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Background The occurrence and development of acute coronary syndrome (ACS) are closely associated with inflammatory responses, but the relationship between dietary inflammatory potential and severity of coronary artery disease of ACS patients is currently unknown. Objective To investigate the relationship between dietary inflammatory potential evaluated by dietary inflammation index (DII) and severity of coronary artery disease in ACS patients. Methods Convenient sampling method was used to select 309 patients diagnosed as ACS for the first time by coronary arteriography in the Department of Cardiology, the Second Affiliated Hospital of Harbin Medical University from April 2022 to March 2023, and they were divided into DII-1 group (from -8.35 to -4.56), DII-2 group (from -4.55 to -0.77), DII-3 group (from -0.76 to 3.02) and DII-4 group (from 3.03 to 6.81) according to the quartile of DII, into Q1 group (4-32 scores), Q2 group (34-52 scores), Q3 group (54-84 scores) and Q4 group (86-192 scores) according to the quartile of Gensini score. Demographic and clinical features, overall DII, and DII of nutrient were compared in ACS patients with different severity of coronary artery stenosis, multivariate Logistic regression analysis was used to analyze the relation of DII with the severity of coronary artery stenosis. Results There was significant difference in educational level, LDL-C, LP-a, overall DII, DII of total fat, saturated fatty acids, vitamin E, carotene in ACS patients with different severity of coronary artery stenosis, respectively (P≤0.05). After the correction of confounders of educational level, LDL-C and LP-a, the multivariate Logistic regression analysis showed that, DII-4 group was the influencing factor of Q2 group (OR=15.389, 95%CI=1.595-148.432), Q3 group (OR=15.102, 95%CI=1.620-140.788) and Q4 group (OR=17.319, 95%CI=1.901-157.807), respectively (P

Objective To investigate the association between fibrinogen/albumin ratio （FAR） and the severity of coronary artery lesions in patients with premature coronary artery disease （PCAD）. Methods Clinical data of patients who initially underwent coronary angiography （CAG） due to chest pain， male patients aged < 55 years old and female aged < 65 years old， were collected. A total of 261 patients were recruited in this study. According to CAG results， all patients were divided into the non-coronary heart disease group and PCAD group. Relevant indexes and data of patients in two groups were collected and FAR was calculated. The degree of coronary artery lesions was evaluated according to the Gensini score （GS）. The differences of fibrinogen （Fib）， albumin （ALB） and FAR levels were compared between two groups， and the relationship between these three indexes and GS was discussed. Results Compared with the non-coronary heart disease group， the Fib and FAR levels were increased， whereas the ALB level was decreased in the PCAD group， and the differences were statistically significant （all P < 0.05）. Spearman correlation analysis showed that Fib and FAR levels were positively correlated with GS， while albumin level was negatively correlated with GS. Among three indexes， FAR had the highest correlation. Logistic regression analysis suggested that increased Fib and FAR levels were the risk factors for increased degree of stenosis of coronary lesions （OR>1）， whereas increased ALB level was a protective factor （OR

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

Purpose The purpose of this study was to investigate the relationship between serum immunoglobulin M (IgM) and the severity of coronary artery disease in Chinese patients who underwent coronary angiography. Methods A total of 2,045 patients who underwent coronary angiography (CAG) from March 2017 to March 2020 at Beijing Hospital were included in this study. Serum IgM concentration and biochemical indicators were measured before coronary angiography (CAG). The triquartile IgM levels at baseline in the population were analysed. Spearman rank correlation was used to analyse the association between IgM and traditional risk factors for coronary artery disease (CAD). CAD patients were divided into subgroups by affected area, number of affected vessels, and Gensini score to analyse the relationship between IgM and CAD severity. Multivariable logistic regression analysis was used to evaluate the association between IgM and CAD severity. Results Serum IgM levels were significantly lower in the CAD group (63.5 mg/dL) than in the non-coronary artery disease (NCAD) group (72.3 mg/dL) (P < 0.001). Serum IgM levels were significantly associated with sex. Serum IgM levels were positively correlated with traditional CAD risk factors such as TG, TC and LDL-C (P < 0.05), and negatively associated with the number of obstructed vessels, the number of affected areas, and Gensini scores. After adjusting for age, sex, smoking status, hypertension, dyslipidaemia, diabetes, stroke, and statin use history, a high IgM level was independently negatively associated with the severity of CAD expressed by the Gensini score. Conclusion We determined that serum IgM was independently negatively associated with the severity of CAD diagnosed by angiography in Chinese adults.

