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Liu X, Dong M, Li T, Wang J. Correlation of circulating fibroblast growth factor 21 levels with inflammatory factors and the degree of coronary artery stenosis in patients with acute myocardial infarction. Cytokine 2024; 178:156591. [PMID: 38554500 DOI: 10.1016/j.cyto.2024.156591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 03/23/2024] [Accepted: 03/26/2024] [Indexed: 04/01/2024]
Abstract
BACKGROUND Fibroblast growth factor 21 (FGF21) is a secreted protein that plays an important role in atherosclerosis and pathological cardiac remodeling. However, the correlation between FGF21 and the degree of coronary artery stenosis and its potential role in acute myocardial infarction (AMI) remain unclear. We examined whether changes in FGF21 levels in AMI correlate with the degree of coronary artery stenosis and the levels of inflammatory factors, and preliminarily investigated the effects of FGF21 on inflammatory factor levels and myocardial injury in rats with AMI. METHODS Serum levels of FGF21 and inflammatory factors in the AMI group and control group were measured, and the correlation between FGF21 and clinical indicators and inflammatory factors was analyzed. The effects of FGF21 on cardiac function and inflammatory response were evaluated through echocardiography and measurement of inflammatory factors. RESULTS Multivariate logistic regression analysis showed that neutrophil percentage (NEUT%, odds ratio [OR]: 1.232; 95 % confidence interval [CI]: 1.028-1.477; p = 0.024) and FGF21 levels (OR: 2.063; 95 % CI: 1.187-3.586; p = 0.01) had independent effects on AMI. Spearman's rank correlation test showed that FGF21 levels were positively correlated with leukocyte count, NEUT%, neutrophil count, neutrophil to lymphocyte ratio, C-reactive protein, interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), monocyte chemotactic protein-1 (MCP-1) and Gensini scores (p < 0.01), but negatively correlated with lymphocyte count (p < 0.01). FGF21 levels in myocardial tissues and serum levels of FGF21, IL-6, TNF-a, and MCP-1 were significantly higher in AMI rats than in the sham-operated group (p < 0.01). After overexpression of FGF21, serum levels of IL-6, TNF-a, and MCP-1 in rats were significantly decreased (p < 0.01), and cardiac function improved significantly. CONCLUSIONS FGF21 levels were independently associated with AMI and may be related to the severity of coronary artery stenosis. Overexpression of FGF21 reduced serum inflammatory factor levels and improved cardiac function in AMI rats.
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Affiliation(s)
- Xu Liu
- Department of Cardiology, Second Hospital of Jilin University, No. 218 Ziqiang Street, Changchun 130041, China
| | - Mengying Dong
- Departments of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210000, China
| | - Tianyi Li
- Department of Cardiology, Second Hospital of Jilin University, No. 218 Ziqiang Street, Changchun 130041, China
| | - Junnan Wang
- Department of Cardiology, Second Hospital of Jilin University, No. 218 Ziqiang Street, Changchun 130041, China.
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Shahsanaei F, Abbaszadeh S, Behrooj S, Rahimi Petrudi N, Ramezani B. The value of neutrophil-to-lymphocyte ratio in predicting severity of coronary involvement and long-term outcome of percutaneous coronary intervention in patients with acute coronary syndrome: a systematic review and meta-analysis. Egypt Heart J 2024; 76:39. [PMID: 38546902 PMCID: PMC10978563 DOI: 10.1186/s43044-024-00469-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 03/19/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND The value of counting inflammatory cells and especially their counting ratio in predicting adverse clinical outcomes in patients with acute coronary syndrome (ACS) undergoing revascularization has been shown, but the results of studies have been very diverse and paradoxical. The aim of the current study was to systematically review the studies that investigated the role of increased neutrophil-to-lymphocyte ratio (NLR) in predicting long-term clinical outcomes in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). METHODS Data abstraction was independently performed by both un-blinded reviewers on deeply assessing Medline, Web of Knowledge, Google Scholar, Scopus, and Cochrane Central Register of Controlled Trials and using the relevant keywords. The risk of bias for each study was assessed using the criteria outlined in the Cochrane Handbook for Systematic Reviews of Interventions and the QUADAS-2 tool. Statistical analysis was performed using the Stata software. Overall, 14 articles published between 2010 and 2021 were eligible for the final analysis. RESULTS A total of 20,846 ACS patients undergoing PCI were included. Higher values of NLR were associated with higher numbers of involved coronaries (RR: 1.175, 95%CI 1.021-1.353, P = 0.024). Increasing the value of NLR was associated with a 3.4 times increase in long-term death (RR: 3.424, 95%CI 2.325-5.025, P = 0.001). Similarly, higher values of NLR were significantly associated with a higher likelihood of long-term MACE (RR: 2.604, 95%CI 1.736-3.906, P = 0.001). CONCLUSIONS NLR has a high value in predicting both the severity of coronary artery involvement and long-term adverse clinical outcomes following the PCI procedure.
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Affiliation(s)
- Farzad Shahsanaei
- Cardiovascular Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Shahin Abbaszadeh
- Cardiovascular Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Soudabeh Behrooj
- Cardiovascular Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Nima Rahimi Petrudi
- Cardiovascular Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Bahareh Ramezani
- Cardiovascular Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
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Wang J, Hu Z, Xu Q, Shi Y, Cao X, Ma Y, Wang M, Zhang C, Luo X, Lin F, Li X, Duan Y, Cai H. Gut microbiome-based noninvasive diagnostic model to predict acute coronary syndromes. Front Cell Infect Microbiol 2024; 13:1305375. [PMID: 38298920 PMCID: PMC10829574 DOI: 10.3389/fcimb.2023.1305375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 12/26/2023] [Indexed: 02/02/2024] Open
Abstract
Background Previous studies have shown that alterations in the gut microbiota are closely associated with Acute Coronary Syndrome (ACS) development. However, the value of gut microbiota for early diagnosis of ACS remains understudied. Methods We recruited 66 volunteers, including 29 patients with a first diagnosis of ACS and 37 healthy volunteers during the same period, collected their fecal samples, and sequenced the V4 region of the 16S rRNA gene. Functional prediction of the microbiota was performed using PICRUSt2. Subsequently, we constructed a nomogram and corresponding webpage based on microbial markers to assist in the diagnosis of ACS. The diagnostic performance and usefulness of the model were analyzed using boostrap internal validation, calibration curves, and decision curve analysis (DCA). Results Compared to that of healthy controls, the diversity and composition of microbial community of patients with ACS was markedly abnormal. Potentially pathogenic genera such as Streptococcus and Acinetobacter were significantly increased in the ACS group, whereas certain SCFA-producing genera such as Blautia and Agathobacter were depleted. In addition, in the correlation analysis with clinical indicators, the microbiota was observed to be associated with the level of inflammation and severity of coronary atherosclerosis. Finally, a diagnostic model for ACS based on gut microbiota and clinical variables was developed with an area under the receiver operating characteristic (ROC) curve (AUC) of 0.963 (95% CI: 0.925-1) and an AUC value of 0.948 (95% CI: 0.549-0.641) for bootstrap internal validation. The calibration curves of the model show good consistency between the actual and predicted probabilities. The DCA showed that the model had a high net clinical benefit for clinical applications. Conclusion Our study is the first to characterize the composition and function of the gut microbiota in patients with ACS and healthy populations in Southwest China and demonstrates the potential effect of the microbiota as a non-invasive marker for the early diagnosis of ACS.
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Affiliation(s)
- Jincheng Wang
- Department of Cardiology, the First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Zhao Hu
- Department of Geriatric Cardiology, the First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Qiuyue Xu
- Department of Clinical Laboratory, The First Affiliated Hospital of Kunming Medical University, Yunnan Key Laboratory of Laboratory Medicine, Yunnan Province Clinical Research Center for Laboratory Medicine, Kunming, China
| | - Yunke Shi
- Department of Cardiology, the First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Xingyu Cao
- Department of Cardiology, the First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Yiming Ma
- Department of Cardiology, the First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Mingqiang Wang
- Department of Cardiology, the First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Chaoyue Zhang
- Department of Cardiology, the First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Xiang Luo
- Department of Cardiology, the First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Fanru Lin
- Department of Cardiology, the First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Xianbin Li
- Department of Cardiology, the First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Yong Duan
- Department of Clinical Laboratory, The First Affiliated Hospital of Kunming Medical University, Yunnan Key Laboratory of Laboratory Medicine, Yunnan Province Clinical Research Center for Laboratory Medicine, Kunming, China
| | - Hongyan Cai
- Department of Cardiology, the First Affiliated Hospital of Kunming Medical University, Kunming, China
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Meo L, Savarese M, Munno C, Mirabelli P, Ragno P, Leone O, Alfieri M. Circulating Biomarkers for Monitoring Chemotherapy-Induced Cardiotoxicity in Children. Pharmaceutics 2023; 15:2712. [PMID: 38140053 PMCID: PMC10747387 DOI: 10.3390/pharmaceutics15122712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 11/24/2023] [Accepted: 11/29/2023] [Indexed: 12/24/2023] Open
Abstract
Most commonly diagnosed cancer pathologies in the pediatric population comprise leukemias and cancers of the nervous system. The percentage of cancer survivors increased from approximatively 50% to 80% thanks to improvements in medical treatments and the introduction of new chemotherapies. However, as a consequence, heart disease has become the main cause of death in the children due to the cardiotoxicity induced by chemotherapy treatments. The use of different cardiovascular biomarkers, complementing data obtained from electrocardiogram, echocardiography cardiac imaging, and evaluation of clinical symptoms, is considered a routine in clinical diagnosis, prognosis, risk stratification, and differential diagnosis. Cardiac troponin and natriuretic peptides are the best-validated biomarkers broadly accepted in clinical practice for the diagnosis of acute coronary syndrome and heart failure, although many other biomarkers are used and several potential markers are currently under study and possibly will play a more prominent role in the future. Several studies have shown how the measurement of cardiac troponin (cTn) can be used for the early detection of heart damage in oncological patients treated with potentially cardiotoxic chemotherapeutic drugs. The advent of high sensitive methods (hs-cTnI or hs-cTnT) further improved the effectiveness of risk stratification and monitoring during treatment cycles.
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Affiliation(s)
- Luigia Meo
- Department of Chemistry and Biology, University of Salerno, Via Giovanni Paolo II, 132, 84084 Salerno, Italy; (L.M.); (P.R.)
| | - Maria Savarese
- Clinical Pathology, Santobono-Pausilipon Children’s Hospital, 80123 Naples, Italy; (M.S.); (C.M.); (O.L.)
| | - Carmen Munno
- Clinical Pathology, Santobono-Pausilipon Children’s Hospital, 80123 Naples, Italy; (M.S.); (C.M.); (O.L.)
| | - Peppino Mirabelli
- Clinical and Translational Research Unit, Santobono-Pausilipon Children’s Hospital, 80123 Naples, Italy;
| | - Pia Ragno
- Department of Chemistry and Biology, University of Salerno, Via Giovanni Paolo II, 132, 84084 Salerno, Italy; (L.M.); (P.R.)
| | - Ornella Leone
- Clinical Pathology, Santobono-Pausilipon Children’s Hospital, 80123 Naples, Italy; (M.S.); (C.M.); (O.L.)
| | - Mariaevelina Alfieri
- Clinical Pathology, Santobono-Pausilipon Children’s Hospital, 80123 Naples, Italy; (M.S.); (C.M.); (O.L.)
