Coronary Artery Disease

Artificial intelligence applied in identifying left ventricular walls in myocardial perfusion scintigraphy images: Pilot study

This paper proposes the use of artificial intelligence techniques, specifically the nnU-Net convolutional neural network, to improve the identification of left ventricular walls in images of myocardial perfusion scintigraphy, with the objective of improving the diagnosis and treatment of coronary artery disease. The methodology included data collection in a clinical environment, followed by data preparation and analysis using the 3D Slicer Platform for manual segmentation, and subsequently, the application of artificial intelligence models for automated segmentation, focusing on the efficiency of identifying the walls of the left ventricular. A total of 83 clinical routine exams were collected, each exam containing 50 slices, which is 4,150 images. The results demonstrate the efficiency of the proposed artificial intelligence model, with a Dice coefficient of 87% and an average Intersection over Union of 0.8, reflecting high agreement with the manual segmentations produced by experts and surpassing traditional interpretation methods. The internal and external validation of the model corroborates its future applicability in real clinical scenarios, offering a new perspective in the analysis of myocardial perfusion scintigraphy images. The integration of artificial intelligence into the process of analyzing myocardial perfusion scintigraphy images represents a significant advancement in diagnostic accuracy, promoting substantial improvements in the interpretation of medical images, and establishing a foundation for future research and clinical applications, such as artifact correction.

High gestational leucine level dampens WDPCP/MAPK signaling to impair the EMT and migration of cardiac microvascular endothelial cells in congenital heart defects

Congenital heart defects (CHDs) represent one of the most prevalent categories of neonatal defects, and maternal dietary patterns have been linked to the risk of these conditions. Branched-chain amino acids (BCAAs), particularly leucine, are essential for various metabolic and physiological processes involved in heart development. In this study, we examined the molecular mechanisms through which elevated levels of leucine induce defects in cardiac microvascular endothelial cells. We collected plasma samples from healthy controls and neonatal patients with CHDs, employed a high-leucine diet for pregnant female mice, and applied high-leucine treatment in human cardiac microvascular endothelial cells (HCMECs). The impacts of high-leucine levels on WD Repeat Containing Planar Cell Polarity Effector (WDPCP)/MAPK signaling axis were investigated in the cell and animal models. We reported heightened plasma leucine levels in neonatal patients with CHDs and observed that a high-leucine diet in pregnant mice was associated with reduced expression of WDPCP and attenuated MAPK/ERK signaling. High-leucine treatment in HCMECs impaired epithelial-mesenchymal transition (EMT) and cell migration; however, overexpression of WDPCP or activation of MAPK exhibited a rescue effect. The upregulation of endomucin (EMCN) under high-leucine conditions contributed to the impaired EMT and migratory capacity of HCMECs, and the WDPCP/MAPK signaling axis regulated EMCN overexpression in response to high-leucine treatment. High levels of leucine in neonatal patients with CHDs may inhibit the WDPCP/MAPK axis, leading to an increase in EMCN expression that undermines the function of cardiac microvascular endothelial cells. These findings suggest the potential of targeting the WDPCP/MAPK axis as an intervention strategy for neonatal CHDs.

Effect of care bundles based on importance degree analysis on postoperative comorbid state, coping style and disease management ability of patients with coronary heart disease

Coronary heart disease (CHD) is a significant global health concern, particularly among the elderly. While care bundles present a comprehensive strategy for clinical disorders, their application in CHD rehabilitation remains understudied. This research addresses this gap by investigating the effectiveness of care bundles in CHD patients. By analyzing important performance degrees, we aim to contribute valuable insights to bridge existing knowledge deficiencies. Our study strives to establish a theoretical foundation for the broader implementation of care bundles, potentially improving the quality of care and patient outcomes in CHD rehabilitation. This is a retrospective study. 360 patients with CHD who were admitted to our hospital from January 2019 to October 2022 were enrolled in this retrospective study and divided into the observation group (n = 180) and control group (n = 180) according to the different care that they received. All cases were given routine nursing after CHD operation, and the observation group was given care bundles on the basis of the analysis of important performance degrees. The perioperative indexes, self-management ability score, depression, anxiety, stress scale (DASS), coping styles, medical compliance and the incidence of complications were compared between the 2 groups. Aftercare, the time of hospitalization and getting out-of-bed in the observation group was notably shorter (P < .05). Aftercare, the scores of self-management ability and related dimensions in the observation group were notably higher (P < .05). After care, the score of depression (P < .001), anxiety (P = .003) and stress (P = .017) of the observation group were notably lower. Aftercare, the observation group face score was significantly higher than the control group (P = .005), while the observation group avoidance score (P = .028) and yield score (P < .001) were significantly lower than the control group scores. Aftercare, the compliance behavior of patients in the observation group was notably better (P = .013). Aftercare, the incidence of complications in the observation group was notably lower (P = .039). Care bundles based on the degree of importance analysis can play a positive role in postoperative comorbid state, coping styles and self-management ability of patients with CHD, which can improve the rehabilitation effects on patients.