OBJECTIVE: To evaluate gender difference in non-traditional cardiovascular risk factors among Saudi patients with angiographically defined coronary artery disease (CAD). METHODS: We recruited 144 (male=105, female=39) patients with CAD who underwent coronary angiography. Laboratory analysis of total cholesterol (TC), triglycerides (TG), low density lipoprotein (LDL), high density lipoprotein (HDL), lipoprotein(a) [Lp(a)], and high sensitivity C-reactive protein (hs-CRP) were performed along with echocardiographic evaluation. RESULTS: Systolic blood pressure (SBP) was significantly higher in females (138.65±18.67 vs 129.59±21.03 mmHg; p=0.0363). Although no significant difference was observed in TC (4.30±1.36 vs 4.67±1.07 mmol/L), however significantly higher levels of both HDL and LDL were seen in females (0.86±0.17 vs 0.70±0.23 mmol/L; p=0.0592 and 3.50±0.67 vs 2.72±1.13; p=0.0466 respectively). There were no significant differences in TG, Lp(a) and hs-CRP, however females had comparatively higher Lp(a) (30.43±28.89 vs 24.02±23.42 mg/dl) and hs-CRP (1.14±1.46 vs 0.95±1.25 mg/L). On angiography, greater extent of stenosis was observed in left anterior descending and right coronary arteries among males, while the left circumflex artery was affected more in the female patients without statistical significance (p=0.0797; 0.3890 and 0.5032 respectively). Gensini Score in males & females was 60.46±46.17 and 74.39±39.52 respectively (p=0.3013). Significantly narrower aortic root diameter (ARD) was observed among females (27.30±6.66 vs 29.73±3.40 mm; p=0.0293). CONCLUSION: Female patients have greater risk of cardiovascular diseases due to higher SBP and LDL levels which could lead to a greater Gensini score when compared to male patients. In addition, narrow ARD among females could also be a contributing factor to CAD.

Objective: To find association between CHA2DS2-VASc-HSF score and severity of Coronary Artery Disease (CAD), assessed by Gensini score in Non-ST Elevation Myocardial Infarction (NSTEMI) patients. Study Design: Analytical Cross-sectional study. Place and Duration of Study: Armed Forces Institute of Cardiology/National Institute of Heart Disease, Rawalpindi Pakistan, from Jan to Jul 2023. Methodology: Total one hundred and forty-seven patients were included using non-probability consecutive sampling. For the purpose of study, participants having NSTEMI, confirmed by elevated biomarkers, who had coronary angiography, were included in the study. ANOVA, Chi-square and Pearson Correlation were applied to find the significance level of study findings. p

The association between serum uric acid and ischemic heart disease remains controversial and serum uric acid has not yet been established as cardiovascular risk factor. Our objective was to study the association of serum uric acid level with angiographic severity of coronary artery disease in males and females with ischemic heart disease. This observational study was conducted on two hundred patients divided into one hundred male patient, subdivided into fifty patient with elevated SUA and fifty patient with normal SUA and one hundred female patient subdivided into fifty patient with elevated SUA and fifty patient with normal SUA underwent coronary angiography for detection of CAD in cath lab unit of cardiology department of Beni-Suef and Sohag university. The severity of CAD was assessed on the basis of Gensini score and clinical vessel score. For all groups, conventional risk factors, levels of serum uric acid, and other biochemical markers were assessed.

