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Common Congenital Heart Lesions - page 30 / 126

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Estrogen Status

  • Prior to menopause women have a lower incidence of coronary events compared to men.

  • After menopause however, the risk is similar, suggesting a potentially atheroprotective property of estrogen...

Other, “new” risk factors (note that these are still under evaluation) include the following:

  • Homocysteine

  • Lipoprotein (a)

  • C-reactive protein

  • Infection

Homocysteine

  • Abnormally high amounts (hyperhomocysteinemia) may promote thrombosis

  • Hyperhomocysteinemia may result from:

    • o

      Genetic defects in methionine metabolism

      • o

        Insufficient dietary intake of folic acid

Lipoprotein (a)

  • Associated with Apo(a), which structurally resembles the plasma protein

plasminogen, which plays a role in the lysis of fibrin plots.

C-reactive protein (CRP)

  • Marker of inflammation produced by the liver upon stimulation via IL-6; thus, CRP is thought to be a marker of low-grade systemic inflammationi associated with atherosclerosis.

  • May also be a mediator of atherogenesis as it has the ability to activate complementÆinflammation

Infection

  • Infectious agents like C. pneumoniae and Herpes have been detected in

atherosclerotic lesions

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