Università Magna Græcia di Catanzaro Dipartimento di Medicina Sperimentale e Clinica Cattedra di Medicina Interna Scuola di Specializzazione in Geriatria U.O. Malattie Cardiovascolari Geriatriche Prof. Francesco Perticone Sindrome Sindrome Infiammatoria Infiammatoria Sistemica e Sistemica e Rischio CV Rischio CV
Università Magna Græcia di Catanzaro. Dipartimento di Medicina Sperimentale e Clinica. Cattedra di Medicina Interna Scuola di Specializzazione in Geriatria U.O. Malattie Cardiovascolari Geriatriche Prof. Francesco Perticone. Sindrome Infiammatoria Sistemica e Rischio CV. - PowerPoint PPT Presentation
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Università Magna Græcia di CatanzaroUniversità Magna Græcia di CatanzaroDipartimento di Medicina Sperimentale e ClinicaDipartimento di Medicina Sperimentale e Clinica
Cattedra di Medicina InternaScuola di Specializzazione in Geriatria
U.O. Malattie Cardiovascolari GeriatricheProf. Francesco Perticone
Cattedra di Medicina InternaScuola di Specializzazione in Geriatria
U.O. Malattie Cardiovascolari GeriatricheProf. Francesco Perticone
Sindrome Sindrome Infiammatoria Infiammatoria
Sistemica e Sistemica e Rischio CVRischio CV
Association Between Airflow Obstruction, CRP and AMI
Ukena C et al. Int J Cardiol 2010
Inflammatory Events in Complex Inflammatory Events in Complex ComorbiditiesComorbidities
Ukena C et al. Int J Cardiol 2010
Cardiopulmonary ContinuumCardiopulmonary ContinuumConcept of systemic inflammatory processes as underlying
pathophysiological relationship between COPD and CAD
Ukena C et al. Int J Cardiol 2010
Low-Dose Aspirin Reduces Low-Dose Aspirin Reduces Thromboxane BThromboxane B22 but not but not
CRPCRP
Seru
m C
RP
(% o
f B
ase
line)
140
100
60
20
Placebo(n=11)
Feldman M et al. J Am Coll Cardiol 2001;37:2036-2041
140
100
60
20Seru
m T
hro
mb
oxane
(% o
f B
ase
line)
ASA 81 mg qd(n=13)
Placebo(n=11)
ASA 81 mg qd(n=13)
28 Days31 Days
* p<0.001
* *
0
1
2
3R
isch
io r
ela
tivo d
i u
n e
vento
Infiammazione Assente
Infiammazione Presente( PCR e SAA)
P trend=0.005
Ridker et al: Circulation 1998;98:839–844
PP=0.007=0.007
CARE: La Pravastatina Riduce il Rischio CARE: La Pravastatina Riduce il Rischio Rappresentato dall’InfiammazioneRappresentato dall’Infiammazione
L-ascorbic Acid Depletion in Spiked Sera L-ascorbic Acid Depletion in Spiked Sera from Nonsmoking Men (10 control subjects, from Nonsmoking Men (10 control subjects, 15 PAD patients), Stratified for Serum CRP 15 PAD patients), Stratified for Serum CRP
(5.0 mg/L)(5.0 mg/L)Correlation Between Serum L-ascorbic Acid Correlation Between Serum L-ascorbic Acid
and CRP Concentrations in PAD Patientsand CRP Concentrations in PAD Patients
r= -0.72P< .001
Cangemi R et al, Eur Heart J 2008;29:54–62
Oxidative Stress and AtorvastatinOxidative Stress and Atorvastatin
Perticone F et al, Clin J Am Soc Nephrol, accepted
Vascular Function According to Median Vascular Function According to Median of Hbof Hb
Baseline 0 30 60 90 120
SBP
DBP
HR
Hemodynamics and FlowHemodynamics and FlowBefore and After SmokingBefore and After Smoking
60
80
100
120
140H
R (
b/m
) and B
P
(mm
Hg)
FBF
100
120
140
160
180
FBF
(ml/m
in)
J Lekakis et al, Am J Cardiol 1998;81:1225-28
min
Flow-mediated Dilation of the Brachial Artery Flow-mediated Dilation of the Brachial Artery after Smoking, Sham Smoking and after after Smoking, Sham Smoking and after
Smoking a Second CigaretteSmoking a Second Cigarette
0
2
4
6
8
10
12
0 30 60 90 120Time, min
J Lekakis et al, Am J Cardiol 1998
FM
D (
%)
sham1st cigarette2nd cigarette
Relationship Between Relationship Between Smoking and Flow Smoking and Flow Mediated DilationMediated Dilation
FM
D %
10
5
0
Celermajer et al, N Engl J Med 1996
None
1 - 4
5 - 9
10 - 19
> 20
P < .01< .01
P < .001
0
5
10
15
20
Controls Passive Active smokers smokers
FMD
%P < .001 P = NS
Celermajer et al, N Engl J Med 1996
Relationship Between Relationship Between Passive Smoking and Flow Passive Smoking and Flow
Mediated DilationMediated Dilation
O2
O-2
e-
NADH/NA DPHOxidase
NO
OONO-
L-arginina
NO-
citrullina
e-NOS
Maximal vasodilatory response to ACh (%)Maximal vasodilatory response to ACh (%)
5.6
-years
esti
mate
d
5.6
-years
esti
mate
d
pro
bab
ilit
y o
f d
iab
ete
s (
%)
pro
bab
ilit
y o
f d
iab
ete
s (
%)
10008006004002000
80
60
40
20
0
Exponential fittingr=0.85P<0.001
Endothelial Dysfunction and C-Reactive Protein Are Risk Factors for Diabetes in Essential Hypertension
Perticone F et al, Diabetes 2008Perticone F et al, Diabetes 2008
0 1 2 3 4 50
2
4
6
8
C-r
eact
ive
Pro
tein
(m
g/L)
Number of Components of the Metabolic Syndrome
Ridker PM, et al. Circulation. 2003;107:391-397.
Sindrome Metabolica e Sindrome Metabolica e LLivelli di PCRivelli di PCR