Background: Non-alcoholic fatty liver disease (NAFLD) is a growing concern due to its potential to lead to liver transplants and its association with cardiovascular disease (CVD). However, the relationship between NAFLD and CVD remains debated, and non-invasive diagnostic methods for NAFLD are recommended. This study aimed to estimate the prevalence of NAFLD among patients with CAD and explore the association between CAD severity and the probability of developing NAFLD. Methodology: A cross-sectional study was conducted among CAD patients. Patients with a history of infectious liver disease, pregnant or lactating individuals, and those with excessive alcohol consumption were excluded. Coronary angiography was performed to assess CAD severity using the Gensini score. Ultrasonography and non-invasive assessments, such as the Fibrosis-4 (FIB-4) index, were used to diagnose and stage NAFLD. Result: The study included 156 CAD patients, with 79 (50.6%) being male. Out of total, 31 (19.8%) had severe, 79(50.6%) had moderate, and 46 (29.48%) had mild NAFLD. Male patients showed a significantly higher prevalence of severe NAFLD compared to females. There was no significant difference in the mean age of CAD patients across NAFLD severities. Severe NAFLD was associated with higher mean Gensini scores and FIB-4 values compared to mild to moderate NAFLD patients. A positive correlation was found between Gensini score and FIB4, suggesting that Gensini score could be an alternative to FIB4 in diagnosing NAFLD severity among CAD patients. Conclusion: The study revealed a high prevalence of NAFLD among CAD patients, with severe NAFLD being associated with higher CAD severity.

Background: There is increasing evidence that cardiovascular disease risk starts rising from the stage of prediabetes. Our aim was to study the relationship of prediabetes with coronary artery disease (CAD) severity and whether the degree of glycaemia impacts the severity of CAD. Methods: In this cross-sectional study patients admitted with acute coronary syndrome (ACS) who had impaired fasting glucose (IFG) were studied. Coronary angiography (CAG) severity was calculated using Gensini scoring system. Their glycaemic status was reclassified and reanalysed after 1 month using oral glucose tolerance test. Glycaemic status was then correlated with CAD severity. Results: Of the 140 patients studied, at 1 month follow-up, only 94 persisted in the IFG category; Stress hyperglycaemia (SH) was evident in 32.8%. A moderate positive correlation (0.4) was observed between Gensini score and 2h PPG as compared to that with FBS (0.18) and glycosylated haemoglobin (HbA1c) (0.1). Multiple linear regression showed only 2h postprandial blood glucose (2h-PPBG) had a significant correlation with Gensini score (adjusted odds ratio 1.006). Conclusions: SH, being a major confounding factor during acute coronary events, demands revisiting patients' glycaemic status after 1 month for correct classification. Significant correlation was found between CAD severity and IGT. This highlights the importance of assessing 2h-PPBG in predicting the risk of macrovascular complications like ACS even in prediabetic individuals.

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

Background: Non-Alcoholic Fatty Liver Disease (NAFLD) is closely related to several metabolic disorders and is also associated with increased risk of cardiovascular disease (CVD), including coronary artery disease (CAD). Patients and methods: This was a prospective study involving patients who underwent coronary catheterization and had proven coronary artery diseases.All patients were subjected to abdominal ultrasonography and transient elastography to detect NAFLD and grading of steatosis . Results: A total of 100 patient, with mean ageof 47.9 ± 8.4 years, 70% were males , 70% were diabetics. According to ultrasonographic findings, there were 58 patients (58%) normal and 42 patients (42%) with fatty liver. As regard degree of steatosis, there were 12 patients (12%) of S0, 38 patients (38%) of S1, 22 patients (22%) of S2 and 28 patients (28%) of S3.The mean of Genseni score was 50.9.There was highly statistical significant correlation (p-value < 0.001) between degree of steatosis and Genseni score in studied patients,the mean of Gensini score was 10.5, 21.7, 57.6 and 102.6 in Grade S0, S1, S2 and S3 respectively. Conclusion: The present study indicated a Statistically significant correlation between CAD and NAFLD.

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 for 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

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.

