Variations in the Community Structure of Fungal Microbiota Associated with Apple Fruit Shaped by Fruit Bagging-Based Practice

The various fungal communities that adhere to apple fruit are influenced by agricultural practices. However, the effects of fruit bagging-based management practice on the fungal microbiota are still unknown, and little is known about the fungal communities of bagged apple fruit. We conducted a study using apple fruit grown in a conventionally managed orchard where pesticide use is an indispensable practice. Fungal communities were collected from the calyx-end and peel tissues of bagged and unbagged fruit and characterized using barcode-type next-generation sequencing. Fruit bagging had a stronger effect on fungal richness, abundance, and diversity of the fungal microbiota in comparison to non-bagging. In addition, bagging also impacted the compositional variation of the fungal communities inhabiting each fruit part. We observed that fruit bagging had a tendency to maintain ecological equilibrium since Ascomycota and Basidiomycota were more distributed in bagged fruit than in unbagged fruit. These fungal communities consist of beneficial fungi rather than potentially harmful fungi. Approximately 50 dominant taxa were detected in bagged fruit, for example, beneficial genera such as Articulospora, Bullera, Cryptococcus, Dioszegia, Erythrobasidium, and Sporobolomyces, as well as pathogenic genera such as Aureobasidium and Taphrina. These results suggested that fruit bagging could significantly increase fungal richness and promote healthy fungal communities, especially the harmless fungal communities, which might be helpful for protecting fruit from the effects of pathogens. This study provides a foundation for understanding the impacts of bagging-based practice on the associated fungal microbiota.

Study on the Interactive Effects of Solid Particles and Asphaltenes on the Interfacial Structure and Stability of a Water-in-Model Oil Emulsion

Asphaltenes and solid particles are common compositions in crude oil emulsions. They can be anchored at the oil/water interface, exerting significant effects on the strength of an interfacial layer. In this study, the interactive effects of the asphaltenes and solid particles on the interfacial structure are investigated. First, the solid particles and asphaltenes are proven to perform different roles in stabilizing the emulsion by influencing the strength of the interfacial layer with the change in asphaltene concentration. Subsequently, the competitive coadsorption process of the asphaltenes and particles is examined by measuring the dynamic interfacial tension. The adsorption of particles could occupy the interfacial area, postponing the adsorption of asphaltenes. The crumpling ratio of the interfacial layer formed by the asphaltenes and solid particles indicates that the composite layer should be more flexible with a higher compressibility compared to that formed by only asphaltenes. It is observed by SEM that the binary layer possesses a composite structure with the particles as the framework and the asphaltenes as the filling. The interactive mechanism between the asphaltenes and particles should lie in the adsorption of the asphaltenes on the particles. Systematic experiments on the contact angle, adsorbed amount, and desorption percentage reveal that asphaltenes could adsorb on the surface of the particles, modifying the wettability. The change in asphaltene concentration will result in the varying wettability modification due to asphaltene adsorption on the particles, leading to the different adsorption abilities and barrier effects of the modified particles at the interface.

TMT-based quantitative proteomic analysis of the effects of Pseudomonas syringae pv. tabaci (Pst) infection on photosynthetic function and the response of the MAPK signaling pathway in tobacco leaves

