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Christiane A Geluk

Publications and source records attributed to Christiane A Geluk.

4 recordsLinked to original sources
PubMed2006

C-reactive protein and angiographic characteristics of stable and unstable coronary artery disease: data from the prospective PREVEND cohort.

AIMS: High sensitive-C-reactive protein (hs-CRP) is associated with coronary risk, which may be explained by an association with (unstable) coronary artery disease (CAD). Until now, histopathological and angiographic studies have failed to consistently demonstrate a strong relationship. However, most of these studies were limited by a cross-sectional design. Our aim was to prospectively evaluate the association between hs-CRP and plaque instability. Therefore, firstly, we investigated the relation between hs-CRP measured long before coronary angiography (CAG) and angiographic characteristics of stable and unstable CAD. In addition, we investigated the association with coronary events during follow up in the total PREVEND population. METHODS AND RESULTS: Of the population based Prevention of Renal and Vascular Endstage Disease (PREVEND) study, 8139 subjects without previous documented CAD were followed for the incidence of CAG and coronary events from 1997 to 2003. For the qualitative angiographic analysis, 216 CAGs were available. Mean time to CAG was 37+/-19 months. The 864 coronary vessels were graded as follows: 436 coronary vessels as normal, 175 as non-obstructive CAD, 179 as stable obstructive CAD and 74 as unstable obstructive CAD. Multilevel ordinal regression analysis was performed to study associations between baseline clinical variables and angiographic findings. Hs-CRP contributed significantly to the multivariate model after adjustment for age, gender, smoking, lipids and blood pressure. In 8139 subjects, 201 (2.5%) first coronary events occurred during follow up. Cox survival analysis showed age- and sex-adjusted hazard ratios for hs-CRP 1-3 and >3mg/L of, respectively, 1.26 (95% CI 0.67-2.40) and 3.16 (95% CI 1.26-3.16), relative to hs-CRP <1mg/L. CONCLUSION: In the prospective PREVEND study of subjects without previous documented CAD, hs-CRP levels at baseline were associated with angiographic characteristics and clinical consequences of plaque instability during follow up. This observation supports the concept that hs-CRP significantly contributes to coronary atherogenesis.

Aged↗
PubMed2005

Impact of statins in microalbuminuric subjects with the metabolic syndrome: a substudy of the PREVEND Intervention Trial.

AIMS: Microalbuminuria frequently clusters with the metabolic syndrome and may identify subjects at increased coronary risk. Statin treatment may reduce the incidence of major adverse cardiac events in subjects with the metabolic syndrome, but evidence is limited. We evaluated the impact of pravastatin treatment on the incidence of major adverse cardiac events in microalbuminuric subjects with the metabolic syndrome. METHODS AND RESULTS: This substudy of the PREVEND Intervention Trial (a randomized, placebo-controlled trial with a 2x2 factorial design) included 864 microalbuminuric subjects, who were randomized to fosinopril 20 mg or matching placebo and pravastatin 40 mg or matching placebo (mean follow-up 46 months). The metabolic syndrome was defined according to the NCEP ATPIII-report. Subjects with or without the metabolic syndrome were characterized by a higher age, male sex, and increased albuminuria. The incidence of major adverse cardiac events in subjects with the metabolic syndrome [9.1%; 95% confidence interval (CI) 6.0-13.0%] was increased vs. those without [3.6%; 95% CI 2.3-5.5%; P=0.007). Pravastatin treatment lowered the incidence of major adverse cardiac events in subjects with the metabolic syndrome after adjustment for age and sex (hazard ratio=0.39; 95% CI 0.17-0.89; P=0.025). CONCLUSION: This study supports the use of statins in microalbuminuric subjects with the metabolic syndrome to reduce the incidence of major adverse cardiac events.

Albuminuria↗
PubMed2004

Daytime triglyceridemia in normocholesterolemic patients with premature atherosclerosis and in their first-degree relatives.

Postprandial hypertriglyceridemia tested under metabolic ward conditions with unphysiological high fat loads has been reported in CAD patients and their relatives even in the presence of normal fasting lipids. It is unclear whether this also occurs in the daytime situation. Twenty-seven normocholesterolemic, non-obese and nondiabetic patients with premature coronary artery disease (CAD) and 56 first-degree relatives without CAD measured daytime capillary triglyceride profiles (TGc-AUC) as an estimate of postprandial lipemia. Fasting capillary triglycerides (TGc) were not significantly different between CAD index patients and their relatives (1.68 +/- 0.63 and 1.54 +/- 0.71 mmol/L, respectively). In contrast, daytime triglyceridemia was significantly higher in CAD patients (30.7 +/- 13.6 mmol. h/L) compared to their relatives (24.4 +/- 9.4 mmol. h/L) and this was also the case after correction for fasting TGc (7.24 +/- 7.41 and 2.79 +/- 6.89 mmol. h/L; P <.05). The best predictors of TGc-AUC by multiple regression analysis in CAD families were fasting TGc, systolic blood pressure, and high-density lipoprotein cholesterol (HDL-C), which are all components of the metabolic syndrome, explaining 65% of the variation. Since there were no major differences in nutritional intake between index patients and their relatives, this could not explain the differences Daytime triglyceridemia, measured under physiological conditions, is increased in patients with premature atherosclerosis and normal fasting TG levels, when compared to their non-CAD relatives. This study confirms previous observations using standardized oral fat loading tests and underlines the importance of postprandial hyperlipidemia in CAD.

Blood Pressure↗