Assessment of biomarkers of endothelial dysfunction in patients with angiographically proven coronary artery disease

Abstract

Introduction: The endothelium plays an important role in vascular homeostasis. Endothelial dysfunction leads to vasospasm, vasoconstriction, excessive thrombosis, and abnormal vascular proliferation. Endothelial dysfunction may be present in asymptomatic individuals, those could later develop hypertension, diabetes mellitus, and heart-related problems, which is one of the major causes of morbidity and mortality in India. The markers of endothelial dysfunction studied in this work are high-sensitivity C-reactive protein (hs-CRP), urine microalbumin creatinine ratio, and associated other markers such as lipid profile and fasting plasma sugar. Aims and Objective: The primary aim of this study was to assess biomarkers of endothelial dysfunction in patients with angiographically proven coronary artery disease (CAD). The secondary aim of this study was to estimate the levels of serum hs-CRP, urine microalbumin creatinine ratio, lipid profile, and fasting plasma sugar level in patients with angiographically proven CAD. Materials and Methods: This cross-sectional descriptive study was carried out from May 1, 2017 to April 30, 2019, at MGM Medical College, Aurangabad on approval of the Institutional Ethics Committee. A total of 231 patients with CAD of both sexes aged 21–80 years were included in the study. Serum hs-CRP was estimated by immunoturbidimetry, lipid profile by microslide method on VITROS 5600 (Ortho Clinical Diagnostics, Raritan, NJ, USA), urine microalbumin by immunoturbidimetry, urine creatinine by enzymatic reaction, and urine microalbumin creatinine ratio is calculated. Results and Discussion: hs-CRP was elevated in smokers, especially in triple vessels as compared to single and double vessels in patients with CAD, whereas the difference was nonsignificant between two- and three-vessel disease groups. In this study, we found an increased association between patients with microalbuminuria and abnormalities in serum lipoproteins. These lipid abnormalities include a lower high-density lipoprotein (HDL) level as well as higher values for low-density lipoprotein (LDL) and total triglycerides. Conclusion: This study showed that hs-CRP and urine microalbumin creatinine ratio levels were higher especially in smoker patients with CAD. There was an increase in levels of serum triglycerides, hs-CRP, LDL, and reduced HDL cholesterol levels in patients with CAD.

Keywords

• coronary artery disease
• endothelial dysfunction
• biomarkers