Objective: Vitamin D deficiency has been shown to be associated with coronary artery disease (CAD). In addition, there are studies suggesting that hyperuricemia is an independent risk factor for atherosclerosis, whereas the relationship between the combination of these 2 parameters and severity of CAD remains unclear. The aim of this study was to investigate the association between the combination of vitamin D deficiency and hyperuricemia and the extent of CAD. Methods: A total of 502 patients who had experienced myocardial infarction (MI) were included in this cross-sectional study. The 25-hydroxyvitamin D (25OHD) and serum uric acid (SUA) levels were measured in blood samples taken at the time of admission. A 2x2 factorial design was used to create groups according to the presence of hyperuricemia (>7 mg/dL) and vitamin D deficiency (

Atherosclerosis and chemokines are strongly related, but the role of the chemokine CXCL17 in atherogenesis is still poorly understood. We aim to investigate the serum CXCL17 levels in different stages of patients with coronary heart disease and explore whether these differences contribute to atherosclerosis. In the current prospective study, we enrolled 48 patients with unstable angina (UA), 51 patients with stable angina (SA) and 41 patients for the control group (CG). All subjects were diagnosed by coronary angiography and Gensini score was used to evaluate the severity of coronary artery disease. The CXCL17 levels were determined using ELISA, while lipid metabolism indicators and high sensitivity C-reactive protein (hs-CRP) were detected by automatic biochemical analyzer. We observed that the unstable angina group had higher CXCL17 levels compared with the stable angina and the control group. The logistic regression analysis showed that CXCL17 was an independent risk factor for unstable angina. Our results showed that CXCL17 was also statistically correlated with hs-CRP, while it was irrelevant with Gensini score. CXCL17 levels were associated with activity of inflammatory response and the instability of atherosclerotic plaques. These results suggest that CXCL17 elevation may be a potential new biomarker of unstable angina.

Objective: Although early repolarization pattern (ERP) has been recognized as a benign variant, in recent studies have shown that it is associated with life-threatening arrhythmias. There are different studies demonstrated that there is a strong relationship between life-threatening arrhythmias and the severity of coronary artery disease (CAD). In this study, we aimed to determine whether Gensini score (GS) values were higher in patients with ERP compared to patients without ERP.Materials and Methods: Totally 110 patients with ERP and 90 control subjects were enrolled to the study. GS was calculated for each patient. p values lt; 0.05 were considered significant.Results: GS was significantly higher in the ERP patients compared with the control group (19.5±20.2 vs 2.15±4.1; p lt;0.001). There was significant correlation between GS and age (r=0.507, p lt;0.001). GS was an independent predictor of ERP in multivariate logistic regression analysis (OR=0.655, 95% CI=0.557-0.769, p lt;0.001). In addition to, age and low-density lipoprotein cholesterol were independent predictors associated with GS in linear regression analysis (OR=0.370, 95% CI=0.085-0.655, p=0.011 and OR= -0.094, 95% CI= (-0.176-0.013), p=0.024, respectively). Conclusions: An increase in the severity of CAD may be shown as a mechanism that leads to the emergence of ERP.

Aim:Heart-type fatty acid binding protein (H-FABP), an early marker of cardiac necrosis, is released rapidly from myocardium as a consequence of ischemic injury. We hypothesized that more severe and extensive coronary atherosclerosis would result in more pronounced myocardial injury and necrosis in patients with acute myocardial infarction (AMI). Therefore, we sought the relationship between serum H-FABP levels and the severity and extent of coronary artery disease (CAD) assessed using the Gensini score.Materials and Methods:Fifty patients with AMI who underwent invasive coronary angiography were divided into 2 groups according to the angiographic Gensini score, namely the moderate to severe CAD group (group 1) and the mild CAD group (group 2). A point of care test and Cardiodetect Quant device were used to detect whether H-FABP was positive and the quantitative measurements. The data obtained from this study were evaluated using the PASW statistic programme.Results:Mean serum H-FABP concentration was significantly higher in group 1 when compared to that in group 2. Furthermore, a strongly positive correlation was found between the Gensini score and serum H-FABP levels.Conclusion:The findings of our study suggest that the quantity of myocardial necrosis demonstrated by serum H-FABP levels is higher in patients with AMI who have more severe and extensive CAD. H-FABP levels are also positively correlated to the Gensini score. We propose that H-FABP, an early marker of myocardial necrosis, may also provide a clue about the severity and extent of CAD, especially in the setting of AMI.

