Elevated ALP levels are associated with higher Gensini scores and a more severe form of CAD.

Objectives: Increased homocysteine (HCY) levels are associated with an increased risk of cardiovascular disease. Plasma HCY is increased in chronic heart failure (CHF) patients, and previous studies suggest that hyperhomocysteinemia causes adverse cardiac remodeling and affects pump function. We aimed to evaluate the HCY levels in patients with diastolic heart failure with preserved left ventricular ejection fraction (LVEF). Methods: We prospectively studied 68 patients (39 females and 29 males) who were hospitalized for symptomatic heart failure, as well as 40 age- and sex-matched healthy subjects who comprised the control group. CHF was diagnosed in all cases based on Framingham diagnostic criteria. CHF with preserved LVEF was defined as cases with CHF with an LVEF of 50% or more. Patients with regional left ventricular wall motion abnormalities, atrial fibrillation, and renal failure were excluded. Results: The mean age was 65.5 ± 9.6 years in the heart failure group and 65.2 ± 9.7 years in the control group. The mean LVEF was 59.8 ± 5.3 in the heart failure group and 61.4 ± 5.2 in the control group. The mean total fasting HCY concentrations were significantly higher in patients with heart failure (16.9 ± 5.27 µmol/l vs. 10.15 ± 3.49 µmol/l, respectively; p < 0.001). Multiple regression analysis indicated that NT-proBNP, hs-CRP, E/A ratio, and HbA1C were independently associated with hyperhomocysteinemia. Conclusions: Our results suggest that hyperhomocysteinemia is prevalent in heart failure with preserved ejection fraction. Larger scale studies are needed to clarify its pathogenic mechanisms and effects on the natural history of heart failure.

Consecutive patients (n = 235) with coronary ischemia were studied; 69 patients (29%) had diabetes. An oral glucose tolerance test (OGTT) was administered to the 166 patients without diabetes; 76 (46%) had normal glucose tolerance (group I = NGT), 68 (41%) had impaired glucose tolerance ([IGT] group II = IGT), and 22 (13%) had diabetic glucose tolerance (DGT). The DGT patients were added to the known diabetics forming (Group III; n = 91). Multivessel disease was significantly more prevalent in group III; 30 patients (43%) in group I, 32 patients (51%) in group II, and 57 patients (69%) in group III (P = .002). Gensini scores were 43.20 ± 24.92 in group I, 54.22 ± 42.61 in group II, and 60.59 ± 38.21 in group III. (P = .037) The severity of coronary artery disease is related to abnormal glucose tolerance. Patients with IGT could be neglected in terms of interventions focused to improve risk factors.

Background: Patients with end stage renal disease (ESRD) have increased inflammatory and thrombotic activity. Lacks of available data exist on pro-inflammatory and prothrombotic properties of low serum 25-OH-D3 level. We aimed to analyse the association of 25-OH vitamin D with indirect markers of inflammatory and thrombotic activity in patients on haemodialysis (HD) or peritoneal dialysis (PD)

In conclusion, our study results, which are in agreement with previous results, indicate that not only diabetic glucose tolerance but also impaired glucose tolerance has an adverse impact on the development of coronary collaterals.