Accuracy of analytically determined fractional flow reserve derived from coronary angiography for non-invasive assessment of coronary artery stenosis

BACKGROUND

Fractional flow reserve (FFR) determined invasively has been globally accepted as the gold standard for determining the functional significance of coronary artery stenoses. However, despite its great importance, the invasive method has certain disadvantages, including the risk of vascular injuries, the need for vasodilation, and significant medical costs. That is why great attention was paid to the development of non-invasive methods that would enable reliable diagnosis without exposing patients to the risk of unwanted consequences.

OBJECTIVE

This paper aimed to create and verify an alternative, less resource- and time-demanding, non-invasive solution.

METHODS

The determination of FFR is based on the application of the fundamental laws of fluid dynamics. All energy losses in the coronary artery with stenosis were identified and analyzed in detail. A three-dimensional model of a coronary artery was generated using the corresponding angiographic images. Finally, the pressure due to stenosis was calculated and the FFR was determined.

RESULTS

The results obtained using the proposed analytical method were compared with available experimental data for 40 patients who experienced the invasive coronary angiography. The coefficient of determination, mean difference and standard deviation values are determined to be 0.726, -0.017 and 0.056, respectively. These values were slightly higher for FFR values above 0.80.

CONCLUSION

The FFR calculated by the proposed analytical method has a relatively good correlation with clinical data, which leads to the conclusion that it can provide a reliable assessment of the functional significance of coronary stenosis.

Self-efficacy instruments for individuals with coronary artery disease: a systematic review protocol

INTRODUCTION

Self-efficacy is associated with management of diseases, psychological well-being, improved quality of life and rehabilitation adherence. Several instruments related to behaviour or specific disease (eg, coronary artery disease (CAD)) assess self-efficacy. The evaluation of cardiac self-efficacy in individuals with CAD will support healthcare professionals to improve self-efficacy via interventions; therefore, a suitable instrument is crucial. This systematic review aims to assess measurement properties, methodological quality and content of outcome measures of cardiac self-efficacy instruments for individuals with CAD.

METHODS AND ANALYSIS

The study has been developed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol and Consensus Norms for Selection of Health Measuring Instruments (COSMIN). The following databases will be searched: MEDLINE (Ovid), Web of Science, EMBASE and PsycINFO. Studies assessing measurement properties of cardiac self-efficacy instruments for individuals with CAD will be included. No date or language restrictions will be applied to the search. Two independent authors will be responsible for assessing the eligibility of studies. Methodological quality of studies will be assessed using the COSMIN RoB Checklist, and the Grading of Recommendations, Assessment, Development and Assessment will be used to assess the quality of each study. Two authors will independently evaluate the content of instruments and link this to the International Classification of Functioning, Disability and Health.

ETHICS AND DISSEMINATION

This study does not require ethics committee approval since it is based on previously published data. Evidence from this systematic review will be disseminated through publication in peer-reviewed journals and presentation at scientific conferences.

PROSPERO REGISTRATION NUMBER

CRD42021262613.

