1
|
La S, Beltrame J, Tavella R. Sex-specific and ethnicity-specific differences in MINOCA. Nat Rev Cardiol 2024; 21:192-202. [PMID: 37775559 DOI: 10.1038/s41569-023-00927-6] [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] [Accepted: 08/28/2023] [Indexed: 10/01/2023]
Abstract
Suspected myocardial infarction with non-obstructive coronary arteries (MINOCA) has received increasing attention over the past decade. Given the heterogeneity in the mechanisms underlying acute myocardial infarction in the absence of obstructive coronary arteries, the syndrome of MINOCA is considered a working diagnosis that requires further investigation after diagnostic angiography studies have been performed, including coronary magnetic resonance angiography and functional angiography. Although once considered an infrequent and low-risk form of myocardial infarction, recent data have shown that the prognosis of MINOCA is not as benign as previously assumed. However, despite increasing awareness of the condition, many questions remain regarding the diagnosis, risk stratification and treatment of MINOCA. Women seem to be more susceptible to MINOCA, but studies on the sex-specific differences of the disease are scarce. Similarly, ethnicity-specific factors might explain discrepancies in the observed prevalence or underlying pathophysiological mechanisms of MINOCA but data are also scarce. Therefore, in this Review, we provide an update on the latest evidence available on the sex-specific and ethnicity-specific differences in the clinical features, pathophysiological mechanisms, treatment and prognosis of MINOCA.
Collapse
Affiliation(s)
- Sarena La
- Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
- Department of Cardiology, Central Adelaide Local Health Network, SA Health, Adelaide, South Australia, Australia
- Basil Hetzel Institute for Translational Health Research, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
| | - John Beltrame
- Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
- Department of Cardiology, Central Adelaide Local Health Network, SA Health, Adelaide, South Australia, Australia
- Basil Hetzel Institute for Translational Health Research, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
| | - Rosanna Tavella
- Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia.
- Department of Cardiology, Central Adelaide Local Health Network, SA Health, Adelaide, South Australia, Australia.
- Basil Hetzel Institute for Translational Health Research, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia.
| |
Collapse
|
2
|
Samii A, Aslani S, Imani D, Razi B, Samaneh Tabaee S, Jamialahmadi T, Sahebkar A. MTHFR gene polymorphisms and susceptibility to myocardial infarction: Evidence from meta-analysis and trial sequential analysis. IJC HEART & VASCULATURE 2023; 49:101293. [PMID: 38035258 PMCID: PMC10687297 DOI: 10.1016/j.ijcha.2023.101293] [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: 08/04/2023] [Revised: 10/27/2023] [Accepted: 10/30/2023] [Indexed: 12/02/2023]
Abstract
Background This meta-analysis aimed to provide a comprehensive assessment of the association between Methylenetetrahydrofolate reductase (MTHFR) gene polymorphisms, specifically C677T and A1298C, and the susceptibility to myocardial infarction (MI). Methods A systematic literature search was conducted in MEDLINE, Web of Science, and Scopus until April 2023 to identify studies investigating the relationship between MTHFR gene polymorphisms (C677T and A1298C) and the risk of MI. Results The analysis included 66 studies involving 16,860 cases and 20,403 controls for the C677T polymorphism and 18 studies comprising 3162 cases and 3632 controls for the A1298C polymorphism. Significant associations were observed between the C677T polymorphism and MI risk in various genetic models: dominant (OR = 1.16, 95 % CI = 1.06-1.28, P = 0.008), recessive (OR = 1.20, 95 % CI = 1.12-1.28, P < 0.001), allelic (OR = 1.13, 95 % CI = 1.06-1.21, P < 0.001), TT vs. CC (OR = 1.19, 95 % CI = 1.05-1.36, P < 0.001), and CT vs. CC (OR = 1.11, 95 % CI = 1.02-1.21, P = 0.01). Furthermore, an overall analysis indicated a marginally significant association between the A1298C polymorphism and MI risk in the recessive model (OR = 1.27, 95 % CI = 1.06-1.51, P = 0.008), allelic model (OR = 1.18, 95 % CI = 1.01-1.39, P = 0.03), and CC vs. AA model (OR = 1.22, 95 % CI = 1.01-1.47, P = 0.04). Meta-regression analysis revealed that none of the potential factors contributed to the observed heterogeneity. Conclusions This meta-analysis revealed an association between MTHFR gene C677T and A1298C polymorphisms and the risk of MI.
Collapse
Affiliation(s)
- Amir Samii
- Department of Hematology and Blood Transfusion, School of Allied Medical Science, Iran University of Medical Sciences, Tehran, Iran
| | - Saeed Aslani
- Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Danyal Imani
- Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Bahman Razi
- Department of Hematology and Blood Transfusion, Faculty of Medical Sciences, Tarbiat Modares University (TMU), Tehran, Iran
| | - Seyedeh Samaneh Tabaee
- Noncommunicable Disease Research Center, Neyshabur University of Medical Sciences, Neyshabur, Iran
- Faculty of Medicine, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Tannaz Jamialahmadi
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amirhossein Sahebkar
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| |
Collapse
|
3
|
Badescu MC, Butnariu LI, Costache AD, Gheorghe L, Seritean Isac PN, Chetran A, Leancă SA, Afrăsânie I, Duca ȘT, Gorduza EV, Costache II, Rezus C. Acute Myocardial Infarction in Patients with Hereditary Thrombophilia-A Focus on Factor V Leiden and Prothrombin G20210A. Life (Basel) 2023; 13:1371. [PMID: 37374153 DOI: 10.3390/life13061371] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 05/21/2023] [Accepted: 06/07/2023] [Indexed: 06/29/2023] Open
Abstract
Factor V (FV) Leiden and prothrombin G20210A are the most common hereditary thrombophilias. While their role in venous thromboembolism is well known, there are still uncertainties regarding their relationship with arterial thrombotic events, especially coronary ones. Our research, based on an in-depth analysis of the available literature, provides up-to-date information on the relationship between FV Leiden and prothrombin G20210A and acute myocardial infarction. FV Leiden and prothrombin G20210A screening should be implemented only in select cases, such as acute coronary syndrome in young individuals and/or in the absence of traditional cardiovascular risk factors and/or in the absence of significant coronary artery stenosis at angiography. Their identification should be followed by the implementation of optimal control of modifiable traditional cardiovascular risk factors to reduce the risk of recurrent events and genotyping and genetic counseling of all family members of affected cases for proper prophylaxis. An extended dual antiplatelet therapy (DAPT) may be considered, given the lower risk of bleeding under DAPT conferred by FV Leiden.
