[Gastroduodenal mucosal lesions and coronary atherosclerosis severity in patients with coronary artery disease]

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Marko Banić¹, Damir Fabijanić, Dusko Kardum

¹Zavod za gastroenterologiju i hepatologiju, Klinika za unutarnje bolesti KB Dubrava Zagreb.

Lijecnicki Vjesnik

|December 10, 2008

Insights

In coronary artery disease (CAD) patients, ischemia does not significantly contribute to gastroduodenal (GD) mucosa impairment. This study found no correlation between the severity of coronary atherosclerosis and GD mucosal lesions, suggesting ischemia plays a minor role.

Area of Science:

Gastroenterology
Cardiology
Pathophysiology

Context:

Gastroduodenal (GD) mucosa is highly metabolically active, making it susceptible to ischemia.
Coronary artery disease (CAD) involves atherosclerosis, potentially impacting blood supply to other organs.
Understanding the link between CAD severity and GD mucosal lesions is crucial for patient management.

Purpose:

To investigate the potential contribution of ischemia to gastroduodenal (GD) mucosal impairment in patients with coronary artery disease (CAD).
To compare the severity of coronary atherosclerosis with the prevalence and severity of GD mucosal lesions.

Summary:

This prospective study analyzed 150 CAD patients, assessing coronary atherosclerosis severity using multiple scores and GD mucosal lesions via the Lanza score.
No significant difference in CAD severity was observed between patients with and without GD mucosal lesions.
No correlation was found between the severity of CAD and the severity of GD mucosal lesions, including Helicobacter pylori infection status.

Impact:

The findings suggest that ischemia has a minimal or no role in the pathogenesis of GD mucosal impairment in CAD patients.
This research may influence clinical approaches to managing GD issues in patients with cardiovascular conditions.
Highlights the need for further research into other factors contributing to GD mucosal lesions in CAD patients.

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Abstract

Aim:

Due to high metabolic activity and oxygen demands, ischemia of gastroduodenal (GD) mucosa is an important factor in the pathogenesis of its impairment. Comparing the degree of coronary atherosclerosis, for evaluation of severity of atherosclerosis, with the prevalence and severity of GD mucosal lesions, we wanted to investigate the possible ischemia of GD mucosa could contribute to its impairment.

Patients And Methods:

This prospective study included 150 coronary artery disease (CAD) patients, 109 (72.7%) male and 41 (27.3%) female, average age 62.61 +/- 10.23 years. We noted clinical and anthropometric parameters, standard laboratory findings, treatment until inclusion into the study and standard cardiovascular risk factors. The severity of CAD was assessed by several parameters: 1) number of coronary arteries affected with atherosclerosis, 2) modified Gensa score, and 3) number of coronary arteries with stenosis > 50%. The severity of GD mucosal lesions was assessed by modified Lanza score, and Helicobacter pylori infection was confirmed by biopsy and pathohistological analysis of GD mucosa. Predictive value of different independent factors regarding the presence of GD mucosal lesions was assessed by multivariate analysis.

Results:

The severity of CAD in patients with or without GD mucosal lesions did not differ by any of used scoring methods: 1) number of coronary arteries affected by atherosclerosis (2.15 +/- 0.85 vs. 2.00 +/- 0.87, p = 0.292), 2) modified Gensa score (71.22 +/- 51.78 vs. 69.89 +/- 54.18, p = 0.881), 3) number of coronary arteries with stenosis > 50% (3.89 +/- 2.05 vs. 3.47 +/- 2.25, p = 0.244). We also noticed that there had been no correlation between severity of CAD and severity of GD mucosal lesions. Correlation of number of coronary arteries affected with atherosclerosis with Lanza score resulted in r = 0.029, p = 0.721, correlation of Genza score with Lanza score resulted in r = 0.019, p = 0.082, and correlation of the number of coronary arteries with stenosis > 50% with Lanza score resulted in r = 0.079, p = 0.337.

Conclusion:

According to available method for evaluating the severity of CAD, in CAD patients ischemia has no or very minor role in pathogenesis of GD mucosa impairment.

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