Severity of stable coronary artery disease and its biomarkers differ between men and women undergoing angiography

Crystel M.  Gijsberts; Aisha  Gohar; Guilielmus H.J.M.  Ellenbroek; Imo E. Hoefer; Dominique P. V.  de Kleijn; Folkert W. Asselbergs; Hendrik M. Nathoe; Pierfrancesco Agostoni; Saskia Z. H.  Rittersma; Gerard Pasterkamp; Yolande Appelman; Hester M. den Ruijter

doi:10.1016/j.atherosclerosis.2015.02.002

Severity of stable coronary artery disease and its biomarkers differ between men and women undergoing angiography

Crystel M. Gijsberts, Aisha Gohar, Guilielmus H.J.M. Ellenbroek, Imo E. Hoefer, Dominique P. V. de Kleijn, Folkert W. Asselbergs, Hendrik M. Nathoe, Pierfrancesco Agostoni, Saskia Z. H. Rittersma, Gerard Pasterkamp, Yolande Appelman, Hester M. den Ruijter^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Background: Coronary artery disease (CAD) affects both men and women. Cardiovascular biomarkers have been suggested to relate to CAD severity, but data on sex-specificity is scarce. Therefore, we investigated the association of established biomarkers with the severity of CAD in stable patients undergoing coronary angiography in a sex-specific manner.

Methods: We studied stable patients undergoing coronary angiography and measured CAD severity by SYNTAX score and biomarker levels (N-terminal pro-brain natriuretic peptide (NT pro-BNP), high-sensitivity CRP (hsCRP), cystatin C (CysC), myeloperoxidase (MPO), high-sensitivity troponin I (hsTnI) and von Willebrand factor (VWF)). We tested for sex differences in SYNergy between percutaneous coronary intervention with TAXUS (TM) and cardiac surgery (SYNTAX) scores and biomarker levels using multivariable ANCOVA. We investigated the association of biomarker levels with SYNTAX score in a multivariable linear regression with interaction terms for sex.

Results: We analysed data on 460 men and 175 women. SYNTAX scores were significantly lower in women (9.99 points vs. 11.88 points). Univariably, hsCRP and hsTnI levels were significantly associated with SYNTAX scores (both beta 2.5). In multivariable analysis only hsCRP associated with SYNTAX score (b 1.9, p = 0.009). Sex did not modify the association of biomarkers with SYNTAX score.

Conclusion: CAD severity as quantified by SYNTAX score is lower in women than men based on coronary angiography. The association of biomarkers with CAD severity did not differ between the sexes. (C) 2015 Elsevier Ireland Ltd. All rights reserved.

Original language	English
Pages (from-to)	234-240
Number of pages	7
Journal	Atherosclerosis
Volume	241
Issue number	1
DOIs	https://doi.org/10.1016/j.atherosclerosis.2015.02.002
Publication status	Published - Jul 2015

Keywords

Epidemiology
Sex
Biomarkers
Coronary angiography
C-REACTIVE PROTEIN
SERUM CYSTATIN C
HEART-DISEASE
PLASMA-LEVELS
RISK-FACTORS
MICROVASCULAR DYSFUNCTION
COMPUTED-TOMOGRAPHY
CLINICAL UTILITY
SYNTAX SCORE
ATHEROSCLEROSIS

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Gijsberts, C. M., Gohar, A., Ellenbroek, G. H. J. M., Hoefer, I. E., de Kleijn, D. P. V., Asselbergs, F. W., Nathoe, H. M., Agostoni, P., Rittersma, S. Z. H., Pasterkamp, G., Appelman, Y., & den Ruijter, H. M. (2015). Severity of stable coronary artery disease and its biomarkers differ between men and women undergoing angiography. Atherosclerosis, 241(1), 234-240. https://doi.org/10.1016/j.atherosclerosis.2015.02.002

