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Saeed MH, Hama JI. Cardiac disease prediction using AI algorithms with SelectKBest. Med Biol Eng Comput 2023; 61:3397-3408. [PMID: 37679578 DOI: 10.1007/s11517-023-02918-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 08/21/2023] [Indexed: 09/09/2023]
Abstract
Atherosclerotic cardiovascular disease (ASCVD), which includes coronary heart disease (CHD) and ischemic stroke, is the leading cause of mortality globally. According to the European Society of Cardiology (ESC), 26 million people worldwide have heart disease, with 3.6 million diagnosed each year. Early detection of heart disease will aid in lowering the mortality rate. The lack of diversity in training data and the difficulty in comprehending the findings of complicated AI models are the key issues in current research for heart disease prediction using artificial intelligence. To overcome this, in this paper, cardiac disease prediction using AI algorithms with SelectKBest has been proposed. Features are standardized, balanced, and selected using the StandardScaler, SMOTE, and SelectKBest techniques. Machine learning models such as support vector machine (SVM), K-nearest neighbor(KNN), decision tree (DT), logistic regression (LR), adaptive boosting (AB), naive Bayes (NB), random forest (RF), and extra tree (ET) and deep learning models such as vanilla long short-term memory (LSTM), bidirectional long short-term memory (LSTM), stacked long short-term memory (LSTM), and deep neural network (DNN) are assessed using Alizadeh Sani, combined (Cleveland, Hungarian, Switzerland, Long Beach VA, and Stalog), and Pakistan heart failure datasets. As a result of the evaluation, the proposed deep neural network (DNN) with SelectKBest predicted heart disease in a promising way. The prediction rate of unweighted accuracy of 99% on Alizadeh Sani, 98% on combined, and 97% on Pakistan are gained in tenfold cross-validation experiments. The suggested approach can be utilized to diagnose heart disease in its early stages.
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Affiliation(s)
- Mariwan Hama Saeed
- College of Basic Education, University of Halabja, Halabja, 46018, Iraq.
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2
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Almulhim M, Alqattan J, Almajed A, Alkhars MA, Alhafith AA, Alajmi MS, Alhussain R, Ali S, Elsheikh E, Al Sahlawi M. Prediction of the 10-Year Risk of Cardiovascular Diseases Among Patients in Primary Health Care Centers in Eastern Province, Saudi Arabia. Cureus 2023; 15:e47551. [PMID: 38021652 PMCID: PMC10665772 DOI: 10.7759/cureus.47551] [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] [Accepted: 10/23/2023] [Indexed: 12/01/2023] Open
Abstract
Background Cardiovascular diseases (CVDs), primarily coronary artery disease (CAD) and stroke, stand as a leading cause of morbidity and mortality globally. Our objective was to predict the 10-year risk of CVD in the Eastern Province of Saudi Arabia. Methods This cross-sectional study was conducted in eight randomly selected primary healthcare centers using cluster sampling based on geographical location in Saudi Arabia's Eastern Province, specifically the Al-Ahsa region. The study aimed to assess the risk of developing CVD in the next 10 years among patients with at least one cardiovascular risk factor. Patients visiting the healthcare centers for checkups filled out the Framingham Cardiovascular Disease (10-year risk) score questionnaire. Results Of the 665 patients enrolled, 54.4% were female. The average age of the patients was 54.2 (SD 8.48) years. The overall average Framingham Risk Score (FRS) percentage was 19.2% (SD 15.4%). In terms of 10-year CVD risk, 34.6% of the patients were at high risk, 31.6% were at moderate risk, and 33.8% were considered low-risk individuals. Factors associated with a higher risk of CVD included older age, male gender, lower educational attainment, smoking, normal BMI, stage 2 hypertension, and diagnoses of hypertension, diabetes, and obesity. Conclusion Utilizing the FRS, it was determined that older men with lower educational levels had a higher 10-year risk of developing CVD. Furthermore, CVD risk factors such as diabetes, hypertension, obesity, and smoking were associated with individuals' CVD risk. Considering the ease of use and applicability of the FRS in daily clinical practice, as well as its potential to identify high-risk individuals, a more systematic implementation in general practice appears to be warranted.
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Affiliation(s)
- Mohammed Almulhim
- Internal Medicine, College of Medicine, King Faisal University, Al-Ahsa, SAU
| | | | - Adnan Almajed
- College of Medicine, King Faisal University, Al-Ahsa, SAU
| | | | | | | | | | - Sayed Ali
- Family and Community Medicine, King Faisal University, Al-Ahsa, SAU
| | - Eman Elsheikh
- Cardiology, College of Medicine, Tanta University, Tanta, EGY
- Internal Medicine, College of Medicine, King Faisal University, Al-Ahsa, SAU
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3
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Ye X, Wang S, Liu X, Wu Q, Lv Y, Lv Q, Li J, Li L, Yang Y. Effects of PCSK9 inhibitors on coronary microcirculation, inflammation and cardiac function in patients with CHD after PCI: a protocol for systematic review and meta-analysis. BMJ Open 2023; 13:e074067. [PMID: 37723117 PMCID: PMC10510950 DOI: 10.1136/bmjopen-2023-074067] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 08/14/2023] [Indexed: 09/20/2023] Open
Abstract
INTRODUCTION Coronary heart disease (CHD) is one of the common cardiovascular diseases that seriously jeopardise human health, and endothelial inflammation and dyslipidaemia are the initiating links leading to its occurrence. Percutaneous coronary intervention (PCI) is one of the most effective surgical treatments for CHD with narrowed or blocked blood vessels, which can quickly unblock the blocked vessels and restore coronary blood supply. However, most patients may experience coronary microcirculation disorders (CMDs) and decreased cardiac function after PCI treatment, which directly affects the efficacy of PCI and the prognosis of patients. Preprotein converting enzyme subtilisin/Kexin 9 (PCSK9) inhibitors are novel pleiotropy lipid-lowering drug with dual anti-inflammation and lipid-lowering effects, and represent a new clinical pathway for rapid correction of dyslipidaemia. Therefore, we designed this protocol to systematically evaluate the effects of PCSK9 inhibitors on coronary microcirculation and cardiac function in patients with CHD after PCI, and to provide high-quality evidence-based evidence for the clinical application of PCSK9 inhibitors. METHODS AND ANALYSIS This protocol is reported strictly in accordance with the 2020 Preferred Reporting Items for Systematic Reviews and Meta-analyses Protocols Guidelines. We will search PubMed, EMBASE, Web of Science and three Chinese databases (CNKI, Wanfang and VIP database) according to preset search strategies, without language and publication data restrictions. We will work with manual retrieval to screen references that have been included in the literature. Google Scholar will be used to search for grey literature. The final included literature must meet the established inclusion criteria. Titles, abstracts and full text will be extracted independently by two reviewers, and disagreements will be resolved through discussion or the involvement of a third reviewer. Extracted data will be analysed using Review Manager V.5.3. The Cochrane Risk of Bias Tool will be used to evaluate the risk of bias. Publication bias will be assessed by funnel plots. Heterogeneity will be assessed by I2 test and subgroup analyses will be used to further investigate potential sources of heterogeneity. The quality of the literature will be assessed by GRADE score. This protocol will start in January 2026 and end in December 2030. ETHICS AND DISSEMINATION This study is a systematic review of published literature data and no special ethical approval was required. PROSPERO REGISTRATION NUMBER CRD42022346189.
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Affiliation(s)
- Xuejiao Ye
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Shihan Wang
- Department of Cardiology, China Academy of Traditional Chinese Medicine Guang'anmen Hospital, Beijing, China
| | | | - Qian Wu
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yanfei Lv
- Shanghai Qianhe Technology Co LTD, Shanghai, China
| | - Qianyu Lv
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Junjia Li
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Lanlan Li
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yingtian Yang
- Beijing University of Chinese Medicine, Beijing, China
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4
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Obradovic M, Sudar-Milovanovic E, Gluvic Z, Banjac K, Rizzo M, Isenovic ER. The Na +/K +-ATPase: A potential therapeutic target in cardiometabolic diseases. Front Endocrinol (Lausanne) 2023; 14:1150171. [PMID: 36926029 PMCID: PMC10011626 DOI: 10.3389/fendo.2023.1150171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 02/14/2023] [Indexed: 03/08/2023] Open
Abstract
Cardiometabolic diseases (CMD) are a direct consequence of modern living and contribute to the development of multisystem diseases such as cardiovascular diseases and diabetes mellitus (DM). CMD has reached epidemic proportions worldwide. A sodium pump (Na+/K+-ATPase) is found in most eukaryotic cells' membrane and controls many essential cellular functions directly or indirectly. This ion transporter and its isoforms are important in the pathogenesis of some pathological processes, including CMD. The structure and function of Na+/K+-ATPase, its expression and distribution in tissues, and its interactions with known ligands such as cardiotonic steroids and other suspected endogenous regulators are discussed in this review. In addition, we reviewed recent literature data related to the involvement of Na+/K+-ATPase activity dysfunction in CMD, focusing on the Na+/K+-ATPase as a potential therapeutic target in CMD.
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Affiliation(s)
- Milan Obradovic
- Department of Radiobiology and Molecular Genetics, “VINČA“ Institute of Nuclear Sciences - National Institute of thе Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Emina Sudar-Milovanovic
- Department of Radiobiology and Molecular Genetics, “VINČA“ Institute of Nuclear Sciences - National Institute of thе Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Zoran Gluvic
- University Clinical-Hospital Centre Zemun-Belgrade, Clinic of Internal medicine, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Katarina Banjac
- Department of Radiobiology and Molecular Genetics, “VINČA“ Institute of Nuclear Sciences - National Institute of thе Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Manfredi Rizzo
- School of Medicine, Promise Department, University of Palermo, Palermo, Italy
- *Correspondence: Manfredi Rizzo,
| | - Esma R. Isenovic
- Department of Radiobiology and Molecular Genetics, “VINČA“ Institute of Nuclear Sciences - National Institute of thе Republic of Serbia, University of Belgrade, Belgrade, Serbia
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Salem WA, Elkady EF, Fouad MA, Mohammad MAA. DoE Screening and Optimization of Liquid Chromatographic Determination of Nicotinic Acid and Six Statins: Application to Pharmaceutical Preparations and Counterfeit Detection. J Chromatogr Sci 2022; 61:74-86. [PMID: 34894146 DOI: 10.1093/chromsci/bmab131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Indexed: 01/11/2023]
Abstract
An isocratic reversed-phase high performance liquid chromatographic method has been developed and validated to simultaneously determine nicotinic acid, pravastatin sodium, rosuvastatin calcium, atorvastatin calcium, pitavastatin calcium, lovastatin sodium and simvastatin sodium in focus on counterfeit drug detection. Thin-layer chromatography, nuclear magnetic resonance and mass spectrometry have been additionally performed to verify the identification of adulterants of counterfeit herbal medicines. Chromatographic separation was carried out on Inertsil® ODS-3 C18 (4.6 × 150 mm, 5 μm) with isocratic mobile phase elution containing a mixture of acetonitrile: methanol: 25 mM potassium dihydrogen phosphate buffer, pH 2.86 adjusted with 0.1 M o-phosphoric acid (48: 30: 22, v/v/v), at a flow rate of 1 mL/min and with UV detection at 238 nm. The design of experiment methodology, Plackett-Burman and Box-Behnken designs, was used to screen and optimize the mobile phase composition. The validation of the method was also carried out under the International Conference on Harmonization guidelines. The developed method was sensitive, accurate, simple, economical and highly robust, in addition to the comprehensiveness and novelty of this method for separating the seven drugs. The results were statistically compared with the reference methods used Student's t-test and variance ratio F-test at P < 0.05.
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Affiliation(s)
- Wadhah Atef Salem
- Supreme Board of Drugs and Medical Appliances, Ministry of Health and Population, Khormakser, Airport Road, Aden 6022, Yemen
| | - Ehab Farouk Elkady
- Pharmaceutical Chemistry Department, Faculty of Pharmacy, Cairo University, Kasr El-Aini St., Cairo 11562, Egypt
| | - Marwa Ahmed Fouad
- Pharmaceutical Chemistry Department, Faculty of Pharmacy, Cairo University, Kasr El-Aini St., Cairo 11562, Egypt.,Pharmaceutical Chemistry Department, School of Pharmacy, New Giza University, Newgiza, km 22 Cairo-Alexandria Desert Road, Cairo 12511, Egypt
| | - Mohammad Abdul-Azim Mohammad
- Pharmaceutical Chemistry Department, Faculty of Pharmacy, Cairo University, Kasr El-Aini St., Cairo 11562, Egypt
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6
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Gao D, Hua R, Jiesisibieke D, Ma Y, Li C, Wu S, Ma Q, Xie W. C-reactive protein and coronary atheroma regression following statin therapy: A meta-regression of randomized controlled trials. Front Cardiovasc Med 2022; 9:989527. [PMID: 36440015 PMCID: PMC9691666 DOI: 10.3389/fcvm.2022.989527] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 10/24/2022] [Indexed: 10/11/2023] Open
Abstract
OBJECTIVE Several clinical trials have indicated that statins stabilize and reverse atherosclerotic plaque. However, different studies have provided inconsistent findings regarding mechanisms and influencing factors of plaque regression under statin therapy. Apart from lipid-lowering effect, statins have pleiotropic effects including anti inflammation in humans. In this study, meta-analysis and meta-regression were used to determine the effects of statin medications on coronary plaque volume. Meanwhile, to assess whether statins promote plaque regression effect was related to their anti-inflammatory ability, the impact of CRP/hsCRP reduction during statin therapy on plaque regression was investigated. METHODS Up to June 15, 2022, a systematic PubMed, EMBASE, and Cochrane search was performed for randomized controlled trials that assessed treatment effect using total atheroma volume (TAV), percent atheroma volume (PAV), or plaque volume (PV). Only CRP/hsCRP and LDL-C values reported before and after treatment were considered. RESULTS 12 studies (2,812 patients with heart and/or vascular disease) fulfilled the inclusion criteria and were included in the systematic review. A meta-analysis of 15 statin-treated arms reported a significant reduction in change of TAV/PV [standardized mean difference (SMD): -0.27, 95% confidence intervals (-CI): -0.42, -0.12, p < 0.001], compared with the control arms. Another meta-analysis of 7 trials also found that patients in the intervention group had a significant reduction in change of PAV (SMD: -0.16, 95% CI: -0.29, -0.03, p = 0.019), compared with those in the control group. Meta-regressionanalysis revealed that the percent change of CRP/hsCRP was significantly associated with SMD in change of TAV/PV after adjusting for percent change of LDL-C, age, gender and study duration. Meta-regression analysis showed that percent change of CRP/hsCRP statistically influenced SMD in change of PAV, when percent change of CRP/hsCRP was included separately. However, the percent change of CRP/hsCRP was not significantly associated with SMD of PAV change after adjusting for all covariates. CONCLUSION In conclusion, statin therapy is beneficial for plaque regression. Statins promote plaque regression, which might be associated to their anti-inflammatory ability.
