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MicroRNA-33b (miR-33b) affected various biological pathways in regulating cholesterol homeostasis which may link to the pathogenesis of atherosclerotic lesions. However, whether this marker is associated with the presence and severity of coronary heart disease (CHD) is undetermined. We aim to explore the diagnostic value of circulating miR-33b level in the presence and severity of CHD. Altogether 320 patients were enrolled, including 240 patients diagnosed with CHD while 80 were classified as controls after CAG examination. Circulating miR-33b level was analyzed in all subjects, the Gensini score was calculated to assess the severity of stenotic lesions. The association between miR-33b and the presence and severity of CHD was analyzed, and the diagnostic potential of miR-33b of CHD was performed by the receiver operating characteristic (ROC) analysis. The CHD group had higher miR-33b levels ( p  < 0.001), and the miR-33b content significantly elevated following an increasing Gensini score ( p for trend < 0.001). After adjustments for potential risk factors, such as several blood lipid markers, miR-33b remained a significant determinant for CHD ( p  < 0.001). ROC analysis disclosed that the AUC was 0.931. The optimal cutoff value of miR-33b was with a sensitivity of 81.3% and a specificity of 98.7% in differentiating CHD. It can prognosticate that the higher level of miR-33b was linked to increased severity of disease in CHD patients. Thus, the application of this marker might assist in the diagnosis and classification of CHD patients. Nevertheless, additional studies with larger sample sizes will be required to verify these results.

Background: ​Vascular endothelial growth factor A (VEGFA) is well acknowledged as a powerful angiogenesis-promoting agent mainly through its receptor VEGFR2. Ischemia stimulates VEGFA/VEGFR2 signaling pathway and elevated serum levels of VEGFA were detected in coronary heart disease (CHD) patients. The goal of the current study is to determine how four SNPs in the genes for VEGFA (rs3025039 and rs699947) and VEGFR2 (rs2305948 and rs1870377) contribute to the development of CHD. We also wanted to use the Gensini score to confirm if these four SNPs have an effect on the severity of coronary lesions., Methods: In this case-control research, we used the restriction fragment length polymorphism of the polymerase chain reaction to genotype 239 CHD patients and 200 controls. Age, sex, smoking behavior, and obesity were taken into account in the statistical analysis., Results: Two VEGFA/VEFGR2 signaling pathway SNPs (rs699947 and rs1870377) were found to be associated with CHD (C vs. A, P = 0.002; OR = 1.47 (1.12-1.93); A vs. T, P = 0.001; OR = 1.58 (1.17-2.13) respectively). The rs2305948 showed no allelic associations with CHD susceptibility, although we noticed a slight association under the recessive model of rs3025039 TT genotype (p = 0.023; OR = 6.41 (1.14-36.12)) only under adjusted analyses. In addition, both VEGFA SNPs (rs699947and rs3025039) were found to be associated with high Gensini score (p < 0.001)., Conclusions: Our research helps to shed further light on the pathophysiology of CHD. The VEGFA/VEGFR2 signaling pathway may have been downregulated, increasing CHD susceptibility and risk., (© 2023. The Author(s), under exclusive licence to Springer Nature B.V.)

Aim: This study aimed to investigate the correlation of ITIH4 with inflammatory cytokines, stenosis degrees and prognosis in coronary heart disease (CHD) patients. Methods: Serum ITIH4 levels of 300 CHD patients and 30 controls, together with levels of TNF-α, IL-6, IL-8 and IL-17A of CHD patients, were determined using ELISA. Results: Serum ITIH4 was reduced in CHD patients versus controls (p < 0.001). ITIH4 was negatively linked with TNF-α, IL-6, IL-8, IL-17A, C-reactive protein, serum creatinine and Gensini score in CHD patients (all p < 0.050). ITIH4 quartile level negatively correlated with the cumulative major adverse cardiovascular event rate (p = 0.041). Conclusion: Serum ITIH4 may serve as an anti-inflammatory biomarker that negatively associates with stenosis degree and major adverse cardiovascular event risk in CHD patients.

Background: Long non-coding RNA nuclear enriched abundant transcript 1 (lnc-NEAT1) regulates endothelial cell functions, CD4 + T cell regulation and chronic inflammation related to coronary heart disease (CHD). Then this case-control study measured lnc-NEAT1 expression in CHD patients, aiming to explore its clinical value in CHD management., Methods: Totally, 120 documented CHD patients and 120 suspected subjects without CHD diagnosis as controls were enrolled. Plasma lnc-NEAT1 was detected by RT-qPCR in all participants, plasma inflammatory cytokines were assessed by ELISA, T helper (Th) 1, Th2, Th 17 cell proportions in CD4 + T cells were analyzed by flow cytometric analysis in CHD patients, respectively., Results: Lnc-NEAT1 was higher in CHD patients than in controls (p < 0.001). In CHD patients, lnc-NEAT1 positively associated with Gensini score (r = 0.323, p < 0.001). Besides, lnc-NEAT1 positively correlated with tumor necrosis factor-α (r = 0.271, p = 0.003), interleukin (IL)-1β (r = 0.216, p = 0.018), IL-6 (r = 0.217, p = 0.018) and IL-17 (r = 0.292, p = 0.001); meanwhile, it was positively associated with the percentage of Th 17 cells (r = 0.384, p = 0.002). However, no correlation was found in lnc-NEAT1 with the percentage of Th1 or Th2 cells (all p > 0.05). Moreover, lnc-NEAT1 was correlated with higher hyperuricemia prevalence (p = 0.028), increased total cholesterol (r = 0.263, p = 0.004) and low-density lipoprotein cholesterol (r = 0.261, p = 0.004), but was not associated with other characteristics (all p > 0.05)., Conclusion: Lnc-NEAT1 correlates with Th17 cells and proinflammatory cytokines, also reflects stenosis degree and cholesterol level in CHD patients, which potentially improves the management of CHD patients., (© 2022 The Authors. Journal of Clinical Laboratory Analysis published by Wiley Periodicals LLC.)

Background: This study aimed to explore the correlation of long non-coding RNA metastasis-associated lung adenocarcinoma transcript 1 (lncRNA MALAT1) with microRNA (miR)-125b and further investigated their associations with disease risk, severity, and prognosis of coronary heart disease (CHD)., Methods: Totally, 230 patients who underwent diagnostic coronary angiography were recruited; meanwhile, 140 of them were diagnosed as CHD and the remaining 90 non-CHD patients served as controls. Plasma sample was collected from each participant for lncRNA MALAT1 and miR-125b mRNA expression detection by reverse transcription-quantitative polymerase chain reaction. The extent of coronary stenosis was evaluated by the Gensini score, and major adverse cardiovascular event (MACE) occurrence during the follow-up was documented in CHD patients., Results: Long non-coding RNA metastasis-associated lung adenocarcinoma transcript 1 relative expression was increased, but miR-125b relative expression was decreased in CHD patients compared with controls. ROC curve exhibited that lncRNA MALAT1 and miR-125b were of good value in differentiating CHD patients from controls, and further logistic regression analysis verified their independent correlation with CHD risk. Furthermore, lncRNA MALAT1 presented a closely negative correlation with miR-125b in CHD patients, while it presented a weakly negative association with miR-125b in controls. In CHD patients, lncRNA MALAT1 was positively correlated with Gensini score, total cholesterol, low-density lipoprotein cholesterol, C-reactive protein, tumor necrosis factor α, interleukin (IL)-1β, IL-6, IL-17, and accumulating MACE occurrence; reversely, miR-125b presented a opposite trend., Conclusion: Long non-coding RNA metastasis-associated lung adenocarcinoma transcript 1 might be associated with increased CHD risk, severity, and accumulating MACE incidence via negative interaction with miR-125b, suggesting their possible clinical application as biomarkers in the CHD screening and surveillance., (© 2021 The Authors. Journal of Clinical Laboratory Analysis Published by Wiley Periodicals LLC.)

Background and Aims: Bile acids play important roles in lipid metabolism. Several studies have found that patients with coronary artery disease (CAD) have lower bile acid fecal excretion compared to individuals without CAD. However, few studies have focused on the roles of more accessible serum total bile acids (TBA) in the progression of CAD. The aim of this study was to explore the potential relationship between fasting serum TBA and the presence of CAD, myocardial infarction (MI) and severity of coronary lesions., Methods: A total of 7438 consecutive patients with suspected CAD, who had undergone coronary angiography, were enrolled. The severity of coronary lesions was evaluated using the Gensini score (GS). The relationships between fasting serum TBA and the presence and severity of CAD were evaluated., Results: CAD patients had lower serum TBA than individuals without CAD, and patients with MI had lower TBA than those without CAD. Spline analyses showed an L-shaped relationship of the fasting serum TBA with the presence and severity of CAD, and the breakpoint approximated the normal upper limit (10 μmol/L). A lower TBA concentration (less than the median 3.6 μmol/L) was independently and significantly associated with the presence and severity of CAD, especially for the presence of MI (odds ratios 2.04, 95% confidence interval (1.71-2.44), C-index 0.9269)., Conclusions: Fasting serum TBA level is highly associated with the presence and severity of CAD in patients undergoing coronary angiography for suspected CAD., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Purpose: To investigate the effects of asymmetric dimethyl-arginine (ADMA), adiponectin (APN) and apelin in predicting macroangiopathy in impaired glucose regulation (IGR) patients., Methods: A total of 210 patients undergoing oral glucose tolerance test were included in this study. They were classified to normal glucose tolerance (NGT, n=42), impaired fasting glucose (IFG, n=36), impaired glucose tolerance (IGT, n=92, including 44 IGT1 and 48 IGT2 patients) and IFG+IGT (n=40) groups. APN, apelin and ADMA levels, blood pressure, blood lipid, insulin, body mass index (BMI), and homeostasis model assessment of insulin resistance (HOMA-IR) were detected. The severity and extent of coronary atherosclerosis were determined by the Gensini score., Results: The prevalence of coronary heart disease and Gensini scores in IGT and IFG+IGT groups were similar but both were higher than NGT and IFG groups (all P<0.05). Lower APN, higher ADMA and apelin levels were witnessed in IGT and IGT+IFG groups compared with NGT and IFG groups (all P<0.05). IGT2 group had higher 2-h PG and apelin levels and Gensini scores but lower APN levels than IGT1 group (all P<0.05). Gensini score was positively correlated with apelin (r=0.669) and ADMA (r=0.764), but were negatively correlated with APN (r=-0.555, all P<0.001). ADMA and APN were the independent factors affecting Gensini score., Conclusion: ADMA and APN levels could be predictive factors for macroangiopathy in IGR patients, especially in IGT cases., (Copyright © 2016 Elsevier Masson SAS. All rights reserved.)