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Shoaib A, Salim N, Shahid AR, Amir MA, Shiraz MI, Ayaz A, Khan BS, Ansari SA, Suheb MK, Merza N, Shahid I. Effectiveness of Emergency versus Nonemergent Coronary Angiography After Out-of-Hospital Cardiac Arrest without ST-Segment Elevation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Am J Cardiol 2023; 205:379-386. [PMID: 37657411 DOI: 10.1016/j.amjcard.2023.07.163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 07/23/2023] [Accepted: 07/30/2023] [Indexed: 09/03/2023]
Abstract
The optimal timing of coronary angiography (CAG) in patients after out-of-hospital cardiac arrest (OHCA) without ST-segment elevation remains controversial. Therefore, we conducted a meta-analysis of randomized control trials to investigate the effectiveness of emergency CAG versus delayed CAG in OHCA patients with a non-ST-segment elevated rhythm. PubMed, Scopus, CINAHL, Cochrane CENTRAL, and JBI databases were searched from inception to September 7, 2022. Our primary end point was survival with a good neurological outcome, whereas the secondary outcomes included short-term survival, mid-term survival, recurrent arrhythmias, myocardial infarction after hospitalization, major bleeding, acute kidney injury, and left ventricular ejection fraction. Nine randomized control trials involving 2,569 patients were included in this analysis. Our meta-analysis showed no significant difference in the improvement of neurological outcome (RR 0.96, 95% Confidence Interval [CI] [0.87, 1.06]), short-term survival (risk ratio [RR] 0.98, 95% CI [0.89, 1.08]), mid-term survival (RR 0.98, 95% CI [0.87, 1.10]), recurrent arrhythmias (RR 1.02, 95% CI [0.50, 2.06]), myocardial infarction (RR 0.66, 95% CI [0.13, 3.30]), major bleeding (RR 0.96, 95% CI [0.55, 1.69]), acute kidney injury (RR 1.20, 95% CI [0.32, 4.49]) and left ventricular ejection fraction (RR 0.89, 95% CI [0.69, 1.15]) in patients who underwent emergency CAG compared with delayed CAG patients. In conclusion, our analysis revealed that emergency CAG had no prognostic superiority over delayed CAG in patients with OHCA without ST-segment elevation.
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Affiliation(s)
- Aqsa Shoaib
- Department of Medicine, Karachi Medical and Dental College, Karachi, Sindh, Pakistan
| | - Najwa Salim
- Department of Medicine, Karachi Medical and Dental College, Karachi, Sindh, Pakistan
| | - Abdul Rehman Shahid
- Department of Medicine, Dow International Medical College, Dow University of Health Sciences, Karachi, Sindh, Pakistan
| | - Muhammad Ali Amir
- Department of Medicine, Dow International Medical College, Dow University of Health Sciences, Karachi, Sindh, Pakistan
| | - Moeez Ibrahim Shiraz
- Department of Medicine, Dow International Medical College, Dow University of Health Sciences, Karachi, Sindh, Pakistan
| | - Aliza Ayaz
- Department of Medicine, Karachi Medical and Dental College, Karachi, Sindh, Pakistan
| | - Bilal Shahid Khan
- Department of Medicine, Dow International Medical College, Dow University of Health Sciences, Karachi, Sindh, Pakistan
| | - Saad Ali Ansari
- Department of Internal Medicine, University of California Riverside School of Medicine, Riverside
| | - Mahammed Khan Suheb
- Department of Medicine, Aurora St Luke's Medical Center, Milwaukee, Wisconsin
| | | | - Izza Shahid
- Division of Preventive Cardiology, Department of Cardiology, Houston Methodist Academic Institute, Houston, Texas.
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Katsioupa M, Kourampi I, Oikonomou E, Tsigkou V, Theofilis P, Charalambous G, Marinos G, Gialamas I, Zisimos K, Anastasiou A, Katsianos E, Kalogeras K, Katsarou O, Vavuranakis M, Siasos G, Tousoulis D. Novel Biomarkers and Their Role in the Diagnosis and Prognosis of Acute Coronary Syndrome. Life (Basel) 2023; 13:1992. [PMID: 37895374 PMCID: PMC10608753 DOI: 10.3390/life13101992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 09/23/2023] [Accepted: 09/28/2023] [Indexed: 10/29/2023] Open
Abstract
The burden of cardiovascular diseases and the critical role of acute coronary syndrome (ACS) in their progression underscore the need for effective diagnostic and prognostic tools. Biomarkers have emerged as crucial instruments for ACS diagnosis, risk stratification, and prognosis assessment. Among these, high-sensitivity troponin (hs-cTn) has revolutionized ACS diagnosis due to its superior sensitivity and negative predictive value. However, challenges regarding specificity, standardization, and interpretation persist. Beyond troponins, various biomarkers reflecting myocardial injury, neurohormonal activation, inflammation, thrombosis, and other pathways are being explored to refine ACS management. This review article comprehensively explores the landscape of clinically used biomarkers intricately involved in the pathophysiology, diagnosis, and prognosis of ACS (i.e., troponins, creatine kinase MB (CK-MB), B-type natriuretic peptides (BNP), copeptin, C-reactive protein (CRP), interleukin-6 (IL-6), d-dimers, fibrinogen), especially focusing on the prognostic role of natriuretic peptides and of inflammatory indices. Research data on novel biomarkers (i.e., endocan, galectin, soluble suppression of tumorigenicity (sST2), microRNAs (miRNAs), soluble oxidized low-density lipoprotein receptor-1 (sLOX-1), F2 isoprostanes, and growth differentiation factor 15 (GDF-15)) are further analyzed, aiming to shed light on the multiplicity of pathophysiologic mechanisms implicated in the evolution of ACS. By elucidating the complex interplay of these biomarkers in ACS pathophysiology, diagnosis, and outcomes, this review aims to enhance our understanding of the evolving trajectory and advancements in ACS management. However, further research is necessary to establish the clinical utility and integration of these biomarkers into routine practice to improve patient outcomes.
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Affiliation(s)
- Maria Katsioupa
- 3rd Department of Cardiology, Thoracic Diseases General Hospital “Sotiria”, National and Kapodistrian University of Athens, 11527 Athens, Greece; (M.K.); (I.K.); (E.O.); (V.T.); (I.G.); (K.Z.); (A.A.); (E.K.); (K.K.); (O.K.); (M.V.)
| | - Islam Kourampi
- 3rd Department of Cardiology, Thoracic Diseases General Hospital “Sotiria”, National and Kapodistrian University of Athens, 11527 Athens, Greece; (M.K.); (I.K.); (E.O.); (V.T.); (I.G.); (K.Z.); (A.A.); (E.K.); (K.K.); (O.K.); (M.V.)
| | - Evangelos Oikonomou
- 3rd Department of Cardiology, Thoracic Diseases General Hospital “Sotiria”, National and Kapodistrian University of Athens, 11527 Athens, Greece; (M.K.); (I.K.); (E.O.); (V.T.); (I.G.); (K.Z.); (A.A.); (E.K.); (K.K.); (O.K.); (M.V.)
| | - Vasiliki Tsigkou
- 3rd Department of Cardiology, Thoracic Diseases General Hospital “Sotiria”, National and Kapodistrian University of Athens, 11527 Athens, Greece; (M.K.); (I.K.); (E.O.); (V.T.); (I.G.); (K.Z.); (A.A.); (E.K.); (K.K.); (O.K.); (M.V.)
| | - Panagiotis Theofilis
- 1st Department of Cardiology, “Hippokration” General Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece; (P.T.); (D.T.)
| | - Georgios Charalambous
- Department of Emergency Medicine, “Hippokration” General Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - George Marinos
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - Ioannis Gialamas
- 3rd Department of Cardiology, Thoracic Diseases General Hospital “Sotiria”, National and Kapodistrian University of Athens, 11527 Athens, Greece; (M.K.); (I.K.); (E.O.); (V.T.); (I.G.); (K.Z.); (A.A.); (E.K.); (K.K.); (O.K.); (M.V.)
| | - Konstantinos Zisimos
- 3rd Department of Cardiology, Thoracic Diseases General Hospital “Sotiria”, National and Kapodistrian University of Athens, 11527 Athens, Greece; (M.K.); (I.K.); (E.O.); (V.T.); (I.G.); (K.Z.); (A.A.); (E.K.); (K.K.); (O.K.); (M.V.)
| | - Artemis Anastasiou
- 3rd Department of Cardiology, Thoracic Diseases General Hospital “Sotiria”, National and Kapodistrian University of Athens, 11527 Athens, Greece; (M.K.); (I.K.); (E.O.); (V.T.); (I.G.); (K.Z.); (A.A.); (E.K.); (K.K.); (O.K.); (M.V.)
| | - Efstratios Katsianos
- 3rd Department of Cardiology, Thoracic Diseases General Hospital “Sotiria”, National and Kapodistrian University of Athens, 11527 Athens, Greece; (M.K.); (I.K.); (E.O.); (V.T.); (I.G.); (K.Z.); (A.A.); (E.K.); (K.K.); (O.K.); (M.V.)
| | - Konstantinos Kalogeras
- 3rd Department of Cardiology, Thoracic Diseases General Hospital “Sotiria”, National and Kapodistrian University of Athens, 11527 Athens, Greece; (M.K.); (I.K.); (E.O.); (V.T.); (I.G.); (K.Z.); (A.A.); (E.K.); (K.K.); (O.K.); (M.V.)
| | - Ourania Katsarou
- 3rd Department of Cardiology, Thoracic Diseases General Hospital “Sotiria”, National and Kapodistrian University of Athens, 11527 Athens, Greece; (M.K.); (I.K.); (E.O.); (V.T.); (I.G.); (K.Z.); (A.A.); (E.K.); (K.K.); (O.K.); (M.V.)
| | - Manolis Vavuranakis
- 3rd Department of Cardiology, Thoracic Diseases General Hospital “Sotiria”, National and Kapodistrian University of Athens, 11527 Athens, Greece; (M.K.); (I.K.); (E.O.); (V.T.); (I.G.); (K.Z.); (A.A.); (E.K.); (K.K.); (O.K.); (M.V.)
| | - Gerasimos Siasos
- 3rd Department of Cardiology, Thoracic Diseases General Hospital “Sotiria”, National and Kapodistrian University of Athens, 11527 Athens, Greece; (M.K.); (I.K.); (E.O.); (V.T.); (I.G.); (K.Z.); (A.A.); (E.K.); (K.K.); (O.K.); (M.V.)
| | - Dimitris Tousoulis
- 1st Department of Cardiology, “Hippokration” General Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece; (P.T.); (D.T.)
