1
|
Leiherer A, Muendlein A, Brandtner E, Saely CH, Vonbank A, Mader A, Sprenger L, Maechler M, Jylha A, Laaperi M, Laaksonen R, Maerz W, Fraunberger P, Kleber M, Drexel H. Ceramide-based lipid profiles and the prevalence of type 2 diabetes differ between patients with coronary artery disease and those with peripheral artery disease. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.3073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Serum lipids and metabolic diseases, in particular type 2 diabetes (T2D) and non-alcoholic fatty liver disease (NAFLD), predict the atherosclerotic diseases coronary artery disease (CAD) and peripheral arterial disease (PAD).
Purpose
The purpose of this study was to investigate in how far a more detailed characterization including serum lipids improves discrimination of PAD from CAD.
Method
A cohort of 274 statin-naïve patients with either PAD (n=89) or stable CAD (n=185) were referred to metabolic screening and were characterized using nuclear magnetic resonance- and liquid chromatography-tandem mass spectrometry based advanced lipid and lipoprotein analysis. Results were validated in an independent cohort of 1239 patients with PAD or CAD.
Results
We found a significant difference in T2D prevalence and in the ceramide-based lipid profile between PAD and CAD patients. However, neither cholesterol-based markers (including LDL-C, HDL-C) and detailed lipoprotein profiles nor the LD status differed significantly between PAD and CAD patients (figure). The difference between ceramide-based lipid profiles of CAD and PAD remained significant also after adjusting for body composition, smoking, inflammatory parameters, and T2D.
Conclusion
We conclude that PAD and CAD differ in ceramide-based lipid profiles and T2D status, but not in other lipid characteristics or metabolic diseases.
Funding Acknowledgement
Type of funding sources: None.
Collapse
Affiliation(s)
- A Leiherer
- Vorarlberg Institute for Vascular Investigation & Treatment , Feldkirch , Austria
| | - A Muendlein
- Vorarlberg Institute for Vascular Investigation & Treatment , Feldkirch , Austria
| | - E Brandtner
- Vorarlberg Institute for Vascular Investigation & Treatment , Feldkirch , Austria
| | - C H Saely
- Private University of the Principality of Liechtenstein , Triesen , Liechtenstein
| | - A Vonbank
- Academic Teaching Hospital Feldkirch , Feldkirch , Austria
| | - A Mader
- Academic Teaching Hospital Feldkirch , Feldkirch , Austria
| | - L Sprenger
- Academic Teaching Hospital Feldkirch , Feldkirch , Austria
| | - M Maechler
- Academic Teaching Hospital Feldkirch , Feldkirch , Austria
| | - A Jylha
- Zora Biosciences , Espoo , Finland
| | | | | | - W Maerz
- Medical University of Graz , Graz , Austria
| | | | - M Kleber
- Medical Faculty Mannheim, Heidelberg University , Mannheim , Germany
| | - H Drexel
- County Hospital Bregenz , Bregenz , Austria
| |
Collapse
|
2
|
Bjornestad E, Dhar I, Svingen GFT, Pedersen ER, Orn S, Svenningsson M, Tell GS, Ueland PM, Sulo G, Laaksonen R, Nygaard O. Long-term prognostic value of trimethylamine N-oxide in community-based adults and patients with coronary heart disease. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Trimethylamine N-oxide (TMAO) is an amine oxide generated by gut microbial metabolism. Emerging evidence suggests pro-atherosclerotic and pro-inflammatory properties of TMAO; however, the clinical utility of circulating TMAO in risk stratification is uncertain.
Purpose
We prospectively assessed relationships of plasma TMAO with long-term risk of all-cause, cardiovascular (CV) and non-CV mortality in community-dwelling adults and patients with coronary heart disease.
Methods
By Cox modelling, risk-associations were examined in the Hordaland Health Study (HUSK; 6393 community-based adults) and the Western Norway Coronary Angiography Cohort (WECAC; 4132 patients with suspected chronic coronary syndrome).
Results
Median follow-up time was 11.0 and 10.3 years in HUSK and WECAC, respectively. Following adjustments for established CV risk factors in HUSK, the HRs (95% CIs) comparing the 4th vs. 1st TMAO-quartile were 1.11 (0.88–1.40), 0.97 (0.65–1.46) and 1.17 (0.88–1.54) for all-cause, CV and non-CV mortality, respectively. Corresponding risk estimates in WECAC were 1.07 (0.86–1.32), 1.16 (0.83–1.62) and 1.02 (0.77–1.34). Similar results were observed in patients with angiographically significant coronary artery disease and patients with reduced left ventricular ejection fraction.
Conclusion
Plasma TMAO was not predictive of long-term all-cause, CV or non-CV mortality in patients with or without established coronary heart disease. This large-scale study does not support a role of TMAO for patient risk stratification in primary or secondary prevention.
Funding Acknowledgement
Type of funding sources: None.
Collapse
Affiliation(s)
- E Bjornestad
- Stavanger University Hospital , Stavanger , Norway
| | - I Dhar
- University of Bergen, Department of Clinical Science , Bergen , Norway
| | - G F T Svingen
- Haukeland University Hospital, Department of Cardiology , Bergen , Norway
| | - E R Pedersen
- Haukeland University Hospital, Department of Cardiology , Bergen , Norway
| | - S Orn
- Stavanger University Hospital, Department of Cardiology , Stavanger , Norway
| | - M Svenningsson
- Haukeland University Hospital, Department of Cardiology , Bergen , Norway
| | - G S Tell
- University of Bergen, Department of Global Public Health and Primary Care , Bergen , Norway
| | - P M Ueland
- University of Bergen, Department of Clinical Science , Bergen , Norway
| | - G Sulo
- Norwegian Institute of Public Health, Centre for Disease Burden , Bergen , Norway
| | - R Laaksonen
- Tampere University, Finnish Cardiovascular Research Center , Tampere , Finland
| | - O Nygaard
- Haukeland University Hospital, Department of Cardiology , Bergen , Norway
| |
Collapse
|
3
|
Leiherer A, Muendlein A, Saely C, Larcher B, Mader A, Maechler M, Sprenger L, Grabher V, Laaksonen R, Laaperi M, Jylha A, Fraunberger P, Drexel H. The ceramide- and phosphatidylcholine- based coronary event risk test2 (CERT2) and cardiovascular mortality in men and women with type 2 diabetes. Atherosclerosis 2022. [DOI: 10.1016/j.atherosclerosis.2022.06.708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
|
4
|
Leiherer A, Muendlein A, Saely CH, Larcher B, Mader A, Maechler M, Sprenger L, Mutschlechner B, Benda M, Laaksonen R, Laaperi M, Jylha A, Fraunberger P, Drexel H. The ceramide- and phosphatidylcholine- based Coronary Event Risk Test2 (CERT2) and cardiovascular mortality in men and women with type 2 diabetes. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
The recently introduced Coronary Event Risk Test version 2 (CERT2) is a validated cardiovascular risk predictor score that uses circulating ceramide and phosphatidylcholine concentrations.