Objective: Microvascular mechanisms are increasingly recognized as being involved in a significant proportion of coronary artery disease (CAD) cases, but their exact contribution or role is unclear. We aimed to define the association between retinal microvascular signs and both CAD extent and severity., Methods: 1120 participants of the Australian Heart Eye Study were included. Retinal vessel caliber was measured from digital retinal images. Extent and severity of CAD was assessed using several approaches. First, a simple scoring classifying participants as having one-vessel, two-vessel, and three-vessel disease was used. Gensini and Extent scores were calculated using angiography findings., Results: After multivariable adjustment, significantly narrower retinal arteriolar caliber in women (comparing lowest versus highest quartile or reference) and wider venular caliber in men (comparing highest versus lowest quartile or reference) were associated with 2-fold and 54% higher odds of having at least one stenosis ≥50% in the epicardial coronary arteries, respectively. Women in the third versus first tertile of retinal venular caliber had 92% and ∼2-fold higher likelihood of having higher Gensini and Extent scores, respectively. Women in the lowest versus highest tertile of retinal arteriolar caliber had greater odds of having higher Extent scores, OR 2.99 (95% CI 1.45-6.16). In men, non-significant associations were observed between retinal vascular caliber and Gensini and Extent scores., Conclusions: An unhealthy retinal microvascular profile, namely, narrower retinal arterioles and wider venules was associated with more diffuse and severe CAD among women., (Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.)

Resistin, which is derived from the gene of RSTN, belongs to a family of cysteine-rich secretory proteins called resistin-like molecules (RELMs). Increased serum resistin levels are associated with coronary artery disease (CAD) and the risk of cardiovascular death. Patients (n = 214) with an initial diagnosis of stable angina pectoris, unstable angina pectoris, and myocardial infarction without ST-segment elevation and referred to catheter laboratory for coronary angiography were enrolled in the study. We aimed to investigate the relationship between increased serum resistin level and CAD. The severity of CAD was calculated by the Gensini scoring system. In conclusion, we established a significant correlation between serum resistin levels and CAD (P = .010). Also, serum resistin levels correlated with the Gensini score that represents the severity of CAD angiographically (P = .010).

[Objectives] This study was conducted to explore the relationship between neutrophil percentage-to-albumin ratio (NPAR) and coronary heart disease complicated with diabetes. [Methods] A total of 603 patients with coronary heart disease who underwent coronary angiography in Pingquan County Hospital from January, 2023 to December, 2023 and met the inclusion criteria were included as the research object. All the patients were divided into a coronary heart disease complicated with diabetes group (CAD +T2DM group) (n=298 cases) and a control group (CAD group) (n=305 cases), according to patients' medical history, heart color ultrasound and biochemical test results. The clinical data, biochemical test results and coronary artery imaging data of patients were recorded, and the Gensini score was calculated. The neutrophil percentage (NEUT% ) and albumin count were determined to calculate NPAR. [Results] The NPAR value of the coronary heart disease complicated with diabetes mellitus group was (1. 6 ± 0. 42), which was significantly higher than that of the control group (1.47 ±0.49), and the difference was statistically significant (P<0.05). The area under the ROC curve was 0.619 (95% CI: 0.591-0.675, P < 0. 05), and the prediction of coronary heart disease complicated with diabetes using NPAR showed a Youden index of 0. 31, a sensitivity of 60.4%, a specificity of 40.3%, and a best cut-off score of 1.450 6. [Conclusions] The neutrophil percentage-to-albumin ratio (NPAR) is closely related to coronary heart disease complicated with diabetes mellitus, and NPAR has clinical application value in the diagnosis of coro-nary heart disease complicated with diabetes mellitus. [ABSTRACT FROM AUTHOR]

Aim: Coronary artery diseases (CAD) are chronic disorders in which atherosclerosis plays a major role in their pathogenesis. Their severity is directly related to cardiovascular outcomes. The assessment of Coronary Artery severity is quite complex, in which different parameters are used, such as the gensini score, syntax score, etc.Methods: This was a retrospective study of adult (≥ 18 years) patients who underwent angiography in Mogadishu Somali Türkiye Training and Research Hospital from June 2022 to September 2023. Gensini scores were calculated to determine the extent and severity of atherosclerosis among patients with coronary artery disease.Results: A total of 278 participants (78% male and 22%% women) were analyzed. Their risk factors were assessed with hypertension being the leading risk factor (48%). While a significant relationship was found between gensini score and dyslipidemia in patients with chronic ischemic heart disease (p 0.035), no significance was found with other risk factors On the other hand, the Gensini score had a significant correlation with the final decision of management (medical, PCI vs CABG).Conclusion: This study indicated that the Gensini score can be used as a guide for CAD decisions. [ABSTRACT FROM AUTHOR]

Background Coronary heart disease (CHD) is the leading cause of death world wide. Coronary angiography is often used as an effective approach for the diagnosis of CHD. However, coronary angiography accounts for relatively low percentagein examination approaches due to the limitation of various conditions in primary care, and more meaningful biomarkers need to be explored to provide a basis for primary care physicians to diagnose and treat CHD. In the previous study of our research group, it is found that early growth response 3 (Egr3) gene may be a susceptibility factor in the heterogeneity of CHD pathogenesis, and there are few reports on the correlation between CHD and Egr3 gene and inflammatory biomarkers. Objective To investigate the correlation between Egr3, interleukin-6 (IL-6) and CHD, as well as their expression levels and the severity of coronary stenosis, so as to provide a favorable laboratory basis for clinical diagnosis and treatment inprimary care. Methods A total of 110 patients who admitted to the Fifth Affiliated Hospital of Xinjiang Medical University for CHD symptoms and completed coronary artery angiography (CAG) during June to December 2021 were collected and divided into the mild stenosis group (group A≤52 points, n=50) , moderate-severe stenosis group (group B>52 points, n=30) and control group (group C, n=30) according to the CAG results and median Gensini score (52 points) . Serum Egr3 and IL-6 levels of the included patients were measured by enzyme-linked immunosorbent assay. Results The IL-6 level in group B was higher than that in group A and group C (P

Background: Dyslipidemia is the main risk factor for Acute Coronary Syndrome (ACS). Atherogenic Index of Plasma (AIP) calculated as logarithm triglycerides/high-density lipoprotein cholesterol (TG/HDL-C) is a reflection of plasma atherogenicity. The aim of this study was to find out the correlation of Atherogenic Index of Plasma with coronary artery disease severity in Non ST segment Elevation Acute Coronary Syndrome(NSTE-ACS). Methods: This cross-sectional analytical study was conducted in the department of cardiology, National Heart Foundation Hospital and Research Institute from October, 2019 to August, 2020. Total 120 patients of NSTE-ACS who underwent coronary angiography included after considering inclusion and exclusion criteria, study population was divided into three groups according to AIP; Group I: AIP≤ 0.19 (n=41), Group II: AIP>0.19-0.32 (n=41), Group III: AIP>0.32 (n=38). Baseline characteristics, biochemical variables and coronary disease severity by Gensini score were then compared between the three groups. Results: Participants had a mean age of 56.05± 9.81 years with 81.7% men. AIP was significantly increased with increased Gensini score. There was positive correlation (r= 0.819) observed between AIP and Gensini score, which was statistically significant (p<0.05). Logistic regression analysis showed that AIP was independently associated with severity of coronary artery disease assessed by Gensini score (OR=26.662, p<0.001). Conclusion: Atherogenic Index of Plasma was an independent predictor of coronary artery disease severity in patients with Non ST segment Elevation Acute Coronary Syndrome. [ABSTRACT FROM AUTHOR]

Background: Coronary angiography (CAG) is an invasive examination with high risks and costs and various complications may occur. It is necessary to find a diagnostic method, non-invasiveness, inexpensive with low risk. This study aims to analyze the correlation between the levels of serum homocysteine (Hcy), cystatin C (Cys C) and uric acid (UA) and Gensini score in patients with coronary heart disease (CHD) and assess their diagnostic value for CHD. Methods: A retrospective analysis was conducted on 1412 patients underwent CAG from October 2019 to December 2021, and we conducted this study from January to July 2022. A total of 765 patients with CHD confirmed by CAG were selected as the research group, while 647 patients revealed as non-obstructive stenosis by CAG as the control group. The serum Hcy, Cys C and UA levels were detected and the correlation between Gensini score and variables was analyzed. The receiver-operating characteristic (ROC) curve was performed to assess the diagnostic value of the Hcy, Cys C and UA for CHD. Results: The serum Hcy, Cys C and UA levels in the research group were higher as compared with the control group (p< 0.05). Spearman correlation and multivariate linear regression analysis showed that there was a significantly positive correlation between Gensini score and serum Hcy, Cys C and UA levels (p< 0.05). The ROC curve analysis presented the combined Hcy and Cys C with UA having the highest specificity of diagnostic value for CHD (area under the curve (AUC)=0.768, 95% CI 0.706– 0.823, specificity = 72.34%, sensitivity = 67.88%, Youden Index = 0.4022). Conclusion: The serum Hcy, Cys C and UA levels in patients with CHD were significantly increased, positive correlation with Gensini score. The combined Hcy and Cys C with UA could be used to assess the severity of coronary artery stenosis and provide predictive and early intervention treatment values for CHD and a new way of diagnosing CHD, which is cheap, safe, effective and deserving of clinical application. [ABSTRACT FROM AUTHOR]