To reveal the mechanism of photosynthesis inhibition by infection and the response of the MAPK signaling pathway to pathogen infection, tobacco leaves were inoculated with Pseudomonas syringae pv. tabaci (Pst), and the effects of Pst infection on photosynthesis of tobacco leaves were studied by physiological and proteomic techniques, with a focus on MAPK signaling pathway related proteins. Pst infection was observed to lead to the degradation of chlorophyll (especially Chl b) in tobacco leaves and the down-regulation of light harvesting antenna proteins expression, thus limiting the light harvesting ability. The photosystem II and I (PSII and PSI) activities were also decreased, and Pst infection inhibited the utilization of light and CO2. Proteomic analyses showed that the number of differentially expressed proteins (DEPs) under Pst infection at 3 d were significantly higher than at 1 d, especially the number of down-regulated proteins. The KEGG enrichment of DEPs was mainly enriched in the energy metabolism processes such as photosynthesis antenna proteins and photosynthesis. The down-regulation of chlorophyll a-b binding protein, photosynthetic electron transport related proteins (e.g., PSII and PSI core proteins, the Cytb6/f complex, PC, Fd, FNR), ATP synthase subunits, and key enzymes in the Calvin cycle were the key changes associated with Pst infection that may inhibit tobacco photosynthesis. The effect of Pst infection on the PSII electron acceptor side was significantly greater than that on the PSII donor side. The main factor that decreased the photosynthetic ability of tobacco leaves with Pst infection at 1 d may be the inhibition of photochemical reactions leading to an insufficient supply of ATP, rather than decreased expression of enzymes involved in the Calvin cycle. At 1 d into Pst infection, the PSII regulated energy dissipation yield Y(NPQ) may play a role in preventing photosynthetic inhibition in tobacco leaves, but the long-term Pst infection significantly inhibited Y(NPQ) and the expression of PsbS proteins. Proteins involved in the MAPK signaling pathway were up-regulated, suggesting the MAPK signaling pathway was activated to respond to Pst infection. However, at the late stage of Pst infection (at 3 d), MAPK signaling pathway proteins were degraded, and the defense function of the MAPK signaling pathway in tobacco leaves was damaged.

Increased long-term risk of heart failure and other adverse cardiac outcomes in dermatomyositis and polymyositis: Insights from a nationwide cohort

BACKGROUND

Mounting evidence suggests that dermatomyositis/polymyositis (DM/PM) are associated with increased risk of atherosclerotic events and venous thromboembolism. However, data on the association between DM/PM and other cardiac outcomes, especially heart failure (HF), are scarce.

OBJECTIVES

To examine the long-term risk and prognosis associated with adverse cardiac outcomes in patients with DM/PM.

METHODS

Using Danish administrative registries, we included all patients ≥18 years with newly diagnosed DM/PM (1996-2018). Risks of incident outcomes were compared with non-DM/PM controls from the background population (matched 1:4 by age, sex, and comorbidity). In a secondary analysis, we compared mortality following HF diagnosis between DM/PM patients with HF and non-DM/PM patients with HF (matched 1:4 by age and sex).

RESULTS

The study population included 936 DM/PM patients (median age 58.5 years, 59.0% women) and 3744 matched non-DM/PM controls. The median follow-up was 6.9 years. Absolute 10-year risks of incident outcomes for DM/PM patients vs matched controls were as follows: HF, 6.98% (CI, 5.16-9.16%) vs 4.58% (3.79-5.47%) (P = 0.002); atrial fibrillation, 10.17% (7.94-12.71%) vs 7.07% (6.09-8.15%) (P = 0.005); the composite of ICD implantation/ventricular arrhythmias/cardiac arrest, 1.99% (1.12-3.27%) vs 0.64% (0.40-0.98%) (P = 0.02); and all-cause mortality, 35.42% (31.64-39.21%) vs 16.57% (15.10-18.10%) (P < 0.0001). DM/PM with subsequent HF was associated with higher mortality compared with HF without DM/PM (adjusted hazard ratio 1.58 [CI, 1.01-2.47]).

CONCLUSION

Patients with DM/PM had a higher associated risk of HF and other adverse cardiac outcomes compared with matched controls. Among patients developing HF, a history of DM/PM was associated with higher mortality.

