Atherosclerosis
Conditions
Keywords
obesity, men, TFPI, Lipoprotein(a), Lp(a), Tissue Factor pathway inhibitor, aspirin
Brief summary
Atherosclerotic cardiovascular disease is a leading cause of mortality in our countries. Clinically, symptoms could be chest pain suggesting stable angina. Atherosclerosis is influenced by cardiovascular risk factors which obesity (Body Mass Index\>30). Obesity is associated with an increase risk of cardiovascular complications. Lipoprotein(a) is regarded as an independent risk factor for premature cardiovascular disease. Lp(a) is composed of low-density lipoprotein - like particle bound to glycoprotein molecule: apolipoprotein(a). Plasma levels are determinated to more than 90% by genetic factors (no significant influence of statin, weight, lifestyle factor: diet, exercise). Two study with few patients have found that aspirin lowers serum Lp(a) levels. Elevated Lp(a) is a risk factor for recurrent coronary events in obese patient. Atherosclerosis is associated with imbalance of coagulation. TFPI (tissue factor pathway inhibitor) is the earliest inhibitor of the blood coagulation process, natural direct inhibitor of tissue factor. In-vitro, TFPI activity is inhibited by high Lp(a) . The aim of this study is to research reverse association between Lp(a) and TFPI activity in obese patient with chest pain like stable angina suggesting atherosclerotic heart disease and effect of aspirin.
Interventions
OTHERblood sample
blood sample at inclusion and 1 month after inclusion
Sponsors
Centre Hospitalier Universitaire de Saint Etienne
Study design
Observational model
CASE_ONLY
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
MALE
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Major * Men * Obese BMI\>30 * No aspirin treatment before inclusion * Coronary exploration: coronary angiography or tomography coronary angiography * Chest pain like stable angina
Exclusion criteria
* Women * Severe hepatic insufficiency * Inflammatory disease * Neoplasia * Protein S deficiency * Aspirin treatment 10 days before inclusion * Oral anticoagulant treatment at inclusion * Heparin or low molecular weight heparin treatment at inclusion
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| correlation between Lp(a) and TFPI activity | day 1 | Establish correlation between Lp(a) rate and TFPI activity in obese patients with chest pain like stable angina |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Correlation between Lp(a) and TFPI resistance | day 1 | Establish correlation between Lp(a) rate and TFPI resistance at inclusion and 1 month after aspirin treatment |
| Correlation between lp(a) rate and TFPI activity | 1 month | Establish the correlation, 1 month after initiation of aspirin treatment, between lp(a) rate and TFPI activity |
| thrombin generation | day 1 | describe thrombin generation with calibrated automated thrombinography technique in obese patient with chest pain like angina and hight Lp(a)rate |
Countries
France
Outcome results
None listed