Objective: We sought to investigate the correlation of pericoronary adipose tissue with coronary artery disease and left ventricular (LV) function.Methods: Participants with clinically suspected coronary artery disease were enrolled. All participants underwent coronary computed tomography angiography (CCTA) and echocardiography followed by invasive coronary angiography (ICA) within 6 months. Pericoronary adipose tissue (PCAT) was extracted to analyze the correlation with the Gensini score and LV function parameters, including IVS, LVPW, LVEDD, LVESD, LVEDV, LVESV, FS, LVEF, LVM, and LVMI. The correlation between PCAT and the Gensini score was assessed using Spearman's correlation analysis, and that between the PCAT volume or FAI and LV function parameters was determined using partial correlation analysis.Results: One hundred and fifty-nine participants (mean age, 64.55 ± 10.64 years; men, 65.4% [104/159]) were included in the final analysis. Risk factors for coronary artery disease, such as hypertension, diabetes, dyslipidemia, and a history of smoking or drinking, had no significant association with PCAT (P > 0.05), and there was also no correlation between PCAT and the Gensini score. However, the LAD-FAI was positively correlated with the IVS (r = 0.203, P = 0.013), LVPW (r = 0.218, P = 0.008), LVEDD (r = 0.317, P < 0.001), LVESD (r = 0.298, P < 0.001), LVEDV (r = 0.317, P < 0.001), LVESV (r = 0.301, P < 0.001), LVM (r = 0.371, P < 0.001), and LVMI (r = 0.304, P < 0.001). Also, the LCX-FAI was positively correlated with the LVEDD (r = 0.199, P = 0.015), LVESD (r = 0.190, P = 0.021), LVEDV (r = 0.203, P = 0.013), LVESV (r = 0.197, P = 0.016), LVM (r = 0.220, P = 0.007), and LVMI (r = 0.172, P = 0.036), and the RCA-FAI was positively correlated with the LVEDD (r = 0.258, P = 0.002), LVESD (r = 0.238, P = 0.004), LVEDV (r = 0.266, P = 0.001), LVESV (r = 0.249, P = 0.002), LVM (r = 0.237, P = 0.004), and LVMI (r = 0.218, P = 0.008), respectively. Finally, the total volume was positively correlated with FS (r = 0.167, P = 0.042).Conclusion: The FAI was positively correlated with the LV function but was not associated with the severity of coronary artery disease. [ABSTRACT FROM AUTHOR]

Objective: Echocardiography is a time and cost‐effective imaging modality, providing evidence of myocardial ischemia by detecting the regional wall motion abnormalities (RWMA). However, quite a few coronary heart disease (CHD) patients do not present RWMA. The left atrium (LA) plays an irreplaceable role in determining the prognosis and risk stratification of cardiovascular disease including CHD. In this present study, we intend to explore the myocardial mechanics changes of LA mainly using four‐dimensional (4D) LA quantitative volume‐strain in CHD patients without RWMA at rest but were confirmed by coronary angiography (CAG) and to figure out several variables of the LA that could contribute to the identification of those patients. Methods: We prospectively enrolled 76 patients who underwent two‐dimensional echocardiography (2DE), four‐dimensional echocardiography (4DE), and CAG for suspected CHD but without echocardiographic visible RWMA at rest. Patients diagnosed with CHD by CAG were furtherly divided into three groups according to the extent of coronary stenosis accessed by Gensini score (GS) as the mild, moderate, and severe CHD group. Twenty‐four subjects with negative CAG results served as the control group. LA end‐systolic anteroposterior diameter (LAAPD) and biplane LV ejection fraction (Biplane LVEF) were measured by 2DE; LA maximum volume (LAVmax), LA minimum volume (LAVmin), LA volume at the onset of atrial contraction (LAVpreA), LAVmax index (LAVmaxI), LA ejection volume (LAEV), LA ejection fraction (LAEF) accompanied by LA longitudinal strain during reservoir phase (LASr), conduit phase (LAScd), contraction phase (LASct) and LA circumferential strain during reservoir phase (LASr_c), conduit phase (LAScd_c), contraction phase (LASct_c) were measured by 4DE automatically. We compared these parameters between groups, explored how they change and whether they are related to the CHD severity. Results: LAEF, LASr_c, and LASct_c was lower in CHD group compared with the control group (p =.031,.002,.004, respectively). Pearson correlation analysis showed that LASr, LASct, LASr_c, and LASct_c negatively correlated with the GS. Additionally, LASr of patients in the severe CHD group decreased significantly compared with those in the mild CHD group, moderate CHD group, and control group, demonstrating the highest area under the receiver operating characteristic (ROC) curve (AUC) (AUC =.736 [p =.003, 95% CI.589–.884], sensitivity 67.8%, specificity 70.6%) with the cut‐off value of 17.5% for predicting severe CHD patients. Conclusion: Four‐dimensional LA strain may provide new insight into identification and management for CHD patients and correlate with CHD severity. LASr showed good sensitivity (67.8%) and specificity (70.6%) for diagnosing severe CHD individuals. [ABSTRACT FROM AUTHOR]

To investigate the correlation between the levels of serum secreted curly protein 5 (SFRP5), fibroblasts growth factor 21 (FGF21) and insulin-like growth factor 1 (IGF-I) and blood lipids and the severity of coronary artery disease in patients with coronary atherosclerotic heart disease (CHD). A total of 109 patients with CHD (CHD group) who were admitted to our hospital from June 2018 to June 2021 were selected. According to the types of CHD, they were divided into stable angina group (SAP group, 32 cases), unstable angina group (UA group, 42 cases) and acute myocardial infarction group (AMI group, 35 cases). According to Gensini score, they were divided into mild lesion group (≤ 20 scores, 42 cases), moderate lesion group (21~40 scores, 44 cases) and severe lesion group (> 40 scores, 23 cases). 53 patients with normal results of coronary angiography in our hospital at the same time were selected as the control group. Serum SFRP5, FGF21, IGF-I and blood lipid levels were detected and compared in each group, and the correlation between serum SFRP5, FGF21, IGF-I and blood lipids and Gensini score were analyzed. The serum SFRP5, FGF21, IGF-I and HDL-C levels in patients with CHD with different types and degrees of coronary artery disease were lower than those in the control group, while the serum TC, TG and LDL-C levels were higher than those in the control group, the differences were statistically significant (P<0.05). The differences comparison of serum SFRP5, FGF21 and IGF-I levels showed that UA group was lower than SAP group, AMI group was lower than UA group, moderate lesion group was lower than mild lesion group, and severe lesion group was lower than moderate lesion group, the differences were statistically significant (P<0.05). The differences comparison of serum TC and LDL-C levels showed that UA group was higher than SAP group, AMI group was higher than UA group, moderate lesion group was higher than mild lesion group, and severe lesion group was higher than moderate lesion group, the differences were statistically significant (P<0.05). There were no significant differences in serum TG and HDL-C levels between SAP group, UA group and AMI group, as well as between mild lesions group, moderate lesions group and severe lesions group (P>0.05). Pearson correlation analysis showed that serum SFRP5, FGF21 and IGF-I levels were negatively correlated with TC, LDL-C and Gensini score (P<0.05). The serum SFRP5, FGF21 and IGF-I levels in patients with CHD are decreased, which are related to the increase of blood lipids level and the aggravation of CHD lesions. [ABSTRACT FROM AUTHOR]

Objective: Although the levels of plasma fibrinogen and albumin have been proven to be in relation to coronary heart disease (CHD), the association between fibrinogen-to-albumin ratio (FAR) and acute coronary syndrome (ACS) has not been adequately investigated. The aim of this study is to investigate the relationship between FAR and the presence and severity of CHD in patients with ACS.Methods and Results: A total of 1575 individuals who received coronary angiography (CAG) were enrolled. Patients were divided into the ACS group and the control group. The severity of ACS was determined by Gensini score, number of diseased coronary artery and the presence of myocardial infarction (MI). Data showed that the level of FAR in ACS group was higher than in the control group (81.20 ± 35.45 vs. 72.89 ± 20.24, P < 0.001). The results from subgroup analysis indicated that the values of FAR in the high Gensini score group, MI group and multiple-vessel stenosis group were higher than the matched subgroups. After adjustment for confounders, FAR was still independently related to the presence and severity of ACS (MI OR 2.097, 95%CI 1.430-3.076; High GS: OR 2.335, 95%CI 1.567-3.479; multiple-vessel disease: OR 2.088, 95%CI 1.439-3.030; P < 0.05).Conclusion: The levels of FAR are independently associated with the presence and the severity of coronary artery disease in patients with ACS. Furthermore, FAR, as a more convenient and rapid biological indicator, may provide a new idea for predicting the presence and severity of ACS. [ABSTRACT FROM AUTHOR]