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: Introduction: In previous studies, the relationship between atherosclerosis and erectile dysfunction (ED) was examined, but the relationship and correlation between Gensini score which evaluates the extent and severity of chronic coronary syndrome (CCS), and ED severity were not investigated. Aim: To evaluate the relationship between Gensini score and ED in patients with CCS. Methods: We included 142 consecutive male patients with the diagnosed CCS and underwent an elective coronary angiography between January 2019 and March 2020. Main Outcome Measure: Correlation analysis demonstrated that Gensini score significantly negatively correlated with the International Index Erectile Function - 5 (IIEF-5) score (r = -0.417, P < .001). Results: Severe ED was present in 48 (33.8%) patients, moderate ED in 31 (21.8%) patients, and mild ED in 22 (15.5%) patients. 41(28.9%) patients did not have ED. Both the No ED and Mild ED groups were statistically significantly lower than the Severe ED group in terms of the Gensini score (P < .05). When the recommended optimal cut-off point and accuracy measurements were made for the Gensini score, the area under curve (AUC) value in predicting ED was 0.806 (95% CI: 0.732-0.880, P < .001). Multivariate logistic regression analysis demonstrated that independent predictors for ED were Gensini score and age (P < .001, and P = .026, respectively). Every 1 unit increase in Gensini score resulted in a 6% increase in the occurrence of ED (OR = 1.06, CI:1.03-1.10, P < .001). Conclusion: ED can be caused by endothelial dysfunction. Patients with severe CSS and high Gensini score should be evaluted for ED. ED may be a sign of severe CCS and a high Gensini score. It is also necessary to evaluate cardiological in patients with ED.Deger M, Ozmen C, Akdogan N, et al. The Relationship Between Gensini Score and Erectile Dysfunction in Patients with Chronic Coronary Syndrome. Sex Med 2021;9:100376.

Objective: The role of psychosocial risk factors is becoming increasingly important in the etiology of acute coronary syndrome (ACS). The purpose of this study was to assess an association between the personality types of young patients with ACS and the prevalence and severity of coronary artery disease (CAD). Methods: Patients younger than 45 years of age who presented with ACS and who underwent coronary angiography in the period from 2012 to 2016 were included in the study. The coronary angiography records of the patients were examined and their Gensini score (GS) was calculated; GS ≥20 was considered to be severe CAD. The Eysenck Personality Questionnaire-Revised Short Form scales were used to measure psychoticism, extraversion, lying, and neuroticism. Results: A total of 139 patients were included in the study. The median psychoticism score of patients with GS

Background: Angiopoietin-2 (Ang-2) plays a crucial role in hypoxia-induced angiogenesis and is expressed only in sites of vascular remodeling. Ang-2 expression can be regulated by hypoxia inducible factors and other regulators with exposure to hypoxia. The objective of this study was to investigate the influence of percutaneous coronary intervention (PCI) on serum Ang-2 concentrations, and analyze the correlation between serum Ang-2 and the severity of coronary artery stenosis in patients with coronary heart disease (CHD). Methods: Sixty-four patients with CHD were selected as the study group, each undergone PCI. Thirty-two healthy subjects were selected as the control group. Pre-PCI and post-PCI serum Ang-2 were measured by enzyme-linked immunosorbent assay. The severity of coronary artery stenosis was evaluated using angiographic Gensini scores, and the coronary collateral vessels were scored according to Rentrop′s classification. Results: Concentrations of pre-PCI serum Ang-2 in the study group were significantly higher than those in the control group (4625.06 ± 1838.06 vs. 1945.74 ± 1588.17 pg/ml, P < 0.01); however, concentrations of post-PCI serum Ang-2 were significantly lower than those of pre-PCI (3042.63 ± 1845.33 pg/ml vs. 4625.06 ± 1838.06 pg/ml, P < 0.01). Concentrations of pre-PCI serum Ang-2 were significantly correlated with Gensini scores (r = 0.488, P < 0.01); however, the decrease in serum Ang-2 after PCI was not correlated with Gensini scores, coronary collateral vessel grading, or left ventricular ejection fraction. Conclusions: Serum Ang-2 concentrations significantly increased in patients with CHD, and PCI treatment significantly decreased these concentrations. Serum Ang-2 concentrations, but not the decrease in serum Ang-2 concentrations, were significantly correlated with the severity of coronary artery stenosis. These results suggested that Ang-2 may be a biomarker of myocardial ischemia and vessel remodeling.