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Liu Y, Guan S, Xu H, Zhang N, Huang M, Liu Z. Inflammation biomarkers are associated with the incidence of cardiovascular disease: a meta-analysis. Front Cardiovasc Med 2023; 10:1175174. [PMID: 37485268 PMCID: PMC10360053 DOI: 10.3389/fcvm.2023.1175174] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 06/26/2023] [Indexed: 07/25/2023] Open
Abstract
Background Inflammation is a risk factor for cardiovascular disease (CVD), and particular inflammatory parameters can be used to predict the incidence of CVD. The aim of this study was to assess the association between fibrinogen (FIB), interleukin-6 (IL-6), C-reactive protein (CRP) and galectin-3 (Gal-3) and the risk of cardiovascular disease using meta-analysis. Methods PubMed, Embase, Scopus, and Web of Science databases were searched with the appropriate strategies to identify observational studies relevant to this meta-analysis. A random-effects model was used to combine inflammation factor-associated outcomes and cardiovascular disease outcomes, except in the case of galectin-3, where a fixed-effects model was used because of less heterogeneity. Location, age, type of cardiovascular disease, and sample size factors were used to explore heterogeneity in stratification and metaregression for subgroup analysis. A case-by-case literature exclusion approach was used for sensitivity analysis. The funnel plot and Begg's test were combined to assess publication bias. Results Thirty-three papers out of 11,456 were screened for inclusion in the analysis. Four inflammation biomarkers were significantly associated with the development of CVD: FIB (OR: 1.21, 95% CI: 1.15-1.27, P < 0.001; HR: 1.04, 95% CI: 1.00-1.07, P < 0.05), IL-6 (HR: 1.16, 95% CI: 1.10-1.22, P < 0.001), CRP (OR: 1.25, 95% CI: 1.15-1.35, P < 0.001; HR: 1.20, 95% CI: 1.14-1.25, P < 0.001) and Gal-3 (HR: 1.09, 95% CI: 1.05-1.14, P < 0.001). Location factors help explain the source of heterogeneity, and there is publication bias in the Gal-3 related literature. Conclusion Taken together, the current research evidence suggests that high levels of fibrinogen, interleukin-6, C-reactive protein and galectin-3 are risk factors for cardiovascular disease and can be used as biomarkers to predict the development of cardiovascular disease to some extent. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO, identifier: CRD42023391844.
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Affiliation(s)
- Yifei Liu
- School of Public Health, Ningxia Medical University, Yinchuan, China
- Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Yinchuan, Ningxia, China
| | - Suzhen Guan
- School of Public Health, Ningxia Medical University, Yinchuan, China
- Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Yinchuan, Ningxia, China
| | - Haiming Xu
- School of Public Health, Ningxia Medical University, Yinchuan, China
- Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Yinchuan, Ningxia, China
| | - Na Zhang
- School of Public Health, Ningxia Medical University, Yinchuan, China
- Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Yinchuan, Ningxia, China
| | - Min Huang
- School of Public Health, Ningxia Medical University, Yinchuan, China
- Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Yinchuan, Ningxia, China
| | - Zhihong Liu
- School of Public Health, Ningxia Medical University, Yinchuan, China
- Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Yinchuan, Ningxia, China
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Wójcik W, Mezhiievska I, Pavlov SV, Lewandowski T, Vlasenko OV, Maslovskyi V, Volosovych O, Kobylianska I, Moskovchuk O, Ovcharuk V, Lewandowska A. Medical Fuzzy-Expert System for Assessment of the Degree of Anatomical Lesion of Coronary Arteries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:979. [PMID: 36673734 PMCID: PMC9859614 DOI: 10.3390/ijerph20020979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 12/30/2022] [Accepted: 01/01/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Today, cardiovascular diseases cause 47% of all deaths among the European population, which is 4 million cases every year. In Ukraine, CAD accounts for 65% of the mortality rate from circulatory system diseases of the able-bodied population and is the main cause of disability. The aim of this study is to develop a medical expert system based on fuzzy sets for assessing the degree of coronary artery lesions in patients with coronary artery disease. METHODS The method of using fuzzy sets for the implementation of an information expert system for solving the problems of medical diagnostics, in particular, when assessing the degree of anatomical lesion of the coronary arteries in patients with various forms of coronary artery disease, has been developed. RESULTS The paper analyses the main areas of application of mathematical methods in medical diagnostics, and formulates the principles of diagnostics, based on fuzzy logic. The developed models and algorithms of medical diagnostics are based on the ideas and principles of artificial intelligence and knowledge engineering, the theory of experiment planning, the theory of fuzzy sets and linguistic variables. The expert system is tested on real data. Through research and comparison of the results of experts and the created medical expert system, the reliability of supporting the correct decision making of the medical expert system based on fuzzy sets for assessing the degree of anatomical lesion of the coronary arteries in patients with various forms of coronary artery disease with the assessment of experts was 95%, which shows the high efficiency of decision making. CONCLUSIONS The practical value of the work lies in the possibility of using the automated expert system for the solution of the problems of medical diagnosis based on fuzzy logic for assessing the degree of anatomical lesion of the coronary arteries in patients with various forms of coronary artery disease. The proposed concept must be further validated for inter-rater consistency and reliability. Thus, it is promising to create expert medical systems based on fuzzy sets for assessing the degree of disease pathology.
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Affiliation(s)
- Waldemar Wójcik
- Faculty of Electrical Engineering and Computer Science, Lublin University of Technology, Nadbystrzycka 38d, 20-618 Lublin, Poland
| | - Iryna Mezhiievska
- Department of Internal Medicine No. 3, National Pirogov Memorial Medical University, Pirogov Str. 56, 21018 Vinnytsya, Ukraine
| | - Sergii V. Pavlov
- Laboratory of Biomedical Optics, Faculty for Infocommunications, Radioelectronics and Nanosystems, Vinnytsia National Technical University, Khmelnytske Shose 95, 21021 Vinnytsia, Ukraine
| | - Tomasz Lewandowski
- Institute of Technical Engineering, State School of Technology and Economics in Jaroslaw, 37-500 Jaroslaw, Poland
| | - Oleh V. Vlasenko
- Laboratory of Experimental Neurophysiology, National Pirogov Memorial Medical University, 21018 Vinnytsia, Ukraine
| | - Valentyn Maslovskyi
- Department of Internal Medicine No. 3, National Pirogov Memorial Medical University, Pirogov Str. 56, 21018 Vinnytsya, Ukraine
| | - Oleksandr Volosovych
- Department of Biomedical Engineering and Optic-Electronic Systems, Vinnytsia National Technical University, Khmelnytske Shose 95, 21021 Vinnytsia, Ukraine
| | - Iryna Kobylianska
- Department of Life Safety and Safety Pedagogy, Vinnytsia National Technical University, Khmelnytske Shose 95, 21021 Vinnytsia, Ukraine
| | - Olha Moskovchuk
- Department of Pedagogy, Vinnytsia Mykhailo Kotsiubynskyi State Pedagogical University, Ostrozhsky Str. 32, 21000 Vinnytsia, Ukraine
| | - Vasyl Ovcharuk
- Department of Physical Education, Vinnytsia National Technical University, Khmelnytske Shose 95, 21021 Vinnytsia, Ukraine
| | - Anna Lewandowska
- Institute of Healthcare, State University of Technology and Economics in Jaroslaw, Czarniecki Street 16, 37-500 Jaroslaw, Poland
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Sadeghi R, Roshdi Dizaji S, Vazirizadeh-Mahabadi M, Sarveazad A, Forouzannia SA. Prognostic Value of The Leuko-Glycemic Index in Acute Myocardial Infarction; a Systematic Review and Meta-Analysis. ARCHIVES OF ACADEMIC EMERGENCY MEDICINE 2023; 11:e25. [PMID: 36919141 PMCID: PMC10008249 DOI: 10.22037/aaem.v11i1.1915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
Introduction In recent years, studies have provided evidence on the prognostic value of the leuko-glycemic index (LGI) in acute myocardial infarction (MI), but there is a lack of consensus. In addition, various reported cut-offs for LGI have raised concern regarding its clinical applicability. So, to conclude, through this systematic review and meta-analysis, we aimed to investigate all available evidence on the prognostic value of LGI in acute MI. Methods Two independent researchers summarized records available in the four main databases of Medline (Via PubMed), Embase, Scopus, and Web of Science until 15 Sep 2022. Articles studying the prognostic value of the LGI in acute MI were included. Finally, sensitivity, specificity, prognostic odds ratio, and the area under the curve (AUC) for LGI were analyzed and reported. Results Eleven articles were included (3701 patients, 72.1% male). Based on the analyses, AUC, sensitivity, and specificity for LGI in prediction of mortality following acute MI were 0.77 (95% CI: 0.73 to 0.80), 0.75 (95% CI: 0.62 to 0.84), and 0.66 (95% CI: 0.51 to 0.78), respectively. Positive and negative post-test probability of LGI in prediction of mortality were 21% and 5%, respectively. AUC, sensitivity, and specificity for LGI in prediction of major cardiac complications after acute MI were 0.81 (95% CI: 0.77 to 0.84), 0.84 (95% CI: 0.70 to 0.92), and 0.64 (95% CI: 0.49 to 0.84), respectively. Also, the Positive and negative post-test probability of LGI in this regard were 59% and 13%, respectively. Conclusion Although the results demonstrated that the LGI could predict mortality and acute cardiac complication after MI, the low post-test probability of LGI in risk stratification of patients raises questions regarding its applicability. Nevertheless, as most of the available studies have been conducted in the Latino/Hispanic population, further evidence is warranted to generalize the validity of this tool to other racial populations.
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Affiliation(s)
- Roxana Sadeghi
- Prevention of Cardiovascular Disease Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | | | - Arash Sarveazad
- Colorectal Research Center, Iran University of Medical Sciences, Tehran, Iran.,Nursing Care Research Center, Iran University of Medical Sciences, Tehran, Iran
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10
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Bahrami A, Nikoomanesh F, Khorasanchi Z, Mohamadian M, Ferns GA. The relationship between food quality score with inflammatory biomarkers, and antioxidant capacity in young women. Physiol Rep 2023; 11:e15590. [PMID: 36695752 PMCID: PMC9875818 DOI: 10.14814/phy2.15590] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 01/05/2023] [Accepted: 01/06/2023] [Indexed: 01/26/2023] Open
Abstract
Diet has the potential to decrease oxidative stress and inflammation and this may be beneficial in several diseases. This study investigated the association between food quality score (FQS) with antioxidant and inflammatory properties in 171 apparently healthy young women. This cross-sectional study was conducted using a validated food frequency questionnaire to determine the dietary intake of participants. FQS was calculated by summing all the scores obtained from healthy and unhealthy food groups. The total antioxidant capacity and free radical scavenging activity of serum and urine were quantified using the ferric reducing/antioxidant power (FRAP) and α, α-diphenyl-β-picrylhydrazyl (DPPH) methods, respectively. Malondialdehyde (MDA) was measured using the formation of thiobarbituric acid reactive substances (TBARS). White blood cell (WBC) and neutrophil counts, mean platelet volume (MPV) and red blood cell distribution width (RDW), were measured. Neutrophil: lymphocyte ratio (NLR), platelet: lymphocyte ratio (PLR), and RDW: platelet ratio (RPR) were also calculated. A high food quality (rich in fruit and vegetables, nuts, whole grain, and low intake of sweetened beverage, potato chips and fried food from outside the home) was related to lower hematological inflammatory biomarkers including WBC count, RDW, NLR, and PLR. Multivariable-adjusted odds ratios (95% CIs) demonstrated that higher FQS group (third tertile vs. first tertile) was associated with a significant lower levels of urinary FRAP (ORadj = 0.82; 95%CI: 0.70 to 0.97), and DPPH. High food quality was associated with reduced of markers of inflammation and oxidative stress in Iranian young girl.