The inflammatory hypothesis of atherosclerosis is appealing in acute coronary syndromes, but the dynamics and precise role are not established. The study investigates the levels of C reactive protein (CRP), interleukin 1β (IL-1β) and stromal-derived factor 1α (SDF-1α) at the time of acute myocardial infarction (AMI) and at 1 and 6 months afterwards, compared with a control group. In the acute phase of AMI, CRP and SDF-1α were significantly higher, while IL-1β showed lower levels compared with controls. CRP positively correlated with coronary stenosis severity (rho = 0.3, p=.05) and negatively related with left ventricle ejection fraction (LVEF) at 1 month (rho= −0.43, p=.05). IL-1β weakly correlated with the severity of coronary lesions (rho =0.29, p=.02) and strongly with LVEF (rho= −0.8, p=.05). SDF-1α, slightly correlated with LVEF at 1 month (rho = 0.22, p=.01) and with the severity of coronary atherosclerosis (rho= −0.41, p=.003). CRP, IL-1β and SDF-1α have important dynamic in the first 6 months after AMI and CRP and SDF-1α levels correlated with the severity of coronary lesions and LVEF at 1 month after the acute ischaemic event. [ABSTRACT FROM AUTHOR]

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Objective: To determine frequency of elevated serum uric acid levels in patients with coronary artery disease, association of hyperuricemia with severity of coronary artery disease, gender, age, hypertension, and diabetes mellitus. Study Design: Cross-sectional study. Place and Duration of Study: Internal Medicine department, Combined Military Hospital Multan, from Nov 2015 to May 2016. Methodology: One hundred and fifty patients with coronary artery disease were selected consecutively and admitted for coronary angiography. Serum uric acid levels were evaluated after eight hours fasting by photometric technique having normal reference range of 3.5-6.7 mg/dL. Coronary angiography was performed and Gensini score computed. To compare mean Gensini score between normouricemic and hyperuricemic population, student's t-test was applied. Results: A total of 150 study cases (mean age: 54.4 ± 8.5 years), 101 (67.3%) were male while 49 (32.7%) were female. Diabetes mellitus was present in 43 (28.7%) of cases and hypertension was present in 65 (43.3%). Hyperuricemia was noted in 58 (38.7%) of cases. The mean Gensini score in hyperuricemic patients was significantly higher (40.31 ± 14.64) compared to patients with normal serum uric acid levels (25.02 ± 10.94) (p<0.001). The frequency of hyperuricemia was significantly higher in males, patients ≤60 years of age, and patients with diabetes mellitus (p<0.001, p=0.001 and p=0.001). No significant asso-ciation with hypertension was observed (p=0.314). Conclusion: Frequency of 38.7% for hyperuricemia was noted in our study among patients with coronary artery disease. Hyperuricemia was significantly associated with higher Gensini score, male gender, younger age, and diabetes mellitus. [ABSTRACT FROM AUTHOR]

The albumin to globulin ratio (AGR) is used as a prognostic marker in acute ischemic cardiovascular events. We investigated whether serum AGR, fibrinogen, and fibrinogen to albumin ratio (FAR) are related to the presence and severity of coronary artery disease (CAD). Patients who underwent coronary angiography procedures were analyzed retrospectively. The severity of CAD was assessed by the Gensini score. The study population (3031 patients; 1071 females and 1960 males) was divided into 3 tertiles based on AGR values. Gensini score, lipid levels, diabetes mellitus (DM), hypertension (HT), age, and fibrinogen level were higher in the low AGR group. Pearson correlation analysis showed that AGR (r = −0.068, P <.001) was negatively and fibrinogen (r = 0.187, P <.001) was positively correlated with the Gensini score. Male gender, HT, smoking, DM, age, high triglyceride (TG) level, low-density lipoprotein cholesterol (LDL-C) >160 mg/dL, estimated glomerular filtration rate (eGFR) <60 mL/min, and fibrinogen level >3.5 g/L were independent predictors of CAD. Male gender, age, eGFR, DM, LDL-C, TG, and FAR had an independent positive relation to the Gensini score. In conclusion, similar to traditional risk factors, plasma fibrinogen and albumin levels showed a close relation with the presence and severity of CAD. [ABSTRACT FROM AUTHOR]

ORIGINAL RESEARCH The Relationship Between Chronic Kidney Disease and the Severity and Long-T erm Prognosis of Patients with Coronary Artery Disease After Drug-Eluting Stent Implantation This article was published in the following Dove Press journal: International Journal of General Medicine Xianjing Wei 1 Ying Zhang 1 Gaoliang Yan 2 Xiaoqing Wang 1 1 Department of Cardiology, The Affiliated Zhongshan Hospital of Dalian University, Dalian, Liaoning, 110016, People's Republic of China; 2 Department of Cardiology, Zhongda Hospital of Southeast University Medical School, Nanjing, Jiangsu, People's Republic of China Objective: To investigate the relationship between chronic kidney disease (CKD) and the severity and long-term prognosis of patients with coronary artery disease (CAD) after drug- eluting stent (DES) implantation. Conclusions In conclusion, our analysis of the clinical and follow-up date of a large group of patients with CAD after DES implantation shows that CKD was an important predictor for the prognosis of CAD in this population. Compared with patients without CKD, patients with CAD combined with CKD had a higher incidence of hypertension (49.5% vs 42.8%). Keywords: chronic kidney disease, coronary artery disease, Gensini score, major adverse cardiac and cerebrovascular events Introduction In recent years, more and more attention has been paid to the occurrence and development of chronic kidney disease (CKD) alongside coronary artery disease (CAD). [Extracted from the article]

Background: Lp(a) and LDL-C are both risk factors of atherosclerotic cardiovascular disease (ASCVD). But there was a contradiction point in LDL-C and Lp(a) control. The appropriate level of LDL-C and Lp(a) in the prevention of ASCVD is still pending.Objective: To investigate the correlation of Lp(a) and coronary atherosclerotic lesion, and find out the balance point in LDL-C and Lp(a) control.Method: 3449 patients were divided to coronary atherosclerotic heart disease (CAHD) Group and Non-CAHD Group based on the result of coronary angiography. The clinical characteristics were compared, and Logistic regressions were applied to find the CAHD risk factors in total, High-LDL-C Group (LDL-C ≥ 100 mg/dL) and Low-LDL-C Group (LDL-C < 100 mg/dL) patients. Spearman correlation analysis of Lp(a), LDL-C and Gensini Score was performed in patients with different LDL-C concentration.Results: Except male and diabetes, the traditional CAHD risk factors were well matched between two groups. But triglyceride, LDL-C and Lp(a) were higher, HDL-C and Apo-A1 were lower in CAHD group (2771). In the Logistic regression analysis, diabetes, LDL-C and Lp(a) are risk factors of CAHD in all patients, while in High-LDL-C Group, they were age, LDL-C, non-HDL-C and ApoB, in Low-LDL-C Group, they were age, Lp(a) and ApoB. Lp(a) correlated with Gensini with coefficient r = 0.41 in all patients, 0.67 in Low-LDL-C Group and 0.32 in High-LDL-C Group. The coefficient r for Lp(a) and Gensini decreased, while the r for LDL-C and Gensini increased with LDL-C concentration increasing. The two fitted lines of rs crossed at LDL-C = 2.7 mmol/L (104 mg/dL).Conclusion: Lp(a) was the risk factor of CAHD in patients with LDL-C < 100 mg/dL. The correlation between Lp(a) and Gensini was influenced by LDL-C concentration, and the correlation was stronger than LDL-C when LDL-C < 104 mg/dl. [ABSTRACT FROM AUTHOR]

Cardiac troponin blood levels are frequently elevated in patients with impaired renal function. Their predictive value for the severity of stable coronary artery disease (CAD) remains unclear in these cases. Therefore, we aimed to evaluate the blood levels of high-sensitivity troponin T and I (hsTnT/I) and their association with the severity of stable CAD in patients with chronic kidney disease. Overall, 2209 patients with suspected stable CAD undergoing invasive coronary angiography were included in an ongoing prospective cohort study. We identified 595 patients with impaired renal function defined as an estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m2. Coronary morphology was assessed by the number of affected major coronary vessels (CAD classification), SYNTAX, and Gensini scores. hsTnT/I blood levels were measured by three latest-generation assays (Roche Diagnostics Elecsys, Abbott ARCHITECT STAT, and Singulex Clarity). Ordinal logistic regression for the severity of CAD adjusted by classical cardiovascular risk factors and eGFR were performed with each troponin assay as an independent variable. Mean age was 72.9 ± 9.8 years (33.6% female). Median eGFR was 47.5 ml/min/1.73 m2 (interquartile range [IQR] 34.9, 54.1). For the association of Roche-hsTnT, Abbott-hsTnI, and Singulex-hsTnI with the CAD classification, odds ratios per standard deviation (OR) were 1.27 (95% confidence interval [CI] 1.07–1.51), 1.21 (CI 1.02–1.44), and 1.24 (CI 1.04–1.47), respectively. The associations for the investigated assays with SYNTAX and Gensini scores, respectively, were OR 1.40, CI 1.11–1.78 and OR 1.24, CI 1.01–1.51 (Roche-hsTnT), OR 1.42, CI 1.12–1.78 and OR 1.25, CI 1.02–1.52 (Abbott-hsTnI), OR 1.38, CI 1.09–1.74 and OR 1.25, CI 1.02–1.53 (Singulex-hsTnI). In patients with impaired renal function, blood levels of hsTnT/I were significantly associated with the severity of stable CAD. These findings may help clinicians guide further diagnostic assessment. Image 1 • High-sensitivity troponins (hsTn) are elevated in patients with chronic kidney disease (CKD). • The association of elevated hsTn with coronary artery disease (CAD) remains unclear in CKD. • The present study demonstrates higher hsTn blood levels in patients with CAD. • hsTn are associated with the severity of CAD even after adjustment for CV risk factors and eGFR. [ABSTRACT FROM AUTHOR]

