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Biomedical subjects

Christos Pitsavos

Publications and source records attributed to Christos Pitsavos.

At least 19 recordsLinked to original sources
PubMed2007

Metabolic syndrome prevalence and characteristics in Greek adults with familial combined hyperlipidemia.

Familial combined hyperlipidemia (FCH) is closely related with metabolic syndrome (MetSyn), and coronary artery disease (CAD) is positively associated to MetSyn and FCH. In this study, we evaluated the prevalence of MetSyn and its components between patients with FCH and a control group. We also investigated the role of MetSyn and diabetes mellitus (DM) on the incidence of CAD within the FCH group. Our study population consisted of 463 male and 243 female patients with FCH who were not receiving any hypolipidemic treatment, and 1128 men and 1154 women who came from the same geographical region. The prevalence of MetSyn was 42% and 19.8% among FCH subjects and controls, respectively, whereas MetSyn increased with age in both groups. The prevalence of CAD was 15.3% in the FCH group. Moreover, after dividing FCH patients into 3 subgroups, with and without MetSyn and with DM, CAD prevailed at a percentage of 15.2%, 11.1%, and 26.5%, respectively. However, statistically significant differences in the prevalence of CAD were observed only between FCH subjects with DM compared with the other 2 subgroups, even when an adjustment for age, sex, and smoking was conducted. People with FCH and MetSyn differed in several anthropometric, biochemical, and clinical characteristics, compared with the non-MetSyn subgroup of FCH. MetSyn is more prevalent in the FCH than in the control group. Among subjects with FCH, only DM was significantly associated with an increase in the prevalence of CAD in this subgroup compared with FCH individuals with or without MetSyn.

Adult↗
PubMed2007

Association of creatinine clearance and in-hospital mortality in patients with acute coronary syndromes: the GREECS study.

BACKGROUND: The relationship between renal dysfunction and mortality in patients with myocardial infarction (MI) has been extensively investigated, but there are limited data about this relationship in patients presenting with non-ST-segment-elevation MI and unstable angina. Therefore, the aim of the present study was to investigate whether renal insufficiency is an independent predictor for in-hospital mortality among such patients. METHODS AND RESULTS: Two thousand a hundred and seventy-two patients presenting with acute coronary syndrome (ACS) in 6 Greek hospitals were enrolled. Creatinine clearance rates were estimated by the Cockcroft-Gault formula. Five percentage of patients presented with severe renal dysfunction, 27% with moderate dysfunction and the other 68% were normal. Patients with moderate or severe renal dysfunction were older, more likely to be women and more likely to have history of hypertension and diabetes mellitus compared with those with normal renal function. In comparison with patients with normal renal function, those with moderate and severe renal dysfunction were respectively 3- and 12-fold more likely to die. Moreover, moderate and severe renal insufficiency continued to be a prognostic factor for mortality, even after controlling for potential confounders. CONCLUSIONS: Creatinine clearance rate is an important independent predictor of in-hospital mortality, so patients with ACS complicated by renal dysfunction should receive more aggressive medical care.

Aged↗
PubMed2006

Evidence that non-lipid cardiovascular risk factors are associated with high prevalence of coronary artery disease in patients with heterozygous familial hypercholesterolemia or familial combined hyperlipidemia.

BACKGROUND: Heterozygous familial hypercholesterolemia (hFH) and familial combined hyperlipidemia (FCH) have been associated with increased risk for coronary artery disease (CAD), but the impact of traditional risk factors to the incidence of CAD in these patients remains unknown. The present study evaluates the contribution of such risk factors to the development of CAD in these two dyslipidemic populations. METHODS: This cross-sectional study enrolled a total 1306 subjects; 600 individuals with hFH (mean age 41+/-13 years, 261 males and 339 females), and 706 individuals with FCH (mean age 49+/-11 years, 463 males and 243 females). Blood samples were collected after 12 hours fasting period, and serum lipids were determined. Multivariate logistic regression models were used to estimate the odds ratios of CAD based on the type of hyperlipidemia, after adjustment for demographic characteristics and risk factors. RESULTS: Subjects with FCH were older (P<0.001), and they had a significantly increased prevalence of hypertension, diabetes and metabolic syndrome (40 vs. 10%, 13 vs. 2% and 41 vs. 6% respectively, all P<0.001) compared to the hFH group. Total cholesterol, LDL-cholesterol, and apolipoprotein B levels were higher (all P<0.001) in hFH subjects. Although in multivariate analysis lipid abnormalities found in hFH were associated with increased risk of CAD (P<0.001) compared with lipid abnormalities of FCH, the overall prevalence of CAD was similar between the two groups (16.7 vs. 15.3%, P=NS). CONCLUSIONS: Despite the high atherogenic potential of altered lipid metabolism found in hFH, the prevalence of CAD is similarly increased in patients with hFH or FCH. This may be related to the clustering of non-lipid cardiovascular risk factors, such as diabetes mellitus, observed in patients with FCH.

