Does low glycemic index diet superior than routine diet to control blood inflammation state and lipid parameters in patients with coronary artery disease?

Background and aims

Low glycemic index diet has been shown several benefits in terms of reduction in atherosclerotic biomarkers in patients with coronary artery disease (CAD).

Objective of the study

To demonstrate superiority of the low glycemic index diet in patients with CAD in terms of blood inflammation state and lipid parameters.

Methods

One hundred and sixty patients aged 38–76 years established with CAD entered as 12 week dietary intervention either with low glycemic index (n=80) or routine diet (n=80) together with standard therapy from 2016 to 2019 (male=48%; 58.2±12.0 years). Laboratory (including hs-CRP, pro-inflammatory interleukins, IL-1β, IL-6, TNF-α, lipid parameters TC, TG, LDL-Cholesterol, HDL-Cholesterol) and instrumental data were obtained at baseline and in 12 weeks of the intervention.

Results

There were no statistically differences in biochemical data between two groups at their baseline characteristics. Low glycemic index diet positively influenced on hs-CRP (from 252.4±40.6 mg/dL to 161.9±28.5 mg/dL vs. from 237.8±35.6 mg/dL to 202.4±23.8 mg/dL; P<0.05), HbA1c (from 6.95±1.95% to 4.78±1.18% vs. 6.80±1.65% to 6.25±1.45%; P<0.05), TG (from 5.2±2.2 to 3.1±1.8 vs. from 5.8±2.8 to 4.9±2.0, P<0.05), TNF-α (from 1.48±0.91 to 0.88±0.19 vs. from 1.55±1.35 to 1.12±0.35, P<0.05), IL-6 (from 8.2 pg/mL to 4.9 pg/mL vs. from 8.2 pg/mL to 4.9 pg/mL, P<0.005) than routine diet. Although reduction in IL-1β were observed in both groups (from 32.5±17.2 pg/ml to 28.9±16.8 pg/ml, P>0.05; vs. 33.6±21.6 pg/ml to 29.8±20.4, P>0.05;), however there were no statistically significant from baseline and between groups (P>0.05).

Conclusions

Low glycemic index diet demonstrated superiority to routine diet to improve inflammatory state and lipid parameters in patients with CAD.

Funding Acknowledgement

Type of funding sources: None.

P1001Efficacy of ranolazine for the prevention of atrial fibrillation in high-risk patients with chronic coronary syndrome and hypertension

Background

Ranolazine currently is used to relief angina symptoms in patients with chronic coronary syndrome (CCS). Additional its anti-angina effect it has been showing antiarrhythmic effect by predominantly inhibiting late sodium and rapid potassium rectifier current. We aimed to assess the efficacy of ranolazine for the prevention of atrial fibrillation (AF) in high-risk patients older than 60 years with CCS at least >5 years and hypertension.

Methods

264 older high-risk patients (>60 years) with CCS and hypertension were prospectively enrolled (mean age was 66 ± 11.5 years, male 48%). Among them 132 patients have received additional ranolazine to the standard therapy while control group patients (n = 132) have received only standard therapy. Mean follow-up period was 5.0 ± 4.6 years. All statistical analyzes was performed using one sample student t-test.

Results

Initial baseline characteristics of patients were not statistically different. During the follow-up period in 8.3 % (n = 11) of patents have occurred MACE (AMI, PCI, CABG, death) in ranolazine group vs. in 9.8% (n = 13) of patients in the control group (P > 0.05). During the follow-up AF (paroxysmal and persistent) was developed significantly lower in ranolizine group than standard group (respectively: 13.6 % vs.18 percentage; P < 0.05). Sinus rhythm was recovered in the higher percent of patients in ranolazine group than standard group after cardioversion (89% vs. 79%, P < 0.05). Conclusion: Adding ranolazine to the standard treatment seems to have a beneficial role for the prevention of AF in high-risk patients with CCS and hypertension.

P3570Bilateral renal artery stenting is effective method for the treatment of uncontrolled hypertension and renal function

Background

Renal artery (RA) stenosis is one of the main causes of severe uncontrolled primary hypertension among population. Aim of the study was to investigate effectiveness of stent replacement in renal arteries and influence it on renal function in uncontrolled hypertensive patients (UHP) with pharmacotherapies.

Methods

86 consecutive UHP with renal etiology confirmed by angiography were enrolled in this study. Mean age of the patients was 43.2±12.5 years (aged 31–59 years, male=46%). Blood pressure, serum creatinine, microalbuminuria were assessed at baseline and after the intervention and during the follow-up for statistics. Mean follow-up was 2.0±1.0 years.

Results

Total of 128 hemodynamically significant renal artery stenosis were treated by implanting stents in all 86 patients. Among them in 42 patients were performed bilateral stenting (Group I) and 44 patients unilateral stenting (Group II). Systolic and diastolic blood pressure (SBP, DBP) decreased in both groups during the follow-up, however it was noted that only SBP were decreased significantly in Group I (unilateral stenting) whilst reduction in DBP not significantly when compared to Group II. Mean reduction in SBP was from 165.0±20.5 mmHg to 130.4±14.0 mmHg in Group I vs. from 158.0±22.0 to 135.0±15.0 mmHg in Group II (P=0.003 when compared two groups) and in DBP was from 95.0±11.2 mmHg to 83.4±8.0 mmHg in Group I vs. from 93.0±10.0 to 82.0±7.5 mmHg in Group II (P>0.05 when compared two groups). Serum creatinine levels were reduced from 123.0±49.0 μmol/l to 85.4±30.6 μmol/l in Group I vs 116.8±51.2 μmol/l to 86.9±35.5 μmol/l (P<0.05 when compared two groups). Significantly reduction in MAU were noted in both groups (P<0.05) but when compared two groups there were no significant changes in reduction.

Conclusion

Renal artery stenting is effective method for the treatment of UHP and may improve outcomes of the patients. Bilateral stenting seems to be more effective in blood pressure and serum creatinine control in UHP.