To analyze the relationship between serum anti-apoptotic polypeptide (HN), C1q/TNF-related protein 3 (CTRP3) and blood lipid and severity of illness in patients with coronary heart disease. A total of 360 patients with CHD (CHD group) who were admitted to the Second Affiliated Hospital of Xi'an Medical University from January 2017 to December 2018 were selected, and 100 healthy subjects in the same period were selected as healthy control group (NC group), the serum HN, CTRP3, blood lipid and baseline data were compared between the two groups. CHD patients were divided into single-vessel lesion group (n=131), double-vessel lesion group (n=119) and multi-vessel lesion group (n=110) according to the number of lesion branches, .Gensini score was measured according to the results of coronary angiography, Pearson correlation analysis was used to analyze the correlation between HN and CTRP3 and blood lipid and Gensini scores. The proportion of smoking history, systolic blood pressure, fasting blood sugar, total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL-C) in CHD group were higher than those in NC group(P<0.05), while serum HN, CTRP3 and high density lipoprotein (HDL-C) were lower than those in NC group (P<0.05); The smoking history, fasting blood glucose, TC level and Gensini score in CHD double-vessel lesion group and multi-vessel lesion group were higher than those in single-vessel lesion group, and CTRP3 and HDL-C levels were lower than those in single-vessel lesion group. Systolic blood pressure in multi-vessel lesion group was higher than that in single-vessel lesion group, the smoking history, fasting blood sugar and Gensini score in multi-vessel lesion group were higher than those in double-vessel lesion group, and CTRP3 in multi-vessel lesion group was lower than that in double-vessel lesion group (all P<0.05). Pearson correlation analysis showed that serum HN level was positively correlated with HDL-C level in patients with CHD, and serum CTRP3 level was negatively correlated with Gensini scores in patients with CHD (P<0.05). The serum HN and CTRP3 levels are significantly decreased in patients with CHD. HN is positively correlated with HDL-C. The degree of CTRP3 reduction is related to the severity of illness in patients with CHD. It could be considered as an auxiliary serological index to evaluate the severity of illness in patients with CHD. [ABSTRACT FROM AUTHOR]

Introduction: N-Terminal pro Brain Natriuretic Peptide (NT-pro BNP) is an important biomarker in the management of patients with heart failure. Several studies reported its importance as a predictor of morbidity and mortality in Acute Coronary Syndrome (ACS) patients. Aim: To compare serum NT-proBNP levels in Non ST Elevation Acute Coronary Syndrome (NSTE-ACS) patients and controls and to assess the relation between Nt-proBNP and the severity of Coronary Artery Disease (CAD) in patients with NSTE-ACS including unstable Angina (UA) and Non ST Elevation Myocardial Infarction (NSTEMI). Materials and Methods: Sixty NSTE-ACS patients and 20 matched control without significant obstructive CAD were included in the study. Cardiac enzymes, blood urea, serum creatinine, serum NT-proBNP were measured in all patients immediately before coronary angiography. Gensini score and Syntax score were calculated for all study patients. The NSTEACS patients were followed-up for six months Major Adverse Cardiovascular Events (MACE) including mortality, myocardial infarction, heart failure, stroke, revascularisation by primary percutaneous coronary intervention or Coronary Artery Bypass Grafting (CABG). Results: The mean serum NT-proBNP in NSTE-ACS (UA and NSTEMI) patients was significantly higher (662.7±635.2) pg/mL than that in the control (102.3±96.4) pg/mL, p<0.001. The effective cut-off value for the diagnosis of CAD was 139 pg/mL, Area Under Curve (AUC)=0.950, 95% CI: 0.890-1.00). The serum NT-proBNP was correlated with the severity and complexity of CAD as measured by Gensini score (r=0.496, p<0.001) and Syntax score (r=0.443, p<0.001). The mean value of NT-proBNP in patients with six months MACE was insignificantly higher than in patients without six months MACE with Interquartile Range (IQR) of 418.5 (139-2037) vs. 366 (175-3237) pg/mL, p=0.970. Conclusion: NT-proBNP was correlated with the severity and complexity of CAD in NSTE-ACS with preserved left ventricular systolic function, but it has no impact on six months MACE. [ABSTRACT FROM AUTHOR]

Background and aims: Identification of coronary artery disease by non-invasive means is a subject of interest for all. Myocardial strain has shown some promising results. This study intends to see if change in strain value correlates with the angiographic findings in patients with stable angina. It is also assessing whether myocardial strain can predict the presence of coronary artery disease (CAD) in stable angina patients. Methods: This cross-sectional study was carried out on 84 stable angina patients with no previous cardiac history and normal LV function undergoing coronary angiogram for guideline-based indication. After careful history, clinical examination and investigations, including conventional echocardiography, selected participants underwent 2-D speckle tracking echocardiography for measurement of myocardial strain by automated functional imaging. All participants underwent coronary angiogram and stenosis >70% was considered significant. Gensini score was calculated. The myocardial strain value and Gensini score were correlated. Results: Global longitudinal strain (GLS) was significantly lower in patients with significant CAD than those with non-significant CAD (-16.1±2.6% vs -19.4±2.2%; p < 0.001). The optimal cut-off value of GLS, which discriminated between patients with and without significant coronary artery disease, was -18.05% (sensitivity=81.8% and specificity=85%). Also, GLS declined incrementally with the increasing severity of CAD defined by increasing number of stenotic vessels. There was an inverse correlation between GLS and severity of CAD (expressed in Gensini score) in this study (r = 0.669, p< 0.001), meaning that GLS decreased with increasing severity of CAD. GLS remained an independent predictor for the presence of significant CAD after multivariate adjustment for other significant baseline characteristics and echocardiographic parameters. Conclusion: The myocardial strain by 2DSE correlates with the angiographic severity by coronary angiogram in patients with stable angina. It is an independent predictor of significant coronary artery disease, which it can detect with good sensitivity and specificity. [ABSTRACT FROM AUTHOR]

Objective: To investigate gender differences in risk factors associated with coronary artery disease (CAD), and to explore the association between glycated albumin (GA) and CAD. Method: We recruited 350 adult patients, collected their clinical information and divided them into CAD and non-CAD groups, based on angiography results. Results: Patients with CAD showed significantly higher age related GA, fasting blood glucose, serum creatinine (SCr) and Gensini score. Multivariate Logistic regression analysis identified gender, age, superoxide dismutase(SOD) and GA as independent factors in CAD patients (p < 0.05) and the mean GA level in females was higher than in males. Univariate linear regression analysis also showed that GA was not associated with male CAD patients. In females, SOD, low-density lipoprotein cholesterol (LDL-c), and GA were associated with a significant Gensini score (p < 0.05). Finally, GA was capable of classifying CAD in women (AUC > 0.767; p<0.001). Conclusion: GA is positively correlated with the severity of coronary artery obstruction in female patients presenting with CAD. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Surgery & Medicine (JOSAM) is the property of Journal of Surgery & Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The aim of this study was to evaluate whether serum cystatin C could serve as a predictor of multivessel coronary artery disease identified by coronary angiography in type 2 diabetes patients with normal renal function and to suggest the cutoff point of serum cystatin C for predicting multivessel disease.Methods: Serum cystatin C concentrations were measured by using particle-enhanced immunonephelometric assays before coronary angiography in 135 consecutive type 2 diabetes patients and 179 nondiabetic patients with normal renal function. Routine anthropometric and serologic data were collected. The severity of multivessel disease was assessed with the Gensini score after coronary angiography. The associations of serum cystatin C with the Gensini score were investigated, and the independent risk factors associated with multivessel disease were assessed.Results: Serum cystatin C and the Gensini score were significantly elevated in diabetes patients. Cystatin C had a positive correlation with Gensini score. A multiple logistic regression analysis demonstrated that cystatin C was independently associated with the presence of multivessel disease (the OR score is 2.21, P = 0.003). Based on the ROC curve, a cystatin C level of 0.865 mg/L showed 67.7% sensitivity and 76.3% specificity with an AUC of 0.748 in diabetes patients for detecting multivessel disease.Conclusion: Serum cystatin C is significantly correlated with the presence of multivessel disease, suggesting that cystatin C might be utilized as a screening tool for predicting multivessel disease in type 2 diabetes mellitus patients with normal renal function. [ABSTRACT FROM AUTHOR]

Objective: Subclinical hypothyroidism (SCH) has been identified as a risk for atherosclerosis and Coronary Artery Disease (CAD). The aim of this study was to determine the prevalence and association between hypothyroidism or subclinical hypothyroidism (SCH) and lipid parameters, anthropometric data and the severity of coronary artery disease (CAD) in patients awaiting Coronary Artery Bypass Graft Surgery (CABG) from a selected center. Method: A cross sectional analytical study was carried out amony patients awaiting CABG in a selected center. Thyroid profile (enzyme immunoassay method), lipoprotein (a) [Lp(a)], C- reactive protein (CRP) (immunoturbidimetric method) were determined and the Gensini score calculated. Lipid parameters and details of current medication were obtained from the medical records and anthropometric data were measured. Results: From a total of 102 patients 3% were on treatment for hypothyroidism and 15% had subclinical hypothyroidism. A significantly high (p= 0.04) percentage of SCH patients (75%) were dyslipidemic. There were no significant differences observed in lipid profiles and Lp(a) among SCH and euthyroid patients when the total sample or dyslipidemic sample was considered. However, a significantly high percentage (58%, p<0.05) of SCH patients on statins had a higher level of low density lipoprotein cholesterol (LDLc) compared to euthyroid dyslipidemic patients. A significant negative (p< 0.05) correlation was observed between thyroid stimulating hormone concentration and high density lipoprotein cholesterol (r= -0.67) in SCH group. No significant differences were observed in anthropometric data, CRP or Gensini score of SCH and euthyroid patients with CAD. Conclusion: The prevalence of dyslipidemia among SCH patients with CAD was significantly high. The patients suffering from SCH exhibited higher levels of LDLc compared to euthyroid patients from both the total and dyslipidemic groups. SCH patients under statin treatment displayed a higher LDLc suggesting a strong association between coronary artery disease and thyroid disease. [ABSTRACT FROM AUTHOR]