The purpose of this study was to investigate the power of CERT2 to predict cardiovascular mortality in 280 male and 121 female patients with type 2 diabetes (T2DM).
Prospectively, we recorded 55 cardiovascular deaths in men and 19 in women during a mean follow-up time of 7.6±3.6 and 8.1±3.4 years respectively.
Overall, cardiovascular survival decreased with increasing CERT2 risk categories (figure 1). In Cox regression models, CERT2 significantly predicted the incidence of cardiovascular mortality in male patients with T2DM (unadj. HR 1.82 [1.39–2.37] per standard deviation; p<0.001), the unadj. HR in women was 1.36 [0.83–2.22]; p=0.228). After adjustment for age, BMI, current smoking, LDL cholesterol, HDL cholesterol, hypertension, and statin use the HR in men was 1.73 [1.31–2.29]; p<0.001) and 1.40 [083–2.36]; p=0.210 in women. Interaction terms CERT2 x gender were non-significant both in univariate analysis (p=0.354) and after multivariate adjustment (p=0.359).
We conclude that sex does not significantly impact the association of CERT2 with cardiovascular mortality in patients with T2DM.
Funding Acknowledgement
Type of funding sources: None. Figure 1
Collapse
Affiliation(s)
- A Leiherer
- Private University of the Principality of Liechtenstein, Triesen, Liechtenstein
| | | | - C H Saely
- Private University of the Principality of Liechtenstein, Triesen, Liechtenstein
| | - B Larcher
- Academic Teaching Hospital Feldkirch, Feldkirch, Austria
| | - A Mader
- Academic Teaching Hospital Feldkirch, Feldkirch, Austria
| | | | | | | | - M Benda
- VIVIT Institute, Feldkirch, Austria
| | | | | | - A Jylha
- Zora Biosciences, Espoo, Finland
| | | | - H Drexel
- County Hospital Bregenz, Bregenz, Austria
| |
Collapse
|
5
|
Bjornestad EO, Dhar I, Svingen GFT, Svenningsson MM, Pedersen ER, Tell GS, Ueland PM, Orn S, Laaksonen R, Nygaard O. Circulating trimethyllysine predicts total and cardiovascular mortality in patients with and without coronary heart disease. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The carnitine precursor trimethyllysine (TML) is associated with the microbiota-derived metabolite trimethylamine N-oxide (TMAO) and predicts future cardiovascular events in patients with established coronary heart disease (CHD).
Purpose
To examine circulating TML as a predictor of total and cardiovascular mortality in two independent cohorts of subjects with or without CHD.
Methods
By Cox regression modelling, risk associations were examined in 6393 subjects in the community-based Hordaland Health Study (HUSK). A replication study was performed among 4117 patients undergoing coronary angiography for suspected stable angina pectoris in the Western Norway Coronary Angiography Cohort (WECAC).
Results
During a median follow-up of 10.9 years in the HUSK-cohort, 884 (13.8%) subjects died, of whom 287 from cardiovascular causes. After adjustments for traditional cardiovascular risk factors, the hazard ratio (HR) (95% CI) for total mortality comparing the 4th vs. 1st TML-quartile was 1.66 (1.31–2.10, p<0.001). Particularly strong associations were observed with cardiovascular mortality (HR [95% CI] 2.04 [1.32–3.15, p=0.001]). Corresponding risk estimates in the WECAC-cohort (median follow-up of 10.3 years) were 1.35 (1.10–1.66, p=0.004) for total and 1.45 (1.06–1.98, p=0.02) for cardiovascular mortality. Additional adjustments for plasma TMAO did not materially influence the risk estimates in either cohort, and no effect modification by TMAO was observed.
Conclusions
Circulating TML is associated with increased risk of total and cardiovascular mortality in both subjects with and without CHD.
Funding Acknowledgement
Type of funding sources: None.