Adult↗
PubMed2006

The emerging anti-inflammatory role of HDL-cholesterol, illustrated in cardiovascular disease free population; the ATTICA study.

OBJECTIVE: In this work we assessed the relationship between HDL-cholesterol levels and various inflammation markers status in a sample of cardiovascular disease free adult men and women from Greece. METHODS: The ATTICA study is a population-based cohort that has randomly enrolled 1128 men and 1154 women (aged >18 years old), stratified by age-gender, from the greater area of Athens, during 2001-2002. Adherence to Mediterranean diet was assessed through a diet-score that was based on a validated food-frequency questionnaire. In this study we assessed the relationship between HDL-cholesterol levels and inflammation markers (high sensitivity C-reactive protein, interleukin-6, homocysteine and amyloid-a), after taking into account the effect of several confounders. RESULTS: 46% of men and 40% of women had total serum cholesterol levels >200 mg/dl, while 21% of men and 7% of women had HDL-cholesterol levels <35 mg/dl. The mean value for HDL-cholesterol was 53+/-14 mg/dl in females and 44+/-14 mg/dl in males. HDL-cholesterol levels were inversely correlated to the hs-CRP levels (b=-0.028, P=0.001) and homocysteine levels (b=-0.039, P=0.036), after adjustment for sex, age, body mass index, physical activity status, smoking, total cholesterol levels, lipid lower agents, ethanol intake and diabetes mellitus; while no statistical significance was found between HDL-cholesterol levels and interleukin-6 and serum amyloid-a. CONCLUSIONS: In this work we evaluated the inverse relationship between HDL-cholesterol levels and inflammatory markers in a sample adult cardiovascular disease free population. This study among others illustrates the anti-inflammatory emerging role of HDL-cholesterol in reducing cardiovascular risk.

Adult↗
PubMed2006

Prevalence of self-reported hypertension and its relation to dietary habits, in adults; a nutrition & health survey in Greece.

BACKGROUND: Hypertension leads to many degenerative diseases, the most common being cardiovascular in origin. This study has been designed to estimate the prevalence of self-reported hypertension in a random nationwide sample of adult Greek population, while focus was set to the assessment of participants' nutritional habits in relation to their hypertension status. METHODS: A random-digit dialed telephone survey. Based on a multistage, stratified sampling, 5003 adults (18 - 74 yr) participated (men: 48.8%, women: 51.2%). All participants were interviewed via telephone by trained personnel who used a standard questionnaire. The questionnaire included demographic and socioeconomic characteristics, medical history, lifestyle habits and nutritional assessment. RESULTS: The prevalence of self-reported hypertension was 13.3% in men and 17.7% in women (P < 0.001). Furthermore, women reported higher values of systolic blood pressure (180 +/- 27 mmHg) than men (169 +/- 24 mmHg). Positive relationships were found between hypertension status and the prevalence of the rest investigated health conditions (i.e. hypercholesterolaemia, diabetes mellitus, renal failure and obesity). Nutritional assessment showed that consumption of fish, fruits and juices, cereals, and low fat milk and yogurt was significantly higher among hypertensive subjects while the opposite was observed for food items as red meat, pork, egg, pasta and rice, full fat dairy products and desserts. CONCLUSION: Hypertension seems to be a serious public health problem in Greece. It is encouraging that hypertensives may have started adopting some more healthy nutritional behaviour compared to normotensive ones. However, they can gain significant benefits regarding to blood pressure control, if they increase the level of compliance with dietary recommendations.

Adolescent↗
PubMed2006

The implication of obesity on total antioxidant capacity in apparently healthy men and women: the ATTICA study.