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Affiliation(s)
- Darui Gao
- Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China
- Peking University Clinical Research Institute Heart and Vascular Health Research Center at Peking University Shougang Hospital, Beijing, China
- Key Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing, China
| | - Rong Hua
- Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China
- Peking University Clinical Research Institute Heart and Vascular Health Research Center at Peking University Shougang Hospital, Beijing, China
- Key Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing, China
| | | | - Yanjun Ma
- Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China
- Peking University Clinical Research Institute Heart and Vascular Health Research Center at Peking University Shougang Hospital, Beijing, China
- Key Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing, China
| | - Chenglong Li
- Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China
- Peking University Clinical Research Institute Heart and Vascular Health Research Center at Peking University Shougang Hospital, Beijing, China
- Key Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing, China
| | - Sijing Wu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Qian Ma
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Wuxiang Xie
- Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China
- Peking University Clinical Research Institute Heart and Vascular Health Research Center at Peking University Shougang Hospital, Beijing, China
- Key Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing, China
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7
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The Efficacy of Rosuvastatin, Amlodipine, and Aspirin in the Treatment of Hypertension with Coronary Heart Disease and Its Effect on Platelet Aggregation. DISEASE MARKERS 2022; 2022:1111438. [PMID: 36284992 PMCID: PMC9588327 DOI: 10.1155/2022/1111438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 09/10/2022] [Accepted: 09/12/2022] [Indexed: 11/17/2022]
Abstract
Objective This study was to study the efficacy of rosuvastatin, amlodipine, and aspirin in the treatment of hypertension with coronary heart disease and its effect on platelet aggregation. Methods The participants included 60 patients with hypertension and coronary heart disease who were treated at our hospital between January 2020 and May 2021 and were randomly assigned to receive either rosuvastatin, amlodipine, and Ziyin Huoxue Recipe (observation group) or rosuvastatin, amlodipine, Ziyin Huoxue Recipe, and aspirin (experimental group), with 30 patients in each. Outcome measures included clinical effectiveness, blood pressure indicators, blood lipid indices, plasma viscosity, platelet aggregation, cardiac function, and adverse responses. Results The clinical efficacy in the experimental group was significantly higher than that in the observation group (P < 0.05). The differences were found in blood pressure indices and blood lipid indices between the two groups before treatment (P > 0.05). However, after treatment, the blood pressure indices in the experimental group were significantly lower than those in the observation group (P < 0.05). After treatment, the blood lipid indices, plasma viscosity, and platelet aggregation in the experimental group were significantly lower than those in the observation group (P < 0.05). The left ventricular ejection fraction (LVEF) of patients in the experimental group after treatment was significantly higher than that of patients in the observation group (P < 0.05). There was no significant difference in the incidence of adverse reactions among patients in the two groups (P > 0.05). Conclusion The clinical efficacy of rosuvastatin, amlodipine, and aspirin markedly reduces the blood pressure indices, blood lipid indices, plasma viscosity, and platelet aggregation of patients with hypertension and coronary heart disease, improves LVEF, and has a good safety profile.
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8
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The effect of statin therapy in combination with ezetimibe on circulating C-reactive protein levels: a systematic review and meta-analysis of randomized controlled trials. Inflammopharmacology 2022; 30:1597-1615. [DOI: 10.1007/s10787-022-01053-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Accepted: 08/08/2022] [Indexed: 12/14/2022]
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9
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Improving Cardiovascular Outcomes: The Era of Personalized Therapy in Atherosclerosis. J Clin Med 2022; 11:jcm11113077. [PMID: 35683466 PMCID: PMC9181141 DOI: 10.3390/jcm11113077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 05/27/2022] [Indexed: 11/17/2022] Open
Abstract
Data from the European Society of Cardiology report that cardiovascular disease (CVD) is responsible for app [...].
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10
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The Role of Zinc and Copper in Platelet Activation and Pathophysiological Thrombus Formation in Patients with Pulmonary Embolism in the Course of SARS-CoV-2 Infection. BIOLOGY 2022; 11:biology11050752. [PMID: 35625480 PMCID: PMC9138256 DOI: 10.3390/biology11050752] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 05/03/2022] [Accepted: 05/11/2022] [Indexed: 01/09/2023]
Abstract
To date, many studies have proved that COVID-19 increases the incidence of thrombus formation and coagulopathies but the exact mechanism behind such a disease outcome is not well known. In this review we collect the information and discuss the pathophysiology of thrombus formation in patients with pulmonary embolism in the course of COVID-19 disease and the role of zinc and copper in the process. Supplementation of zinc and copper may be beneficial for COVID-19 patients due to its anti-inflammatory and anti-oxidative properties. On the other hand, excess of those microelements in the organism may be harmful, that is why marking the level of those micronutrients should be done at first. We also propose further investigation of diagnostic and therapeutic options of zinc and copper in course of COVID-19 thrombus formation to their potential in patient care, with particular emphasis on the dosage and the duration of their misbalance.
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11
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Relationship between genomic risk scores (GRS) and coronary artery calcium (CAC) score: A pilot study. Clin Nutr ESPEN 2022; 47:293-298. [DOI: 10.1016/j.clnesp.2021.11.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 11/10/2021] [Accepted: 11/23/2021] [Indexed: 11/19/2022]
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12
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Effect of Statins on Serum level of hs-CRP and CRP in Patients with Cardiovascular Diseases: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Mediators Inflamm 2022; 2022:8732360. [PMID: 35125965 PMCID: PMC8816584 DOI: 10.1155/2022/8732360] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 12/17/2021] [Indexed: 12/14/2022] Open
Abstract
Background. Several studies have reported that statins have anti-inflammatory effects. Nevertheless, results of clinical trials concerning the effect of statins on the levels of C-reactive protein (CRP) and high-sensitivity CRP (hs-CRP) have been inconsistent. Therefore, we performed a systematic review and meta-analysis of randomized clinical trials (RCTs) evaluating the effect of statins on CRP and hs-CRP levels in patients with cardiovascular diseases (CVDs). Methods. Literature search of the major databases was performed to find eligible RCTs assessing the effect of statins on serum levels of CRP and hs-CRP from the inception until the last week of April 2021. The effect sizes were determined for weighted mean difference (WMD) and 95% confidence intervals (CI). Results. 26 studies were identified (3010 patients and 2968 controls) for hs-CRP and 20 studies (3026 patients and 2968 controls) for CRP. Statins reduced the serum levels of hs-CRP (
; 95% CI: -1.26 to -0.68 mg/L;
) and CRP (
; 95% CI: -4.86 to -1.25 mg/L;
) in patients with CVDs. Statins decreased the serum levels of hs-CRP in patients receiving both high-intensity and moderate/low-intensity treatments with these drugs. In addition, the duration of treatment longer than 10 weeks decreased hs-CRP levels. Only high-intensity statin treatment could marginally decrease serum levels of CRP in CVDs patients. Conclusions. This meta-analysis showed the efficacy of statins to reduce the concentrations of CRP and hs-CRP in patients with different types of CVDs.
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Metelskaya VA, Zhatkina MV, Gavrilova NE, Yarovaya EB, Bogdanova NL, Kutsenko VA, Rudenko BA, Drapkina OM. Associations of circulating biomarkers with the presence and severity of coronary, carotid and femoral arterial atherosclerosis. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2022. [DOI: 10.15829/1728-8800-2021-3098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Aim. To identify and characterize the associations of the presence and severity of atherosclerosis of various localization with the blood level of biochemical parameters, as well as to assess the potential of their use as markers of metabolic disorders with increased atherogenic potential.Material and methods. The study included 216 patients (men, 53%) aged 24-87 years (mean age, 61,5±10,73 years). All patients underwent coronary angiography, carotid (CA) and femoral arterial (FA) duplex ultrasound to assess the presence and severity of atherosclerosis. In blood serum/plasma, biochemical parameters were analyzed using standard methods.Results. Based on the analysis of circulating biomarker profile, diagnostic complexes have been established that allow assessing atherosclerosis of different localization. According to the data obtained, the determinants of coronary and CA atherosclerosis are endothelial dysfunction (concentration of nitric oxide metabolites <36,0 μmol/L) and an increased level of creatinine (≥73,0 μmol/L). The specific markers associated with severe atherosclerosis of coronary and FAs (but not CA) were low high-density lipoprotein cholesterol (≤1,0/1,2 μmol/L for male/ female, respectively) and an increased C-reactive protein level (≥1,0 mg/l). Severe peripheral atherosclerosis (CA and FA involvement) was associated with hyperglycemia (glucose ≥6,1 μmol/L), while severe FA atherosclerosis — with hyperinsulinemia (insulin ≥14,0 μU/ml).Conclusion. The analysis of associations of circulating biochemical parameters with atherosclerosis localization and severity revealed a number of metabolic markers associated with the increased atherogenic potential. It is possible to distinguish both universal parameters that are associated with atherosclerosis, regardless of its localization and/or severity, and specific biomarkers that characterize either the localization or the severity of atherosclerosis, or both.
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Affiliation(s)
| | - M. V. Zhatkina
- National Medical Research Center for Therapy and Preventive Medicine; O.M. Filatov City Clinical Hospital № 15
| | | | | | - N. L. Bogdanova
- National Medical Research Center for Therapy and Preventive Medicine
| | | | - B. A. Rudenko
- National Medical Research Center for Therapy and Preventive Medicine
| | - O. M. Drapkina
- National Medical Research Center for Therapy and Preventive Medicine
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14
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Jóźwiak JJ, Kasperczyk S, Tomasik T, Osadnik T, Windak A, Studziński K, Mastej M, Catapano A, Ray KK, Mikhailidis DP, Toth PP, Howard G, Lip GYH, Tomaszewski M, Charchar FJ, Sattar N, Williams B, MacDonald TM, Krzemień P, Dobrakowski M, Kasperczyk A, Nowak D, Skowron Ł, Żak Ż, Lewek J, Banach M. Design and rationale of a nationwide screening analysis from the LIPIDOGRAM2015 and LIPIDOGEN2015 studies. Arch Med Sci 2022; 18:604-616. [PMID: 35591817 PMCID: PMC9103403 DOI: 10.5114/aoms.2020.96052] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 05/24/2020] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Cardiovascular disease (CVD) is a major cause of morbidity and mortality throughout the world. The LIPIDOGRAM2015 study was performed to estimate the prevalence of risk factors for atherosclerotic diseases as well as cardiovascular and related disorders in the primary care setting in Poland. The LIPIDOGEN2015 sub-study was designed to include a random cohort of patients in order to analyse parameters related to lipid metabolism, oxidative stress, inflammatory responses, autoimmune disorders, and gene variants that confer susceptibility to cardiometabolic and atherosclerotic diseases. MATERIAL AND METHODS The recruitment was carried out by 438 primary care physicians in Poland. The expected number of patients recruited for the LIPIDOGRAM2015 study was 13,000-14,000 with 13-15% (1700-2000) also participating in the LIPIDOGEN2015 sub-study. Each patient had to complete a questionnaire concerning medical and family history, concomitant diseases, and pharmacotherapy. Anthropometric measurements were performed at the doctor's office. For the LIPIDOGEN2015 sub-study, saliva samples for DNA isolation and blood samples for measurement of glycated haemoglobin, oxidative stress parameters, autoantibody levels, and inflammatory cytokine profile and apolipoprotein profile were collected. Follow-up data will be obtained from the National Health Fund in Poland. RESULTS The LIPIDOGRAM2015 and LIPIDOGEN2015 study cohort reflects the prevalence of cardiovascular risk factors and concomitant diseases, markers of oxidative stress, the presence of autoantibodies, inflammatory cytokine profile, and apolipoprotein profile, as well as genetic variants potentially conferring susceptibility to cardiometabolic and atherosclerotic diseases. CONCLUSIONS This study presents the prevalence of different CV risk factors, with special emphasis on lipid disorders, and it assesses the relationship between inflammation, oxidative stress, and mutations in genes encoding proteins regulating lipid metabolism, as well as genes conferring susceptibility to cardiovascular, cardiometabolic, and related diseases.
