Role of novel cardiac bio markers in prediction, diagnosis, and severity assessmenl of atherosclerotic coronary artjary disease

Abstract EN

Allwruxclerolic cardiovascular disease is a major health problem around the world.

Insulin resistance assessed by homeostatic model assessment of insulin resistance (HOMA-IR), triglyceride/ IIDL, serum high sensitive C-reactive protein (hs-CRP), and HbAlc are probably associated with alherosclerosis.

The aim of this study was to find if there was an association between HOMA-IR, triglyceride/ HDL ratio and their product as well as hs-CRP and HbAlc with the presence and the severity of coronary artery disease and to find the best cut off' value for clinical practice.

Methods: The study involved 170 consecutive patienis with suspected or known CAD referred for coronary angiography divided into two groups; CAD ip-oup (Group I) and non CAD group (Group II) based on coronary angiography.

The blood samples including HbAlc, hs-C-reactive protein, fasting bjood glucose, creatinine, urea, insulin and lipid spectrum were obtained after overnight fasting.

Results: Patients with CAD had higher HOMA-IR than those no CAD (4.47 ± 4.26 vs.

2.49 ± 1.99, P=0.002).

Stepwise multiple logistic regression analysis demonstrated that HOMA-IR > 2.66 was independently associated with CAD (odds ratio: 3.057 ; 93% confidence interval: 1.211-7.717; P=0.018) after adjustment for age, male sex, diabetes and waist circumference.

HOMA-IR correlates positively with BMl (P 0008 & r-^0.227), waist circumference (P=^0.002 & r=0.267 ) and HbAlc (P^O.015 & r 0.213 ).

Also IlOMA-IR^TG/HDL was higher in patients with CAD compared to those no CAD (IH.35 1 22.72 vi, 9.50 i 10.50, P-0.018).

However there were insignificant differences in levels of triglyceride/IIDL, HbAlc, and hs-CRP among both groups (P= 0.124, 0.523, 0.250 & 0.764 respectivelyj.

IlOMI-IR was significantly higher in patients with DVD (Double-vessel.

Disease) and MVD (Multi-vessel Disease) compared to patients with no CAD (P-0.002 & 0.000^respectively).

Moreover HOMA-IR was significantly higher in patients with DVD and MVD compared to patients with SVD (Single-vessel Disease) (P^O.035, 0.001 respectively).

HOMA-IRxTG/HDL was significantly increased in DVD and MVD patients (P=0.012 & 0.001 respectively) compared to patients with no CAD and also when compared to patients with SVD (P=0.005 & 0.000 respectively).

Conclusion: HOMA-IR is considered as a marker for prediction of CAD and se'verity assessment.