Background: Lipid disorder was one of the major risk factors for coronary artery disease (CAD), especially in postmenopausal women, whose lipid profile significantly changed during the transition period to menopause. The aim of the present study was to examine whether plasma lipoprotein(a) [Lp(a)] was a biomarker for predicting the presence and severity of CAD in postmenopausal women. Methods: A total of 783 postmenopausal women who had their first angina-like chest pain were enrolled and classified into two groups according to the results of coronary angiography: CAD group (n = 309) and age-matched non-CAD group (n = 309). Patients with CAD were further divided into the three groups based on Gensini score (GS). The relationships of plasma Lp(a) levels to the presence and severity of CAD were evaluated, and the predictive value of Lp(a) for CAD was also examined. Results: CAD group had higher Lp(a) levels when compared to non-CAD ones (p < 0.001). The multivariate logistic regression analysis suggested that Lp(a) was an independent predictor for the presence of CAD (p < 0.001). Plasma levels of Lp(a) were significantly related to GS (p < 0.001). In addition, plasma Lp(a) level was significantly elevated according to the tertiles of GS (p = 0.001) and was independently associated with high GS (p < 0.001). In receiver-operating characteristic analysis for predicting the presence of CAD in postmenopausal women, Lp(a) was found to have the area under the curve of 0.703, with an optimal cutoff value of 255.69 mg/L. Conclusions: Lp(a) is an independent risk factor for predicting the presence and the severity of new-onset CAD in postmenopausal women, suggesting that Lp(a) may be a lipid target for prevention and treatment in such patients. [ABSTRACT FROM AUTHOR]

Aim: Vaspin is an insulin-sensitive adipokine secreted from visceral fat tissue, and belongs to the serine protease inhibitor family. The relationship between vaspin level and coronary artery disease is not known yet. We aimed to investigate the relationship between serum vaspin levels and degree of vessel involvement in coronary angiography in patients with stable angina pectoris. Methods: The patients were chosen from those who had coronary angiography with the diagnosis of stable angina pectoris. Patients with previously diagnosed chronic heart disease, chronic liver disease, renal failure, thyroid dysfunction and any systemic infectious or malignant disease, patients receiving immunosupressive treatment and those who did not give informed consent were excluded from the study. Serum vaspin measurements were performed using an East Biopharm enzyme-linked immunoassay (ELISA) kit using the sandwich ELISA method. For determination of the severity of coronary lesions, the modified Gensini score was used. Results: Eighty-eight patients [34 female (38.6%) and 54 male (91.4%)] were included in the study. Vaspin levels were similar in male (1.17±1.54 ng/L) and female (1.09±1.23 ng/L) patients (p=0.46). There was no correlation between vaspin levels and the number of vessels involved (p=0.75). Vaspin levels were similar in diabetic and nondiabetic patients. Conclusion: Vaspin may not be a sensitive marker of the degree of vascular lesions in patients with stable angina pectoris. The underlying cause is probably lack of significant changes in inflammatory cascade and oxidative stress in the involved group of patients. [ABSTRACT FROM AUTHOR]

Objective: Interleukin (IL) 25, also known as IL-17E, is an inflammatory cytokine and has been demonstrated to be closely related to cardiovascular diseases by regulating immunity and inflammation, including atherosclerosis. This study was aimed to evaluate the expression of IL-25 in patients with coronary artery disease (CAD). Methods: In this study, the expression of IL-25 in normal (n=6) and atherosclerotic (n=10) human coronary arteries was detected by immunofluorescent staining. In addition, the serum IL-25, IL-6, and tumor necrosis factor (TNF) a concentrations in stable angina pectoris (SAP, n=44), unstable angina pectoris (UAP, n=46), acute myocardial infarction (AMI, n=34), and non-CAD (control, n=36) were measured using enzyme-linked immunosorbent assay (ELISA) kits. Results: IL-25 was significantly increased in coronary arteries of CAD patients when compared with normal coronary arteries, with macrophages and T lymphocytes being the sources of IL-25, especially macrophages. Moreover, the serum concentrations of IL-25 were markedly elevated in CAD patients and gradually increased in SAP, UAP, and AMI groups. In addition, IL-25 levels were positively correlated with the IL-6 and TNF-a levels, and Gensini score in CAD patients. Logistic regression analysis showed that IL-25 was independently positively correlated with the occurrence of acute coronary syndrome (ACS). A receiver operator characteristic curve suggested that IL-25 presented a significant diagnosis value in ACS. Conclusion: IL-25 is increased in the coronary arteries and serum of CAD patients and is associated with the severity of coronary stenosis and the occurrence of ACS, suggesting that IL-25 may be one of the biomarkers of ACS. [ABSTRACT FROM AUTHOR]

Background: Studies had reported an increasing trend of coronary artery disease (CAD) cases in the military population. However, the severity of the CAD among different military rank is yet to be studied. The Gensini scoring system as a popular and developed objective method to quantify the CAD severity through the coronary an giographic findings. Material and Method: In this retrospective cross-sectional study, researchers consecutively enrol a consecutive total of 171 patients referred to the Indonesian Navy Hospital of Dr Ramelan, who underwent elective coronary angiography from January to June 2019. Researchers divided the study population into three groups of low-rank military personnel, high-rank military personnel, and the civilian. Anthropometric, laboratory finding, and Gensini score were obtained from medical records. Results: This research found that Post-hoc LSD test analysis showed the average score of Gensini Score of high-rank military personnel (18.39 ± 32.71) is significantly lower than both low-rank (32.76 ± 41.84; p=0.031) and civilian (36.08 ± 43.41; p=0.005). Conclusions: High-rank military personnel was found to have lower Gensini score compared to low-rank and civilian. [ABSTRACT FROM AUTHOR]

Coronary atherosclerosis is a chronic systemic inflammatory disease. Laboratory parameters such as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and systemic immune inflammation index (SII) have been used to assess inflammation degree and coronary artery disease (CAD) severity. The lymphocyte-to-C-reactive protein ratio (LCR) is a new SII. However, its relationship with CAD development and severity is unclear. A total of 1,107 patients (479 in control group, 628 in CAD group) underwent coronary angiography. The routine and biochemical indices of the venous blood of patients were assessed before coronary angiography. LCR, SII, NLR and PLR were calculated and statistical analyses were performed. Propensity score matching (PSM) and a logistic regression model were used to analyze the relationship between LCR and CAD. After the PSM, 384 pairs of patients with or without CAD were successfully matched. After the median binary classification of all indicators, uni- and multivariate logistic regression analyses showed that platelet count was an independent risk factor and LCR was an independent protective factor. Using the same method, in the coronary heart disease severity group, 212 pairs were successfully matched and NLR and PLR were independent risk factors, while LCR was an independent protective factor. In conclusion, LCR is an independent protective factor against CAD development and severity. [ABSTRACT FROM AUTHOR]

Lipoprotein-associated phospholipase A2 (Lp-PLA2) is a newly emerging biomarker with strong pro-inflammatory effects, and is an independent risk predictor of atherosclerotic plaque rupture and thrombosis. In addition, ischemic modified albumin (IMA) is another important marker for the evaluation of myocardial ischemia, and has been approved by the U.S. Food and Drug Administration. The objective of this study was to investigate serum Lp-PLA2 and IMA in the early diagnosis, progression and prognosis of acute coronary syndrome (ACS). Serum Lp-PLA2 and IMA were detected using an AU5800 automatic biochemical analyzer in samples from 180 patients with ACS [n = 60 with unstable angina pectoris (UA), n = 56 with non-ST segment elevation myocardial infarction (NSTEMI), and n = 64 with ST segment elevation myocardial infarction (STEMI)] and 60 healthy control subjects. The relationship between Lp-PLA2 and IMA with Gensini score and the number of coronary artery lesions was explored, and logistic regression was conducted to identify risk factors for major adverse cardiovascular events (MACE). Serum Lp-PLA2 and IMA were significantly higher in all ACS subgroups compared to the control group (P < 0.05), were positively associated with the severity of ACS based on the Gensini score (P < 0.05), and were significantly higher in patients with double- and triple-vessel lesions compared to those with single-vessel lesions and healthy controls (P < 0.05). Logistic regression identified Lp-PLA2, IMA, and troponin I levels as independent risk factors for MACE. Lp-PLA2 and IMA were predictive of the degree of myocardial ischemia in patients with ACS, and may provide important clinical significance for the early diagnosis of ACS and the choice of treatment strategy. [ABSTRACT FROM AUTHOR]

Objectives: Our study investigated left ventricular dyssynchrony (LVD) in coronary artery disease (CAD) patients without regional wall‐motion abnormality (RWMA) by three‐dimensional echocardiography (3‐DE) and explored the relationship between LVD and severity of CAD as assessed by the Gensini score (GS). Methods: Sixty‐one patients with a confirmed diagnosis of CAD by coronary angiography (CAG) were enrolled. We quantified LVD parameters, including the left ventricular segments (16, 12, and 6) standard deviation of the time to minimum systolic volume (TmsvSD‐16, TmsvSD‐12, and TmsvSD‐6) and the systolic dyssynchrony index in regions 16, 12, and 6 (16R‐SDI, 12R‐SDI, 6R‐SDI) using 3‐DE. The severity of coronary atherosclerotic lesions was evaluated by the GS system on the basis of CAG findings. We further divided all patients into three groups according to the tertiles of GS: low‐GS ≤20, mid‐GS >20 and ≤48, and high‐GS >48. The differences of LVD values among the three groups were compared, and the associations between LVD parameters and GS were analyzed. Results: Coronary artery disease patients demonstrated increased LVD parameters compared with healthy controls. TmsvSD12, 16R‐SDI, and 6R‐SDI were prolonged in the high‐GS group compared with the low‐ and mid‐GS groups. 16R‐SDI was positively correlated with the GS, and multivariate regression analysis showed that 16R‐SDI was an independent predictor of the GS. 16R‐SDI above 10.7% had a sensitivity of 84.21% and a specificity of 92.86% for identifying high‐GS. Conclusion: Three‐dimensional echocardiography is a noninvasive technique to detect LVD in non‐RWMA CAD patients, and the parameter 16R‐SDI was significantly correlated with CAD severity. [ABSTRACT FROM AUTHOR]