Introduction: Coronary Artery Disease (CAD) occurs due to atherosclerosis which results in progressive narrowing of coronary artery lumen. N-Terminal pro Brain Natriuretic Peptide (NT-proBNP) has been used as a marker of heart failure. However, its role in stable coronary artery disease without left ventricular dysfunction is limited. Aim: To measure and compare the serum NT-proBNP levels in stable coronary artery patients and controls and to correlate serum NT-proBNP levels with severity of CAD. Materials and Methods: The present study was conducted in Department of Biochemistry in collaboration with Department of Cardiology Kasturba Medical College, Manipal after the approval from Institutional Ethics Committee. A written consent was obtained from 86 study subjects (controls 36, cases 50). Serum NT-proBNP was measured using ELISA kit. Severity of CAD was graded by angiogram based Gensini scoring system. Mann-Whitney U-tests and spearman’s correlations were used. Serum NT-proBNP was expressed in median and interquartile range. The p-value

Introduction: A plethora of risk assessment scores which identify the severity of Coronary Artery Disease (CAD) are available. However, most of them require results of coronary angiography or coronary computed tomography angiography. Aim: In this study, we assessed the accuracy of newly developed CHA2DS2-VASc-HS scoring system which does not require such sophisticated evaluations and compared it with Gensini score. Materials and Methods: The study was a single center, prospective, observational cohort study. The cohort of patients admitted to the Amrita School of Medicine, Kochi, Kerala, India for diagnostic angiography from November 2014 to October 2015 were observed for Gensini score and CHA2DS2-VASc-HS scores. Patients undergoing repeat angiography were excluded. The outcomes were classified into three groups as Normal, Mild CAD and Severe (Obstructive) CAD and the scores were compared. Statistical methods such an ANOVA, Spearman’s rank correlation and Mann-Whitney test were applied. Results: A total of 100 patients were studied whose mean age was 59.4±8.9 years. Among these patients, 19 patients (19%) had normal angiograms, 22 patients (22%) had mild CAD, and 59 (59%) patients had obstructive (severe) CAD. A significant increase in both the scores was observed with increase in severity of CAD. Mean Gensini score in the group with CHA2DS2-VAScHS score

OBJECTIVE: Heart rate turbulence (HRT) indicates the impairment of cardiac autonomic function. With the literature containing insufficient information on HRT in stable coronary artery disease (CAD), this study aimed to investigate the role of HRT in patients with stable CAD. METHODS: The study included 58 patients (mean age: 58.9+-10.0 years; 25 male) with documented CAD and demonstrating ventricular premature complexes on Holter monitoring, and a control group of 52 patients (mean age: 55.9+-9.3 years; 36 male) with no history of CAD and demonstrating ventricular premature complexes. HRT parameters such as turbulence onset (TO) and slope (TS) were analyzed. Angiographic Gensini score were used to evaluate CAD severity. RESULTS: There was a significant difference in HRT parameters between the 2 groups. TO: 0.47+-1.52% vs. -1.61+-2.0% (p=0.001) and TS: 4.7+-3.0 vs. 6.4+-3.7 ms/RR (p=0.009) in patients with CAD and control group respectively. Given also that TO ≥0% and TS ≤2.5 ms/ RR values are considered abnormal, there was significant difference between the two groups; TO abnormal: 27 patients (46.6%) vs. 7 patients (13.5%), p=0.001, and TS abnormal: 15 patients (25.9%) vs. 4 patients (7.7%), (p=0.004) in CAD patients and control group respectively. A positive correlation was detected between TO and Gensini score (r=0.282, p=0.001) and a negative correlation detected between TS and Gensini score (r=-0.287, p=0.001). CONCLUSION: The study demonstrated that HRT variables are impaired in patients with stable CAD when compared to those in the control group, and that these variables also correlate with severity of CAD.