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Affiliation(s)
- Afsane Bahrami
- Clinical Research Development Unit, Imam Reza Hospital, Faculty of MedicineMashhad University of Medical SciencesMashhadIran
- Clinical Research Development Unit of Akbar HospitalMashhad University of Medical SciencesMashhadIran
| | - Fatemeh Nikoomanesh
- Infectious Diseases Research CenterBirjand University of Medical SciencesBirjandIran
- Cellular and Molecular Research CenterBirjand University of Medical SciencesBirjandIran
| | - Zahra Khorasanchi
- Department of Nutrition, School of MedicineMashhad University of Medical SciencesMashhadIran
| | - Malihe Mohamadian
- Cellular and Molecular Research CenterBirjand University of Medical SciencesBirjandIran
| | - Gordon A. Ferns
- Division of Medical EducationBrighton & Sussex Medical SchoolBrightonUK
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11
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Parsa SA, Nourian S, Safi M, Namazi MH, Saadat H, Vakili H, Eslami V, Salehi A, Kiaee FH, Sohrabifar N, Khaheshi I. The Association Between Hematologic Indices With TIMI Flow In STEMI Patients Who Undergo primary percutaneous coronary intervention. Cardiovasc Hematol Disord Drug Targets 2022; 22:CHDDT-EPUB-126290. [PMID: 36100995 DOI: 10.2174/1871529x22666220913122046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 07/26/2022] [Accepted: 08/17/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND The Primary Percutaneous Coronary Intervention (PPCI) is the preferred therapeutic strategy for patients who experienced ST-Elevation Myocardial Infarction (STEMI). OBJECTIVE We aimed to evaluate the association of hematological indices, including hemoglobin level, platelets, White Blood Cells (WBCs) count, and MPV before PPCI with the TIMI grade flow after PPCI. METHODS STEMI patients who experienced PPCI were included in the present retrospective crosssectional study. Then participants were divided into three groups based on their post-procedural TIMI flow grades. Demographic data and hematologic indices of patients before PPCI were collected and their association with the TIMI grade flow after PPCI was evaluated. To compare the quantitative and qualitative variables, chi-square and t-tests were performed, respectively. RESULTS We found that elevated levels of hemoglobin and decreased levels of MPV had a significant association with an advanced grade of TIMI flow. Interestingly, in the normal range, there was a significant association between higher platelet count and TIMI-flow grade 1. Besides, TIMI flow grades 2 and 3 had a significant association with low and moderate platelets count, respectively. CONCLUSION In conclusion, evaluating MPV, platelets, and hemoglobin levels before PPCI as easy and accessible parameters may be able to identify high-risk STEMI patients undergoing PPCI.
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Affiliation(s)
- Saeed Alipour Parsa
- Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saeed Nourian
- Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Morteza Safi
- Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Hasan Namazi
- Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Habib Saadat
- Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hossein Vakili
- Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Vahid Eslami
- Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ayoub Salehi
- Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Nasim Sohrabifar
- Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Isa Khaheshi
- Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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12
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Comparison of intracoronary versus intravenous tirofiban in acute ST-elevation myocardial infarction patients undergoing primary percutaneous coronary intervention. Coron Artery Dis 2022; 33:547-552. [PMID: 35942633 DOI: 10.1097/mca.0000000000001177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study aimed to investigate the effect of intracoronary (IC) tirofiban compared to intravenously administered tirofiban in STEMI patients treated with PPCI. METHODS This study included 180 STEMI patients who were underwent PPCI. Patients were randomized into an IC group (n = 90) and intravenous (IV) group (n = 90). During the procedure, the both groups were administered IC or IV injections of tirofiban, respectively, followed by an IV infusion of tirofiban for 24 hours. Changes in TIMI flow grading, TMP grade 3, Sum-STR two hours after the operation, the number of thrombus aspirations during the operation, myocardial enzyme, inflammatory factors,cardiac functional parameters, MACE and bleeding were investigated. RESULTS Following treatment, TIMI flow grading and TMP grade 3 were improved in the IC tirofiban compared to the IV group (P = 0.022 and P = 0.014, respectively). Additionally, the Sum-STR two hours after operation, the incidence of MACEs, levels of AST, CRP, ESR, and TNI in the IC group was improved, compared with the IV group (all P < 0.05). Furthermore. Cardiac function including CO and LVEF were significantly improved in the IC group 6 months after discharge. CONCLUSION This study found that IC administration of tirofiban in patients with STEMI who underwent PPCI improved TIMI, TMP flow and cardiac function 6 months after discharge, and reduced CRP, ESR, and TNI. However, the incidence of bleeding between the two groups was comparable. These findings suggest that IC administration should be applied in certain acute STEMI patients.
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13
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Vandenberghe W, Bové T, De Somer F, Herck I, François K, Peperstraete H, Dhondt A, Martens T, Schaubroeck H, Philipsen T, Czapla J, Claus I, De Waele JJ, Hoste EAJ. Impact of mean perfusion pressure and vasoactive drugs on occurrence and reversal of cardiac surgery-associate acute kidney injury: A cohort study. J Crit Care 2022; 71:154101. [PMID: 35763994 DOI: 10.1016/j.jcrc.2022.154101] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 06/09/2022] [Accepted: 06/18/2022] [Indexed: 10/17/2022]
Abstract
PURPOSE Low cardiac output and kidney congestion are associated with acute kidney injury after cardiac surgery (CSA-AKI). This study investigates hemodynamics on CSA-AKI development and reversal. MATERIALS AND METHODS Adult patients undergoing cardiac surgery were retrospectively included. Hemodynamic support was quantified using a new time-weighted vaso-inotropic score (VISAUC), and hemodynamic variables expressed by mean perfusion pressure and its components. The primary outcome was AKI stage ≥2 (CSA-AKI ≥2) and secondary outcome full AKI reversal before ICU discharge. RESULTS 3415 patients were included. CSA-AKI ≥2 occurred in 37.4%. Mean perfusion pressure (MPP) (OR 0.95,95%CI 0.94-0.96, p < 0.001); and central venous pressure (CVP) (OR 1.17, 95%CI 1.13-1.22, p < 0.001) are associated with CSA-AKI ≥2 development, while VISAUC/h was not (p = 0.104). Out of 1085 CSA-AKI ≥2 patients not requiring kidney replacement therapy, 76.3% fully recovered of AKI. Full CSA-AKI reversal was associated with MPP (OR 1.02 per mmHg (95%CI 1.01-1.03, p = 0.003), and MAP (OR = 1.01 per mmHg (95%CI 1.00-1.02), p = 0.047), but not with VISAUC/h (p = 0.461). CONCLUSION Development and full recovery of CSA-AKI ≥2 are affected by mean perfusion pressure, independent of vaso-inotropic use. CVP had a significant effect on AKI development, while MAP on full AKI reversal.
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Affiliation(s)
- Wim Vandenberghe
- Department of Critical Care Medicine, Ghent University Hospital, Ghent, Belgium.
| | - Thierry Bové
- Department of Cardiac Surgery, Ghent University Hospital, Ghent University, Ghent, Belgium
| | - Filip De Somer
- Department of Cardiac Surgery, Ghent University Hospital, Ghent University, Ghent, Belgium
| | - Ingrid Herck
- Department of Critical Care Medicine, Ghent University Hospital, Ghent, Belgium
| | - Katrien François
- Department of Cardiac Surgery, Ghent University Hospital, Ghent University, Ghent, Belgium
| | | | - Annemieke Dhondt
- Department of Nephrology, Ghent University Hospital, Ghent University, Ghent, Belgium
| | - Thomas Martens
- Department of Cardiac Surgery, Ghent University Hospital, Ghent University, Ghent, Belgium
| | - Hannah Schaubroeck
- Department of Critical Care Medicine, Ghent University Hospital, Ghent, Belgium
| | - Tine Philipsen
- Department of Cardiac Surgery, Ghent University Hospital, Ghent University, Ghent, Belgium
| | - Jens Czapla
- Department of Cardiac Surgery, Ghent University Hospital, Ghent University, Ghent, Belgium
| | - Isabelle Claus
- Department of Cardiac Surgery, Ghent University Hospital, Ghent University, Ghent, Belgium
| | - Jan J De Waele
- Department of Critical Care Medicine, Ghent University Hospital, Ghent, Belgium; Research Foundation-Flanders (FWO), Brussels, Belgium
| | - Eric A J Hoste
- Department of Critical Care Medicine, Ghent University Hospital, Ghent, Belgium; Research Foundation-Flanders (FWO), Brussels, Belgium
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14
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Ren Y, Hou M, Ren Y, Zhang L. Diagnostic efficacy of serum ST2 in patients with ASC. J Clin Lab Anal 2022; 36:e24511. [PMID: 35613943 PMCID: PMC9279964 DOI: 10.1002/jcla.24511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 05/06/2022] [Accepted: 05/11/2022] [Indexed: 11/12/2022] Open
Abstract
Background Soluble suppression of tumorigenicity 2 (ST2) is closely related to the development of cardiovascular disease, but the level of acute coronary syndrome (ACS) and the relationship between ST2 and ACS are unclear. Patients and Methods Patients with the acute coronary syndrome were divided into the unstable angina pectoris (USAP) group (n = 65) and non‐ST‐segment elevation myocardial infarction (NSTEMI) group (n = 58), and the healthy population, without chest pain and with normal coronary CT, was included as a control group (n = 55). Laboratory index levels were collected from each participant. The baseline information was reviewed and analyzed. The binary logistic regression was used to explore the relation of ST2 levels with the occurrence of ACS and NSTEMI, and the diagnostic performance of ST2 for diagnosing ACS or NSTEMI was evaluated using a receiver‐operating characteristic (ROC) curve. Results The level of ST2 was found significantly higher in NSTEMI than in USAP and was higher in USAP than in control (p < 0.01). ST2 levels were positively correlated with ALT, AST, and BNP in the control group, were negatively correlated with HGB and TG in the USAP group, and were positively correlated with WBC, GLU, BNP, and Gensini scores in the NSTEMI group. Multivariate analysis revealed that the occurrence of ACS was associated with ST2, BNP, GLU, TC, BUN, WBC, and PLT, and the occurrence of NSTEMI was associated with AST, WBC, LDL‐C, and ST2. Meanwhile, ST2 levels achieved good performance for ACS and NSTEMI diagnostician. Conclusion ST2 could be used as an auxiliary diagnostic indicator for the occurrence of ACS and NSTEMI.
