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Zhang L, Tan D, Zhang Y, Ding Y, Liang H, Zhang G, Xie Z, Sun N, Wang C, Xiao B, Zhang H, Li L, Zhao X, Zeng Y. Ceramides and metabolic profiles of patients with acute coronary disease: a cross-sectional study. Front Physiol 2023; 14:1177765. [PMID: 38146506 PMCID: PMC10749667 DOI: 10.3389/fphys.2023.1177765] [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: 03/02/2023] [Accepted: 10/19/2023] [Indexed: 12/27/2023] Open
Abstract
Metabolic Syndrome (MS) is a rapidly growing medical problem worldwide and is characterized by a cluster of age-related metabolic risk factors. The presence of MS increases the likelihood of developing atherosclerosis and significantly raises the morbidity/mortality rate of acute coronary syndrome (ACS) patients. Early detection of MS is crucial, and biomarkers, particularly blood-based, play a vital role in this process. This cross-sectional study focused on the investigation of certain plasma ceramides (Cer14:0, Cer16:0, Cer18:0, Cer20:0, Cer22:0, and Cer24:1) as potential blood biomarkers for MS due to their previously documented dysregulated function in MS patients. A total of 695 ACS patients were enrolled, with 286 diagnosed with MS (ACS-MS) and 409 without MS (ACS-nonMS) serving as the control group. Plasma ceramide concentrations were measured by LC-MS/MS assay and analyzed through various statistical methods. The results revealed that Cer18:0, Cer20:0, Cer22:0, and Cer24:1 were significantly correlated with the presence of MS risk factors. Upon further examination, Cer18:0 emerged as a promising biomarker for early MS detection and risk stratification, as its plasma concentration showed a significant sensitivity to minor changes in MS risk status in participants. This cross-sectional observational study was a secondary analysis of a multicenter prospective observational cohort study (Chinese Clinical Trial Registry, https://www.who.int/clinical-trials-registry-platform/network/primary-registries/chinese-clinical-trial-registry-(chictr), ChiCTR-2200056697), conducted from April 2021 to August 2022.
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Affiliation(s)
- Liang Zhang
- Department of Cardiology, Beijing Anzhen Hospital, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, Beijing, China
- Heart Center, Beijing Chest Hospital, Capital Medical University, Beijing, China
| | - Dawei Tan
- Department of Invasive Technology, Emergency General Hospital, Beijing, China
| | - Yang Zhang
- Department of Cardiology, Beijing Anzhen Hospital, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, Beijing, China
| | - Yaodong Ding
- Department of Cardiology, Beijing Anzhen Hospital, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, Beijing, China
| | - Huiqing Liang
- Department of Cardiology, The First Affiliated Hospital of Hebei North University, Zhangjiakou, China
| | - Gong Zhang
- Department of Cardiology, Beijing Daxing District People’s Hospital, Beijing, China
| | - Zhijiang Xie
- Department of Cardiology, Handan First Hospital, Handan, China
| | - Nian Sun
- Beijing Health Biotechnology Co., Ltd., Beijing, China
| | - Chunjing Wang
- Beijing Health Biotechnology Co., Ltd., Beijing, China
| | - Bingxin Xiao
- Beijing Health Biotechnology Co., Ltd., Beijing, China
| | - Hanzhong Zhang
- Beijing 21st Century International School, Beijing, China
| | - Lin Li
- Beijing Health Biotechnology Co., Ltd., Beijing, China
| | - Xiufeng Zhao
- Department of Cardiology, Handan First Hospital, Handan, China
| | - Yong Zeng
- Department of Cardiology, Beijing Anzhen Hospital, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, Beijing, China
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Li MN, Bao BW, Si-Yu D, Chun-Fei J, Xiao-Jun S, Da-Sheng G, Qin G, Hong-Ju W. Correlation between plasma glutathione peroxidase 4 and N-acetylneuraminic acid levels with clinical risk stratification and prognosis of patients with acute coronary syndrome. Saudi Med J 2022; 43:1103-1110. [PMID: 36261209 PMCID: PMC9994492 DOI: 10.15537/smj.2022.43.10.20220444] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 09/19/2022] [Indexed: 06/16/2023] Open
Abstract
OBJECTIVES To investigate the correlation between plasma glutathione peroxidase 4 (GPX4) and N-acetyl-neuraminic acid (Neu5Ac) with clinical risk stratification and outcomes of acute coronary syndrome (ACS) patients. METHODS Between October 2018 and July 2019, 413 patients that were scheduled for coronary angiography were enrolled in this prospective study at the First Affiliated Hospital of Bengbu Medical College, Bengbu, China. Patients were divided into control and ACS groups. Patients with ACS were divided into 3 risk levels based on their thrombolysis in myocardial infarction risk score. After discharge, ACS patients were followed for the incidence of major adverse cardiac events (MACEs). For the analysis of cumulative endpoint event occurrences, the Kaplan-Meier method was applied. RESULTS The ACS group had lower plasma GPX4 but higher Neu5Ac levels than the control group. There was a greater increase in plasma Neu5Ac in the high-risk group when compared with the medium-risk and low-risk groups, while GPX4 levels were higher in the low-risk group. The MACEs group had higher plasma Neu5Ac but lower GPX4 levels than the non-MACEs group. The plasma Neu5Ac was an independent risk factor but GPX4 was a protective factor for MACEs. CONCLUSION Glutathione peroxidase 4 and Neu5Ac levels in plasma can be used to diagnose, stratify risks, and predict long-term outcomes in patients with ACS.
