Importance of so called "novel cardiovascular risk factors" in severity of coronary artery calcification; how serious they should be taken: a systematic review and metaanalysis / Importancia de los denominados "factores novedosos de riesgo cardiovascular" en la severidad de la calcificación de las arterias coronarias; qué tan serios deben tomarse: una revisión sistemática y un metaanálisis

Abstract Cardiovascular diseases are among important causes of death. Atherosclerosis is an important etiology for coronary artery diseases in which coronary artery calcification plays a principal role. Recently novel cardiovascular risk factors in coronary calcification are under attention. In this study, we investigated possible association between novel cardiovascular risk factors and coronary calcification. This is a prospectively registered systematic review and meta-analysis in PROSPERO and was performed in accordance with PRISMA guidelines. Medical databases were searched. Primary papers were screened and studies reporting our outcomes of interest were selected for data extraction. Quantitative data syntheses were performed using Comprehensive Meta-analysis Ver.3. In this study, 5252 papers were screened and finally 28 papers including 31241 patients underwent data extraction. Based on our findings, neutrophil/lymphocyte ratio (8 out of 10), red cell distribution width (r = 0.250, p < 0.0001), and interleukin 6 (odds ratio [OR]: 1.101 [95% confidence interval (CI): 1.001-1.210], p = 0.047) were associated with severity of coronary calcification while C-reactive protein (one out of eight) was not associated with coronary calcification. Results of lymphocyte/monocyte ratio (r = -0.120, p < 0.001), platelet/lymphocyte ratio (OR: 1.47 [95% CI: 0.89-2.41, p = 0.124]), and MPV (r = 0.017, p = 0.814 vs. OR: 1.91 [95% CI: 1.28-2.85, p = 0.002]) remained controversial due to few number of included studies or contrary results. We can conclude that neutrophil/lymphocyte ratio, red cell distribution width, and interleukin-6 are significantly associated with coronary calcification and C-reactive protein is not significantly associated with severity of coronary calcification. Our results about mean platelet volume, platelet/lymphocyte ratio, and lymphocyte/monocyte ratio are not reliable and require further investigations.

Resumen Las enfermedades cardiovasculares se encuentran entre las primeras causas de mortalidad. La aterosclerosis es una etiología importante de las enfermedades de las arterias coronarias en la que la calcificación de las arterias coronarias juega un papel principal. Recientemente, se están prestando atención a factores novedosos de riesgo cardiovascular en la calcificación coronaria. En este estudio investigamos la asociación posible entre los factores novedosos de riesgo cardiovascular y la calcificación coronaria. Esta es una revisión sistemática y metaanálisis registrados de forma prospectiva en PROSPERO y se realizó de acuerdo con las pautas de PRISMA. Se realizaron búsquedas en bases de datos médicas. Se examinaron los artículos primarios y se seleccionaron para la extracción de datos los estudios cuyos resultados fueron de nuestro interés. Las síntesis de datos cuantitativos se realizaron utilizando Comprehensive Meta-analysis Ver.3. En este estudio se seleccionaron 5252 artículos y finalmente se extrajeron los datos de 28 artículos que incluían 31241 pacientes. Según nuestros hallazgos, la proporción de neutrófilos/linfocitos (8 de 10), el ancho de distribución de glóbulos rojos (r = 0,250, valor de p < 0.0001) y la interleucina 6 (OR: 1.101 [IC del 95%: 1.001-1.210], valor p = 0.047) se asociaron con la gravedad de la calcificación coronaria, mientras que la proteína C reactiva (1 de 8) no se asoció con la calcificación coronaria. Resultados de la proporción linfocitos/monocitos (r = -0,120, valor p < 0,001), la proporción plaquetas/linfocitos (OR: 1,47 [IC 95%: 0.89-2.41, valor p = 0.124]) y el volumen plaquetario medio (r = 0.017, valor p = 0.814 C. OR: 1.91 [IC 95%: 1.28-2.85, valor p = 0.002]) siguieron siendo polémicos debido al escaso número de estudios incluidos o resultados contrarios. Podemos concluir que la proporción de neutrófilos/linfocitos, el ancho de distribución de los glóbulos rojos y la interleucina 6 se asocian significativamente con la calcificación coronaria y la proteína C reactiva no se asocia significativamente con la gravedad de la calcificación coronaria. Nuestros resultados sobre el volumen plaquetario medio, la proporción de plaquetas/linfocitos y la proporción de linfocitos/monocitos no son confiables y requieren más investigaciones.

