Tabriz University of Medical Sciences Journal of Cardiovascular and Thoracic Research 2008-5117 17 4 2025 12 17 Tendency to acidosis or alkalosis: Which one is associated with coronary artery disease? 283 290 10.34172/jcvtr.025.33519 EN Alireza Amirzadegan https://orcid.org/0000-0003-1751-019X Elahia Mohseni https://orcid.org/0009-0001-3910-0100 Hassan Aghajani https://orcid.org/0000-0002-2181-4850 Arash Jalali https://orcid.org/0000-0003-3225-8498 Ahmad Vakili-Basir https://orcid.org/0000-0003-3721-0434 Yeganeh Karimi https://orcid.org/0000-0001-7726-2752 Journal Article 10.34172/jcvtr.025.33519 2025 03 01 2025 09 11 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.