Collapse
Affiliation(s)
- Minerva Codruta Badescu
- Department of Internal Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
- III Internal Medicine Clinic, "St. Spiridon" County Emergency Clinical Hospital, 700111 Iasi, Romania
| | - Lăcrămioara Ionela Butnariu
- Department of Mother and Child Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Alexandru Dan Costache
- Department of Internal Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
- Cardiovascular Rehabilitation Clinic, Clinical Rehabilitation Hospital, 700661 Iasi, Romania
| | - Liliana Gheorghe
- Department of Radiology, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
- Radiology Clinic "St. Spiridon" County Emergency Clinical Hospital, 700111 Iasi, Romania
| | - Petronela Nicoleta Seritean Isac
- Department of Internal Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
- III Internal Medicine Clinic, "St. Spiridon" County Emergency Clinical Hospital, 700111 Iasi, Romania
| | - Adriana Chetran
- Department of Internal Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
- Cardiology Clinic, "St. Spiridon" County Emergency Clinical Hospital, 700111 Iasi, Romania
| | - Sabina Andreea Leancă
- Department of Internal Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
- Cardiology Clinic, "St. Spiridon" County Emergency Clinical Hospital, 700111 Iasi, Romania
| | - Irina Afrăsânie
- Department of Internal Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
- Cardiology Clinic, "St. Spiridon" County Emergency Clinical Hospital, 700111 Iasi, Romania
| | - Ștefania-Teodora Duca
- Department of Internal Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
- Cardiology Clinic, "St. Spiridon" County Emergency Clinical Hospital, 700111 Iasi, Romania
| | - Eusebiu Vlad Gorduza
- Department of Mother and Child Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Irina Iuliana Costache
- Department of Internal Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
- Cardiology Clinic, "St. Spiridon" County Emergency Clinical Hospital, 700111 Iasi, Romania
| | - Ciprian Rezus
- Department of Internal Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
- III Internal Medicine Clinic, "St. Spiridon" County Emergency Clinical Hospital, 700111 Iasi, Romania
| |
Collapse
|
4
|
Mallhi TH, Shahid M, Rehman K, Khan YH, Alanazi AS, Alotaibi NH, Akash MSH, Butt MH. Biochemical Association of MTHFR C677T Polymorphism with Myocardial Infarction in the Presence of Diabetes Mellitus as a Risk Factor. Metabolites 2023; 13:251. [PMID: 36837870 PMCID: PMC9958922 DOI: 10.3390/metabo13020251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 02/07/2023] [Accepted: 02/07/2023] [Indexed: 02/12/2023] Open
Abstract
Myocardial infarction (MI) is a cardiovascular disease that occurs due to the blockage of the coronary artery. Subsequently, cardiac muscles receive a lower oxygen supply, which leads to the death of cardiac muscles. The etiology of MI is linked to various environmental, occupational, and genetic factors. Various studies have been conducted on the polymorphism of genes involved in MI. Previous studies have shown that different variants of the methylene tetrahydrofolate reductase (MTHFR) gene are involved in causing MI by altering the metabolism of folate and homocysteine. However, the genetic polymorphism of MTHFR C677T (rs1801133) and its association with MI in the presence of diabetes mellitus (DM) as a risk factor still needs to be investigated. This study recruited 300 participants who were divided into three groups, i.e., the control, MI, and MI-DM. The blood samples collected from the study participants were subjected to various biochemical tests and their clinical parameters were monitored. MTHFR C677T (rs1801133) genotyping was performed by Tetra ARMS PCR using predetermined primers. The MTHFR C677T (rs1801133) polymorphism was associated with MI in the presence of DM as a risk factor among the participants. The MTHFR C677T (rs1801133) T/T homozygous genotype was found to be significant among MI patients in the presence of DM as a risk factor.
Collapse
Affiliation(s)
- Tauqeer Hussain Mallhi
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka 72388, Saudi Arabia
| | - Momina Shahid
- Department of Pharmacy, The University of Faisalabad, Faisalabad 38000, Pakistan
- Department of Pharmaceutical Chemistry, Government College University, Faisalabad 38000, Pakistan
| | - Kanwal Rehman
- Department of Pharmacy, The Women University, Multan 60000, Pakistan
| | - Yusra Habib Khan
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka 72388, Saudi Arabia
| | - Abdullah Salah Alanazi
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka 72388, Saudi Arabia
| | - Nasser Hadal Alotaibi
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka 72388, Saudi Arabia
| | | | - Muhammad Hammad Butt
- Department of Medicinal Chemistry, Faculty of Pharmacy, Uppsala University, 75123 Uppsala, Sweden
| |
Collapse
|
5
|
Agosti P, Mancini I, Sadeghian S, Pagliari MT, Abbasi SH, Pourhosseini H, Boroumand M, Lotfi-Tokaldany M, Pappalardo E, Maino A, Rosendaal FR, Peyvandi F. Factor V Leiden but not the factor II 20210G>A mutation is a risk factor for premature coronary artery disease: a case-control study in Iran. Res Pract Thromb Haemost 2023; 7:100048. [PMID: 36798900 PMCID: PMC9926016 DOI: 10.1016/j.rpth.2023.100048] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 12/06/2022] [Accepted: 12/18/2022] [Indexed: 01/13/2023] Open
Abstract
Background Factor V Leiden (FVL) and factor II c.∗97G>A (rs1799963) are genetic risk factors for venous thromboembolism. Their contribution to coronary artery disease (CAD) is less clear. Objectives This study aimed to investigate the association between FVL, rs1799963, and premature CAD in Iranians. Methods We performed a genetic case-control study of 944 cases and 1081 controls from the premature CAD Milano-Iran study, including patients aged 18-55 (female) and 18-45 years (male) who underwent coronary angiography at the Tehran Heart Centre (Iran) in 2004-2011. Cases had luminal stenosis ≥50% in at least 1 main coronary artery or branch. Controls were age- and sex-matched with no CAD history. FVL and rs1799963 were genotyped using TaqMan SNP genotyping assays. Association was tested by logistic regression adjusted for matching factors and ethnicity. Effect modification by sex and cardiovascular risk factors (metabolic [obesity, hypertension, hyperlipidemia, and diabetes], and smoking) was assessed. Results The risk of premature CAD was increased by 50% in FVL carriers (adjusted odds ratio [adjOR] 1.54 [95% CI, 0.95-2.48]) and slightly reduced in rs1799963 carriers (adjOR 0.71 [95% CI, 0.40-1.27]). These effects were more pronounced in women than men (FVL, adjOR 1.66 vs 1.25; rs1799963, adjOR 0.60 vs 1.07). The risk of premature CAD was substantially increased in carriers of FVL with at least 1 metabolic risk factor compared with noncarriers without metabolic risk factors (adjOR 25.14 [95% CI, 12.51-50.52]). Conclusion FVL but not FII rs1799963 was associated with an increased risk of CAD in young Iranians. This risk increased considerably when combined with metabolic cardiovascular risk factors.
