ABSTRACT
OBJECTIVES: Existing evidence suggests that impaired vitamin D metabolism contribute to the development of atherosclerosis. Aortic intima-media thickness (IMT) is an earlier marker than carotid IMT of preclinical atherosclerosis. However, there is a lack of researches on direct investigation of relevance between serum 25-hydroxyvitamin D (25(OH)D) and thoracic aortic IMT. In this study, we aimed to assess the relationship between thoracic aortic IMT and 25(OH)D. METHODS: We studied 117 patients (mean age: 45.5 ± 8.4 years) who underwent transesophageal echocardiography (TEE) for various indications. Serum 25(OH)D was measured using a direct competitive chemiluminescent immunoassay. The patients were divided into three groups according to the their serum 25(OH)D levels (VitDdeficiency , VitDinsufficient and VitDnormal groups). TEE was performed in all subjects. High sensitive C-reactive protein (hsCRP) and other biochemical markers were measured using an automated chemistry analyzer. RESULTS: Only 24.8% (29 patients) of patients had normal levels of 25(OH)D. The highest aortic IMT values were observed in VitDdeficiency group compared with VitDinsufficient and VitDnormal groups (P < 0.05, for all). Also aortic IMT values of VitDinsufficient group were higher than VitDnormal group (P < 0.05). 25(OH)D was independently associated with hs-CRP (ß = -0.442, P < 0.001) and aortic IMT (ß = -0.499, P < 0.001). CONCLUSIONS: The lower 25(OH)D level was independently associated with higher aortic IMT values. Therefore, hypovitaminosis D may have a role on pathogenesis of subclinical thoracic atherosclerosis.
Subject(s)
Atherosclerosis/blood , Atherosclerosis/pathology , Carotid Intima-Media Thickness , Vitamin D/analogs & derivatives , Adult , Atherosclerosis/diagnostic imaging , C-Reactive Protein/metabolism , Female , Humans , Male , Middle Aged , Multivariate Analysis , Vitamin D/bloodABSTRACT
OBJECTIVE: Morning blood pressure surge (MBPS) is an independent predictor of atherothrombotic cardiovascular events in hypertensive patients. There is evidence from studies supporting the validity of mean platelet volume (MPV) as a marker of vascular risk and predictor of thrombotic complications. The aim of this study is to investigate the relationship between MPV and MBPS in hypertensive patients. METHODS: Measurements were obtained from 298 patients with newly diagnosed essential hypertension (Mean age: 51.9 ± 11.7 years). The patients were divided into two groups (MPV(low) group; <10.8 fL, MPV(high) group; ≥ 10.8 fL). The MBPS was calculated as mean systolic BP during the 2 hours after awaking minus the mean systolic BP during the 1 hour that included the lowest sleep BP. RESULTS: MPV was independently associated with MBPS (ß=0.554, p<0.001) and hs-CRP level (ß=0.286, p<0.001). CONCLUSION: Finally, higher MPV values related to enhanced MBPS which are associated with atherothrombotic cardiovascular events.
Subject(s)
Hypertension/physiopathology , Mean Platelet Volume , Stroke/physiopathology , Blood Pressure , Blood Pressure Monitoring, Ambulatory , C-Reactive Protein , Circadian Rhythm , Cross-Sectional Studies , Female , Humans , Hypertension/blood , Male , Middle Aged , Prospective StudiesABSTRACT
Increased aortic stiffness (AS) has been shown to be an independent risk factor for cardiovascular disease in renal failure and was also found to be associated with even mild renal insufficiency. We investigated the relationship between contrast-induced nephropathy (CIN) and AS parameters such as pulse wave velocity (PWV) and augmentation index (AIx). Patients (n = 440) with stable coronary artery disease (CAD) treated with percutaneous coronary intervention (PCI) were included prospectively (mean age: 60.3 ± 10.3 years). The PWV and AIx were calculated using the single-point method. The PWV, age, diabetes, SYNTAX score, and contrast media dose were independent predictors for CIN (P < .05, for all). The cutoff value for PWV obtained by the receiver-operator characteristic curve analysis was 10.35 m/s for the prediction of CIN (95% confidence interval: 0.838-0.916, sensitivity: 82.1%, specificity: 77.9%, and P < .001). In conclusion, a greater AS pre-PCI may predict CIN development in patients with stable CAD.
Subject(s)
Contrast Media/adverse effects , Coronary Angiography/adverse effects , Coronary Artery Disease/therapy , Kidney Diseases/chemically induced , Percutaneous Coronary Intervention , Vascular Stiffness , Aged , Coronary Artery Disease/diagnostic imaging , Coronary Artery Disease/physiopathology , Female , Humans , Kidney Diseases/diagnosis , Male , Middle Aged , Prospective Studies , Pulse Wave Analysis , ROC Curve , Risk Factors , Treatment OutcomeABSTRACT
We investigated the association between serum bilirubin level and thoracic aortic intima-media thickness (IMT). The study population consisted of 417 patients without coronary artery disease, who underwent transesophageal echocardiography examination for various indications. The highest aortic IMT values were observed in the bilirubinlow group compared with the bilirubinhigh group (P < .001). Serum bilirubin level was associated with high-density lipoprotein cholesterol level (r = .162, P = .001), high-sensitivity C-reactive protein (hsCRP; r = -.265, P < .001), and aortic IMT (r = -.551, P < .001) in bivariate analysis. Multivariate linear regression analysis showed that serum bilirubin level was independently and negatively associated with hsCRP (ß = -.095, P = .028) and aortic IMT (ß = -.513, P < .001). Serum bilirubin level may be an independent predictor of the extent of subclinical aortic atherosclerosis assessed by thoracic aortic IMT.
