Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0002962 (angina)
 21,142 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Adipose tissue is a secretory organ producing a variety of bioactive substances, such as adiponectin. Adiponectin has antiatherogenic properties while plasminogen activator inhibitor type 1 (PAI-1) is closely involved in the development of atherosclerosis. The relationship between adiponectin and PAI-1 in patients with coronary artery disease (CAD) has not been clarified. This study examined plasma levels of adiponectin and PAI-1 in 64 patients with stable exertional angina (SEA) and 65 patients with the chest pain syndrome (CPS). Plasma log-adiponectin levels were significantly lower in patients with SEA (0.62+/-0.08 micro g/dL) compared to those with CPS (0.86+/-0.05 micro g/dL) (p<0.0001). The plasma levels of log-PAI-1 were significantly higher in patients with SEA (1.23+/-0.18 ng/mL) compared to those with CPS (1.15+/-0.22 ng/mL) (p<0.05). Plasma log-adiponectin levels correlated negatively with diabetes mellitus (DM), body mass index (BMI), log-PAI-1 (r=-0.284, p<0.001), triglyceride (TG), and remnant-like particles cholesterol (RLP-C), and positively with high-density lipoprotein cholesterol (HDL-C) levels. Plasma levels of log-PAI-1 correlated positively with DM, BMI,TG and RLP-C levels, and negatively with HDL-C levels. Multiple logistic regression analysis identified sex, angina pectoris, and PAI-1 as independent determinants of hyperadiponectinemia (p<0.05). Adiponectin is inversely related to PAI-1. DM, BMI,TG, HDL-C, and RLP-C are common mediators between adiponectin and PAI-1, and treatment for common mediators may prevent the development of CAD by reducing PAI-1 and increasing adiponectin levels.
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PMID:Adiponectin is inversely related to plasminogen activator inhibitor type 1 in patients with stable exertional angina. 1511 65

Adiponectin, an adipocyte-derived protein, has been shown to have vasculoprotective effects. This study examined the possible relationship between coronary vasomotor function and the transcardiac gradient of adiponectin, reflecting adiponectin utilization and/or accumulation in the coronary vascular bed. The epicardial diameter and blood flow response of the left anterior descending coronary artery to intracoronary infusions of ACh was analyzed in 108 consecutive subjects who had a normal coronary angiogram and left ventriculogram. Adiponectin levels were measured by ELISA in plasma obtained from the aortic root (Ao) and the anterior interventricular vein (AIV). Adiponectin levels in the AIV were lower than levels in the Ao. In multivariate linear regression analysis, the transcardiac gradient of adiponectin (Ao - AIV levels) showed a positive correlation with increases in epicardial coronary diameter and coronary blood flow in response to ACh that was independent of traditional coronary risk factors. The transcardiac gradient of adiponectin was not significantly associated with the coronary dilator response to isosorbide dinitrate and the coronary flow response to sodium nitroprusside. In other groups of patients with coronary spastic angina (n = 41) or microvascular angina (n = 32) who had impaired coronary vasomotor responses, there was no significant gradient of adiponectin between the Ao and AIV. The transcardiac gradient of adiponectin may modulate endothelial vasomotor function in large and resistance coronary arteries and may play a role in the pathogenesis of diseases presenting with coronary vasomotor dysfunction.
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PMID:Transcardiac adiponectin gradient is independently related to endothelial vasomotor function in large and resistance coronary arteries in humans. 1692 Aug 2

