Search

Objective— Prevalence of glycoprotein IIIa gene polymorphisms (PlA2) has been reported to be elevated in persons who die of sudden death. PlA2 has been suggested as contributing to the development of atherosclerosis via coronary plaque rupture and thrombus formation. In this prospective study, we investigated the correlation between the PlA2 polymorphism, atherosclerotic plaque burden, and its prognostic significance.Methods and results— One hundred and seventy-eight patients (mean age 51 ± 9.6 years) suspected to have atherosclerotic coronary artery disease underwent a coronary angiography and were evaluated for gene polymorphisms. Patients were followed up for 4 years for major adverse cardiac events (MACE). Thirty-eight patients (21%) had the PlA2 polymorphism.There was no statistically significant correlation between presence of atherosclerotic plaque burden, severity of coronary artery stenosis, and glycoprotein genotype. During the follow-up there were no significant differences between the 2 groups with regard to MACE.Any cause of death and cardiovascular death were higher in patients with PlA2 polymorphism but these differences were not significant. On univariate analysis, smoking, presence of severe coronary artery disease, and presence of myocardial infarction were correlated with elevated risk of MACE; presence of atypical angina was correlated with fewer MACE. On multivariate analysis, smoking was an independent risk factor for a MACE. On univariate or multivariate analysis, there was no relation between the PlA2 polymorphism and a MACE.Conclusions— The glycoprotein IIb/IIIa genotype was not shown to indicate the presence of atherosclerotic plaque.There was no correlation between the genotype and plaque vulnerability.

Objective— Exercise electrocardiography is commonly available and a cost-effective test and therefore is widely used for the diagnosis of coronary artery disease. However, false positivity remains an important problem resulting in many unnecessary coronary angiographic examinations. In this study, we aimed to test the hypothesis that post-exercise B-type natriuretic peptides secreted in response to transient myocardial ischaemia induced by exercise, add any further information on positive test results.Methods— Patients who underwent exercise electrocardiography with the suspicion of coronary artery disease were screened and those with positive test results based on standard electrocardiography criteria were selected. Blood samples for B-type natriuretic peptides were obtained within 5minutes after exercise test. Patients included in the study had preserved left ventricular function on echocardiography. At least 70% stenosis of one epicardial coronary artery on coronary angiography was diagnosed as significant coronary artery disease.Results— Of the 55patients (age 59.8 ± 7.6 y; 48men) included in the study 29 had (52.7%) coronary artery disease requiring revascularization (CAD+) and 26 (47.3%) did not have significant coronary artery disease (CAD-).The cardiovascular risk factor profile of CAD+ and CAD-patients were similar (all p>0.05).The median post-exercise B-type natriuretic peptide level was significantly higher in CAD+ (47.20 pg/ml) than CAD- patients (18.90 pg/ml) (P=0.001).The sensitivity and specificity of a post-exercise B-type natriuretic peptide level>30 pg/ml for the diagnosis of coronary artery disease in exercise test positive patients were calculated as 72% and 69%, respectively.Conclusion— The measurement of post-exercise B-type natriuretic peptide levels may increase the diagnostic value of positive exercise electrocardiography.

During recovery after exercise, the heart rate and blood pressure return to a resting state more rapidly than the end-systolic left ventricular dimensions and fractional shortening. The aim of this study was to assess how exercise-related cardiac changes affect the interpretation of myocardial perfusion images in normal subjects. Systolic cardiac parameters on gated stress and rest images were evaluated in healthy young and elderly subjects.