Clinical & Experimental Cardiology
Open Access

Diminished excretion of cholesterol in the bile-independent risk factor for coronary artery disease

Joint Conference on 17^th European Heart Disease and Heart Failure Congress and 2^nd International Conference on Cardiovascular Medicine and Cardiac Surgery

March 15-17, 2017 London, UK

Karyn Geiger, Ori Argov, Ori Rogowski and Gideon Charach

Tel Aviv Sourasky Medical Center, Israel

Posters & Accepted Abstracts: J Clin Exp Cardiolog

Abstract :

Aim: The reasons for the increase in the coronary artery disease (CAD) risk related to bile acid alteration of excretion remain largely unexplained. The aim of this study was to elucidate the effect of alterations of bile acid excretion (BAE) and its long-term preventing action on CAD during a 20-year follow-up. Significantly low BAE was found in patients with CAD compared to non-CAD patients, leading to the hypothesis that the inability to efficiently excrete bile acids leads to coronary atherosclerosis development. Methods: To investigate the long-term role of BAE in CAD development and related mortality, the BAE of 50 patients with proven CAD were compared with that of 50 patients with chest pain and found not to have CAD (controls). The two groups were matched for clinical and laboratory characteristics. All subjects received a four day standard diet that included ~500 mg of cholesterol. Fecal bile acids from 24-hour stool collections were measured by gas liquid chromatography. Results: CAD patients excreted lower amounts of total bile acids (344.9, ICR 225.3-523.3 mg) than controls (597.5, ICR 401.3-725.5 mg; p<0.001), less deoxycholic acid (179.5, ICR 116.8-259.0 vs. 290.5, ICR 188.5-444.0 mg; p<0.0001) and less lithocholic acid (94.5 ICR�?±78.8 mg vs. 157.0 ICR131.3-234.3 mg; p<0. 01). BAE was the best significant independent laboratory factor that predicted CAD (p<0.05). Mortality and CAD development rates were significantly lower for the controls at the 20-year follow-up. Other vascular events, such as strokes and abdominal aortic aneurism were more common as well. Discussion & Conclusion: BAE<415 mg/day was associated with increased CAD long-term mortality. CAD patients had markedly decreased BAE levels compared to non-CAD controls. Impaired ability to excrete cholesterol may be an additional independent risk factor for CAD development.

Biography :

Email: karynrg@gmail.com