The relation among adiponectin, renal function, and incident cardiovascular disease (CVD) in patients with different degrees of renal dysfunction was investigated. In total, 150 subjects were included in this study and followed prospectively for a mean of 32 months. At baseline, median adiponectin levels for chronic kidney disease (CKD) stages 1, 2, 3, 4 and 5, as estimated by creatinine clearance (> or =90, 60 to 90, 30 to 60, <30 ml/min), were 3.06, 4.04, 6.43, and 11.9 microg/ml, respectively (p for trend <0.01), and a significant association between adiponectin and CKD stages was also confirmed in multivariate regression analysis (F = 6.2, p <0.001). During follow-up, 31 subjects developed CVD, including myocardial infarction, angina pectoris, stroke, and transient ischemic attack. Gender-specific median values of adiponectin were used to separate the higher group from the lower group, and the Kaplan-Meier curve showed a significantly lower event-free survival rate in the lower adiponectin group (<4.39 microg/ml in men, <6.84 microg/ml in women, chi-square 4.88, p <0.03). The risk factor-adjusted Cox regression showed that an increase in adiponectin per 1 microg/ml was associated with a decrease in the risk of CVD to 0.86 (95% confidence interval 0.75 to 0.96, p = 0.004). In the subgroup with previous ischemic heart disease (IHD; n = 65), a significantly lower event-free survival rate of IHD was also observed in the lower adiponectin group (<4.45 microg/ml in men, <4.49 microg/ml in women, chi-square 3.96, p <0.05). The relative distribution of adiponectin isoforms was examined in patients with severe CKD, and the percentage of the high-molecular-weight form in patients with IHD during follow-up (n = 3) was significantly smaller than that in those without IHD (n = 4, p <0.02). In conclusion, renal function is a significant regulator of adiponectin when categorized by CKD stage, whereas hypoadiponectinemia is a predictor of CVD, including recurrent IHD.
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PMID:Adiponectin and renal function, and implication as a risk of cardiovascular disease. 1714 18

Adiponectin is a novel polypeptide that modulates endothelial function. Association between high serum adiponectin level and stimulation of new blood vessel formation have been reported in two experimental studies, however, data in humans are lacking. We sought to determine relationship between serum adiponectin and collateral vessel development in patients with coronary artery disease. We included 89 patients with stable angina pectoris and angiographically documented total occlusion in one of the major coronary arteries. Coronary collateral circulation was graded according to Rentrop scoring method in which collateralisation was graded between 0 and 3 from the poorest to the best. Adiponectin was determined by the ELISA method. High serum adiponectin level were significantly associated with increased new collateralisation (p = 0.001). With the increase of body mass index and waist circumference, the collateral development decreased (p = 0.001, p = 0.002; respectively). Presence of the diabetes mellitus (DM) was more frequent in those with poor collateral group than in those with good collateral group. DM was associated with poor collateral development (p = 0.002). In multiple stepwise logistic regression analysis, low level of serum adiponectin (p = 0.0001), waist circumference (p = 0.001), and presence of DM (p = 0.003) were found to be significant independent predictors of poor collateral formation. In conclusion, we have shown for the first time that elevated levels of serum adiponectin are associated with coronary collateral development in patients with coronary artery disease and additionally, the present study confirms many of the metabolic associations reported previously with adiponectin.
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PMID:High serum levels of adiponectin improve coronary collateral development in patients with coronary artery disease. 1740 74

Adipocyte cytokines regulate glucose metabolism and insulin resistance and adiponectin is thought to have a protective effect against atherosclerosis. Studies have shown that adiponectin expression is decreased in obese subjects and those with metabolic syndrome or diabetes mellitus. The purpose of this study was to investigate the relationship between circulating adipocyte cytokine concentrations and angiographic coronary artery disease (CAD) progression in patients with chest pain. Patients with stable angina pectoris who underwent repeat coronary angiograms and had serum samples at the time of first catheterization between March 1999 and January 2004 were enrolled. A modified Gensini scoring system was used to define angiographic coronary artery progression between the index and follow-up angiograms. Those who had significant angiographic progression of coronary lesions were classified into the progression group (N=55). Those who did not have CAD progression were classified into the non-progression group (N=102). Univariate analysis showed that CAD progression was associated with male gender (93% vs. 78%, p=0.038), higher baseline total cholesterol (187+/-43 vs. 173+/-39 mg/dl, p=0.037) and higher baseline fasting blood glucose (128+/-57 vs. 110+/-40 mg/dl, p=0.037). Patients in the progression group had a significantly lower serum adiponectin level (14.3+/-7.9 vs. 18.9+/-13.2 mug/ml, p=0.007) than, but resistin (28.9+/-13.4 vs. 34.4+/-26.0 ng/ml, p=0.142) and leptin (7.4+/-4.6 vs. 7.7+/-6.5 ng/ml, p=0.675) levels similar to, those in the non-progression group. In a multivariate binary logistic regression model, male gender (odds ratio 4.283, p=0.015), higher serum cholesterol (odds ratio 1.010, p=0.032) and lower serum adiponectin (odds ratio 0.959, p=0.030) were all significant independent predictors of CAD progression. In conclusion, we found that a decreased circulating level of adiponectin is associated with angiographic CAD progression in patients with angina pectoris.
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PMID:Decreased circulating protective adiponectin level is associated with angiographic coronary disease progression in patients with angina pectoris. 1917 15