@article{bd461fe735e442eb94595aac78007ec8,

title = "Severity of stable coronary artery disease and its biomarkers differ between men and women undergoing angiography",

abstract = "Background: Coronary artery disease (CAD) affects both men and women. Cardiovascular biomarkers have been suggested to relate to CAD severity, but data on sex-specificity is scarce. Therefore, we investigated the association of established biomarkers with the severity of CAD in stable patients undergoing coronary angiography in a sex-specific manner.Methods: We studied stable patients undergoing coronary angiography and measured CAD severity by SYNTAX score and biomarker levels (N-terminal pro-brain natriuretic peptide (NT pro-BNP), high-sensitivity CRP (hsCRP), cystatin C (CysC), myeloperoxidase (MPO), high-sensitivity troponin I (hsTnI) and von Willebrand factor (VWF)). We tested for sex differences in SYNergy between percutaneous coronary intervention with TAXUS (TM) and cardiac surgery (SYNTAX) scores and biomarker levels using multivariable ANCOVA. We investigated the association of biomarker levels with SYNTAX score in a multivariable linear regression with interaction terms for sex.Results: We analysed data on 460 men and 175 women. SYNTAX scores were significantly lower in women (9.99 points vs. 11.88 points). Univariably, hsCRP and hsTnI levels were significantly associated with SYNTAX scores (both beta 2.5). In multivariable analysis only hsCRP associated with SYNTAX score (b 1.9, p = 0.009). Sex did not modify the association of biomarkers with SYNTAX score.Conclusion: CAD severity as quantified by SYNTAX score is lower in women than men based on coronary angiography. The association of biomarkers with CAD severity did not differ between the sexes. (C) 2015 Elsevier Ireland Ltd. All rights reserved.",

keywords = "Epidemiology, Sex, Biomarkers, Coronary angiography, C-REACTIVE PROTEIN, SERUM CYSTATIN C, HEART-DISEASE, PLASMA-LEVELS, RISK-FACTORS, MICROVASCULAR DYSFUNCTION, COMPUTED-TOMOGRAPHY, CLINICAL UTILITY, SYNTAX SCORE, ATHEROSCLEROSIS",

author = "Gijsberts, {Crystel M.} and Aisha Gohar and Ellenbroek, {Guilielmus H.J.M.} and Hoefer, {Imo E.} and {de Kleijn}, {Dominique P. V.} and Asselbergs, {Folkert W.} and Nathoe, {Hendrik M.} and Pierfrancesco Agostoni and Rittersma, {Saskia Z. H.} and Gerard Pasterkamp and Yolande Appelman and {den Ruijter}, {Hester M.}",

year = "2015",

month = jul,

doi = "10.1016/j.atherosclerosis.2015.02.002",

language = "English",

volume = "241",

pages = "234--240",

journal = "Atherosclerosis",

issn = "0021-9150",

publisher = "Elsevier",

number = "1",

}

Gijsberts, CM, Gohar, A, Ellenbroek, GHJM, Hoefer, IE, de Kleijn, DPV , Asselbergs, FW, Nathoe, HM, Agostoni, P, Rittersma, SZH , Pasterkamp, G, Appelman, Y & den Ruijter, HM 2015, 'Severity of stable coronary artery disease and its biomarkers differ between men and women undergoing angiography', Atherosclerosis, vol. 241, no. 1, pp. 234-240. https://doi.org/10.1016/j.atherosclerosis.2015.02.002

TY - JOUR

T1 - Severity of stable coronary artery disease and its biomarkers differ between men and women undergoing angiography

AU - Gijsberts, Crystel M.

AU - Gohar, Aisha

AU - Ellenbroek, Guilielmus H.J.M.

AU - Hoefer, Imo E.

AU - de Kleijn, Dominique P. V.

AU - Asselbergs, Folkert W.

AU - Nathoe, Hendrik M.

AU - Agostoni, Pierfrancesco

AU - Rittersma, Saskia Z. H.

AU - Pasterkamp, Gerard

AU - Appelman, Yolande

AU - den Ruijter, Hester M.