Relationship of serum vitamin D deficiency with coronary artery disease severity using multislice CT coronary angiography / Relación entre el déficit de vitamina D sérico y la gravedad de la arteriopatía coronaria evaluada mediante angio-TAC multicortes

Aim: To assess the relationship between vitamin D deficiency and severity of coronary artery disease using multislice CT coronary angiography. Methods: 100 patients diagnosed with coronary artery disease during multislice CT coronary angiography were subjected to full evaluation of coronary artery disease severity followed by measurement of serum vitamin D level. Results: The mean value of serum vitamin D level was 13.35±7.49ng/ml. 76% of the patients had vitamin D deficiency (<20ng/ml). 41% of the patients had single vessel disease, 28% had two vessel diseases, and 31% had multi-vessel disease. Patients with vitamin D deficiency had higher degree of coronary stenosis, higher coronary Ca score (p<0.001) and higher number of affected vessels compared with normal vitamin D level subgroup (p<0.001). Vitamin D level showed a significant negative correlations with age (r=−0.290, p=0.003), coronary Ca score (r=−0.630, p<0.001) and severity of coronary lesions. Multivariate linear regression analysis showed that dyslipidemia and vitamin D level were independent predictors of percent severity of coronary stenosis. Conclusion: In addition to traditional cardiovascular risk factors, vitamin D deficiency looks to be independent predictor of coronary artery disease severity including percent stenosis, number of the affected vessels as well as degree of coronary calcification.(AU)

Objetivo: Evaluar la relación entre el déficit de vitamina D y la gravedad de la arteriopatía coronaria mediante angio-TAC coronaria multicortes. Métodos: Cien pacientes con diagnóstico de arteriopatía coronaria durante la realización de angio-TAC multicortes fueron sometidos a evaluación completa de la gravedad de la enfermedad tras la medición del nivel de vitamina D sérico. Resultados: El valor medio del nivel de vitamina D sérico fue de 13,35 ± 7,49 ng/ml. El 76% de los pacientes tenían déficit de vitamina D (<20 ng/ml). El 41% de los pacientes tenía afectado un único vaso, y el 28% tenía afectados dos vasos, y el 31% tenía afectados múltiples vasos. Los pacientes con déficit de vitamina D tenían un mayor grado de estenosis coronaria, mayor puntuación de Ca coronario (p < 0,001) y un mayor número de vasos afectados en comparación con el subgrupo con un nivel normal de vitamina D (p < 0,001). El nivel de vitamina D reflejó correlaciones negativas significativas con la edad (r = −0,290, p = 0,003), puntuación de Ca coronario (r = −0,630, p < 0,001) y gravedad de las lesiones coronarias. El análisis de regresión lineal multivariante reflejó que la dislipidemia y el nivel de vitamina D eran factores predictivos independientes del porcentaje de gravedad de la estenosis coronaria. Conclusión: Además de los factores tradicionales de riesgo cardiovascular, el déficit de vitamina D parece ser un factor predictivo independiente de la gravedad de la arteriopatía coronaria incluyendo el porcentaje de estenosis, el número de vasos afectados y el grado de calcificación coronaria.(AU)

Relationship of serum vitamin D deficiency with coronary artery disease severity using multislice CT coronary angiography.

AIM: To assess the relationship between vitamin D deficiency and severity of coronary artery disease using multislice CT coronary angiography. METHODS: 100 patients diagnosed with coronary artery disease during multislice CT coronary angiography were subjected to full evaluation of coronary artery disease severity followed by measurement of serum vitamin D level. RESULTS: The mean value of serum vitamin D level was 13.35±7.49ng/ml. 76% of the patients had vitamin D deficiency (<20ng/ml). 41% of the patients had single vessel disease, 28% had two vessel diseases, and 31% had multi-vessel disease. Patients with vitamin D deficiency had higher degree of coronary stenosis, higher coronary Ca score (p<0.001) and higher number of affected vessels compared with normal vitamin D level subgroup (p<0.001). Vitamin D level showed a significant negative correlations with age (r=-0.290, p=0.003), coronary Ca score (r=-0.630, p<0.001) and severity of coronary lesions. Multivariate linear regression analysis showed that dyslipidemia and vitamin D level were independent predictors of percent severity of coronary stenosis. CONCLUSION: In addition to traditional cardiovascular risk factors, vitamin D deficiency looks to be independent predictor of coronary artery disease severity including percent stenosis, number of the affected vessels as well as degree of coronary calcification.