Collapse
Affiliation(s)
- Pasquale Agosti
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, and Fondazione Luigi Villa, Milan, Italy
| | - Ilaria Mancini
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, and Fondazione Luigi Villa, Milan, Italy
| | - Saeed Sadeghian
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Maria Teresa Pagliari
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Milan, Italy
| | - Seyed Hesameddin Abbasi
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran,Department of Global Health and Population, Bernard Lown Scholar in Cardiovascular Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Hamidreza Pourhosseini
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammadali Boroumand
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoumeh Lotfi-Tokaldany
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Emanuela Pappalardo
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, and Fondazione Luigi Villa, Milan, Italy
| | - Alberto Maino
- Azienda Provinciale per i Servizi Sanitari, Ospedale Santa Chiara, Unit of Internal Medicine, Trento, Italy
| | - Frits R. Rosendaal
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Flora Peyvandi
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, and Fondazione Luigi Villa, Milan, Italy,Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Milan, Italy,Correspondence Flora Peyvandi, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Via Pace 9, 20122, Milan, Italy. @flora_peyvandi
| |
Collapse
|
6
|
Causes, Angiographic Characteristics, and Management of Premature Myocardial Infarction: JACC State-of-the-Art Review. J Am Coll Cardiol 2022; 79:2431-2449. [PMID: 35710195 DOI: 10.1016/j.jacc.2022.04.015] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 03/31/2022] [Accepted: 04/13/2022] [Indexed: 12/13/2022]
Abstract
Among patients presenting with acute myocardial infarction (AMI), the proportion of young individuals has increased in recent years. Although coronary atherosclerosis is less extensive in young patients with AMI, with higher prevalence of single-vessel disease and rare left main involvement, the long-term prognosis is not benign. Young patients with AMI with obstructive coronary artery disease have similar risk factors as older patients except for higher prevalence of smoking, lipid disorders, and family history of premature coronary artery disease, and lower prevalence of diabetes mellitus and hypertension. Smoking cessation is by far the most effective secondary preventive measure. Myocardial infarction with nonobstructive coronary arteries is a relatively common clinical entity (10%-20%) among young patients with AMI, with intravascular and cardiac magnetic resonance imaging being key for diagnosis and potentially treatment. Spontaneous coronary artery dissection is a frequent pathogenetic mechanism of AMI among young women, requiring a high degree of suspicion, especially in the peripartum period.
Collapse
|
7
|
Shah T, Kapadia S, Lansky AJ, Grines CL. ST-Segment Elevation Myocardial Infarction: Sex Differences in Incidence, Etiology, Treatment, and Outcomes. Curr Cardiol Rep 2022; 24:529-540. [PMID: 35286662 DOI: 10.1007/s11886-022-01676-7] [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] [Accepted: 02/03/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE Although there have been marked improvements in the standard of care for treatment of ST-elevation myocardial infarction, women, especially younger women, continue to have significantly worse outcomes than men. RECENT FINDINGS This review highlights the current sex differences in presentation, etiology, treatment, and outcomes among these patients in order to make providers aware of the heterogeneous entities that cause ST-elevation myocardial infarction particularly in women and of disparities in treatment that lead to poorer outcomes in women. Furthermore, it emphasizes evidence-based strategies including standardized protocols for early revascularization, mechanical circulatory support, and access methodology that can reduce sex-based disparities in treatments and outcomes.
Collapse
Affiliation(s)
- Tayyab Shah
- Yale University School of Medicine, New Haven, CT, USA
| | | | | | - Cindy L Grines
- Northside Hospital Cardiovascular Institute, Atlanta, GA, USA.
| |
Collapse
|
8
|
Chow E, Diep B, Getman T, Kilani A, Khiatah B, Jazayeri S, Mansour C. Clinical presentation and management of myocardial infarction with nonobstructive coronary arteries (MINOCA): A literature review. Heliyon 2021; 7:e08362. [PMID: 34816048 PMCID: PMC8591493 DOI: 10.1016/j.heliyon.2021.e08362] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 09/17/2021] [Accepted: 11/08/2021] [Indexed: 11/26/2022] Open
Abstract
Myocardial Infarction with Nonobstructive Coronary Arteries (MINOCA), as the name implies, is an acute myocardial infarction (MI) in the absence of significant coronary artery obstruction. Diagnosis and management of such cases have been challenging. There are many etiologies of MINOCA including coronary artery spasm, coronary microvascular dysfunction, plaque disruption, spontaneous coronary thrombosis or emboli, spontaneous coronary artery dissection, or cardiomyopathies. In this paper, the pathophysiology, diagnostic work-up, and clinical management for each subtype are described, and an overarching approach on how to evaluate and manage a patient presenting with MINOCA.
Collapse
Affiliation(s)
- Erica Chow
- Western University of Health Sciences, Pomona, CA 91766, USA.,Community Memorial Hospital, 147 N Brent St, Ventura CA 93003, USA
| | - Brian Diep
- Western University of Health Sciences, Pomona, CA 91766, USA.,Community Memorial Hospital, 147 N Brent St, Ventura CA 93003, USA
| | - Tatiana Getman
- Western University of Health Sciences, Pomona, CA 91766, USA.,Community Memorial Hospital, 147 N Brent St, Ventura CA 93003, USA
| | - Amir Kilani
- Western University of Health Sciences, Pomona, CA 91766, USA.,Community Memorial Hospital, 147 N Brent St, Ventura CA 93003, USA
| | - Bashar Khiatah
- Department of Internal Medicine, Community Memorial Hospital, 147 N Brent St, Ventura CA 93003, USA
| | - Sam Jazayeri
- Department of Internal Medicine, Community Memorial Hospital, 147 N Brent St, Ventura CA 93003, USA
| | - Craig Mansour
- Cardiology Associates Medical Group, 168 North Brent Street Suite 503, Ventura, CA 93003, USA
| |
Collapse
|
9
|
Ya'qoub L, Elgendy IY, Pepine CJ. Syndrome of Nonobstructive Coronary Artery Diseases: A Comprehensive Overview of Open Artery Ischemia. Am J Med 2021; 134:1321-1329. [PMID: 34343507 PMCID: PMC8754003 DOI: 10.1016/j.amjmed.2021.06.038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 06/25/2021] [Accepted: 06/28/2021] [Indexed: 02/06/2023]
Abstract
Syndromes of cardiac ischemia with nonobstructive coronary arteries have been increasingly recognized as a clinical entity with heterogeneous clinical presentations, commonly encountered in women. Knowledge of pathophysiology and clinical risk factors is key to ensuring appropriate diagnostic evaluation and management for these often-neglected patients. In this review, we discuss the epidemiology, risk factors, and clinical presentations of these syndromes. We provide algorithms for diagnosis and management of these entities based on current scientific knowledge and highlight some of the key knowledge gaps and ongoing trials in this emerging field.