Collapse
Affiliation(s)
- E O Bjornestad
- Stavanger University Hospital, Department of Cardiology, Stavanger, Norway
| | - I Dhar
- University of Bergen, Department of Clinical Science, Bergen, Norway
| | - G F T Svingen
- Haukeland University Hospital, Department of Cardiology, Bergen, Norway
| | - M M Svenningsson
- Haukeland University Hospital, Department of Cardiology, Bergen, Norway
| | - E R Pedersen
- Haukeland University Hospital, Department of Cardiology, Bergen, Norway
| | - G S Tell
- University of Bergen, Department of Global Public Health and Primary Health Care, Bergen, Norway
| | - P M Ueland
- University of Bergen, Department of Clinical Science, Bergen, Norway
| | - S Orn
- Stavanger University Hospital, Department of Cardiology, Stavanger, Norway
| | - R Laaksonen
- Tampere University, Finnish Cardiovascular Research Center, Tampere, Finland
| | - O Nygaard
- Haukeland University Hospital, Department of Cardiology, Bergen, Norway
| |
Collapse
|
6
|
Leiherer A, Muendlein A, Saely C, Laaksonen R, Laaperi M, Vonbank A, Larcher B, Mader A, Fraunberger P, Baumgartner I, Dopheide J, Drexel H. Serum ceramides and type 2 diabetes are mutually independent predictors of cardiovascular events in patients with peripheral artery disease. Atherosclerosis 2020. [DOI: 10.1016/j.atherosclerosis.2020.10.077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
7
|
Leiherer A, Muendlein A, Saely C, Laaksonen R, Laaperi M, Vonbank A, Larcher B, Mader A, Baumgartner I, Fraunberger P, Drexel H. The ceramide-based coronary event risk test (CERT) predicts cardiovascular mortality in cardiovascular disease patients with type 2 diabetes as well as in those without diabetes. Atherosclerosis 2020. [DOI: 10.1016/j.atherosclerosis.2020.10.232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
8
|
Leiherer A, Muendlein A, Saely C, Laaksonen R, Laaperi M, Vonbank A, Larcher B, Mader A, Fraunberger P, Drexel H. Serum ceramide ratios predict cardiovascular events in patients with type 2 diabetes independently from the presence of coronary artery disease. Atherosclerosis 2020. [DOI: 10.1016/j.atherosclerosis.2020.10.705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
9
|
Leiherer A, Muendlein A, Saely C, Laaksonen R, Laaperi M, Vonbank A, Fraunberger P, Drexel H. Comparison of two recent ceramide-based coronary risk prediction scores: CERT and CERT-2. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2922] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
The Coronary Event Risk Test (CERT) is a validated cardiovascular risk predictor that uses circulating ceramide concentrations to allocate patients into one of four risk categories. This test has recently been updated (CERT-2), now additionally including phosphatidylcholine concentrations.
The purpose of this study was to investigate the power of CERT and CERT-2 to predict cardiovascular mortality in patients with cardiovascular disease (CVD).
We investigated a cohort of 999 patients with established CVD.
Overall, comparing survival curves (figure) for over 12 years of follow up and the predictive power of survival models using net reclassification improvement (NRI), CERT-2 was the best predictor of cardiovascular mortality, surpassing CERT (NRI=0.456; p=0.01) and also the 2019 ESC-SCORE (NRI=0.163; p=0.04). Patients in the highest risk category of CERT as compared to the lowest category had a HR of 3.63 [2.09–6.30] for cardiovascular death; for CERT-2 the corresponding HR was 6.02 [2.47–14.64]. Among patients with T2DM (n=322), the HR for cardiovascular death was 3.00 [1.44–6.23] using CERT and 7.06 [1.64–30.50] using CERT-2; the corresponding HRs among non-diabetic subjects were 2.99 [1.20–7.46] and 3.43 [1.03–11.43], respectively.
We conclude that both, CERT and CERT-2 scores are powerful predictors of cardiovascular mortality in CVD patients, especially in those patients with T2D. Performance is even higher with CERT-2.
Funding Acknowledgement
Type of funding source: None
Collapse
Affiliation(s)
- A Leiherer
- Private University of the Principality of Liechtenstein, Triesen, Liechtenstein
| | - A Muendlein
- Vorarlberg Institute for Vascular Investigation & Treatment (VIVIT), Feldkirch, Austria
| | - C.H Saely
- Private University of the Principality of Liechtenstein, Triesen, Liechtenstein
| | | | | | - A Vonbank
- Academic Teaching Hospital Feldkirch, Feldkirch, Austria
| | | | - H Drexel
- Drexel University College of Medicine, Philadelphia, United States of America
| |
Collapse
|
10
|
Mantovani A, Lunardi G, Bonapace S, Dugo C, Altomari A, Molon G, Conti A, Bovo C, Laaksonen R, Byrne CD, Bonnet F, Targher G. Association between increased plasma ceramides and chronic kidney disease in patients with and without ischemic heart disease. Diabetes Metab 2020; 47:101152. [PMID: 32283179 DOI: 10.1016/j.diabet.2020.03.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 03/21/2020] [Accepted: 03/31/2020] [Indexed: 10/24/2022]
Abstract
AIM Plasma levels of certain ceramides are increased in patients with ischemic heart disease (IHD). Many risk factors for IHD are also risk factors for chronic kidney disease (CKD), but it is currently uncertain whether plasma ceramide levels are increased in patients with CKD. METHODS We measured six previously identified high-risk plasma ceramide concentrations [Cer(d18:1/16:0), Cer(d18:1/18:0), Cer(d18:1/20:0), Cer(d18:1/22:0), Cer(d18:1/24:0) and Cer(d18:1/24:1)] in 415 middle-aged individuals who attended our clinical Cardiology and Diabetes services over a period of 9 months. RESULTS A total of 97 patients had CKD (defined as e-GFRCKD-EPI<60ml/min/1.73m2 and/or urinary albumin-to-creatinine ratio≥30mg/g), 117 had established IHD and 242 had type 2 diabetes. Patients with CKD had significantly (P=0.005 or less) higher levels of plasma Cer(d18:1/16:0), Cer(d18:1/18:0), Cer(d18:1/20:0), Cer(d18:1/22:0), Cer(d18:1/24:0), and Cer(d18:1/24:1) compared to those without CKD. The presence of CKD remained significantly associated with higher levels of plasma ceramides (standardized beta coefficients ranging from 0.124 to 0.227, P<0.001) even after adjustment for body mass index, smoking, hypertension, diabetes, prior IHD, plasma LDL-cholesterol, hs-C-reactive protein levels and use of any lipid-lowering medications. Notably, more advanced stages of CKD and abnormal albuminuria were both associated (independently of each other) with increased levels of plasma ceramides. These results were consistent in all subgroups considered, including patients with and without established IHD or those with and without diabetes. CONCLUSION Increased levels of plasma ceramides are associated with CKD independently of pre-existing IHD, diabetes and other established cardiovascular risk factors.
