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Diminished bile acids excretion is a risk factor for coronary artery disease: 20-year follow up and long-term outcome

BACKGROUND: Patients with coronary artery disease (CAD) had significantly lower bile acid excretion (BAE) compared with non-CAD patients, leading to the hypothesis that the inability to efficiently excrete bile acids leads to coronary atherosclerosis development. We investigated the long-term role o...

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Autores principales: Charach, Gideon, Argov, Ori, Geiger, Karyn, Charach, Lior, Rogowski, Ori, Grosskopf, Itamar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5784550/
https://www.ncbi.nlm.nih.gov/pubmed/29383025
http://dx.doi.org/10.1177/1756283X17743420
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author Charach, Gideon
Argov, Ori
Geiger, Karyn
Charach, Lior
Rogowski, Ori
Grosskopf, Itamar
author_facet Charach, Gideon
Argov, Ori
Geiger, Karyn
Charach, Lior
Rogowski, Ori
Grosskopf, Itamar
author_sort Charach, Gideon
collection PubMed
description BACKGROUND: Patients with coronary artery disease (CAD) had significantly lower bile acid excretion (BAE) compared with non-CAD patients, leading to the hypothesis that the inability to efficiently excrete bile acids leads to coronary atherosclerosis development. We investigated the long-term role of BAE in CAD development and related mortality in 50 patients with proven CAD compared with that of 50 patients with chest pain and no CAD (controls) matched for clinical and laboratory characteristics. METHODS: All subjects received a 4-day standard diet that included ~500 mg of cholesterol. Fecal bile acids from 24-h stool collections were measured by gas liquid chromatography. RESULTS: CAD patients excreted lower amounts of total bile acids than controls (p < 0.001), less deoxycholic acid (p < 0.0001) and less lithocholic acid (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. CONCLUSIONS: These results showed that CAD patients had markedly decreased BAE levels compared with non-CAD controls. BAE <415 mg/day was associated with increased CAD long-term mortality. Impaired ability to excrete cholesterol might be considered an additional independent risk factor for CAD development.
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spelling pubmed-57845502018-01-30 Diminished bile acids excretion is a risk factor for coronary artery disease: 20-year follow up and long-term outcome Charach, Gideon Argov, Ori Geiger, Karyn Charach, Lior Rogowski, Ori Grosskopf, Itamar Therap Adv Gastroenterol Original Research BACKGROUND: Patients with coronary artery disease (CAD) had significantly lower bile acid excretion (BAE) compared with non-CAD patients, leading to the hypothesis that the inability to efficiently excrete bile acids leads to coronary atherosclerosis development. We investigated the long-term role of BAE in CAD development and related mortality in 50 patients with proven CAD compared with that of 50 patients with chest pain and no CAD (controls) matched for clinical and laboratory characteristics. METHODS: All subjects received a 4-day standard diet that included ~500 mg of cholesterol. Fecal bile acids from 24-h stool collections were measured by gas liquid chromatography. RESULTS: CAD patients excreted lower amounts of total bile acids than controls (p < 0.001), less deoxycholic acid (p < 0.0001) and less lithocholic acid (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. CONCLUSIONS: These results showed that CAD patients had markedly decreased BAE levels compared with non-CAD controls. BAE <415 mg/day was associated with increased CAD long-term mortality. Impaired ability to excrete cholesterol might be considered an additional independent risk factor for CAD development. SAGE Publications 2017-12-04 /pmc/articles/PMC5784550/ /pubmed/29383025 http://dx.doi.org/10.1177/1756283X17743420 Text en © The Author(s), 2018 http://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Research
Charach, Gideon
Argov, Ori
Geiger, Karyn
Charach, Lior
Rogowski, Ori
Grosskopf, Itamar
Diminished bile acids excretion is a risk factor for coronary artery disease: 20-year follow up and long-term outcome
title Diminished bile acids excretion is a risk factor for coronary artery disease: 20-year follow up and long-term outcome
title_full Diminished bile acids excretion is a risk factor for coronary artery disease: 20-year follow up and long-term outcome
title_fullStr Diminished bile acids excretion is a risk factor for coronary artery disease: 20-year follow up and long-term outcome
title_full_unstemmed Diminished bile acids excretion is a risk factor for coronary artery disease: 20-year follow up and long-term outcome
title_short Diminished bile acids excretion is a risk factor for coronary artery disease: 20-year follow up and long-term outcome
title_sort diminished bile acids excretion is a risk factor for coronary artery disease: 20-year follow up and long-term outcome
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5784550/
https://www.ncbi.nlm.nih.gov/pubmed/29383025
http://dx.doi.org/10.1177/1756283X17743420
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