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This study aims to analyze the correlation between Systemic Inflammatory Response Index (SIRI) and the severity of coronary artery stenosis in patients with coronary heart disease (CHD). It also aims to assess the predictive value of SIRI for the severity of coronary artery stenosis. A total of 2990 patients who underwent coronary angiography were included in this study. The Gensini score was used to estimate the severity of coronary vascular lesions. The predictive ability of SIRI for CHD was evaluated using receiver operating characteristic (ROC) curves. Binary multivariate logistic regression analysis was used to predict the likelihood of CHD based on the SIRI index. The results showed that people with higher SIRI index were more likely to have CHD (P < 0.001). After controlling for other risk factors, the highest quartile had a significantly higher incidence of coronary artery disease compared to the lowest quartile (odds ratio [OR] 2.25, 95% confidence interval [CI] 1.73-3.92, P < 0.001). Furthermore, the Gensini score was significantly higher in the fourth quartile group (T4) compared to the first (T1) and second (T2) quartile groups (P < 0.001). Additionally, the SIRI index was significantly higher in the group with severe coronary artery lesions compared to the mild and moderate groups (P < 0.001). The SIRI index also showed a higher predictive ability for the extent of coronary lesions under the ROC curve compared to other commonly used markers, including platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), and neutrophil-to-lymphocyte ratio (NLR) (P < 0.001). Therefore, SIRI index positively correlates with coronary artery stenosis in CHD patients, serving as an effective early screening marker for assessing stenosis severity.

Aim To investigate the correlation between triglyceride-glucose (TyG) index and the severity of coronary artery disease assessed in patients with acute myocardial infarction (AMI). Methods The study restrospectively selected 424 patients with AMI in the Fourth Affiliated Hospital of Xinjiang Medical University from January 2020 to March 2023. Clinical data and results of coronary angiography (CAG) were collected. Gensini score was used to quantitatively assess the degree of coronary artery stenosis. According to tertiles of the Gensini, the patients were classified into three groups: low Gensini score group (<45 points, n =140), medium Gensini score group (45 ~ 86 points, n =143), and high Gensini score group (≥87 points, n =141). The associations between TyG index and the occurrence of coronary artery disease with high Gensini score by Logistic regression analysis; Spearman correlation was used to analyze the correlation between TyG index and Gensini score in AMI patients; ROC curve was used to analyze the value of TyG index in predicting the severity of coronary artery lesions. Results TyG index of high Gensini score group was significantly higher than that of low and medium Gensini score group (P<0. 05). Logistic regression analysis showed that TyG index was an independent risk factor for severe coronary lesions in AMI patients (OR=13. 327, 95%CI: 2. 642 ~67. 235, P =0. 002). Spearman correlation analysis showed that TyG index was positively correlated with the severity of coronary artery disease (r =0. 331, P<0. 001). ROC curve analysis showed that the area under curve of TyG index was 0. 680 (95%CI: 0. 630 ~0. 731, P<0. 001). When the cut-off value of TyG index was 1. 555, the predicted efficacy of of severe coronary artery disease in patients with AMI was the highest, with a sensitivity of 79. 4% and a specificity of 50. 5%. Conclusion TyG, as a novel biomarker, was significantly and independently associated with the severity of the coronary arteries in patients with AMI. [ABSTRACT FROM AUTHOR]