Collapse
Affiliation(s)
- A Mantovani
- Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Piazzale Stefani, 1, 37126 Verona, Italy
| | - G Lunardi
- Medical Analysis Laboratory, "IRCCS Sacro Cuore - Don Calabria" Hospital, Negrar, VR, Italy
| | - S Bonapace
- Division of Cardiology, "IRCCS Sacro Cuore - Don Calabria" Hospital, Negrar, VR, Italy
| | - C Dugo
- Division of Cardiology, "IRCCS Sacro Cuore - Don Calabria" Hospital, Negrar, VR, Italy
| | - A Altomari
- Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Piazzale Stefani, 1, 37126 Verona, Italy
| | - G Molon
- Division of Cardiology, "IRCCS Sacro Cuore - Don Calabria" Hospital, Negrar, VR, Italy
| | - A Conti
- Medical Analysis Laboratory, "IRCCS Sacro Cuore - Don Calabria" Hospital, Negrar, VR, Italy
| | - C Bovo
- Medical Direction, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - R Laaksonen
- Zora Biosciences Oy, Espoo, Finland; Finnish Cardiovascular Research Center Tampere, Faculty of Medicine and Life Sciences, University of Tampere, Tampere University Hospital, Tampere, Finland
| | - C D Byrne
- Southampton National Institute for Health Research Biomedical Research Centre, University Hospital Southampton, Southampton General Hospital, Southampton, UK; Nutrition and Metabolism, Faculty of Medicine, University of Southampton, Southampton, UK
| | - F Bonnet
- University Hospital of Rennes, University of Rennes 1, CHU, Rennes, France
| | - G Targher
- Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Piazzale Stefani, 1, 37126 Verona, Italy.
| |
Collapse
|
11
|
Laaksonen R, Hilvo M, Kauhanen D, Lakic TG, Lindback J, Held C, Granger CB, Koenig W, Stewart RAH, White HD, Siegbahn A, Wallentin L. P3640Association of ceramide and phospholipid levels and cardiovascular events in stable coronary heart disease: findings from the STABILITY Biomarkers substudy. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Both levels of protein and lipid biomarkers have been found associated with cardiovascular outcomes in patients with stable coronary heart disease (CHD). There are few large-scale studies comparing the prognostic value of and interactions between these two groups of biomarkers in CHD.
Methods
In the 15,828 CHD patients included in the STABILITY trial 10,205 provided plasma samples at baseline allowing measurements of distinct ceramide and phospholipid species by mass spectrometry and markers of cardiac dysfunction (N-terminal pro-B-type natriuretic peptide [NT-proBNP]), high sensitivity cardiac troponin-T [cTnT-hs]), renal dysfunction (cystatin-C), oxidative stress (growth differentiation factor 15 [GDF-15]) by electro-immunoassays. During 3.7 years median follow-up, 1291 CVD, MI, and stroke events occurred. A previously developed ceramide and phospholipid species based risk score (CERT) and its associations to outcomes before and after adjustment were evaluated by Cox-regression models.
Results
The CERT model was significantly associated to all cardiovascular outcomes before and after adjustment for clinical characteristics and routine laboratory tests. However, the associations were attenuated after adjustment for other prognostic biomarkers. The data are summarized in Table 1 below.
Table 1. HR per 1 SD increase in CERT HR (95% CI) p-value MACE Model 1 1.30 (1.24–1.37) <0.0001 Model 2 1.23 (1.16–1.31) <0.0001 Model 3 1.08 (1.02–1.15) 0.0120 CVD Death Model 1 1.57 (1.45–1.69) <0.0001 Model 2 1.38 (1.26–1.50) <0.0001 Model 3 1.14 (1.04–1.26) 0.0052 MACE = CVD death, stroke and MI. Model 1 includes score and randomized treatment. Model 2 includes score, randomized treatment, age, gender, and prior (MI, coronary revas., multivessel CHD), B/L diabetes, hypertension, history of smoking, PVD, region, B/L systolic BP, B/L BMI, HB, WBC, CKD-EPI, LDL-C, HDL-C and TG. Model 3 includes the following covariates in addition to Model 2: TnT-hs, proBNP, Cystatin-C, CRP-hs and IL-6.
Conclusion
A ceramide/phospholipids based risk score is associated with the risk of fatal and non-fatal cardiovascular events in patients with stable CHD. The score is attenuated by adjustment for biomarkers indicating cardiorenal dysfunction and inflammatory activity and may be related to underlying mechanisms for adverse outcomes in stable CHD.
Acknowledgement/Funding
The original STABILITY study was funded by GlaxoSmithKline
Collapse
Affiliation(s)
| | - M Hilvo
- Zora Biosciences Oy, Espoo, Finland
| | | | | | | | - C Held
- Uppsala University, Uppsala, Sweden
| | - C B Granger
- Duke University Medical Center, Durham, United States of America
| | - W Koenig
- German Heart Center of Munich, Munich, Germany
| | | | - H D White
- The University of Auckland, Auckland, New Zealand
| | | | | |
Collapse
|
12
|
Leiherer A, Muendlein A, Saely CH, Laaksonen R, Laaperi M, Vonbank A, Larcher B, Mader A, Baumgartner I, Fraunberger P, Drexel H. P4992The ceramide-based Coronary Event Risk Test (CERT) predicts cardiovascular mortality in cardiovascular disease patients with type 2 diabetes mellitus as well as in those without diabetes. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
The recently introduced Coronary Event Risk Test (CERT) is a validated cardiovascular risk predictor that uses circulating ceramide concentrations to allocate patients into one of four risk categories.
Purpose
The purpose of this study was to investigate the power of CERT to predict cardiovascular mortality in patients with established cardiovascular disease (CVD) including patients with type 2 diabetes (T2DM).
Methods
We investigated a total of 1087 patients with established CVD, including 360 patients with T2DM.
At baseline, the prevalence of T2DM increased through CERT categories (29.1, 31.1, 37.4, and 53.4%, respectively, ptrend<0.001). Prospectively, cardiovascular deaths were recorded during a mean follow-up time of 8.1±3.2 years.
Results
A total of 130 cardiovascular deaths occurred. Overall, cardiovascular mortality increased with increasing CERT categories (figure) and was higher in T2DM patients than in those who did not have diabetes (17.7 vs. 9.4%; p<0.001). In Cox regression models, CERT categories predicted cardiovascular mortality in patients with T2DM (unadjusted HR 1.60 [1.28–2.01]; p<0.001; HR adjusted for age, gender, BMI, smoking, LDL cholesterol, HDL cholesterol, hypertension, and statin use 1.65 [1.27–2.15]; p<0.001) and in those without diabetes (unadjusted HR 1.43 [1.10–1.85]; p=0.008 and adjusted HR 1.41 [1.07–1.85]; p=0.015).
