A total of 124 patients were enrolled (78 men; 63%; mean age, 67 ± 1 years); of these, 98 patients (79%) had positive EBCT results, ie, a CCS > 0. All patients were classified into three groups according to CCSs: group 1, no calcification (CCS 0) [n = 26]; group 2, small-to-moderate coronary calcification (CCS 1 to 199) [n = 50]; and group 3, moderate-to-severe calcification (CCS a 200) [n = 48]. The baseline characteristics of the three groups are shown in Table 1. In group 3, the patients were older than those in groups 1 and 2 (p < 0.05). No significant differences in baseline characteristics were found among the three groups, except there were more patients with hypertension and diabetes in group 3 than in groups 1 and 2 (p < 0.05) and higher body mass index in group 2. There were more patients receiving medications, including antiplatelet agents, P-blockers, and nitrates, in group 3 than in groups 1 and 2 (p < 0.05), as shown in Table 2.
Among the three groups, there was an inverse association between the extent of coronary artery calcification and endothelium-dependent FMD (6.9 ± 0.6% vs 5.3 ± 0.3% vs 3.7 ± 0.3%, respectively; p < 0.001), as shown in Table 3 and Figure 1, top, A. But no significant association existed between the CCS and endothelium-independent NMD (Fig 1, bottom, B). Both hsCRP and MCP-1 revealed no significant difference among the three groups (p = not significant), as shown in Table 3 and Figure 2. On the contrary, serum levels of hsCRP and MCP-1 were shown to be correlated significantly with endothelium-dependent FMD (r = — 0.211, p = 0.019; and r = — 0.188, p = 0.037, respectively) but not with endothelium-independent NMD (p = not significant), By multivariate analysis, enhanced coronary calcification was a strong independent predictor of endothelial dysfunction (p < 0.001).
Read the rest of this entry »