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Affiliation(s)
- Yaping Ren
- Department of Cardiology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China.,Emergency Department, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
| | - Min Hou
- Emergency Department, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
| | - Yunxia Ren
- Department of Cardiology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China.,Emergency Department, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
| | - Lei Zhang
- Department of Cardiology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China.,Emergency Department, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
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15
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Zhu L, Zhang C, Mao G, Xu J, Qian J, Jiang L, Ye J. Serum CD40L, ST2, IL-6, and CRP serving as biomarkers for acute coronary syndrome. EUR J INFLAMM 2022. [DOI: 10.1177/20587392211051115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
To analyze the diagnostic value of CD40 ligand (CD40L), soluble growth stimulating expression gene 2 protein (ST2), interleukin-6 (IL-6), and C-reactive protein (CRP) are used in patients with acute coronary syndrome (ACS). Serum samples were collected from 259 ACS patients admitted to our hospital. Additionally, 119 healthy individuals who received physical examination in the hospital at the same time period were included as normal control. The levels of CD40L, ST2, IL-6, and CRP in 259 patients with ACS and 119 healthy subjects were detected by ELISA. The levels of CD40L, ST2, IL-6, and CRP were significantly increased in unstable angina (UA) patients, while ST2, CRP, and IL-6 were significantly elevated in acute myocardial infarction (AMI) patients. Pearson correlation analysis showed that ST2 was also closely related to CRP in ACS patients, while ST2 was positively correlated with creatine kinase (CK), creatine kinase isoenzyme (CK-MB), and troponin I (cTnI) in AMI patients. The levels of glucose (GLU) and low-density lipoprotein cholesterol (LDL-c) were significantly decreased, while the levels of high-density lipoprotein cholesterol (HDL-c) were significantly increased in AMI patients treated with stent implantation. Furthermore, the level of serum CD40 L was significantly elevated in coronary heart disease (CHD) patients treated with stent implantation, while the levels of ST2 and IL-6 in AMI patients treated with the stent implantation decreased significantly. The levels of inflammatory factors significantly changed in patients with ACS. These inflammatory factors may involve in the pathological progression of ACS and can be used as diagnostic indexes for ACS.
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Affiliation(s)
- Li Zhu
- Department of Cardiology, Taizhou People’s Hospital, Taizhou, China
| | - Chuanmeng Zhang
- The Center for Translational Medicine, Taizhou People’s Hospital, Jiangsu, China
| | - Guangyao Mao
- The Center for Translational Medicine, Taizhou People’s Hospital, Jiangsu, China
| | - Jie Xu
- The Center for Translational Medicine, Taizhou People’s Hospital, Jiangsu, China
| | - Jingyu Qian
- The Center for Translational Medicine, Taizhou People’s Hospital, Jiangsu, China
| | - Lin Jiang
- Department of Anesthesiology, Taizhou People’s Hospital, Taizhou, China
| | - Jun Ye
- The Center for Translational Medicine, Taizhou People’s Hospital, Jiangsu, China
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16
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Antipova II, Smirnova IN, Titskaya EV, Barabash LV, Tonkoshkurova AV, Maritskaya EA. [The effect of low-frequency electrostatic therapy on immunoinflammatory reactions in patients with acute myocardial infarction after endovascular myocardial revascularization at the inpatient stage of medical rehabilitation]. VOPROSY KURORTOLOGII, FIZIOTERAPII, I LECHEBNOI FIZICHESKOI KULTURY 2022; 99:13-21. [PMID: 36279372 DOI: 10.17116/kurort20229905113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
PURPOSE OF THE STUDY To study the effect of complex rehabilitation with the inclusion of low-frequency electrostatic therapy on the dynamics of immune status in patients with myocardial infarction (MI) after endovascular myocardial revascularization. MATERIAL AND METHODS The state of the immune status was studied in 68 patients with MI after percutaneous coronary intervention (PCI) - coronary angioplasty with stenting, admitted to the inpatient stage of medical rehabilitation. RESULTS The study proved the involvement of the immune system in a complex set of reactions occurring in patients with myocardial infarction after PCI. Significant correlations between biochemical and immunological markers of inflammation and risk factors for cardiovascular diseases have been established. Carrying out complex rehabilitation measures using low-frequency electrostatic therapy at the stationary stage of medical rehabilitation helps to reduce the activity of the inflammatory process and eliminate the immunological imbalance in MI patients after endovascular myocardial revascularization. CONCLUSION The inclusion of low-frequency electrostatic therapy in the medical rehabilitation complex has a significant immunocorrective effect on the parameters of cellular and humoral immunity, the ratio of pro- and anti-inflammatory cytokines, which justifies the prospects for its use in the rehabilitation of patients with myocardial infarction.
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Affiliation(s)
- I I Antipova
- Federal Scientific and Clinical Center for Medical Rehabilitation and Balneology of the Federal Medical and Biological Agency, Moscow, Russia
| | - I N Smirnova
- Federal Scientific and Clinical Center for Medical Rehabilitation and Balneology of the Federal Medical and Biological Agency, Moscow, Russia
| | - E V Titskaya
- Federal Scientific and Clinical Center for Medical Rehabilitation and Balneology of the Federal Medical and Biological Agency, Moscow, Russia
| | - L V Barabash
- Federal Scientific and Clinical Center for Medical Rehabilitation and Balneology of the Federal Medical and Biological Agency, Moscow, Russia
| | - A V Tonkoshkurova
- Federal Scientific and Clinical Center for Medical Rehabilitation and Balneology of the Federal Medical and Biological Agency, Moscow, Russia
| | - E A Maritskaya
- Federal Scientific and Clinical Center for Medical Rehabilitation and Balneology of the Federal Medical and Biological Agency, Moscow, Russia
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17
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Wu M, Yang S, Liu G, Gu C, Ren P, Zhao R, Zhao Y, Xing Y, Liu L, Liang J. Treating unstable angina with detoxifying and blood-activating formulae: A randomized controlled trial. JOURNAL OF ETHNOPHARMACOLOGY 2021; 281:114530. [PMID: 34416295 DOI: 10.1016/j.jep.2021.114530] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 07/17/2021] [Accepted: 08/16/2021] [Indexed: 06/13/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Detoxifying and blood-activating Chinese medicine granule formula, which includes 15 g of Polygonum cuspidatum Sieb. et Zucc. (Polygonum cuspidatum) and 10 g of Crataegus pinnatifida Bunge (Hawthorn), can relieve the symptoms and serve as supplementary treatment for unstable angina. AIM OF THE STUDY This study aimed to explore the role of detoxifying and blood-activating formulae in the treatment of unstable angina and the potential mechanism involved. MATERIALS AND METHODS A total of 144 participants with unstable angina were randomly divided into experimental and control groups. Both groups were treated with standardized Western medicine; the experimental group was additionally treated with detoxifying and blood-activating Chinese medicine granules, which included 15 g of P. cuspidatum and 10 g of C. pinnatifida for 4 weeks. The primary endpoint was the frequency of weekly angina pectoris attacks before and after treatment. The secondary endpoints, also observed before and after treatment, included blood glucose, blood lipids, high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α), interleukin (IL)-6, IL-10, and adiponectin levels, as well as the ratio of pro/anti-inflammatory factors and evaluation scales of symptoms and syndromes in Chinese and Western medicine. RESULTS In both experimental and control groups, the frequency of weekly angina pectoris attacks was lower after treatment (P < 0.01), but with no significant intergroup difference (P = 0.10). After intervention, the hs-CRP, TNF-α, and IL-6 levels decreased, while the IL-10 and adiponectin levels significantly increased in the experimental group (P < 0.05 or 0.01). The ratios of the inflammatory factors significantly decreased after treatment, particularly in the experimental group (P < 0.01). Symptoms and syndromes were also ameliorated in the experimental group (P < 0.01), showing a significant difference from the control group (P < 0.01). CONCLUSIONS Detoxifying and blood-activating formulae can reduce the frequency and relieve symptoms of unstable angina, and this mechanism may be related to a regulation of the balance of pro- and anti-inflammatory factors.
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Affiliation(s)
- Min Wu
- Guang'an Men Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
| | - Shengjie Yang
- Guang'an Men Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
| | - Guijian Liu
- Guang'an Men Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
| | - Chun Gu
- Guang'an Men Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
| | - Peng Ren
- Guang'an Men Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
| | - Ran Zhao
- Guang'an Men Hospital, China Academy of Chinese Medical Sciences, Beijing, China; Beijing University of Chinese Medicine, Beijing, China.
| | - Yixi Zhao
- Guang'an Men Hospital, China Academy of Chinese Medical Sciences, Beijing, China; Beijing University of Chinese Medicine, Beijing, China.
| | - Yanwei Xing
- Guang'an Men Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
| | - Longtao Liu
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
| | - Jiaqi Liang
- Department of Cardiovascular, Beijing Longfu Hospital, Beijing, China.
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Smith CW. Release of α-granule contents during platelet activation. Platelets 2021; 33:491-502. [PMID: 34569425 DOI: 10.1080/09537104.2021.1913576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Upon activation, platelets release a plethora of factors which help to mediate their dynamic functions in hemostasis, inflammation, wound healing, tumor metastasis and angiogenesis. The majority of these bioactive molecules are released from α-granules, which are unique to platelets, and contain an incredibly diverse repertoire of cargo including; integral membrane proteins, pro-coagulant molecules, chemokines, mitogenic, growth and angiogenic factors, adhesion proteins, and microbicidal proteins. Clinically, activation of circulating platelets has increasingly been associated with various disease states. Biomarkers indicating the level of platelet activation in patients can therefore be useful tools to evaluate risk factors to predict future complications and determine treatment strategies or evaluate antiplatelet therapy. The irreversible nature of α-granule secretion makes it ideally suited as a marker of platelet activation. This review outlines the release and contents of platelet α-granules, as well as the membrane bound, and soluble α-granule cargo proteins that can be used as biomarkers of platelet activation.
