PURPOSE: Many patients admitted for acute myocardial infarction (AMI) have chronic renal insufficiency and erectile dysfunction (ED). This study aimed to evaluate the relationship between ED and the glomerular filtration rate (GFR) in patients with coronary artery disease. MATERIALS AND METHODS: We studied 183 patients undergoing coronary angiography owing to AMI. The GFR was calculated and the International Index of Erectile Function-5 (IIEF-5) was used to evaluate ED. The relations between erectile function, GFR, and the number of occluded coronary arteries were evaluated. RESULTS: Of 183 patients with a mean age of 55.2+/-11.16 years who underwent coronary angiography owing to AMI, 100 (54.64%) had ED. The ED rate was 45.36% (44/97) in patients with single-vessel disease, 64.5% (31/48) in patients with two-vessel disease, and 65.7% (25/38) in patients with three-vessel disease. The ED rate in patients with single-vessel disease was significantly lower than in the other groups (p<0.001). The mean IIEF scores were 24.2+/-4.3, 20.4+/-4.9, and 20.5+/-4.2 in the three groups, respectively (p<0.001). Mean GFRs were similar in patients with single-vessel disease, two-vessel disease, and three-vessel disease (128.2+/-46.8, 130.8+/-70.9, and 110.8+/-44.6, respectively, p=0.171). The GFR was significantly lower in the presence of ED only for single-vessel disease (p=0.001). CONCLUSIONS: This study confirmed that the presence and severity of ED are linked to the number of occluded vessels as documented by coronary angiography. The presence of ED and reduced GFR are associated with single-vessel coronary artery disease. This relationship can be used to predict the likelihood of coronary artery disease.
Adult ; Aged ; *Coronary Angiography ; Coronary Artery Disease/*radiography ; Coronary Occlusion/*radiography ; Erectile Dysfunction/*epidemiology ; Glomerular Filtration Rate ; Humans ; Male ; Middle Aged ; Myocardial Infarction/*radiography ; Renal Insufficiency, Chronic/*epidemiology ; Risk Factors ; Severity of Illness Index

Glutathione S-transferase (GST) plays a key role in the detoxification of xenobiotic atherogen generated by smoking. To analyze the effect of GSTM1/T1 gene polymorphisms on the development of smoking-related coronary artery disease (CAD), 775 Korean patients who underwent coronary angiography were enrolled. The subjects were classified by luminal diameter stenosis into group A (>50%), B (20-50%), or C (<20%). GSTM1 and GSTT1 gene polymorphisms were analyzed using multiplex polymerase chain reaction (PCR) for GSTM1/T1 genes and CYP1A1 gene for internal control. Of 775 subjects, 403 patients belonged to group A. They had higher risk factors for CAD than group B (N=260) and group C (N=112). The genotype frequencies of null GSTM1 and GSTT1 showed no significant differences among 3 groups. Considering the effect of GSTM1 gene polymorphisms on the smoking-related CAD, smokers with GSTM1 null genotype had more increased risk for CAD than non-smoker with GSTM1 positive genotype (odds ratios [OR], 2.07, confidence interval [CI], 1.06-4.07). Also the effect of GSTT1 gene polymorphism on smoking-related CAD showed the same tendency as GSTM1 gene (OR, 2.00, CI, 1.05-3.84). This effect of GSTM1/T1 null genotype on smoking-related CAD was augmented when both gene polymorphisms were considered simultaneously (OR, 2.76, CI, 1.17-6.52). We concluded that GSTM1/T1 null genotype contributed to the pathogenesis of smoking-related CAD to some degree.
Aged ; Coronary Angiography ; Coronary Artery Disease/epidemiology/*genetics/radiography ; Female ; Genetic Predisposition to Disease/epidemiology ; Genotype ; Glutathione Transferase/*genetics ; Humans ; Male ; Middle Aged ; *Polymorphism, Genetic ; Risk Factors ; Severity of Illness Index ; Smoking/epidemiology/*genetics

