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Isella C, Gasparini A, Lucca G, Ielmini M, Caselli I, Poloni N, Dajelli Ermolli C, Caravati F, Castiglioni B, De Ponti R, Callegari C. Resilience, Cardiological Outcome, and Their Correlations With Anxious-Depressive Symptoms and Quality of Life in Patients With an Implantable Cardioverter Defibrillator. Front Psychiatry 2021; 12:763726. [PMID: 34899424 PMCID: PMC8653768 DOI: 10.3389/fpsyt.2021.763726] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 10/27/2021] [Indexed: 01/09/2023] Open
Abstract
Background: Resilience is proven as a protective factor against the development of psychiatric disorders, and it has gained clinical relevance in the development and progression of cardiovascular pathology. The authors performed a longitudinal study on patients with implantable cardioverter defibrillator (ICD) with the primary aim to highlight the possible existence of a correlation between individual resilience capacity, depressive and anxiety symptoms, and quality of life in terms of outcomes. The secondary aim was to analyze the differences between patients with major cardiac events in the follow-up and patients without cardiac events with respect to the previous variables. Materials and Methods: A total of 80 patients enrolled in the Cardiology Unit were evaluated at T0 and during the follow-up through the following scales: the 14-item Resilience Scale (RS-14), the Hospital Anxiety and Depression Scale (HADS), and the World Health Organization Quality of Life-Brief Version (WHOQOL-Bref). Results: A significant linear correlation between resilience and all the areas of quality of life at T0, T1, and T2 emerged. A negative correlation between resilience and anxiety and depressive symptoms emerged, as well as between depression and anxiety and quality of life. Patients with cardiac events during the follow up have shown a worse quality of life and the onset of anxiety-depressive symptoms over time, without changes to the resilience scores. Patients without cardiac events showed an increasing trend in resilience scores. Discussion: Given the speed and simplicity of use of the RS-14 scale, it seems promising to further investigate the real clinical usefulness of this instrument in the cardiology field.
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Affiliation(s)
- Celeste Isella
- Department of Medicine and Surgery, Section of Psychiatry, University of Insubria, Varese, Italy
| | - Alessandra Gasparini
- Department of Medicine and Surgery, Section of Psychiatry, University of Insubria, Varese, Italy
| | - Giulia Lucca
- Department of Medicine and Surgery, Section of Psychiatry, University of Insubria, Varese, Italy
| | - Marta Ielmini
- Department of Medicine and Surgery, Section of Psychiatry, University of Insubria, Varese, Italy
| | - Ivano Caselli
- Department of Medicine and Surgery, Section of Psychiatry, University of Insubria, Varese, Italy
| | - Nicola Poloni
- Department of Medicine and Surgery, Section of Psychiatry, University of Insubria, Varese, Italy
| | - Carlo Dajelli Ermolli
- Department of Heart and Vessels, Ospedale di Circolo, University of Insubria, Varese, Italy
| | - Fabrizio Caravati
- Department of Heart and Vessels, Ospedale di Circolo, University of Insubria, Varese, Italy
| | - Battistina Castiglioni
- Department of Heart and Vessels, Ospedale di Circolo, University of Insubria, Varese, Italy
| | - Roberto De Ponti
- Department of Heart and Vessels, Ospedale di Circolo, University of Insubria, Varese, Italy
| | - Camilla Callegari
- Department of Medicine and Surgery, Section of Psychiatry, University of Insubria, Varese, Italy
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Hasanzad M, Sarhangi N, Aghaei Meybodi HR, Nikfar S, Khatami F, Larijani B. Precision Medicine in Non Communicable Diseases. INTERNATIONAL JOURNAL OF MOLECULAR AND CELLULAR MEDICINE 2019; 8:1-18. [PMID: 32351905 PMCID: PMC7175610 DOI: 10.22088/ijmcm.bums.8.2.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 07/20/2019] [Indexed: 12/12/2022]
Abstract
Non-communicable diseases (NCDs) are the leading cause of death and disease burden globally, cardiovascular diseases (CVDs) account for the major part of death related to NCDs followed by different types of cancer, chronic obstructive pulmonary disease (COPD), and diabetes. As the World Health Organization (WHO) and the United Nations have announced a 25% reduction in mortality of NCDs by 2025, different communities need to adopt preventive strategies for achieving this goal. Personalized medicine approach as a predictive and preventive strategy aims for a better therapeutic goal to the patients to maximize benefits and reduce harms. The clinical benefits of this approach are already realized in cancer targeted therapy, and its impact on other conditions needs more studies in different societies. In this review, we essentially describe the concept of personalized (or precision) medicine in association with NCDs and the future of precision medicine in prediction, prevention, and personalized treatment.
