HDL-C in Cardiac Syndrome X (HIRICS-X)

HDL-Cholesterol is Inversely Related With Inflammation in Cardiac Syndrome X

High density lipoprotein cholesterol (HDL-C) is in the centrum of the process of reverse cholesterol transport from peripheral cells to the liver[10]. HDL-C promotes endothelial generation of nitric oxide (NO) and improves endothelial function and arterial vasoreactivity[11]. In several studies, lower HDL-C level was reported to be associated with increased coronary artery disease (CAD) risk[12-14]. HDL-C also has anti- inflammatory and anti-oxidant activities[15,16]. Concerning anti-inflammatory activity, HDL-C inhibits the activation of monocytes/macrophages and neutrophils[17,18] and inhibits the expression of endothelial adhesion molecules, such as vascular cell adhesion molecule-1 (VCAM-1) and E-selectin[15].

In this study we aimed to investigate the relation of HDL-C level with systemic inflammatory markers in patients with cardiac syndrome X (CSX).

Study Overview

• Status: Completed
• Conditions: Heart Diseases; Cardiovascular Diseases; Microvascular Angina; Unstable Angina; Myocardial Ischaemia

• Study Type: Observational
• Enrollment (Actual): 710

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 47 years to 58 years (Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

CSX was defined as typical chest pain during rest or effort, abnormal test result for exercise ECG and myocardial perfusion scintigraphy, and the presence of angiographically normal epicardial coronary arteries. Control group was selected from volunteers presented to our hospital with the complaint of typical anginal chest pain who had no ischemia on myocardial perfusion scintigraphy or during the treadmill exercise test, had similar risk profile with the patients (diabetes, hypertension, age, gender) and had normal epicardial coronaries at coronary angiography.

Description

Inclusion Criteria:

• Must be able to get exercise stress test
• Must be able to have coronary angiography
• Clinical diagnosis of typical anginaduring rest or effort
• Abnormal test result for exercise ECG or myocardial perfusion scintigraphy
• Must have of angiographically normal epicardial coronary arteries

Exclusion Criteria:

• Patients with valvular heart disease (mitral stenosis and moderate to severe mitral regurgitation
• Patients with moderate to severe aortic stenosis and regurgitation including mitral annular calcification)
• Patients with heart failure (left ventricular ejection fraction <50%)
• Patients with congenital heart disease, cardiomyopathy, left ventricular hypertrophy, right ventricular hypertrophy
• Patients with cardiac surgery
• Patients with thyroid disease
• Patients with anemia
• Patients with pulmonary diseases
• Patients with infectious diseases (locally or systemic)

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort
Control Group
Cardiac Syndrome X

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
HDL-Cholesterol	HDL-Cholesterol <40 mg/dL(male) / < 50mg/dL(female) ==> low HDL-C	6 MONTHS
Cardiac Syndrome X	Patients who have typical anginal chest pain+ischaemic findings at exercise stress test/myocardial scintigraphy + normal epicardial coronaries at coronary angiography ==> Cardiac syndrome X	6 months
Inflammation	CRP > 2,98 mg/dL ==> systemic inflammation	6 months

Collaborators and Investigators

• Sponsor: Bursa Yüksek İhtisas Education and Research Hospital

Study record dates

Study Major Dates

• Study Start: March 1, 2012
• Primary Completion (Actual): December 1, 2013
• Study Completion (Actual): January 1, 2014

Study Registration Dates

• First Submitted: March 17, 2014
• First Submitted That Met QC Criteria: March 24, 2014
• First Posted (Estimate): March 26, 2014

Study Record Updates

• Last Update Posted (Estimate): March 26, 2014
• Last Update Submitted That Met QC Criteria: March 24, 2014
• Last Verified: March 1, 2014

More Information

Terms related to this study

• Keywords: inflammation; dyslipidemia; cardiac syndrome X
• Additional Relevant MeSH Terms: Pathologic Processes; Vascular Diseases; Pain; Neurologic Manifestations; Chest Pain; Heart Diseases; Myocardial Ischemia; Cardiovascular Diseases; Ischemia; Angina Pectoris; Angina, Unstable; Microvascular Angina
• Other Study ID Numbers: BYIEAH-281