Abstract 15941: The Predictive Value of Low Grade Inflammation and Endothelial Function in Patients Presenting With Chest Pain
Introduction: Endothelial dysfunction and proinflammatory mediators are strongly related with atherosclerosis development. Routine assessment of plasma inflammatory biomarkers and endothelial function could be used for the risk stratification of patients with angina symptoms, but this remains still debated.
Hypothesis: Endothelial function and plasma interleukin 6 (IL-6) levels are associated with symptomatic CAD in patients undergoing diagnostic coronary catheterization for angina symptoms.
Methods: 627 consecutive subjects with angina symptoms undergoing coronary angiography were classified as CAD patients (n=347, stenosis>70% in a major epicardial artery) or control subjects (n=280). IL-6 levels were measured by ELISA. Flow mediated dilatation (FMD) was measured in the brachial artery by ultrasound as a well-established method to estimate endothelial function.
Results: There were no differences in age between the two groups, however CAD patients had increased incidence of male gender (59% vs. 40%, p<0.001), arterial hypertension (61% vs. 39%, p<0.001), diabetes mellitus (71% vs.29%, p<0.001) and dyslipidemia (61% vs. 38%, p<0.001) compared to control group. Importantly, CAD patients had significantly impaired FMD (CAD: 3.82±2.59% vs. control: 6.28±2.91%, p<0.001) and increased IL-6 levels (CAD:2.97±1.36pg/ml vs. controls:1.42±0.56pg/ml, p<0.001). A binary logistic regression model demonstrated that independently of the aforementioned confounders FMD (HR: 0.71, 95%CI: 0.63-0.79, p<0.001) and IL-6 levels (HR:6.9, 95% CI: 4.38-10.87, p<0.001) were strongly associated with CAD prevalence.
Conclusions: These findings highlight the important role of endothelial dysfunction and systemic low grade inflammation in atherosclerosis progression and their strong association with increased pre-test risk for symptomatic, angina-provoking CAD in subjects undergoing diagnostic coronary angiography for chest pain.
Author Disclosures: E. Oikonomou: None. A. Miliou: None. A. Antonopoulos: None. G. Siasos: None. N. Papageorgiou: None. G. Hatzis: None. K. Mourouzis: None. H. Ververeli: None. F. Zacharia: None. G. Vogiatzi: None. G. Papamikroulis: None. D. Tousoulis: None.
- © 2016 by American Heart Association, Inc.