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Affiliation(s)
- Jacek J. Jóźwiak
- Department of Family Medicine and Public Health, Faculty of Medicine, University of Opole, Opole, Poland
| | - Sławomir Kasperczyk
- Department of Biochemistry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Poland
| | - Tomasz Tomasik
- Chair of Family Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Tadeusz Osadnik
- Department of Pharmacology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Poland
| | - Adam Windak
- Chair of Family Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Krzysztof Studziński
- Chair of Family Medicine, Jagiellonian University Medical College, Krakow, Poland
| | | | - Alberico Catapano
- Department of Pharmacological Sciences University of Milano and Multimedica IRCCS, Milano, Italy
| | - Kausik K. Ray
- Imperial Centre for Cardiovascular Disease Prevention, Department of Primary Care and Public Health, Imperial College, Kensington, London, UK
| | - Dimitri P. Mikhailidis
- Department of Clinical Biochemistry, Royal Free Hospital, University College London, London, UK
| | - Peter P. Toth
- Cicarrone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, and CGH Medical Center, Sterling, Illinois, USA
| | - George Howard
- Department of Biostatistics, School of Public Health of Alabama, Birmingham, AL, USA
| | - Gregory Y. H. Lip
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom; and Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Maciej Tomaszewski
- Division of Cardiovascular Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Fadi J. Charchar
- School of Health and Life Sciences, Federation University Australia, Ballarat, Victoria, Australia
| | - Naveed Sattar
- Institute of Cardiovascular and Medical Science, University of Glasgow, Glasgow, UK
| | - Bryan Williams
- NIHR University College London Biomedical Research Centre, University College London and University College London Hospitals NHS Foundation Trust, London, UK
| | - Thomas M. MacDonald
- MEMO Research, University of Dundee, Ninewells Hospital and Medical School, Dundee DD1 9SY, UK
| | | | - Michał Dobrakowski
- Department of Biochemistry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Poland
| | - Aleksandra Kasperczyk
- Department of Biochemistry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Poland
| | | | - Łukasz Skowron
- Department of Gastroenterology and Internal Diseases, Military Institute of Medicine, Warsaw, Poland
| | - Żaneta Żak
- Department of Family Medicine and Public Health, Faculty of Medicine, University of Opole, Opole, Poland
| | - Joanna Lewek
- Polish Mothers Memorial Hospital Research Institute, Lodz, Poland
| | - Maciej Banach
- Polish Mothers Memorial Hospital Research Institute, Lodz, Poland
- Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Lodz, Poland
- Cardiovascular Research Centre, University of Zielona Gora, Zielona Gora, Poland
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15
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Zhang L, Chi J, Chen J, Jiang S, Wu D. Effects of swimming on the development of atherosclerosis in mice. Am J Transl Res 2021; 13:13759-13767. [PMID: 35035714 PMCID: PMC8748149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 11/19/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To investigate the effects of swimming on the formation of atherosclerotic lesions and the corresponding mechanism. METHODS 20 ApoE-deficient young male mice of SFP grade were assigned equally into two groups: atherosclerosis group and swimming group. Atherosclerosis models were established by feeding with high cholesterol diet. Swimming exercise was performed at a frequency of 90 min per day, 6 days per weeks for 10 weeks. The weight index, histologic changes of aorta area, blood lipid levels, expression levels of eNOS, tNOS and iNOS, expression levels of MMP-9 and MMP-14, inflammatory factor levels, and oxidative stress status were compared between the two groups. RESULTS Compared to the atherosclerosis group, the plaque area, plaque rupture rates, and vulnerable index in the aorta of the swimming group were significantly less and the fibrous cap thickness was greater. The weight of mice and serum lipid levels in the swimming group were superior. In addition, in contrast to atherosclerosis group, mRNA expression levels of eNOS, tNOS, iNOS, and SOD in the swimming group were signifiantly elevated, while the levels of MMP-9, MMP-14 and MDA, and serum levels of IL-6, Lp-PLA2, and TNF-α were significantly decreased. CONCLUSION Swimming exercise significantly decreases the development of atherosclerotic plaque in ApoE-deficient mice, possibly due to a reduction in the expression of blood lipid, MMP-9, MMP-14, MDA, IL-6, Lp-PLA2, and TNF-α and elevation in the expression of eNOS, tNOS, iNOS, and SOD.
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Affiliation(s)
- Longpu Zhang
- China Basketball College, Beijing Sport UniversityBeijing 100084, China
| | - Jian Chi
- China Basketball College, Beijing Sport UniversityBeijing 100084, China
| | - Junxia Chen
- Art and Sports Teaching and Research Office, School of Humanities and Economic Management, China Agricultural University (Yantai)Yantai 264670, Shandong Province, China
| | - Shiqin Jiang
- Competitive Sports Division, Shandong Shooting Bicycle Sport Management CenterJinan 250100, Shandong Province, China
| | - Di Wu
- China Basketball College, Beijing Sport UniversityBeijing 100084, China
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16
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Pandrc M, Ratković N, Perić V, Stojanović M, Kostovski V, Rančić N. PREVALENCE OF TRADITIONAL CARDIOVASCULAR RISK FACTORS FOR CORONARY ARTERY DISEASE AND ELEVATED FIBRINOGEN AMONG ACTIVE MILITARY PERSONNEL IN REPUBLIC OF SERBIA: A CROSS-SECTIONAL STUDY. J Med Biochem 2021; 41:221-229. [PMID: 35510206 PMCID: PMC9010046 DOI: 10.5937/jomb0-33428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 10/25/2021] [Indexed: 11/18/2022] Open
Abstract
Background It is well known that less than 1% of the population achieves ideal cardiovascular health, and 65% of patients do not have their conventional risk biomarkers under control. Military service has its own particularities that may contribute to cardiovascular risk. Methods To define the preventive strategy goals, we analysed the prevalence of traditional cardiovascular risk factors for coronary artery disease and elevated fibrinogen among active military personnel in the Republic of Serbia. Results The cross-sectional study included 738 individuals older than 20 years, mostly between 31 and 40 years old. The mean value of SBP for the whole group was 122.39± 9.42 mmHg, and for the DBP, it was 79.94±6.56 mmHg. Among active military personnel, 72.7% (533) had prehypertension, and 13.8% (101) was hypertensive. Both body mass and BMI index among the observed age subgroups were found to increase with the age of the patients and cholesterol values. HDL cholesterol values also differed statistically significantly between age subgroups, with the proportion of individuals with HDL less than 1.5 mmol/L in all subgroups being about 85%, the only in the 41-50 age group was lower, 76.4%. LDL cholesterol and the proportion of individuals who had LDL 3.5 increases with the age of patients, and an identical trend was recorded with triglycerides. With ageing, fibrinogen levels increased. Conclusions Those findings considering cardio and cerebrovascular risk factors would help create a new approach for primary prevention for these categories of individuals.
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Affiliation(s)
- Milena Pandrc
- Military Medical Academy, Clinic for Urgent Internal Medicine, Belgrade
| | - Nenad Ratković
- Military Medical Academy, Sector for treatment, Belgrade
| | - Vitomir Perić
- University of Defence in Belgrade, Military Medical Academy, Medical Faculty, Belgrade
| | | | - Vanja Kostovski
- University of Defence, Military Medical Academy, Clinic for Cardiothoracic Surgery, Belgrade
| | - Nemanja Rančić
- Military Medical Academy, Center for Clinical Pharmacology, Belgrade
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17
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Wang Q, Li W, Wang Y, Li H, Zhai D, Wu W. Prediction of coronary heart disease in rural Chinese adults: a cross sectional study. PeerJ 2021; 9:e12259. [PMID: 34721974 PMCID: PMC8515995 DOI: 10.7717/peerj.12259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 09/15/2021] [Indexed: 11/25/2022] Open
Abstract
Background Coronary heart disease (CHD) is a common cardiovascular disease with high morbidity and mortality in China. The CHD risk prediction model has a great value in early prevention and diagnosis. Methods In this study, CHD risk prediction models among rural residents in Xinxiang County were constructed using Random Forest (RF), Support Vector Machine (SVM), and the least absolute shrinkage and selection operator (LASSO) regression algorithms with identified 16 influencing factors. Results Results demonstrated that the CHD model using the RF classifier performed best both on the training set and test set, with the highest area under the curve (AUC = 1 and 0.9711), accuracy (one and 0.9389), sensitivity (one and 0.8725), specificity (one and 0.9771), precision (one and 0.9563), F1-score (one and 0.9125), and Matthews correlation coefficient (MCC = one and 0.8678), followed by the SVM (AUC = 0.9860 and 0.9589) and the LASSO classifier (AUC = 0.9733 and 0.9587). Besides, the RF model also had an increase in the net reclassification index (NRI) and integrated discrimination improvement (IDI) values, and achieved a greater net benefit in the decision curve analysis (DCA) compared with the SVM and LASSO models. Conclusion The CHD risk prediction model constructed by the RF algorithm in this study is conducive to the early diagnosis of CHD in rural residents of Xinxiang County, Henan Province.
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Affiliation(s)
- Qian Wang
- School of Public Health, Xinxiang Medical University, Xinxiang, Henan, China
| | - Wenxing Li
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Southern Medical University, Guangzhou, Guangdong, China
| | - Yongbin Wang
- School of Public Health, Xinxiang Medical University, Xinxiang, Henan, China
| | - Huijun Li
- School of Public Health, Xinxiang Medical University, Xinxiang, Henan, China
| | - Desheng Zhai
- School of Public Health, Xinxiang Medical University, Xinxiang, Henan, China
| | - Weidong Wu
- School of Public Health, Xinxiang Medical University, Xinxiang, Henan, China
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18
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Iqtidar K, Qamar U, Aziz S, Khan MU. Phonocardiogram signal analysis for classification of Coronary Artery Diseases using MFCC and 1D adaptive local ternary patterns. Comput Biol Med 2021; 138:104926. [PMID: 34656868 DOI: 10.1016/j.compbiomed.2021.104926] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 09/15/2021] [Accepted: 10/01/2021] [Indexed: 11/30/2022]
Abstract
Coronary Artery Diseases (CADs) are a dominant cause of worldwide fatalities. The development of accurate and timely diagnosis routines is imperative to reduce these risks and mortalities. Coronary angiography, an invasive and expensive technique, is currently used as a diagnostic tool for the detection of CAD but it has some procedural hazards, i.e., it requires arterial puncture, and the subject gets exposed to iodinated radiation. Phonocardiography (PCG), a non-invasive and inexpensive technique, is a modality employing heart sounds to diagnose heart diseases but it requires only trained medical personnel to apprehend cardiac murmurs in clinical environments. Furthermore, there is a strong compulsion to characterize CAD into its types, such as Single vessel coronary artery disease (SVCAD), Double vessel coronary artery disease (DVCAD), and Triple vessel coronary artery disease (TVCAD) to assist the cardiologist in decision making about the treatment procedure followed. This paper presents a computer-aided diagnosis system for the categorization of CAD and its types based on Phonocardiogram (PCG) signal analysis. The raw PCG signals were denoised via empirical mode decomposition (EMD) to remove redundant information and noise. Next, we extract MFCC and proposed 1D-Adaptive Local Ternary Patterns (1D-ALTP) and fused them serially to get a strong feature representation of multiple PCG signal classes. Features were further reduced through Multidimensional Scaling (MDS) and subjected to several classification methods such as support vector machines (SVM), Decision Tree (DT), and K-nearest neighbors (KNN) in a comparative fashion. The best classification performances of 98.3% and 97.2% mean accuracies were obtained through SVM with the cubic kernel for binary and multiclass experiments, respectively. The performance of the proposed system is comprehensively tested through 10-fold cross-validation and hold-out train-test techniques to avoid model overfitting. Comparative analysis with existing approaches advocates the superiority of the proposed approach.
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Affiliation(s)
- Khushbakht Iqtidar
- Knowledge and Data Science Research Centre, Department of Computer & Software Engineering, National University of Sciences and Technology (NUST), Islamabad, Pakistan.
| | - Usman Qamar
- Knowledge and Data Science Research Centre, Department of Computer & Software Engineering, National University of Sciences and Technology (NUST), Islamabad, Pakistan
| | - Sumair Aziz
- Department of Electronics Engineering, University of Engineering and Technology, Taxila, Pakistan
| | - Muhammad Umar Khan
- Department of Electronics Engineering, University of Engineering and Technology, Taxila, Pakistan
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Piras CC, Patterson AK, Smith DK. Hybrid Self-Assembled Gel Beads for Tuneable pH-Controlled Rosuvastatin Delivery. Chemistry 2021; 27:13203-13210. [PMID: 34346527 PMCID: PMC8519141 DOI: 10.1002/chem.202101405] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Indexed: 12/11/2022]
Abstract
This article describes the fabrication of new pH-responsive hybrid gel beads combining the polymer gelator calcium alginate with two different low-molecular-weight gelators (LMWGs) based on 1,3 : 2,4-dibenzylidene-d-sorbitol: pH-responsive DBS-COOH and thermally responsive DBS-CONHNH2 , thus clearly demonstrating that different classes of LMWG can be fabricated into gel beads by using this approach. We also demonstrate that self-assembled multicomponent gel beads can be formed by using different combinations of these gelators. The different gel bead formulations exhibit different responsiveness - the DBS-COOH network can disassemble within those beads in which it is present upon raising the pH. To exemplify preliminary data for a potential application for these hybrid gel beads, we explored aspects of the delivery of the lipid-lowering active pharmaceutical ingredient (API) rosuvastatin. The release profile of this statin from the hybrid gel beads is pH-dependent, with greater release at pH 7.4 than at pH 4.0 - primary control of this process results from the pKa of the API. The extent of pH-mediated API release is also significantly further modified according to gel bead composition. The DBS-COOH/alginate beads show rapid, highly effective drug release at pH 7.4, whereas the three-component DBS-COOH/DBS-CONHNH2 /alginate system shows controlled slow release of the API under the same conditions. These initial results indicate that such gel beads constitute a promising, versatile and easily tuned platform suitable for further development for controlled drug-delivery applications.