PY - 2015/7

Y1 - 2015/7

N2 - Background: Coronary artery disease (CAD) affects both men and women. Cardiovascular biomarkers have been suggested to relate to CAD severity, but data on sex-specificity is scarce. Therefore, we investigated the association of established biomarkers with the severity of CAD in stable patients undergoing coronary angiography in a sex-specific manner.Methods: We studied stable patients undergoing coronary angiography and measured CAD severity by SYNTAX score and biomarker levels (N-terminal pro-brain natriuretic peptide (NT pro-BNP), high-sensitivity CRP (hsCRP), cystatin C (CysC), myeloperoxidase (MPO), high-sensitivity troponin I (hsTnI) and von Willebrand factor (VWF)). We tested for sex differences in SYNergy between percutaneous coronary intervention with TAXUS (TM) and cardiac surgery (SYNTAX) scores and biomarker levels using multivariable ANCOVA. We investigated the association of biomarker levels with SYNTAX score in a multivariable linear regression with interaction terms for sex.Results: We analysed data on 460 men and 175 women. SYNTAX scores were significantly lower in women (9.99 points vs. 11.88 points). Univariably, hsCRP and hsTnI levels were significantly associated with SYNTAX scores (both beta 2.5). In multivariable analysis only hsCRP associated with SYNTAX score (b 1.9, p = 0.009). Sex did not modify the association of biomarkers with SYNTAX score.Conclusion: CAD severity as quantified by SYNTAX score is lower in women than men based on coronary angiography. The association of biomarkers with CAD severity did not differ between the sexes. (C) 2015 Elsevier Ireland Ltd. All rights reserved.

AB - Background: Coronary artery disease (CAD) affects both men and women. Cardiovascular biomarkers have been suggested to relate to CAD severity, but data on sex-specificity is scarce. Therefore, we investigated the association of established biomarkers with the severity of CAD in stable patients undergoing coronary angiography in a sex-specific manner.Methods: We studied stable patients undergoing coronary angiography and measured CAD severity by SYNTAX score and biomarker levels (N-terminal pro-brain natriuretic peptide (NT pro-BNP), high-sensitivity CRP (hsCRP), cystatin C (CysC), myeloperoxidase (MPO), high-sensitivity troponin I (hsTnI) and von Willebrand factor (VWF)). We tested for sex differences in SYNergy between percutaneous coronary intervention with TAXUS (TM) and cardiac surgery (SYNTAX) scores and biomarker levels using multivariable ANCOVA. We investigated the association of biomarker levels with SYNTAX score in a multivariable linear regression with interaction terms for sex.Results: We analysed data on 460 men and 175 women. SYNTAX scores were significantly lower in women (9.99 points vs. 11.88 points). Univariably, hsCRP and hsTnI levels were significantly associated with SYNTAX scores (both beta 2.5). In multivariable analysis only hsCRP associated with SYNTAX score (b 1.9, p = 0.009). Sex did not modify the association of biomarkers with SYNTAX score.Conclusion: CAD severity as quantified by SYNTAX score is lower in women than men based on coronary angiography. The association of biomarkers with CAD severity did not differ between the sexes. (C) 2015 Elsevier Ireland Ltd. All rights reserved.

KW - Epidemiology

KW - Sex

KW - Biomarkers

KW - Coronary angiography

KW - C-REACTIVE PROTEIN

KW - SERUM CYSTATIN C

KW - HEART-DISEASE

KW - PLASMA-LEVELS

KW - RISK-FACTORS

KW - MICROVASCULAR DYSFUNCTION

KW - COMPUTED-TOMOGRAPHY

KW - CLINICAL UTILITY

KW - SYNTAX SCORE

KW - ATHEROSCLEROSIS

U2 - 10.1016/j.atherosclerosis.2015.02.002

DO - 10.1016/j.atherosclerosis.2015.02.002

M3 - Article

C2 - 25670231

SN - 0021-9150

VL - 241

SP - 234

EP - 240

JO - Atherosclerosis

JF - Atherosclerosis

IS - 1

ER -

Severity of stable coronary artery disease and its biomarkers differ between men and women undergoing angiography

Abstract

Keywords

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