High prevalence of inflammation in the hearts of CABG patients

Ingvild Oma and colleagues have compared inflammation in the heart and vitamin D status in surgically treated heart patients with and without inflammatory rheumatic disease.


MAIN RESULTS:

  1. Heart patients with inflammatory rheumatic diseases have higher levels of vitamin D.
  2. Genes associated with vitamin D are differently expressed in rheumatic and non-rheumatic coronary artery bypass grafting patients.
  3. The prevalence of inflammation in the heart is high in heart patients with and without rheumatic disease

THESIS DEFENCE:

Thesis: Vitamin D and inflammation in the heart and vessels of patients with coronary artery disease and inflammatory rheumatic disease
Candidate: Ingvild Oma
Time: September 18, 2018 at 13:15
Place: Oslo University Hospital, Rikshospitalet B: Red auditorium
Link to university website (in Norwegian)


SUMMARY:

(1) Surprisingly, levels of vitamin D were higher in patients with coronary artery disease and inflammatory rheumatic disease than in patients without rheumatism. Thus, the study does not support the hypothesis that low levels of vitamin D in blood is one cause of the increased cardiovascular risk in rheumatic patients.

The study includes 121 patients treated with coronary artery bypass grafting (CABG), of which 68 had inflammatory rheumatic disease.

(3) Oma and co-workers found higher expression of the GADD45A and NCOR1 genes in the aorta of heart patients with rheumatoid arthritis, compared with other CABG patients. Another vitamin D related gene, PON2, was downregulated in the rheumatic group. This study includes surgical specimens from a total of 16 patients.

(2) The infiltration of inflammatory cells in the heart was not higher in heart patients with than without inflammatory rheumatic disease. Such cells were found in approximately 60 % of the patients in each group, mainly in the epicardium.

Thus, inflammation in the myocardium does not seem to play a more important role in cardiovascular disease of patients with concommitant inflammatory rheumatic disease. The study is based on biopses from the hearts of 88 patients.


REFERENCES:

(1) Oma, I., Andersen, J. K., Lyberg, T., Molberg, Ø., Whist, J. E., Fagerland, M. W.,  & Hollan, I. (2017). Plasma vitamin D levels and inflammation in the aortic wall of patients with coronary artery disease with and without inflammatory rheumatic diseaseScandinavian journal of rheumatology46(3), 198-205.

(2) Andersen, J. K., Oma, I., Prayson, R. A., Kvelstad, I. L., Almdahl, S. M., Fagerland, M. W., & Hollan, I. (2016). Inflammatory cell infiltrates in the heart of patients with coronary artery disease with and without inflammatory rheumatic disease: a biopsy studyArthritis research & therapy18(1), 232.

(3) Oma, I., Olstad, O. K., Andersen, J. K., Lyberg, T., Molberg, Ø., Fostad, I., Fagerland, M. W., Almdahl, S. M., Rynning, S. E., Yndestad, A., Aukrust, P., Whist, J. E., & Hollan, I. (2018). Differential expression of vitamin D associated genes in the aorta of coronary artery disease patients with and without rheumatoid arthritisPloS one13(8), e0202346.

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