Cardiovascular survival of CVD patients
Conclusion
We conclude that CERT predicts cardiovascular mortality in CVD patients with T2DM as well as in those without diabetes.
Collapse
Affiliation(s)
| | | | - C H Saely
- Private University of the Principality of Liechtenstein, Triesen, Liechtenstein
| | | | | | - A Vonbank
- Academic Teaching Hospital, Department of Medicine I, Feldkirch, Austria
| | - B Larcher
- Academic Teaching Hospital, Department of Medicine I, Feldkirch, Austria
| | - A Mader
- Academic Teaching Hospital, Department of Medicine I, Feldkirch, Austria
| | - I Baumgartner
- Swiss Cardiovacular Center; University Hospital, Division of Angiology, Bern, Switzerland
| | | | - H Drexel
- Swiss Cardiovacular Center; University Hospital, Division of Angiology, Bern, Switzerland
| |
Collapse
|
13
|
Leiherer A, Muendlein A, Saely CH, Laaksonen R, Laaperi M, Vonbank A, Larcher B, Mader A, Fraunberger P, Dopheide JF, Baumgartner I, Drexel H. P4497Serum ceramides and type 2 diabetes are mutually independent predictors of cardiovascular events in patients with peripheral artery disease. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Ceramides are enriched in atherosclerotic plaques, and a set of circulating ceramides including Cer(d18:1/16:0), Cer(d18:1/18:0), Cer(d18:1/24:1), and Cer(d18:1/24:0) has recently emerged as predictors of cardiovascular outcomes in coronary artery disease patients.
Purpose
The purpose of this study was to investigate their power to predict cardiovascular events in patients with peripheral artery disease (PAD).
Methods
We measured the serum concentrations of the above mentioned ceramides in a cohort of 380 patients with sonographically proven PAD, of whom 107 had type 2 diabetes (T2DM). Prospectively, we recorded 221 cardiovascular events over a mean follow-up time of 6.3±2.3 years.
Results
Cardiovascular event risk was higher in T2DM patients than in those who did not have diabetes (69 vs. 52%, p=0.001). The ceramides Cer(18:1/16:0) and Cer(18:1/24:1) and the respective ratios Cer(18:1/16:0) / Cer(18:1/24:0) and Cer(18:1/24:1) / Cer(18:1/24:0) were significant predictors of cardiovascular events both univariately and after multivariate adjustment including the presence of T2DM (figure). Conversely, T2DM predicted cardiovascular events independently from the investigated ceramides (adjusted HR 1.76 [1.31–2.35], p<0.001).
Conclusion
We conclude that the investigated ceramides and T2DM are mutually independent predictors of cardiovascular events in PAD patients.
Collapse
Affiliation(s)
| | | | - C H Saely
- Private University of the Principality of Liechtenstein, Triesen, Liechtenstein
| | | | | | - A Vonbank
- Academic Teaching Hospital, Department of Medicine I, Feldkirch, Austria
| | - B Larcher
- Academic Teaching Hospital, Department of Medicine I, Feldkirch, Austria
| | - A Mader
- Academic Teaching Hospital, Department of Medicine I, Feldkirch, Austria
| | | | - J F Dopheide
- Swiss Cardiovacular Center; University Hospital, Division of Angiology, Bern, Switzerland
| | - I Baumgartner
- Swiss Cardiovacular Center; University Hospital, Division of Angiology, Bern, Switzerland
| | - H Drexel
- Swiss Cardiovacular Center; University Hospital, Division of Angiology, Bern, Switzerland
| |
Collapse
|
14
|
Alexanova A, Viiri L, Laaksonen R, Kiamehr M, Aalto-Setälä K. Modeling Lipid Metabolism Of Coronary Artery Disease Patients With Induced Pluripotent Stem Cell Derived Hepatocytes. Atherosclerosis 2019. [DOI: 10.1016/j.atherosclerosis.2019.06.344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
15
|
Ozsait‐Selcuk B, Komurcu‐Bayrak E, Jylhä M, Luukkaala T, Perola M, Kristiansson K, Mononen N, Hurme M, Kähönen M, Goebeler S, Laaksonen R, Hervonen A, Erginel‐Unaltuna N, Karhunen P, Lehtimäki T. The
rs2516839
variation of
USF1
gene is associated with 4‐year mortality of nonagenarian women: The Vitality 90+ study. Ann Hum Genet 2018; 83:34-45. [DOI: 10.1111/ahg.12282] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 07/17/2018] [Accepted: 07/30/2018] [Indexed: 11/29/2022]
Affiliation(s)
- B. Ozsait‐Selcuk
- Department of Clinical Chemistry, Fimlab Laboratories, and Finnish Cardiovascular Research Center ‐ Tampere, Faculty of Medicine and Life Sciences University of Tampere Tampere Finland
- Department of Genetics, Aziz Sancar Institute of Experimental Medicine Istanbul University Istanbul Turkey
| | - E. Komurcu‐Bayrak
- Department of Clinical Chemistry, Fimlab Laboratories, and Finnish Cardiovascular Research Center ‐ Tampere, Faculty of Medicine and Life Sciences University of Tampere Tampere Finland
- Department of Genetics, Aziz Sancar Institute of Experimental Medicine Istanbul University Istanbul Turkey
| | - M. Jylhä
- Gerontology Research Center (GEREC), University of Tampere; School of Health Sciences University of Tampere Tampere Finland
| | - T. Luukkaala
- Tampere School of Health Sciences, University of Tampere, Tampere; Science Center Pirkanmaa Hospital District Finland
| | - M. Perola
- Department of Health National Institute for Health and Welfare Helsinki Finland
| | - K. Kristiansson
- Department of Microbiology and Immunology, Faculty of Medicine and Life Sciences University of Tampere Tampere Finland
| | - N. Mononen
- Department of Clinical Chemistry, Fimlab Laboratories, and Finnish Cardiovascular Research Center ‐ Tampere, Faculty of Medicine and Life Sciences University of Tampere Tampere Finland
| | - M. Hurme
- Department of Microbiology and Immunology, Faculty of Medicine and Life Sciences University of Tampere Tampere Finland
| | - M. Kähönen