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Affiliation(s)
- Miao-Nan Li
- From the Department of Cardiovascular Disease (Li, Bao, Ding, Ji, Shi, D-S. Gao, Q. Gao, Wang), The First Affiliated Hospital of Bengbu Medical College, and from the Department of Physiology (Q. Gao), Key Laboratory of Cardiovascular and Cerebrovascular Diseases, Bengbu Medical College, Bengbu, China.
| | - Bing-Wei Bao
- From the Department of Cardiovascular Disease (Li, Bao, Ding, Ji, Shi, D-S. Gao, Q. Gao, Wang), The First Affiliated Hospital of Bengbu Medical College, and from the Department of Physiology (Q. Gao), Key Laboratory of Cardiovascular and Cerebrovascular Diseases, Bengbu Medical College, Bengbu, China.
| | - Ding Si-Yu
- From the Department of Cardiovascular Disease (Li, Bao, Ding, Ji, Shi, D-S. Gao, Q. Gao, Wang), The First Affiliated Hospital of Bengbu Medical College, and from the Department of Physiology (Q. Gao), Key Laboratory of Cardiovascular and Cerebrovascular Diseases, Bengbu Medical College, Bengbu, China.
| | - Ji Chun-Fei
- From the Department of Cardiovascular Disease (Li, Bao, Ding, Ji, Shi, D-S. Gao, Q. Gao, Wang), The First Affiliated Hospital of Bengbu Medical College, and from the Department of Physiology (Q. Gao), Key Laboratory of Cardiovascular and Cerebrovascular Diseases, Bengbu Medical College, Bengbu, China.
| | - Shi Xiao-Jun
- From the Department of Cardiovascular Disease (Li, Bao, Ding, Ji, Shi, D-S. Gao, Q. Gao, Wang), The First Affiliated Hospital of Bengbu Medical College, and from the Department of Physiology (Q. Gao), Key Laboratory of Cardiovascular and Cerebrovascular Diseases, Bengbu Medical College, Bengbu, China.
| | - Gao Da-Sheng
- From the Department of Cardiovascular Disease (Li, Bao, Ding, Ji, Shi, D-S. Gao, Q. Gao, Wang), The First Affiliated Hospital of Bengbu Medical College, and from the Department of Physiology (Q. Gao), Key Laboratory of Cardiovascular and Cerebrovascular Diseases, Bengbu Medical College, Bengbu, China.
| | - Gao Qin
- From the Department of Cardiovascular Disease (Li, Bao, Ding, Ji, Shi, D-S. Gao, Q. Gao, Wang), The First Affiliated Hospital of Bengbu Medical College, and from the Department of Physiology (Q. Gao), Key Laboratory of Cardiovascular and Cerebrovascular Diseases, Bengbu Medical College, Bengbu, China.
| | - Wang Hong-Ju
- From the Department of Cardiovascular Disease (Li, Bao, Ding, Ji, Shi, D-S. Gao, Q. Gao, Wang), The First Affiliated Hospital of Bengbu Medical College, and from the Department of Physiology (Q. Gao), Key Laboratory of Cardiovascular and Cerebrovascular Diseases, Bengbu Medical College, Bengbu, China.