BACKGROUND AND AIM: We evaluated the association of obesity with serum total antioxidant capacity (TAC), in a population-based sample of 3042 adults. METHODS AND RESULTS: During 2001-2002 we randomly enrolled 1514 men (18-87 years old) and 1528 women (18-89 years old), from the Attica area in Greece into the study, and the sample was stratified by the age-sex distribution of the region (census 2001). Among several variables we also measured serum TAC and weight, height, waist and hip circumferences. Waist circumference greater than 102 cm for men and 88 cm for women was considered an indicator of central fat. METHODS AND RESULTS: Mean waist circumference was 98+/-13 cm in men and 84+/-22 cm in women (P<0.001), while mean hip circumference was 106+/-28 cm in men and 103+/-13 cm in women (P<0.001). Central fat prevailed in 53% of men and 45% of women (P<0.001). Male participants with central fat exhibited 5% lower TAC concentrations compared to leaner individuals (214+/-35 vs. 226+/-33 micromol/L, P=0.04) and female participants with central fat exhibited 7% lower TAC concentrations (256+/-38 vs. 239+/-27 micromol/L, P=0.03). Similarly, obese or overweight male participants had 6% lower TAC concentrations compared to normal weight (217+/-33 vs. 234+/-39 micromol/L, P=0.03) and female obese or overweight participants had 10% lower TAC concentrations (226+/-32 vs. 250+/-30 micromol/L, P=0.02) compared to the others. CONCLUSIONS: Our results suggest an inverse relationship between body fat, central adiposity and antioxidant capacity, irrespective of age and various other potential confounders, namely smoking, physical activity, dietary habits, blood pressure, glucose levels, and lipid concentrations.

Abdominal Fat↗
PubMed2006

Association between plasma inflammatory markers and irrational beliefs; the ATTICA epidemiological study.

OBJECTIVE: Recent research data suggest that inflammation and/or depression are associated with the development and progression of cardiovascular disease (CVD). Considering that depression may arise as a response to irrational beliefs according to the Ellis model of psychological disturbances and therapy, we sought to evaluate whether irrational beliefs are associated with plasma inflammatory factors in cardiovascular disease-free people. METHOD: From May 2001 to December 2002 we randomly enrolled 453 men (23-69 years old) and 400 women (24-71 years old) stratified by age and gender. C-reactive protein, interleukin-6, serum amyloid-A, tumor necrosis factor-alpha and white blood cells were measured in all participants. Detailed dietary characteristics of these people were assessed through a validated food frequency questionnaire. Subjects completed also the irrational beliefs inventory (IBI), which is a brief self-report measure consistent with the Ellis model of psychological disturbance and therapy and the Zung's Depression questionnaire. RESULTS: The IBI scores were similar in men and women (53+/-11 vs. 53+/-10, p = 0.83). IBI score was positively correlated with C-reactive protein (rho = 0.14, p = 0. 02), interleukin-6 (rho = 0.11, p = 0.02), tumor necrosis factor-alpha (rho = 0.21, p = 0.014) and white blood cell counts (rho = 0.14, p = 0.02). These associations were confirmed even after adjusting for age, sex, years of school, body mass index, physical activity status, depression level and food items consumed by the participants. CONCLUSION: These findings indicate that irrational beliefs are associated with increased inflammation process, among apparently healthy individuals.

Adult↗
PubMed2006

Cigarette smoking and myocardial infarction in young men and women: a case-control study.

BACKGROUND: The effect of cigarette smoking on the risk of myocardial infarction (MI) has long been investigated. However, its role on the likelihood of having MI at young age has not been well understood and appreciated. We investigated whether smoking habits can discriminate young individuals with MI from age- and sex-matched controls. METHODS: We enrolled 100 consecutive patients who had survived their first episode of MI before the age of 36 years and 100 age- and sex-matched controls without a history of cardiovascular disease. Smoking habits, physical activity status, body mass index and blood lipids levels were measured in all participants. RESULTS: 96% of the patients with premature MI and 55% of the controls reported current smoking habits (p<0.001). Moreover, patients had higher levels of total cholesterol, low density lipoprotein cholesterol, triglycerides and lower levels of high density lipoprotein cholesterol (p<0.05). Multivariate logistic regression analysis showed that current smoking increased 6-fold the odds of having a MI (95% CI 1.01 to 37), after controlling for age, sex, body mass index, hypertension, diabetes, physical activity, family history of coronary heart disease and total cholesterol levels. Finally, discriminant analysis showed that pack-years of smoking was the strongest discriminator for MI among all the investigated factors (lambda-Wilks=0.85). CONCLUSIONS: Our study suggests that cigarette smoking seems to play the most important role for having a MI in individuals under the age of 36 years.

Adult↗
PubMed2006

MedDietScore: a computer program that evaluates the adherence to the Mediterranean dietary pattern and its relation to cardiovascular disease risk.