Graphical representation of pathological events in coronary artery disease. • Senescence indicators and elements of methylation cycle correlate with Gensini scores. • Cell cycle arrest distinguishes patients with zero Gensini score from ≥1 Gensini score. • Cell cycle arrest can be considered as a non-invasive diagnostic tool to pre-screen patients with suspected CAD, before angiogram. Peripheral blood mononuclear-cells (PBMNC) senescence in relation to coronary-artery-disease (CAD) severity, and factors influencing senescence and severity are limited. Here, we explored the association of PBMNC-senescence with the extent of coronary stenosis and methylation-cycle; and methylation-cycle with severity. We assessed telomerase activity (TA) and cell cycle arrest (CCA) in PBMNC as senescence-indicators; plasma concentrations of analytes (asymmetric-dimethylarginine:ADMA, homocysteine:HCY) and SAM-dependent-methyltransferase activity in PBMNC for methylation-cycle. Based on Gensini scores (GS), 45 participants were assigned to either insignificant CAD (with ≤50% stenosis) or established CAD (with >50% stenosis) group. Using LC-ESI-MS, HTRF-assay, propidium-iodide flow-cytometry and PCR-ELISA approaches, concentrations of analytes, methyltransferase-activity, CCA and TA were assessed. There were significant differences in senescence indicators, methylation-cycle and GS among the groups (P < 0.05). GS has positive correlation (P = 0.0001) with CCA, methyltransferase-activity and analytes concentrations; negative correlation (P = 0.0001) with TA. Additionally, methyltransferase-activity and analytes' concentrations are positively correlated (P = 0.0001) with CCA; negatively correlated (P = 0.0001) with TA. Together, senescence indicators and methylation-cycle elements were altered in patients with or without stenosis. This study shows that PBMNC-senescence signatures can be defined for GS; CCA can be developed as a non-invasive tool to assess CAD severity as CCA distinguishes patients with and without significant coronary artery stenosis. [ABSTRACT FROM AUTHOR]

Purpose: Obstructive sleep apnea (OSA) is highly prevalent among patients with coronary artery disease (CAD). The relationship between the severity of OSA and the severity of CAD has not been entirely established. The objective was to explore the type of correlation existent between the apnea-hypopnea index and the Gensini score, which provides granularity in terms of CAD extension and severity, in search of a dose-response relationship. Methods: A cross-sectional study was conducted among patients that underwent cardiac catheterization due to the suspicion of CAD. Coronary lesions were classified according to one's Gensini score. The severity of OSA was determined by the apnea-hypopnea index (AHI), obtainable through a respiratory polysomnography. Results: Eighty patients were eligible for the study. The mean age was 55 years, and 37% had AHI ≥ 15. Forty-four subjects (55%) had a Gensini score of 0, and five had a score < 2, indicating a 25% obstruction in a non-proximal artery; these individuals were considered non-CAD controls; and clinical characteristics were similar between them and CAD cases. Attempts to correlate the AHI with the Gensini score either converting both variables to square root (r = 0.08) or using Spearman's rho (rho = 0.13) obtained small, non-significant coefficients. AHI ≥ 15 was a predictor of a Gensini score ≥ 2 with a large effect size (OR 4.46) when adjusted for age ≥ 55 years, BMI ≥ 25 kg/m2, uric acid, and hypertension. Conclusions: In patients undergoing coronary angiography due to suspected CAD, moderate-severe OSA was associated with the presence of CAD but no significant correlation was found between the lesion severity and the AHI. Our results suggest that OSA influences CAD pathogenesis but a dose-response relationship is unlikely. [ABSTRACT FROM AUTHOR]

Current assessment tools for patients with acute chest pain are either traumatic (coronary angiography) or unreliable (measurement of cardiac troponin concentrations). We investigated whether the novel cardiovascular stress markers, serum growth differentiation factor-15 (GDF-15), Krüppel-like factor 4 (KLF4) and growth arrest-specific 6 (gas6) may be useful biomarkers of coronary artery disease (CAD). A total of 350 male patients were enrolled, 198 with CAD and 152 controls, based on coronary angiography. GDF-15, KLF4 and gas6 concentrations were measured using commercial enzyme-linked immunosorbent assay kits. Multivariate logistic regression and multivariate linear regression were performed to evaluate potential associations of GDF-15, KLF4 and gas6 with risk of CAD or CAD severity. Serum GDF-15, KLF4 and gas6 concentrations were significantly higher in male patients with CAD than in control subjects (P <.05), and they correlated significantly with involvement of coronary vessels (P <.05). After adjusting for confounding factors, we found that circulating GDF-15 concentrations remained positively associated with the presence of CAD (odds ratio [OR] per 1-standard deviation [SD] increase, 3.182; 95% confidence interval [CI] 1.586 to 6.382; P =.001), as did KLF4 concentrations (OR per 1-SD increase, 13.05; 95% CI 2.940 to 57.921, P =.001). Moreover, circulating GDF-15 concentrations were positively associated with the Gensini score (estimated SD change per 1-SD increase, 22.091; 95% CI 9.147 to 35.035, P =.001), as were KLF4 concentrations (estimated SD change per 1-SD increase, 27.996; 95% CI 10.082 to 45.910, P =.002). Gas6, in contrast, showed no relationship to presence of CAD or Gensini score., In this case-control study, increased concentrations of circulating GDF-15 and KLF4 were significantly associated with the presence and severity of CAD. • Serum GDF-15, KLF4 and gas6 concentrations were higher in patients with CAD, especially in 3-vessel disease. • Serum GDF-15, and KLF4 concentrations significantly associated with the severity of coronary atherosclerosis. • Our findings provide us with new angle of use of combination of biomarkers can aid in early diagnosis and treatment of CAD. [ABSTRACT FROM AUTHOR]

Background: Although lipoprotein(a) (Lp(a)) has been regarded as an independent risk factor for atherosclerotic cardiovascular disease (ASCVD), its predictive role in outcomes in stable coronary artery disease (CAD) has been undetermined. The aim of the present study was to investigate the relations of Lp(a) to the coronary severity and events in Chinese patients with angiography-proven stable CAD.Methods: A total of 3,278 patients with stable CAD were consecutively enrolled and the coronary severity was evaluated by the Gensini Score (GS) system. Patients were divided into two groups according to the median of GS: high GS group (n=1,585) and low GS group (n=1,693). The associations of continuous Lp(a), Lp(a) ≥300mg/L, and tertiles of Lp(a) with GS and events were respectively evaluated.Results: Patients in the high GS group had significantly higher concentrations of Lp(a). In addition, the multivariate Cox regression analysis indicated that elevated Lp(a) (odds ratio: 1.164, 95% confidence interval: 1.005-1.349), Lp(a) ≥300mg/L (odds ratio: 1.200, 95% confidence interval: 1.028-1.401), and the highest tertile of Lp(a) (odds ratio: 1.205, 95% confidence interval: 1.010-1.438) were statistically associated with GS after adjusted for potential confounders. However, although 215 (6.56%) events were established during a median of follow-up over 10,170 patient-years, no relationship between Lp(a) and events was found.Conclusions: In this Chinese cohort study on stable CAD with moderate sample size and follow-up duration, data showed that Lp(a) was significantly associated with the coronary severity while not with cardiovascular events, similar to several studies, suggesting that further study is needed regarding the role of Lp(a) in ASCVD. [ABSTRACT FROM AUTHOR]

Introduction: Over the years, the extraskeletal effects of Vitamin D (vit D) are gaining prominence. The role of vit D deficiency (VDD) in coronary artery disease (CAD) is conflicting. Hence, the present study was aimed to correlate serum vit D levels with high-sensitivity C-reactive protein (hs-CRP) and Gensini score in CAD individuals. Materials and Methods: This cross-sectional study was conducted on 70 angiographically proven CAD individuals aged between 35 and 55 years of both sexes who presented with a history of myocardial injury or ischemia for the first time. The angiographic findings were graded using Gensini score. Serum vit D and hs-CRP were estimated using enzyme-linked immunosorbent assay. Results: The average serum vit D level was 15 ng/mL, and the ratio of diabetes and nondiabetes individuals was 52:18. Among the 70 patients, 66% (n = 46) were deficient, 20% (n = 14) were insufficient, and 14% (n = 10) had normal vit D status. Although insignificant, vit D levels had negative correlation with Gensini score (r = −0.17, P = 0.14) and hs-CRP levels (r = −0.03, P = 0.77) which was not sustained after multivariate logistic regression. A significant negative correlation (r = −0.35, P = 0.01) was found between serum vit D status and duration of diabetes. Conclusion: VDD observed in diabetes individuals is inversely related to the duration of diabetes which incidentally is associated with CAD. Thus, screening for vit D status may be vital for the management of CAD particularly in diabetes individuals. [ABSTRACT FROM AUTHOR]