Genetic Variants of MIR27A, MIR196A2 May Impact the Risk for the Onset of Coronary Artery Disease in the Pakistani Population

Genetic variants in microRNA genes have a detrimental effect on miRNA-mediated regulation of gene expression and may contribute to coronary artery disease (CAD). CAD is the primary cause of mortality worldwide. Several environmental, genetic, and epigenetic factors are responsible for CAD susceptibility. The contribution of protein-coding genes is extensively studied. However, the role of microRNA genes in CAD is at infancy. The study is aimed to investigate the impact of rs895819, rs11614913, and rs2168518 variants in MIR27A, MIR196A2, and MIR4513, respectively, in CAD using allele-specific PCR. Results: For variant rs11614913, significant distribution of the genotypes among the cases and controls was determined by co-dominant [χ² = 54.4; p value ≤ 0.0001], dominant (C/C vs. C/T + T/T) [OR = 0.257 (0.133-0.496); p value ≤ 0.0001], recessive (T/T vs. C/T + C/C) [OR = 1.56 (0.677-0.632); p value = 0.398], and additive models [OR = 0.421 (0.262-0.675); p value = 0.0004]. Similarly, a significant association of rs895819 was determined by co-dominant [χ² = 9.669; p value ≤ 0.008], dominant (A/A vs. A/G + G/G) [OR = 0.285 (0.1242-0.6575); p value ≤ 0.0034], recessive (G/G vs. A/G + A/A) [OR = 0.900 (0.3202-3.519); p value = 1.000], and additive models [OR = 0.604 (0.3640-1.002); p value = 0.05] while no significant association of rs2168518 with CAD was found. Conclusion: The variants rs895819 and rs11614913 are the susceptibility factors for CAD.

A machine learning strategy for fast prediction of cardiac function based on peripheral pulse wave

OBJECTIVE

Pulse wave has been considered as a message carrier in the cardiovascular system (CVS), capable of inferring CVS conditions while diagnosing cardiovascular diseases (CVDs). Clarification and prediction of cardiovascular function by means of powerful feature-abstraction capability of machine learning method based on pulse wave is of great clinical significance in health monitoring and CVDs diagnosis, which remains poorly studied.

METHODS

Here we propose a machine learning (ML)-based strategy aiming to achieve a fast and accurate prediction of three cardiovascular function parameters based on a 412-subject database of pulse waves. We proposed and optimized an ML-based model with multi-layered, fully connected network while building up two high-quality pulse wave datasets comprising a healthy-subject group and a CVD-subject group to predict arterial compliance (AC), total peripheral resistance (TPR), and stroke volume (SV), which are essential messengers in monitoring CVS conditions.

RESULTS

Our ML model is validated through consistency analysis of the ML-predicted three cardiovascular function parameters with clinical measurements and is proven through error analysis to have capability of achieving a high-accurate prediction on TPR and SV for both healthy-subject group (accuracy: 85.3%, 86.9%) and CVD-subject group (accuracy: 88.3%, 89.2%).

DISCUSSION

The independent sample t-test proved that our subject groups could represent the typical physiological characteristics of the corresponding population. While we have more subjects in our datasets rather than previous studies after strict data screening, the proposed ML-based strategy needs to be further improved to achieve a disease-specific prediction of heart failure and other CVDs through training with larger datasets and clinical measurements.

CONCLUSION

Our study points to the feasibility and potential of the pulse wave-based prediction of physiological and pathological CVS conditions in clinical application.

Serum Levels of Growth Differentiation Factor-15 as an Inflammatory Marker in Patients with Unstable Angina Pectoris

Background: Growth differentiation factor-15 (GDF-15), a member of transforming growth factors, is a stress-responsive marker whose levels may significantly increase in response to pathological stresses associated with inflammatory tissue injuries such as unstable angina pectoris (USAP). This study evaluated the diagnostic value of GDF-15 in patients with USAP.

Methods: The present cross-sectional study recruited 39 patients with USAP criteria and 30 patients with stable angina pectoris (SAP), referred to Shahid Beheshti Hospital, Kashan, Iran. All the patients with USAP had at least 1 coronary artery stenosis (>50%) in angiography. The control group comprised 42 healthy individuals. The serum levels of GDF-15 were measured in all the participants by ELISA. Also analyzed were the relationship between GDF-15 levels and thrombolysis in myocardial infarction (TIMI) and the Global Registry of Acute Coronary Events (GRACE) risk scores in the patients with USAP to determine the severity of the disease.

Result: The study population consisted of 111 subjects, 62 women and 49 men, divided into 3 groups of USAP (n=39, mean age=60.07±14.10 y), SAP (n=30, mean age=67.56±9.88 y), and control (n=42, mean age=61.21±7.76 y). The mean serum level of GDF-15 in the USAP group was significantly different from the other 2 groups (P<0.001), while no significant difference was observed in this regard between the SAP and control groups (P=0.797). No correlation was found between the mean GDF-15 serum level and the GRACE (P=0.816) and TIMI (P=0.359) risk scores in the USAP group.