Characteristics and metabolic patterns of soil methanogenic archaea communities in the high-latitude natural forested wetlands of China

Soil methanogenic microorganisms are one of the primary methane-producing microbes in wetlands. However, we still poorly understand the community characteristic and metabolic patterns of these microorganisms according to vegetation type and seasonal changes. Therefore, to better elucidate the effects of the vegetation type and seasonal factors on the methanogenic community structure and metabolic patterns, we detected the characteristics of the soil methanogenic mcrA gene from three types of natural wetlands in different seasons in the Xiaoxing'an Mountain region, China. The results indicated that the distribution of Methanobacteriaceae (hydrogenotrophic methanogens) was higher in winter, while Methanosarcinaceae and Methanosaetaceae accounted for a higher proportion in summer. Hydrogenotrophic methanogenesis was the dominant trophic pattern in each wetland. The results of principal coordinate analysis and cluster analysis showed that the vegetation type considerably influenced the methanogenic community composition. The methanogenic community structure in the Betula platyphylla-Larix gmelinii wetland was relatively different from the structure of the other two wetland types. Indicator species analysis further demonstrated that the corresponding species of indicator operational taxonomic units from the Alnus sibirica wetland and the Betula ovalifolia wetland were similar. Network analysis showed that cooperative and competitive relationships exist both within and between the same or different trophic methanogens. The core methanogens with higher abundance in each wetland were conducive to the adaptation to environmental disturbances. This information is crucial for the assessment of metabolic patterns of soil methanogenic archaea and future fluxes in the wetlands of the Xiaoxing'an Mountain region given their vulnerability.

Integrin intra-heterodimer affinity inversely correlates with integrin activatability

Integrins are heterodimeric cell surface receptors composed of an α and β subunit that mediate cell adhesion to extracellular matrix proteins such as fibronectin. We previously studied integrin α5β1 activation during zebrafish somitogenesis, and in the present study, we characterize the integrin αV fibronectin receptors. Integrins are activated via a conformational change, and we perform single-molecule biophysical measurements of both integrin activation via fluorescence resonance energy transfer (FRET)-fluorescence lifetime imaging microscopy (FLIM) and integrin intra-heterodimer stability via fluorescence cross-correlation spectroscopy (FCCS) in living embryos. We find that integrin heterodimers that exhibit robust cell surface expression, including αVβ3, αVβ5, and αVβ6, are never activated in this in vivo context, even in the presence of fibronectin matrix. In contrast, activatable integrins, such as integrin αVβ1, and alleles of αVβ3, αVβ5, αVβ6 that are biased to the active conformation exhibit poor cell surface expression and have a higher intra-heterodimer dissociation constant (KD). These observations suggest that a weak integrin intra-heterodimer affinity decreases integrin cell surface stability and increases integrin activatability.

Molecular Dissection of Perithecial Mating Line Development in Colletotrichum fructicola, a Species with a Nontypical Mating System Featuring Plus-to-Minus Switch and Plus-Minus-Mediated Sexual Enhancement

The genetic regulation of Colletotrichum (Glomerella) sexual reproduction does not strictly adhere to the Ascomycota paradigm and remains poorly understood. Morphologically different but sexually compatible strain types, termed plus and minus, have been recognized, but the biological and molecular distinctions between these strain types remain elusive. In this study, we characterized the sexual behaviors of a pair of plus and minus strains of C. fructicola with the aid of live-cell nucleus-localized fluorescent protein labeling, gene expression, and gene mutation analyses. We confirmed a genetically stable plus-to-minus switching phenomenon and demonstrated the presence of both cross-fertilized and self-fertilized perithecia within the mating line (perithecia cluster at the line of colony contact) between plus and minus strains. We demonstrated that pheromone signaling genes (a-factor-like and α-factor-like pheromones and their corresponding GPCR receptors) were differently expressed between vegetative hyphae of the two strains. Moreover, deletion of pmk1 (a FUS/KSS1 mitogen-activate protein kinase) in the minus strain severely limited mating line formation, whereas deletion of a GPCR (FGSG_05239 homolog) and two histone modification factors (hos2, snt2) in the minus strain did not affect mating line development but altered the ratio between cross-fertilization and self-fertilization within the mating line. We propose a model in which mating line formation in C. fructicola involves enhanced protoperithecium differentiation and enhanced perithecium maturation of the minus strain mediated by both cross-fertilization and diffusive effectors. This study provides insights into mechanisms underlying the mysterious phenomenon of plus-minus-mediated sexual enhancement being unique to Colletotrichum fungi. IMPORTANCE Plus-minus regulation of Colletotrichum sexual differentiation was reported in the early 1900s. Both plus and minus strains produce fertile perithecia in a homothallic but inefficient manner. However, when the two strain types encounter each other, efficient differentiation of fertile perithecia is triggered. The plus strain, by itself, can also generate minus ascospore progeny at high frequency. This nontypical mating system facilitates sexual reproduction and is Colletotrichum specific; the underlying molecular mechanisms, however, remain elusive. The current study revisits this longstanding mystery using C. fructicola as an experimental system. The presence of both cross-fertilized and self-fertilized perithecia within the mating line was directly evidenced by live-cell imaging with fluorescent markers. Based on further gene expression and gene mutation analysis, a model explaining mating line development (plus-minus-mediated sexual enhancement) is proposed. Data reported here have the potential to allow us to better understand Colletotrichum mating and filamentous ascomycete sexual regulation.