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Rao BH, N S RR, C S SR, Patel PR, Korabathina R, Raj JP, Azam MS, Rao BA, Yerra SK, Abdullakutty J, Raju PK. Metabolic Risk Factors In First Acute Coronary Syndrome (MERIFACS). Indian Heart J 2022; 74:275-281. [PMID: 35931204 PMCID: PMC9453050 DOI: 10.1016/j.ihj.2022.07.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 07/15/2022] [Accepted: 07/19/2022] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES In acute coronary syndrome (ACS) patients the focus is on major conventional risk factors - CRF [diabetes, hypertension, elevated low-density cholesterol (LDL-C) and smoking] whereas others - specific metabolic risk factors - MRF [high-density lipoprotein cholesterol (HDL-C), body-mass index (BMI), waist-hip ratio (WHR), and triglycerides, and HbA1c get less attention. METHODS This is a prospective case-control observational study from 15 tertiary care hospitals in India. CRF and MRF in patients presenting with first incidence of ACS (n=2153) were compared with matched controls (n=1210). RESULTS Propensity score matching (PSM) yielded 1193 cases and matched 1210 controls. Risk factor prevalence in cases vs. controls were CRF: hypertension - 39.4% vs 16.4% (P<0.0001), diabetes - 42.6% vs 12.7% (P<0.0001), smoking - 28.3% vs 9.3% (P<0.0001) and elevated LDL-C - 70.2% vs 57.9% (P<0.0001). MRF: BMI - 54.7% vs55.1% (P=0.84), waist: hip ratio 79.5% vs 63.6% (P<0.0001), high HbA1C - 37.8% vs 14.9% (P<0.0001), low HDL-C - 56.2% vs 42.8% (P<0.0001) and elevated triglycerides - 49.7% vs 44.2%. (P=0.007). Adjusted Odds ratios by multivariate analysis were CRF: hypertension - 2.3 (P<0.001), diabetes - 4.7 (P<0.001), high LDL-C - 3.3 (P<0.001) and smoking- 6.3 (P<0.001). MRF: waist: hip ratio - 2.4 (P<0.001) high HbA1c - 3.2 (P<0.001), low HDL-C 2.2 (P<0.001) and elevated triglycerides - 0.878 P=0.17. CONCLUSION In India, the risk of ACS conferred by specific metabolic risk factors (High waist: hip ratio, Low HDL-C and High HbA1c) is comparable to that caused by CRF.
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Affiliation(s)
- B Hygriv Rao
- Department of Cardiology, KIMS Hospitals, Hyderabad, India; KIMS Foundation and Research Centre (KFRC), Hyderabad, India; Arrhythmia Research & Training Society, Hyderabad, India.
| | - Rama Raju N S
- Department of Cardiology, KIMS Hospitals, Rajahmundry, India
| | | | | | | | | | - Md Sadiq Azam
- Department of Cardiology, KIMS Hospitals, Hyderabad, India
| | - B Annaji Rao
- Department of Cardiology, KIMS Hospitals, Srikakulam, India
| | - Shiv Kumar Yerra
- Department of Cardiology, KIMS Hospitals, Hyderabad, India; Department of Cardiology, Mahavir Hospital, Hyderabad
| | | | - P Krishnam Raju
- Department of Cardiology, CARE Hospital, Banjara Hills, Hyderabad, India
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Zhao LH, Liu Y, Xiao JY, Wang JX, Li XW, Cui Z, Gao J. Prognostic Value of Metabolic Syndrome in Patients With Non-ST Elevated Myocardial Infarction Undergoing Percutaneous Coronary Intervention. Front Cardiovasc Med 2022; 9:912999. [PMID: 35811732 PMCID: PMC9260082 DOI: 10.3389/fcvm.2022.912999] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 05/23/2022] [Indexed: 12/12/2022] Open
Abstract
