RESUMEN
Coronary artery disease (CAD) continues to be a main cause of high cardiovascular morbidity and mortality and its prevalence is expected to increase as the population ages, so its prevention is a key public health policy goal. The risk of developing atherosclerosis is related to a complex interaction of genetic, environmental and lifestyle factors. Significant progress has been made in understanding the genetic architecture of this disease in the last decade. In this article, we attempt to map the current knowledge about the genetics of atherosclerosis, in particular the interleukin-6 system and its contribution to the development of coronary atherosclerosis.
Asunto(s)
Aterosclerosis , Enfermedad de la Arteria Coronaria , Humanos , Enfermedad de la Arteria Coronaria/genética , Interleucina-6/genética , Polimorfismo Genético , Aterosclerosis/genética , Progresión de la Enfermedad , Factores de Riesgo , Predisposición Genética a la EnfermedadRESUMEN
PURPOSE: Recent studies indicate that the effects of interleukin 6 (IL-6) realized via soluble IL-6 receptor (sIL-6R) facilitate the development of various pathological processes. Soluble gp130 (sgp130) is a naturally occurring inhibitor of signal transduction via this pathway. In this study, we assessed the relationship between circulating levels of IL-6, sIL-6R and sgp130 and severity of coronary atherosclerosis in patients with stable coronary artery disease (CAD). METHODS: Plasma levels of IL-6, sIL-6R and sgp130 were measured in patients with atherosclerotic coronary lesions (n = 128, group 1) and with intact coronary arteries (n = 48, group 2). The severity of coronary atherosclerosis was evaluated by the number of affected arteries and by Gensini Score index. RESULTS: Circulating IL-6 levels in group 1 were significantly higher than those in group 2. The levels of sIL-6R did not differ considerably in both the groups. The levels of sgp130 in group 1 were significantly lower than in group 2. A negative correlation has been revealed between sgp130 levels and the number of affected coronary arteries and Gensini Score index. CONCLUSIONS: Serum concentration of sgp130 in patients with stable CAD is inversely related to severity of coronary damage. Low sgp130 level may serve as an additional indicator of coronary atherosclerosis severity.
Asunto(s)
Biomarcadores/sangre , Enfermedad de la Arteria Coronaria/sangre , Receptor gp130 de Citocinas/sangre , Índice de Severidad de la Enfermedad , Adulto , Anciano , Enfermedad de la Arteria Coronaria/patología , Femenino , Humanos , Interleucina-6/sangre , Modelos Lineales , Masculino , Persona de Mediana Edad , Análisis Multivariante , Receptores de Interleucina-6/sangreRESUMEN
BACKGROUND: Single nucleotide polymorphisms (SNPs) of the secretory phospholipase A2 type IIa (sPLA-IIa) gene (PLA2G2A) affect sPLA2-IIa level and activity in patients with diabetes mellitus, acute coronary syndrome or recent cardiovascular surgical interventions. Our study examined the effects of PLA2G2A SNPs on sPLA2-IIa levels and activity in patients with stable CHD. METHODS AND RESULTS: The study included a total of 396 patients (30% women). Six SNPs of PLA2G2A: rs1774131, rs11573156, rs3753827, rs2236771, rs876018, and rs3767221, sPLA2-IIa level and activity were determined for all patients. Four SNPs (rs1774131, rs11573156, rs3753827, rs3767221) correlated with sPLA2-IIa level but not activity with the strongest correlation observed for rs11573156 (r=0.49, p=3.7·10(-13)). All partial correlations controlling for rs11573156 became insignificant, whereas, the partial correlation of rs11573156 with sPLA2-IIa level controlling for other SNPs remained significant. Only rs11573156 showed association with sPLA2-IIa level in multiple regression analysis. Haplotype CGGGTT was associated with a significantly higher sPLA2-IIa level but not activity compared with all other haplotypes after adjustment for gender, age, diabetes mellitus and statin use (p=0.0023). CONCLUSIONS: According to our results the examined SNPs affect the sPLA2-IIa level to a greater extent than its activity in patients with stable CHD. It seems that, the impact of these SNPs on sPLA2-IIa level is caused by their linkage to rs11573156 whose minor alleles were associated with higher sPLA2-IIa level. At the same time haplotype CGGGTT, which includes the minor allele of rs11573156, was the dominant haplotype and was associated with the highest sPLA2-IIa level.
Asunto(s)
Enfermedad Coronaria/genética , Fosfolipasas A2 Grupo II/sangre , Fosfolipasas A2 Grupo II/genética , Polimorfismo de Nucleótido Simple , Anciano , Enfermedad Coronaria/sangre , Enfermedad Coronaria/enzimología , Femenino , Frecuencia de los Genes , Estudios de Asociación Genética , Predisposición Genética a la Enfermedad , Haplotipos , Homocigoto , Humanos , Desequilibrio de Ligamiento , Masculino , Persona de Mediana EdadRESUMEN
BACKGROUND: The EucaTax stent (EUPES) is a coronary stent with biodegradable polymer and camouflage coating that has been developed to promote the complete elution of drugs and decrease the risk of late complications. The aim of this study was to evaluate the efficacy and safety of the double-coated EUPES in patients with stable angina versus sirolimus-eluting stent CYPHER (SES) with permanent polymer coating. METHODS AND MATERIALS: The study included consecutive patient with at least 70% de novo coronary lesions in one or two native coronary arteries and who had undergone the coronary stenting using either EUPES or SES. We evaluated the 2-year major adverse cardiac events (MACE) rates, including total death (cardiac, non-cardiac), myocardial infarction (MI), target lesion revascularisation (TLR) and stent thrombosis. RESULTS: Between 2006 and 2009 this observational, prospective, single centre study included 602 patients (282 with EUPES and 320 with SES). At 2years, the rates of TLR (16.3% versus 6.25%; p=0.0001) and MACE (18.4% versus 7.8%; p=0.001) were significantly higher in the EUPES than in the SES group. The rate of TLR was significantly higher in the EUPES group compared with SES group in stenting of artery with a diameter less than 3mm, using stent length more than 18mm, as well as when the residual stenosis was more than 12%. CONCLUSIONS: We found that EUPES was inferior to SES during the 2-year follow-up with respect to rates of MACE and TLR that were significantly higher in the EUPES than in the SES group.