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Affiliation(s)
- Mandana Hasanzad
- Medical Genomics Research Center, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.,Personalized Medicine Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Negar Sarhangi
- Personalized Medicine Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Reza Aghaei Meybodi
- Personalized Medicine Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shekoufeh Nikfar
- Personalized Medicine Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Department of Pharmacoeconomics and Pharmaceutical Administration, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Khatami
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Bagher Larijani
- Personalized Medicine Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Warlo EMK, Arnesen H, Seljeflot I. A brief review on resistance to P2Y 12 receptor antagonism in coronary artery disease. Thromb J 2019; 17:11. [PMID: 31198410 PMCID: PMC6558673 DOI: 10.1186/s12959-019-0197-5] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 04/25/2019] [Indexed: 12/17/2022] Open
Abstract
Background Platelet inhibition is important for patients with coronary artery disease. When dual antiplatelet therapy (DAPT) is required, a P2Y12-antagonist is usually recommended in addition to standard aspirin therapy. The most used P2Y12-antagonists are clopidogrel, prasugrel and ticagrelor. Despite DAPT, some patients experience adverse cardiovascular events, and insufficient platelet inhibition has been suggested as a possible cause. In the present review we have performed a literature search on prevalence, mechanisms and clinical implications of resistance to P2Y12 inhibitors. Methods The PubMed database was searched for relevant papers and 11 meta-analyses were included. P2Y12 resistance is measured by stimulating platelets with ADP ex vivo and the most used assays are vasodilator stimulated phosphoprotein (VASP), Multiplate, VerifyNow (VN) and light transmission aggregometry (LTA). Discussion/conclusion The frequency of high platelet reactivity (HPR) during clopidogrel therapy is predicted to be 30%. Genetic polymorphisms and drug-drug interactions are discussed to explain a significant part of this inter-individual variation. HPR during prasugrel and ticagrelor treatment is estimated to be 3–15% and 0–3%, respectively. This lower frequency is explained by less complicated and more efficient generation of the active metabolite compared to clopidogrel. Meta-analyses do show a positive effect of adjusting standard clopidogrel treatment based on platelet function testing. Despite this, personalized therapy is not recommended because no large-scale RCT have shown any clinical benefit. For patients on prasugrel and ticagrelor, platelet function testing is not recommended due to low occurrence of HPR.
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Affiliation(s)
- Ellen M K Warlo
- 1Center for Clinical Heart Research, Department of Cardiology, Oslo University Hospital, Pb 4956 Nydalen, 0424 Oslo, Norway.,2Faculty of Medicine, University of Oslo, Oslo, Norway.,3Center for Heart Failure Research, University of Oslo, Oslo, Norway
| | - Harald Arnesen
- 1Center for Clinical Heart Research, Department of Cardiology, Oslo University Hospital, Pb 4956 Nydalen, 0424 Oslo, Norway.,2Faculty of Medicine, University of Oslo, Oslo, Norway.,3Center for Heart Failure Research, University of Oslo, Oslo, Norway
| | - Ingebjørg Seljeflot
- 1Center for Clinical Heart Research, Department of Cardiology, Oslo University Hospital, Pb 4956 Nydalen, 0424 Oslo, Norway.,2Faculty of Medicine, University of Oslo, Oslo, Norway.,3Center for Heart Failure Research, University of Oslo, Oslo, Norway
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Horton RH, Lucassen AM. Recent developments in genetic/genomic medicine. Clin Sci (Lond) 2019; 133:697-708. [PMID: 30837331 PMCID: PMC6399103 DOI: 10.1042/cs20180436] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 11/21/2018] [Accepted: 02/27/2019] [Indexed: 12/23/2022]
Abstract
Advances in genetic technology are having a major impact in the clinic, and mean that many perceptions of the role and scope of genetic testing are having to change. Genomic testing brings with it a greater opportunity for diagnosis, or predictions of future diagnoses, but also an increased chance of uncertain or unexpected findings, many of which may have impacts for multiple members of a person's family. In the past, genetic testing was rarely able to provide rapid results, but the increasing speed and availability of genomic testing is changing this, meaning that genomic information is increasingly influencing decisions around patient care in the acute inpatient setting. The landscape of treatment options for genetic conditions is shifting, which has evolving implications for clinical discussions around previously untreatable disorders. Furthermore, the point of access to testing is changing with increasing provision direct to the consumer outside the formal healthcare setting. This review outlines the ways in which genetic medicine is developing in light of technological advances.