Mediterranean dietary traditions have long been associated with lower mortality rates and better health status. The Mediterranean dietary pattern has become customary to be represented in the form of a pyramid, the base of which refers to foods which are suggested to be consumed most frequently and the top of the pyramid to those foods consumed rarely. Recently, an index (diet score) that estimates the adherence level to Mediterranean diet was developed and associated with cardiovascular disease risk and biomarkers. In this work we present a computer program that can easily calculate this diet score, as well as its association with cardiovascular disease risk. The application of this software to the general public might be a useful tool for the reduction of the disease burden related with nutritional habits at population level.

Biomarkers↗
PubMed2006

The association between pre-hypertension status and oxidative stress markers related to atherosclerotic disease: the ATTICA study.

BACKGROUND: We sought to evaluate the association between pre-hypertension status and oxidative stress markers (total antioxidant capacity (TAC) and oxidized low density lipoprotein (LDL)), in a random sample of cardiovascular disease-free adults. METHODS: The ATTICA study is a cross-sectional population-based survey that conducted in Attica region during 2001-2002. Based on a multistage and stratified random sampling, 1514 men and 1528 women (18-89 years old) were enrolled. The survey included a detailed interview; blood samples collected after 12h of fasting and, among other clinical measurements, status of blood pressure levels was evaluated. RESULTS: Six hundred and fifty-three men (43%) and 535 women (35%) were defined as pre-hypertensives. Both systolic and diastolic blood pressures were inversely correlated with TAC (p<0.001) and positively correlated to oxidized LDL (p<0.001). Particularly, compared to normotensive subjects, pre-hypertensives had 7% lower TAC levels (p<0.001) and 15% higher oxidized LDL levels (p<0.05), after correcting for multiple comparisons and adjusting for age, body mass index, blood lipids, glucose, food groups consumed and other potential confounders. CONCLUSIONS: Studying a large sample of cardiovascular disease-free adults, we revealed an association of pre-hypertension with oxidative stress markers linking to atherosclerotic process.

Adult↗
PubMed2006

The relationship between adherence to the Mediterranean diet and the severity and short-term prognosis of acute coronary syndromes (ACS): The Greek Study of ACS (The GREECS).

BACKGROUND: Although adherence to the Mediterranean diet has long been associated with lower incidence of various chronic diseases among apparently healthy individuals, its relationship with the severity and short prognosis (30 d) of patients with cardiovascular disease has rarely been investigated. OBJECTIVE: We sought to evaluate the association between adherence to the Mediterranean diet and the severity and prognosis of acute coronary syndromes. METHODS: From October 2003 to September 2004, a sample of 6 hospitals located in several urban and rural Greek regions was selected, and almost all survivors after an acute coronary syndrome were enrolled into the study (2172 patients were included in the study; 76% were men and 24% women). Adherence to the Mediterranean diet was assessed by a diet score that incorporated the inherent characteristics of this diet. Higher values of the score (range 0-55) were closer to the Mediterranean diet. Biochemical indices of myocardial damage were also considered. RESULTS: Diet score was inversely correlated with entry values of cardiac troponin I (rho = -0.19, P < 0.001), creatine phosphokinase (rho = -0.09, P < 0.001), and creatine phosphokinase-MB (rho = -0.09, P < 0.001). An increment in the diet score was associated with significant decrease in troponin I and creatine phosphokinase-MB levels (P < 0.01) after adjusting for various potential confounders. Moreover, diet score was associated with lower risk of recurrent events (odds ratio = 0.81, 95% confidence interval 0.61-0.98). However, this association became insignificant when the discharge diagnosis of the patients was taken into account. CONCLUSION: Background dietary habits close to the Mediterranean diet seem to be associated with lower severity of coronary heart disease.

Acute Disease↗
PubMed2006

Prevalence of self-reported hypercholesterolaemia and its relation to dietary habits, in Greek adults; a national nutrition & health survey.

