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Tendency to acidosis or alkalosis: Which one is associated with coronary artery disease?
Alireza Amirzadegan1, Elahia Mohseni1, Hassan Aghajani1
1Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Insights
Lower base excess (BE), indicating acidosis, is significantly associated with increased coronary artery disease (CAD) severity. This finding suggests BE may serve as a potential biomarker for CAD progression.
Area of Science:
- Cardiology
- Biochemistry
Background:
- Base excess (BE) reflects non-respiratory acid-base balance.
- Acid-base imbalances are implicated in cardiovascular health.
- The relationship between BE and coronary artery disease (CAD) severity requires further investigation.
Purpose of the Study:
- To evaluate the association between peripheral blood base excess (BE) and the severity of coronary artery disease (CAD).
- To determine if BE levels correlate with the Gensini score, a measure of CAD complexity.
Main Methods:
- A cross-sectional study involving 351 patients undergoing coronary angiography.
- Demographic and clinical data were collected.
- Arterial blood gas analysis was performed to measure BE before contrast injection.
- Coronary angiography was used to calculate the Gensini score.
Main Results:
- A decrease in base excess (BE) was significantly correlated with elevated Gensini scores (β: -0.04; P=0.027).
- Negative BE values showed a significant inverse association with the Gensini score (β=-0.05; P<0.001).
- BE did not significantly affect the Gensini score of 0 (P=0.843).
Conclusions:
- Base excess (BE) is associated with coronary artery disease (CAD) severity.
- BE tending towards acidosis is potentially linked to CAD.
- BE may serve as a biomarker for assessing CAD severity.
Introduction:
Base excess (BE) is an indicator of non-respiratory acid-base imbalances, which can impact coronary artery disease (CAD). This study evaluated the association between the severity of CAD and peripheral blood BE.
Methods:
This cross-sectional study included patients aged 18 and older who were candidates for coronary angiography. Demographic and clinical data were collected from medical records. Blood gas analysis was performed on a 2-millilitre arterial blood sample taken from the access artery before contrast injection. All patients underwent coronary angiography, and the Gensini score was calculated.
Results:
A total of 351 patients (194 males, 55.3%) were included in the study. The study population had a mean age of 60.79±9.5 and a mean BMI of 29.4±4.85. Coronary angiography revealed normal or minimal (<50% stenosis) findings in 51.3% of cases (15.4% with normal coronary arteries and 35.9% with minimal non-obstructive lesions), single-vessel disease in 17.4%, two-vessel disease in 14.5%, and three-vessel disease in 16.8%. Median Gensini score was 13.0, with an IQR of 3.5 and 49. The findings indicated that a decrease in BE was significantly correlated with elevated Gensini scores (β: -0.04; 95% CI: -0.08 to -0.01; P=0.027). However, BE did not significantly affect the Gensini score of 0 (P=0.843). Moreover, negative values of BE were significantly and inversely associated with the Gensini score (β=-0.05; 95% CI: -0.07 to -0.02, P<0.001).
Conclusion:
This study revealed an association between BE and CAD, suggesting that BE tending to acidosis is potentially associated with CAD.
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