Utility of Systematic Coronary Risk Evaluation (SCORE) system to predict coronary artery disease severity in low to moderate risk hypertensive patients undergoing elective coronary angiography

Background: Coronary artery disease (CAD) is the leading cause of mortality in hypertensive patients. Systematic Coronary Risk Evaluation (SCORE) is the preferred scoring system to predict future fatal cardiovascular events in hypertensive patients. However, the relationship between SCORE and coronary atherosclerosis is not well described. We aimed to investigate whether SCORE has a relationship with CAD severity in hypertensive patients, even in the absence of high risk features. Material and methods: Four hundred and fifty-two hypertensive patients who underwent elective coronary angiography and defined as low or moderate risk according to SCORE were included into the study. Patients were divided into two groups. Patients with a SCORE < 1% were defined as low risk group, and patients with a SCORE ≥ 1% and < 5% were defined as moderate risk group. The groups were compared regarding CAD severity. Results: The frequency of stenotic CAD and multivessel disease, and mean SYNTAX score, were significantly higher in SCORE ≥ 1%, and < 5% group compared to patients with SCORE < 1%. Correlation analysis revealed a significant positive moderate correlation between SCORE and SYNTAX score (Pearson’s r: 0.679, p < 0.001). ROC curve analysis demonstrated that a SCORE ≥ 3% predicted SYNTAX score > 22 with a sensitivity of 75% and a specificity of 86.5% (AUC: 0.879, p < 0.001). Furthermore, multivariate analysis demonstrated that SCORE was an independent predictor of stenotic CAD (OR: 1.616, p < 0.001), multivessel disease (OR: 1.913, p < 0.001), and SYNTAX score > 22. (OR: 1.817, p < 0.001). Conclusion: Our results suggest that SCORE is associated with CAD severity in hypertensive patients even in theabsence of high risk features. The SCORE system may be useful in further risk stratification of hypertensive patientswith moderate risk features and suspected CAD

Analyses of C-Reactive Protein, Endothelial Nitric Oxide Synthase and Interleukin-6 Gene Polymorphisms in Adolescents with a Family History of Premature Coronary Artery Disease: A Pilot Study

Background: Family history of premature atherosclerosis imposes a high risk to people. The relationship between atherosclerosis and gene polymorphisms of various biomarkers such as Endothelial Nitric Oxide Synthase (eNOS), C-Reactive Protein (CRP), and Interleukin-6 (IL-6) has shown in previous studies. Aims: The major aim of the study was to evaluate the CRP, eNOS, and IL-6 gene polymorphisms in a group of adolescents who have a parental history of early coronary artery disease (CAD). Study Design: Case-control study. Methods: Thirty-six volunteers with a father with obstructive CAD during the first four decades and 46 subjects with a father with normal coronary arteries documented with coronary angiography were included in the study. Polymerase chain reaction-restriction fragment length polymorphism techniques were used to analyze CRP, eNOS, and IL-6 polymorphisms. Results: We did not find any differences between the two groups with regard to age, sex, body mass index, renal functions, systolic and diastolic blood pressures, lipid profile, and fasting glucose, hemoglobin, and high sensitivity CRP. A significant difference was only observed in IL-6-572 G/C genotype distribution and allele frequency between two groups (Pc=0.036 OR=3.48 CI (95%) 1.17-10.32). Conclusion: The present study showed a significant association between the IL-6-572 G/C gene polymorphism (presence of C allele) and adolescents with a parental history of premature CAD