- Department of Clinical Physiology, Tampere University Hospital, and Finnish Cardiovascular Research Center ‐ Tampere, Faculty of Medicine and Life Sciences University of Tampere Tampere Finland
| | - S. Goebeler
- Department of Forensic Medicine, University of Tampere, Fimlab Laboratories Pirkanmaa Hospital District Tampere Finland
| | - R. Laaksonen
- Medical School, University of Tampere; Finnish Clinical Biobank University Hospital of Tampere Tampere Finland
| | - A. Hervonen
- Gerontology Research Center (GEREC), University of Tampere; School of Health Sciences University of Tampere Tampere Finland
| | - N. Erginel‐Unaltuna
- Department of Genetics, Aziz Sancar Institute of Experimental Medicine Istanbul University Istanbul Turkey
| | - P.J. Karhunen
- Department of Clinical Chemistry, Fimlab Laboratories, and Department of Forensic Medicine, Finnish Cardiovascular Research Center ‐ Tampere, Faculty of Medicine and Life Sciences University of Tampere Tampere Finland
| | - T. Lehtimäki
- Department of Clinical Chemistry, Fimlab Laboratories, and Finnish Cardiovascular Research Center ‐ Tampere, Faculty of Medicine and Life Sciences University of Tampere Tampere Finland
| |
Collapse
|
16
|
Sulkava M, Levula M, Lyytikäinen L, Mishra pashupati P, Klopp N, Illig T, Seppälä I, Kholova I, Laaksonen R, Järvinen O, Mennander A, Kähönen M, Miettinen M, Lehtimäki T, Oksala N, Raitoharju E. Formyl peptide receptors 1-3 and annexin 1 in atherosclerotic plaques —tampere vascular study. Atherosclerosis 2018. [DOI: 10.1016/j.atherosclerosis.2018.06.287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
17
|
Ruuth M, Nguyen S, Vihervaara T, Hilvo M, Uusitupa M, Schwab U, Savolainen M, Jauhiainen M, Käkelä R, Baruch A, Laaksonen R, Kovanen P, Öörni K. Susceptibility of LDL particles to aggregate depends on particle lipidome, is modifiable, and associates with future cardiovascular deaths. Atherosclerosis 2018. [DOI: 10.1016/j.atherosclerosis.2018.06.081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
18
|
Weichwald S, Candreva A, Burkholz R, Klingenberg R, Raeber L, Mach F, Rodondi N, Laaksonen R, Manka R, Luescher TF, Ruschitzka F, Buhmann JM, Matter CM. P6246Machine learning for improving risk stratification after ACS. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- S Weichwald
- Max Planck Institute for Intelligent Systems, Tübingen, Germany
| | - A Candreva
- University Heart Center, Zurich, Switzerland
| | - R Burkholz
- Swiss Federal Institute of Technology Zurich (ETH Zurich), Zurich, Switzerland
| | | | - L Raeber
- University of Bern, Department of Cardiology, Bern, Switzerland
| | - F Mach
- University of Geneva, Faculty of Medicine, Geneva, Switzerland
| | - N Rodondi
- University of Bern, Institute of Primary Health Care, Bern, Switzerland
| | - R Laaksonen
- University of Tampere, Faculty of Medicine and Life Sciences, Tampere, Finland
| | - R Manka
- University Heart Center, Zurich, Switzerland
| | | | | | - J M Buhmann
- Swiss Federal Institute of Technology Zurich (ETH Zurich), Zurich, Switzerland
| | - C M Matter
- University Heart Center, Zurich, Switzerland
| |
Collapse
|
19
|
Oksala N, Seppälä I, Rahikainen R, Mäkelä KM, Raitoharju E, Illig T, Klopp N, Kholova I, Laaksonen R, Karhunen P, Hytönen V, Lehtimäki T. Synergistic Expression of Histone Deacetylase 9 and Matrix Metalloproteinase 12 in M4 Macrophages in Advanced Carotid Plaques. Eur J Vasc Endovasc Surg 2017; 53:632-640. [DOI: 10.1016/j.ejvs.2017.02.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Accepted: 02/09/2017] [Indexed: 01/16/2023]
|
20
|
Busnelli M, Manzini S, Hilvo M, Parolini C, Ganzetti G, Dellera F, Ekroos K, Jänis M, Sirtori C, Laaksonen R, Chiesa G. Hepatocyte-specific PPAP2B ablation increases plasma levels of several minor pro-atherogenic lipid species and worsens atherosclerosis in apoE -/- MICE. Atherosclerosis 2016. [DOI: 10.1016/j.atherosclerosis.2016.07.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
21
|
Chiesa G, Busnelli M, Parolini C, Manzini S, Ganzetti G, Dellera F, Suoniemi M, Hilvo M, Hurme R, Ekroos K, Sirtori C, Laaksonen R. Lipidomics of plasma, liver and aorta of Pcsk9-KO mice. Atherosclerosis 2016. [DOI: 10.1016/j.atherosclerosis.2016.07.581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
22
|
Niiranen K, Silvennoinen R, Laaksonen R, Airaksinen M, Lehtonen L. DD-032 The impact of computerised physician order entry on medication errors in chemotherapy. Eur J Hosp Pharm 2016. [DOI: 10.1136/ejhpharm-2016-000875.267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
23
|
Alfirevic A, Neely D, Armitage J, Chinoy H, Cooper RG, Laaksonen R, Carr DF, Bloch KM, Fahy J, Hanson A, Yue QY, Wadelius M, Maitland-van Der Zee AH, Voora D, Psaty BM, Palmer CNA, Pirmohamed M. Phenotype standardization for statin-induced myotoxicity. Clin Pharmacol Ther 2014; 96:470-6. [PMID: 24897241 PMCID: PMC4172546 DOI: 10.1038/clpt.2014.121] [Citation(s) in RCA: 137] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Accepted: 05/27/2014] [Indexed: 11/12/2022]
Abstract
Statins are widely used lipid-lowering drugs that are effective in reducing cardiovascular disease risk. Although they are generally well tolerated, they can cause muscle toxicity, which can lead to severe rhabdomyolysis. Research in this area has been hampered to some extent by the lack of standardized nomenclature and phenotypic definitions. We have used numerical and descriptive classifications and developed an algorithm to define statin-related myotoxicity phenotypes, including myalgia, myopathy, rhabdomyolysis, and necrotizing autoimmune myopathy.