Aim To explore the correlation between platelet morphology parameters and the severity of coronary artery disease in patients with acute coronary syndrome (ACS). Methods 121 ACS patients who were hospitalized in the Department of Cardiovascular Medicine of Second Affiliated Hospital of University of South China from January 2019 to October 2019 were selected, and 35 patients with normal results of selective coronary angiography during the same period were selected as the control group. Mean platelet volume (MPV), platelet distribution width (PDW), and platelet large cell ratio (PLCR) were used as platelet morphology parameters. All patients underwent coronary angiography and were divided into low score (1 ~ 40 points) group, medium score (41 ~ 80 points) group, and high score (81 points and above) group. The differences in platelet morphology parameters between each group were compared to identify risk factors for high Gensini scores. Results The MPV, PDW, PLCR, male proportion, creatine kinase isoenzyme (CK-MB), N-terminal-pro brain natriuretic peptide (NT-proBNP), uric acid (UA), and cardiac troponin I (cTnI) in the ACS group were significantly higher than those in the control group (P<0. 05). PDW, MPV and PLCR gradually increased in the control group and Gensini low, medium, and high score groups (P <0. 05). Pearson correlation analysis showed a positive correlation between PDW(r =0. 814, P<0. 05), MPV (r =0. 822, P<0. 05), PLCR (r =0. 802, P<0. 05) and Gensini score. Multiple Logistic regression analysis showed that PLCR can be a risk factor for high coronary Gensini score. Conclusion PLCR, PDW and MPV are positively correlated with the severity of coronary artery disease in patients with ACS, and have potential importance in evaluating the severity of coronary artery disease. [ABSTRACT FROM AUTHOR]

Background: Non-ST-segment elevation Acute Cronary Syndrome (NSTE-ACS) stays as the most common cause of mortality in people with cronary artery disease (CAD). Objective: The purpose of this research was to assess the probable association between the severity of CAD disease (by using the Syntax score) and c-reactive protein/albumin ratio (CAR) calculated by measuring serum levels upon admission. Patients and Methods: A prospective study that included 100 patients who were admitted to Agoza Hospital and Benha University Hospital with clinical features of NSTEMI and treated with percutaneous coronary intervention (PCI). We divided the patients into 2 groups: according to Syntax score, group 1 included 59 patients with Syntax score = 22. Group 2 included 41 patients with Syntax score > 22. Results: Regarding laboratory findings in the studied patients, neutrophil was significantly higher in group 2 (7.6) than in group 1 (6) (P < 0.001). Platelets were significantly higher in group 2 (332%) than in group 1 (293) (P < 0.001). Median CRP was significantly higher in group 2 (14.8) than in group 1 (6) (P < 0.001). Median CAR was significantly higher in Group 2 (35.6) than in group 1 (14.6) (P < 0.001). Neutrophil to lymphocyte ratio (NLR) was significantly higher in group 2 (3) than in group 1 (2.5) P < 0.001). Left main cronary artery (LMCA) disease, three vessels disease (3VD), bifurcation, complete total occlusion (CTO), Lesion > 20 mm and severe tortuosity were significantly higher in group 2 than in group 1. Conclusion: GRS, LMCA disease, TVD, bifurcation, CTO, Lesion > 20 mm, severe tortuosity, neutrophil, platelets, median CRP, median CAR and NLR were significantly higher in those with Syntax score > 22 than those with syntax score = 22. CAR was revealed to be an independent predictor for the high SS group, with a stronger correlation to the complexity and severity of CAD. [ABSTRACT FROM AUTHOR]

Background: The association of dietary patterns and metabolic syndrome with the severity of coronary artery disease (CAD) is little known. Aim: This study aimed to explore the relationship between major dietary patterns and the severity of CAD among newly discovered patients by using structural equation modeling (SEM). Methods: In this cross-sectional study, we included 423 newly diagnosed patients with CAD, aged 35–65 years, who underwent coronary angiography. The severity of CAD was assessed by the Gensini score. All patients were tested by using a semi-quantitative food frequency questionnaire, international physical activity questionnaire, perceived stress scale, lipid profile, fasting blood glucose, and anthropometric and blood pressure measurements. Statistical analysis was performed using SPSS and AMOS version 24. Results: Two dietary patterns (DPs) were identified by principal components analysis and labeled as "unhealthy DP" and "healthy DP". The results of SEM analysis showed that the unhealthy DP has a significant positive direct association with the severity of CAD (β=0.304, p <0.001), which is indirectly mediated by the presence of metabolic syndrome (β=0.021, p =0.021), adjusted for age and perceived stress scale. However, healthy DP has a significant negative direct association with the Gensini score (β=-0.213, p <0.001), and an indirect association through negative metabolic syndrome (β=-0.019, p =0.022), controlled for gender, physical activity, and perceived stress scale. Conclusions: The severity of CAD was directly associated with the unhealthy DP and indirectly mediated by the presence of the metabolic syndrome, while a healthy DP had a direct inverse association with CAD severity and indirectly mediated by the absence of metabolic syndrome. [ABSTRACT FROM AUTHOR]