Conclusion: The mean serum level of GDF-15 exhibited a rise in our patients with USAP. GDF-15 may be a diagnostic biomarker of USAP and its severity.

Long non-coding RNA THRIL is upregulated in coronary heart disease and binds to microRNA-424 to upregulate TXNIP in mice

Cardiovascular disease, particularly coronary heart disease (CHD), is one of the diseases with the highest fatality. The close correlation between long non-coding RNAs (lncRNAs) and the occurrence and development of myocardial injury has been highlighted recently. This article mainly focused on the regulation of THRIL on myocardial injury caused by CHD in mice. After establishment of a mouse model with CHD, a lncRNA microarray analysis was performed on mouse myocardial tissues to detect differentially expressed lncRNAs, followed by RT-qPCR validation. CHD was induced in mice by high-fat diet feeding and THRIL was silenced using si-THRIL. The results showed that treating CHD mice with si-THRIL attenuated myocardial damage by restoring LVEF, LVFS, and HDL-C levels, while lowering HMI, LVMI, TC, TG, LDL-C, CK-MB, and cTnI levels. Meanwhile, mechanistical studies using bioinformatics prediction, dual-luciferase and subcellular fractionation assays revealed that THRIL bound to microRNA (miR)-424, inhibited miR-424 interaction with TXNIP and promoted TXNIP expression in the myocardial tissues. The cardioprotective effects of si-THRIL on mice were attenuated when miR-424 was downregulated. Moreover, TXNIP exerted its effects on myocardial injury by mediating the p53 pathway. Taken together, this study demonstrated that THRIL inhibition alleviates myocardial injury in CHD possibly through the miR-424/TXNIP/p53 axis.

Long noncoding RNA metastasis-associated lung adenocarcinoma transcript 1 correlates with microRNA-125b/microRNA-146a/microRNA-203 and predicts 2-year restenosis risk in coronary heart disease patients

Aim: To investigate correlations of long noncoding RNA metastasis-associated lung adenocarcinoma transcript 1 (lnc-MALAT1) and its target microRNAs with clinical features and restenosis risk in coronary heart disease (CHD) patients post drug-eluting stent-percutaneous coronary intervention (DES-PCI). Materials & methods: A total of 274 CHD patients undergoing DES-PCI were enrolled, pre-operative plasma samples were obtained to detect lnc-MALAT1, miR-125b, miR-146a, miR-203 by RT-qPCR; 2-year restenosis was determined by quantitative coronary angiography. Results: Lnc-MALAT1 negatively correlated with miR-125b, miR-146a and miR-203. Furthermore, lnc-MALAT1, miR-125b, miR-146a and miR-203 correlated with diabetes mellitus, hyperuricemia, lesion properties, cholesterol, inflammation and cardiac function indexes. Additionally, lnc-MALAT1 was increased, while miR-125b and miR-146a were decreased in patients with 2-year restenosis than patients without 2-year restenosis; however, miR-203 did not differ. Conclusion: Lnc-MALAT1 and its target miRNAs might help manage restenosis risk in CHD patients post DES-PCI.

Decision tree-based diagnosis of coronary artery disease: CART model

BACKGROUND AND OBJECTIVE

As the most common cardiovascular defect, coronary artery disease (CAD), also called ischemic heart disease, is one of the substantial causes of death globally. Several diagnosis approaches such as baseline electrocardiography, echocardiography, magnetic resonance imaging, and coronary angiography are suggested for screening the suspected patients that may suffer from CAD. However, applying such methods may have health side effects and/or expensive costs.

METHODS

As an alternative to the available diagnosis tools/methods, this research involves a decision tree learning algorithm called classification and regression tree (CART) for a simple and reliable diagnosis of CAD. Several CART models are developed based on the recently CAD dataset published in the literature.