Birth month associates with risk of coronary artery disease and its complications: A propensity score matched analysis.

OBJECTIVE: Birth month and climate affect lifetime disease risk, while the underlying mechanisms remain largely elusive. It is vital to investigate the risks of coronary artery disease (CAD) and its complications in patients born in different months. METHODS: A total of 12,263 patient medical records were reviewed from the BioBank of First Affiliated Hospital of Xinxiang Medical University, with 4729 records from patients with CAD (CAD group) and 7534 records from control patients without CAD (control group). Two groups of patients were matched by the propensity score matched method. Birth months were compared between two groups of patients. The relationships between birth month and the numbers of CAD and its complications were also investigated. Interestingly, we also explore the relationship between the birth seasons and the numbers of CAD and its complications. RESULTS: Compared to control, CAD group had greater CAD risks for patients born in November (OR 1.390, 95% CI 1.090-1.772), December (OR 1.358, 95% CI 1.067-1.730), and February (OR 1.332, 95% CI 1.043-1.700) compared to those born in May. Compared to patients born in December, patients born in January to March and May to September had greater risk of heart failure (P<0.05). There was no difference in the incidence of myocardial infarction, conduction block, and atrial fibrillation across birth months (P>0.05). In terms of birth season, patients born in winter have greater CAD risk than those born in spring (OR 1.247, 95% CI 1.075-1.447). And there was no difference in the incidence of CAD complications across with birth seasons (P>0.05). CONCLUSIONS: There was a correlation between birth month and CAD. People born in November, December, and February had greater CAD risk, and people born in winter had greater CAD risk. Among CAD patients, those born in January to March and May to September had the greater risk of heart failure.

Evaluación del lipidograma y ciertos factores de riesgo de ateroesclerosis en niños cuyos padres tuvieron arteriopatía coronaria de inicio temprano / Assessment of lipid profile and some risk factors of atherosclerosis in children whose parents had early onset coronary artery disease

Antecedentes/Objetivo. El objetivo de nuestro estudio fue analizar el lipidograma y ciertos factores de riesgo de ateroesclerosis, tales como las lipoproteínas de baja densidad oxidadas (ox-LDL, por su sigla en inglés) y las lipoproteínas de baja densidad pequeñas y densas (sdLDL, por su sigla en inglés) en los hijos de pacientes con cardiopatía coronaria (CC) prematura. Población y métodos. Hijos de padres con CC de inicio temprano emparejados con pares de su misma edad y mismo sexo. Se analizaron las concentraciones de lípidos, apolipoproteínas (ApoA, B, E), ox-LDL, sdLDL y lipoproteína (a) [Lp(a)] en los niños de estudio y de referencia. Los datos se evaluaron con el programa SPSS, junto con la prueba t de Student y la prueba U de Mann-Whitney. Resultados. Los niños del grupo de estudio (n: 43) tenían niveles más elevados de LDL, Lp(a) y ox-LDL y cocientes mayores de CT/HDL, ApoB/ApoA, LDL/HDL y ox-LDL/HDL (p < 0,05) que los del grupo de referencia. Conclusión. Con base en estos hallazgos, se sugiere que la dislipidemia y las concentraciones elevadas de LDL, Lp(a) y ox-LDL son frecuentes en los hijos de pacientes con CC de inicio temprano y representan gran parte de la predisposición familiar a tener CC

Background/Aim: The objective of our study was to analyze the lipid profile and some risk factors of atherosclerosis such as oxidized-low density lipoprotein (ox-LDL), small dense LDL (sd LDL) in the offspring of patients with premature coronary heart disease (CHD). Population and Methods: Children whose parents had early onset CHD were matched with age and sex pairs. Study and controls were analyzed for lipid levels, apolipoproteins (Apo- A,B,E), ox-LDL, sd LDL and lipoprotein (a) [Lp(a)]. The data were evaluated with SPSS using "Student tand Mann-Whitney U" tests. Results: Thestudy group children (n: 43) had higher LDL, Lp(a) and ox-LDL levels, ratios of TC/HDL, Apo-B/A, LDL/HDL and ox-LDL/HDL (p<0.05) than control group. Conclusion: These findings suggest that dyslipidemia and increased LDL, Lp(a) and ox-LDL levels are common in the offspring of patients with early onset CHD and account largely for their familial predisposition for CHD.