Objective We aim to investigate the prognostic effects of metabolic syndrome (MS) on patients with non-ST elevated myocardial infarction (NSTEMI) after percutaneous coronary intervention (PCI). Methods Patients with NSTEMI undergoing PCI were consecutively collected. According to the presence or absence of MS, they were divided into two groups and followed up for 1 year. The endpoint was major adverse cardiovascular events (MACE), including all-cause death, unstable angina hospitalization, heart failure (HF) hospitalization, non-fatal recurrent myocardial infarction (MI), and target lesion revascularization. Also, six subgroups were made according to gender, age, left ventricular ejection fraction (LVEF), Global Registry of Acute Coronary Events (GRACE) score, hypersensitive troponin (hsTNT), and several diseased vessels. Cox proportional hazard model was adopted to analyze the effect of MS on MACE in all the patients and different subgroups. Results A total of 1,295 patients were included in the current analysis and 660 (50.97%) of them had MS. About 88 patients were lost to follow-up, and the overall average follow-up was 315 days. MS was an independent risk factor for MACE (HR 1.714, CI 1.265–2.322, p = 0.001), all-cause death, heart failure (HF) hospitalization, and non-fatal recurrent MI. In the MS component, BMI ≥28 kg/m2 was positively associated with MACE. Subgroup analysis indicated the prognostic value of MS was more striking for patients with the following: age of >60, LVEF of ≤40%, GRACE of >140, multivessel disease, or hsTNT of >0.1 ng/ml. Conclusions The MS was a robust adverse prognostic factor in patients diagnosed with NSTEMI, especially among those of older age and at higher ischemic risk. A BMI of ≥28 kg/m2 independently predicted the occurrence of MACE. Prognosis may be improved by controlling abdominal obesity.
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Affiliation(s)
- Li-Hong Zhao
- Graduate School, Tianjin Medical University, Tianjin, China
- Cardiac Function Department, The First Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology, Baotou, China
| | - Yin Liu
- Department of Cardiology, Tianjin Chest Hospital, Tianjin, China
| | - Jian-Yong Xiao
- Department of Cardiology, Tianjin Chest Hospital, Tianjin, China
| | - Ji-Xiang Wang
- Department of Cardiology, Tianjin Chest Hospital, Tianjin, China
| | - Xiao-Wei Li
- Department of Cardiology, Tianjin Chest Hospital, Tianjin, China
| | - Zhuang Cui
- School of Public Health, Tianjin Medical University, Tianjin, China
| | - Jing Gao
- Tianjin Cardiovascular Institute, Tianjin Chest Hospital, Tianjin, China
- Thoracic Clinical College, Tianjin Medical University, Tianjin, China
- *Correspondence: Jing Gao
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Association of mild cognitive impairment and metabolic syndrome in patients with hypertension. Asian J Psychiatr 2020; 53:102185. [PMID: 32540752 DOI: 10.1016/j.ajp.2020.102185] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 05/22/2020] [Accepted: 05/26/2020] [Indexed: 12/27/2022]
Abstract
AIM The aim of this study was to evaluate the prevalence of mild cognitive impairment (MCI) in patients with hypertension and to evaluate the association of MCI with metabolic syndrome (MetS). METHODOLOGY 186 subjects with hypertension were evaluated on Montreal Cognitive Assessment (MoCA) and Patient Health Questionnaire (PHQ-9) for cognitive decline and depression, respectively and MetS was diagnosed as per the Consensus definition. RESULTS The prevalence of MCI was 65.6 % and that of MetS was 45.7 %. Compared to those without MetS, those with MetS had significantly poorer cognitive functioning on the all cognitive domain of the MoCA, even after controlling for age, education, severity of the depression and duration of illness. Low High-Density Lipoprotein (HDL) was found to have a positive correlation with MoCA. Higher age, lower education, higher duration of illness and use of higher numbers of medications were associated with significantly lower score on MoCA. CONCLUSION Presence of MetS among persons with hypertension is associated with cognitive decline. Hence, there is a need to monitor and manage other parameters of MetS among patients with hypertension, to reduce the risk of cognitive decline and future dementia.