BACKGROUND: The strong causal role of hypercholesterolaemia on the progression of atherosclerosis and subsequently on the development of cardiovascular disease is well described. Main aim of this study was to evaluate the prevalence of self-reported hypercholesterolaemia and its relation to nutritional habits, in a representative nationwide sample of adult Greek population. METHODS: Cross sectional survey. Based on a multistage sampling, 5003 adults (18-74 yr) were enrolled (men: 48.8%, women: 51.2%). All participants were interviewed by trained personnel who used a standard questionnaire. The questionnaire included demographic and socioeconomic characteristics, medical history, lifestyle habits and nutritional assessment. RESULTS: The prevalence of self-reported hypercholesterolaemia was 16.4% in men and 21.8% in women (P < 0.001). Hypercholesterolaemic status was positively associated with the prevalence of hypertension, diabetes mellitus, renal failure, obesity and physical inactivity, and inversely with the prevalence of smoking. The analysis of reported food consumption patterns showed that consumption of fish, fruits and juices, cereals, and low fat milk and yogurt was significantly higher among hypercholesterolaemic participants while the opposite was observed for food items as red meat, pork, egg, full fat dairy products and desserts. CONCLUSION: Hypercholesterolaemia seems to affect a large part of Greek population. It is hopeful that hypercholesterolaemics may have started adopting some more healthy nutritional behaviour compared to normocholesterolaemic ones.

Adolescent↗
PubMed2006

Dietary patterns: a Mediterranean diet score and its relation to clinical and biological markers of cardiovascular disease risk.

BACKGROUND AND AIM: It has been suggested that overall dietary patterns and not single nutrients should be studied, since food items might have a synergistic and antagonistic effect on health. The Mediterranean diet has long been associated with lower incidence of cardiovascular disease and cancer. Therefore, we developed a diet score that incorporates the inherent characteristics of this dietary pattern. METHODS AND RESULTS: We used 11 main components of the Mediterranean diet (non-refined cereals, fruits, vegetables, potatoes, legumes, olive oil, fish, red meat, poultry, full fat dairy products and alcohol). For the consumption of items presumed to be close to this pattern we assigned scores 0, 1, 2, 3, 4 and 5 when a participant reported no consumption, rare, frequent, very frequent, weekly and daily, respectively. For the consumption of foods presumed to be away from this pattern we assigned the scores on a reverse scale. Especially for alcohol, we assigned score 5 for consumption of less than 300 ml/day, score 0 for consumption of more than 700 ml/day or none and scores 1-4 for consumption of 300-400, 400-500, 500-600, and 600-700 ml/day (100 ml = 12 g ethanol), respectively. Then a total score ranging from 0 to 55 was calculated. After having applied this diet score in the participants of the ATTICA study we observed a significant positive association with monounsaturated fat and monounsaturated-to-saturated fat intake. We also observed, an inverse association with serum lipids, blood pressures, inflammation and coagulation markers related to cardiovascular disease. The application of that score in a case-control study (CARDIO2000) suggested that the score was inversely associated with the odds of having acute coronary syndromes. CONCLUSION: The Mediterranean diet score proposed above may be useful in assessing the nutritional status of an individual and investigating the relationship of the Mediterranean diet with various health outcomes.

Biomarkers↗
PubMed2006

Genetic polymorphisms G894T on the eNOS gene is associated with endothelial function and vWF levels in premature myocardial infarction survivors.

BACKGROUND: Genetic polymorphism G894T on endothelial nitric oxide synthase (eNOS) gene has been associated with endothelial dysfunction in young smokers, but its role in the pathogenesis of MI is obscure. We examined the effect of G894T polymorphism on endothelial function, on markers of endothelial cells injury and activation such as von Willebrand factor (vWF) and on serum levels of proinflammatory cytokines such as interleukins 6 (IL-6) and 1b (IL-1b), in young myocardial infarction (MI) survivors. METHODS: The study population consisted of 56 patients with a history of premature MI. The forearm blood flow (FBF) was measured by using strain-gauge plethysmography during reactive hyperemia and after sublingual administration of nitroglycerin. G894T polymorphism was determined by polymerase chain reaction (PCR), while plasma vWF and serum IL1b and IL-6 levels were determined with ELISA. RESULTS: There was no significant difference in resting FBF and in the responses to nitroglycerin between the genotypes. However, the presence of T allele (GT+TT, n=35) was associated with decreased FBF during reactive hyperemia (10.23+/-0.70 ml/100ml tissue/min) and decreased forearm vasodilatory response to reactive hyperemia (54.28+/-4.81%) compared to GG (13.82+/-0.92 ml/100 ml tissue/min and 83.92+/-9.89% respectively, p<0.01 for both). Carriers of the T allele had also higher levels of vWF (79.66+/-5.56%) compared to GG (60.94+/-5.27% p<0.05). However, no significant difference was observed in IL-1b and IL-6 serum levels between the genotypes (p=ns for both). CONCLUSIONS: The presence of 894T allele on eNOS gene is associated with impaired endothelial function and higher levels of von Willebrand factor in relatively young patients with myocardial infarction. This finding implies that genetic polymorphism G894T on eNOS may affect endothelial function in patients with a history of premature myocardial infarction.