RESULTS

Utilizing all the features of the dataset (55 independent parameters), it was found that only 40 independent parameters influence the CAD diagnosis and consequently development of the predictive model. Based on the feature importance obtained from the first CART model, three new CART models are then developed using 18, 10, and 5 selected features. Except for the five-feature CART model, the outcomes of developed CART models demonstrate the maximum achievable accuracy, sensitivity, and specificity for CAD diagnosis (100%), while comparing the predictions with the reported targets. The error analysis reveals that the literature models including sequential minimal optimization (SMO), bagging SMO, Naïve Bayes (NB), artificial neural network (ANN), C4.5, J48, Bagging, and ANN in conjunction with the genetic algorithm (GA) do not outperform the CART methodology in classifying patients as normal or CAD.

CONCLUSIONS

Hence, the robustness of the tree-based algorithm in accurate and fast predictions is confirmed, implying the proposed classification technique can be successfully utilized to develop a coherent decision-making system for the CAD diagnosis.

Up-regulation of long non-coding RNA THRIL in coronary heart disease: Prediction for disease risk, correlation with inflammation, coronary artery stenosis, and major adverse cardiovascular events

Objective

This study aimed to investigate the role of long non‐coding RNA (lncRNA) THRIL in coronary heart disease (CHD) patients.

Methods

A total of 420 patients who underwent coronary arteriography due to suspected symptoms of CHD were enrolled, in which 220 were diagnosed as CHD and 200 were set as control subjects. LncRNA THRIL in plasma samples of CHD patients and control subjects was detected by reverse transcription‐quantitative polymerase chain reaction. Gensini score and biochemical indexes were evaluated in CHD patients and control subjects. Plasma inflammatory cytokines were detected, and major adverse cardiovascular events (MACE) were recorded in CHD patients.

Results

Both before and after adjustment by age/gender, lncRNA THRIL was increased in CHD patients compared with control subjects (both P < .001), and it well predicted enhanced CHD risk by receiver operating characteristic curves. For coronary artery stenosis, it was positively correlated with Gensini score (P < .001, r = .430). For clinical characteristics, lncRNA THRIL was positively correlated with diabetes mellitus occurrence (P < .001) and fasting blood glucose (FBG) level (P = .029, r = .147). For inflammation, it was positively associated with CRP (P < .001, r = .374), TNF‐α (P < .001, r = .249), IL‐1β (P = .001, r = .222), IL‐8 (P < .001, r = .254), and IL‐17 (P = .011, r = .172), while negatively correlated with IL‐10 (P < .001, r = −.244). For prognosis, lncRNA THRIL was positively associated with MACE accumulating rate (P = .037) in CHD patients.

Conclusion

Long non‐coding RNA THRIL was increased in CHD patients and well predicted elevated CHD risk. Moreover, it was correlated with enhanced coronary stenosis, systematic inflammation, FBG level, and MACE risk in CHD patients.

miR-146a and miR-146b predict increased restenosis and rapid angiographic stenotic progression risk in coronary heart disease patients who underwent percutaneous coronary intervention

OBJECTIVE

This study aimed to investigate the potential of microRNA (miR)-146a and miR-146b for predicting restenosis and rapid angiographic stenotic progression (RASP) risk in coronary heart disease (CHD) patients who underwent percutaneous coronary intervention (PCI) with drug-eluting stent (DES) implantation.

METHODS

In total, 255 CHD patients who underwent PCI with DES were enrolled, and their baseline, procedural, and post procedure characteristics were recorded. Plasma samples were obtained before PCI treatment to detect the miR-146a and miR-146b expression by reverse transcription quantitative polymerase chain reaction. Besides, restenosis and RASP occurrences were assessed based on coronary angiograms at 12 months after the surgery.

RESULTS

The occurrence rates of restenosis and RASP were 9.0% and 32.9% respectively in CHD patients who underwent PCI with DES. Furthermore, miR-146a and miR-146b expressions were elevated in CHD patients with restenosis compared with CHD patients without restenosis. Subsequent receiver operating characteristic (ROC) curve analysis showed that miR-146a (area under the curve (AUC), 0.674; 95% CI, 0.567-0.781) and miR-146b (AUC, 0.801; 95% CI, 0.729-0.875) could predict increased restenosis risk, among which miR-146b numerically exhibited a better predictive value for higher restenosis risk. Besides, miR-146a and miR-146b expressions were raised in CHD patients with RASP compared with CHD patients without RASP. Followed ROC curve analysis illuminated that miR-146a (AUC, 0.772; 95% CI, 0.714-0.829) and miR-146b (AUC, 0.706; 95% CI, 0.644-0.769) presented similar values in predicting elevated RASP risk.

