Significance of changes in plasma adiponectin concentration after the implantation of stents in patients with stable angina

SummaryObjectiveAlthough plasma adiponectin levels may be a marker for the severity of coronary artery disease (CAD) and can help to predict future cardiovascular events in patients with CAD, the significance of changes in plasma adiponectin levels after the implantation of stents in patients with stable angina is unclear.MethodsThe subjects included 32 consecutive patients with stable angina who had undergone successful coronary stenting [bare metal stent (BMS, n=16) or sirolimus-eluting stent (SES, n=16)]. Blood sampling was performed at baseline, and at 24h, 48h, 14 days and 6 months after stenting.ResultsPlasma high-sensitivity C-reactive protein (hs-CRP) levels at baseline (0.16±0.15mg/dl) were significantly increased at 24h (0.36±0.45mg/dl, p=0.011) and 48h (1.01±1.01mg/dl, p<0.001), and plasma adiponectin levels at baseline (6.7±4.2μg/ml) were significantly decreased at 24h (6.1±4.2μg/ml, p=0.019) and 48h (6.2±4.9μg/ml, p=0.010) in all subjects. Although there were no significant differences in changes in plasma hs-CRP and adiponectin levels between BMS and SES groups during the study period, BMS group (6.5±0.9μg/ml at baseline) showed a significant reduction of plasma adiponectin at 48h (5.8±1.1μg/ml, p=0.022) and 6 months after stenting (4.7±2.3μg/ml, p=0.011). Percent diameter stenosis (%DS) at 6 months after stenting was negatively correlated with changes in the plasma adiponectin levels within 6 months [Δadiponectin (6 months−baseline)]. In addition, multiple logistic regression analysis revealed that the %DS at 6 months after stenting was most closely correlated with Δadiponectin (6 months−baseline) after adjusting for age, sex and body mass index.ConclusionsCoronary stenting may decrease circulating adiponectin in association with an inflammatory response. The changes in plasma levels of adiponectin after stenting may also be a predictor of coronary restenosis in patients with CAD

Effects of gender and aging in patients who undergo coronary artery bypass grafting: From the FU-Registry

Background: It is unclear whether gender and aging influence the characteristics of patients who undergo coronary artery bypass grafting (CABG). Methods: We retrospectively reviewed a clinical database of 1,498 patients (male/female = 1133/365, age 67 &#177; 9 years) who underwent CABG at Fukuoka University Hospital from 1994 to 2010. Results: Male showed significantly younger, higher percentages (%) of smoking and hyperuricemia (HU), higher levels of serum creatinine, and lower % hypertension (HT) and diabetes mellitus (DM), and lower levels of left ventricular ejection fraction than female. In multivariate analysis, all parameters identified independent variables associated with the gender difference. Next, we divided the patients into 5 groups according to age, and each group was then separated by gender. The % of males significantly decreased with aging, whereas % female significantly increased. Although % smoking and estimated glomerular filtration rate (eGFR), and body mass index (BMI) in all patients, males and females significantly decreased with aging, HU, left ventricular end diastolic pressure and the number of significantly stenosed coronary vessels were not associated with gender or aging. Interestingly, % HT in all patients and males significantly increased with aging, whereas that in females was not associated with aging. Serum low-density lipoprotein cholesterol levels in males significantly decreased with aging, while those in all patients and females were not associated with aging. In this contemporary data set, the decreases in % smoking and eGFR with aging were common characteristics in male and female patients. In addition, there were gender and aging differences in % smoking, % HT, BMI and eGFR, whereas no differences were observed in % DM, % dyslipidemia or % HU. Conclusions: Before CABG, high-risk patients with coronary artery disease who is going to undergo CABG may need to be managed more strictly considering to gender and age to avoid CABG

Association between plasma levels of pigment epithelium-derived factor and renal dysfunction in patients with coronary artery disease

Background: Although plasma pigment epithelium-derived factor (PEDF) levels have been shown to be significantly correlated with the levels of creatinine (Cr) in type 2 diabetes, little is known about the association between PEDF levels and renal dysfunction in patients with coronary artery disease (CAD). Methods: We enrolled 134 consecutive patients with diagnosed CAD and measured plasma levels of PEDF, serum Cr, uric acid (UA) and high-sensitive C-reactive protein (hsCRP). Results: Plasma PEDF levels were positively correlated with serum Cr (p < 0.0001) and UA (p < 0.0001) and negatively correlated with the estimated glomerular filtration rate (eGFR) (p < 0.0001), whereas there was no association between plasma PEDF and age or hsCRP. When the subjects were divided into five groups (0&#8211;4) according to the number of metabolic factors (obesity, diabetes, hypertension and dyslipidemia), PEDF levels in patients with four factors were significantly higher than those in patients without factors. Next, we divided the patients into quartiles according to their plasma PEDF levels (< 9.9 &#956;g/mL, 9.9&#8211;12.8, 12.9&#8211; &#8211;15.7, > 15.7). The eGFR in the first group was significantly higher than those in the third and fourth groups. Multivariate logistic analysis indicated that eGFR (p < 0.0001) and age (p = 0.030) were significant independent variables that correlated with the quartile classification according to PEDF levels. Conclusions: This study revealed that PEDF may play a role in renal dysfunction in CAD patients. (Cardiol J 2011; 18, 5: 515&#8211;520

Small Molecules with Similar Structures Exhibit Agonist, Neutral Antagonist or Inverse Agonist Activity toward Angiotensin II Type 1 Receptor

Small differences in the chemical structures of ligands can be responsible for agonism, neutral antagonism or inverse agonism toward a G-protein-coupled receptor (GPCR). Although each ligand may stabilize the receptor conformation in a different way, little is known about the precise conformational differences. We synthesized the angiotensin II type 1 receptor blocker (ARB) olmesartan, R239470 and R794847, which induced inverse agonism, antagonism and agonism, respectively, and then investigated the ligand-specific changes in the receptor conformation with respect to stabilization around transmembrane (TM)3. The results of substituted cysteine accessibility mapping studies support the novel concept that ligand-induced changes in the conformation of TM3 play a role in stabilizing GPCR. Although the agonist-, neutral antagonist and inverse agonist-binding sites in the AT1 receptor are similar, each ligand induced specific conformational changes in TM3. In addition, all of the experimental data were obtained with functional receptors in a native membrane environment (in situ)

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第13回日本機能性食品医用学会総会会長講