Sir Hospital and Research Center

Girgaum, India

Sir Hospital and Research Center

Girgaum, India
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Deo S.S.,Sir Hospital and Research Center | Chogle A.R.,Sir Hospital and Research Center | Mistry K.J.,Sir Hospital and Research Center | Shetty R.R.,Sir Hospital and Research Center | Nadkar U.L.,Sir Hospital and Research Center
Experimental and Clinical Cardiology | Year: 2012

BACKGROUND: Studies have shown that rheumatoid arthritis (RA) patients are two to five times more likely to develop premature cardiovascular disease, thus shortening their life expectancy by five to 10 years. This risk has risen to approximately 12.6% in the urban population and 7.4% in the rural population of India. The Framingham risk score (FRS) identifies patients at increased cardiovascular risk and helps determine the need for preventive interventions. An investigation of the patients' coronary arteries and coronary artery calcification (CAC) - a measure of atherosclerotic plaque - has been found to be a strong predictor of cardiovascular disease. OBJECTIVE: To identify important biological markers for easy and noninvasive identification of cardiovascular disease in RA patients, and to investigate whether there is a relationship between the FRS and coronary artery atherosclerosis in RA patients. METHODS: The present study included 43 established RA patients and 50 healthy individuals (controls). Traditional and nontraditional risk factors were studied and compared with the control group. Insulin resistance was assessed using the homeostasis model of assessment of insulin resistance (HOMA-IR) and the homeostasis model of assessment of beta cell function. The FRS and the 10-year cardiovascular risk were compared between RA patients and controls. The presence of CAC was determined using electronbeam computed tomography, and the association between the FRS and CAC was examined. RESULTS: Significant differences in body mass index, waist circumference, rheumatoid factors (immunoglobulin [Ig]G, IgM and IgA) and inflammatory markers - C-reactive protein and erythrocyte sedimentation rate - were noted. There was significant correlation between HOMA-IR and body mass index, hypertension and C-reactive protein, but no correlation was seen with the homeostasis model of assessment of beta cell function. Significant differences were observed in the nontraditional biomarkers in RA patients, thus supporting their importance. Calcium deposition was observed in only seven RA patients. CONCLUSIONS: RA patients with increased C-reactive protein levels and erythrocyte sedimentation rates showed an increase in serum insulin levels and significant differences in HOMA-IR, thus indicating insulin resistance, which could lead to underlying progression of artherosclerosis. Significant differences were observed in the nontraditional risk factors, which could be chosen as biomarkers for endothelial dysfunction. There was a significant correlation between calcium score and the FRS in seven patients, suggestive of an underlying risk of atherosclerosis. ©2012 Pulsus Group Inc. All rights reserved.


Shalia K.K.,Sir Hospital and Research Center | Mashru M.R.,Sir Hospital and Research Center | Shah V.K.,Sir Hospital and Research Center | Soneji S.L.,Sir Hospital and Research Center | Payannavar S.,Sir Hospital and Research Center
Indian Heart Journal | Year: 2012

Aims/objective: Over expression of matrix degrading enzymes have been implicated in plaque destabilisation and rupture. Cathepsins associated with extracellular matrix breakdown make them intriguing suspects. The aim of the study was to analyse peripheral levels of cathepsin B and cathepsin K and their inhibitor cystatin C during acute myocardial infarction (AMI). Materials and methods: Study population included AMI patients at acute event (AMI group, n = 48), stable angina patients (stable angina group n = 17), and healthy individuals (Control group, n = 31). Cathepsin B, cathepsin K, cystatin C, and matrix metalloproteinases (MMP)-9 were analysed by enzyme-linked immunosorbent assay (ELISA) method. Results: Cathepsin B (45. 9%) and cathepsin K (92. 31%) at acute event of myocardial infarction (AMI group) increased (P = 0. 001) while cystatin C decreased marginally (12. 5%) as compared to con- trols. Stable angina group, demonstrated only marginal reduction in all the parameters studied as compared to controls. Conclusion: Cathepsin B and cathepsin K can be further evaluated as biomarkers in identifying high-risk individuals for AMI. © 2012, Cardiological Society of India. All rights reserved.


PubMed | Sir Hospital and Research Center
Type: Journal Article | Journal: Indian heart journal | Year: 2012

Over expression of matrix degrading enzymes have been implicated in plaque destabilisation and rupture. Cathepsins associated with extracellular matrix breakdown make them intriguing suspects. The aim of the study was to analyse peripheral levels of cathepsin B and cathepsin K and their inhibitor cystatin C during acute myocardial infarction (AMI).Study population included AMI patients at acute event (AMI group, n=48), stable angina patients (stable angina group n = 17), and healthy individuals (Control group, n=31). Cathepsin B, cathepsin K, cystatin C, and matrix metalloproteinases (MMP)-9 were analysed by enzyme-linked immunosorbent assay (ELISA) method.Cathepsin B (45.9%) and cathepsin K (92.31%) at acute event of myocardial infarction (AMI group) increased (P=0.001) while cystatin C decreased marginally (12.5%) as compared to controls. Stable angina group, demonstrated only marginal reduction in all the parameters studied as compared to controls.Cathepsin B and cathepsin K can be further evaluated as biomarkers in identifying high-risk individuals for AMI.

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