Postprandial Dyslipidemia Clinical Trial
Official title:
Relation Between Postprandial Lipogram and Coronary Artery Disease Severity
Coronary artery disease (CAD) is usually used to refer to the pathological problem affecting
the coronary arteries (usually atherosclerosis) that leads to Coronary Heart disease (CHD)
which includes the diagnoses of angina pectoris, MI and silent myocardial ischemia.
Despite the mortality for this condition has gradually declined over the last decades in
western countries, it still causes about one-third of all deaths in people older than 35
years.
Dyslipidemia is very important risk factors of atherosclerosis that is one of the causes
leading to cardiovascular disease Despite management of dyslipidemia by controling fasting
total plasma cholesterol and LDL cholesterol as these are the best biomarkers for prediction
of cardiovascular diseases (CVD) risk.
LDL elevation is absent in many patients with atherosclerosis and about 1/3 of cardiac
events remains to be unpredicted using this method. Even more, in fasting normolipidemic
subjects, increased CVD risk is associated with an exaggerated postprandial lipemic
response.
Postprandial dyslipidemia is defined as a rise in triglyceride-rich lipoproteins (TRLs),
including chylomicron remnants (CMRs) and remnant lipoproteins (RLPs), after eating, has
drawn an increasing interest recently because of its association with cardiovascular events.
Chylomicron remnants (CMRs) have been shown to penetrate the artery wall and to be retained
within the intima.
Endothelial dysfunction is an initial process of atherogenesis and it contributes to the
pathogenesis of CHD. Postprandial hyperlipidemia (postprandial hypertriglyceridemia) is
involved in the production of proinflammatory cytokines, recruitment of neutrophils, and
generation of oxidative stress, resulting in endothelial dysfunction
| Status | Recruiting |
| Enrollment | 100 |
| Est. completion date | April 1, 2018 |
| Est. primary completion date | April 1, 2018 |
| Accepts healthy volunteers | Accepts Healthy Volunteers |
| Gender | All |
| Age group | N/A and older |
| Eligibility |
Inclusion Criteria: - Patients with documented coronary artery disease and stable for 3 months with no secondary dyslipidemia as hypothyroidism and renal impairment Exclusion Criteria: - patients with acute coronary syndrome or any cause of Secondary dyslipidemia |
| Country | Name | City | State |
|---|---|---|---|
| Egypt | Assiut University Hospital | Assiut |
| Lead Sponsor | Collaborator |
|---|---|
| Assiut University |
Egypt,
Ceriello A, Assaloni R, Da Ros R, Maier A, Piconi L, Quagliaro L, Esposito K, Giugliano D. Effect of atorvastatin and irbesartan, alone and in combination, on postprandial endothelial dysfunction, oxidative stress, and inflammation in type 2 diabetic patients. Circulation. 2005 May 17;111(19):2518-24. Epub 2005 May 2. — View Citation
Cervellin G, Lippi G. Of MIs and men--a historical perspective on the diagnostics of acute myocardial infarction. Semin Thromb Hemost. 2014 Jul;40(5):535-43. doi: 10.1055/s-0034-1383544. Epub 2014 Jun 26. — View Citation
Graham I, Atar D, Borch-Johnsen K, Boysen G, Burell G, Cifkova R, Dallongeville J, De Backer G, Ebrahim S, Gjelsvik B, Herrmann-Lingen C, Hoes A, Humphries S, Knapton M, Perk J, Priori SG, Pyorala K, Reiner Z, Ruilope L, Sans-Menendez S, Op Reimer WS, Weissberg P, Wood D, Yarnell J, Zamorano JL, Walma E, Fitzgerald T, Cooney MT, Dudina A, Vahanian A, Camm J, De Caterina R, Dean V, Dickstein K, Funck-Brentano C, Filippatos G, Hellemans I, Kristensen SD, McGregor K, Sechtem U, Silber S, Tendera M, Widimsky P, Zamorano JL, Altiner A, Bonora E, Durrington PN, Fagard R, Giampaoli S, Hemingway H, Hakansson J, Kjeldsen SE, Larsen ML, Mancia G, Manolis AJ, Orth-Gomer K, Pedersen T, Rayner M, Ryden L, Sammut