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Affiliation(s)
- Carmen C. Piras
- Department of ChemistryUniversity of YorkHeslington, YorkYO10 5DDUK
| | | | - David K. Smith
- Department of ChemistryUniversity of YorkHeslington, YorkYO10 5DDUK
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20
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Fanelli SM, Jonnalagadda SS, Pisegna JL, Kelly OJ, Krok-Schoen JL, Taylor CA. Poorer Diet Quality Observed Among US Adults With a Greater Number of Clinical Chronic Disease Risk Factors. J Prim Care Community Health 2021; 11:2150132720945898. [PMID: 32996366 PMCID: PMC7533933 DOI: 10.1177/2150132720945898] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background Obesity and chronic disease risk are significantly related to healthy lifestyle behavior, including dietary intakes. Further, the interrelated etiology of many chronic conditions supports the comorbidity in US adults to manage multiple diagnoses. The purpose of this study was to assess diet quality across varying numbers of existing conditions, including obesity, hypercholesterolemia, hyperglycemia, and hypertension. Methods Cross-sectional analysis of data from 17 356 adults aged 45 years and older from the 2005-2016 National Health and Nutrition Examination Survey were assessed for the presence of overweight or obesity (body mass index >25 kg/m2), hyperglycemia (glycated hemoglobin >5.7%), hypercholesterolemia (>200 mg/dL), and high blood pressure (>120/80 mm Hg). Overall diet quality was assessed using Healthy Eating Index 2015 scores computed from the intakes reported during the 24-hour dietary recall collected in the mobile examination center. The total score (range 0-100) is based on the sum of 13 subscales that represent concordance with the Dietary Guidelines for Americans. Results Few adults presented with no markers of chronic disease (n = 407), with other presenting 1 indicator (n = 1978), 2 indicators (n = 4614), 3 indicators (n = 6319), and all 4 indicators (4038). While there was no significant difference in mean energy intakes on the day of intake, those with all 4 markers of chronic disease had a significantly poorer diet quality (P < .001) and consumed significantly more saturated fat (P = .026), but significantly less total carbohydrates, dietary fiber, and added sugars (P < .005). While mean consumption of protein was lowest in those with more chronic conditions, the differences were not significant. Conclusion Overall dietary intakes from the day of intake indicated that those with a greater number of chronic conditions presented with poorer overall dietary intakes. The foundational intervention strategy across all evidence-based treatment strategies is the promotion of healthy lifestyle behaviors.
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21
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Henein MY, Bytyçi I, Nicoll R, Shenouda R, Ayad S, Cameli M, Vancheri F. Combined Cardiac Risk Factors Predict COVID-19 Related Mortality and the Need for Mechanical Ventilation in Coptic Clergy. J Clin Med 2021; 10:2066. [PMID: 34065902 PMCID: PMC8151318 DOI: 10.3390/jcm10102066] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 05/03/2021] [Accepted: 05/10/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND AND AIMS The clinical adverse events of COVID-19 among clergy worldwide have been found to be higher than among ordinary communities, probably because of the nature of their work. The aim of this study was to assess the impact of cardiac risk factors on COVID-19-related mortality and the need for mechanical ventilation in Coptic clergy. METHODS Of 1570 Coptic clergy participating in the COVID-19-Clergy study, serving in Egypt, USA and Europe, 213 had the infection and were included in this analysis. Based on the presence of systemic arterial hypertension (AH), participants were divided into two groups: Group-I, clergy with AH (n = 77) and Group-II, without AH (n = 136). Participants' demographic indices, cardiovascular risk factors, COVID-19 management details and related mortality were assessed. RESULTS Clergy with AH were older (p < 0.001), more obese (p = 0.04), had frequent type 2 diabetes (DM) (p = 0.001), dyslipidemia (p = 0.001) and coronary heart disease (CHD) (p = 0.04) compared to those without AH. COVID-19 treatment at home, hospital or in intensive care did not differ between the patient groups (p > 0.05 for all). Clergy serving in Northern and Southern Egypt had a higher mortality rate compared to those from Europe and the USA combined (5.22%, 6.38%, 0%; p = 0.001). The impact of AH on mortality was significant only in Southern Egypt (10% vs. 3.7%; p = 0.01) but not in Northern Egypt (4.88% vs. 5.81%; p = 0.43). In multivariate analysis, CHD OR 1.607 ((0.982 to 3.051); p = 0.02) and obesity, OR 3.403 ((1.902 to 4.694); p = 0.04) predicted COVID-19 related mortality. A model combining cardiac risk factors (systolic blood pressure (SBP) ≥ 160 mmHg, DM, obesity and history of CHD) was the most powerful independent predictor of COVID-19-related mortality, OR 3.991 ((1.919 to 6.844); p = 0.002). Almost the same model also proved the best independent multivariate predictor of mechanical ventilation OR 1.501 ((0.809 to 6.108); p = 0.001). CONCLUSION In Coptic clergy, the cumulative impact of risk factors was the most powerful predictor of mortality and the need for mechanical ventilation.
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Affiliation(s)
- Michael Y. Henein
- Institute of Public Health and Clinical Medicine, Umea University, 90187 Umea, Sweden; (I.B.); (R.N.); (R.S.)
- Molecular and Clinic Research Institute, St George University, London SW17 0QT, UK
- Institute of Fluid Dynamics, Brunel University, London UB8 3PH, UK
| | - Ibadete Bytyçi
- Institute of Public Health and Clinical Medicine, Umea University, 90187 Umea, Sweden; (I.B.); (R.N.); (R.S.)
| | - Rachel Nicoll
- Institute of Public Health and Clinical Medicine, Umea University, 90187 Umea, Sweden; (I.B.); (R.N.); (R.S.)
| | - Rafik Shenouda
- Institute of Public Health and Clinical Medicine, Umea University, 90187 Umea, Sweden; (I.B.); (R.N.); (R.S.)
- International Cardiac Centre, Alexandria 21526, Egypt
| | - Sherif Ayad
- Department of Cardiology, Faculty of Medicine, Alexandria University, Alexandria 21526, Egypt;
| | - Matteo Cameli
- Department of Cardiovascular Disease, University of Siena, 53100 Siena, Italy;
| | - Federico Vancheri
- Department of Internal Medicine, S. Elia Hospital, 93100 Caltanissetta, Italy;
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22
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Denegri A, Boriani G. High Sensitivity C-reactive Protein (hsCRP) and its Implications in Cardiovascular Outcomes. Curr Pharm Des 2021; 27:263-275. [PMID: 32679014 DOI: 10.2174/1381612826666200717090334] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 05/20/2020] [Indexed: 11/22/2022]
Abstract
Atherosclerosis and its fearsome complications represent the first cause of morbidity and mortality worldwide. Over the last two decades, several pieces of evidence have been accumulated, suggesting a central role of inflammation in atheroma development. High sensitivity C-reactive protein (hsCRP) is a well-established marker of cardiovascular (CV) disease; high levels of hsCRP have been associated with adverse CV outcome after acute coronary syndrome (ACS) and, despite some controversy, an active role for hsCRP in initiation and development of the atherosclerotic plaque has been also proposed. Randomized clinical trials focusing on hsCRP have been crucial in elucidating the anti-inflammatory effects of statin therapy. Thus, hsCRP has been progressively considered a real CV risk factor likewise to low-density lipoprotein cholesterol (LDL-C), expanding the concept of residual CV inflammatory risk. Subsequent research has been designed to investigate potential new targets of atherothrombotic protection. Despite the fact that the clinical usefulness of hsCRP is widely recognized, hsCRP may not represent the ideal target of specific anti-inflammatory therapies. Clinical investigations, therefore, have also focused on other inflammatory mediators, restricting hsCRP to an indicator rather than a therapeutic target. The aim of the present review is to provide an illustrative overview of the current knowledge of atherosclerosis and inflammation, highlighting the most representative clinical studies of lipid-lowering and antiinflammatory therapies focused on hsCRP in CV diseases.
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Affiliation(s)
- Andrea Denegri
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria di Modena, Largo del Pozzo, 71, 41125, Modena, Italy
| | - Giuseppe Boriani
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria di Modena, Largo del Pozzo, 71, 41125, Modena, Italy
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Lorensia A, Budiono R, Suryadinata RV, Tiarasari N. Quantitative determination of EPA and DHA in fish oil capsules for cardiovascular disease therapy in Indonesia by GC-MS. J Public Health Res 2021; 10:2159. [PMID: 33855393 PMCID: PMC8129766 DOI: 10.4081/jphr.2021.2159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 03/11/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The consumption of EPA (Eicosapentaenoic acid), and DHA (docosahexaenoic acid), from fish oil, in the long run, has been observed to have a positive impact on patients with coronary heart disease. Fish oil products, with so much EPA and DHA content are available, and have very variable prices. Therefore, as a therapy to be used for long-term treatment, the cost factor is to be considered. DESIGN AND METHODS This study analyzed the content of EPA and DHA, using GC-MS. The sample to be analyzed was the fish oil that has the lowest price (Product A1), and that of the highest (Product A2). Furthermore, the macroscopic analysis was performed, by observing the physical form including organoleptic and qualitative tests, by reading the fragments identified by EPA and DHA. RESULTS Clinical trials were conducted on patients (about 46 people), with risk factors and dyslipidemia. Product A1 showed EPA at tR= 15.574 min (relative%= 88.49%, similarity= 95%), and DHA at tR= 21.714 min (relative%= 88.92%, similarity= 93%). Product A2 showed EPA at tR= 28.719 min (relative%= 22.58%, similarity= 89%), and DHA at tR= 32.327 min (relative%= 22.87%, similarity= 90%), which meant that both had EPA and DHA contents, in accordance with their labels. Both products were confirmed to reduce total cholesterol in 4weeks (p=0.000, p= 0.000), with no significant difference in their effectiveness (p=0.652). CONCLUSION The results showed that both the A1 and A2 products, had the EPA and DHA contents in accordance with their respective labels. However, with the A2 product having a percentage relatively higher than that of the A1 brand, both are equally very effective.
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Affiliation(s)
- Amelia Lorensia
- Department of Clinical Pharmacy-Community, Faculty of Pharmacy, Universitas Surabaya, Jl. Raya Kalirungkut, Surabaya.
| | - Ryanto Budiono
- Department of Clinical Pharmacy-Community, Faculty of Pharmacy, Universitas Surabaya, Jl. Raya Kalirungkut, Surabaya.
| | | | - Navy Tiarasari
- Undergraduate Student, Faculty of Pharmacy, Universitas Surabaya, Jl. Raya Kalirungkut, Surabaya.
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Bashir A, Doreswamy S, Narra LR, Patel P, Guarecuco JE, Baig A, Lahori S, Heindl SE. Childhood Obesity as a Predictor of Coronary Artery Disease in Adults: A Literature Review. Cureus 2020; 12:e11473. [PMID: 33329969 PMCID: PMC7734699 DOI: 10.7759/cureus.11473] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Obesity in children is becoming a worldwide epidemic that requires immediate attention. Despite all the efforts directed towards controlling this issue, its prevalence is increasing overtime both in developed and developing countries. With an increasing prevalence in the younger age groups, it is emerging as a public health crisis. A rise in body mass index (BMI) results in an increased risk of developing a variety of metabolic and cardiovascular diseases, particularly coronary artery disease (CAD). The early onset of the disease affects the peak productivity years in young individuals leading to disability at a later age. It makes it essential that we understand the contributory factors towards the development of obesity as a risk factor for CAD and develop strategies that hinder the progression towards adverse outcomes. There is an urgent need to screen these children at a younger age and educate them to change their lifestyle to decrease the BMI within the normal range to promote cardiovascular health. It requires a multidisciplinary approach involving dietary, physical, and behavioral-centered strategies. Failure to control this epidemic timely may cause widespread consequences for the quality of life and longevity.
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Affiliation(s)
- Anam Bashir
- Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Shriya Doreswamy
- Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA.,Otorhinolaryngology, Vydehi Institute of Medical Sciences and Research Centre, Bangalore, IND
| | - Lakshmi Rekha Narra
- Anesthesiology, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Pinal Patel
- Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Jesus E Guarecuco
- Neuroscience and Psychology, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Ayesha Baig
- Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Simmy Lahori
- Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Stacey E Heindl
- Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA.,Medicine, Avalon University School of Medicine, Willemstad, CUW
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Luo R, Sun X, Shen F, Hong B, Wang Z. Effects of High-Dose Rosuvastatin on Ventricular Remodelling and Cardiac Function in ST-Segment Elevation Myocardial Infarction. Drug Des Devel Ther 2020; 14:3891-3898. [PMID: 33061295 PMCID: PMC7520152 DOI: 10.2147/dddt.s254948] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Accepted: 08/05/2020] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE To investigate the effects of high-dose rosuvastatin on ventricular remodelling and cardiac function in ST-segment elevation myocardial infarction (STEMI). MATERIALS AND METHODS From January 2017 to March 2019, the clinical data of 93 patients with STEMI were collected and analysed, with 46 cases in the conventional-dose group (rosuvastatin, 10 mg/d) and 47 cases in the high-dose group (rosuvastatin, 20 mg/d). Blood lipid (TC, TG, LDL-C and HDL-C), serum inflammatory markers (hs-CRP, IL-6, TNF-α and ICAM-1), ventricular remodelling markers (NT-pro BNP, MMP-9, TIMP-4 and Gal-3) and indicators of cardiac function (LVESD, LVESD, LVESV, LVEDV, IVST and LVEF) were collected from all patients at the time of admission and 8 weeks after rosuvastatin treatment. RESULTS After treatment with rosuvastatin for 8 weeks, compared with those in conventional-dose group, the levels of TC, TG, LDL-C, hs-CRP, IL-6, TNF-α, ICAM-1, NT-pro BNP, MMP-9 and Gal-3 in the high-dose group decreased significantly (P<0.05), while the increase of HDL-C and TIMP-4 levels was more obvious (P<0.05) than that in the conventional-dose group. Moreover, LVEF was significantly higher (P<0.05) and LVESD, LVESD, LVESV, LVEDV and IVST were significantly lower (P< 0.05) after treatment than before treatment in both groups. The improvement of cardiac ultrasound results in the high-dose group was more significant than that in the conventional-dose group (P< 0.05). CONCLUSION This study suggests that high-dose rosuvastatin was better than conventional-dose rosuvastatin for improving blood lipid metabolism, reducing the inflammatory response, and preventing and treating ventricular remodelling and myocardial fibrosis, indicating that high-dose rosuvastatin had stronger therapeutic effect on STEMI than conventional-dose rosuvastatin.