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Affiliation(s)
- Christopher W Smith
- Institute of Cardiovascular Sciences, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, B15 2TT, Birmingham, UK
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Gayretli Yayla K, Yayla C, Erdol MA, Karanfil M, Ertem AG, Akcay AB. Relationship Between C-Reactive Protein to Albumin Ratio and Infarct-Related Artery Patency in Patients With ST-Segment Elevation Myocardial Infarction. Angiology 2021; 73:260-264. [PMID: 34132120 DOI: 10.1177/00033197211024047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The C-reactive protein to albumin ratio (CAR) is a predictive marker of systemic inflammatory state in atherosclerotic coronary disease when compared with the predictive value of these 2 markers separately. We investigated the relationship between CAR and infarct-related artery (IRA) patency in patients with ST-segment elevation myocardial infarction (STEMI). The study population (n = 1047) was divided into 2 groups according to IRA patency which was assessed by the Thrombolysis in Myocardial Infarction (TIMI) flow grade. Nonpatent flow was defined as TIMI grade 0 (no-reflow), 1, and 2 flows, and normal flow was defined as TIMI 3 flow. There was a significant positive correlation between CAR and SYNTAX score (r = 0.312, P < .001) and a negative correlation between CAR and TIMI grade flow (r = -0.210, P < .001). At a cutoff level of 0.693, the CAR predicted TIMI no-reflow with a sensitivity of 65.4% and a specificity of 65.5% (area under the curve: 0.670, 95% CI: 0.62-0.71, P < .001). Multivariate logistic regression analyses showed that CAR was an independent predictor of IRA patency (0.003 [0.001-0.029]; P < .001). A higher CAR is a significant and independent predictor of IRA patency in patients with STEMI.
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Affiliation(s)
- Kadriye Gayretli Yayla
- Department of Cardiology, Dr. Abdurrahman Yurtaslan Ankara Onkoloji Education and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Cagri Yayla
- Department of Cardiology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Mehmet Akif Erdol
- Department of Cardiology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Mustafa Karanfil
- Department of Cardiology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Ahmet Goktug Ertem
- Department of Cardiology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Adnan Burak Akcay
- Department of Cardiology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
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Yasak IH, Tascanov MB, Gönel A, Seyhanli ES. The Relationship Between the Severity of Coronary Artery Disease and Erythrocyte Morphology Parameters Measured by New-Generation Hematology Analyzer. Comb Chem High Throughput Screen 2021; 25:1278-1283. [PMID: 34053423 DOI: 10.2174/1386207324666210528113024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 03/08/2021] [Accepted: 04/12/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND There is a possible relation between red blood cell distribution width (RDW) and various clinical conditions. These conditions can render RDW disadvantageous in its relation with cardiovascular disease. There may be a relation between the severity of acute coronary syndrome (ACS) and the percentage of hypochromia (hypo%), percentage of hyperchromia (hyper%), percentage of macrocytosis (MAC%), and percentage of microcytosis (MIC%) values measured using new-generation hematological devices. OBJECTIVE We aimed to examine the relation between the SYNTAX score and the hypo%, hyper%, MAC%, and MIC% values in patients admitted with ACS. METHOD A group of 55 patients who underwent coronary angiography with diagnosis of ACS (STEMI and NSTEMI) and a control group of 48 patients with normal coronary arteries were included in the study. Venous blood samples were collected in the morning after a fasting of at least 8 h and analyzed using standard laboratory methods. Hemogram parameters were studied using Alinity HQ (Abbott, USA) a completely automated hemogram autoanalyzer. Biochemical parameters were studied using Architect c16000 (Abbott, USA) a completely automated biochemistry autoanalyzer. RESULTS Significant difference was observed in erythrocyte morphology-related tests (mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, RDW, hypo%, hyper%, MIC%, and MAC%) between the groups. Correlation analysis showed a positive correlation between the SYNTAX score and MAC% (r = 0.315, p = 0.019). Multivariate logistic regression analysis was performed for MAC% to identify the independent predictors of the SYNTAX score (β = 0.315, p = 0.019). CONCLUSION Changes in MAC% test can be measured in emergencies with new-generation hematological devices and used as independent predictors of presence of severe coronary artery disease.
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Affiliation(s)
- Ibrahin Halil Yasak
- Department of Emergency Medicine, Harran University Medicine Faculty, Sanliurfa, Turkey
| | | | - Ataman Gönel
- Department of Medicinal Biochemistry, Harran University Medicine Faculty, Sanliurfa, Turkey
| | - Eyyup Sabri Seyhanli
- Department of Emergency Medicine, Harran University Medicine Faculty, Sanliurfa, Turkey
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21
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Liu L, Zhao J, Zhang R, Wang X, Wang Y, Chen Y, Feng R. Serum untargeted metabolomics delineates the metabolic status in different subtypes of non-alcoholic fatty liver disease. J Pharm Biomed Anal 2021; 200:114058. [PMID: 33865049 DOI: 10.1016/j.jpba.2021.114058] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 03/28/2021] [Accepted: 03/30/2021] [Indexed: 02/07/2023]
Abstract
AIMS The aim of this study was to identify novel serum metabolites associated with non-alcoholic fatty liver disease (NAFLD), and to explore the metabolic discrepancies between Lean-NAFLD and Obese-NAFLD. METHODS Serum samples from patients with NAFLD (n = 161) and healthy participants (n = 149) were collected, and metabolites were analyzed with UPLC-Q-TOF MS/MS. Subgroup analyses were performed to explore the metabolic differences among Lean-NAFLD, Obese-NAFLD and healthy controls RESULTS: A total of 24 differentially present metabolites were found between patients with NAFLD and healthy controls. Marked metabolic pathway differences were observed among the NAFLD subtypes, including in fatty acid and amino acid metabolism. Ultimately, five metabolites (prasterone, indoxylsulfuric acid, sebacic acid, arachidonic acid and pregnenolone sulfate) were used to establish a diagnostic model to distinguish patients with NAFLD regardless of Lean- or Obese-NAFLD type. CONCLUSIONS This study suggested that significant metabolic differences existed among subtypes of NAFLD, and our model might be useful to distinguish patients with NAFLD. These findings may lay a foundation for the detection and treatment of NAFLD subtypes.
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Affiliation(s)
- Liyan Liu
- National Key Discipline Laboratory, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, PR China
| | - Jinhui Zhao
- National Key Discipline Laboratory, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, PR China
| | - Runan Zhang
- National Key Discipline Laboratory, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, PR China
| | - Xuemei Wang
- National Key Discipline Laboratory, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, PR China
| | - Yan Wang
- National Key Discipline Laboratory, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, PR China
| | - Yang Chen
- National Key Discipline Laboratory, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, PR China
| | - Rennan Feng
- National Key Discipline Laboratory, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, PR China.
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22
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Willim HA, Harianto JC, Cipta H. Platelet-to-Lymphocyte Ratio at Admission as a Predictor of In-Hospital and Long-Term Outcomes in Patients With ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis. Cardiol Res 2021; 12:109-116. [PMID: 33738014 PMCID: PMC7935631 DOI: 10.14740/cr1219] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 01/23/2021] [Indexed: 11/11/2022] Open
Abstract
Background ST-segment elevation myocardial infarction (STEMI) is the most severe form of acute coronary syndrome (ACS) which is associated with significant adverse outcomes. Platelet-to-lymphocyte ratio (PLR) is a novel inflammatory biomarker that has been used as a predictor of various cardiovascular diseases, including ACS. This meta-analysis aimed to investigate the prognostic value of PLR as a predictor of in-hospital and long-term outcomes in patients with STEMI undergoing primary percutaneous coronary intervention (PCI). Methods We performed a comprehensive systematic literature search in the databases of PubMed, ScienceDirect, Cochrane Library, and ProQuest for eligible studies. The primary outcomes were major adverse cardiac events (MACEs) and mortality, both in-hospital and long-term follow-up. The outcomes were compared between patients with high and low admission PLR. The quality assessment was conducted using the Newcastle-Ottawa scale. Review Manager 5.3 was used to perform the meta-analysis. Results Six cohort studies involving 4,289 STEMI patients undergoing primary PCI were included in this meta-analysis. The pooled analysis showed that a high PLR at admission was associated with increased in-hospital MACE (odds ratio (OR) = 1.94, 95% confidence interval (CI) = 1.56 - 2.40, P < 0.00001, I2 = 45%) and in-hospital mortality (OR = 2.07; 95% CI = 1.53 - 2.80; P < 0.00001; I2 = 50%), as well as increased long-term MACE (OR = 1.98; 95% CI = 1.31 - 3.00; P = 0.001; I2 = 72%) and long-term mortality (OR = 2.79; 95% CI = 1.45 - 5.36; P = 0.002; I2 = 83%). Conclusions In patients with STEMI undergoing primary PCI, a high PLR at admission predicts in-hospital MACE and mortality along with long-term MACE and mortality.
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Affiliation(s)
- Herick Alvenus Willim
- Department of Emergency Medicine, Dr. Agoesdjam Regional Public Hospital, Ketapang, West Kalimantan, Indonesia
| | - Joan Carmen Harianto
- Faculty of Medicine, Tanjungpura University, Pontianak, West Kalimantan, Indonesia
| | - Harie Cipta
- Department of Cardiology and Vascular Medicine, Dr. Agoesdjam Regional Public Hospital, Ketapang, West Kalimantan, Indonesia
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Circulating peroxisome proliferator-activated receptor γ is elevated in systemic sclerosis. Postepy Dermatol Alergol 2021; 37:921-926. [PMID: 33603610 PMCID: PMC7874880 DOI: 10.5114/ada.2019.84746] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 04/27/2019] [Indexed: 11/23/2022] Open
Abstract
Introduction Systemic sclerosis (SSc) is an autoimmune connective tissue disease with distinguished fibrosis of the skin and internal organs. Vascular damage, immune dysregulation and fibroblasts activation contribute to SSc pathogenesis. Peroxisome proliferator-activated receptor γ (PPAR-γ) can be a link between cell metabolism and fibrosis in SSc due to its anti-fibrotic and immunomodulatory properties. Aim To measure the serum level of PPAR-γ in SSc patients and correlate it with the SSc subtype, hs-CRP, disease duration, vascular and internal organ involvement. Material and methods Twenty-two SSc patients (15 limited SSc, 7 diffuse SSc) matched with healthy controls were analysed. Clinical and laboratory data were collected including specific antibodies, interstitial lung disease, oesophageal involvement, digital pitting scars, disease duration, Raynaud’s phenomenon (RP) and modified Rodnan skin score (mRSS). PPAR-γ levels were analysed by ELISA. Statistical analysis was performed with χ2, Student’s t-test and Mann-Whitney-U test. Pearson and Spearman correlation analyses were used to establish variables association. The significance threshold was set at p < 0.05. Results PPAR-γ concentration was elevated in SSc patients in comparison to controls (p = 0.007) with the highest difference for diffuseSSc (p = 0.004) with significantly elevated mRSS. No association between PPAR-γ levels and hs-CRP, internal organ and vascular involvement, disease duration, autoantibodies and RP onset was found. Conclusions The present study revealed elevated serum PPAR-γ in SSc patients, in particular those with a diffuse form, presenting highest mRSS and lowest BMI. Whether circulating PPAR-γ originates from atrophic adipose tissue, reperfused vessels or ischemic tissues needs assessing. Also the biological meaning or effect of elevated serum PPAR-γ requires further studies.
