Latvian Early Atherosclerosis Registry

Patients with early atherosclerosis undergoing coronary angiography or percutaneous transluminal coronary angioplasty (PTCA) at Pauls Stradins Clinical University Hospital, Latvia will be included in the early atherosclerosis registry. Patients without explicit atherosclerosis risk factors undergoing coronary angiography or PTCA will undergo near-infrared spectroscopy imaging and blood samples for microRNA expression evaluation and genetic analysis will be obtained.

Exclusion criteria

• Refusion to participate in the registry
• Men ≥55 years and women ≥65 years
• Coronary artery atherosclerosis < 50% or ≥50% without proven ischaemia and planned revascularization or no history of coronary artery revascularization

Exclusion criteria

for additional genetic analysis and intravascular coronary imaging:

• Diabetes mellitus
• Serum total cholesterol ≥ 7 mmol/l and/or LDL ≥ 5 mmol/l
• Family hypercholesterolemia
• Positive family history of cardiovascular disease (myocardial infarction, sudden cardiac death or cardiovascular disease of first-degree relatives at a young age - men <55 years, women <65 years)
• ≥20 pack years of smoking
• Malignant or resistant hypertension ≥ 10 years
• Body mass index ≥40 kg/m2

At the time of recruitment demographic characteristics, medical and family history, anthropometric parameters, smoking status, history of other risk factors and daily used medications will be recorded and venous blood samples will be obtained.

In obtained venous blood samples study researchers will evaluate biochemistry analysis which includes high-density and low-density lipoprotein cholesterols, total cholesterol, triglycerides, alanine aminotransaminase, aspartate aminotransferase, bilirubin, creatine kinase, glucose and glycated haemoglobin levels. Genetic analysis will include sequencing of the four major candidate genes for monogenic hypercholesterolemia (LDLR, APOB, PCSK9 and LDLRAP1). microRNA (miR)-126, miR-145 and miR-155 expression will be evaluated in all venous blood samples.

Patients undergoing repeated coronary angiography or PTCA will undergo intravascular imaging - near-infrared spectroscopy to determine coronary plaque lipidic tissue content.

Follow-up phone calls will be performed after 6, 12 and 24 months. In the follow-up study researchers will obtain additional information on study participants including smoking status, daily used medications and anthropometric parameters.

Inclusion criteria

• Signed informed consent
• Early atherosclerosis defined as coronary atherosclerosis in men aged <55 years and women <65 years
• Coronary artery atherosclerosis with angiographically proven coronary vessel luminal stenosis ≥ 50% and ischaemia
• Coronary artery atherosclerosis with planned revascularization
• History of coronary artery revascularization (PTCA or coronary artery bypass surgery)
• Coronary vessel suitable for NIRS pullback

Exclusion criteria

• Diabetes
• Total cholesterol ≥7 mmol/l and/or LDL ≥ 5 mmol/l
• family hypercholesterolemia
• positive family history of early cardiovascular disease (myocardial infarction, sudden cardiac death or cardiovascular disease of first degree relatives at young age - men <55 years, women <65 years)
• malignant or resistant hypertension ≥ 10 years
• body mass index ≥40 kg/m 2 )
• 20 or more pack years of smoking