Collapse
Affiliation(s)
- Lina Ya'qoub
- Department of Cardiology, Ochsner-Louisiana State University, Shreveport, La
| | - Islam Y Elgendy
- Department of Medicine, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Carl J Pepine
- Division of Cardiovascular Medicine, University of Florida, Gainesville.
| |
Collapse
|
10
|
Molecular Analysis of Prothrombotic Gene Variants in Patients with Acute Ischemic Stroke and with Transient Ischemic Attack. ACTA ACUST UNITED AC 2021; 57:medicina57070723. [PMID: 34357004 PMCID: PMC8306646 DOI: 10.3390/medicina57070723] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 07/03/2021] [Accepted: 07/14/2021] [Indexed: 12/28/2022]
Abstract
Background and objectives: ischemic stroke (IS) is among the most frequent causes of death worldwide; thus, it is of paramount relevance to know predisposing factors that may help to identify and treat the high-risk subjects. Materials and Methods:we tested nine variants in genes involved in thrombotic pathway in 282 patients that experienced IS and 87 that had transient ischemic attacks (TIA) in comparison to 430 subjects from the general population (GP) of the same geographic area (southern Italy). We included cases of young and child IS to evaluate the eventual differences in the role of the analyzed variants. Results: we did not observe significant differences between TIA and the GP for any of the variants, while the allele frequencies of methylene-tetrahydrofolate reductase (MTHFR) C677T, beta-fibrinogen -455G>A and factor (FXIII) V34L were significantly higher in patients with IS than in the subjects from the GP. No significant interaction was observed with sex. Conclusions: the present data argue that some gene variants have a role in IS and this appears to be an interesting possibility to be pursued in large population studies to help design specific strategies for IS prevention.
Collapse
|
11
|
Ciliberti G, Compagnucci P, Urbinati A, Bianco F, Stronati G, Lattanzi S, Dello Russo A, Guerra F. Myocardial Infarction Without Obstructive Coronary Artery Disease (MINOCA): A Practical Guide for Clinicians. Curr Probl Cardiol 2020; 46:100761. [PMID: 33360675 DOI: 10.1016/j.cpcardiol.2020.100761] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Accepted: 11/24/2020] [Indexed: 12/14/2022]
Abstract
Myocardial infarction without obstructive coronary artery disease (MINOCA) is defined by the evidence of spontaneous acute myocardial infarction (MI) and angiographic exclusion of coronary stenoses ≥50% in any potential infarct related artery, after having ruled out other clinically overt causes for the acute presentation. The introduction of this new concept was meant to encourage discovery of putative pathophysiological mechanisms and development of specific therapeutic measures. In recent years, we have witnessed significant advances in the fields of epidemiology, pathophysiology, diagnosis, prognosis estimation and therapeutics of MINOCA. So far, however, the definition of MINOCA has been rather heterogeneous since specific cardiac conditions such as myocarditis and Takotsubo syndrome have often been included, generating conflicting results. In this review, we summarize the current state-of-the-art in the expanding MINOCA field and propose a comprehensive stepwise approach for the rational diagnostic assessment of these challenging patients. Our aim is to provide clinicians with an "Ariadne's thread" according to the recent fourth universal definition of MI in order to not get lost in MINOCA's labyrinth.
Collapse
Affiliation(s)
- Giuseppe Ciliberti
- Cardiology and Arrhythmology Clinic, Marche Polytechnic University, University Hospital "Umberto I - Lancisi - Salesi," Ancona, Italy
| | - Paolo Compagnucci
- Cardiology and Arrhythmology Clinic, Marche Polytechnic University, University Hospital "Umberto I - Lancisi - Salesi," Ancona, Italy
| | - Alessia Urbinati
- Cardiology and Arrhythmology Clinic, Marche Polytechnic University, University Hospital "Umberto I - Lancisi - Salesi," Ancona, Italy
| | - Francesco Bianco
- Department of Neuroscience, Imaging and clinical Sciences, "G. d'Annunzio" University, Chieti, Italy
| | - Giulia Stronati
- Cardiology and Arrhythmology Clinic, Marche Polytechnic University, University Hospital "Umberto I - Lancisi - Salesi," Ancona, Italy
| | - Simona Lattanzi
- Neurology Clinic, Marche Polytechnic University, Ancona, Italy
| | - Antonio Dello Russo
- Cardiology and Arrhythmology Clinic, Marche Polytechnic University, University Hospital "Umberto I - Lancisi - Salesi," Ancona, Italy
| | - Federico Guerra
- Cardiology and Arrhythmology Clinic, Marche Polytechnic University, University Hospital "Umberto I - Lancisi - Salesi," Ancona, Italy.
| |
Collapse
|
12
|
Amanat S, Requena T, Lopez-Escamez JA. A Systematic Review of Extreme Phenotype Strategies to Search for Rare Variants in Genetic Studies of Complex Disorders. Genes (Basel) 2020; 11:genes11090987. [PMID: 32854191 PMCID: PMC7564972 DOI: 10.3390/genes11090987] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 08/14/2020] [Accepted: 08/19/2020] [Indexed: 12/12/2022] Open
Abstract
Exome sequencing has been commonly used to characterize rare diseases by selecting multiplex families or singletons with an extreme phenotype (EP) and searching for rare variants in coding regions. The EP strategy covers both extreme ends of a disease spectrum and it has been also used to investigate the contribution of rare variants to the heritability of complex clinical traits. We conducted a systematic review to find evidence supporting the use of EP strategies in the search for rare variants in genetic studies of complex diseases and highlight the contribution of rare variations to the genetic structure of polygenic conditions. After assessing the quality of the retrieved records, we selected 19 genetic studies considering EPs to demonstrate genetic association. All studies successfully identified several rare or de novo variants, and many novel candidate genes were also identified by selecting an EP. There is enough evidence to support that the EP approach for patients with an early onset of a disease can contribute to the identification of rare variants in candidate genes or pathways involved in complex diseases. EP patients may contribute to a better understanding of the underlying genetic architecture of common heterogeneous disorders such as tinnitus or age-related hearing loss.