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Yang C, Deng Z, Li J, Ren Z, Liu F. Meta-analysis of the relationship between interleukin-6 levels and the prognosis and severity of acute coronary syndrome. Clinics (Sao Paulo) 2021; 76:e2690. [PMID: 34231707 PMCID: PMC8240769 DOI: 10.6061/clinics/2021/e2690] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 04/27/2021] [Indexed: 12/25/2022] Open
Abstract
This study aimed to explore the relationship between plasma interleukin 6 (IL-6) levels, adverse cardiovascular events, and the severity of acute coronary syndrome (ACS). A literature review was performed of studies regarding IL-6 and ACS extracted from databases including EMBASE, Cqvip, MEDLINE, Web of Knowledge, PubMed, Cochrane Library, China National Knowledge Infrastructure, and Wanfang data. The Newcastle-Ottawa scale (NOS) was used to evaluate the quality of the literature. The literature was screened, its quality was evaluated, and relevant data were extracted for performing meta-analysis using RevMan software (version 5.3). A total of 524 studies were included in the initial survey. After several rounds of screening and analysis, six studies met the inclusion criteria and underwent meta-analysis using a fixed-effect model. Patients were divided into non-severe and severe groups based on the concentration of high-sensitivity C-reactive protein. Meta-analysis of the relationship between IL-6 and the severity of ACS showed that the plasma IL-6 level of patients in the severe group was significantly higher than that of patients in the non-severe group (p<0.00001). Additionally, patients with experience of major adverse cardiovascular events had significantly higher plasma IL-6 levels than did patients without experience of such events (p<0.00001). In summary, patients with ACS and high IL-6 levels tended to be in a critical condition, with a higher risk of adverse cardiovascular events and worse prognosis. Thus, IL-6 levels could indicate whether patients with ACS may have adverse cardiovascular events and determine the severity of ACS.
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Cohen Arazi H, Chirino D, Costabel JP, Pulmari CA, Hirschson Prado A, Barba V, Agüero P, Badimon JJ. Leuko-platelet index predicts thrombotic events in patients with acute coronary syndrome. Int J Cardiol 2020; 328:29-34. [PMID: 33301835 DOI: 10.1016/j.ijcard.2020.11.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 11/29/2020] [Accepted: 11/30/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE To evaluate the predictive value of a bedside index in hospitalized patients with acute coronary syndromes (ACS). METHODS We studied the association of leuko-platelet index (LPI: platelet count * leukocyte count/108) with risk of mortality, shock, or heart failure (combined end point-CEP), and with the response to antiplatelet therapy, measured by light transmission aggregometry. RESULTS In the derivation cohort we included 1100 patients with non STEM-ACS, GRACE score of 133 ± 52, Crusade score 24,3 ± 14, 66% male, 65 + 11 years. LPI was 17 (12-24). LPI was higher (19 (13-25)) in patients with MI than in patients with unstable angina (16 (12-22) in (p < 0.001)). A total of 115 patients (10.5%) had the CEP. CEP was associated to LPI (OR 1.04 (1.002-1.08), p = 0.03), age (OR 1.01 (0.97-1.05), p = 0.62) and GRACE>140 (OR 8.1 (2.2-29), p = 0.02). LPI (OR 1.04 (1.004-1.07) p = 0.03) and GRACE score (OR 1.02 (1.01-1.03) p < 0.01) were associated to cardiovascular mortality. We confirmed these results in the validation cohort #1 (686 patients, 61 + 11 years old, 47% nonST-ACS, 53% ST-ACS, 21% had CEP) and in validation cohort #2 (218 patients, 56.8% males, 73 + 7 years old, 79% nonST-ACS, GRACE score 136 + 30) and 8.3% with CEP. We used the cutoff points of LPI obtained in the derivation cohort (>24). CONCLUSIONS LPI > 24 was associated to CEP (OR (1.7-5.2), p 0.01), independently of age (OR 1 (0.98-1.02), p = 0.8), and GRACE score (OR 1.01 (0.99-1.01), p 0.69), and It was associated to antiplatelet resistance (OR 1.03 (95% CI 1.00-1.06) p = 0.05).
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Affiliation(s)
| | | | | | - Camilo A Pulmari
- Larcade Hospital and Malvinas Argentinas Hospital, Buenos Aires, Argentina
| | | | | | - Pablo Agüero
- Larcade Hospital and Malvinas Argentinas Hospital, Buenos Aires, Argentina
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Relationship between White Blood Count to Mean Platelet Volume Ratio and Clinical Outcomes and Severity of Coronary Artery Disease in Patients Undergoing Primary Percutaneous Coronary Intervention. Cardiovasc Ther 2020; 2020:9625181. [PMID: 32934665 PMCID: PMC7482024 DOI: 10.1155/2020/9625181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 07/16/2020] [Accepted: 07/29/2020] [Indexed: 11/18/2022] Open
Abstract
Background The white blood cell count to mean platelet volume ratio (WMR) is an indicator of inflammation in patients with atherosclerotic disease. Residual SYNTAX Score (RSS) is an objective measure of degree and complexity of residual stenosis after percutaneous coronary intervention (PCI). We investigated the relationship between WMR and clinical prognosis and RSS in patients undergoing primary percutaneous coronary intervention (P-PCI). Method Between June 2015 and December 2018, 537 patients who underwent primary PCI were evaluated for in-hospital events, and 477 patients were evaluated for clinical events during follow-up after discharge. The endpoint of our study is major adverse cardiac events (MACEs) seen in the in-hospital and follow-up periods. Results In our study, 537 patients were stratified into two groups according to admission median WMR. There were 268 patients in the low WMR group (WMR < 1286) and 269 patients in the high WMR group (WMR ≥ 1286). RSS (p = 0.01) value of the high WMR group was higher than that of the low WMR group. The rates of in-hospital MACE (p = 0.001), cardiac death (p < 0.001), decompansated heart failure (0.007), and ventricular tachycardia/fibrillation (p = 0.003) were higher in the high WMR group than in the low WMR group. The follow-up MACEs (p = 0.043), cardiac death (p = 0.026), and reinfarction (p = 0.031) ratio were higher in the high WMR group. In ROC analysis, cut-off values of in-hospital and follow-up MACEs were >1064 (sensitivity: 83.12%, and specificity: 36.29%) and >1130 (sensitivity: 69.15%, and specificity: 44.91%), respectively. The Kaplan-Meier analysis showed that the high WMR group had the significantly lowest MACE-free survival rate (log-rank test, p = 0.006). A moderate correlation was observed between WMR and RSS (r: 456, p = 0.002). Conclusion A higher WMR value on admission was associated with worse outcomes in patients with P-PCI and independently predicted for follow-up MACEs. The WMR provides both a rapid and an easily obtainable parameter to identify reliably high-risk patients who underwent primary percutaneous coronary intervention due to STEMI.
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Yang Q, Du J, Wang B. Complications during hospitalization and at 30 days in the intensive cardiac care unit for patients with ST-elevation versus non-ST-elevation acute coronary syndrome: A protocol for systematic review and meta analysis. Medicine (Baltimore) 2020; 99:e20655. [PMID: 32541506 PMCID: PMC7302585 DOI: 10.1097/md.0000000000020655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 05/02/2020] [Accepted: 05/08/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND In this meta-analysis, we aimed to systematically compare the complications during hospitalization and at 30 days respectively, in intensive cardiac care unit (ICCU) for patients with ST elevation (STE) vs non-STE acute coronary syndrome (NSTE ACS). METHODS Electronic search databases including http://www.ClinicalTrials.gov, EMBASE, Cochrane Central, Google Scholar, Web of Science, and MEDLINE were searched for publications comparing complications observed in STE ACS vs NSTE ACS patients admitted in ICCU, intensive care unit (ICU) or coronary care unit (CCU). This is a meta-analysis and risk ratios (RR) with 95% confidence intervals (CI) were used to illustrate the data following analysis by the RevMan 5.3 software. RESULTS Six studies consisting of a total number of 25,604 participants (12,880 participants admitted due to STE ACS and 12,724 participants admitted due to NSTE ACS) were included. Our results showed that the total outcomes including severely abnormal electrocardiography (ECG) (RR: 1.48, 95% CI: 1.27-1.73; P = .00001) and mortality (RR: 1.83, 95% CI: 1.64-2.04; P = .00001) were significantly higher in patients with STE ACS. Re-infarction (RR: 0.86, 95% CI: 0.62-1.19; P = .37) and heart failure (RR: 1.04, 95% CI: 0.88-1.23; P = .62) were similarly manifested in those patients with ACS. However, the risk for recurrent angina was significantly higher with NSTE ACS (RR: 0.65, 95% CI: 0.46-0.92; P = .01). CONCLUSIONS Patients with STE ACS were at a higher risk for in-hospital and 30 days mortality in this analysis. In hospital, severely abnormal ECG was also significantly higher in this category of patients compared to NSTE ACS. However, re-admission for heart failure and re-infarction was similar in both groups. Future studies should be able to confirm this hypothesis.
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Lao X, Ma L, Ma Q, Ma Q, Yang Z, Guo L, Nong W. Hematological factors associated with immunity, inflammation, and metabolism in patients with systemic lupus erythematosus: Data from a Zhuang cohort in Southwest China. J Clin Lab Anal 2020; 34:e23211. [PMID: 31978275 PMCID: PMC7307337 DOI: 10.1002/jcla.23211] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 12/19/2019] [Accepted: 12/26/2019] [Indexed: 01/01/2023] Open
Abstract
Introduction Hematological parameters play important role in multiple diseases. This study was to investigate the possible association of the routine hematological parameters involved in immunity, inflammation, and metabolism with systemic lupus erythematosus (SLE) in patients of Zhuang ethnicity in Guangxi, southwest China. Methods The medical records of 195 Zhuang SLE patients between January 2013 and November 2018 were retrospectively reviewed. Random forest algorithm and multivariate logistic regression were used to identify the feature hematological parameters in patients with SLE. Association rules were explored between each parameter and immunity‐ (IgG, IgA, IgM, C3, and C4), inflammation‐ (ESR, hs‐CRP, and CAR), and metabolism‐ (TG, TC, HDL‐C, LDL‐C, TP, PA, ALB, and UA) related indexes. Results Random forest algorithm and logistic regression analysis showed that neutrophil‐to‐lymphocyte ratio (NLR), red blood cell distribution width (RDW), and platelet‐to‐lymphocyte ratio (PLR) were the feature parameters for distinguishing SLE patients from healthy controls. According to the ROC curves, the optimal cutoff values to predict SLE were 1.98 for NLR, 13.35 for RDW, and 145.64 for PLR. Association rule analysis showed that NLR was strongly associated with C3, hs‐CRP, TG, ALB, and UA; RDW was strongly associated with C3, C4, hs‐CRP, TG, and ALB; PLR was strongly associated with IgG, hs‐CRP, HDL‐C, and UA. Conclusions Neutrophil‐to‐lymphocyte ratio, RDW, and PLR may serve as effective predictors of dysregulation in immunity, inflammation, and metabolism. These three indicators may be potential for cardiovascular risk assessment in Zhuang SLE patients in southwest China.
