Sensitivity, specificity of biochemical markers for early prediction of endothelial dysfunction in atherosclerotic obese subjects

Independent prognostic importance of endothelial activation and stress index (EASIX) in critically ill patients with heart failure: modulating role of inflammation

Background

The connection between endothelial activation and stress index (EASIX) and risk of mortality in critically ill patients with heart failure (HF) remains unclear. This research sought to explore this relationship.

Methods

MIMIC-IV database (version 3.1) was utilized to provide clinical data. Due to the non-normal distribution, EASIX was logarithmic. An optimal cut-off value for log2(EASIX) was determined to serve as an indicator of mortality risk under the maximally selected rank statistics. Kaplan-Meier survival analysis and Cox regression models were used to assess the link between log2(EASIX) and mortality within 1 year. Subgroup analyses were performed to ascertain the prognostic impact of log2(EASIX) in various patient groups. Mediation analysis was employed to uncover and elucidate causal pathways connecting log2(EASIX) to mortality.

Results

It encompassed 7,901 patients. According to the Kaplan-Meier curves, increased log2(EASIX) levels correlated with a higher likelihood of all-cause mortality (p < 0.001). Cox models and subgroup analyses further revealed that groups with high log2(EASIX) levels exhibited a greater mortality risk than those with lower levels (hazard ratio (HR): 1.62, 95% CI: 1.47-1.78), a trend that persisted across most subgroups, with the exception of varying levels of APS III, body mass index, white blood cell counts, or albumin (p for interaction < 0.05 for all). Subsequent mediation analysis suggested that blood urea nitrogen and red cell distribution width partially mediated the relationship between log2(EASIX) and mortality with 17.3% and 36.5% of the mediating effect.

Conclusion

It found an independent association between elevated log2(EASIX) levels and a higher risk of 1 year all-cause mortality in ICU patients suffering from HF, with a stronger effect observed in patients with low levels of APS III or white blood cell counts, or high levels of body mass index or albumin. This association may be partially mediated by blood urea nitrogen and red cell distribution width.

Predictive Value of Selected Plasma Biomarkers in the Assessment of the Occurrence and Severity of Coronary Artery Disease

Despite significant advances in imaging modalities for diagnosing coronary artery disease (CAD), there remains a need for novel diagnostic approaches with high predictive values and fewer limitations. Circulating biomarkers, including cytokines such as interleukin-6 (IL-6) and interleukin-8 (IL-8), cell adhesion molecules such as soluble vascular cell adhesion molecule-1 (sVCAM-1), peptides secreted by endothelial cells such as endothelin-1 (ET-1), and enzymes involved in extracellular matrix remodeling such as a disintegrin and metalloproteinase with thrombospondin motifs-1 (ADAMTS-1) offer a promising alternative. This study aimed to evaluate the correlation between the plasma levels of selected biomarkers and the presence and severity of CAD. We enrolled 40 patients admitted for elective coronary angiography. CAD was defined as having at least one coronary artery stenosis ≥ 50%. The severity of CAD was assessed using the Gensini Score (GS). IL-8 levels were significantly higher in the CAD group, with a mean of 9.78 (SD 0.46) compared to 8.37 (SD 0.40) in the non-CAD group (p = 0.0228). No significant differences were observed for the other biomarkers between the groups. A positive Spearman correlation was found between IL-8 levels and the GS (ρ = 0.39, p = 0.017). These findings suggest that IL-8 may have potential as an additional tool for diagnosing or excluding atherosclerosis. Further studies with larger sample sizes are needed to validate its clinical utility.

Associations of blood biomarkers with arterial stiffness in patients with diabetes mellitus: A population-based study

BACKGROUND

Arterial stiffness contributes to additional cardiovascular risks in diabetic patients by triggering the loss of vascular and myocardial compliance and promoting endothelial dysfunction. Thus, prevention of arterial stiffness is a public health priority, and the identification of potential biomarkers may provide benefits for early prevention. This study investigates the relationships between serum laboratory tests and pulse wave velocity (PWV) tests. We also investigated the associations between PWV and all-cause mortality.

METHODS

We examined a panel of 33 blood biomarkers among diabetic populations in the Atherosclerosis Risk in Communities Study. The carotid-femoral (cfPWV) and femoral-ankle PWV (faPWV) were measured using an automated cardiovascular screening device. The aortic-femoral arterial stiffness gradient (afSG) was calculated as faPWV divided by cfPWV. Biomarker levels were log-transformed and correlated with PWV. Cox proportional hazard models were employed for survival analysis.

RESULTS

Among 1079 diabetic patients, biomarkers including high-density lipoprotein cholesterol, glycated hemoglobin, high-sensitivity troponin T, cystatin C, creatinine, and albuminuria were significantly correlated with afSG (R = 0.078, -0.193, -0.155, -0.153, -0.116, and -0.137, respectively) and cfPWV (R = -0.068, 0.175, 0.128, 0.066, 0.202, and 0.062, respectively). Compared with the lowest tertile of afSG, the risk of all-cause mortality was lower in the highest tertile (hazard ratio 0.543; 95% confidence interval 0.328-0.900).