Adiponectin is an adipocyte-specific secretory protein that is highly and specifically expressed in adipose tissue, and low plasma levels of adiponectin are associated with coronary artery disease (CAD). It has been suggested that high molecular weight (HMW) adiponectin is more important for vascular protection than total amount of adiponectin. To establish the clinical relevance of HMW adiponectin, we measured its serum levels in 149 patients with CAD. The levels were lower in vasospastic angina pectoris (3.4 +/- 2.4 microg/ml, p <0.01), stable angina pectoris (3.3 +/- 2.6 microg/ml, p <0.001), and healed myocardial infarction (3.8 +/- 2.9 microg/ml, p <0.01) than chest pain syndrome (controls) (6.6 +/- 5.4 microg/ml). The levels were also lower in multivessel CAD (3.4 +/- 2.4 microg/dl) compared with single vessel CAD (4.2 +/- 2.7 microg/ml, p <0.05) or no organic stenosis (5.1 +/- 3.5 microg/ml, p <0.01). In univariate analysis, diabetes mellitus (p = 0.03), insulin resistance (p = 0.06), high-sensitivity C-reactive protein levels (p = 0.0012), and low HMW adiponectin levels (p = 0.0001) predicted cardiovascular events during 7 years of follow-up. However, multivariate analysis showed that only HMW adiponectin levels were an independent predictor of cardiovascular events (relative risk 2.79, 95% confidence interval 1.49 to 5.24, p = 0.0014). In conclusion, serum HMW adiponectin levels may serve as a predictor of future cardiovascular events in patients with CAD as well as a marker for severity of CAD.
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PMID:High molecular weight adiponectin as a predictor of long-term clinical outcome in patients with coronary artery disease. 1769 7

Although many clinical studies have evaluated plaque growth in response to positive or negative remodeling in coronary arteries using intravascular ultrasound (IVUS), little is known about the associations between metabolic factors and coronary plaque growth or remodeling. In this cross-sectional study, we analyzed 100 consecutive patients with stable angina who had undergone preinterventional IVUS. The characteristics of coronary plaque (plaque area [PA] and volume [PV]) and remodeling patterns were analyzed by IVUS. Patients were divided into two groups: a positive remodeling (P) group (remodeling index [RI]>1.0, n=37) and a non-positive remodeling (NP) group (RI< or =1.0, n=63). Patient characteristics, including age, gender, body mass index and angiographic variables, were similar between the two groups. Interestingly, plasma adiponectin levels in the P group were significantly lower than those in the NP group. The remodeling classification was most closely associated with plasma adiponectin levels (p=0.006) among the metabolic factors. Although there were no significant correlations between RI and %PA or %PV, and although %PA but not %PV in the P group was significantly higher than that in the NP group, %PV was significantly associated with plasma low-density lipoprotein cholesterol (LDL-C) and diastolic blood pressure, but not adiponectin, in all patients. In addition, higher %PV was most closely correlated with higher plasma LDL-C (p=0.009) among metabolic factors. In conclusion, among the metabolic factors examined, plasma adiponectin levels may be critical for arterial remodeling, while higher levels of LDL-C may be most useful for predicting PV.
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PMID:Associations between metabolic factors and coronary plaque growth or arterial remodeling as assessed by intravascular ultrasound in patients with stable angina. 1913 98

Plasma brain natriuretic peptide (BNP) level is known to reflect left ventricular wall stress (LVWS). Recent studies have shown that obese individuals have lower BNP levels. However, the usefulness of BNP level as a marker of LVWS in obese individuals remains unclear. This study examined whether BNP reflects LVWS even in obese individuals.This study enrolled 136 hospital inpatients who had suffered chronic heart failure (NYHA class I or II), or who had undergone a thorough examination for angina pectoris. On the basis of body mass index (BMI), we divided the inpatients into nonobese (< 25) and obese (> or = 25) groups. All BNP measurements, cardiac catheterizations, and echocardiographic examinations were carried out within 24 hours. Although no significant differences were found between the two groups in the hemodynamic parameters examined, including end-diastolic LVWS (LV-EDWS) and end-systolic LVWS (LV-ESWS), BNP levels were significantly lower in the obese group compared to the nonobese group. In the nonobese group, a definite correlation between LV-EDWS or LV-ESWS and BNP (r = 0.43, r = 0.46, respectively) was observed, whereas no correlation was found between LV-EDWS or LV-ESWS and BNP in the obese group (r = -0.09, r = 0.06, respectively). To explore the mechanism for suppressed BNP levels in obese individuals, the correlation of BNP with biochemical markers was analyzed. Statistical significance was found only between adiponectin and BNP (r = 0.44), implying that BNP or adiponectin might influence the plasma levels of the other.In conclusion, BNP levels cannot be used as a marker of LVWS in obese individuals.
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PMID:Usefulness of plasma BNP levels as a marker of left ventricular wall stress in obese individuals. 1936 28