Comparison of mitochondrial genomes provides insights into intron dynamics and evolution in Botryosphaeria dothidea and B. kuwatsukai

Botryosphaeria dothidea is one of the most common fungal pathogens on a large number of hosts worldwide. Botryosphaeria dothidea and B. kuwatsukai are also the main causal agents of apple ring rot. In this study, we sequenced, assembled and annotated the circular mitogenomes of 12 diverse B. dothidea isolates (105.7-114.8 kb) infecting various plants including apple, and five diverse B. kuwatsukai isolates (118.0-124.6 kb) from apple. B. dothidea mitogenomes harboured a set of 29-31 introns and 48-52 ORFs. In contrast, B. kuwatsukai mitogenomes harboured more introns (32-34) and ORFs (51-54). The variation in mitogenome sizes was associated mainly with different numbers of introns and insertions of mobile genetic elements. Interestingly, B. dothidea and B. kuwatsukai displayed distinct intron distribution patterns, with three intron loci showing presence/absence dynamics in each species. Large numbers of introns (57% in B. dothidea and 49% in B. kuwatsukai) were most likely obtained through horizontal transfer from non-Dothideomycetes. The mitochondrial gene phylogeny supported the differentiation of the two species. Overall, this study sheds light into the mitochondrial evolution of the plant pathogens B. dothidea and B. kuwatsukai, and intron distribution patterns could be useful markers for studies on population diversity.

Responses of photosynthesis and antioxidants to simulated acid rain in mulberry seedlings

Acid rain, which has negative impacts on the vegetation of ecological systems, is widespread in Northern and Southern China. However, relatively little is known about the effects of acid rain on the growth and yield of economically important tree species in China. To address this issue, we studied the responses of mulberry seedlings to simulated acid rain (SAR) at different pH values. At pH 4.5, SAR induced increased antioxidant activities, total antioxidant capacity, and the accumulation of reactive oxygen species (OFR) relative to controls. However, the growth of the seedlings under SAR treatments at pH 4.5 and pH 5.6 was greater than controls. No significant differences in photosynthesis and chlorophyll a fluorescence quenching parameters were observed between the SAR treatments at pH 4.5 and pH 5.6 and controls. However, the SAR treatment at pH 3.5 resulted in altered leaf surface characteristics and changes to chloroplast ultrastructure, together with an increase in membrane electrical conductivity and an accumulation of OFR and malondialdehyde. In contrast, leaf antioxidant enzyme activities were decreased, together with electron transport parameters and photosynthesis. Taken together, these results show that the effects of acid rain on the growth and leaf physiology of mulberry seedling are dependent on pH. Moreover, mulberry seedlings had a high tolerance to acid rain at pH 4.5.

