In symptomatic patients with suspected CAD referred for evaluation by DSE, who have no resting wall motion abnormalities, pneumatic compression of the lower extremities during DSE improved the sensitivity but slightly reduced the specificity for detection of angiographically significant CAD, compared with standard DSE. Moreover, it reduced the test duration.
Objectives
to detect the value of serum Glycated Albumin measurement as a marker for RA associated coronary artery atherosclerosis and also a marker for RA disease activity.
Patients and Methods
serum GA using enzyme-linked immunosorbent assay (ELISA), chemical and immunological markers of RA were measured in 30 RA patients and 15 age and sex matched controls known to have established coronary artery disease. Disease activity was assessed using the DAS-28 score. Carotid ultrasound was done to both groups to measure the carotid IMT.
Results
A significantly higher serum GA level on comparing RA patients and controls (T = 5.096, P < 0.001). Serum GA had a significant positive correlation with ESR (r = 0.546, P < 0.002) and CRP (r = 0.768, P < 0.001), a significant positive correlation with DAS-28 (r = 0.532 , P < 0.002), a significant positive correlation with mean carotid IMT (r = 0.471, P = 0.019). The mean carotid IMT showed a highly significant positive correlation with the disease duration (r = 0.645, P < 0.001), a positive correlation with severe disease activity (r = 0.771, P = 0.015), but negative correlation with mild and moderate disease activity (r = 0.500, P = 0.667) and ( r = 0.452, P = 0.059) respectively. Another significant positive correlation was found between the mean carotid IMT and the LDL (r = 0.408, P = 0.025) but negative correlation with total cholesterol and HDL (r = 0.120, P = 0.527) and (r = -0.250, P = 0.183). On comparing the mean carotid IMT with the presence of soft atheromatous plaque it gave negative results with positive correlation (T = -3.273, P = 0.003)
Conclusion
Serum GA is a specific and sensitive biomarker for detection of subclinical atherosclerosis and disease activity in RA.
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