2nd Department of Cardiology, Medical University, Bieganski Hospital, Łódź, Poland.
Cardiol J. 2010;17(6):599-606.
Patients with advanced coronary artery disease (CAD) have an unfavorable prognosis. Therefore, early identification of this high-risk group is important. The aim of this study was to assess the usefulness of clinical, electrocardiographic and echocardiographic parameters supported by novel atherogenesis and angiogenesis markers in identifying patients with stable, three-vessel coronary artery disease.
The study group comprised 107 patients suffering from three-vessel CAD and a control group of 15 patients presenting with typical angina, a positive exercise stress test and abnormal segmental contractility, but no hemodynamically significant coronary stenosis in their angiograms. In each patient, we characterized a biochemistry test panel including novel markers: angiogenin, resistin, adiponectin, IL-8 and a TNF-a. The angiographic severity of CAD was expressed as a Gensini score.
There were significant differences between three-vessel CAD patients and control groups with respect to the serum levels of: hsCRP (2.8 vs 1.4 mg/L, p = 0.01), HDL-cholesterol (45 vs 54 mg/dL, p = 0.04), LDL-cholesterol (102 vs 95 mg/dL, p = 0.04), NT-proBNP (392 vs 151 pg/mL, p = 0.008) and a marker of angiogenetic activity, angiogenin (414 vs 275 ng/mL, p = 0.02), However, no significant differences were found between three-vessel CAD and the control group with respect to the serum level of adiponectin (8.08 vs 7.82 μg/mL), resistin (17.5 vs 21 ng/mL), IL-8 (20.7 vs 26.8 pg/mL) and TNF-a (4.1 vs 4.3 pg/mL). Angiogenin tended to be higher in patients with higher Gensini scores (p = 0.06) but no influence of ejection fraction was noted.
Angiogenin is a novel marker of three-vessel coronary disease showing a relationship with the angiographic severity of the disease.
患有晚期冠状动脉疾病 (CAD) 的患者预后不佳。因此,早期识别这种高危人群很重要。本研究旨在评估临床、心电图和超声心动图参数的有用性,并辅以新的动脉粥样形成和血管生成标志物,以识别患有稳定型三血管 CAD 的患者。
研究组包括 107 名患有三血管 CAD 的患者和对照组 15 名患者,这些患者有典型心绞痛、运动应激试验阳性和节段性收缩功能异常,但血管造影无血流动力学意义的冠状动脉狭窄。在每位患者中,我们描述了包括新型标志物在内的生物化学检测指标:血管生成素、抵抗素、脂联素、IL-8 和 TNF-a。CAD 的血管造影严重程度用 Gensini 评分表示。
三血管 CAD 患者与对照组在以下方面存在显著差异:hsCRP(2.8 与 1.4 mg/L,p=0.01)、HDL-胆固醇(45 与 54 mg/dL,p=0.04)、LDL-胆固醇(102 与 95 mg/dL,p=0.04)、NT-proBNP(392 与 151 pg/mL,p=0.008)和血管生成活性标志物血管生成素(414 与 275 ng/mL,p=0.02)。然而,三血管 CAD 患者与对照组在脂联素(8.08 与 7.82 μg/mL)、抵抗素(17.5 与 21 ng/mL)、IL-8(20.7 与 26.8 pg/mL)和 TNF-a(4.1 与 4.3 pg/mL)的血清水平方面无显著差异。血管生成素在 Gensini 评分较高的患者中呈升高趋势(p=0.06),但与射血分数无关。
血管生成素是一种新的三血管 CAD 标志物,与疾病的血管造影严重程度有关。