Collapse
Affiliation(s)
- A Alfirevic
- Department of Molecular and Clinical Pharmacology, TheWolfson Centre for Personalised Medicine, Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - D Neely
- Department of Clinical Biochemistry, Newcastle upon Tyne Hospitals NHS Foundation Trust, Royal Victoria Infirmary, Newcastle upon Tyne, UK
| | | | - H Chinoy
- Centre for Musculoskeletal Research/NIHR Manchester Musculoskeletal Biomedical Research Unit, University of Manchester, Manchester, UK
| | - R G Cooper
- MRC/ARUK Institute of Ageing and Chronic Disease, Faculty of Health & Life Sciences, University of Liverpool, Liverpool, UK
| | - R Laaksonen
- Zora Biosciences Ltd, Tieotie 2, Espoo, Finland
| | - D F Carr
- Department of Molecular and Clinical Pharmacology, TheWolfson Centre for Personalised Medicine, Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - K M Bloch
- Department of Molecular and Clinical Pharmacology, TheWolfson Centre for Personalised Medicine, Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - J Fahy
- Department of Molecular and Clinical Pharmacology, TheWolfson Centre for Personalised Medicine, Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - A Hanson
- Department of Molecular and Clinical Pharmacology, TheWolfson Centre for Personalised Medicine, Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - Q-Y Yue
- The Medical Products Agency, Uppsala, Sweden
| | - M Wadelius
- Department of Medical Sciences, Clinical Pharmacology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - A H Maitland-van Der Zee
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, Faculty of Science, Utrecht Institute for Pharmaceutical Sciences, Utrecht, The Netherlands
| | - D Voora
- Duke Institute for Genome Sciences and Policy, Durham, North Carolina, USA
| | - B M Psaty
- Cardiovascular Health Research Unit, Departments of Medicine, Epidemiology and Health Services, University of Washington, Seattle, Washington, USA
- Group Health Research Institute, Group Health Cooperative, Seattle, Washington, USA
| | - C N A Palmer
- Medical Research Institute, Ninewells Hospital and Medical School, Dundee, UK
| | - M Pirmohamed
- Department of Molecular and Clinical Pharmacology, TheWolfson Centre for Personalised Medicine, Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| |
Collapse
|
24
|
Busnelli M, Parolini C, Manzini S, Ganzetti G, Dellera F, Katainen R, Suoniemi M, Tarasov K, Hurme R, Ekroos K, Sirtori C, Laaksonen R, Chiesa G. Impact of dietary treatments on the lipidomic profile of plasma, aorta and liver from ldlr-ko and pcsk9-ko mice. Atherosclerosis 2014. [DOI: 10.1016/j.atherosclerosis.2014.05.541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
25
|
Laine N, Vaara M, Anttila VJ, Laaksonen R, Airaksinen M, Saxen H. CP-089 The effect of the blood culture result on subsequent antimicrobial treatment in paediatric hospital-acquired infections. Eur J Hosp Pharm 2014. [DOI: 10.1136/ejhpharm-2013-000436.87] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
26
|
Laaksonen R, Tarasov K, Kauhanen D, Sylvänne T, Jänis M, Hurme R, Ekroos K, Mombelli G, Sirtori C, Tardif JC. 24 SENSITIVE BIOMARKER FOR STATIN-INDUCED MYOTOXICITY. ATHEROSCLEROSIS SUPP 2011. [DOI: 10.1016/s1567-5688(11)70025-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
27
|
Raitoharju E, Lyytikäinen LP, Levula M, Oksala N, Mennander A, Laaksonen R, Lehtimäki T. 598 MIR-21, MIR-210, MIR-34A, MIR-146A AND MIR-146B-5P ARE UP-REGULATED IN HUMAN ATHEROSCLEROTIC PLAQUES. ATHEROSCLEROSIS SUPP 2011. [DOI: 10.1016/s1567-5688(11)70599-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
28
|
Komurcu Bayrak E, Onat A, Yuzbasiogullari B, Mononen N, Laaksonen R, Hergenc G, Humphries S, Lehtimäki T, Erginel-Unaltuna N. MS194 THE INFLUENCE OF APOLIPOPROTEIN E GENETIC VARIANTS ON SERUM LIPIDS AND INSULIN RESISTANCE IN TARF STUDY. ATHEROSCLEROSIS SUPP 2010. [DOI: 10.1016/s1567-5688(10)70695-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
29
|
Laaksonen R, Jänis M, Tarasov K, Hurme R, Marais D, Ekroos K. W27 LIPID LOWERING THERAPY INDUCES A SIGNIFICANT UPREGULATION OF THE PLASMA LIPIDOME IN FH PATIENTS. ATHEROSCLEROSIS SUPP 2010. [DOI: 10.1016/s1567-5688(10)70028-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
30
|
Raitoharju E, Levula M, Kuukasjärvi P, Laurikka J, Nikus K, Huovila AP, Laaksonen R, Karhunen P, Viik J, Tarkka M, Kähönen M, Lehtimäki T. P173 THE CONNECTIONS OF ADAM8S (A DISINTEGRIN AND METALLOPROTEASE) GENETIC POLYMORPHISMS TO CORONARY ARTERY DISEASE AND MYOCARDIAL INFARCTION. ATHEROSCLEROSIS SUPP 2010. [DOI: 10.1016/s1567-5688(10)70240-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
31
|
Komurcu-Bayrak E, Erginel-Unaltuna N, Onat A, Ozsait B, Eklund C, Hurme M, Mononen N, Laaksonen R, Hergenc G, Lehtimäki T. Association of C-reactive protein (CRP) gene allelic variants with serum CRP levels and hypertension in Turkish adults. Atherosclerosis 2009; 206:474-9. [DOI: 10.1016/j.atherosclerosis.2009.03.030] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2008] [Revised: 03/25/2009] [Accepted: 03/29/2009] [Indexed: 11/25/2022]
|
32
|