Collapse
Affiliation(s)
- Sana Amanat
- Otology & Neurotology Group CTS495, Department of Genomic Medicine, GENYO—Centre for Genomics and Oncological Research—Pfizer/University of Granada/Junta de Andalucía, PTS, 18016 Granada, Spain;
| | - Teresa Requena
- Centre for Discovery Brain Sciences, Edinburgh Medical School: Biomedical Sciences, University of Edinburgh, Edinburgh EH8 9JZ, UK;
| | - Jose Antonio Lopez-Escamez
- Otology & Neurotology Group CTS495, Department of Genomic Medicine, GENYO—Centre for Genomics and Oncological Research—Pfizer/University of Granada/Junta de Andalucía, PTS, 18016 Granada, Spain;
- Department of Otolaryngology, Instituto de Investigación Biosanitaria ibs.GRANADA, Hospital Universitario Virgen de las Nieves, Universidad de Granada, 18016 Granada, Spain
- Department of Surgery, Division of Otolaryngology, Universidad de Granada, 18016 Granada, Spain
- Correspondence: ; Tel.: +34-958-715-500-160
| |
Collapse
|
13
|
Cernera G, Di Minno A, Zarrilli F, Elce A, Liguori R, Bruzzese D, Di Lullo AM, Castaldo G, Amato F, Comegna M. Prothrombotic gene variants in acute myocardial infarction at a young age (yAMI). Rationale for tailored prevention strategies in specific risk-group subjects for acute coronary disease? Nutr Metab Cardiovasc Dis 2020; 30:1397-1400. [PMID: 32513575 DOI: 10.1016/j.numecd.2020.04.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 04/17/2020] [Accepted: 04/21/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Gustavo Cernera
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università di Napoli Federico II, Naples, Italy; CEINGE-Biotecnologie Avanzate, Naples, Italy
| | - Alessandro Di Minno
- CEINGE-Biotecnologie Avanzate, Naples, Italy; Dipartimento di Farmacia, Università di Napoli Federico II, Naples, Italy
| | - Federica Zarrilli
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università di Napoli Federico II, Naples, Italy; CEINGE-Biotecnologie Avanzate, Naples, Italy
| | - Ausilia Elce
- CEINGE-Biotecnologie Avanzate, Naples, Italy; Università Telematica Pegaso, Naples, Italy
| | | | - Dario Bruzzese
- Dipartimento di Sanità Pubblica, Università di Napoli Federico II, Naples, Italy
| | - Antonella Miriam Di Lullo
- CEINGE-Biotecnologie Avanzate, Naples, Italy; Dipartimento di Neuroscienze, Scienze Riproduttive ed Odontostomatologiche, Università di Napoli Federico II, Naples, Italy
| | - Giuseppe Castaldo
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università di Napoli Federico II, Naples, Italy; CEINGE-Biotecnologie Avanzate, Naples, Italy
| | - Felice Amato
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università di Napoli Federico II, Naples, Italy; CEINGE-Biotecnologie Avanzate, Naples, Italy.
| | - Marika Comegna
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università di Napoli Federico II, Naples, Italy; CEINGE-Biotecnologie Avanzate, Naples, Italy
| |
Collapse
|
14
|
Cernera G, Di Minno A, Amato F, Elce A, Liguori R, Bruzzese D, Di Lullo AM, Castaldo G, Zarrilli F, Comegna M. Molecular Analysis of Prothrombotic Gene Variants in Venous Thrombosis: A Potential Role for Sex and Thrombotic Localization. J Clin Med 2020; 9:jcm9041008. [PMID: 32252449 PMCID: PMC7231221 DOI: 10.3390/jcm9041008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 04/01/2020] [Indexed: 01/07/2023] Open
Abstract
Background: Requests to test for thrombophilia in the clinical context are often not evidence-based. Aim: To define the role of a series of prothrombotic gene variants in a large population of patients with different venous thromboembolic diseases. Methods: We studied Factor V Leiden (FVL), FVR2, FII G20210A, Methylenetetrahydrofolate reductase (MTHFR) C677T and A1298C, beta-fibrinogen -455 G>A, FXIII V34L, and HPA-1 L33P variants and PAI-1 4G/5G alleles in 343 male and female patients with deep vein thrombosis (DVT), 164 with pulmonary embolism (PE), 126 with superficial vein thrombosis (SVT), 118 with portal vein thrombosis (PVT), 75 with cerebral vein thrombosis (CVT) and 119 with retinal vein thrombosis (RVT), and compared them with the corresponding variants and alleles in 430 subjects from the general population. Results: About 40% of patients with DVT, PE and SVT had at least one prothrombotic gene variant, such as FVL, FVR2 and FII G20210A, and a statistically significant association with the event was found in males with a history of PE. In patients with a history of PVT or CVT, the FII G20210A variant was more frequent, particularly in females. In contrast, a poor association was found between RVT and prothrombotic risk factors, confirming that local vascular factors have a key role in this thrombotic event. Conclusions: Only FVL, FVR2 and FII G20210A are related to vein thrombotic disease. Other gene variants, often requested for testing in the clinical context, do not differ significantly between cases and controls. Evidence of a sex difference for some variants, once confirmed in larger populations, may help to promote sex-specific prevention of such diseases.
Collapse
Affiliation(s)
- Gustavo Cernera
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università di Napoli Federico II, 80131 Naples, Italy; (G.C.); (F.A.); (R.L.); (G.C.); (M.C.)
- CEINGE-Biotecnologie avanzate, 80131 Naples, Italy; (A.D.M.); (A.E.); (A.M.D.L.)
| | - Alessandro Di Minno
- CEINGE-Biotecnologie avanzate, 80131 Naples, Italy; (A.D.M.); (A.E.); (A.M.D.L.)
- Dipartimento di Farmacia, Università di Napoli Federico II, 80131 Naples, Italy
| | - Felice Amato
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università di Napoli Federico II, 80131 Naples, Italy; (G.C.); (F.A.); (R.L.); (G.C.); (M.C.)
- CEINGE-Biotecnologie avanzate, 80131 Naples, Italy; (A.D.M.); (A.E.); (A.M.D.L.)
| | - Ausilia Elce
- CEINGE-Biotecnologie avanzate, 80131 Naples, Italy; (A.D.M.); (A.E.); (A.M.D.L.)
- Università Telematica Pegaso, 80143 Naples, Italy
| | - Renato Liguori
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università di Napoli Federico II, 80131 Naples, Italy; (G.C.); (F.A.); (R.L.); (G.C.); (M.C.)
- CEINGE-Biotecnologie avanzate, 80131 Naples, Italy; (A.D.M.); (A.E.); (A.M.D.L.)
| | - Dario Bruzzese
- Dipartimento di Sanità Pubblica, Università di Napoli Federico II, 80131 Naples, Italy;
| | - Antonella Miriam Di Lullo
- CEINGE-Biotecnologie avanzate, 80131 Naples, Italy; (A.D.M.); (A.E.); (A.M.D.L.)
- Dipartimento di Neuroscienze e Scienze Riproduttive ed Odontostomatologiche, Università di Napoli Federico II, 80131 Naples, Italy
| | - Giuseppe Castaldo
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università di Napoli Federico II, 80131 Naples, Italy; (G.C.); (F.A.); (R.L.); (G.C.); (M.C.)
- CEINGE-Biotecnologie avanzate, 80131 Naples, Italy; (A.D.M.); (A.E.); (A.M.D.L.)
| | - Federica Zarrilli
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università di Napoli Federico II, 80131 Naples, Italy; (G.C.); (F.A.); (R.L.); (G.C.); (M.C.)
- CEINGE-Biotecnologie avanzate, 80131 Naples, Italy; (A.D.M.); (A.E.); (A.M.D.L.)
- Correspondence: ; Tel.: +39-081-373-7860
| | - Marika Comegna
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università di Napoli Federico II, 80131 Naples, Italy; (G.C.); (F.A.); (R.L.); (G.C.); (M.C.)