Draft Genome Sequence of Cumin Blight Pathogen Alternaria burnsii

The fungal genus Alternaria consists of highly diverse species. They can be isolated readily from soil, water, and many plants, and even from animals and humans. Alternaria burnsii is a small-spored species of section Alternaria. It has been reported as a pathogen, an endophyte, and a saprophyte, and can also be found in indoor air. It causes cumin blight, a destructive disease on cumin (Cuminum cyminum), and also causes other serious diseases, such as pumpkin seed rot, date palm leaf spot, wheat leaf spot, and gray spot of Notopterygium incisum. In this study, we sequenced and assembled the first genome of A. burnsii isolate CBS 107.38. The draft genome can be used as a reference for the further study of related pathogens and comparative genomics of Alternaria species.

Estrogen enhances the expression of a growth-associated long noncoding RNA in chicken liver via ERα

1. The long noncoding RNA lncGLM is significantly differentially expressed in the livers of peak-laying hens compared with that in the livers of pre-laying hens, but its potential biological role and expression regulation are unclear.2. To explore the potential biological function of lncGLM, single nucleotide polymorphism (SNP) detection and association analysis were carried out in the Gushi×Anka F₂ resource population.3. The tissues and spatiotemporal expression characteristics of lncGLM were analysed by real-time quantitative PCR. The effects of 17β-oestradiol on the expression of lncGLM expression were analysed through in vitro and in vivo experiments.4. The results showed that a g.19069338 T > C SNP was present in lncGLM. Association analysis revealed that lncGLM was significantly associated with body slanting length at 12 weeks, body weight at 12 weeks, shank length at four weeks, chest depth at eight weeks, pelvic width at 12 weeks, eviscerated weight, head weight, pancreas weight, pectoralis weight, leg muscle weight, muscular stomach weight rate, pancreas weight rate, carcase weight, aspartate aminotransferase, creatinine and pectoral muscle water loss rate.5. The expression of lncGLM in the liver was higher than that in other sampled tissues. In addition, the expression of lncGLM in the liver was significantly higher in the peak-laying period than at the pre-laying period. Both in vitro and in vivo experiments showed that lncGLM expression was regulated by 17β-oestradiol via oestrogen receptor alpha (ER-α). These results demonstrated that the chicken lncGLM gene is highly expressed in liver tissue and regulated by oestrogen through ER-α.

Survey on recent developments in automatic detection of diabetic retinopathy

Diabetic retinopathy (DR) is a disease facilitated by the rapid spread of diabetes worldwide. DR can blind diabetic individuals. Early detection of DR is essential to restoring vision and providing timely treatment. DR can be detected manually by an ophthalmologist, examining the retinal and fundus images to analyze the macula, morphological changes in blood vessels, hemorrhage, exudates, and/or microaneurysms. This is a time consuming, costly, and challenging task. An automated system can easily perform this function by using artificial intelligence, especially in screening for early DR. Recently, much state-of-the-art research relevant to the identification of DR has been reported. This article describes the current methods of detecting non-proliferative diabetic retinopathy, exudates, hemorrhage, and microaneurysms. In addition, the authors point out future directions in overcoming current challenges in the field of DR research.

Umbilical cord blood transplantation can overcome the poor prognosis of KMT2A-MLLT3 acute myeloid leukemia and can lead to good GVHD-free/relapse-free survival