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Affiliation(s)
- Rachel H Horton
- Clinical Ethics and Law, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Anneke M Lucassen
- Clinical Ethics and Law, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
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Tortajada-Genaro LA, Niñoles R, Mena S, Maquieira Á. Digital versatile discs as platforms for multiplexed genotyping based on selective ligation and universal microarray detection. Analyst 2019; 144:707-715. [DOI: 10.1039/c8an01830h] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The development of a high-performance assay readout using integrated detectors is a current challenge in the implementation of DNA tests in diagnostic laboratories, particularly for supporting pharmacogenetic tests.
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Affiliation(s)
- Luis A. Tortajada-Genaro
- Departamento de Química
- Universitat Politècnica de València
- Valencia
- Spain
- Instituto Interuniversitario de Investigación de Reconocimiento Molecular y Desarrollo Tecnológico (IDM)
| | - Regina Niñoles
- Instituto Interuniversitario de Investigación de Reconocimiento Molecular y Desarrollo Tecnológico (IDM)
- Universitat Politècnica de València-Universitat de València
- Valencia
- Spain
- Instituto de Biología Molecular y Celular de Plantas (IBMCP)
| | - Salvador Mena
- Instituto Interuniversitario de Investigación de Reconocimiento Molecular y Desarrollo Tecnológico (IDM)
- Universitat Politècnica de València-Universitat de València
- Valencia
- Spain
| | - Ángel Maquieira
- Departamento de Química
- Universitat Politècnica de València
- Valencia
- Spain
- Instituto Interuniversitario de Investigación de Reconocimiento Molecular y Desarrollo Tecnológico (IDM)
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Effect of cytochrome P450 2C19 polymorphism on adverse cardiovascular events after drug-eluting stent implantation in a large Hakka population with acute coronary syndrome receiving clopidogrel in southern China. Eur J Clin Pharmacol 2017; 74:423-431. [DOI: 10.1007/s00228-017-2393-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 11/28/2017] [Indexed: 10/18/2022]
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Dubois A, Dubé MP, Tardif JC. Precision medicine to change the landscape of cardiovascular drug development. EXPERT REVIEW OF PRECISION MEDICINE AND DRUG DEVELOPMENT 2017. [DOI: 10.1080/23808993.2017.1392826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Anick Dubois
- Montreal Heart Institute, Montreal, Canada
- Université de Montréal Beaulieu-Saucier Pharmacogenomics Centre, Montreal, Canada
| | - Marie-Pierre Dubé
- Montreal Heart Institute, Montreal, Canada
- Faculty of Medicine, Université de Montréal, Montreal, Canada
- Université de Montréal Beaulieu-Saucier Pharmacogenomics Centre, Montreal, Canada
| | - Jean-Claude Tardif
- Montreal Heart Institute, Montreal, Canada
- Faculty of Medicine, Université de Montréal, Montreal, Canada
- Université de Montréal Beaulieu-Saucier Pharmacogenomics Centre, Montreal, Canada
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