BACKGROUND: The association of dietary patterns (DPs) linked to the severity of coronary artery disease (CAD) is little known. Therefore, this study aims to explore the relationship between major DPs and the severity of CAD. METHODS: This cross-sectional study was conducted among423 newly discovered CAD patients (both genders, aged 35-65 years), who underwent coronary angiography. The severity of CAD was assessed by the Gensini score. All patients were tested using a semi-quantitative food frequency questionnaire and other related data through face-to-face interviews. Factor analysis and logistic regression were applied by using SPSS version-24. RESULTS: By principal component analysis, two major DPs were identified: "Unhealthy" DP that characterized mainly by high intakes of sugar and sweets, soft drinks, salts, cooking oils, and processed meats, and "Healthy" DP that consisting high intakes of fruits, fish, poultry, vegetables, whole grains. After adjustment for confounding variables, the odds of severe CAD was significantly higher in the third (T3) and second (T2) tertile of the unhealthy pattern by 4.79 and 2.48 times more compared to the first tertile (T1) (OR 4.79; 95%CI 2.60, 8.83; P<0.001) and (OR 2.48; 95%CI 1.40, 4.39; P=0.002), respectively. However, the odds of CAD severity in the T3 and T2 of the healthy pattern was lowered by 0.24 and 0.38 times less compared to the T1 (OR 0.24; 95%CI 0.12, 0.47; P=0.002) and (OR 0.38; 95%CI 0.20, 0.73; P=0.006), respectively. CONCLUSION: The severity of CAD was significantly increased by the unhealthy dietary pattern, while decreased by adherence to the healthy pattern. [ABSTRACT FROM AUTHOR]

Objective: Cardiovascular diseases are the main cause of mortality worldwide. Depression is one of the effective factors in the incidence of cardiovascular diseases like coronary artery stenosis. This study aimed to investigate the relationship between depression symptoms and severity of coronary artery disease (CAD) in patients scheduled for angiography. Method: This prospective, cross sectional research was conducted on as many as 401 patients scheduled to undergo angiography at Dr. Heshmat heart hospital as the referral center in the north of Iran in 2016. Before cardiac catheterization, patients' demographic information (age, gender, level of education, and place of residence) and patients’ medical history (history of diabetes mellitus, hypertension, and family history of cardiac disease) were obtained. Also, Beck Depression Questionnaire 2 (BDI II) was completed by a psychologist before angiography. After collecting the data, SPSS v.21 and statistical tests such as Spearman correlation, and Mann-Whitney U regression were used to analyze the data. Results: After controlling for age, sex, and having history of diabetes mellitus, no relation was found between having depression symptoms and more frequency of vessel involvement (OR = 1.35, 95% CI: 0.92 to 1.98, P =0.130) or higher severity of CAD (OR = 1.47, 95% CI: 0.95 to 2.28, P = 0.087). The results were similar for the relation between severity of depression symptoms and CAD extent or CAD severity. Conclusion: The results of this study showed that in patients undergoing angiography, depression symptoms were not related to CAD severity and number of involved vessels. Depression was associated with angina, independently of CAD severity. Our study found no significant correlation between CAD severity and severity of depression. The reason may be that measuring depression at a single time point cannot accurately reveal the impact of this problem on the trend of atherosclerosis over time.

