The level of complement C3 is associated with the severity of atherosclerosis but not with arterial calcification in peripheral artery disease.

AIM: Recent evidences show correlations between atherosclerosis and the serum level of third component of complement (C3). However, there is less data on the connection of C3 and the severity of atherosclerosis. The aim of our study was to evaluate the association of serum C3 levels with atherosclerosis and arterial calcification in patients with chronic lower extremity atherosclerosis. METHODS: In a single centre cross-sectional study 103 patients and 109 healthy controls were examined. Sera were analyzed for C3. To identify the severity of atherosclerosis and calcification, ankle-brachial Doppler index, angiographic Bollinger score, arterial calcification score and carotid intima-media thickness was determined. RESULTS: Serum level of C3 was significantly higher in the lower extremity atherosclerosis group than in healthy patients (P=0.00004). In the patient group, serum level of C3, C4 was significantly and inversely associated with ABI (r=-0.246, P=0.014), (r=-0.259, P=0.011). C3 inversely correlates with Bollinger score (r= -0.357, P=0.028). Among our patients no correlation was found between C3 levels and CS (P=0.672, r=-0.046) or between C3 levels and carotid IMT (r=0.104, P=0.351). The serum levels of different complement components were associated with C-reactive protein, Hba1c, peptide-C and insulin. CONCLUSION: Our results suggest that C3 serum levels are associated with ABI and angiographic parameters of atherosclerosis, but do not relate to the severity of calcification.

Decreased plasma nociceptin/orphanin FQ levels after acute coronary syndromes.

Foregoing researches made on the N/OFQ system brought up a possible role for this system in cardiovascular regulation. In this study we examined how N/OFQ levels of the blood plasma changed in acute cardiovascular diseases. Three cardiac patient groups were created: enzyme positive acute coronary syndrome (EPACS, n = 10), enzyme negative ACS (ENACS, n = 7) and ischemic heart disease (IHD, n = 11). We compared the patients to healthy control subjects (n = 31). We found significantly lower N/OFQ levels in the EPACS [6.86 (6.21-7.38) pg/ml], ENACS [6.97 (6.87-7.01) pg/ml and IHD groups [7.58 (7.23-8.20) pg/ml] compared to the control group [8.86 (7.27-9.83) pg/ml]. A significant correlation was detected between N/OFQ and white blood cell count (WBC), platelet count (PLT), creatine kinase (CK), glutamate oxaloacetate transaminase (GOT) and cholesterol levels in the EPACS group.Decreased plasma N/OFQ is closely associated with the presence of acute cardiovascular disease, and the severity of symptoms has a significant negative correlation with the N/OFQ levels. We believe that the rate of N/OFQ depression is in association with the level of ischemic stress and the following inflammatory response. Further investigations are needed to clarify the relevance and elucidate the exact effects of the ischemic stress on the N/OFQ system.

Serum fetuin-A levels inversely correlate with the severity of arterial calcification in patients with chronic lower extremity atherosclerosis without renal disease.

AIM: Fetuin-A is a hepatic glycoprotein that inhibits extraosseous calcification. Lower serum fetuin-A concentration was associated with severe arterial calcification in patients with end stage renal disease. We evaluated the association of serum fetuin-A levels and the severity of atherosclerosis in patients with peripheral vascular disease having normal renal function. METHODS: In this cross-sectional study among 93 chronic atherosclerotic patients with lower extremity vascular disease, systemic atherosclerosis and calcification was assessed by ultrasound (carotid intima-media thickness/IMT/, calcification at the abdominal aorta, carotid and femoral bifurcations, aortic and mitral valves) and angiography (Bollinger score). Standard serum markers of inflammation, diabetes, renal function, ankle-brachial indexes and traditional risk factors for atherosclerosis were noted and Fontaine classification was applied for the severity of symptoms. RESULTS: The patients mean (SD) age was 59.95 (7.61) years, 78% were men, 35% had diabetes. Serum fetuin-A level showed significant negative correlation with ultrasound calcification score (P=0.018, r=-0.257) and Bollinger angiographic score (P=0.035, r=-0.347). Fetuin-A did not correlate with IMT or Fontaine classification. Fetuin-A also showed significant correlation with albumin, transferrin and hemoglobin A1c (r=0.287, 0.305 and 0.219, respectively at P<0.05). Logistic regression analysis confirmed the association between fetuin-A and calcification score (OR: 3.03, CI: 1.05-8.7), P=0.039) independent of traditional risk factors. CONCLUSION: Our data show that serum fetuin-A levels inversely correlate with the severity of atherosclerosis in nonuremic patients with symptomatic chronic lower limb ischemia. These data support a putative protective role for fetuin-A in the development of arterial calcification.