Role of sevelamer hydrochloride in the coronary artery calcification score.

The coronary artery calcification score (CACS) is higher in hemodialysis (HD) patients than in non-HD patients for each age group from the fifth to the eighth decade of life. In order to clarify the relationship between the rate of change in the CACS and several factors related to calcium (Ca) and phosphate (P) metabolism in HD patients, we determined the CACS twice in 144 HD outpatients at an interval of approximately 12 months (2003 and 2004). The dosage of vitamin D formulations (alfacalcidol or maxacalcitol) was reduced or ceased if the serum Ca concentration exceeded 5.0 mEq/L, or the serum P concentration exceeded 6.0 mg/dL, and the dosage of combined sevelamer hydrochloride (SH) and calcium carbonate (CaCO3), as the phosphate binder, was adjusted to maintain the concentrations below these levels. The study parameters were: (1) the total dosage of alfacalcidol (microg), maxacalcitol (microg), SH (mg), and CaCO3 at the time of each CACS measurement; and (2) serum concentrations of Ca, P, alkaline phosphatase, high-sensitivity parathyroid hormone (HS-PTH), total protein, albumin, total cholesterol, triglycerides (TG). Regression analysis showed a significant correlation among the total SH dosage, TG, and alphaCACS. Future investigations will include the differences in alphaCACS between patients treated with SH who experience a rise in Ca and/or P and those with a decrease in Ca and/or P.

Plasma concentrations of LPL and LCAT are in putative association with females and alcohol use which are independent negative risk factors for coronary atherosclerosis among Japanese.

BACKGROUND: Coronary heart disease (CHD) prevalence appears low among Japanese. Analysis of their negative risk factors is therefore important for public health strategy. METHODS: We analyzed the impact on coronary atherosclerosis of sex, alcohol intake, plasma lipoproteins and enzymes to regulate cholesterol transport, lipoprotein lipase (LPL) and lecithin:cholesterol acyltransferase (LCAT) for the 110 patients who underwent coronary angiography, consecutively enrolled by excluding those >70 years or under hypolipidemic-drug treatment. Subgroup combinations compared were males vs. females in non-drinkers, and drinkers vs. non-drinkers in males. RESULTS: Coronary stenosis was less in females and in drinkers, accompanied by high-density lipoprotein (HDL) in the respective comparison. LPL associated with sex (females>males) and LCAT with alcohol intake (drinkers>non-drinkers) although neither enzyme demonstrated direct correlation with coronary stenosis. LPL positively associated only with HDL in most of subgroups and LCAT correlated with low-density lipoprotein (LDL) in all subgroups but with HDL only in males. CONCLUSIONS: Among non-drinkers, females are at lower risk for coronary atherosclerosis than males mainly due to higher HDL in potential association with high LPL, and that drinkers are protected among males also by high HDL that is in apparent association with LCAT.