Objective: Cardiovascular diseases are the main cause of mortality worldwide. Depression is one of the effective factors in the incidence of cardiovascular diseases like coronary artery stenosis. This study aimed to investigate the relationship between depression symptoms and severity of coronary artery disease (CAD) in patients scheduled for angiography. Method: This prospective, cross sectional research was conducted on as many as 401 patients scheduled to undergo angiography at Dr. Heshmat heart hospital as the referral center in the north of Iran in 2016. Before cardiac catheterization, patients' demographic information (age, gender, level of education, and place of residence) and patients' medical history (history of diabetes mellitus, hypertension, and family history of cardiac disease) were obtained. Also, Beck Depression Questionnaire 2 (BDI II) was completed by a psychologist before angiography. After collecting the data, SPSS v.21 and statistical tests such as Spearman correlation, and Mann-Whitney U regression were used to analyze the data. Results: After controlling for age, sex, and having history of diabetes mellitus, no relation was found between having depression symptoms and more frequency of vessel involvement (OR = 1.35, 95% CI: 0.92 to 1.98, P =0.130) or higher severity of CAD (OR = 1.47, 95% CI: 0.95 to 2.28, P = 0.087). The results were similar for the relation between severity of depression symptoms and CAD extent or CAD severity. Conclusion: The results of this study showed that in patients undergoing angiography, depression symptoms were not related to CAD severity and number of involved vessels. Depression was associated with angina, independently of CAD severity. Our study found no significant correlation between CAD severity and severity of depression. The reason may be that measuring depression at a single time point cannot accurately reveal the impact of this problem on the trend of atherosclerosis over time. [ABSTRACT FROM AUTHOR]

Aim: Patients with acute coronary syndrome who underwent percutaneous coronary intervention (PCI) constitute the group with the highest risk of contrast-induced nephropathy development. Contrast media exposure might increase in patients who have lesions with >70% stenosis in the major epicardial arteries. Also, the impaired kidney function is associated with severity of coronary artery disease. We evaluated the relationship with severity of coronary artery disease (CAD) calculated by Gensini score and contrast induced nephropathy (CIN) in patients with mild renal insufficiency in acute coronary syndrome (ACS). Material and Methods: We enrolled 227 patients with ACS who underwent percutaneous coronary intervention. Patients were divided into groups according to CIN development. Severity of CAD was evaluated by Gensini score. Logistic regression analysis (univariate and multivariate) was performed to evaluate the predictors of CIN using variables that are clinically related to CIN. The 95% confidence interval (CI) and odds ratios (OR) were presented. Receiver–operating characteristic (ROC) curve was performed to demonstrate the sensitivity and specificity of the Gensini score. Results: A total of 69 (30.1%) patients with ACS had CIN. Compared to CIN (-) patients, CIN (+) patients had higher Gensini score, incidence of diabetes mellitus and amount of contrast media. Multivariate logistic regression analyses demonstrated that Gensini score, DM and amount of contrast media were independent risk factors for CIN development (p < 0.05 for all parameters). Conclusion: Gensini score, which simply shows severity of CAD, may be helpful in the determination of CIN risk in patients with ACS. [ABSTRACT FROM AUTHOR]

Background/aim: In the present study, we aimed to investigate the relationship between NT-proBNP and SYNTAX score, which is a measure of the complexity of coronary artery disease. Materials and methods: We enrolled 405 consecutive patients with myocardial infarction who underwent coronary angiographic examination. Patients were divided into 3 groups according to their SYNTAX scores. Those with SYNTAX score ≤22 were included in the low SYNTAX score group (LSTX), those with a score of 23-32 were included in the intermediate SYNTAX score group (ISTX), and those with a score of ≥33 were included in the high SYNTAX score group (HSTX). Results: NT-proBNP levels were found to be significantly higher in the HSTX group compared to the other groups (P < 0.001) and in the ISTX group compared to the LSTX group (P < 0.001). The NT-proBNP levels demonstrated an increase from low SYNTAX score to high SYNTAX score tertiles. Conclusions: NT-ProBNP levels in patients with myocardial infarction on admission were independently associated with extent, severity, and complexity of coronary atherosclerosis as assessed by SYNTAX score. [ABSTRACT FROM AUTHOR]