CONCLUSION

miR-146a and miR-146b predict increased restenosis and RASP risk in CHD patients who underwent PCI with DES.

Clinical impact of low-radiation computed tomography coronary angiography diagnosis for coronary artery stenosis: Study Protocol

BACKGROUND

The objective of this study aims to assess the clinic impact of low-radiation computed tomography coronary angiography (LR-CTCA) diagnosis for coronary artery stenosis (CAS).

METHODS

This study will comprehensively search the following electronic databases from inception to the present: PUBMED, EMBASE, Cochrane Library, PsycINFO, Web of Science, Google, Allied and Complementary Medicine Database, Chinese Biomedical Literature Database, VIP database, WANGFANG, and China National Knowledge Infrastructure. All these electronic databases will be searched without language restrictions. All case-controlled studies on assessing the clinical impact of LR-CTCA diagnosis for patients with CAS will be included. Quality Assessment of Diagnostic Accuracy Studies tool will be utilized to evaluate the methodological quality for each qualified studies.

RESULTS

We will assess the clinic impact of LR-CTCA diagnosis for CAS by measuring sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio.

CONCLUSION

The results of this study will summarize the latest evidence of LR-CTCA diagnosis for CAS.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42019139336.

The association between CD31hiEmcnhi endothelial cells and bone mineral density in Chinese women

Osteoporosis is the most common bone disease in humans. During bone remodeling, specialized blood vessels influenced by the endothelial cells (CD31^hiEmcn^hi, also called type H cells) are formatted to supply nutrients. Reductions in vascular supply are associated with bone loss resulting in osteoporosis. Therefore, the objective of the present study was to explore the association between the CD31^hiEmcn^hi endothelial cells and bone mineral density (BMD). In this prospective study, 134 Chinese women were enrolled and examined. BMD was measured by DEXA method while the percentage of CD31^hiEmcn^hi endothelial cells in the intertrochanteric part was measured by flow cytometry. The percentage of CD31^hiEmcn^hi endothelial cells in postmenopausal subjects was significantly lower compared with premenopausal women (8.7 ± 4.0% vs 13.2 ± 5.6%, P < 0.01). Meanwhile, the CD31^hiEmcn^hi endothelial cell levels in osteopenia and osteoporosis were significantly lower compared with subjects with normal BMD (9.84 ± 4.2% in osteopenia and 7.11 ± 3.2% in osteoporosis vs 12.7 ± 5.6% in subjects with normal T score, P < 0.01). Multiple regression analyses showed that the CD31^hiEmcn^hi endothelial cells level was positively associated with femur neck and total hip BMD, but not with lumbar BMD. Our study suggests a significantly positive association between CD31^hiEmcn^hi endothelial cells and local BMD in Chinese women. The proportion of CD31^hiEmcn^hi endothelial cells is a marker of bone quality and represents a potential target for treatment of bone loss.

PPARA, PPARD and PPARG gene polymorphisms in patients with unstable angina

BACKGROUND

Peroxisome proliferator-activated receptors (PPARs) include the nuclear receptor superfamily of ligand-activated transcription factors involved in several metabolic processes, including carbohydrate and lipid metabolism.

MATERIAL AND METHODS

In this study we examined PPARA: rs4253778, rs1800206, PPARD: rs2267668, rs2016520, rs1053049, PPARG rs1801282 and PPARGC1A rs8192678 polymorphisms in patients with unstable angina. This study included 246 patients with unstable angina confirmed by coronary angiography (defined by >70% stenosis in at least one major coronary artery) and 189 healthy controls.

RESULTS

We observed statistically significant difference in distribution of PPARG rs1801282 genotypes and alleles between patients and control group. Among patients there was the increased frequency of CG and GG genotypes and G alleles. The association between PPARG rs1801282 G allele and unstable angina was confirmed in multivariate regression analysis. There were no statistically significant differences in the distributions of other studied polymorphisms between patients with unstable angina and the control group.

CONCLUSIONS

The results of our study suggest the association between PPARG rs1801282 G allele and unstable angina in Polish population.

Triglyceride-glucose index is associated with symptomatic coronary artery disease in patients in secondary care

BACKGROUND

The triglyceride-glucose index (TyG index) is a tool for insulin resistance evaluation, however, little is known about its association with coronary artery disease (CAD), which is the major cardiovascular death cause, and what factors may be associated with TyG index.