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Affiliation(s)
- Rong Luo
- Department of Cardiology, Qingpu Medical Center, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Xiaochen Sun
- Department of Cardiology, Qingpu Medical Center, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Feiyan Shen
- Department of Cardiology, Qingpu Medical Center, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Bin Hong
- Department of Cardiology, Qingpu Medical Center, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Zilong Wang
- Department of Cardiology, Qingpu Medical Center, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
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Ribas VR, Ribas RDMG, Barros MGS, Ribas KHDS, Neto NA, Barros MGS, Martins HADL. Hemodynamics, baroreflex index and blood biomarkers of a patient who died after being affected by COVID-19: case report. Hematol Transfus Cell Ther 2020; 42:206-211. [PMID: 32646837 PMCID: PMC7301134 DOI: 10.1016/j.htct.2020.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 06/11/2020] [Accepted: 06/15/2020] [Indexed: 02/07/2023] Open
Affiliation(s)
| | | | | | | | - Nery Adamy Neto
- Instituto do Cérebro de Pernambuco (ICerPE), Jaboatão dos Guararapes, PE, Brazil
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Jiang Y, He Q, Zhang T, Xiang W, Long Z, Wu S. Exploring the mechanism of Shengmai Yin for coronary heart disease based on systematic pharmacology and chemoinformatics. Biosci Rep 2020; 40:224907. [PMID: 32436944 PMCID: PMC7286881 DOI: 10.1042/bsr20200286] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 04/21/2020] [Accepted: 04/29/2020] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE To explore the mechanism of Shengmai Yin (SMY) for coronary heart disease (CHD) by systemic pharmacology and chemoinformatics. METHODS Traditional Chinese Medicine Systems Pharmacology Database (TCMSP), traditional Chinese medicine integrative database (TCMID) and the traditional Chinese medicine (TCM) Database@Taiwan were used to screen and predict the bioactive components of SMY. Pharmmapper were utilized to predict the potential targets of SMY, the TCMSP was utilized to obtain the known targets of SMY. The Genecards and OMIM database were utilized to collect CHD genes. Cytoscape was then used for network construction and analysis, and DAVID was used for Gene Ontology (GO) and pathway enrichment analysis. After that, animal experiments were then performed to further validate the results of systemic pharmacology and chemoinformatics. RESULTS Three major networks were constructed: (1) CHD genes' protein-protein interaction (PPI) network; (2) SMY-CHD PPI network; (3) SMY known target-CHD PPI network. The other networks are minor networks generated by analyzing the three major networks. Experimental results showed that compared with the model group, the Shengmai injection (SMI) can reduce the myocardial injury score and the activities of serum aspartate aminoconvertase (AST), CK and lactate dehydrogenase (LDH) in rats (P<0.05), and reduce serum lipid peroxide (LPO) content and increase serum superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) activities in myocardial infarction rats (P<0.05). SMI can also decrease the expression of MMP-9 mRNA and increase that of TIMP-1 mRNA (P<0.01). CONCLUSION SMY may regulate the signaling pathways (such as PPAR, FoxO, VEGF signaling), biological processes (such as angiogenesis, blood pressure formation, inflammatory response) and targets (such as AKT1, EGFR, MAPK1) so as to play a therapeutic role in CHD.
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Affiliation(s)
- Yan Jiang
- Department of General Surgery, The First Affiliated Hospital of University of South China, Hengyang, Hunan Province, China
- Graduate College, Hunan Normal University, Changsha, Hunan Province, China
| | - Qi He
- Intensive Care Unit, People’s Hospital of Ningxiang City, Ningxiang 410600, Hunan Province, China
| | - Tianqing Zhang
- Graduate College, University of South China, Hengyang, Hunan Province, China
- Department of Cardiology, The First Affiliated Hospital of University of South China, Hengyang, Hunan Province, China
| | - Wang Xiang
- Graduate College, Guilin Medical University, Guilin, Guangxi Province, China
- Department of Rheumatology, Affiliated Hospital of Guilin Medical University, Guilin, Guangxi Province, China
| | - Zhiyong Long
- Department of Physical Medicine and Rehabilitation, Guangdong General Hospital, Shantou University Medical College, Shantou, Guangdong, China
- Graduate College, Shantou University Medical College, Shantou, Guangdong Province, China
| | - Shiwei Wu
- Department of Traditional Chinese Medicine, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong Province, China
- Correspondence: Shiwei Wu ()
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Naheeda P, Sharifullah K, Ullah SS, Azeem AM, Shahzad Y, Kinza W. Development of a cost-effective CVD prediction model using lifestyle factors. A cohort study in Pakistan. Afr Health Sci 2020; 20:849-859. [PMID: 33163052 PMCID: PMC7609114 DOI: 10.4314/ahs.v20i2.39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: Cardiovascular diseases (CVD) such as hypertension and ischemic heart diseases cause 35 to 40% of deaths every year in Pakistan. Several lifestyle factors such as dietary habits, lack of exercise, mental stress, body habitus (i.e., body mass index, waist), personal habits (smoking, sleep, fitness) and clinical conditions (i.e., diabetes, dyslipidemia and hypertension) have been shown to be strongly associated with the etiology of CVD. Epidemiological studies in Pakistan have shown poor adherence of people to healthy lifestyle and lack of knowledge in adopting healthy alternatives. There are well validated cardiovascular risk estimation tools (QRISK model) that cn predict the probability of future cardiac events. The existing tools are based on laboratory investigations of biochemical test but there is no widely accepted tool available that predicts the CVD risk probability based on lifestyle factors. Aims: Aim of the current study was to develop alternative CVD risk estimation model based on lifestyle factors and physical attributes (without using laboratory investigation) using QRISK model as the gold standard. Study Design: Clinical and lifestyle data of one hundred and sixty subjects were collected to formulate a regression model for predicting CVD risk probability. Methods: Lifestyle factors as independent variables (IV) include BMI, waist circumference, physical activities (stamina, strength, flexibility, posture), smoking, general illnesses, dietary intake, stress and physical characteristics. CVD risk probability of QRISK Intervention computed through clinical variables was used as a dependent variable (DV) in present research. Chronological age was also included in analysis in addition to selected lifestyle factors. Regression analysis, principal component analysis and bivariate correlations were applied to assess the relationship among predictor variables and cardiovascular risk score. Results: Chronological age, waist circumference, BMI and strength showed significant effect on CVD risk probability. The proposed model can be used to calculate CVD risk probability with 72.9% accuracy for the targeted population. Conclusion: The model involves only those features which can be measured without any clinical test. The proposed model is rapid and less costly hence appropriate for use in developing countries like Pakistan.
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Affiliation(s)
- Parveen Naheeda
- School of Electrical Engineering and Computer Science, National University of Sciences and Technology (NUST), Islamabad, Pakistan
| | - Khan Sharifullah
- School of Electrical Engineering and Computer Science, National University of Sciences and Technology (NUST), Islamabad, Pakistan
- Corresponding author: Sharifullah Khan, School of Electrical Engineering and Computer Science, National University of Sciences and Technology (NUST), Islamabad, Pakistan.
| | - Shah Saeed Ullah
- Department of Cardiology, Shifa International Hospital Islamabad, Pakistan
| | - Abbas Muhammad Azeem
- University Institute of Information Technology, PMAS, Arid Agriculture University, Rawalpindi, Pakistan
| | - Younis Shahzad
- School of Electrical Engineering and Computer Science, National University of Sciences and Technology (NUST), Islamabad, Pakistan
| | - Waqar Kinza
- Department of Cardiology, Shifa International Hospital Islamabad, Pakistan
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Alipour M, Rostami H, Parastouei K. Association between inflammatory obesity phenotypes, FTO-rs9939609, and cardiovascular risk factors in patients with type 2 diabetes. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2020; 25:46. [PMID: 32765616 PMCID: PMC7377118 DOI: 10.4103/jrms.jrms_429_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Revised: 10/08/2019] [Accepted: 02/17/2020] [Indexed: 12/17/2022]
Abstract
Background The role of inflammatory states in cardiometabolic risks among patients with type 2 diabetes mellitus (T2DM) with similar degrees of obesity is unknown. The study aimed to compare cardiometabolic risk factors in inflammatory obesity phenotypes with regard to the role of the FTO rs9939609 gene polymorphism. Materials and Methods This study was performed on 155 patients with T2DM (77 men and 78 women) in Ahvaz, Iran. Participants were grouped into four groups based on the presence of obesity and inflammation (high-sensitivity C-reactive protein ≥3.9 mg/L): low inflammatory normal weight (LINW), high inflammatory normal weight (HINW), low inflammatory obese (LIO), and high inflammatory obese (HIO). The genotypes of FTO rs9939609, including homozygous carriers of the FTO risk allele (AA), heterozygous carriers (AT), and carrying no risk allele (TT), were studied. The cardiometabolic risk factors, including anthropometric status, hypertension, lipid and glycemic profile, and inflammatory markers, were evaluated. The waist-hip ratio (WHR), mean arterial pressure (MAP), and atherogenic index of plasma (AIP) were calculated. Results The patients in inflammatory groups (HINW and HIO) have significantly higher levels in AIP when compared to inflammatory healthy groups (LINW and LIO). No significant differences between any of the four group means were detected in WHR, blood pressure, MAP, glycemic status (fasting blood sugar and insulin), homeostatic model assessment, lipid profile (triglyceride, very low-density lipoprotein, high-density lipoprotein, low-density lipoprotein, and cholesterol), interleukin-6, and total antioxidant capacity. The most frequent of high-risk genotype (AA) of FTO rs9939609 was in HIO, LIO, HINW, and LINW. Conclusion T2DM patients with inflammatory condition have similar degree of increased atherogenic risk irrespective of obesity. The obesity-risk genotype AA of FTO gene was associated with an increased risk for inflammatory obesity in T2DM patients.
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Affiliation(s)
- Meysam Alipour
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Hosein Rostami
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Karim Parastouei
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
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Using Network Pharmacology to Explore Potential Treatment Mechanism for Coronary Heart Disease Using Chuanxiong and Jiangxiang Essential Oils in Jingzhi Guanxin Prescriptions. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2019; 2019:7631365. [PMID: 31772600 PMCID: PMC6854988 DOI: 10.1155/2019/7631365] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 08/30/2019] [Accepted: 09/14/2019] [Indexed: 01/06/2023]
Abstract
Background To predict the active components and potential targets of traditional Chinese medicine and to determine the mechanism behind the curative effect of traditional Chinese medicine, a multitargeted method was used. Jingzhi Guanxin prescriptions expressed a high efficacy for coronary heart disease (CHD) patients of which essential oils from Chuanxiong and Jiangxiang were confirmed to be the most important effective substance. However, the interaction between the active components and the targets for the treatment of CHD has not been clearly explained in previous studies. Materials and Methods Genes associated with the disease and the treatment strategy were searched from the electronic database and analyzed by Cytoscape (version 3.2.1). Protein-protein interaction network diagram of CHD with Jiangxiang and Chuanxiong essential oils was constructed by Cytoscape. Pathway functional enrichment analysis was executed by clusterProfiler package in R platform. Results 121 ingredients of Chuanxiong and Jiangxiang essential oils were analyzed, and 393 target genes of the compositions and 912 CHD-related genes were retrieved. 15 coexpression genes were selected, including UGT1A1, DPP4, RXRA, ADH1A, RXRG, UGT1A3, PPARA, TRPC3, CYP1A1, ABCC2, AHR, and ADRA2A. The crucial pathways of occurrence and treatment molecular mechanism of CHD were analyzed, including retinoic acid metabolic process, flavonoid metabolic process, response to xenobiotic stimulus, cellular response to xenobiotic stimulus, cellular response to steroid hormone stimulus, retinoid binding, retinoic acid binding, and monocarboxylic acid binding. Finally, we elucidate the underlying role and mechanism behind these genes in the pathogenesis and treatment of CHD. Conclusions Generally speaking, the nodes in subnetwork affect the pathological process of CHD, thus indicating the mechanism of Jingzhi Guanxin prescriptions containing Chuanxiong and Jiangxiang essential oils in the treatment of CHD.