This is a retrospective study comparing the effectiveness of umbilical cord blood transplantation (UCBT) and chemotherapy for patients in the first complete remission period for acute myeloid leukemia with KMT2A-MLLT3 rearrangements. A total of 22 patients were included, all of whom achieved first complete remission (CR1) through 1–2 rounds of induction chemotherapy, excluding patients with an early relapse. Twelve patients were treated with UCBT, and 10 patients were treated with chemotherapy after 2 to 4 courses of consolidation therapy. The 3-year overall survival (OS) of the UCBT group was 71.3% (95% CI, 34.4–89.8%), and that of the chemotherapy group was 10% (95% CI, 5.89–37.3%). The OS of the UCBT group was significantly higher than that of the chemotherapy group (P = 0.003). The disease-free survival (DFS) of the UCBT group was 60.8% (95% CI, 25.0–83.6%), which was significantly higher than the 10% (95% CI, 5.72–35.8%) of the chemotherapy group (P = 0.003). The relapse rate of the UCBT group was 23.6% (95% CI, 0–46.8%), and that of the chemotherapy group was 85.4% (95% CI, 35.8–98.4%), which was significantly higher than that of the UCBT group (P < 0.001). The non-relapse mortality (NRM) rate in the UCBT group was 19.8% (95% CI, 0–41.3%), and that in the chemotherapy group was 0.0%. The NRM rate in the UCBT group was higher than that in the chemotherapy group, but there was no significant difference between the two groups (P = 0.272). Two patients in the UCBT group relapsed, two died of acute and chronic GVHD, and one patient developed chronic GVHD 140 days after UCBT and is still alive, so the GVHD-free/relapse-free survival (GRFS) was 50% (95% CI, 17.2–76.1%). AML patients with KMT2A-MLLT3 rearrangements who receive chemotherapy as their consolidation therapy after CR1 have a very poor prognosis. UCBT can overcome the poor prognosis and significantly improve survival, and the GRFS for these patients is very good. We suggest that UCBT is a better choice than chemotherapy for KMT2A-MLLT3 patients.

Effect of different body position on anorectal manometry for chronic constipation patients

OBJECTIVE

To analyze the different influence of body position on wireless high-resolution anorectal manometry parameters and in classification for chronic constipation patients.

PATIENTS AND METHODS

Fifty consecutive patients with chronic constipation and 20 healthy volunteers were included in this study, all of whom accepted the Rome IV constipation questionnaires, underwent rectal balloon expulsion test and wireless high-resolution anorectal manometry. The wireless high-resolution anorectal manometry was performed in the left lateral, seated, and squatting positions for every study subject. The Statistical Product and Service Solutions (SPSS) 21.0 software (IBM Corp., Armonk, NY, USA) was used for statistical analysis.

RESULTS

The anal sphincter resting pressure, anal sphincter squeezing pressure, and rectal internal pressure during the evacuation in the seated position and squatting position were significantly higher than those in the left lateral position in both the volunteer group and patient group, without a significant difference between the seated position and squatting position. The initial perception threshold was higher in the patient group than in the volunteer group. The wireless high-resolution anorectal manometry in different positions combined with the rectal balloon expulsion test mainly affects the diagnosis of the subtype of inadequate defecatory propulsion.

CONCLUSIONS

Compared with the left lateral position test, the wireless high-resolution anorectal manometry in the seated position and squatting positions is more consistent with the human physiological bowel condition, and the result of the test can be affected by the body position. The wireless high-resolution anorectal manometry can differentiate between subtypes during the diagnosis of inadequate defecatory propulsion.

Overexpression of Trx CDSP32 gene promotes chlorophyll synthesis and photosynthetic electron transfer and alleviates cadmium-induced photoinhibition of PSII and PSI in tobacco leaves

Cadmium stress causes a decrease in chlorophyll content and inhibits photosynthesis in tobacco leaves. The role of thioredoxin-like protein CDSP32 expressed in plant chloroplasts is to alleviates the reduced enzymes expression involved in chlorophyll synthesis of tobacco leaves due to Cd exposure, effectively preventing chlorophyll degradation and promoting increased tobacco biomass. Overexpression of Trx CDSP32 can protect the oxygen-evolving complex on the PSII donor side and promote electron transfer on the PSII acceptor side of tobacco leaves under Cd stress. Trx CDSP32 not only significantly increase the PSI activity of tobacco leaves, but also alleviate cadmium-induced PSI photoinhibition. Although Trx CDSP32 has no significant effect on the expression of PC and FNR proteins in tobacco leaves under Cd stress, it can alleviate the decreased expression of protein subunits involved in photosynthetic electron transfer such as Cyt b6/f complex subunits, Fd, and ATP synthase subunits. Trx CDSP32 can promote the synthesis of chlorophyll, stabilize the electron transfer chain, and promote ATP synthase activity to alleviate cadmium-induced photoinhibition of PSII and PSI in tobacco leaves.