CONCLUSION

Certain biomarkers related to blood glucose monitoring, myocardial injury, and renal function significantly correlated with PWV, suggesting that these putative risk factors are likely to be important atherosclerosis mechanisms in diabetic patients. AfSG may be an independent predictor of mortality among diabetic populations.

Cytokine profile characterization of naïve patients with psoriasis and psoriatic arthritis: implications for a pathogenic disease continuum

Background

The idea of psoriatic disease continuum has been progressively prompted based on the advances of the knowledge about the pathogenic steps underpinning the occurrence of psoriasis (PSO) and psoriatic arthritis (PSA). To evaluate biomolecules (inflammatory cytokines, inflammatory chemokines, cell adhesion and cellular mediators) in naïve patients with PSO, PSA with PSO, and PSA sine PSO. To stratify the results considering the presence of psoriatic nail involvement, extensive skin disease and obesity evaluating all involved patients.

Methods

By multiplex technology, 20 serum biomolecules were assessed with the inclusion of pro-inflammatory cytokines (GM-CSF, IFN-γ, IL-1α, IL-1β, IL-6, IL-8, IL-12p70, IL-17A, IL-23, TNF), anti-inflammatory cytokines (IFN-α, IL-4, IL-10, IL-13), inflammatory chemokines (IP-10, MCP-1, MIP-1α, MIP-1β), cell adhesion and cellular mediators (ICAM-1, E-selectin, P-selectin). The assessment of possible statistical differences between the means of the three groups was performed by One-Way ANOVA. In addition, by non-parametric T-tests, we stratified the results according to selected clinical characteristics (psoriatic nail involvement, PASI ≥ 10, BMI ≥ 30).

Results

In 80 assessed naïve patients, patients with PSO showed significant increases of E-selectin (p=0.021) and IL-8 (0.041) than other groups. In patients with PSA with PSO, significant higher levels of ICAM-1 were observed (p=0.009) than other groups. We did not observe further differences comparing pro-inflammatory and anti-inflammatory cytokines, inflammatory chemokines, and cell adhesion and cellular mediators in patients with PSO, PSA with PSO, and PSA sine PSO. Patients with psoriatic onychopathy showed significant increased levels of ICAM-1 (p=0.010) and IP-10 (0.030) than others. In patients with PASI ≥ 10, significantly enhanced values of IL-8 (p=0.004), TNF (p=0.013), E-selectin (p=0.004), MIP-1α (p=0.003), and MIP-1β (p=0.039). In patients with BMI ≥ 30, significantly higher levels of E-selectin were pointed out (p=0.035) than others.

Conclusion

Our findings may suggest that a similar cytokine profile may characterize naïve patients with PSO, PSA with PSO, and PSA sine PSO, reinforcing the concept of psoriatic disease continuum. However, some differences may be also shown, underlying possible pathogenic differences and leading to the clinical heterogeneity of these patients.

Heart Rate from Progressive Volitional Cycling Test Is Associated with Endothelial Dysfunction Outcomes in Hypertensive Chilean Adults

BACKGROUND

A progressive volitional cycling test is useful in determining exercise prescription in populations with cardiovascular and metabolic diseases. However, little is known about the association between heart rate during this test and endothelial dysfunction (EDys) parameters in hypertensive (HTN) patients.

OBJECTIVE

To investigate the association between EDys markers (flow-mediated dilation [FMD], pulse wave velocity of the brachial artery [PWVba], and carotid-intima media thickness [cIMT]) and heart rate during a cycling test in HTN adults. A secondary aim was to characterize cardiovascular, anthropometric, and body composition outcomes in this population.

METHODS

This was a descriptive clinical study in which adults (men and women) were assigned to one of three groups: HTN, elevated blood pressure (Ele), or a normotensive control group (CG), and completed a progressive cycling test. The primary outcomes were FMD, PWVba, cIMT, and heart rate (HR) at 25-50 watts (HR_25-50), 50-100 watts (HR_50-100), and 75-150 watts (HR_75-150) of the Astrand test. Secondary outcomes included body mass index (BMI), waist circumference, body fat percentage (BF%), skeletal muscle mass (SMM), resting metabolic rate (RMR), and estimated body age, as measured by a bio-impedance digital scale.

RESULTS

Analyses of the associations between FMD, PWV, and HR_25-50, HR_50-100, and HR_75-150 watts revealed no significant association in the HTN, Ele, and CG groups. However, a significant association was found between cIMT and HR_75-150 watts in the HTN group (R² 47.1, β -0.650, p = 0.038). There was also a significant trend (p = 0.047) towards increasing PWVba in the CG, Ele, and HTN groups.

CONCLUSION

Heart rate during a progressive cycling test is associated with the EDys parameters cIMT in HTN patients, with particularly strong predictive capacity for vascular parameters in the second and third stages of the Astrand exercise test compared to normotensive control.

Editorial

NIL.