M, Schneiderman N, Stalenhoef AF, Tokgözoglu L, Wiklund O, Zampelas A; European Society of Cardiology (ESC).; European Association for Cardiovascular Prevention and Rehabilitation (EACPR).; Council on Cardiovascular Nursing.; European Association for Study of Diabetes (EASD).; International Diabetes Federation Europe (IDF-Europe).; European Stroke Initiative (EUSI).; International Society of Behavioural Medicine (ISBM).; European Society of Hypertension (ESH).; European Society of General Practice/Family Medicine (ESGP/FM/WONCA).; European Heart Network (EHN).. European guidelines on cardiovascular disease prevention in clinical practice: executive summary. Fourth Joint Task Force of the European Society of Cardiology and other societies on cardiovascular disease prevention in clinical practice (constituted by representatives of nine societies and by invited experts). Eur J Cardiovasc Prev Rehabil. 2007 Sep;14 Suppl 2:E1-40. — View Citation
Kádár A, Glasz T. Development of atherosclerosis and plaque biology. Cardiovasc Surg. 2001 Apr;9(2):109-21. Review. — View Citation
Nichols M, Townsend N, Scarborough P, Rayner M. Cardiovascular disease in Europe 2014: epidemiological update. Eur Heart J. 2014 Nov 7;35(42):2929. doi: 10.1093/eurheartj/ehu378. — View Citation
Pal S, Semorine K, Watts GF, Mamo J. Identification of lipoproteins of intestinal origin in human atherosclerotic plaque. Clin Chem Lab Med. 2003 Jun;41(6):792-5. — View Citation
Proctor SD, Vine DF, Mamo JC. Arterial retention of apolipoprotein B(48)- and B(100)-containing lipoproteins in atherogenesis. Curr Opin Lipidol. 2002 Oct;13(5):461-70. Review. — View Citation
Rapp JH, Lespine A, Hamilton RL, Colyvas N, Chaumeton AH, Tweedie-Hardman J, Kotite L, Kunitake ST, Havel RJ, Kane JP. Triglyceride-rich lipoproteins isolated by selected-affinity anti-apolipoprotein B immunosorption from human atherosclerotic plaque. Arterioscler Thromb. 1994 Nov;14(11):1767-74. — View Citation
Rosamond W, Flegal K, Furie K, Go A, Greenlund K, Haase N, Hailpern SM, Ho M, Howard V, Kissela B, Kittner S, Lloyd-Jones D, McDermott M, Meigs J, Moy C, Nichol G, O'Donnell C, Roger V, Sorlie P, Steinberger J, Thom T, Wilson M, Hong Y; American Heart Association Statistics Committee and Stroke Statistics Subcommittee.. Heart disease and stroke statistics--2008 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2008 Jan 29;117(4):e25-146. Epub 2007 Dec 17. Erratum in: Circulation. 2010 Jul 6;122(1):e10. Kissela, Bret [corrected to Kissela, Brett]. — View Citation
Tanaka A, Tomie N, Nakano T, Nakajima K, Yui K, Tamura M, Numano F. Measurement of postprandial remnant-like particles (RLPs) following a fat-loading test. Clin Chim Acta. 1998 Jul 6;275(1):43-52. — View Citation
van Oostrom AJ, Sijmonsma TP, Verseyden C, Jansen EH, de Koning EJ, Rabelink TJ, Castro Cabezas M. Postprandial recruitment of neutrophils may contribute to endothelial dysfunction. J Lipid Res. 2003 Mar;44(3):576-83. Epub 2002 Dec 16. — View Citation
Zilversmit DB. Atherogenesis: a postprandial phenomenon. Circulation. 1979 Sep;60(3):473-85. — View Citation
* Note: There are 12 references in all — Click here to view all references
| Type | Measure | Description | Time frame | Safety issue |
|---|---|---|---|---|
| Primary | Relationship of postprandial lipid profile .HDL and coronary artery disease severity | candidates will be subjected to ; Full History taking including: history of DM and its management history of hypertension and its management history of drug abuse family history Patient Examination as: BMI waist circumference -investigations as: ECG Echocardiography lipid profile We will check fasting (14 hours fasting) and 2 hours postprandial lipogram after fat loading with 17 g/body surface (m2),then we will assess CAD severity by coronary angiography using syntax score |
1 year |