Genetic Markers at ANRIL, FTO and 2q36.3 Locus in Czech Patients Undergoing Coronary Artery Bypass Graft Surgery.

Coronary artery bypass graft (CABG) surgery is one of the most commonly performed operations worldwide. We compared genotype frequencies of three major cardiovascular disease (CVD)-associated genetic markers (ANRIL, FTO and 2q36.3 locus) between 753 patients who underwent CABG at the Institute for Clinical and Experimental Medicine (Prague, Czech Republic) and 2,559 controls from the Czech post-MONICA study. Subjects with at least one major A allele in the rs10757274 polymorphism (ANRIL) were more prevalent in patients after CABG than in the controls (81.7 % vs 72.7 %; OR [95 % CI] 1.67 [1.35-2.05]; P < 0.0001). In contrast, variants within the FTO gene (OR 0.87; 95 % CI, 0.70-1. 09 in a TT vs. GG comparison, P = 0.24) and 2q36.3 locus (OR 1.16; 95% CI, 0.98-1.37 in a +A vs. CC comparison, P = 0.08) were not significantly associated with CVD in our study. Variants were not associated with anthropometric, biochemical, or clinical characteristics within the patient group. Our study suggests that patients with CABG are more commonly carriers of some but not all CVD-associated alleles.

Bilateral oophorectomy may have an unfavorable effect on glucose metabolism compared with natural menopause.

The incidence of diabetes mellitus is rising worldwide. The aim of this prospective epidemiological study was to compare the effects of natural and surgical menopause on parameters of glucose metabolism. In a group of 587 repeatedly examined women, with a baseline age of 45-55 years, the following subgroups of women were separated: those after bilateral oophorectomy (BO, n=37) and those in natural menopause (NAT, n=380) including women menopausal already at baseline (POST, n=89). The study parameters including glycemia, insulinemia, HOMA-IR and beta-cell function using HOMA-beta were determined at baseline and 6 years later. Over the study period, there was a marked rise in prediabetic and diabetic values of fasting glycemia; the percentage of women with diabetic values increased in the NAT (from 0.8 % to 3.9 %) and POST (from 2.2 % to 9.0 %) subgroups, with the highest prevalence in the BO subgroup (from 8.1 % to 10.8 %). While, among women with non-diabetic fasting glycemia, an increase in fasting glycemia was observed in all study subgroups, it was more marked in the BO subgroup than in the NAT and POST ones (p=0.02 both). This difference between NAT and BO was also found in the long-term trend of development of glycemia in non-diabetic women (p=0.014). Compared with natural menopause, bilateral oophorectomy may have an adverse effect on glucose metabolism.

Relation between preclinical atherosclerosis and venous thromboembolism in patients with thrombophilias - longitudinal study.

Preclinical atherosclerosis may represent a risk factor for venous thromboembolism (VTE). In longitudinal study we followed longitudinally 96 patients (32 men) with thrombophilias with (n=51) and without (n=45) history of VTE. In both groups we studied the changes of preclinical atherosclerosis at peripherally located arteries detected by ultrasound. In addition, we assessed changes in selected risk factors of atherosclerosis. During the mean follow-up of 56.0+/-7.62 months we did not find significant change in preclinical atherosclerosis defined as Belcaro score in either group (-3 % in the VTE group vs 0 % in non VTE group). Significant increase in body mass index (1.03+/-1.98 kg*m(-2), resp. 1.21+/-1.67 kg*m(-2), p<0.01) and non-significant increase in systolic blood pressure were detected in both groups. Waist circumference increased significantly only in patients without VTE (4.11+/-7.84 cm, p<0.05). No differences in changes of risk factors under study between both groups were detected. In summary, patients with thrombophilia and history of VTE showed no evidence of greater progression of atherosclerosis or increase in traditional risk factors of atherosclerosis than patients with thrombophilia without history of VTE. Unfavorable changes of body mass index, waist circumference and systolic blood pressure were detected in both groups during study period.

Association between symptoms of chronic venous disease in the lower extremities and cardiovascular risk factors in middle-aged women.

AIM: The association between chronic venous disease (CVD) and atherosclerosis has been intensively investigated. Because data regarding cardiovascular disease in women are sparse, we evaluated the potential association between the symptoms of CVD and cardiovascular risk factors including markers of preclinical atherosclerosis in middle-aged women. METHODS: A questionnaire for chronic lower limb venous insufficiency was completed by 902 women, aged 45-54 years, from the general population. At the same time, all women were examined for the presence of cardiovascular risk factors, including the ankle/brachial systolic blood pressure index (ABI) and carotid intima media thickness of the common carotid arteries measured by ultrasound. Differences in cardiovascular risk factors and markers of preclinical atherosclerosis between women with and without symptoms of CVD were evaluated. RESULTS: Symptoms (cramps, aching, edema, disturbance of sleep) suggestive of CVD in the lower extremities were reported by 606 (67.2%) women and 114 (12.6%) reported that those symptoms were severe enough to limit their usual daily activities. A higher prevalence of ABI of less than 0.91 was observed in women with any (P=0.005) or severe (P=0.029) CVD symptoms. A significantly higher prevalence of the following were observed in women with any or severe CVD symptoms: coronary artery disease, history of diabetes mellitus, increased body mass index, waist circumference, serum triglycerides, serum C-reactive protein and lower serum HDL cholesterol. CONCLUSION: CVD symptoms were strongly associated with a higher prevalence of pathological values of ABI and several other manageable cardiovascular risk factors. These findings support the data that chronic venous disease might also indicate increased risk for atherosclerosis.

Preclinical atherosclerosis and other determinants of venous thromboembolism in patients with thrombophilias.

At present, the supposed association between venous thromboembolism and atherosclerosis has yet to be proven. However, no data are available from patients with thrombophilias. We evaluated the association between preclinical atherosclerosis and prevalence of thromboembolic events in patients with thrombophilias. Presence of preclinical atherosclerosis in common carotid and femoral arteries measured by ultrasound was assessed by Belcaro score (based mainly on the presence of plaques) and by measurements of intima media thickness in the same location in 109 patients (43 men, mean age 41.5+/-13 years) with established thrombophilias. Other parameters under the study were age, presence of traditional cardiovascular risk factors, anthropometric and clinical data including blood pressure measurements and medication. The differences between patients with (n=47) and without (n=62) thromboembolic events were assessed by paired t-test and chi square tests. In patients with a history of venous thromboembolism, body mass index and the prevalence of antihypertensive treatment (AT) were significantly higher than in patients without history of thromboembolism (BMI: 26.5+/-5.0 vs. 24.4+/-3.7 kg/m2; p=0.04, AT: 25.5 % vs. 8.1 %; p=0.013). No significant differences between groups were found regarding preclinical atherosclerosis. Overweight and hypertension, but not preclinical atherosclerosis, were more prevalent in patients with thrombophilias suffering from thromboembolism.