4.6 Article

Coronary artery disease progression is associated with C-reactive protein and conventional risk factors but not soluble CD40 ligand

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CANADIAN JOURNAL OF CARDIOLOGY
卷 22, 期 8, 页码 691-696

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ELSEVIER SCIENCE INC
DOI: 10.1016/S0828-282X(06)70938-2

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adhesion molecules; CAD progression; CD40 ligand; CRP; inflammatory markers; MCP-1

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BACKGROUND: Coronaryartery disease (CAD) is a major cause of death worldwide. Epidemiological Studies have documented conventional risk factors; however, 110 studies to date have addressed the roles of soluble CD40 ligand (sCD40L)and monocyte chemoattractant protein-1 (MCP-1), and there have been cow reports on other novel risk factors in CAD progression. The aim of the present study was to explore the roles of novel and conventional risk factors in CAD progression. METHODS: Patients with stable angina pectoris who Underwent repeat coronary angiograms and had serum samples at the time of their first catheterizaton between March 1999 and January 2004 were enrolled. Those who had progression of coronary atherosclerosis were classified into the progression group (n=66). Those who did not have CAD progression were classified into the nonprogression group (n=124). RESULTS: There were more cases of diabetes diabetes (36%) versus 20%; P = 0.024) and more men (92% vcrsLis 81%; P = .040) in the CAD progression group than in the nonprogression group, respectively. The progression group also had poorer lipid profiles than the nonprogression group, including higher total cholesterol (188 +/- 42 mg/dL versus 173 +/- 39 mg/dL, respectively; P=0.014) and low density lipoprotein cholesterol (122 +/- 38 mg/dL versus 112 +/- 36 mg/dL, respectively; P=0.025). In terms of inflammatory markets, progression patients had higher baseline high-sensitivity C-reactive protein (hs-CRP) concentrations (P=0.018), which was also related to the subsequent angiographic severity score changes; however, sCD40L (6182 +/- 4352 pg/mL versus 6244 +/- 4602 pg/mL; P=0.961), MCP-1 (427 +/- 540 pg/mL versus 341 +/- 128 pg/mL; P=0.580) and adhesion molecules concentrations were indifferent between the progression group and the nonprogression group, respectively. Using it multivariate logistical repression model, the ORs for predicting progression were 2.19 for diabetes metlitus, 2.04 for hypercholesterolemia and 1.52 for hs-CRP (P < 0.05). CONCLUSION: In the present study, only conventional risk factors, and particularly hs-CRP, were markets for predicting CAD progression. Novel risk factors, such its concentrations of SCD40L, MCP-1 and adhesion molecules, did not play significant roles.

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