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High-sensitivity C-reactive Protein, Lipoprotein(a) and Homocysteine are Risk Factors for Coronary Artery Disease in Japanese Patients with Peripheral Arterial Disease.
MedLine Citation:
PMID:  25296963     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Aim: The goal of the study was to investigate the relationships between coronary artery disease (CAD) and risk factors, including the serum levels of high-sensitivity C-reactive protein (hs-CRP), lipoprotein(a) (Lp(a)) and homocysteine, in Japanese patients with peripheral arterial disease (PAD). Methods: Coronary angiography was performed in 451 patients with PAD, among whom the prevalence and clinical characteristics of CAD were analyzed. A multiple logistic analysis was used to evaluate the relationships between CAD and the risk factors. The relationships between the severity of coronary arterial lesions and the risk factors were evaluated using multiple regression analysis. Results: The prevalence of CAD (≥70% luminal diameter narrowing or a history of CAD) and coronary artery stenosis (≥50%) was 55.9% and 74.1%, respectively, and the rate of CAD (≥70%) with single-, double- and triple-vessel disease was 25.9%, 13.5% and 10.6%, respectively. The prevalence of diabetes was higher among the patients with CAD than among those without. The serum levels of hs-CRP, Lp(a), and homocysteine were higher in the patients with CAD, whereas the estimated glomerular filtration rates and HDL-cholesterol levels were lower in these patients. According to the multiple logistic analysis, CAD was related to diabetes (hazard ratio [HR]: 2.253; 95% confidence interval [CI]: 1.137-4.464, p=0.020), hs-CRP (HR: 1.721; 95% CI: 1.030-2.875, p=0.038), Lp(a) (HR: 1.015; 95% CI: 1.001-1.029, p=0.041) and homocysteine (HR: 1.084; 95% CI: 1.012-1.162, p=0.021). Furthermore, diabetes and the D-dimer and LDL-cholesterol levels exhibited significant relationships with the number of stenotic coronary lesions in the stepwise multiple regression analysis (p<0.05). Conclusions: Diabetes, hs-CRP, Lp(a), homocysteine and lipid abnormalities are critical risk factors for CAD in Japanese patients with PAD.
Authors:
Hisao Kumakura; Kishu Fujita; Hiroyoshi Kanai; Yoshihiro Araki; Yoshiaki Hojo; Shu Kasama; Toshiya Iwasaki; Shuichi Ichikawa; Kuniki Nakashima; Kazutomo Minami
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-10-08
Journal Detail:
Title:  Journal of atherosclerosis and thrombosis     Volume:  -     ISSN:  1880-3873     ISO Abbreviation:  J. Atheroscler. Thromb.     Publication Date:  2014 Oct 
Date Detail:
Created Date:  2014-10-9     Completed Date:  -     Revised Date:  2014-10-10    
Medline Journal Info:
Nlm Unique ID:  9506298     Medline TA:  J Atheroscler Thromb     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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