Effects of targeted hydration on risk of major adverse renal and cardiac events: a systematic review and meta-analysis of randomized controlled trials

Background

Inconsistent results have been published that have evaluated the preventive effect of targeted hydration in major adverse renal and cardiac events among patients exposed to contrast agents.

Methods

Online databases were searched up to October, 2019, for randomized controlled trials (RCTs). The primary outcome was the incidence of contrast-induced acute kidney injury (CI-AKI), and the secondary outcomes were all-cause in-hospital mortality, all-cause long-term mortality, requirement for dialysis, acute pulmonary edema and stroke/transient ischemic attack (TIA).

Results

9 high quality trials were identified including 2424 patients. Overall, compared with general hydration, targeted hydration significantly reduced the incidence of CI-AKI by 58% (RR 0.42; 95% CI: 0.33–0.54, p&lt;0.01), the requirement for dialysis by 68% (RR 0.32, 95% CI: 0.17–0.62, p&lt;0.01) and the all-cause long-term mortality by 55% (RR 0.45; 95% CI: 0.26–0.76, p&lt;0.01). The effect on all-cause in-hospital mortality was not statistically significant. The effect on acute pulmonary edema and stroke/TIA also showed no difference between two groups (RR: 0.54, 95% CI: 0.28–1.03, p=0.18; RR: 0.61, 95% CI: 0.14–2.61, p=0.49, respectively). Trial sequential analysis confirmed that an additional 3900 study participants would need to be recruited to demonstrate a statistically significant improvement for all-cause in-hospital mortality.

Conclusions

Targeted hydration likely reduces the incidence of CI-AKI, dialysis and all-cause long-term mortality in patients exposed to contrast agents. However, further independent high-quality RCTs should elucidate the effectiveness and safety of this prophylactic strategy in interventional cardiology.

Funding Acknowledgement

Type of funding source: None

Association of high-sensitivity C-reactive protein and long-term mortality may differ from lipoprotein(a) levels among patients undergoing coronary angiography

Background

The use of high-sensitivity C-reactive protein (hs-CRP) as an inflammation biomarker in predicting long-term mortality remains controversial. We aimed to investigate whether the association of hs-CRP with long-term mortality differs from another inflammation biomarker, lipoprotein(a), in patients undergoing coronary angiography (CAG).

Methods

A total of 2422 patients undergoing CAG were included in the final analysis from a prospective, observational study. We divided them into 4 groups according to hs-CRP level (high ≥4.8 mg/l, low &lt;4.8 mg/l) and lipoprotein(a) level (high ≥17 mg/dl, low &lt;17 mg/dl).

Results

The overall incidence of all-cause long-term mortality was 133/2422 (5.5%). In the high lipoprotein(a) group, after adjusting for LDL-cholesterol concentration (LDL-C), age, sex, smoking status, diabetes mellitus and estimated glomerular filtration rate (eGFR), a high hs-CRP level was an independent predictor of all-cause long-term mortality (hazard ratio: 2.01; 95% CI: 1.13–3.54; p=0.02). In the low lipoprotein(a) group, a similar result was not found (hazard ratio: 1.42; 95% CI: 0.92–2.01; p=0.24).

Conclusions

Our data suggested that the association of hs-CRP with all-cause long-term mortality may differ from lipoprotein(a) levels among patients undergoing CAG. In addition to hs-CRP, a high lipoprotein(a) level might be a simultaneous intervention target for improving long-term prognosis in the future.

Funding Acknowledgement

Type of funding source: None