Backgrounds: Hyperuricemia has not yet been established as cardiovascular risk factor. We aimed to study the angiographic severity in patients with coronary artery disease (CAD) and hyperuricemia. Materials and Methods: In this observational cross-sectional study we measured serum uric acid level in 82 patients of CAD who underwent coronary angiography in catheterisation laboratory of our Institution. Severity of CAD was determined on the basis of Gensini score, number of diseased vessels, critical lesions and total occlusions. Results: The prevalence of hyperuricemia in patients with CAD was 42.68% in our study. Hyperuricemia was associated with higher Gensini score (33.33±10.64 vs. 22.90±6.75, p value

Background: As an acute phase protein, α1-antitrypsin (AAT) has been extensively studied in acute coronary syndrome, but it is unclear whether a relationship exists between AAT and stable angina pectoris (SAP). The purpose of the present study was to investigate the association between AAT plasma levels and SAP. Methods: Overall, 103 SAP patients diagnosed by coronary angiography and clinical manifestations and 118 control subjects matched for age and gender were enrolled in this case-control study. Plasma levels of AAT, high-sensitivity C-reactive protein (hsCRP), lipid profiles and other clinical parameters were assayed for all participants. The severity of coronary lesions was evaluated based on the Gensini score (GS) assessed by coronary angiography. Results: Positively correlated with the GS (r = 0.564, P < 0.001), the plasma AAT level in the SAP group was significantly higher than that in the control group (142.08 ± 19.61 mg/dl vs. 125.50 ± 19.67 mg/dl, P < 0.001). The plasma AAT level was an independent predictor for both SAP (odds ratio [OR] = 1.037, 95% confidence interval [CI]: 1.020-1.054, P < 0.001) and a high GS (OR = 1.087, 95% CI: 1.051-1.124, P < 0.001) in a multivariate logistic regression model. In the receiver operating characteristic curve analysis, plasma AAT level was found to have a larger area under the curve (AUC) for predicting a high GS (AUC = 0.858, 95% CI: 0.788-0.929, P < 0.001) than that of hsCRP (AUC = 0.665, 95% CI: 0.557-0.773, P = 0.006; Z = 2.9363, P < 0.001), with an optimal cut-off value of 137.85 mg/dl (sensitivity: 94.3%, specificity: 68.2%). Conclusions: Plasma AAT levels correlate with both the presence and severity of coronary stenosis in patients with SAP, suggesting that it could be a potential predictive marker of severe stenosis in SAP patients.

Background: To determine the frequency of diabetic retinopathy in type 2 diabetic patients undergoing angiographic evaluation and compare the severity (Mean vessel score and mean Gensini score) of coronary artery disease in patients with or without diabetic retinopathy. Methods: In this cross sectional study, 300 diabetic patients, with suspected coronary artery disease undergoing coronary angiography, were included. All the patients were assessed for the presence or absence of diabetic retinopathy and severity of coronary artery disease. Results: One hundred and three out of 300 patients (34.3%) had diabetic retinopathy. In patients with diabetic retinopathy, the mean vessel score was 2.62 + 0.60 as compared to 1.90 + 1.03 in non retinopathy group (p=0.000). Gensini score was also found to be significantly higher in diabetic retinopathy group (103 + 37.17 versus 38.5508 + 22.205) (p=0.000). Conclusions: Severity scores (Vessel and Gensini scores) of coronary artery disease were significantly higher in patient with diabetic retinopathy as compared to those without diabetic retinopathy.

Introduction: Platelets have been well known contributors in the pathogenesis of cardiovascular disorders such as atherosclerosis and its complications such as acute Myocardial Infarction (MI). Aim: To study the changes in platelet volume indices and platelet count in ST-Elevated Myocardial Infarction (STEMI) and assess their usefulness in predicting coronary events. Materials and Methods: A case-control observational study was carried out on 173 cases diagnosed with STEMI and 191 controls from January 2015 to December 2015, considering the inclusion and exclusion criteria. In total, 364 patients were included, 173 patients with STEMI, from those patients admitted to the intensive care unit and the emergency ward. In addition, 191 healthy non diabetic non hypertensive age-matched controls were enrolled. Results: The mean age of cases was 59.4±11.9 years and of controls were 55.25±8.5 years. Males (74.6%) had higher incidence of STEMI then females (25.4%). The Mean Platelet Volume (MPV) was significantly higher in patients with STEMI (10.2±2.8) as compared to controls (8.5±6.9). The Platelet Distribution Width (PDW) was also significantly higher in cases compared to controls (p