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Abstract
PURPOSE OF REVIEW To review randomized interventional clinical and imaging trials that support lower targeted atherogenic lipoprotein cholesterol goals in "extreme" and "very high" atherosclerotic cardiovascular disease (ASCVD) risk settings. Major atherosclerotic cardiovascular event (MACE) prevention among the highest risk patients with ASCVD requires aggressive management of global risks, including lowering of the fundamental atherogenic apolipoprotein B-associated lipoprotein cholesterol particles [i.e., triglyceride-rich lipoprotein remnant cholesterol, low-density lipoprotein cholesterol (LDL-C), and lipoprotein(a)]. LDL-C has been the long-time focus of imaging studies and randomized clinical trials (RCTs). The 2004 adult treatment panel (ATP-III) update recognized that the long-standing targeted LDL-C goal of < 100 mg/dL potentially fostered substantial undertreatment of the very highest coronary heart disease (CHD) risk individuals and was lowered to < 70 mg/dL as an "optional" goal for "very high" 10-year CHD [CHD death + myocardial infarction (MI)] risk exceeding 20%. This evidence-based guideline change was supported by the observed benefits demonstrated in the high-risk primary and secondary prevention populations in the Heart Protection Study (HPS), the acute coronary syndrome (ACS) population in the Pravastatin or Atorvastatin Evaluation and Infection Therapy-Thrombolysis in Myocardial Infarction 22 trial (PROVE-IT), and the secondary prevention population in the Reversal of Atherosclerosis with Aggressive Lipid Lowering (REVERSAL) intravascular ultrasound (IVUS) study. Subsequent national and international guidelines maintained a targeted LDL-C goal < 70 mg/dL, or a threshold for management of > 70 mg/dL for patients with CHD, CHD risk equivalency, or ASCVD. RECENT FINDINGS Subgroup or meta-analyses of several RCTs, IVUS imaging studies, and the ACS population in IMProved Reduction of Outcomes: Vytorin Efficacy International Trial (IMPROVE-IT) supported the evidence-based 2017 American Association Clinical Endocrinologist (AACE) guideline change establishing a targeted LDL-C goal < 55 mg/dL, non-HDL-C < 80 mg/dl, and apolipoprotein B (apo B) < 70 mg/dL for patients at "Extreme" ASCVD risk, i.e., 10-year 3-point-MACE-composite (CV death, non-fatal MI, or ischemic stroke) risk exceeding 30%. Moreover, with no recognized lower-limit-associated intolerance or safety issues, even more intensive lowering of atherogenic cholesterol levels is supported by the following evidence base: (1) analysis of eight high-intensity statin-based prospective secondary prevention IVUS atheroma volume regression trials; (2) a distribution analysis of on-treatment, ezetimibe and background-statin, of the very low LDL-C levels reached and CVD event risk in the IMPROVE-IT ACS population; (3) the secondary prevention Global Assessment of Pl\aque Regression With a PCSK9 Antibody as Measured by Intravascular Ultrasound (GLAGOV) on background-statin; and (4) the secondary prevention population of Further Cardiovascular Outcomes Research with PCSK9 Inhibition in Subjects with Elevated Risk (FOURIER). By example, in FOURIER, the population on background-statin at a baseline median 92 mg/dL achieved median LDL-C level of 30 mg/dL and non-HDL-C to < 65 mg/dl, and apo B to < 50 mg/dL, and subgroup and post hoc analyses all demonstrated additional ASCVD event reduction benefits as LDL-C was further reduced. The level of ASCVD risk determines the degree, urgency, and persistence in global risk management, including fundamental atherogenic lipoprotein cholesterol particle lowering. "Extreme" risk patients may require extremely low targeted LDL-C, non-HDL-C and apo B goals; such efforts, implied by more recent interventional trials and analyses, are aimed at maximal atheroma plaque regression, stabilization, and MACE event reduction with the aspiration of improved quality lifespan.
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Affiliation(s)
- Paul D Rosenblit
- Department of Medicine, Division of Endocrinology, Diabetes, & Metabolism, University California, Irvine (UCI), School of Medicine, Irvine, CA, 92697, USA.
- Diabetes Out-Patient Clinic, UCI Medical Center, Orange, CA, 92868, USA.
- Diabetes/Lipid Management & Research Center, 18821 Delaware St., Suite 202, Huntington Beach, CA, 92648, USA.
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Liljensøe A, Laursen JO, Bliddal H, Søballe K, Mechlenburg I. Weight Loss Intervention Before Total Knee Replacement: A 12-Month Randomized Controlled Trial. Scand J Surg 2019; 110:3-12. [DOI: 10.1177/1457496919883812] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background and Aims: Obesity is an increasing problem in patients after total knee replacement. The aim of this study was to investigate whether a weight loss intervention before primary total knee replacement would improve quality of life, knee function, mobility, and body composition 1 year after surgery. Material and Methods: Patients scheduled for total knee replacement due to osteoarthritis of the knee and obesity were randomized to a control group receiving standard care or to an intervention group receiving 8-week low-energy diet before total knee replacement. Patient-reported quality of life, 6-Min Walk Test, and body composition by dual-energy X-ray absorptiometry were assessed before intervention for the diet group, and within 1 week preoperatively for both groups, and the changes in outcome from baseline to 1 year after total knee replacement were compared between groups. The number of participants was lower than planned, which might introduce a type-2 error and underestimate the trend for a better outcome after weight loss. Results: The analyses are based on a total of 76 patients, 38 in each group. This study showed major improvement in both study groups in quality of life and knee function, though no statistically significant differences between the groups were observed 1 year after total knee replacement. The average weight loss after 8-week preoperative intervention was 10.7 kg and consisted of a 6.7 kg reduction in fat mass. One year after total knee replacement, the participants in the diet group managed to maintain the weight reduction, whereas there was no change in the control group. Conclusion: The results suggest that it is feasible and safe to implement an intensive weight loss program shortly before total knee replacement. The preoperative intervention resulted in a 10% body weight loss, improved body composition, lower cardiovascular risk factors, and sustained s-leptin.
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Affiliation(s)
- A. Liljensøe
- Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - J. O. Laursen
- Department of Orthopedics, Hospital of Southern Jutland, Aabenraa, Denmark
| | - H. Bliddal
- The Parker Institute and Department of Rheumatology, Copenhagen University Hospital, Bispebjerg-Frederiksberg, Denmark
| | - K. Søballe
- Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - I. Mechlenburg
- Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus, Denmark
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Applying Pulse Spectrum Analysis to Facilitate the Diagnosis of Coronary Artery Disease. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2019; 2019:2709486. [PMID: 31275406 PMCID: PMC6582909 DOI: 10.1155/2019/2709486] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Revised: 05/11/2019] [Accepted: 05/22/2019] [Indexed: 11/21/2022]
Abstract
Not all patients with angina pectoris have coronary artery stenosis. To facilitate the diagnosis of coronary artery disease (CAD), we sought to identify predictive factors of pulse spectrum analysis, which was developed by Wang and is one technique of modern pulse diagnosis. The patients suffered from chest pain and received cardiac catheterization to confirm the CAD diagnosis and Gensini score were recruited. Their pulse waves of radial artery were recorded. Then, by performing a fast Fourier transform, 10 amplitude values of frequency spectrum harmonics were obtained. Each harmonic amplitude was divided by the sum of all harmonic amplitude values, obtaining the relative percentages of 10 harmonics (C1-C10). Subsequently, multivariate logistic regression was conducted with two models and the areas under the receiver operating characteristic curves (ROC) of these 2 models were compared to see if combining the pulse diagnosis parameters with the risk factor of CAD can increase the prediction rate of CAD diagnosis. The predictive factors of CAD severity were analyzed by multivariate linear regression. A total of 83 participants were included; 63 were diagnosed CAD and 20 without CAD. In the CAD group, C1 was greater and C5 was lower than those of the non-CAD group. The CAD risk factors were put alone in Model 1 to perform the multivariate logistic regression analysis which had a prediction rate of 77.1%; while putting the C1 and C5 harmonics together with the risk factors into Model 2, the prediction rate increased to 80.7%. Finally, the area under ROC of Model 1 and Model 2 was 0.788 and 0.856, respectively. Furthermore, left C1, left C5, gender, and presence of hyperlipidemia were predictors of CAD severity. Therefore, pulse spectrum analysis may be a tool to facilitate CAD diagnosis before receiving cardiac catheterization. The harmonics C1 and C5 were favorable predictive indicators.
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Buddeke J, Gernaat SAM, Bots ML, van den Bongard DHJG, Grobbee DE, Vaartjes I, Verkooijen HM. Trends in the risk of cardiovascular disease in women with breast cancer in a Dutch nationwide cohort study. BMJ Open 2019; 9:e022664. [PMID: 31152022 PMCID: PMC6549609 DOI: 10.1136/bmjopen-2018-022664] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES To investigate trends in cardiovascular disease (CVD) risk following breast cancer using national registry data. METHODS A nationwide cohort study was conducted, comprising 163 881 women with in situ (7.6%) or invasive (92.4%) breast cancer and women of the general population, ranging from 3 661 141 in 1996 to 4 566 573 in 2010. CVD mortality rate in women with and without breast cancer and hospitalisation rate after breast cancer were calculated for the years 1996-2010. Age-adjusted CVD and breast cancer mortality within 5 years after breast cancer admission (1997-2010) were compared with 1996 calculated with a Cox proportional hazard analysis. RESULTS The absolute 10-year CVD mortality risk following breast cancer decreased from 56 per 1000 women in 1996 to 41 in 2005 (relative reduction=27.8%). In the general population, this decreased from 73 per 1000 women in 1996 to 55 in 2005 (-23.9%). The absolute risk of CVD hospitalisation within 1 year following breast cancer increased from 54 per 1000 women in 1996 to 67 in 2009 (+23.6%), which was largely explained by an increase in hospitalisation for hypertension, pulmonary embolism, rheumatoid heart/valve disease and heart failure. The 5-year CVD mortality risk was 42% lower (HR 0.58, 95% CI=0.48 to 0.70) for women admitted for breast cancer in 2010 compared with 1996. CONCLUSIONS CVD mortality risk decreased in women with breast cancer and in women of the general population, with women with breast cancer having a lower risk of CVD mortality. By contrast, there was an increase in hospitalisation for CVD in women with breast cancer.
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Affiliation(s)
- Josefien Buddeke
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, Universitair Medisch Centrum Utrecht, Utrecht, The Netherlands
| | - Sofie A M Gernaat
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, Universitair Medisch Centrum Utrecht, Utrecht, The Netherlands
| | - Michiel L Bots
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, Universitair Medisch Centrum Utrecht, Utrecht, The Netherlands
| | | | - Diederick E Grobbee
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, Universitair Medisch Centrum Utrecht, Utrecht, The Netherlands
| | - Ilonca Vaartjes
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, Universitair Medisch Centrum Utrecht, Utrecht, The Netherlands
| | - Helena M Verkooijen
- Imaging Division, University Medical Center Utrecht, Utrecht, The Netherlands
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Pirim D, Radwan ZH, Wang X, Niemsiri V, Hokanson JE, Hamman RF, Feingold E, Bunker CH, Demirci FY, Kamboh MI. Apolipoprotein E-C1-C4-C2 gene cluster region and inter-individual variation in plasma lipoprotein levels: a comprehensive genetic association study in two ethnic groups. PLoS One 2019; 14:e0214060. [PMID: 30913229 PMCID: PMC6435132 DOI: 10.1371/journal.pone.0214060] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 02/12/2019] [Indexed: 01/15/2023] Open
Abstract
The apolipoprotein E-C1-C4-C2 gene cluster at 19q13.32 encodes four amphipathic apolipoproteins. The influence of APOE common polymorphisms on plasma lipid/lipoprotein profile, especially on LDL-related traits, is well recognized; however, little is known about the role of other genes/variants in this gene cluster. In this study, we evaluated the role of common and uncommon/rare genetic variation in this gene region on inter-individual variation in plasma lipoprotein levels in non-Hispanic Whites (NHWs) and African blacks (ABs). In the variant discovery step, the APOE, APOC1, APOC4, APOC2 genes were sequenced along with their flanking and hepatic control regions (HCR1 and HCR2) in 190 subjects with extreme HDL-C/TG levels. The next step involved the genotyping of 623 NHWs and 788 ABs for the identified uncommon/rare variants and common tagSNPs along with additional relevant SNPs selected from public resources, followed by association analyses with lipid traits. A total of 230 sequence variants, including 15 indels were identified, of which 65 were novel. A total of 70 QC-passed variants in NHWs and 108 QC-passed variants in ABs were included in the final association analyses. Single-site association analysis of SNPs with MAF>1% revealed 20 variants in NHWs and 24 variants in ABs showing evidence of association with at least one lipid trait, including several variants exhibiting independent associations from the established APOE polymorphism even after multiple-testing correction. Overall, our study has confirmed known associations and also identified novel associations in this genomic region with various lipid traits. Our data also support the contribution of both common and uncommon/rare variation in this gene region in affecting plasma lipid profile in the general population.
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Affiliation(s)
- Dilek Pirim
- Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- Department of Molecular Biology and Genetics, Faculty of Arts&Science, Uludag University, Gorukle, Bursa, Turkey
| | - Zaheda H. Radwan
- Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Xingbin Wang
- Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Vipavee Niemsiri
- Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - John E. Hokanson
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver, Aurora, Colorado, United States of America
| | - Richard F. Hamman
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver, Aurora, Colorado, United States of America
| | - Eleanor Feingold
- Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Clareann H. Bunker
- Department of Epidemiology, Graduate School of Public Health, University Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - F. Yesim Demirci
- Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- * E-mail: (MIK); (FYD)
| | - M. Ilyas Kamboh
- Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- * E-mail: (MIK); (FYD)
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Bosomworth NJ. Impediments to clinical application of exercise interventions in the treatment of cardiometabolic disease. CANADIAN FAMILY PHYSICIAN MEDECIN DE FAMILLE CANADIEN 2019; 65:164-170. [PMID: 30867171 PMCID: PMC6515963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- N John Bosomworth
- Honorary Lecturer in the Department of Family Practice at the University of British Columbia in Vancouver.
