High-sensitivity C-reactive protein, lipoproteina and homocysteine are risk factors for coronary artery disease in Japanese patients with peripheral arterial disease

Abstract

Aim: The goal of the study was to investigate the relationships between coronary artery disease CAD and risk factors, including the serum levels of high-sensitivity C-reactive protein hs-CRP, lipoproteina Lpa and homocysteine, in Japanese patients with peripheral arterial disease PAD. Methods: Coronary angiography was performed in 451 patients with PAD, among whom the prevalence and clinical characteristics of CAD were analyzed. A multiple logistic analysis was used to evaluate the relationships between CAD and the risk factors. The relationships between the severity of coronary arterial lesions and the risk factors were evaluated using multiple regression analysis. Results: The prevalence of CAD ≥70% luminal diameter narrowing or a history of CAD and coronary artery stenosis ≥50% was 55.9% and 74.1%, respectively, and the rate of CAD ≥70% with single-, double-and triple-vessel disease was 25.9%, 13.5% and 10.6%, respectively. The prevalence of diabetes was higher among the patients with CAD than among those without. The serum levels of hs-CRP, Lpa, and homocysteine were higher in the patients with CAD, whereas the estimated glomerular filtration rates and HDL-cholesterol levels were lower in these patients. According to the multiple logistic analysis, CAD was related to diabetes hazard ratio [HR]: 2.253; 95% confidence interval [CI]: 1.137-4.464, p=0.020, hs-CRP HR: 1.721; 95% CI: 1.030-2.875, p=0.038, Lpa HR: 1.015; 95% CI: 1.001-1.029, p=0.041 and homocysteine HR: 1.084; 95% CI: 1.012-1.162, p=0.021. Furthermore, diabetes and the D-dimer and LDL-cholesterol levels exhibited significant relationships with the number of stenotic coronary lesions in the stepwise multiple regression analysis p＜0.05. Conclusions: Diabetes, hs-CRP, Lpa, homocysteine and lipid abnormalities are critical risk factors for CAD in Japanese patients with PAD.