BACKGROUND/AIMS: The aim was to determine which of three sets of metabolic syndrome (MetS) criteria (International Diabetes Federation [IDF], National Cholesterol Education Program Adult Treatment Panel III [ATP III], and European Group for the Study of Insulin Resistance [EGIR]) best predicts the coronary artery calcification (CAC) score in a cross-sectional study. This has not been evaluated in previous studies. METHODS: A total of 24,060 subjects were screened for CAC by multi-detector computed tomography. The presence of CAC was defined as a CAC score > 0. The odds ratio for the presence of CAC was analyzed for three different sets of MetS criteria and according to number of MetS components. RESULTS: CAC was observed in 12.6% (3,037) of the subjects. Patients with MetS, as defined by the IDF, ATP III, and EGIR criteria, had a CAC rate of 23.0%, 25.1%, and 29.5%, respectively (p < 0.001). Comparisons of C statistics for multivariate regression models revealed no significant difference among the three sets of criteria. After adjustment for risk factors, the ATP III criteria produced a slightly higher odds ratio for CAC compared with the other criteria, but this difference was not significant. The risk factor-adjusted odds ratio for the presence of CAC increased from 1 to 1.679 as the number of MetS components defined by ATP III increased from 0 to > or = 3 (p for trend < 0.001). CONCLUSIONS: The presence of MetS was associated with the presence of CAC. There was no significant difference among the three sets of MetS criteria in terms of the ability to predict CAC. An increase in the number of MetS components was associated with an increased odds of CAC.
Adult ; Asymptomatic Diseases ; Biological Markers/blood ; Calcium/*analysis ; Coronary Angiography/methods ; Coronary Artery Disease/blood/*epidemiology/radiography ; Coronary Vessels/*chemistry/radiography ; Cross-Sectional Studies ; Female ; Humans ; Male ; Metabolic Syndrome X/blood/diagnosis/*epidemiology ; Middle Aged ; Multidetector Computed Tomography ; Multivariate Analysis ; Odds Ratio ; Predictive Value of Tests ; Prevalence ; Republic of Korea/epidemiology ; Risk Assessment ; Risk Factors ; Vascular Calcification/blood/*epidemiology/metabolism/radiography

OBJECTIVE: We aimed at evaluating the prevalence and CT characteristics of occult coronary artery disease (CAD) in young Korean adults under 40 years of age by performing coronary CT angiography (CCTA). MATERIALS AND METHODS: We retrospectively enrolled 112 consecutive asymptomatic subjects (90 men, mean age: 35.6 +/- 3.7 years) who underwent CCTA as part of a general health evaluation. We classified the subjects into three National Cholesterol Education Program risk categories and we assessed the plaque characteristics on CCTA according to the number of involved vessels, the location and type of plaques and vascular remodeling. RESULTS: Twelve individuals had CAD (11%, 11 men). The prevalence of CAD was significantly higher in the subgroups with moderate (22%) or high (25%) risk than that in the low risk subgroup (5%) (p < 0.05). Nine patients had single-vessel disease and three patients had two-vessel disease. The most common location for plaque was the proximal left anterior descending coronary artery (60%). All the patients had non-significant stenosis and plaque, including the non-calcified (27%), mixed (47%) and calcified (27%) types. Positive vascular remodeling was identified in all the patients with non-calcified or mixed plaques. CONCLUSION: The prevalence of occult CAD was not negligible in the asymptomatic young adults with moderate to high risk, and this suggests the importance of management and risk factor modification in this population. All the patients had non-significant stenosis, and one fourth of the plaques did not show calcification.
Adult ; Chi-Square Distribution ; Contrast Media ; *Coronary Angiography ; Coronary Disease/*epidemiology/*radiography ; Female ; Humans ; Korea/epidemiology ; Male ; Prevalence ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Statistics, Nonparametric ; Tomography, X-Ray Computed/*methods