Objective: To determine correlation between duration of diabetes and severity of coronary artery disease (Gensini score) in patients, undergoing coronary angiography at tertiary care cardiac hospital. Methodology: A cross sectional study was conducted at Department of Cardiology, Tabba Heart Institute, Karachi from 17 September 2014 to 17th March 2015. All type 2 diabetic patients with 5 years or more duration of either gender with age 40 to 70 years, who had co-morbid like hypertension, smoking, and dyslipidemia been included in the study. The severity of coronary artery disease was found determined on Modified Gensini score correlate with duration of diabetes. The data was analyzed using SPSS version 17.0. Pearson correlation, univariate, and multiple linear regressions were applied. Results: Coronary artery disease was found more than double in men as in women. In female patients mean Gensini score was 63.43±45.25 whereas in male it was much higher (84.40±57.26). The mean Gensini score in patients of age =60 years was higher than patients' with age > 60 years. The male gender and duration of diabetics were found strong relation with the Gensini score. Conclusion: The duration of diabetic mellitus and male gender are positively correlated with the Modified Gensini score and appears to be the important determinants of severity of coronary artery disease (CAD). [ABSTRACT FROM AUTHOR]

Left bundle branch block (LBBB) is one of the features which predicts severe organic heart disease. In this study, we aimed to examine the predictive role of Gensini score as marker of severity of coronary artery disease (CAD) in patients with LBBB and its relationship with other CAD risk factors and complications. We have included patients who referred to our center for selective coronary angiography with transient and or permanent LBBB on their surface electrocardiography (ECG). Cases with pacemaker rhythm and known non-CAD related causes of LBBB pattern on surface ECG were excluded from this study. Demographic variables and clinical features were studied. To determine severity of CAD, Gensini score was measured. The relationship between presence of CAD and deteriorated ejection fraction has been demonstrated by previous works, but we found no association between severity of CAD and degree of ejection fraction deterioration. This might imply to the role of non-CAD factors toward reduction of ejection fraction. In cases with hypertension in the setting of LBBB, higher Gensini scores were seen regardless of ventricular ejection fraction. Thus, earlier screening for possible CAD in cases with LBBB and hypertension seems rational. [ABSTRACT FROM AUTHOR]

Coronary artery disease (CAD) has a complex etiology involving numerous environmental and genetic factors of disease risk. To date, the genetic 9p21 locus represents the most robust genetic finding for prevalent and incident CAD. However, limited information is available on the genetic background of the severity and distribution of CAD. CAD manifests itself as stable CAD or acute coronary syndrome. The Gensini score quantifies the extent CAD but requires coronary angiography. Here, we aimed to identify novel genetic variants associated with Gensini score severity and distribution of CAD. A two-stage approach including a discovery and a replication stage was used to assess genetic variants. In the discovery phase, a meta-analysis of genome-wide association data of 4,930 CAD-subjects assessed by the Gensini score was performed. Selected single nucleotide polymorphisms (SNPs) were replicated in 2,283 CAD-subjects by de novo genotyping. We identified genetic loci located on chromosome 2 and 9 to be associated with Gensini score severity and distribution of CAD in the discovery stage. Although the loci on chromosome 2 could not be replicated in the second stage, the known CAD-locus on chromosome 9p21, represented by rs133349, was identified and, thus, was confirmed as risk locus for CAD severity.

