To determine the relationship between pericoronary adipose tissue (dys)function, in terms of the cytokine and adipokine secretion profile and histologic markers of inflammation, and coronary atherosclerosis.
ID
Source
Brief title
Condition
- Coronary artery disorders
- Glucose metabolism disorders (incl diabetes mellitus)
- Arteriosclerosis, stenosis, vascular insufficiency and necrosis
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
onderzoeksvariabelen:
- Adipokine en cytokine mRNA expression (RT-PCR) and secretion (Western
blotting):
adiponectin, IL-6, TNF-α, resistin, PAI-1 en visfatin
- Histologic parameters of inflammation: macrophage infiltration (macrophages
per view), capillary injection (capillaries per view) en fat necrosis (presence
of) .
outcome measures:
- Stenosis (atherosclerotic plaque) measured with coronary angiography.
Secondary outcome
- Plasma adipokine and cytokine concentrations (adiponectine, IL-6, TNF-α,
resistin, PAI-1 en visfatin)
- Parameters of the metabolic syndrome (waist circumference (cm), LDL-c, HDL-c,
total cholesterol, fasting glucose, blood pressure)
- Adipocyte size
Background summary
Currently intra-abdominal adipose tissue is recognized as an active endocrine
and paracrine organ and is associated with the development of both insulin
resistance (metabolic syndrome, type 2 diabetes) and atherosclerotic vascular
disease. Adipose tissue influences inflammation and hemostasis by producing
pro-inflammatory cytokines (e.g. TNF-α, IL-6), adipokines (adiponectin, leptin)
and other proteins (e.g. PAI-1, tissue factor)
Adipose tissue around the coronary arteries which is part of the epicardial
adipose tissue (EAT) depot and produces adipocytokines and inflammatory
cytokines similarly as abdominal adipose tissue, and is in close contact with
the adventitia of the coronary arteries. It could be hypothesized that it
stimulates the progression of atherosclerosis from *outside to inside*.
Study objective
To determine the relationship between pericoronary adipose tissue
(dys)function, in terms of the cytokine and adipokine secretion profile and
histologic markers of inflammation, and coronary atherosclerosis.
Study design
Cross sectional observational study.
- At the preoperative consult (>2 weeks before surgery) patients are asked if
they allow the research physician to inform them about the study. The research
physician will contact the patient to inform them about the study and send the
written patient information and a sample of the informed consent.
- Informed consent will be signed on the day before surgery. After signing IC,
medical history an physical exam will be taken.
- Blood will be drawn and coronary angiography will be performed before surgery
as a part of routine clinical work up.
- during surgery an additional blood sample and adipose tissue biopsies will be
taken.
Study burden and risks
Study specific side effects that could occur are minor bleeding when biopting
the pericoronary adipose tissue, which will be stopped by the cardiothoracic
surgeon using diathermic coagulation.
There will be no financial or health benefits for study participants, since
there is no extra (time) investment because of the study.
Heidelberglaan 100
3584CX, Utrecht
NL
Heidelberglaan 100
3584CX, Utrecht
NL
Listed location countries
Age
Inclusion criteria
Inclusion criteria
1. Written and signed informed consent.
2. Male or female patients.
3. Scheduled for elective CABG.
4. >= 50% stenosis of the RCA, LAD, diagonal branche of the LAD (DIAG) or mo branches of the RCx.
Exclusion criteria
Exclusion criteria
1. Thyroid disease (TSH < 0.35 or > 5.0 mU/L or use of thyroid hormones)
2. History of malignancy (in the last 2 years)
3. Use of thiazolidinediones
4. Use of immune suppressive medication (equivalent of prednisolon >= 10 mg /day)
5. Renal failure GFR< 30 (ml/min/1.73m2)
6. History of cardiothoracic surgery
7. History of percutaneous coronary intervention
8. coronary artery disease of more than 2 vessels
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| CCMO | NL28312.041.09 |