- CEINGE-Biotecnologie avanzate, 80131 Naples, Italy; (A.D.M.); (A.E.); (A.M.D.L.)
| |
Collapse
|
15
|
Pourgholi L, Goodarzynejad H, Ziaee S, Zare E, Jalali A, Boroumand M. Prothrombin Gene G20210A Variant in Angiographically Documented Patients with Coronary Artery Stenosis. J Tehran Heart Cent 2019; 14:150-155. [PMID: 32461754 PMCID: PMC7231676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Background: Studies on the association between the prothrombin G20210A variant and coronary artery disease (CAD) risk are inconclusive. This study aimed to investigate the possible association between the G20210A variant in the prothrombin gene and documented CAD and its severity. Methods: This study enrolled 1460 patients who were consecutively admitted for elective coronary angiography. Via the standard angiographic techniques, coronary angiographies were done and the presence and severity of CAD were determined through the clinical vessel score and the Gensini score. Prothrombin G20210A genotypes were identified using PCR-RFLP. Results: This cross-sectional study was performed on 953 men and 507 women at a mean age of 58.21±10.33 years. The median and the interquartile range for the Gensini score were not statistically significantly different between the wild (GG) and mutant (AA+GA) genotypes (P=0.440). The association between the G20210A polymorphism and the severity of CAD with respect to the vessel score also showed no significant linear trend of higher numbers of diseased vessels (P= 0.765 for the Mantel-Haenszel test of linear trend) in the AA+GA genotype as compared with the GG genotype. Conclusion: Our data failed to confirm the hypothesis that the G20210A variant mutation may be a significant determinant of CAD risk or its severity.
Collapse
Affiliation(s)
- Leyla Pourgholi
- Department of Molecular Pathology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Hamidreza Goodarzynejad
- Department of Cardiac Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Shayan Ziaee
- Department of Molecular Pathology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Elmira Zare
- Department of Cardiac Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Arash Jalali
- Department of Cardiac Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Mohammadali Boroumand
- Department of Molecular Pathology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.,Corresponding Author: Mohammadali Boroumand, Professor of Pathology, Pathology Department, Tehran Heart Center, North Kargar Street,Tehran, Iran. 1411713138. Tel: +98 21 88029256. Fax: +98 21 88029256.E-mail: .
| |
Collapse
|
16
|
Tamis-Holland JE, Jneid H, Reynolds HR, Agewall S, Brilakis ES, Brown TM, Lerman A, Cushman M, Kumbhani DJ, Arslanian-Engoren C, Bolger AF, Beltrame JF. Contemporary Diagnosis and Management of Patients With Myocardial Infarction in the Absence of Obstructive Coronary Artery Disease: A Scientific Statement From the American Heart Association. Circulation 2019; 139:e891-e908. [DOI: 10.1161/cir.0000000000000670] [Citation(s) in RCA: 347] [Impact Index Per Article: 69.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Myocardial infarction in the absence of obstructive coronary artery disease is found in ≈5% to 6% of all patients with acute infarction who are referred for coronary angiography. There are a variety of causes that can result in this clinical condition. As such, it is important that patients are appropriately diagnosed and an evaluation to uncover the correct cause is performed so that, when possible, specific therapies to treat the underlying cause can be prescribed. This statement provides a formal and updated definition for the broadly labelled term
MINOCA
(incorporating the definition of acute myocardial infarction from the newly released “Fourth Universal Definition of Myocardial Infarction”) and provides a clinically useful framework and algorithms for the diagnostic evaluation and management of patients with myocardial infarction in the absence of obstructive coronary artery disease.
Collapse
|
17
|
Prothrombin G20210A (rs1799963) polymorphism increases myocardial infarction risk in an age-related manner: A systematic review and meta-analysis. Sci Rep 2017; 7:13550. [PMID: 29051591 PMCID: PMC5648836 DOI: 10.1038/s41598-017-13623-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Accepted: 09/27/2017] [Indexed: 01/11/2023] Open
Abstract
G20210A polymorphism (rs1799963) within the prothrombin gene is associated with a higher circulation level of prothrombin, thus increasing the likelihood of developing myocardial infarction (MI). Opinions differ regarding the correlation between prothrombin G20210A genotype and MI risk, which prompted us to conduct a meta-analysis to determine this association. PubMed, EMBASE, Web of Science and CNKI were searched for pertinent reports. A total of 34 studies involving 14 611 MI cases and 84 358 controls were analyzed in this quantitative analysis. We found a statistically significant association between prothrombin G20210A polymorphism and MI in the allele model (A vs. G, OR = 1.43, 95%CI: 1.18–1.72), heterozygote model (GA vs. GG, OR = 1.41, 95%CI: 1.16–1.72) and dominant model (GA + AA vs. GG, OR = 1.41, 95%CI: 1.15–1.72). The association remains significant in Caucasians but not in non-Caucasians. Moreover, prothrombin G20210A polymorphism increases MI risk in an age-related manner. A further significant association was found in a subpopulation younger than 55 years (allele model, OR = 1.76, 95%CI: 1.32–2.35; heterozygote model, OR = 1.70, 95%CI: 1.24–2.33; dominant model, OR = 1.70, 95%CI: 1.24–2.34). Sensitivity analysis and publication bias analysis revealed stable and statistically robust results. Our meta-analysis demonstrated that prothrombin G20210A polymorphism may represent a risk factor for MI.
Collapse
|
18
|
Titov BV, Osmak GJ, Matveeva NA, Kukava NG, Shakhnovich RM, Favorov AV, Ruda MY, Favorova OO. Genetic risk factors for myocardial infarction more clearly manifest for early age of first onset. Mol Biol Rep 2017; 44:315-321. [PMID: 28685248 DOI: 10.1007/s11033-017-4112-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Accepted: 07/02/2017] [Indexed: 12/11/2022]
Abstract
Epidemiological genetics established that heritability in determining the risk of myocardial infarction (MI) is substantially greater when MI occurs early in life. However, the genetic architecture of early-onset and late-onset MI was not compared. We analyzed genotype frequencies of SNPs in/near 20 genes whose protein products are involved in the pathogenesis of atherosclerosis in two groups of Russian patients with MI: the first group included patients with age of first MI onset <60 years (N = 230) and the second group with onset ≥60 years (N = 174). The control group of corresponding ethnicity consisted of 193 unrelated volunteers without cardiovascular diseases (93 individuals were over 60 years). We found that in the group of patients with age of onset <60 years, SNPs FGB rs1800788*T, TGFB1 rs1982073*T/T, ENOS rs2070744*C and CRP rs1130864*T/T were associated with risk of MI, whereas in patients with age of onset ≥60 years, only TGFB1 rs1982073*T/T was associated with risk of MI. Using APSampler software, we found composite markers associated with MI only in patients with early onset: FGB rs1800788*T + TGFB1 rs1982073*T; FGB rs1800788*T + LPL rs328*C + IL4 rs2243250*C; FGB rs1800788*T + ENOS rs2070744*C (Fisher p values of 1.4 × 10-6 to 2.2 × 10-5; the permutation p values of 1.1 × 10-5 to 3.0 × 10-4; ORs = 2.67-2.54). Alleles included in the combinations were associated with MI less significantly and with lower ORs than the combinations themselves. The result showed a substantially greater contribution of the genetic component in the development of MI if it occurs early in life, and demonstrated the usefulness of genetic testing for young people.