OBJECTIVE:The aim of the present study was to investigate the relationship between pericoronary fat and the severity and extent of atherosclerosis, quantified using 64-multidetector computed tomography, in patients with suspected coronary artery disease.METHODS:The study population consisted of 131 patients who were clinically referred for noninvasive multislice computed tomography coronary angiography for the evaluation of coronary artery disease. Patients were classified as follows: no atherosclerosis, Group 1; nonobstructive atherosclerosis (luminal narrowing

Recent genome-wide association studies identified the common genetic variants in 9p21 were associated with the coronary artery disease (CAD). However, whether this locus could predict the severity of CAD in Chinese Han population is unclear. 499 CAD patients who underwent coronary angiography (CAG) have been enrolled for this study. The single-nucleotide polymorphisms rs2383207 and rs2383206 in 9p21 were genotyped in 499 CAG cases and 1519 controls in Chinese Han population. The gene dosage of 9p21 was stratified by the degree of vascular lesions and tested for association with the severity of CAD. Rs2383207 and rs2383206 demonstrated significant associations with 2-vessel and 3-vessel disease ( P = 2.0×10−3 and 1.9×10−4, respectively). GG genotypes of rs2383206 occurred higher proportion of left main trunk (LM) disease ( P = 6.0×10−3). GG genotypes of rs2383207 occurred higher proportion of left anterior descending artery disease (LAD) and right CAD (RCA) ( P = 2.7×10−6 and 1.6×10−4, respectively). The risk allele G of rs2383207 was associated with severity of CAD estimated by the Gensini score ( P = 3.6×10−5). Rs2383207 may strongly influence the development of CAD in Chinese Han population. The gene dosage in 9p21 could predict the severity of CAD. [ABSTRACT FROM AUTHOR]

Objective To investigate the clinical significance of soluble CD40 ligand (sCD40L) and lipoprotein associated phospholipase A2 (Lp-PLA2) in the assessment of coronary artery severity and risk classification in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS). Methods Of the 96 patients with coronary heart disease diagnosed by coronary angiography, 28 patients had stable angina pectoris (SAP), 38 patients unstable angina pectoris (UAP) and 30 patients acute non-ST-segment elevation myocardial infarction (NSTEMI). Another 30 patients with non-coronary heart disease (NC) served as controls. The sCD40L and Lp-PLA2 levels were determined by enzyme-linked immune sorbent assay (ELISA) method. The Gensini score was used to assess the severity of coronary artery and analyze the correlation with sCD40L and Lp-PLA2. The correlation of sCD40L and Lp-PLA2 with GRACE risk score was analyzed too. Results 1 sCD40L was significantly higher in NSTEMI and UAP groups than in SAP and NC groups (P<0.05), but there was no significant difference between NSTEMI and UAP groups (P>0.05) or SAP and NC groups (P>0.05). Lp-PLA2 was significantly higher in NSTEMI group than in UAP, SAP and NC groups (P<0.05). Lp-PLA2 was significantly higher in UAP group than in SAP and NC groups (P<0.05). 2 We found that sCD40L had obvious correlation with Lp-PLA2 (r=0.284, P<0.01), Gensini score (r=0.213, P<0.05), and GRACE (r=0.224, P<0.05). Lp-PLA2 was significantly correlated with Gensini score (r=0.270, P<0.05), and GRACE (r=0.323, P<0.01). 3 Multivariate logistic regression analysis showed that Lp-PLA2 was independently associated with NSTE-ACS (P<0.05). Conclusion The sCD40L and Lp-PLA2 which were significantly elevated in NSTE-ACS are correlated with the severity of coronary artery disease. The two indexes indicate the instability of atherosclerotic plaque; thus they can be used as predictors of risk assessment in coronary heart disease. [ABSTRACT FROM AUTHOR]