Obiective. Scopul acestui studiu a fost de a examina efectele polimorfismelor (SNPs) genei PON1 la nivelul regiunii promotor (-909 şi -832) şi a primului exon (+575, 20352A>G, rezultând substituirea Q192R) asupra activităţilor paraoxonazei-1 (PON1) într-un grup format din 53 de pacienţi cu boală coronariană (CHD) dovedită angiografic şi 17 subiecţi fără CHD. Metode şi rezultate. Activităţile PON1 din ser, respectiv arilesteraza (AR-ase) şi paraoxonaza NaCl-stimulată (ssPO-ase), au fost evaluate cu metode spectrofotometrice manuale, folosind acetat de fenil, respectiv paraoxon ca substrat. Markerii biochimici uzuali au fost analizaţi prin metode enzimatice, pe analizorul Roche/Hitachi 912, folosind kituri comerciale. Genotipurile PON1 au fost determinate folosind PCR, iar pentru secvenţierea ampliconilor s-a utilizat kitul BigDye® Terminator v3.1 şi analizorul ABI PRISMTM 310. Severitatea stenozei coronariane s-a evaluat şi clasificat folosind scorul Gensini. Nu s-au observat diferenţe semnificative statistic între grupurile cu şi fără CHD în ceea ce priveste activităţile PON1 şi polimorfismele -909G>C, -832G>A şi +575A>G. Dar, luând în considerare toţi subiecţii investigaţi, am constatat că SNPs -909G>C şi +575A>G au avut efecte semnificative statistic asupra AR-ase, respectiv PO-ase. Folosind modelul regresiei multiple am constatat că diabetul, LDL-colesterolul şi numărul de alele mutante au fost determinanţi semnificativi, independenţi, ai scorului Gensini. O corelaţie pozitivă semnificativă a fost observată numai între scorul Gensini şi numărul de alele mutante. Concluzii. Nu există diferenţe între subiecţi cu si fără CHD în ceea ce priveşte genotipurile şi fenotipurile PON1, dar creşterea numărului de alele PON1 mutante este un factor important în determinarea severităţii leziunilor coronariene

Objectives: This study was aimed to determine plasma levels of total (TFPI-T) and free (TFPI-F) tissue factor pathway inhibitor, plasminogen activator inhibitor-1 (PAI-1), and tissue plasminogen activator (t-PA) in a cohort of Saudi patients with chronic stable angiographically defined coronary artery disease (CAD) and to determine its correlation with its severity.Methods: This cross sectional study was conducted in the department of physiology and department of cardiology, College of Medicine, and King Khalid University Hospital and King Saud University, Riyadh. Sixty known cases of CAD who had undergone angiography (35 males and 25 females) were selected. A control group included 39 (20 males and 19 females) healthy subjects. Fasting venous blood samples were analyzed for total (TFPI-T) and free (TFPI-F) tissue factor pathway inhibitor, plasminogen activator inhibitor-1 (PAI-1), and tissue plasminogen activator (t-PA). Gensini scores and vessel scores were determined for assessing CAD severity.Results: There were non-significant differences between age, body mass index (BMI) and Blood pressure between the controls and CAD subjects. A comparison of hemostatic markers between control and CAD patients showed significantly higher levels of Fibrinogen, PAI-1, TFPI-T and TFPI-F in CAD patients compared to control subjects. But there was no difference in plasma t-PA levels. TFPI-T had a significant positive correlation with severity of disease determined by Gensini Scores (r=0.344; p=0.006) and vessel scores (r=0.338; p=0.015).Conclusion: Plasma levels of total tissue factor pathway inhibitor are significantly related with the presence and severity of CAD. Elevated levels of TFPI-T may be considered as useful diagnostic and prognostic markers in patients with CAD.