Biomarkers of calcification and atherosclerosis in patients with degenerative aortic stenosis in relation to concomitant coronary artery disease

Abstract

IntroductIon There is an ongoing debate regarding aortic valve degenerative processes. Some markers of calcification and atherosclerosis may be potentially useful in establishing their etiology.objEctIvEs The aim of the study was to assess the bio chemical markers of calcification and atherosclerosis in patients with degenerative aortic stenosis (AS) in relation to the aortic valve calcium score (AVCS) and concomitant coronary artery disease (CAD). PAtIEnts And mEthodsThe study involved 88 patients: 68 patients with degenerative AS (group A), including 44 patients with severe AS (A1; 25 patients with CAD) and 24 patients with moderate AS (A2; 13 patients with CAD) and 20 matched subjects as controls (18 patients with CAD). In all patients, clinical data were assessed, laboratory tests were done (including the analysis of serum inter leukin 4 [IL -4], osteoprotegerin [OPG], and fetuin -A levels), coronary angiography was performed, and the AVCS was measured.rEsuLts Study groups and subgroups had comparable serum IL -4, OPG, and fetuin -A levels. There were significant differences in the AVCS between patients with severe AS, moderate AS, and controls (3605 ±2542 Agatston units [AU], 1390 ±1143 AU, 100 ±194 AU, respectively; P <0.001). There were no significant correlations between the AVCS and serum IL -4, OPG, or fetuin -A levels. In moderate AS, serum OPG levels were higher in subjects with concomitant CAD (5.84 ±1.4 vs. 4.03 ±1.3 pmol/l, P = 0.036). In severe AS, the mean AVCS was similar in patients with and without CAD. Higher AVCS was observed only in patients with moderate AS and coexisting CAD compared with patients without CAD (1644 ±1285 vs. 902 ±789 AU, P = 0.038).concLusIons There were no significant differences between patients with and without degenerative AS in selected bio chemical markers. The presence of CAD in moderate AS was associated with increased AVCS and serum OPG levels suggesting the effect of atherosclerosis on early valve calcification. In patients with severe AS, there were no correlations between calcification and atherosclerotic markers.

Hepatocyte growth factor as a long‑term predictor for total and cardiovascular mortality in patients on peritoneal dialysis

“…The CaSc identifies calcified plaques using scatter of X-rays and it could be used as a marker of atherosclerosis that might improve the current risk assessment when added to traditional risk factors. [18][19][20] In conclusion, our study showed that increased HGF levels in response to vascular damage in dialysis patients correlate with vascular calcifications and predict long-term mortality. Given the relationship between HGF levels and CaSc, increased concentrations of early inflammatory factors such as IL-6, hsCRP, and HGF could be considered as risk factors for total and CV mortality in dialysis patients.…”

Biomarkers of Calcific Aortic Valve Disease

“…Studies of osteoprotegerin have yielded discrepant results. In one study of 68 AS patients and 20 matched CAVD free controls, circulating levels of osteoprotegerin predicted the presence of CAD, however, they were not associated with prevalent CAVD 49 . In contrast, a smaller study of 38 patients with severe AS demonstrated significantly increased circulating osteoprotegerin with respect to CAVD free controls 50 .…”

“…Results for progression of CAVD with respect to biomarkers of bone metabolism are limited to one small study of 88 patients with follow up of at least 12 months, in which lower serum fetuin-A levels were not significantly different between patients with no AS, moderate AS, or severe AS 49 . These results highlight the possibility that circulating levels of plasma biomarkers reflecting bone formation and resorption represent a systemic perturbation manifesting with CAVD rather than a valve specific expression of these proteins.…”

Homocysteine and metabolic risk factors in individuals with family history of premature ischemic stroke

“…22,23 The vascular endothelium damaged by hyperhomocysteinemia initiates inflammation and development of atherosclerotic lesions. 24 In women, we observed an association between lower HDL-C and elevated Hcy levels, which might increase the probability of HDL modification by Hcy. It has been shown that modified HDL molecules exhibit lower antioxidant and anti-inflammatory action.…”