title: High-sensitivity C-reactive Protein, Lipoprotein(a) and Homocysteine are Risk Factors for Coronary Artery Disease in Japanese Patients with Peripheral Arterial Disease.
abstract: OBJECTIVE
  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), lipoprotein(a) (Lp(a)) 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, Lp(a), 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), Lp(a) (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, Lp(a), homocysteine and lipid abnormalities are critical risk factors for CAD in Japanese patients with PAD.
authors.affiliation: Department of Internal Medicine, Cardiovascular Hospital of Central Japan (Kitakanto Cardiovascular Hospital).
authors.forename: Hisao
authors.initials: H
authors.lastname: Kumakura
authors.forename: Kishu
authors.initials: K
authors.lastname: Fujita
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Kanai
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Araki
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Hojo
authors.forename: Shu
authors.initials: S
authors.lastname: Kasama
authors.forename: Toshiya
authors.initials: T
authors.lastname: Iwasaki
authors.forename: Shuichi
authors.initials: S
authors.lastname: Ichikawa
authors.forename: Kuniki
authors.initials: K
authors.lastname: Nakashima
authors.forename: Kazutomo
authors.initials: K
authors.lastname: Minami
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000032:analysis*; D015331:Cohort Studies; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood / Q000453:epidemiology / Q000209:etiology*; D003920:Diabetes Mellitus / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D017270:Lipoprotein(a) / Q000097:blood*; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000097:blood / Q000150:complications*; D011379:Prognosis; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D017270:Lipoprotein(a); D006710:Homocysteine; D002097:C-Reactive Protein