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Title: The non-invasive assessment of coronary atherosclerosis
Author: Birnie, David Hugh
Awarding Body: University of Glasgow
Current Institution: University of Glasgow
Date of Award: 1997
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Coronary heart disease (CHD) is the biggest single cause of death in the United Kingdom. The development of valid and reliable techniques of non-invasive assessment of coronary atherosclerosis would be invaluable in a number of ways and this thesis examined three techniques (titres of antibodies to heat shock protein 65, ultrasonographic measurement of carotid artery intimal-medial thickening (IMT) and levels of fibrinolytic factors). The second objective was to investigate the role of the immune response to hsp65 and H.pylori and of the endogenous fibrinolytic system in the pathogenesis of CHD. Anti-hsp65 titres correlated with the severity and extent of coronary atherosclerosis, but with insufficient predictive accuracy to be a useful clinical test. H.pylori would appear to be an important influence on IgG anti-hsp65 as the eradication of H.pylori lead to a significant fall in anti-hsp65 titre (from 25.64 AU/ml to 13.75 AU/ml, p=0.033). Thus an auto-immune response to hsp65 maybe the mechanism by which H.pylori lead to increased CHD risk. Significant correlations between carotid IMT and the angiographic severity and extent of coronary atherosclerosis were demonstrated. However the correlations were quite modest and this casts doubt on the use of carotid IMT as a surrogate marker of CHD mortality and morbidity. There was no evidence of a correlation between plasma PAI-1 antigen or activity or t-PA antigen levels and coronary atherosclerosis. Novel data is presented suggesting that gammaGT is an important influence on PAI-1 antigen levels in a normotriglyceridaemic population.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available