Endocrine Abstracts

Introduction: Atheromatous plaque instability biomarkers are the most important predictors for the evolution with major acute cardiovascular events (MACE) in patients with NSTE-ACS.

Objective: To evaluate the impact of dyslipidemia, endothelial dysfunction, oxidative stress, platelet hyperactivity and hypercoagulable state and their inter-correlation on the outcome of NSTE-ACS.

Methods: Two hundred and forty patients with NSTE-ACS, 154 (64.17%) men, mean age 58.31±8.92, were investigated for dyslipidemia (LDL-Cholesterol>100 md/dl, HDL-Cholesterol<50 mg/dl (men) and <40 mg/dl (women)), oxidative stress [total antioxidant status<1.3 mmol/l, Myeloperoxidase (MPO) (IgG ELISA)>20 U), hypercoagulable state (Von-Willebrand factor activity>169.7%, Protein C<70%, Protein S<72.2%, Antithrombin<71%, Factor V Leiden – APC Resistance V ratio<2.18), and platelet hyperactivity (multiple electrode aggregometry aspirin test (ASPItest)>30 U, and adenosine diphosphate test (ADPtest)>50 U), and were followed up for MACE (cardiovascular death, non-fatal myocardial infarction, recurrent angina with readmission, stroke) during 1 year. Local Ethics Committee approved the study protocol.

Statistics: SPSS 16.0.

Results: Except for the stoke, the incidence of MACE in patients with NSTE-ACS was significantly correlated with high LDL-Chol (r=0.74, P<0.0001), and low HDL-Chol levels (r=0.65, P<0.001), low serum total antioxidant status (r=0.69, P<0.0001), hypercoagulable state (r=0.63, P<0.001), and platelet hyperactivity (r=0.53, P<0.01). In patients with NSTE-ACS and MACE from our study group, a high LDL-Chol level (>100 mg/dl) and a low HDL-Chol level (<50 mg/dl in men and <40 mg/dl in women) were both best correlated with a low total antioxidant status (r=0.63, P<0.001; r=0.54, P=0.02).

Conclusion: In patients with NSTE-ACS from our study group atherogenic dyslipidemia was significantly correlated with endothelial dysfunction, oxidative stress and platelet hyperactivity biomarkers, and with MACE at 1-year follow-up.

This work was supported by CNCSIS-UEFISCU, Project number NII-ID_727/2008