Collapse
Affiliation(s)
- Boris V Titov
- Institute of Experimental Cardiology, Russian Cardiology Scientific and Production Center, Moscow, Russia. .,Department of Molecular Biology and Medical Biotechnology, Pirogov Russian National Research Medical University, Moscow, Russia.
| | - German J Osmak
- Institute of Experimental Cardiology, Russian Cardiology Scientific and Production Center, Moscow, Russia.,Department of Molecular Biology and Medical Biotechnology, Pirogov Russian National Research Medical University, Moscow, Russia
| | - Natalia A Matveeva
- Institute of Experimental Cardiology, Russian Cardiology Scientific and Production Center, Moscow, Russia.,Department of Molecular Biology and Medical Biotechnology, Pirogov Russian National Research Medical University, Moscow, Russia
| | - Nino G Kukava
- Institute of Experimental Cardiology, Russian Cardiology Scientific and Production Center, Moscow, Russia.,Department of Emergency Cardiology, Russian Cardiology Scientific and Production Center, Moscow, Russia
| | - Roman M Shakhnovich
- Department of Emergency Cardiology, Russian Cardiology Scientific and Production Center, Moscow, Russia
| | - Alexander V Favorov
- Department of Computational Biology, Vavilov Institute of General Genetics, Russian Academy of Sciences, Moscow, Russia.,Department of Oncology, Division of Biostatistics and Bioinformatics, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Mikhail Ya Ruda
- Department of Emergency Cardiology, Russian Cardiology Scientific and Production Center, Moscow, Russia
| | - Olga O Favorova
- Institute of Experimental Cardiology, Russian Cardiology Scientific and Production Center, Moscow, Russia.,Department of Molecular Biology and Medical Biotechnology, Pirogov Russian National Research Medical University, Moscow, Russia
| |
Collapse
|
19
|
Genetics of myocardial infarction: The role of thrombosis-associated genes. A review article. Meta Gene 2017. [DOI: 10.1016/j.mgene.2017.03.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
|
20
|
Prevalence of thrombophilic disorders in takotsubo patients: the (ThROmbophylia in TAkotsubo cardiomyopathy) TROTA study. Clin Res Cardiol 2016; 105:717-26. [DOI: 10.1007/s00392-016-0977-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2015] [Accepted: 03/14/2016] [Indexed: 01/18/2023]
|
21
|
Wang DW, Liu M, Wang P, Zhan X, Liu YQ, Zhao LS. ADRB2 polymorphisms predict the risk of myocardial infarction and coronary artery disease. Genet Mol Biol 2015; 38:433-43. [PMID: 26692153 PMCID: PMC4763328 DOI: 10.1590/s1415-475738420140234] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Accepted: 04/27/2015] [Indexed: 12/03/2022] Open
Abstract
Recently, the rs1042713 G > A and rs1042714 C > G polymorphisms in the beta-2
adrenergic receptor (ADRB2) gene were shown to be related to atherosclerosis
diseases. Therefore, we performed a systemic meta-analysis to determine whether the
two functional polymorphisms are related to the risk of myocardial infarction (MI)
and coronary artery disease (CAD). We identified published studies that are relevant
to our topic of interest. Seven case-control studies, with a total of 6,843 subjects,
were incorporated into the current meta-analysis. Our analysis showed a higher
frequency of rs1042713 G > A variant in patients with MI or CAD compared to
healthy controls. A similar result was also obtained with the rs1042714 C > G
variant under both the allele and dominant models. Ethnicity-stratified subgroup
analysis suggested that the rs1042714 C > G variant correlated with an increased
risk of the two diseases in both Asians and Caucasians, while rs1042713 G > A only
contributes to the risk of two diseases in Asians. In the disease type-stratified
subgroups, the frequencies of both the rs1042713 G > A and rs1042714 C > G
variants were higher in the cases than in the controls in both the MI and CAD
subgroups. Collectively, our data contribute towards understanding the correlation
between the rs1042713 G > A and rs1042714 C > G polymorphisms in
ADRB2 and the susceptibility to MI and CAD.
Collapse
Affiliation(s)
- Dong-Wei Wang
- Department of Cardiology, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, P.R. China
| | - Min Liu
- Department of Cardiology, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, P.R. China
| | - Ping Wang
- Department of Cardiology, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, P.R. China
| | - Xiang Zhan
- Department of Cardiology, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, P.R. China
| | - Yu-Qing Liu
- Department of Cardiology, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, P.R. China
| | - Luo-Sha Zhao
- Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, P.R. China
| |
Collapse
|
22
|
Biological role of mannose binding lectin: From newborns to centenarians. Clin Chim Acta 2015; 451:78-81. [DOI: 10.1016/j.cca.2015.03.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Revised: 03/04/2015] [Accepted: 03/08/2015] [Indexed: 11/19/2022]
|
23
|
Acute coronary syndromes in young women - the scale of the problem and the associated risks. POLISH JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY 2015; 12:134-8. [PMID: 26336495 PMCID: PMC4550022 DOI: 10.5114/kitp.2015.52854] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Revised: 05/30/2014] [Accepted: 10/06/2014] [Indexed: 01/18/2023]
Abstract
Diseases of the cardiovascular system mainly affect elderly patients, but they are increasingly often encountered in young individuals. It is estimated that 1 in 20 patients with ischemic heart disease is under the age of 45 years. Only 20% of them are women. According to the PL-ACS register, cases of acute coronary syndromes in young women represent 0.6% of all acute coronary syndrome cases. The most common etiology is atherosclerosis (80%). Other causes include dissections and spasms of the coronary arteries as well as clotting disorders. Smoking tobacco is the most important risk factor, followed by hypertension, hyperlipidemia, and diabetes. The long-term prognosis is usually favorable, but it deteriorates significantly in the event of complications. The literature on this subject is not extensive. Most data come from non-randomized studies of young patients conducted regardless of sex. The purpose of this paper is to present the problem posed by acute coronary syndromes in young women.
