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Submitted: 01 Mar 2025
Revision: 02 Jul 2025
Accepted: 11 Sep 2025
ePublished: 17 Dec 2025
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J Cardiovasc Thorac Res. 2025;17(4): 283-290.
doi: 10.34172/jcvtr.025.33519
  Abstract View: 61
  PDF Download: 82

Original Article

Tendency to acidosis or alkalosis: Which one is associated with coronary artery disease?

Alireza Amirzadegan 1 ORCID logo, Elahia Mohseni 1 ORCID logo, Hassan Aghajani 1 ORCID logo, Arash Jalali 1,2 ORCID logo, Ahmad Vakili-Basir 1,2 ORCID logo, Yeganeh Karimi 1* ORCID logo

1 Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
2 Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
*Corresponding Author: Yeganeh Karimi, Email: karimi.ye@iums.ac.ir, Email: Yeganeh.karimiy@gmail.com

Abstract

Introduction: Base excess (BE) is an indicator of non-respiratory acid-base imbalances, which can impact coronary artery disease (CAD). This study evaluated the association between the severity of CAD and peripheral blood BE.

Methods: This cross-sectional study included patients aged 18 and older who were candidates for coronary angiography. Demographic and clinical data were collected from medical records. Blood gas analysis was performed on a 2-millilitre arterial blood sample taken from the access artery before contrast injection. All patients underwent coronary angiography, and the Gensini score was calculated.

Results: A total of 351 patients (194 males, 55.3%) were included in the study. The study population had a mean age of 60.79±9.5 and a mean BMI of 29.4±4.85. Coronary angiography revealed normal or minimal (<50% stenosis) findings in 51.3% of cases (15.4% with normal coronary arteries and 35.9% with minimal non-obstructive lesions), single-vessel disease in 17.4%, two-vessel disease in 14.5%, and three-vessel disease in 16.8%. Median Gensini score was 13.0, with an IQR of 3.5 and 49. The findings indicated that a decrease in BE was significantly correlated with elevated Gensini scores (β: -0.04; 95% CI: -0.08 to -0.01; P=0.027). However, BE did not significantly affect the Gensini score of 0 (P=0.843). Moreover, negative values of BE were significantly and inversely associated with the Gensini score (β=-0.05; 95% CI: -0.07 to -0.02, P<0.001).

Conclusion: This study revealed an association between BE and CAD, suggesting that BE tending to acidosis is potentially associated with CAD.


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