PURPOSE: In this study, we aimed to evaluate whether nonalcoholic fatty liver disease (NAFLD) was associated with the presence and morphology of coronary atherosclerotic plaques shown by multidetector computed tomography (MDCT) in asymptomatic subjects without a history of cardiovascular disease. MATERIALS AND METHODS: We retrospectively enrolled 772 consecutive South Korean individuals who had undergone both dualsource 64-slice MDCT coronary angiography and hepatic ultrasonography during general routine health evaluations. The MDCT studies were assessed for the presence, morphology (calcified, mixed, and non-calcified), and severity of coronary plaques. RESULTS: Coronary atherosclerotic plaques were detected in 316 subjects (40.9%) by MDCT, and NAFLD was found in 346 subjects (44.8%) by hepatic ultrasonography. Subjects with NAFLD had higher prevalences of all types of atherosclerotic plaque and non-calcified, mixed, and calcified plaques than the subjects without NAFLD. However, the prevalence of significant stenosis did not differ between groups. After adjusting for age, smoking status, diabetes mellitus, hypertension, dyslipidemia, and metabolic syndrome, NAFLD remained a significant predictor for all types of coronary atherosclerotic plaque [odds ratio (OR): 1.48; 95% confidence interval (CI): 1.05-2.08; p=0.025] in binary logistic analysis, as well as for calcified plaques (OR: 1.70; 95% CI: 1.07-2.70; p=0.025) in multinomial regression analysis. CONCLUSION: Our study demonstrated that NAFLD was significantly associated with the presence and the calcified morphology of coronary atherosclerotic plaques detected by MDCT. Further prospective clinical studies are needed to clarify the exact physiopathologic role of NAFLD in coronary atherosclerosis.
Adult ; Aged ; Asian Continental Ancestry Group/statistics & numerical data ; Calcinosis/ethnology/*radiography ; Case-Control Studies ; Coronary Angiography/*methods ; Coronary Artery Disease/ethnology/pathology/*radiography ; Female ; Humans ; Male ; Middle Aged ; Multidetector Computed Tomography/*methods ; Non-alcoholic Fatty Liver Disease/epidemiology/*ultrasonography ; Odds Ratio ; Plaque, Atherosclerotic/*diagnosis/epidemiology ; Prevalence ; Regression Analysis ; Republic of Korea/epidemiology ; Retrospective Studies ; Risk Factors ; Ultrasonography

BACKGROUND/AIMS: Although increased serum uric acid (SUA) concentrations are commonly encountered in patients with risk factors for coronary artery disease (CAD), the clinical value of SUA has not been established. METHODS: The study group comprised 687 consecutive patients with suspected CAD who had undergone coronary angiography. CAD was defined as stenosis > or = 50% of the luminal diameter. CAD severity was expressed as 1-, 2-, or 3-vessel disease. Metabolic syndrome (MS) was defined according to National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III) criteria, and aortofemoral pulse wave velocity (PWV) was obtained by arterial catheterization invasively. RESULTS: In total, 395 patients had CAD. SUA was higher in patients with CAD as compared to those without CAD (5.5 +/- 1.0 vs. 5.2 +/- 1.0 mg/dL, p = 0.004). In addition, SUA was significantly associated with the severity of CAD (p = 0.002). However, after adjusting for significant confounding factors including age, diabetes, smoking, cholesterol, MS, and PWV, SUA was not an independent risk factor for CAD (p = 0.151). Based on a subgroup analysis, SUA was more closely associated with CAD in women than in men, and in the highest quartile (> or = 6.4 mg/dL) than in the first quartile (< 4.8 mg/dL); however, these results were not significant (p = 0.062, p = 0.075, respectively). In a multivariate regression analysis, the most important determinant of SUA was MS (i.e., insulin resistance syndrome), which is strongly associated with CAD. CONCLUSIONS: In patients with suspected CAD, SUA was not an independent risk factor for CAD and may be merely a marker of insulin resistance.
Aged ; Biological Markers/blood ; Coronary Angiography ; Coronary Artery Disease/*blood/*epidemiology/radiography ; Female ; Humans ; Insulin Resistance ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Risk Factors ; *Severity of Illness Index ; Uric Acid/*blood