Collapse
|
24
|
Genetic polymorphism of MTHFR C677T and premature coronary artery disease susceptibility: A meta-analysis. Gene 2015; 565:39-44. [PMID: 25839940 DOI: 10.1016/j.gene.2015.03.062] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Revised: 03/12/2015] [Accepted: 03/27/2015] [Indexed: 02/07/2023]
Abstract
The association between 5, 10-methylenetetrahydrofolate reductase (MTHFR) C677T gene polymorphism and premature coronary artery disease (PCAD) is controversial. To explore a more precise estimation of the association, a meta-analysis was conducted in the present study. The relevant studies were identified by searching PubMed, EMBASE, the Web of Science, Cochrane Collaboration Database, Chinese National Knowledge Infrastructure, Wanfang Database and China Biological Medicine up to November, 2014. The meta-analysis was performed by STATA 11. 21 studies with a total of 6912 subjects, including 2972 PCAD patients and 3940 controls. The pooled analysis showed that MTHFR C677T gene polymorphism was probably associated with PCAD (CT vs. CC: OR=1.13, 95% CI=1.01-1.27; dominant model: OR=1.16, 95% CI=1.04-1.29; recessive model: OR=1.19, 95% CI=1.00-1.40; allele analysis: OR=1.17, 95% CI=1.01-1.34). Subgroup analysis by plasma homocysteine concentration showed a significant association in the homocysteine >15μmol/L subgroup (CT vs. CC: OR=1.44, 95% CI=1.10-1.88; TT vs. CC: OR=2.51, 95% CI=1.12-5.63; dominant model: OR=1.51, 95% CI=1.16-1.96; recessive model: OR=2.33, 95% CI=1.05-5.20; allele analysis: OR=1.48, 95% CI=1.18-1.87). Subgroup analysis by continent displayed a significant association among the Asian population (CT vs. CC: OR=1.51, 95% CI=1.23-1.86; TT vs. CC: OR=2.81, 95% CI=1.87-4.23; dominant model: OR=1.65, 95% CI=1.35-2.01; recessive model: OR=2.22, 95% CI=1.53-3.21; allele analysis: OR=1.61, 95% CI=1.37-1.89). The statistical stability and reliability was demonstrated by sensitivity analysis and publication bias outcomes. In conclusion, the meta-analysis suggests that MTHFR C677T gene polymorphism may be associated with PCAD.
Collapse
|
25
|
Shu J, Yin S, Tan AZ, He M. Association between the prothrombin G20210A mutation and sudden sensorineural hearing loss in European population: a meta-analysis. Thromb Res 2014; 135:73-7. [PMID: 25466842 DOI: 10.1016/j.thromres.2014.10.032] [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: 08/16/2014] [Accepted: 10/29/2014] [Indexed: 11/17/2022]
Abstract
PURPOSE Epidemiological studies have reported inconsistent findings on the association between the prothrombin G20210A mutation and sudden sensorineural hearing loss (SSNHL) in European population. The aim of this meta-analysis was to clarify the association of this polymorphism with SSNHL in European population. METHODS PubMed, Embase, and the China National Knowledge Infrastructure (CNKI) were searched up to August 1, 2014. We used STATA12.0 to calculate summary odds ratios (ORs) with 95% confidence intervals (CIs). RESULTS Eight studies including 1972 patients were identified. Pooled data showed no significant association between the prothrombin G20210A mutation and risk of SSNHL in European population : A vs. G (OR =1.645, 95% CI:0.78-3.49,POR =0.194); AG vs.GG (OR =1.660, 95% CI:0.77-3.60,POR=0.199). CONCLUSIONS The present meta-analysis suggests that the prothrombin G20210A mutation is not significantly associated with an increased risk of SSNHL in European population.
Collapse
Affiliation(s)
- Jingcheng Shu
- Department of Otorhinolaryngology-Head and Neck Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Shihua Yin
- Department of Otorhinolaryngology-Head and Neck Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China.
| | - An-Zhou Tan
- Department of Otorhinolaryngology-Head and Neck Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Meirong He
- Department of Obstetrics and Gynecology, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China
| |
Collapse
|
26
|
A novel polymorphism in the PAI-1 gene promoter enhances gene expression. A novel pro-thrombotic risk factor? Thromb Res 2014; 134:1229-33. [DOI: 10.1016/j.thromres.2014.09.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Revised: 08/27/2014] [Accepted: 09/20/2014] [Indexed: 01/15/2023]
|
27
|
Adler G, Agnieszka G, Valjevac A, Czerska E, Kiseljakovic E, Salkic NN. Prevalence of genetic prothrombotic risk factors: 1691G > A FV, 20210G > A PT and 677C > T MTHFR mutations in the Bosnian population. Ann Hum Biol 2014; 42:576-80. [PMID: 25357225 DOI: 10.3109/03014460.2014.968618] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Venous thrombosis (VT) affects 1-2 out of 10(3) individuals each year. Mutations of 1691G > A FV gene, 20210G > A PT gene and 677C > T gene MTHFR are common in Europe and increase the risk of venous thrombosis. To the authors' knowledge, this is the first report on the prevalence of these mutations in the general population of Bosnia and Herzegovina. AIM The aim of this study was to simultaneously analyse main VT associated polymorphisms and compare the results with those published for other European populations. DATA SOURCES Electronic databases including Medline and Embase were searched from 1995 to December 2013. SUBJECTS AND METHODS The subjects of the study consisted of 100 unrelated healthy people from Bosnia and Herzegovina (82 female and 18 male). The mean age of the cohort was 58.8 (± 10.7) years. PCR-RFLP was used for measurement of allele frequencies. RESULTS All three SNPs were found to be polymorphic, with allele frequencies of 6.0%, 6.0% and 37.5% for 1691A FV, 20210A PT and 677T MTHFR, respectively. CONCLUSION Further studies on larger cohorts with an adequate female-to-male ratio are necessary to confirm a high prevalence of hereditary thrombophilia in the Bosnian population.
Collapse
Affiliation(s)
- Grażyna Adler
- a Department of Gerontobiology , Pomeranian Medical University , Szczecin , Poland
| | - Garstka Agnieszka
- a Department of Gerontobiology , Pomeranian Medical University , Szczecin , Poland
| | - Amina Valjevac
- b Laboratory for Molecular Medicine , Center for Genetics, Medical Faculty, University of Sarajevo , Sarajevo , Bosnia and Herzegovina
| | - Ewa Czerska
- c Central Laboratory , Regional Hospital , Szczecin , Poland
| | - Emina Kiseljakovic
- d Department of Medical Biochemistry, Faculty of Medicine , University of Sarajevo , Cekalusa 90 , Sarajevo , Bosnia and Herzegovina , and
| | - Nermin Nusret Salkic
- e Department of Gastroenterology and Hepatology , University Clinical Center Tuzla , Tuzla , Bosnia and Herzegovina
| |
Collapse
|
28
|
The association between Factor V Leiden with the presence and severity of coronary artery disease. Clin Biochem 2014; 47:356-60. [DOI: 10.1016/j.clinbiochem.2013.12.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2013] [Revised: 11/27/2013] [Accepted: 12/08/2013] [Indexed: 11/19/2022]
|
29
|
Slama DBB, Fekih Mrissa N, Haggui A, Nsiri B, Haouala H, Gritli N. Association of methylenetetrahydrofolate reductase C677T and A1298C polymorphisms with myocardial infarction in Tunisian young patients. ACTA ACUST UNITED AC 2013. [DOI: 10.1007/s00580-013-1836-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|