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Younus M, Fan W, Harrington DS, Wong ND. Usefulness of a Coronary Artery Disease Predictive Algorithm to Predict Global Risk for Cardiovascular Disease and Acute Coronary Syndrome. Am J Cardiol 2019; 123:769-775. [PMID: 30563615 DOI: 10.1016/j.amjcard.2018.11.044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 11/24/2018] [Accepted: 11/28/2018] [Indexed: 10/27/2022]
Abstract
Traditional global risk assessment for cardiovascular disease fails to identify a significant percentage of the population initially classified at low or intermediate risk of cardiovascular disease that are actually at high risk for acute coronary syndrome (ACS). We examined a coronary artery disease predictive algorithm (CADPA) that includes 9 biomarkers involved in the pathogenesis of atherosclerosis initiated by endothelial damage and repair (hepatocyte growth factor, soluble FAS, Fas ligand, eotaxin, cutaneous T cell-attracting chemokine, monocyte chemotactic protein-3, interleukin-16, hemoglobin A1c, high-density lipoprotein-cholesterol), in addition to age, gender, diabetes, and family history of myocardial infarction that more accurately predicts 5-year risk of ACS to identify the patient population at discordantly high risk. We found that 34% of patients at low risk by global risk assessment and 72% of patients at intermediate risk by global risk assessment were actually at discordantly high risk for ACS. This patient population was disproportionately male and older in age. The biomarkers (per standard deviation) that most predicted the odds (95% confidence levels) of discordance were interleukin-16 (2.59 [2.21 to 3.03]), Fas Ligand (0.50 [0.43 to 0.57]), hepatocyte growth factor (1.72 [1.50 to 1.98]), soluble FAS (2.19 [1.86 to 2.58]), cutaneous T cell-attracting chemokine (0.46 [0.40 to 0.53]), and eotaxin (1.78 [1.56 to 2.03]), in addition to age, HbA1c, low-density lipoprotein-cholesterol, and glycated hemoglobin. In conclusion, although future prospective study validation is needed to establish a causal relation between CADPA and cardiovascular events, our study defines a patient population considered low to intermediate risk by conventional clinical evaluation, but who is at discordantly high risk indicated by the endothelial injury serum biomarker algorithm CADPA and may benefit from further evaluation and medical management.
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Bosomworth NJ. [Not Available]. CANADIAN FAMILY PHYSICIAN MEDECIN DE FAMILLE CANADIEN 2019; 65:e79-e86. [PMID: 30867186 PMCID: PMC6515954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- N John Bosomworth
- Chargé de cours honoraire au Département de pratique familiale de l'Université de la Colombie-Britannique, à Vancouver.
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Saadat M, Masoudkabir F, Afarideh M, Ghodsi S, Vasheghani-Farahani A. Discrimination between Obstructive Coronary Artery Disease and Cardiac Syndrome X in Women with Typical Angina and Positive Exercise Test; Utility of Cardiovascular Risk Calculators. MEDICINA (KAUNAS, LITHUANIA) 2019; 55:E12. [PMID: 30646563 PMCID: PMC6359077 DOI: 10.3390/medicina55010012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 01/08/2019] [Accepted: 01/09/2019] [Indexed: 11/17/2022]
Abstract
Introduction: Nearly 40% of women with typical angina and a positive exercise tolerance test (ETT) have normal or near normal coronary angiography (CAG) labeled as cardiac syndrome X (CSX). Objective: We performed this study to evaluate the power of common cardiovascular risk calculators to distinguish patients with CSX from those with coronary artery disease (CAD). Methods: 559 women participated in the study. Three risk scores, including (1) newly pooled cohort equation of American College of Cardiology/American Heart Association (ACC/AHA) to predict 10 years risk of first atherosclerotic cardiovascular hard event (ASCVD), (2) Framingham risk score (FRS) for the prediction of 10 years coronary heart disease, and (3) the SCORE tool to estimate 10-year risk of cardiovascular mortality (SCORE), were applied. Results: CAD was diagnosed in 51.5% of the patients. 11.6% of the population had ASCVD < 2.5%, and only 13.8% of these patients had CAD on their CAG. By choosing FRS, 14.4% of patients had FRS < 7.5%, and only 11.3% of these patients had recorded CAD on CAG, while the rest of the patients were diagnosed as CSX. Using the SCORE model, 13.8% of patients had the least value (<0.5%) in whom the prevalence of CAD was 19.9%. The area under receiver operating characteristic curve (AUROC) to discriminate CSX from CAD was calculated for each scoring system, being 0.750 for ASCVD, 0.745 for FRS, and 0.728 for SCORE (p value for all AUROCs < 0.001). The Hosmer⁻Lemeshow chi squares (df, p value) for calibration were 8.787 (8, 0.361), 11.125 (8, 0.195), and 10.618 (8, 0.224) for ASCVD, FRS, and SCORE, respectively. Conclusions: Patients who have ASCVD < 2.5% or FRS < 7.5% may be appropriate cases for noninvasive imaging (Such as coronary CT angiography). CAG is indicated for patients with ASCVD ≥ 7.5% and FRS ≥ 15%, whereas the patients with intermediate risk need comprehensive patient⁻physician shared decision-making.
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Affiliation(s)
- Mohammad Saadat
- Cardiac Primary Prevention Research Center, Tehran Heart Center, Tehran University of Medical Sciences, Tehran 1411713138, Iran.
- Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran 1411713138, Iran.
| | - Farzad Masoudkabir
- Cardiac Primary Prevention Research Center, Tehran Heart Center, Tehran University of Medical Sciences, Tehran 1411713138, Iran.
- Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran 1411713138, Iran.
| | - Mohsen Afarideh
- Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran 1411713138, Iran.
| | - Saeed Ghodsi
- Cardiac Primary Prevention Research Center, Tehran Heart Center, Tehran University of Medical Sciences, Tehran 1411713138, Iran.
- Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran 1411713138, Iran.
| | - Ali Vasheghani-Farahani
- Cardiac Primary Prevention Research Center, Tehran Heart Center, Tehran University of Medical Sciences, Tehran 1411713138, Iran.
- Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran 1411713138, Iran.
- Department of Electrophysiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran 1411713138, Iran.
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Jiang H, Fu L, Wang Y, Wang S, Zhang X, Zhang X, Liu X. Simultaneous Determination of Six Components in Jingzhiguanxin Tablet by High-Performance Liquid Chromatography. CURR PHARM ANAL 2019. [DOI: 10.2174/1573412914666180315120130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
Jingzhiguanxin (JZGX) tablet, a traditional Chinese prescription, is commonly
used for treating coronary heart disease and angina pectoris in the clinic. There are six active components
(Danshensu (DSS), Protocatechuic aldehyde (PD), Paeoniflorin (PF), Ferulic acid (FA), Salvianolic
acid B (Sal B) and Tanshinone IIA (TA)) in JZGX tablet.
</P><P>
Objective: In this paper, a simple and reliable method was used for simultaneous determining the six
active components by high-performance liquid chromatography coupled with diode array detector
(HPLC-DAD).
Methods:
These six active components were separated on an Agilent Zorbax Eclipse XDB-C18 column
(150 mmx4.6 mm, 5 µm) at 30 °C. Acetonitrile (A), methanol (B) and 0.5% H3PO4 aqueous solution
(C) were used as mobile phase for gradient elution. The flow rate was 1 mL/min and the detection
wavelengths were set at 280 nm for DSS, PD and Sal B, 230 nm for PF, 320 nm for FA and 270 nm for
TA, respectively.
Results:
All of the six components showed good linearity regressions (r2≥0.9997) in the detected concentration
range. The recovery rates and coefficient of variation (CV) for all analytes were 98.66%-
100.18% and 0.75%-1.89%, respectively. This method was successfully applied to simultaneously determine
the six components in JZGX tablet from different batches and manufacturers.
Conclusion:
The validated method can be used in routine quality control analysis of JZGX tablet without
any interference.
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Affiliation(s)
- Hui Jiang
- Tangshan Gongren Hospital, Tangshan 063000, Hebei, China
| | - Lianhao Fu
- Tangshan Gongren Hospital, Tangshan 063000, Hebei, China
| | - Yu Wang
- Tangshan Gongren Hospital, Tangshan 063000, Hebei, China
| | - Shaozhi Wang
- Tangshan Gongren Hospital, Tangshan 063000, Hebei, China
| | - Xiaoxu Zhang
- Tangshan Gongren Hospital, Tangshan 063000, Hebei, China
| | - Xijie Zhang
- Tangshan Gongren Hospital, Tangshan 063000, Hebei, China
| | - Xiaohong Liu
- Tangshan Gongren Hospital, Tangshan 063000, Hebei, China
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Cardiovascular Health Disparities in Underserved Populations. PHYSICIAN ASSISTANT CLINICS 2019. [DOI: 10.1016/j.cpha.2018.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Noortman LCM, Haapala EA, Takken T. Arterial Stiffness and Its Relationship to Cardiorespiratory Fitness in Children and Young Adults with a Fontan Circulation. Pediatr Cardiol 2019; 40:784-791. [PMID: 30770935 PMCID: PMC6451712 DOI: 10.1007/s00246-019-02065-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 01/29/2019] [Indexed: 01/27/2023]
Abstract
There are no previous studies on arterial stiffness and its associations with cardiorespiratory fitness in young Fontan patients. Therefore, we examined the arterial stiffness and its relationship to cardiorespiratory fitness in children and young adults with a Fontan circulation. Altogether, 17 Fontan patients and 26 healthy controls (16 females and 27 males aged 8-40 years) participated in this cross-sectional study. The cardiorespiratory fitness was assessed by cardiopulmonary exercise testing on a cycle ergometer and was defined as the standard deviation scores (SDS) of peak oxygen uptake per body mass (VO2peak/kg) based on the national reference values and assessed with cardiopulmonary exercise testing on a cycle ergometer. Aortic pulse wave velocity (PWVao) as a measure of arterial stiffness and aortic Augmentation Index (AIX) as a measure of peripheral arterial tone, were assessed by non-invasive oscillometric device from upper arm. Body adiposity was determined by body mass index SDS and the sport participation by interview. Data were analyzed using linear regression analyses and Pearson's correlations, adjusted for age and sex. Fontan patients had a lower VO2peak/kg-SDS (- 2.69 vs 0.078), higher PWVao-SDS (1.13 vs - 0.24) and higher AIX (19.26% vs 8.49%) in comparison with healthy controls. PWVao and AIX were negatively associated with VO2peak/kg (standard regression coefficient (β) - 0.525, 95% confidence interval (CI) - 0.722 to - 0.227, p < 0.01 and β - 0.371, 95% CI - 0.672 to - 0.080, p = 0.014). Young Fontan patients have the arterial stiffness of healthy people who are twice as old. Thereby, children and young adults with a Fontan circulation have a lower cardiorespiratory fitness and less sport participation. Arterial stiffness is inversely associated with cardiorespiratory fitness and exercise training might be an intervention to improve vascular health in this population.
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Affiliation(s)
- Laurien C. M. Noortman
- 0000000120346234grid.5477.1Faculty of Medicine, Utrecht University, Utrecht, The Netherlands
| | - Eero A. Haapala
- 0000 0001 1013 7965grid.9681.6Faculty of Sport and Health Sciences, University of Jyväskylä, Jyvaskyla, Finland ,0000 0001 0726 2490grid.9668.1Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland
| | - Tim Takken
- Child Development and Exercise Center, Wilhelmina Children's Hospital, P.O. Box 85090, 3508 AB, Utrecht, The Netherlands. .,Partner of Shared Utrecht Pediatric Exercise Research (SUPER) Lab, Utrecht, The Netherlands.
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Pepe M, Cecere A, D’Alessandro P, Fumarola F, Ciccone MM, Marchese A, Guaricci AI, Giordano A, Bortone AS, Favale S. Massive stent thrombosis during active ulcerative colitis: the tricky balance between manifest hemorrhagic and concealed thrombotic risk. Clin Exp Med 2018; 18:481-485. [DOI: 10.1007/s10238-018-0522-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 08/04/2018] [Indexed: 01/17/2023]
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Mulchandani R, Lyngdoh T, Chakraborty P, Kakkar AK. Statin related adverse effects and patient education: a study from resource limited settings. Acta Cardiol 2018; 73:393-401. [PMID: 29179650 DOI: 10.1080/00015385.2017.1406884] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND Statins are the most widely prescribed class of drugs for coronary artery disease (CAD) patients and yet literature on the prevalence of statin related adverse effects (AEs) and gaps in patient education is quite limited especially in resource-limited settings of developing world. OBJECTIVES The present study was conducted to determine the prevalence of myopathy (muscle ailments) and other statin associated adverse effects among CAD patients on statin therapy. The study also aimed to assess patient perceptions, attitudes and awareness concerning the use of statins. METHODS It was a cross-sectional study conducted among 300 adult CAD patients visiting the out-patient department of a tertiary care hospital in North India, who were receiving statins for their diagnosis. An interviewer administered questionnaire was used to collect data on statin use among patients and adverse effects experienced. RESULTS Myopathy or muscle related ailments like muscle pain, cramps and muscle weakness were the most prevalent (32, 34 and 47%, respectively), followed by numbness, tingling and burning in the extremities (31%). Joint pain and cognitive impairments were seen in nearly 20% of the patients. The level of awareness among participants regarding the use of statins was sub-optimal. Lack of knowledge and under-reporting of adverse effects were major concerns. CONCLUSION The study shows that a considerable proportion of statin users experience adverse effects and knowledge and awareness amongst patients is inadequate. Awareness programmes and counselling for patients, sensitisation of healthcare professionals and better screening systems for monitoring AEs can help improve the scenario.
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Affiliation(s)
| | | | - Praloy Chakraborty
- Department of Cardiology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Ashish Kumar Kakkar
- Department of Pharmacology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
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Cottel D, Montaye M, Marécaux N, Amouyel P, Dallongeville J, Meirhaeghe A. Comparison of the rates of stroke and acute coronary events in northern France. Eur J Prev Cardiol 2018; 25:1534-1542. [PMID: 30019921 DOI: 10.1177/2047487318788921] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Although stroke and acute coronary events share several risk factors, few studies have compared population-level epidemiological surveillance indicators of the two diseases in the same age range and in the same geographical area. Design The objective of the present study was to compare the rate of acute coronary events with that of stroke among inhabitants aged from 35-74 years in Northern France (Lille). Methods All incident and recurrent acute coronary events and stroke events occurring in men and women over 2008-2014 were recorded using two population-based registries with several overlapping sources of case ascertainment for hospitalised/non-hospitalised and fatal/non-fatal events. Log-linear Poisson regression models were used to compare the event and mortality rates. Results The results showed that the incident rates of acute coronary event and stroke were similar except under 60 years. In this group (35-59 years), the incident rate of acute coronary events was 1.6-fold higher than that of stroke. In contrast, the attack (incident and recurrent) rates were higher for acute coronary events than for stroke (1.5-fold; p < 0.0001) - especially in men (1.8-fold; p < 0.0001). The mortality rate was 2.2-fold higher for acute coronary events than for stroke, independent of sex and age group ( p < 0.0001), as was the case-fatality rate (1.5-fold, p < 0.0001). Conclusion In Lille, the overall acute coronary event rate was higher than the stroke rate - especially among men, due to a higher risk of incident acute coronary event under the age of 65 and a higher risk of recurrent acute coronary event in the 65-74 year-old age range. Further efforts should be devoted to primary and secondary prevention strategies after acute coronary events.