Alleles↗
PubMed2006

Association between the prevalence of obesity and adherence to the Mediterranean diet: the ATTICA study.

OBJECTIVE: We evaluated the prevalence of obesity in relation to adherence to a Mediterranean diet. METHODS: We conducted a cross-sectional survey that randomly enrolled 1514 men (18 to 87 y old) and 1528 women (18 to 89 y old) with no history of cardiovascular disease. Anthropometric indices were measured and frequency of various foods consumed during a usual week was recorded. Adherence to a Mediterranean diet was assessed by a diet score that incorporated the inherent characteristics of this diet. RESULTS: Prevalences of overweight and obesity were 53% and 20% in men and 31% and 15% in women. An inverse relation was observed between diet score, waist-to-hip ratio (r = -0.31, P < 0.001), and body mass index (r = -0.4, P < 0.001) after adjusting for sex and age. Greater adherence to the Mediterranean diet (i.e., highest tertile) was associated with a 51% lower odds of being obese (odds ratio 0.49, 95% confidence interval 0.42 to 0.56) and a 59% lower odds of having central obesity (odds ratio 0.41, 95% confidence 0.35 to 0.47) compared with a non-Mediterranean diet (i.e., lowest tertile) after controlling for age, sex, physical activity status, metabolism, and other variables. CONCLUSION: We observed an inverse relation between adherence to a Mediterranean dietary pattern and prevalence of obesity in a free-eating, population-based sample of men and women, irrespective of various potential confounders.

Adolescent↗
PubMed2006

Acute improvement of aortic mechanics following hemodialysis in patients with chronic renal failure.

BACKGROUND: Evidence suggests that distensibility of the aorta is decreased in patients with end-stage renal failure, while the underlying mechanisms are unclear. HYPOTHESIS: The purpose of the study was to evaluate the distensibility of the aorta in patients at the end stage of chronic renal failure before and after hemodialysis (HD). METHODS: The diameter of the ascending aorta and distensibility were assessed in 48 patients on HD (31 men, 17 women, aged 45+/-14 years) and in 27 normal subjects (17 men, 10 women, aged 44+/-14 years). The diameter of the aorta was evaluated by M-mode in the parasternal long-axis view. RESULTS: Aortic distensibility was significantly lower in patients on HD before HD (1.9+/-0.7 cm(2) x dyn(-1) x 10(-6)) than in normal control subjects (3.8+/-1.0 cm(2) x dyn(-1) X 10(-6), p< 0.0001). After dialysis, it increased to 2.6+/-1.2 (p < 0.05 compared with baseline, p < 0.001 compared with controls). The change of aortic distensibility correlated with age (R(2) = 0.629 p < 0.001) and ultrafiltration volume (R(2) = 0.168, p < 0.01). CONCLUSIONS: Aortic distensibility in patients with end-stage renal disease is significantly lower than in normal subjects, and it is significantly improved after HD.

Acute Disease↗
PubMed2006

Natriuretic peptide Val7Met substitution and risk of coronary artery disease in Greek patients with familial hypercholesterolemia.

Atrial natriuretic peptide (ANP or NPPA) is the precursor protein of the form of amyloidosis called isolated atrial amyloid (IAA), which is related to the increased incidence of cardiac pathological conditions with age. Familial hypercholesterolemia (FH) patients are characterized by high concentrations of low-density lipoprotein cholesterol (LDL-C), which frequently gives rise to premature coronary artery disease (CAD). However, not all FH patients have the same clinical phenotype. The aim of the present study was to assess the relationship between ANP polymorphisms and apolipoprotein (Apo) A1 levels and CAD risk in FH patients. Transition T2238C, which leads to ANP with two additional arginines, and G664A (Val7Met) were investigated with lipid values and clinical phenotype in 83 FH patients. ApoA1 and HDL cholesterol levels were lower in GA patients compared to GG homozygotes for the G664A polymorphism. No association was found between the G664A polymorphism and CAD in our population. Moreover, ApoA1 and high-density lipoprotein cholesterol (HDL-C) levels did not differ among the different genotypes of the T2238C polymorphism, even after adjusting for age and sex. The 664A allele of the ANP polymorphism is associated with lower levels of ApoA1 and HDL-C in FH patients, but not with CAD risk. Concerning the T2238C polymorphism, no effect was found on lipid parameters or CAD incidence.

Adult↗