Background: Mitral annular calcification (MAC) is degenerative, fibrous calcification of the mitral valve annulus. It is more common in people over 70 years old. It is a marker of increased cardiovascular risk which occurs in a graded fashion by MAC severity. The aim of this study was to evaluate the association of Mitral annular calcification with severity of coronary artery disease (CAD) in patients under 65 years old. Methods: A total of 140 patients with IHD were enrolled by purposive sampling. Study populations were divided into MAC group and non MAC group. MAC was detected by Trans-thoracic echocardiography as an intense echo-producing structure located at the junction of the atrio-ventricular groove and posterior mitral leaflet in parasternal long axis view. MAC is measured in millimeters from the leading anterior to the trailing posterior edge and quantified as mild to moderate (1 to 4 mm) and severe (>4 mm) considering its thickness. Assessment of angiographic severity of CAD was done in the same hospital stay by Vessel score, Friesinger score and Leaman score. Results: Patients of MAC and non MAC groups were similar in terms of age and sex. Smoking (p=0.001) and family history of IHD (p=0.03) were significantly higher in MAC group. Anterior MI was significantly higher in MAC group (p=0.03). Left main and TVD were significantly higher in MAC group (p=0.001, p=0.01) whereas normal vessels were more in non MAC group (p=0.001). Intermediate and high Friesinger score (e"5) were significantly higher in MAC group whereas low Friesinger score (<5) were more in non MAC group. There was significant (p=0.01) positive correlation between MAC and CAD severity in terms of vessel score (r=0.76) Friesinger score (r=0.75) and Leaman score(r=0.42). Multivariate logistic regression analysis showed that MAC was independent predictors of significant CAD (p=0.02, OR= 2.84). Conclusion: Echocardiographically detected mitral annual calcification (MAC) can be an independent predictor of significant coronary artery disease. There is positive correlation between severity of MAC and severity of CAD. Cheap, available and radiation free nature of the echocardiographic detection of MAC may be a marker of significant CAD. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Prostate-specific antigen (PSA) is a well-known prostate cancer marker. Recent studies have shown that serum PSA levels can fluctuate in response to cardiovascular stress. In this study we aimed to determine if serum PSA levels correlate with the presence and stages of coronary artery disease (CAD) and whether PSA can be used as a marker for the diagnosis and severity of CAD. PATIENTS AND METHODS: This was a retrospective chart review of male patients who un- derwent coronary angiography for suspected CAD. A total of 100 patients with angiographic data and baseline serum PSA measurements were included. Patients with previous history of coronary angiography, stent implantation, benign prostate hypertrophy, known prostate cancer or prostatitis were excluded. RESULTS: The mean age was 57±10 years. Coronary angiography results were normal in 13%, non-obstructive CAD (non-critical plaque formation) in 16%, one-vessel disease in 21%, two-vessel disease in 30% and multi-vessel disease in 20%. Mean values of total and free serum PSA were 1.4±1.3 ng/mL and 0.4±0.4 ng/mL, respectively. Although there was an increasing trend of PSA with more advanced stages of CAD, no significant relationship was established (p > 0.05). Patients with hypertension had significantly elevated total and free serum PSA compared to normotensives. There is no comparison of PSA levels between patients with CAD and without CAD. CONCLUSIONS: Our study suggests that there is no direct relationship between increasing levels of PSA and stage of CAD. Thus, PSA level does not appear to be a suitable marker for diagnosis or severity of CAD. [ABSTRACT FROM AUTHOR]

Diabetes mellitus (DM) is known to cause microvascular and possibly macrovascular complications. This study was performed to find the association between glycosylated haemoglobin (HbA1C) level and the severity of coronary artery disease. One hundred and ten consecutive patients admitted to hospital with acute myocardial infarction were studied. Seventy-eight patients (70.9%) had DM, 73 (93.58%) had HbA1C > 7%, 52 (47.3%) were hypertensive, 19 (17.3%) had a history of smoking and 37 (33.6%) had raised cholesterol. Coronary angiography was carried out in 87 (79.1%) patients and the severity of disease was assessed using the Gensini score. The mean Gensini score was 53.36±36.94 and the mean HbA1C was 8.4±2.39%. There was a significant association between Gensini score and DM (p=0.003) and between Gensini score and hypertension (p=0.018). HbA1C (r=0.427, p=0.001) and duration of DM (r=0.362, p=0.004) had a positive linear correlation with the Gensini score. Multiple regression analysis showed HbA1C to be an independent factor that influenced the Gensini score (p=0.021). [ABSTRACT FROM PUBLISHER]