OBJECTIVE

To evaluate the association between the TyG index and the prevalence of CAD phases, as well as cardiovascular risk factors.

METHODS

The baseline data of patients in secondary care in cardiology from Brazilian Cardioprotective Nutritional Program Trial (BALANCE Program Trial) were analyzed. Anthropometric, clinical, socio-demographic and food consumption data were collected by trained professionals. The TyG index was calculated by the formula: Ln (fasting triglycerides (mg/dl) × fasting blood glucose (mg/dl)/2) and regression models were used to evaluate the associations.

RESULTS

We evaluated 2330 patients, which the majority was male (58.1%) and elderly (62.1%). The prevalence of symptomatic CAD was 1.16 times higher in patients classified in the last tertile of the TyG index (9.9 ± 0.5) compared to those in the first tertile (8.3 ± 0.3). Cardiometabolic risk factors were associated with TyG index, with the highlight for higher carbohydrate and lower lipid consumption in relation to recommendations that reduced the chance of being in the last TyG index tertile.

CONCLUSION

The TyG index was positively associated with a higher prevalence of symptomatic CAD, with metabolic and behavioral risk factors, and could be used as a marker for atherosclerosis. Trial registration ClinicalTrials.gov identifier: NCT01620398. Registered 15 June, 2012.

Nanotechnology, an alternative with promising prospects and advantages for the treatment of cardiovascular diseases

Cardiovascular diseases (CVDs) are one of the most important causes of mortality and affecting the health status of patients. At the same time, CVDs cause a huge health and economic burden to the whole world. Although a variety of therapeutic drugs and measures have been produced to delay the progress of the disease and improve the quality of life of patients, most of the traditional therapeutic strategies can only cure the symptoms and cannot repair or regenerate the damaged ischemic myocardium. In addition, they may bring some unpleasant side effects. Therefore, it is vital to find and explore new technologies and drugs to solve the shortcomings of conventional treatments. Nanotechnology is a new way of using and manipulating the matter at the molecular scale, whose functional organization is measured in nanometers. Because nanoscale phenomena play an important role in cell signal transduction, enzyme action and cell cycle, nanotechnology is closely related to medical research. The application of nanotechnology in the field of medicine provides an alternative and novel direction for the treatment of CVDs, and shows excellent performance in the field of targeted drug therapy and the development of biomaterials. This review will briefly introduce the latest applications of nanotechnology in the diagnosis and treatment of common CVDs.

Recent Advances in the Development of Vaccines for Diabetes, Hypertension, and Atherosclerosis

Vaccines are commonly used in the prevention of infectious diseases. The basic principle of vaccination is to use specific antigens, endogenous or exogenous to stimulate immunity against the specific antigens or cells producing them. Autoantigen or oligo vaccination has been used for disease animal models. More recently humanized monoclonal antibodies have been successfully used for the treatment of neoplastic disorders or familial hypercholesterolemia. Humanized monoclonal antibody therapy needs repeated injection, and the therapy is expensive. Therapeutic vaccination can lead to persistent immunized or immune tolerant against the therapeutic molecule(s) or site. However, immunization against those endogenous substances may also elicit persistent autoimmune reaction or destruction that do harm to health. Therefore, rigorous studies are needed before any clinical application. In this review, we briefly reviewed vaccines used in protection against common metabolic diseases including atherosclerosis, hypertension, and diabetes mellitus.

Anticoagulation in Patients with Ischaemic Heart Disease and Peripheral Arterial Disease: Clinical Implications of COMPASS Study

Patients with established cardiovascular disease may suffer further cardiovascular events, despite receiving optimal medical treatment. Although platelet inhibition plays a central role in the prevention of new events, the use of anticoagulant therapies to reduce events in atheromatous disease has, until recently, been overlooked. The recent Rivaroxaban for the Prevention of Major Cardiovascular Events in Coronary or Peripheral Artery Disease (COMPASS) study showed an important reduction in cardiovascular events without increasing the risk of fatal and intracranial bleeding when using rivaroxaban, a novel oral anticoagulant, combined with aspirin. This article reviews the available evidence regarding the use of anticoagulant therapies for prevention of cardiovascular events, the results of the COMPASS study and how these results may affect patient management in everyday clinical practice.