Allergic asthma can accelerate atherosclerosis, a disease in which plaque is deposited onto arterial walls and that may lead to coronary artery disease (CAD). Eosinophils are the most important effector cells in allergic asthma and are likely to become novel biomarkers for risk stratification of patients with CAD, but the relationship between eosinophil count and CAD remains unclear. We aimed to evaluate this relationship and the use of eosinophils in predicting CAD. A total of 5287 patients who underwent coronary angiography were recruited. Their biochemical parameters, including eosinophil count, were measured and their correlation with the severity of coronary artery stenosis, as quantified by the Gensini score system, was evaluated. The percentages of eosinophils in leukocytes (PELs) were lower in CAD patients (p < 0.001), and had a significant negative correlation with Gensini scores (r = -0.112, p < 0.001). PELs were also significantly lower in acute myocardial infarction patients (p < 0.001). After adjusting for baseline differences, low PELs remained strongly associated with severe CAD and acute coronary arterial thrombotic event. Receiver-operating characteristic curve analysis showed that combining PELs with traditional risk factors in predictive models for CAD severity (z = 4.470, p < 0.001) or acute coronary arterial thrombotic event (z = 9.435, p < 0.001) improved the predictive capabilities of those models. PELs, at least in patients undergoing coronary angiography, may be strongly related to the subtype and severity of CAD and, therefore, eosinophil count may be an accurate and independent biomarker to predict CAD severity and acute coronary arterial thrombotic events. Image 1 • A total of 5287 patients who underwent coronary angiography were included in the study. • The eosinophil count may be strongly negativly related to the subtype and severity of CAD. • Eosinophils may be a promising biomarker that can accurately and independently predict CAD severity and myocardial infarction. [ABSTRACT FROM AUTHOR]

Background: Now a days coronary artery disease (CAD) becomes major cause of death. One among 7 deaths in America caused by CAD. CAD is an atherosclerosis process, which progresively develops into plaque that will lead to stenosis of coronary artery lumen. Several studies found that high serum fibrinogen level is an independent and significant to the severity of artery coronary stenosis. Serum fibrinogen level determined by genetic factor. Polymorphism of fibrinogen gene ß -455 G/A seem plays an important role in plasma fibrinogen level. Although some studies showed a significant correlation between polymorphism and cardiovascular diseases, but some other studies report inversely. Aim. To evaluate the correlation between the polymorphism of fibrinogen gene ß -455 G/A and serum fibrinogen level with the severity of artery coronary stenosis. Method: This is an analytic correlative study with prospective approach without comparison. Coronary angiography was performed in catheterization labor in the department of internal medicine, while DNA analysis and PCR done in the department of microbiology in General Hospital dr Muhammad Husin Palembang-Indonesioa, since July 2015 until Agustus 2016. Samples are CAD patient who undergo for coronary angiography and fulfield the criterias. The severity of stenosis in coronary artery determined by Gensini score. This study included 31 patient. Results. Among 31 CAD patients, this study found severe stenosis of coronary artery in 17 patients (53,1%), moderate in 5 patients (15,6%) and mild in 10 patients (31,2%). Genetic analysis showed that serum fibrinogen level was controlled by polymorphism of fibrinogen gene ß -455 G/A, concecutively by genotipe AA in 15 patients (48,4%), genotipe GA in 12 patient (38,7%) and by genotipe GG in 4 patients (12,9%). Chi Square test showed a significant correlation between polymorphism gene fibrinogen ß -455 G/A and serum fibrinogen level (p=0,039). Spearman's rho test found no significant correlation between serum fibrinogen level and severity of coronary artery stenosis based on Gensini score (r=0,142; p=0,447). And also this study found no significant correlation between polymorphism gene fibrinogen ß -455 G/A with the severity of stenosis in coronary artery (p=0,512). Conclusion. Although this study succeded to prove that serum fibrinogen level was determined by polymorphism fibrinogen gene ß -455 G/A, but there are no significant correlations between polymorphism fibrinogen gene ß -455 G/A and serum fibrinogen level with severity of coronary artery stenosis in CAD patients. This study suggest to study other candidate gene to look for other cardiac risk beside this fibrinogen. [ABSTRACT FROM AUTHOR]

Intrarenal hemodynamic alterations are independent predictors of cardiovascular events in different populations. It has been hypothesized that there is an association between renal hemodynamics and coronary atherosclerotic burden in patients with hypertension. Therefore, the present study examined the associations between renal hemodynamics, coronary atherosclerotic burden and carotid atherosclerotic disease. A total of 130 patients with hypertension aged between 30–80 years who had been referred for an elective coronary angiography were enrolled in the present study. A duplex ultrasound of the intrarenal vasculature was performed to evaluate the resistive index (RI), pulsatility index (PI) and acceleration time (AT). The carotid intima-media thickness was additionally assessed. A coronary angiography was performed to detect the atherosclerotic burden using the Gensini Score (GS). Based on the GS values, subjects were divided into quintiles (I: ≤9; II: 9–17; III: 17–30; IV: 30–44; and V: GS >44) as well as in subjects with mild (GS ≤30) or severe coronary disease (GS >30). A weak significant difference in PI was identified among quintiles (P=0.041), whereas, RI and AT did not differ significantly. PI was associated with GS in the group with low coronary atherosclerotic burden (GS ≤30; P=0.047), whereas, no association was detected in subjects with GS >30. This association remained following adjustment for age and left ventricular ejection fraction (P=0.025). In conclusion, renal vascular alterations were associated with coronary atherosclerotic burden in patients with hypertension with mild coronary disease. [ABSTRACT FROM AUTHOR]

Background: Recent studies have shown EAT to be an indicator of cardiovascular risk and atherosclerotic plaque development. However, such data is sparse from Indian sub-continent. The present study evaluated the relationship of EAT as determined by echocardiography to the presence and severity of coronary artery disease (CAD). Materials and Methods: This was a cross-sectional observational study constituting 500 patients including 250 with angiographically normal coronary arteries (non-CAD group), and 250 patients with significant CAD on coronary angiogram (CAD group). CAD severity was assessed by Gensini and SYNTAX scores. Results: The mean systolic and diastolic EAT thickness in the CAD group (5.7 ± 1.5 mm and 4.3 ± 1.1 mm) were significantly higher than the non-CAD group (4.2 ± 1.2 mm and 3.2 ± 1.2 mm), both P < 0.001. EAT thickness showed a significant positive correlation with waist circumference, LDL-C levels, Gensini score, and SYNTAX score. On multivariate logistic regression analysis, both systolic and diastolic EAT thickness were found to be independent predictor of CAD in addition traditional risk factors. Receiver operating characteristics (ROC) analysis showed that systolic EAT thickness of 5 mm and diastolic EAT thickness of 4 mm had similar sensitivity (85% vs 83%, respectively) and specificity (70% vs 72%, respectively) to detect presence of CAD. Conclusion: Systolic and diastolic EAT thicknesses are increased in CAD patients and related to both presence and severity of CAD. EAT, being modifiable, may be an attractive target for future interventions to reduce CV risk and has potential to monitor the response to life-style modification and therapy. However, larger and prospective studies required to validate these findings. [ABSTRACT FROM AUTHOR]

Background and Aim: Stable angina pectoris is a common disease that may cause disability. Some noninvasive new methods can be useful for the detection of early‐stage coronary artery disease. The relationship between coronary artery disease (CAD) severity and resting 3‐dimensional‐speckle tracking echocardiography (3D‐STE) in stable angina pectoris patients was evaluated in this study. Methods: One hundred and twenty consecutive patients between 18–80 years of age and without a history of CAD to whom elective coronary angiography was planned after positive stress test or myocardial perfusion scintigraphy were enrolled in the study. 3D‐STE was performed and global longitudinal strain (GLS), global circumferential strain (GCS), global radial strain (GRS), and global area strain (GAS) were measured before coronary angiography. A Gensini score of ≥20 was accepted as critical CAD. Correlation between Gensini scores and 3D‐STE results were evaluated. Results: Mean age was 60.7 ± 10.01 years, and 55% of the patient population were male. There were not any significant differences between critical CAD and noncritical CAD groups for age, gender, history of hypertension, diabetes mellitus, hyperlipidemia, and Left Ventricular Ejection Fraction. Mean GLS was −12, GCS was −18.8, GRS was 33.4, GAS was −28.9, and mean Gensini score was 18.8. GLS and all other strain parameters were significantly worse in patients with critical CAD group compared with noncritical CAD group and also positive linear correlation was observed between Gensini score and all measured strain parameters (r = 0.568, P < 0.001 for Gensini score and GLS; r = 0.617, P < 0.001 for Gensini score and GAS). A GLS value of >−10 has 88.9% sensitivity and 92.9% specificity; A GAS value of >−21 has 97.2% sensitivity and 88.1% specificity to detect critical CAD. Conclusions: 3D‐STE is a noninvasive and handy parameter to detect subclinical left ventricular dysfunction and global strain values were significantly correlated with CAD severity. GAS has the sensitivity of 97.2% and specificity of 88.1% to detect critical CAD. Adding 3D strain echocardiography to exercise test or myocardial perfusion scintigraphy might increase sensitivity to detect critical CAD in clinical practice. [ABSTRACT FROM AUTHOR]

Objective: To investigate the correlation of neutrophils/lymphocyte(NLR), mean platelet volume(MPV) with gensini score in Acute coronary syndrome(ACS). Methods: 156 cases of ACS patients were divided into three groups according to the results of coronary angiography: single lesion group, double branch lesions, tripathic group. The NLR, MPV, Gensini score and general clinical data were compared between different groups and the correlation of different index were analyzed. Results: Compared with the single vessel lesion group and double branch lesion group, the percentage of patients with smoking and diabetes, the serum LDL-C、HDL-C,UA, NLR, MPV and Gensini score were significantly increased in the three branches of lesion group(P<0.05); Compared with single vessel lesion group, the above index were significantly increased in he double branch lesion group(P<0.05). There was no significant difference in the age, gender, percentage of patients with hypertension, TC, TG and Cr between the three groups(P>0.05). The Pearson correlation analysis showed that NLR and MPV were positively correlated with Gensini score(r=0.482, 0.702, P<0.05). Conclusions: The MPV and NLR were significantly positive correlated with the degree of coronary artery disease in patients with ACS, and they can effectively assess the degree of coronary artery stenosis. [ABSTRACT FROM AUTHOR]