The Effect of Managing Key Risk Factors on Inflammatory Markers and Their Role in Prognostic Outcomes of Stable Coronary Syndrome: A Gender-Specific Analysis

• Grant number: 25/10326-8
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: July 01, 2025
• End date: June 30, 2026
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Antonio de Padua Mansur
• Grantee: Isabela Giardini Gonçalves
• Host Institution: Instituto do Coração Professor Euryclides de Jesus Zerbini (INCOR). Hospital das Clínicas da Faculdade de Medicina da USP (HCFMUSP). Secretaria da Saúde (São Paulo - Estado). São Paulo , SP, Brazil

Abstract

Chronic Coronary Syndrome (CCS), a condition characterized by the persistentreduction of blood flow to the myocardium due to atherosclerosis, represents asignificant challenge for global and Brazilian health. Data from the GlobalBurden of Disease (GBD) show that the number of people with ischemic heartdisease in Brazil increased from 1.48 million to over 4 million between 1990 and2019. Atherosclerosis, a chronic inflammatory process that narrows andhardens the arteries, is exacerbated by risk factors such as dyslipidemia,diabetes, and systemic arterial hypertension, which accelerate diseaseprogression and increase the risk of adverse cardiovascular events.Dyslipidemia and diabetes mellitus promote inflammation and endothelialdysfunction, while hypertension contributes to vascular damage. Recently,inflammatory markers such as C-reactive protein (CRP) and indices like theSystemic Immune-Inflammation Index (SII) and the Systemic InflammationResponse Index (SIRI) have gained prominence for predicting cardiovascularrisks and reflecting systemic inflammatory status. These indices have also beenassociated with other chronic conditions, such as cancer and coronaryatherosclerotic disease, highlighting their potential as versatile biomarkers.Additionally, gender differences in the presentation and progression of CCScomplicate the clinical scenario. Women tend to present with non-obstructivecoronary artery disease or microvascular dysfunction, while men exhibit morepronounced obstructive disease. Women also have a higher burden of riskfactors, such as diabetes and hypertension, which may lead to a moreaggressive disease course.The proposed study aims to explore the relationship between traditional riskfactors (dyslipidemia, diabetes, and hypertension), markers (RCP), and theinflammatory index (SII and SIRI) in patients with CCS, with a focus on genderdifferences. The goal is to understand how these factors modulate inflammationand influence clinical outcomes, and investigate whether gender-specificinflammatory responses contribute to differences in disease severity andprognosis. The findings could lead to more personalized therapeutic strategies,improving CCS prevention, diagnosis, and treatment and reducing globalcardiovascular morbidity and mortality.