Alcohol consumption is associated with a decreased risk of type II diabetes and cardiovascular diseases. However, there is a great deal of controversy concerning the relationship between alcohol consumption and insulin resistance. This association may be further confounded by an increase in body weight levels. The aim of this study was to determine whether alcohol consumption promotes insulin resistance according to body weight levels in community-dwelling men. Study participants without a clinical history of stroke, transient ischemic attack, myocardial infarction, angina or diabetes were randomly recruited from a single community at the time of their annual health examination (678 men aged 59 +/- 14 years). They were classified into never drinkers, light drinkers [< 1 unit (22.9 g ethanol)/day], moderate drinkers (1-1.9 unit/day), and heavy drinkers (> or = 2 unit/day), and further divided into underweight [body mass index (BMI) < 23 kg/m(2)] or overweight (BMI > or = 23.0 kg/m(2)). Insulin resistance was estimated on the basis of the homeostasis model assessment of insulin resistance (HOMA-IR), and HOMA-IR and potential confounders were compared between the groups. The confounders included age, BMI, smoking status, serum gamma glutamyltransferase, and high molecular-weight adiponectin. In the overall, HOMA-IR is significantly correlated with age, BMI, serum gamma glutamyltransferase, and high molecular-weight adiponectin. After adjustment for potential confounders, mean log HOMA-IR is significantly lower in the heavy drinkers irrespective of BMI categories. In conclusion, alcohol consumption is associated with decreased insulin resistance independent of BMI in Japanese community-dwelling men.
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PMID:Alcohol consumption is associated with decreased insulin resistance independent of body mass index in Japanese community-dwelling men. 1963 38

Previous studies suggested that the adipocytokines, adiponectin and leptin, are associated with the progression and prognosis of coronary artery disease (CAD). The aim of this study was to differentially evaluate plasma levels of adiponectin and leptin in patients with CAD and their association with conventional laboratory parameters and markers of platelet activation. We consecutively evaluated 220 patients, who presented with a symptomatic CAD. Among these 83 (37.7%) presented with an acute coronary syndrome (ACS) and 137 (62.3%) with a stable angina pectoris (SAP). All patients have received coronary angiography. Baseline concentrations were determined by enzyme-linked immunosorbent assay (ELISA). Lower detection limits of the assay were 0.079 ng/mL for total adiponectin and 15.6 pg/mL for leptin. Patients with ACS showed significantly enhanced plasma levels of adiponectin and leptin compared with SAP (ACS vs. SAP (mean +/- SD): adiponectin: 9.9 +/- 7.6 microg/mL vs. 7.2 +/- 5.7 microg/mL; P = 0.008; leptin: 20.9 +/- 16.4 ng/mL vs. 15.2 +/- 10.9 ng/mL; P = 0.012). However, a correlation between plasma total adiponectin and leptin levels has not been observed (r = 0.038; P = 0.706). Plasma levels of total adiponectin and leptin positively correlated with C-reactive protein (adiponectin: r = 0.277; P = 0.001; leptin: r = 0.248; P = 0.007) and troponin-I (adiponectin: r = 0.219; P = 0.001; leptin: r = 0.190; P = 0.025). Plasma levels of both adipocytokines have shown an inverse correlation with markers of platelet activation such as platelet glycoprotein VI (adiponectin: r = -0.120; P = 0.048; leptin:r = -0.205; P = 0.036), and in a negative trend with P-selectin (adiponectin: r = -0.116; P = 0.073; leptin: r = -0.172; P = 0.078). To support our findings, we determined high-molecular-weight adiponectin in a subgroup of 37 patients, which showed similar results. Increased concentrations of total adiponectin and leptin were associated with ACS. Intriguingly, high plasma levels of both adipocytokines seem to modulate platelet activation. Further studies should elucidate the adipocytokine regulation in CAD.
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PMID:High plasma levels of adipocytokines are associated with platelet activation in patients with coronary artery disease. 1995 10


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