Abstract: Objectives: : Paraoxonase-1 (PON1) detoxifies homocysteine thiolactone (HcyT) in human blood and could thus delay the development of atherosclerosis. We investigated (a) PON1 activity and polymorphisms, and (b) the relationship between PON1 activity, homocysteine (Hcy) and the severity of CAD patients in Tunisian population. Design and methods: : We used PCR-RFLP analysis to detect the Q192R and L55M variants of the PON1 gene in 100 patients with CAD and in 120 healthy controls. Paraoxonase activity was measured spectrophotometrically using phenylacetate as a substrate. Total plasma homocysteine concentrations were determined by direct chemiluminescence assay. Results: : We found an increased Hcy level in CAD patients compared to the control group (15.86±8.63 vs. 11.9±3.25 μmol/L respectively, P <0.001), and a decrease in PON1 activity in CAD patients as compared to the control group (117±56 vs. 181±73 U/mL respectively, P <0.001). PON1 Q192R and L55M polymorphisms were not associated with the presence of CAD (P =0.592, P =0.294, respectively). However, we found that PON1 activity is lower with the PON1 192RR than with PON1 192QQ genotypes in the study population. Furthermore, there were no association between PON1 L55M polymorphism and PON1 activity. We showed a significant decrease in PON1 activity in CAD patients presenting 0- to 3-vessel stenosis (155±39; 135±36; 103±22; 77±24 U/mL, respectively; P <0.001). Conclusion: : In this study, we showed that low PON1 activity is associated with the PON1 192RR genotypes and associated with the severity of CAD in the Tunisian population. We hypothesize that high level of Hcy together with low PON1 activity results in an increased plasma HcyT plasma concentration leading to protein N-homocysteinylation and the development and progression of atherosclerosis. [Copyright &y& Elsevier]

Comparative analysis of coronary arteriography and exercise ECG recordings of 33 patients with ischae-mic heart disease is presented. Linear regression was found between the increase of heart rate (HR) as well as increase of systolic blood pressure-heart rate product (SBPxHR) and the level of ST-segment depression developing during exercise. A significant correlation was established between the slope of the regression line (i.e. 'm'coefficient of y=mx+b) expressing the rate of change of ST-segment depression and the degree of coronary artery disease confirmed by arteriography. The average value of 'm' coefficients differed significantly according to the number of diseased vesseb (P< 001-0.001). The ratio of maximal ST depression and maximal HR (ST/HR) measured at the end of the exercise indicated reliably the severity of coronary artery disease and is suggested for everyday practice. [ABSTRACT FROM PUBLISHER]

Coronary artery disease (CAD) has a complex etiology involving numerous environmental and genetic factors of disease risk. To date, the genetic 9p21 locus represents the most robust genetic finding for prevalent and incident CAD. However, limited information is available on the genetic background of the severity and distribution of CAD. CAD manifests itself as stable CAD or acute coronary syndrome. The Gensini score quantifies the extent CAD but requires coronary angiography. Here, we aimed to identify novel genetic variants associated with Gensini score severity and distribution of CAD. A two-stage approach including a discovery and a replication stage was used to assess genetic variants. In the discovery phase, a meta-analysis of genome-wide association data of 4,930 CAD-subjects assessed by the Gensini score was performed. Selected single nucleotide polymorphisms (SNPs) were replicated in 2,283 CAD-subjects by de novo genotyping. We identified genetic loci located on chromosome 2 and 9 to be associated with Gensini score severity and distribution of CAD in the discovery stage. Although the loci on chromosome 2 could not be replicated in the second stage, the known CAD-locus on chromosome 9p21, represented by rs133349, was identified and, thus, was confirmed as risk locus for CAD severity.