29.7.
Results: Patients with triple vessel disease had a long history of angina (mean 84 months), of whom 30 (81%) experienced at least Q-wave myocardial infarction (MI). ECG changes typical for ischaemia were observed more often than in the control group. Also in patients with triple vessel disease echocardiography showed more escalated segmental contractility disorders, and left ventricular ejection fraction in this group was significantly lower than in the control group (44 vs. 55%, p <0.001). There were significant differences between CAD patients and control groups with respect to serum levels of: adiponectin (10.5±4.2 vs. 17.6±3 µg/ml, p=0.001), resistin (13.7±6.1 vs. 7.2±2.4 ng/ml, p=0.007), TNF-α (4.2±2.9 vs. 2.1±1.1 pg/ml, p=0.02) and IL-8 (18.4±4.1 vs. 12.2±4.1 pg/ml, p=0.008). Significant differences were also noted in lipid profile (total cholesterol: 201±47.1 vs. 183±18 mg/dl, NS; HDL cholesterol: 45±8.5 vs. 54±11 mg/dl, p=0.005; LDL cholesterol: 126.1±46.9 vs. 102±29 mg/dl, p=0.004), NT-proBNP [516 (174-1426) vs. 187 (39-573) pg/ml, p=0.02] and fasting blood glucose levels (97±14 vs. 94±11 mg/dl, p=0.03). Significantly lower serum adiponectin levels were observed in men and tobacco smokers.
Conclusions: Medical history, supported by interpretation of selected, routine imaging studies and novel biochemical markers, such as adiponectin, resistin, TNF-α, IL-8 or NT-proBNP, seem to be the key factors when assessing the risk of presence of advanced coronary artery atherosclerosis.
Get Citation

Keywords

multivessel coronary artery disease; adiponectin

About this article
Title

Original article
Novel atherogenesis markers for identification of patients with a multivessel coronary artery disease

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 66, No 11 (2008)

Pages

1173-1180

Published online

2008-11-27

Bibliographic record

Kardiol Pol 2008;66(11):1173-1180.

Keywords

multivessel coronary artery disease
adiponectin

Authors

Radosław Kręcki
Jarosław Drożdż
Piotr Szcześniak
Daria Orszulak-Michalak
Maria Krzemińska-Pakuła

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By "Via Medica sp. z o.o." sp.k., Świętokrzyska 73 street, 80–180 Gdańsk, Poland

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail: viamedica@viamedica.pl