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168 J KARDIOL 2008; 15 (5–6)

ÖKG-Jahrestagung – Abstracts

thrombus resolution in CTEPH are still unclear. Previous studies

have demonstrated an involvement of angiogenetic molecules in the

pathogenesis of pulmonary hypertension. To test the role of angio-

genesis in thrombus resolution, we investigated the effect of a cell-

specific deletion of VEGF-R2/flk-1, an important regulator of an-

giogenesis, in a murine model of stagnant flow venous thrombosis.

Methods Thrombosis was induced in the infrarenal vena cava of

Tie2/Cre flk-1 flox/flox mice on a C57/BL6 background by creating

a venous stenosis with a silk suture. Thrombi were harvested on

days 3, 7, 10, 14 and 28 after surgery for analysis (n = per time

point). Non-transgenic siblings served as controls.

Results Thrombus cross-sectional area analysis over time demon-

strated a significant increase in thrombus area by day 7 after surgery

in flk-1-/-animals compared with controls (ANOVA; p < 0.05)

(Figure 7).

Conclusion Cell-specific deletion of VEGF-R2/flk-1 leads to a

misguided thrombus resolution. The data demonstrate that angio-

genesis plays a crucial role in thrombus resolution.

Key Role of Low HDL Cholesterol for the Association

of the Metabolic Syndrome With Inflammation in

Coronary Patients 026

P. Rein, C. H. Saely, St. Beer, A. Vonbank, M. Woess, C. Boehnel, V. Jankovic,

H. Drexel

VIVIT Institute, Feldkirch

Background The association of the metabolic syndrome (MetS)

and of the individual MetS stigmata with inflammation in patients

with established coronary artery disease (CAD) has not been inves-

tigated yet.

Objective To investigate the association of the MetS with inflam-

mation in this clinically important patient population.

Methods We enrolled 759 consecutive patients with angio-

graphically proven stable CAD.

Results In univariate analyses, hsCRP was higher in patients with

the MetS (ATP-III definition; n = 39) than in those who did not have

the MetS (0.48 ± 0.66 vs 0.41 ± 0.78 mg/dl; p < 0.001), and also was

higher in patients who fulfilled the large waist (0.48 ± 0.67 vs

0.39 ± 0.80 mg/dl; p < 0.001) and the low HDL (0.71 ± 1.16 vs

0.37 ± 0.59 mg/dl; p < 0.001) criteria than in those who did not.

Importantly however, after adjustment for age, gender, smoking and

LDL cholesterol by means of analysis of covariance only the low

HDL cholesterol criterion (F = 21.99; p < 0.001) remained signifi-

cantly associated with hsCRP. The significant and independent as-

sociation of low HDL with hsCRP was confirmed after additional

adjustment for all other MetS traits (F = 23.59; p < 0.001).

Conclusions We conclude that among patients with angio-

graphically proven stable CAD, low HDL cholesterol drives the

association between the MetS and subclinical inflammation. This

observation is well in line with the paramount role of low HDL cho-

lesterol as a marker of cardiovascular risk in this important patient

population.

Decreasing Kidney Function Predicts Vascular Events

Independently From the Glomerular Filtration Rate

at Baseline: A Prospective Cohort Study on Men

Undergoing Coronary Angiography for the Evalua-

tion of Coronary Artery Disease 028

P. Rein, C. H. Saely, L. Risch, A. Vonbank, St. Aczel, St. Beer, U. Neyer, H. Drexel

VIVIT Institute, Feldkirch

Background Impaired kidney function is associated with cardio-

vascular disease. However, it is uncertain, in as far a current de-

crease in the estimated glomerular filtration rate (eGFR) predicts

consequent vascular events in angiographied coronary patients.

Objective We aimed at investigating the impact of a current de-

crease in eGFR on future vascular events.

Methods At baseline and after 2 years we measured serum creati-

nine in 400 consecutive men undergoing coronary angiography for

the evaluation of stable coronary artery disease (CAD); the eGFR

was calculated by the Mayo clinic quadratic equation (MCQE).

Vascular events were recorded over 6 years from baseline.

Results Baseline eGFR levels significantly predicted vascular

events in our cohort of angiographied men after adjustment for age,

BMI, hypertension, diabetes, LDL-C, HDL-C, and smoking (stand-

ardized adjusted HR = 0.808 [0.673–0.971]; p = 0.023). Impor-

tantly, also a decrease in kidney function from baseline to the fol-

low-up visit at 2 years later significantly predicted vascular events

in the following 4 years independently from the baseline eGFR

(standardized adjusted HR = 1.472 [1.162–1.865]; p = 0.001).

Conclusions Independently of the baseline eGFR a decrease in

eGFR over two years strongly and significantly predicts vascular

events over the consequent 4 years in men undergoing coronary

angiography.

Albuminuria, the Glomerular Filtration Rate, and

Angiographically Determined Coronary Atheroscle-

rosis 036

P. Rein, C. H. Saely, L. Risch, St. Beer, A. Vonbank, M. Woess, Ch. Boehnel,

V. Jankovic, U. Neyer, H. Drexel

VIVIT Institute, Feldkirch

Background A recent finding in the Cardiovascular Health Study

was that microalbuminuria was associated with cardiovascular

events but not with atherosclerosis (as measured by carotid intima-

media thickness), leading the authors to conclude that micro-

albuminuria may be associated with plaque destabilization rather

than with atherosclerosis itself.

Objective We aimed addressing this issue in a large population of

856 consecutive patients undergoing coronary angiography for the

evaluation of (CAD).

Methods The urinary albumin/creatinine ratio (ACR) was deter-

mined and the eGFR was calculated by the Mayo clinic quadratic

equation.

Results From our patients, 278 had an eGFR < 90 ml/min/

1.73 m

, and 204 had an elevated ACR (≥ 30 mg/g). When com-

pared to subjects with both normal eGFR and normal ACR (n = 67),

the prevalence of significant coronary stenoses (i. e. stenoses with

lumen narrowing ≥ 50 %) was significantly higher in patients with

normal eGFR and elevated ACR (n = 111) and in those with de-

creased eGFR and elevated ACR (n = 93), but similar in those

(n = 185) who had decreased eGFR but normal ACR (51.8 vs

64.0 %, p = 0.021; 51.8 vs 65.8 %, p = 0.015; and 51.8 vs 49.2 %;

p = 0.545, respectively). Concordantly, in logistic regression analy-

sis the ACR but not the eGFR predicted significant coronary sten-

oses after multivariate adjustment, with odds ratios (OR) of 1.26

(95 %-CI: 1.02–1.56); p = 0.032 and 1.05 (0.86–1.28); p = 0.63,

respectively. The association between the ACR and significant

coronary stenoses remained significant after further adjustment for

eGFR (OR = 1.28 [1.03–1.60]; p = 0.025).

Figure 7:

B. Redwan et al.

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