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Fischer SCPM, Pinto SP, Lins LCDAS, Bianco HT, Monteiro CMDC, Pinheiro LFM, Fonseca FAH, Izar MCDO. Association of Multiple Genetic Variants with the Extension and Severity of Coronary Artery Disease. Arq Bras Cardiol 2018; 110:16-23. [PMID: 29412239 PMCID: PMC5831297 DOI: 10.5935/abc.20170177] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2017] [Accepted: 08/02/2017] [Indexed: 12/28/2022] Open
Abstract
Background Metabolic syndrome (MS) is a condition that, when associated with ischemic
heart disease and cardiovascular events, can be influenced by genetic
variants and determine more severe coronary atherosclerosis. Objectives To examine the contribution of genetic polymorphisms to the extension and
severity of coronary disease in subjects with MS and recent acute coronary
syndrome (ACS). Methods Patients (n = 116, 68% males) aged 56 (9) years, with criteria for MS, were
prospectively enrolled to the study during the hospitalization period after
an ACS. Clinical and laboratory parameters, high-sensitivity C-reactive
protein, thiobarbituric acid reactive substances, adiponectin, endothelial
function, and the Gensini score were assessed. Polymorphisms of
paraoxonase-1 (PON-1), methylenotetrahydrofolate reductase (MTHFR),
endothelial nitric oxide synthase (ENOS), angiotensin-converting enzyme
(ACE), angiotensin II type 1 receptor (AT1R), apolipoprotein C3 (APOC3),
lipoprotein lipase (LPL) were analysed by polymerase chain reaction (PCR)
technique, followed by the identification of restriction fragment length
polymorphisms (RFLP, and a genetic score was calculated. Parametric and
non-parametric tests were used, as appropriate. Significance was set at p
< 0.05. Results Polymorphisms of PON-1, MTHFR and ENOS were not in the Hardy-Weinberg
equilibrium. The DD genotype of LPL was associated with higher severity and
greater extension of coronary lesions. Genetic score tended to be higher in
patients with Gensini score < P50 (13.7 ± 1.5 vs. 13.0 ±
1.6, p = 0.066), with an inverse correlation between genetic and Gensini
scores (R = -0.194, p = 0.078). Conclusions The LPL polymorphism contributed to the severity of coronary disease in
patients with MS and recent ACS. Combined polymorphisms were associated with
the extension of coronary disease, and the lower the genetic score the more
severe the disease.
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Khan Y, Lalchandani A, Gupta AC, Khadanga S, Kumar S. Prevalence of metabolic syndrome crossing 40% in Northern India: Time to act fast before it runs out of proportions. J Family Med Prim Care 2018; 7:118-123. [PMID: 29915744 PMCID: PMC5958552 DOI: 10.4103/jfmpc.jfmpc_10_17] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background: Metabolic syndrome (MetS) is a constellation of high blood pressure, hyperglycemia, obesity, and dyslipidemia. Its presence makes the patient more prone for cardiovascular events. Its prevalence has been documented as 11%–41%. The present study was undertaken to find out the demographic profile of the MetS in Kanpur region of northern India. Materials and Methods: This is a hospital based, cross-sectional study with adequate sample size. Results: Out of the randomly selected 420 patients (232 males and 188 females), 172 cases (61 males and 111 females) were found to have MeTS adopting the National Cholesterol Education Program Adult Treatment Panel III criteria. The overall prevalence of MeTS was found to be 40.9% (26.2% of total males and 59% of total females). Among the 172 cases of MeTS, females were more than males (64.5% vs. 35.4%). Maximum numbers of MeTS cases were in the age range of 50–59 years (55/172 = 31.9%) followed by 40–49 years (50/172 = 29%), >60 years (35/172 = 20.3%), 30–39 years (30/172 = 17.4%), and <30 years (2/172 = 1.1%). In the total study population of 420 cases, hyperglycemia was the most common (29.2%) and hyperglycemia, obesity, and high triglyceride were significantly higher prevalence in females. Among the participants of 111 cases of MeTS, hyperglycemia was the most common (71.5%) and high blood pressure, and low high density lipoprotein was significantly higher among males. Conclusion: The prevalence of MetS was more than 40% and its prevalence in <40 years age group is rapidly increasing. Its high time to be more active physically, before fatal cardiovascular events.
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Affiliation(s)
- Yasmee Khan
- Department of Medicine, AIIMS Bhopal, Bhopal, Madhya Pradesh, India
| | - Arati Lalchandani
- Department of Medicine, GSVM Medical College, Kanpur, Uttar Pradesh, India
| | | | - Sagar Khadanga
- Department of Medicine, AIIMS Bhopal, Bhopal, Madhya Pradesh, India
| | - Sanjeev Kumar
- Department of CFM, AIIMS Bhopal, Bhopal, Madhya Pradesh, India
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