Association studies between -1185A/G von Willebrand factor gene polymorphism and coronary artery disease

High levels of von Willebrand factor (vWF) have been associated with cardiovascular disease. The A allele of the -1185A/G polymorphism in the 5'-regulatory region of the vWF gene was associated with the highest plasma vWF levels in a normal population. To examine the association between -1185A/G polymorphism and coronary artery disease (CAD), 173 Brazilian Caucasian subjects submitted to coronary angiography were studied. Of these, 57 (33 percent) had normal coronary arteries (control group) and 116 (67 percent) had CAD (patient group). Plasma vWF levels were higher in patients (145 U/dl) than in controls (130 U/dl), but the differences were significant only for O blood group subjects. Polymerase chain reaction amplification of the 864-bp vWF promoter region followed by AccII restriction digestion was used to identify the -1185A/G genotypes. The -1185A allele frequency was 43.1 percent in patients and 44.7 percent in controls. Allele and genotype frequencies were not significantly different between patients and controls. No association was observed between the -1185A/G genotypes and plasma vWF levels in patients or controls. These results suggest that -1185A/G polymorphism is not an independent risk factor for CAD

Lack of a relationship between serum ferritin levels and coronary atherosclerosis evaluated by coronary arteriography

Many clinical and epidemiological studies have demonstrated the relationship between serum ferritin and ischemic heart disease. In the present study we evaluated the relationship between coronary heart disease (CHD) and serum ferritin levels in patients submitted to coronary arteriography. We evaluated 307 patients (210 (68.7 percent) males; median age: 60 years) who were submitted to coronary angiography, measurement of serum ferritin and identification of clinical events of ischemic heart disease. Serum ferritin is reported as quartiles. Ninety-six patients (31.27 percent) had normal coronary angiography (group 1) and 211 (68.73 perce) had coronary heart disease (group 2). Of the patients with CHD, 61 (28.9 percent) had serum ferritin levels higher than 194 ng/ml (4th quartile), as opposed to only 14 (14.58 percent) of those without CHD (P = 0.0067). In the 2nd quartile, 39 patients (18.48 percent) had CHD, while 35 patients (36.46 percent) had normal coronary arteries (P = 0.00064). Multivariate analysis of the data showed that the difference between groups was not statistically significant (P = 0.33). We conclude that there is no independent relationship between coronary heart disease and increased levels of serum ferritin

Comparação da aterosclerose coronária em pacientes com infarto do miocárdio e angina do peito / Comparison of coronary heart disease extent and severity in patients with myocardial infarction and angina pectoris

OBJETIVO - Comparar a gravidade da doeça coronária e a presença de fatores de risco cardiovasculares entre pacientes com angina e infarto do miocárdio (IM). MÉTODOS - Estudaram-se 62 pacientes com IM e 129 com angina, através de cineangiocoronariografia, avaliando-se a oclusão (lesäo de 99 'por cento' ou 100 'por cento'), a severidade (escore de 0 a 5 de acordo com o número de vasos afetados) e a extensäo (3 grupos com diferentes graus de estenose). Dois observadores experientes interpretaram cegamente os angiogramas. RESULTADOS - Os pacientes com IM tiveram maior oclusão (50 'por cento' vs 13,2 'por cento'[p<0,01]), maior severidade (79 'por cento' vs 54,3 'por cento' com mais de 90 'por cento' de estenose [p<0,02]) e maior extensão (2,0 vs 0,87 [p<0,001]), mesmo quando controlados para os fatores de risco coronários clássicos e para o tempo de doença. O tabagismo foi o único fator de risco independente correlacionado com IM (P<0,01). CONCLUSÄO - Entre os pacientes estudados, a doença coronária foi maior no grupo IM, bem como a prevalência de tabagismo.

Improvement in wall motion after pindolol: a mechanism for the preservation of left ventricular function in coronary artery disease

In order to evaluate the mechanism by which beta blockers with intrinsic sympathomimetic activity preserve left ventricular systolic function at rest, 46 patients with coronary artery disease were studied by right and left heart catheterization and left ventriculography. Patients were studied using a double-blind, randomized protocol before and after a single intravenous dose of 3 mg propanolol (N = 22) or 0.5 mg pindolol (N = 24). Mean right atrial pressure increased similarly after both drugs. Mean pulmonary artery pressure, left ventricular end-diastolic pressure, mean aortic pressure, and peripheral vascular resistance did not change significantly after either drug. Cardiac index (before: 3.0 + or - 0.7(mean + or - SEM); after: 2.8 + or - 0.2 1 min **-1 m**-2) and heart rate (before: 78 + or - 15; after: 72 + or - 12 bpm) deveased only after propranolol administration. Ejection fraction decreased only after propranolol (48 + or - 16 to 41 + or - 15%). Improvement in segmental wall motion abnormalities was noted (23 of 47 segments) only after pindolo. The total left ventricular wall motion score improved after pindolol and worsened after propranolol (P<0.5). In patients with impaired left ventricular function, pindolol administration resulted in improved resting ejection fraction. Thus, the acute hemodynamic consequences of pindolol administration differ from those of propranolol owing to the preservation of left ventricular systolic function which seem to be related to the...