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Affiliation(s)
- Dominique Cottel
- Inserm, Univ. Lille, Institut Pasteur de Lille, Centre Hosp. Univ Lille, France
| | - Michèle Montaye
- Inserm, Univ. Lille, Institut Pasteur de Lille, Centre Hosp. Univ Lille, France
| | - Nadine Marécaux
- Inserm, Univ. Lille, Institut Pasteur de Lille, Centre Hosp. Univ Lille, France
| | - Philippe Amouyel
- Inserm, Univ. Lille, Institut Pasteur de Lille, Centre Hosp. Univ Lille, France
| | - Jean Dallongeville
- Inserm, Univ. Lille, Institut Pasteur de Lille, Centre Hosp. Univ Lille, France
| | - Aline Meirhaeghe
- Inserm, Univ. Lille, Institut Pasteur de Lille, Centre Hosp. Univ Lille, France
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Zheng Q, Zhu JZ, Bao XY, Zhu PC, Tong Q, Huang YY, Zhang QH, Zhang KJ, Zheng GQ, Wang Y. A Preclinical Systematic Review and Meta-Analysis of Astragaloside IV for Myocardial Ischemia/Reperfusion Injury. Front Physiol 2018; 9:795. [PMID: 30018562 PMCID: PMC6038775 DOI: 10.3389/fphys.2018.00795] [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] [Received: 10/20/2017] [Accepted: 06/06/2018] [Indexed: 12/28/2022] Open
Abstract
Astragaloside IV (AS-IV), the major pharmacological extract from Astragalus membranaceus Bunge, possesses a variety of biological activities in the cardiovascular systems. Here, we aimed to evaluate preclinical evidence and possible mechanism of AS-IV for animal models of myocardial ischemia/reperfusion (I/R) injury. Studies of AS-IV in animal models with myocardial I/R injury were identified from 6 databases from inception to May, 2018. The methodological quality was assessed by using CAMARADES 10-item checklist. All the data were analyzed using Rev-Man 5.3 software. As a result, 22 studies with 484 animals were identified. The quality score of studies ranged from 3 to 6 points. Meta-analyses showed AS-IV can significantly decrease the myocardial infarct size and left ventricular ejection fraction, and increase shortening fraction compared with control group (P < 0.01). Significant decreasing of cardiac enzymes and cardiac troponin and increasing of decline degree in ST-segment were reported in one study each (P < 0.05). Additionally, the possible mechanisms of AS-IV for myocardial I/R injury are promoting angiogenesis, improving the circulation, antioxidant, anti-inflammatory and anti-apoptosis. Thus, AS-IV is a potential cardioprotective candidate for further clinical trials of myocardial infarction.
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Affiliation(s)
- Qun Zheng
- Department of Cardiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Jia-Zhen Zhu
- Department of Cardiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xiao-Yi Bao
- Department of Cardiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Peng-Chong Zhu
- Department of Cardiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Qiang Tong
- Department of Cardiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yue-Yue Huang
- Department of Cardiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Qi-Hao Zhang
- Department of Cardiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Ke-Jian Zhang
- Department of Cardiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Guo-Qing Zheng
- Department of Neurology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yan Wang
- Department of Cardiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
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Clinical Efficacy of Trimetazidine and Holistic Management in the Treatment of Coronary Heart Disease. IRANIAN JOURNAL OF PUBLIC HEALTH 2018; 47:824-829. [PMID: 30087867 PMCID: PMC6077637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
BACKGROUND To investigate the clinical efficacy of trimetazidine and holistic management in the treatment of coronary heart disease. METHODS A total of 128 cases of patients with coronary heart disease were admitted in The Second Affiliated Hospital of Dalian Medical University from October 2014 to June 2017. These patients were divided into control group and experimental group, with 64 patients each. The patients in the control group underwent conventional treatment. On this basis, the patients in the experimental group were treated with trimetazidine. Both groups underwent holistic management. The clinical conditions, echocardiography indexes, life quality, and mental states of patients were compared between the two groups. RESULTS The total efficient rate of patients in the control group was significantly lower than that of the experimental group, and the difference was statistically significant (P<0.05). After treatment, the left ventricular ejection fraction of patients in the experimental group was higher than that of the control group; the left ventricular end diastolic diameter and left ventricular posterior wall thickness of patients in the experimental group were lower than those of the control group, and the differences were statistically significant (P<0.05). The physiological health score, mental health score, Hamilton Depression Scale and Hamilton Anxiety Rating Scale of patients were significantly decreased compared with the control group, and the differences were statistically significant (P<0.05). CONCLUSION The efficacy of trimetazidine in the treatment of coronary heart disease is definite. The assisting holistic management can significantly improve the mental status and life quality of patients by enhancing the cardiac function, which has clinical reference and promotion values.
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Ganesan S, Volodina O, Pearce SC, Gabler NK, Baumgard LH, Rhoads RP, Selsby JT. Acute heat stress activated inflammatory signaling in porcine oxidative skeletal muscle. Physiol Rep 2018; 5:5/16/e13397. [PMID: 28830980 PMCID: PMC5582270 DOI: 10.14814/phy2.13397] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 07/24/2017] [Accepted: 07/27/2017] [Indexed: 11/24/2022] Open
Abstract
Despite well-studied clinical manifestations, intracellular mechanisms of prolonged hyperthermic injury remain unclear, especially in skeletal muscle. Given muscle's large potential to impact systemic inflammation and metabolism, the response of muscle cells to heat-mediated injury warrants further investigation. We have previously reported increased activation of NF-κB signaling and increased NF-κB and AP-1-driven transcripts in oxidative skeletal muscle following 12 h of heat stress. The purpose of this investigation was to examine early heat stress-induced inflammatory signaling in skeletal muscle. We hypothesized that heat stress would increase NF-κB and AP-1 signaling in oxidative skeletal muscle. To address this hypothesis, 32 gilts were randomly assigned to one of four treatment groups (n = 8/group): control (0 h: 21°C) or exposed to heat stress conditions (37°C) for 2 h (n = 8), 4 h (n = 8), or 6 h (n = 8). Immediately following environmental exposure pigs were euthanized and the red portion of the semitendinosus muscle (STR) was harvested. We found evidence of NF-κB pathway activation as indicated by increased protein abundance of NF-κB activator IKK-α following 4 h and increased total NF-κB protein abundance following 6 h of heat stress. Heat stress also stimulated AP-1 signaling as AP-1 protein abundance was increased in nuclear fractions following 4 h of heat stress. Interleukin-6 protein abundance and activation of the JAK/STAT pathway were decreased in heat stressed muscle. These data indicate that heat stress activated inflammatory signaling in the porcine STR muscle via the AP-1 pathway and early activation of the NF-κB pathway.
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Affiliation(s)
- Shanthi Ganesan
- Department of Animal Science, Iowa State University, Ames, Iowa
| | - Olga Volodina
- Department of Animal Science, Iowa State University, Ames, Iowa
| | - Sarah C Pearce
- Department of Animal Science, Iowa State University, Ames, Iowa
| | | | | | - Robert P Rhoads
- Department of Animal and Poultry Sciences, Virginia Tech, Blacksburg, Virginia
| | - Joshua T Selsby
- Department of Animal Science, Iowa State University, Ames, Iowa
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49
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Hou T, Li Y, Chen W, Heffner RR, Vladutiu GD. Histopathologic and Biochemical Evidence for Mitochondrial Disease Among 279 Patients with Severe Statin Myopathy. J Neuromuscul Dis 2018; 4:77-87. [PMID: 28269789 DOI: 10.3233/jnd-160184] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Statins have well-known benefits in the prevention of cardiovascular disease, however, 7-29% of patients develop muscle side effects and up to 0.5% develop severe symptoms. Mitochondrial dysfunction has been associated with severe statin-induced myopathy (SM); however, there is a paucity of systematic studies in affected individuals. OBJECTIVES The goal of this study was to combine clinical and laboratory features with quantitative biochemical and histopathologic studies of skeletal muscle biopsies from SM cases to determine what proportion could be attributed to mitochondrial dysfunction and how many of these had primary respiratory chain defects. METHODS A retrospective analysis was performed on patient records derived from 279 SM patients whose muscle biopsies were referred to our clinical diagnostic laboratory for analysis. Clinical, histopathologic and biochemical features were compared with two myopathic control groups unexposed to statins: individuals with idiopathic mitochondrial myopathy (MMP; n = 94) and with unknown metabolic myopathy (UMP; n = 86); normal controls were unavailable for this record review study. RESULTS More SM patients had significantly elevated plasma CK than in the other two groups (p < 0.01). A subset of SM patients (67 of 279; 24%) had histopathologic and/or electron microscopic (EM) evidence for mitochondrial dysfunction in skeletal muscle; more cases were identified by EM than by histochemical analysis. Of 279 cases, 29 (10%) were confirmed to have respiratory chain defects by biochemical analysis; 4 of these had mitochondrial abnormalities by EM. An additional 20 cases had mitochondrial abnormalities by EM without a biochemical diagnosis. CONCLUSIONS Both primary and secondary mitochondrial dysfunction was found in subsets of SM patients. The fact that respiratory chain defects were not found in most cases with histopathologic mitochondrial abnormalities does not rule out primary mitochondrial disease in these cases, however, it is more likely that secondary effects on mitochondrial structure and function have occurred; molecular analysis may be helpful only in a small number of cases.
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Affiliation(s)
- Tieying Hou
- Department of Pathology and Anatomical Sciences, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, USA
| | - Yilan Li
- Department of Pathology and Anatomical Sciences, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, USA
| | - Weiwei Chen
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Reid R Heffner
- Department of Pathology and Anatomical Sciences, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, USA
| | - Georgirene D Vladutiu
- Departments of Pediatrics, Neurology, and Pathology and Anatomical Sciences, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, USA.,Kaleida Health Laboratories, Buffalo, NY, USA
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50
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Baek H, Suh JW, Kang SH, Kang S, Lim TH, Hwang H, Yoo S. Enhancing User Experience Through User Study: Design of an mHealth Tool for Self-Management and Care Engagement of Cardiovascular Disease Patients. JMIR Cardio 2018; 2:e3. [PMID: 31758783 PMCID: PMC6857966 DOI: 10.2196/cardio.9000] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 11/23/2017] [Accepted: 01/27/2018] [Indexed: 01/22/2023] Open
Abstract
Background As patient communication, engagement, personal health data tracking, and up-to-date information became more efficient through mobile health (mHealth), cardiovascular diseases (CVD) and other diseases that require behavioral improvements in daily life are now capable of being managed and prevented more effectively. However, to increase patient engagement through mHealth, it is important for the initial design to consider functionality and usability factors and accurately assess user demands during the developmental process so that the app can be used continuously. Objective The purpose of the study was to provide insightful information for developing mHealth service for patients with CVD based on user research to help enhance communication between patients and doctors. Methods To drive the mobile functions and services needed to manage diseases in CVD patients, user research was conducted on patients and doctors at a tertiary general university hospital located in the Seoul metropolitan area of South Korea. Interviews and a survey were performed on patients (35 participants) and a focus group interview was conducted with doctors (5 participants). A mock-up mobile app was developed based on the user survey results, and a usability test was then conducted (8 participants) to identify factors that should be considered to improve usability. Results The majority of patients showed a positive response in terms of their interest or intent to use an app for managing CVD. Functional features, such as communication with doctors, self-risk assessment, exercise, tailored education, blood pressure management, and health status recording had a score of 4.0 or higher on a 5-point Likert scale, showing that these functions were perceived to be useful to patients. The results of the mock-up usability test showed that inputting and visualizing blood pressure and other health conditions was required to be easier. The doctors requested a function that offered a comprehensive view of the patient’s daily health status by linking the mHealth app data with the hospital’s electronic health record system. Conclusions Insights derived from a user study for developing an mHealth tool for CVD management, such as self-assessment and a communication channel between patients and doctors, may be helpful to improve patient engagement in care.
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Affiliation(s)
- Hyunyoung Baek
- Healthcare Information and Communication Technology Research Center, Office of eHealth Research and Businesses, Seoul National University Bundang Hospital, Seongnam, Republic Of Korea
| | - Jung-Won Suh
- Department of Cardiology, Seoul National University Bundang Hospital, Seongnam, Republic Of Korea
| | - Si-Hyuck Kang
- Department of Cardiology, Seoul National University Bundang Hospital, Seongnam, Republic Of Korea
| | - Seungjin Kang
- Healthcare Information and Communication Technology Research Center, Office of eHealth Research and Businesses, Seoul National University Bundang Hospital, Seongnam, Republic Of Korea
| | - Tae Ho Lim
- HealthConnect Co, Ltd, Seoul, Republic Of Korea
| | - Hee Hwang
- Healthcare Information and Communication Technology Research Center, Office of eHealth Research and Businesses, Seoul National University Bundang Hospital, Seongnam, Republic Of Korea.,Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Republic Of Korea
| | - Sooyoung Yoo
- Healthcare Information and Communication Technology Research Center, Office of eHealth Research and Businesses, Seoul National University Bundang Hospital, Seongnam, Republic Of Korea
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