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Affiliation(s)
- Xiaoxia Lao
- Department of Clinical Laboratory, Minzu Hospital of Guangxi Zhuang Autonomous Region, Affiliated Minzu Hospital of Guangxi Medical University, Guangxi, China
| | - Liping Ma
- Department of Clinical Laboratory, Minzu Hospital of Guangxi Zhuang Autonomous Region, Affiliated Minzu Hospital of Guangxi Medical University, Guangxi, China
| | - Qingwei Ma
- Department of Clinical Laboratory, Minzu Hospital of Guangxi Zhuang Autonomous Region, Affiliated Minzu Hospital of Guangxi Medical University, Guangxi, China
| | - Qiaorong Ma
- Department of Clinical Laboratory, Minzu Hospital of Guangxi Zhuang Autonomous Region, Affiliated Minzu Hospital of Guangxi Medical University, Guangxi, China
| | - Zhige Yang
- Department of Clinical Laboratory, Minzu Hospital of Guangxi Zhuang Autonomous Region, Affiliated Minzu Hospital of Guangxi Medical University, Guangxi, China
| | - Lingxiao Guo
- Department of Clinical Laboratory, Minzu Hospital of Guangxi Zhuang Autonomous Region, Affiliated Minzu Hospital of Guangxi Medical University, Guangxi, China
| | - Wenzheng Nong
- Department of Gynaecology, Minzu Hospital of Guangxi Zhuang Autonomous Region, Affiliated Minzu Hospital of Guangxi Medical University, Guangxi, China
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Wang XY, Zhang F, Zhang C, Zheng LR, Yang J. The Biomarkers for Acute Myocardial Infarction and Heart Failure. BIOMED RESEARCH INTERNATIONAL 2020; 2020:2018035. [PMID: 32016113 PMCID: PMC6988690 DOI: 10.1155/2020/2018035] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 11/05/2019] [Accepted: 12/04/2019] [Indexed: 01/06/2023]
Abstract
The use of a large number of cardiovascular biomarkers, meant to complement the use of the electrocardiogram, echocardiography cardiac imaging, and clinical symptom assessment, has become a routine in clinical diagnosis, differential diagnosis, risk stratification, and prognosis and guides the management of patients with suspected cardiovascular diseases. There is a broad consensus that cardiac troponin and natriuretic peptides are the preferred biomarkers in clinical practice for the diagnosis of the acute coronary syndrome and heart failure, respectively, while the roles and possible clinical applications of several other potential biomarkers are still under study. This review mainly focuses on the recent studies of the roles and clinical applications of troponin and natriuretic peptides, which seem to be the best-validated markers in distinguishing and predicting the future cardiac events of patients with suspected cardiovascular diseases. Additionally, the review briefly discusses some of the large number of potential markers that may play a more prominent role in the future.
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Affiliation(s)
- Xi-Ying Wang
- Department of Cardiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Fen Zhang
- Department of Cardiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Chi Zhang
- Department of Cardiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Liang-Rong Zheng
- Department of Cardiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Jian Yang
- Department of Cardiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
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Wang J, Li X, Pu J, Jin S, Jia L, Li X, Liu F, Yang Y. Mean platelet volume and coronary plaque vulnerability: an optical coherence tomography study in patients with non-ST-elevation acute coronary syndrome. BMC Cardiovasc Disord 2019; 19:128. [PMID: 31142268 PMCID: PMC6542039 DOI: 10.1186/s12872-019-1115-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Accepted: 05/21/2019] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND The association between mean platelet volume (MPV) and coronary plaque vulnerability in patients with non-ST-elevation ACS (NSTE-ACS) has not been investigated. We performed a retrospective study to evaluate the association between MPV and plaque vulnerability using optical coherence tomography (OCT). METHODS Consecutive NSTE-ACS patients who underwent pre-intervention OCT examination in our center were included in this study. Features of coronary plaques in the culprit arteries were classified as rupture, nonrupture with thin-cap fibroatheroma (TCFA), and nonrupture and non-TCFA. ROC analyses were used to determine the predictive efficacy of MPV for plaque rupture, and multivariate logistic regression analysis was performed to evaluate the potential independent predictors of plaque vulnerability. RESULTS Overall, 94 patients were included in this study. We identified 17 patients with plaque rupture, 10 with nonrupture with TCFA, and 67 with nonrupture and non-TCFA. ROC analyses showed that MPV ≥ 10.5 fL was predictive of plaque rupture in NSTE-ACS patients. Univariate analyses indicated that patients with higher MPV (≥ 10.5 fL) had higher body mass index and poorer lipid profiles compared to those with lower MPV. Moreover, those with higher MPV had higher incidences of plaque rupture and thrombosis (both P < 0.05). Results of multivariate analyses showed that diabetes and higher platelet distribution width (PDW) were independent risk factors of TCFA (P = 0.032 and 0.046, respectively), while diabetes, higher BMI, higher PDW, and higher MPV were independent determinants of plaque rupture in our cohorts (P all < 0.05). CONCLUSIONS Higher MPV is independently associated with higher risk of plaque rupture as evidenced by OCT in our cohort of NSTE-ACS patients.
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Affiliation(s)
- Jun Wang
- Department of Coronary Heart Disease, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011, China
| | - Xing Li
- Department of Coronary Heart Disease, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011, China
| | - Jun Pu
- The Renji Hospital of Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Siyu Jin
- Department of Coronary Heart Disease, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011, China
| | - Lu Jia
- Department of Coronary Heart Disease, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011, China
| | - Xiaomei Li
- Department of Coronary Heart Disease, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011, China
| | - Fen Liu
- Department of Coronary Heart Disease, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011, China
| | - Yining Yang
- Department of Coronary Heart Disease, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011, China.
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Association between Platelet Parameters and Glaucoma Severity in Primary Open-Angle Glaucoma. J Ophthalmol 2019; 2019:3425023. [PMID: 31210983 PMCID: PMC6532286 DOI: 10.1155/2019/3425023] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 04/16/2019] [Accepted: 04/23/2019] [Indexed: 12/19/2022] Open
Abstract
Purpose To evaluate platelet parameters in primary open-angle glaucoma (POAG) patients and to explore the association between platelet parameters and POAG severity. Methods A total of 402 consecutive POAG patients and 408 healthy control subjects from the Department of Ophthalmology and Visual Science, Eye and ENT Hospital, Fudan University, were consecutively recruited between January 2016 and October 2018. Detailed ophthalmological and systematic examinations were performed. Blood samples for platelet parameters, including platelet count (PLT), platelet distribution width (PDW), plateletcrit (PCT), mean platelet volume (MPV), and platelet large cell ratio (P-LCR), were analyzed using an automated hematology analyzer in the department of clinical laboratory science of the hospital. The POAG subgroups were classified according to age (<50, ≥50), gender, and visual field mean deviation (MD): mild (MD ≤ 6 dB), moderate (6 dB < MD ≤ 12 dB), and severe (MD > 12 dB). Results In POAG patients, PLT counts (207.08 ± 54.70 ∗ 109/L) were significantly lower (p=0.001) than those of the control group (220.46 ± 55.85 ∗ 109/L). In the POAG group, PDW (13.76 ± 3.16 fL) and MPV (10.46 ± 1.32 fL) values were significantly higher (all p < 0.001) than those of the control group (PDW 11.82 ± 2.44 fL, MPV 10.13 ± 1.10 fL). PDW and MPV values were highest in the severe POAG group (PDW 14.49 ± 2.99 fL; MPV 10.74 ± 1.39 fL), followed by the moderate group (PDW 12.50 ± 3.14 fL; MPV 10.02 ± 1.08 fL) and then the mild group (PDW 11.82 ± 2.44 fL; MPV 9.92 ± 0.76 fL), with statistically significant differences observed between mild-severe POAG and moderate-severe POAG groups by LSD post hoc test. Multiple linear regression analyses showed a significant association between PDW and MD (β = 0.430, p < 0.001) and MPV and MD (β = 0.363, p=0.001). Logistic regression analyses revealed that PDW (OR = 1.297, 95% CI = 1.011-1.663) was associated with the severity of POAG. Conclusions PDW and MPV values were significantly elevated in POAG patients, and PDW was positively associated with disease severity, which suggested the possibility that platelet activation be involved in pathomechanisms of POAG.
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Qiu L, Pan M, Zhang R, Ren K. Maternal peripheral blood platelet-to-white blood cell ratio and platelet count as potential diagnostic markers of histological chorioamnionitis-related spontaneous preterm birth. J Clin Lab Anal 2019; 33:e22840. [PMID: 30714639 PMCID: PMC6528611 DOI: 10.1002/jcla.22840] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 12/12/2018] [Accepted: 12/13/2018] [Indexed: 11/11/2022] Open
Abstract
Background Histological chorioamnionitis (HCA) is one of the leading causes of spontaneous preterm birth, thus, to identify novel biomarkers for the early diagnosis of HCA is in a great need. Objective To investigate the diagnostic value of maternal peripheral blood platelet‐to‐white blood cell ratio (PLT/WBC) and platelet (PLT) counts in HCA‐related preterm birth. Methods A total of 400 patients with preterm birth were enrolled in this study: non‐HCA group (n = 193) and HCA group (n = 207), and 87 full‐term pregnancies were enrolled as the control. The peripheral blood of the participators was collected, and the neutrophil count, WBC count, platelet count, and levels of C‐reactive protein (CRP) and procalcitonin were recorded, and the platelet‐to‐white blood cell ratio (PLT/WBC) of the participators was calculated. Receiver operating characteristic (ROC) curve has been drawn to show the sensitivity and specificity of PLT/WBC and PLT count for the diagnosis of HCA‐related spontaneous preterm birth patients. Results The neutrophil count, WBC count, and procalcitonin show no significant differences among the three groups, and the PLT count, PLT/WBC, and CRP (P < 0.05) were significantly increased in HCA group compared with non‐HCA group; moreover, the area under the curve (AUC) of PLT/WBC, PLT, and CRP was 0.744 (95% confidence interval [CI], 0.6966‐0.7922), 0.8095 (95% CI, 0.7676‐0.8514), and 0.5730 (95% CI, 0.5173‐0.6287), respectively. Conclusion Platelet count and PLT/WBC may become a potential biomarker of HCA‐related spontaneous preterm birth.
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Affiliation(s)
- Liyin Qiu
- Obstetrical Department, Fujian Provincial Maternity and Children's Hospital, affiliated Hospital of Fujian Medical University, Fujian, China
| | - Mian Pan
- Obstetrical Department, Fujian Provincial Maternity and Children's Hospital, affiliated Hospital of Fujian Medical University, Fujian, China
| | - Ronglian Zhang
- Obstetrical Department, Fujian Provincial Maternity and Children's Hospital, affiliated Hospital of Fujian Medical University, Fujian, China
| | - Kunhai Ren
- Obstetrical Department, Fujian Provincial Maternity and Children's Hospital, affiliated Hospital of Fujian Medical University, Fujian, China
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