Luomala M, Laaksonen R, Janatuinen T, Vesalainen R, Nuutila P, Saarela M, Mattila K, Kalijärvi M, Solakivi T, Knuuti J, Hurme M, Lehtimäki T. High plasma levels of CD40 are associated with low coenzyme Q and vitamin E content of low‐density lipoprotein in healthy men. Scand J Clin Lab Invest 2009; 67:115-22. [PMID: 17365991 DOI: 10.1080/00365510600979394] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE There is a growing body of evidence to suggest that low-density lipoprotein (LDL) cholesterol, inflammation and oxidative stress are pivotal in the development of cardiovascular disease, but their interconnections are not well known. The objective of this study was to determine whether immunological activation, reflected by the plasma levels of soluble CD40 (sCD40), interleukin (IL)-1beta, tumor necrosis factor-alpha and IL-6 are associated with the antioxidant potential of LDL particles or with common lipid, immunological or thrombotic markers in 51 young healthy men. MATERIAL AND METHODS We determined the coenzyme Q level from an oxidized LDL fraction, obtaining the concentration for ubiquinone, which indicates total coenzyme Q levels. RESULTS The plasma level of sCD40 was negatively correlated with LDL ubiquinone (r=-0.45, p=0.001) and E vitamin (r=-0.37, p=0.008) and positively correlated with plasma concentration of plasminogen activator inhibitor-1 (PAI-1, r=0.52, p=0.002) and caspase-1 (r=0.40, p=0.004). No correlation was detected between sCD40 and plasma lipid or C-reactive protein concentrations. As sCD40 was strongly correlated with the content of LDL ubiquinone and vitamin E, their values were compared according to groups formed by sCD40 tertiles. Analysis of variance showed that there were significant differences in LDL ubiquinone (p<0.0001) and vitamin E (p=0.004) concentrations between sCD40 tertiles. CONCLUSIONS The data indicate that increased activation of the CD40 system is related to low levels of LDL ubiquinone and vitamin E. This suggests that chronic or increased immunological activation may consume the antioxidant potential of LDL particles.
Collapse
Affiliation(s)
- M Luomala
- Laboratory of Atherosclerosis Genetics, Center for Laboratory Medicine, Department of Clinical Chemistry, Tampere University Hospital, Tampere, Finland.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
33
|
Ilveskoski E, Lehtimäki T, Laaksonen R, Janatuinen T, Vesalainen R, Nuutila P, Laippala P, Karhunen PJ, Knuuti J. Improvement of myocardial blood flow by lipid‐lowering therapy with pravastatin is modulated by apolipoprotein E genotype. Scandinavian Journal of Clinical and Laboratory Investigation 2009; 67:723-34. [PMID: 17852827 DOI: 10.1080/00365510701297472] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Apolipoprotein E (apoE) polymorphism affects the risk of advanced coronary artery disease, but its role in early atherosclerosis remains unknown. We used positron emission tomography (PET) to study whether coronary reactivity or its response to pravastatin is related to the apoE genotype. MATERIAL AND METHODS Samples from 44 mildly hypercholesterolaemic men (aged 35 +/- 4 years) of an earlier trial were re-analysed according to apoE genotype. Subjects were randomized to receive either 40 mg/day pravastatin or placebo for 6 months. To assess coronary reactivity, myocardial blood flow was measured by PET at rest and during adenosine infusion. PET studies and lipid analyses were done at baseline and after 6 months of therapy. RESULTS There were no differences between apoE epsilon3/3 and epsilon4/3 genotypes in basal or adenosine-stimulated flow or in coronary flow reserve (CFR) at baseline. There was a significant apoE genotype-by-treatment group interaction regarding the change in adenosine-stimulated flow (ANCOVA; p = 0.018) and CFR (p = 0.020) at the end of the study. In the pravastatin group, the adenosine-stimulated flow increased by 32.5 % in subjects with epsilon3/3 (n = 9), but decreased non-significantly (-14.4 %) in subjects with epsilon4/3 (n = 9) (p = 0.0009). The corresponding changes in CFR were +17.8 % for epsilon3/3 and (-11.9 % for epsilon4/3 (p = 0.05). There were no significant changes from the baseline values in placebo recipients. After pravastatin treatment, both genotype groups showed a similar decrease in serum total and low-density lipoprotein cholesterol (p<0.0001 for both). CONCLUSIONS Coronary function improves by 6 months of pravastatin in subjects with the apoE epsilon3/3 genotype, but not in those with the epsilon4/3.
Collapse
Affiliation(s)
- E Ilveskoski
- Laboratory of Atherosclerosis Genetics, Centre for Laboratory Medicine, Department of Clinical Chemistry, Tampere University Hospital and Medical School, University of Tampere, Tampere, Finland.
| | | | | | | | | | | | | | | | | |
Collapse
|
34
|
Ekroos K, Ståhlman M, Verma A, Sylvänne T, Hurme R, Berthold H, Gouni-Berthold I, Boren J, Laaksonen R. Abstract: P1164 EZETIMIBE RESULTS IN INCREASED HDL LIPID CONTENT AND PARTICLE SIZE. ATHEROSCLEROSIS SUPP 2009. [DOI: 10.1016/s1567-5688(09)71157-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
35
|
Laaksonen R, Gouni-Berthold I, Gylling H, Berthold H, Verma A, Tarasov K, Hurme R, Ekroos K. Abstract: 585 LIPIDOMICS CAN BE USED IN PERSONALIZING CHOLESTEROL SYNTHESIS AND ABSORPTION INHIBITOR TREATMENTS. ATHEROSCLEROSIS SUPP 2009. [DOI: 10.1016/s1567-5688(09)70342-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
36
|
Laaksonen R, Mombelli G, Tarasov K, Kauhanen D, Koistinen K, Hurme R, Sirtori C, Ekroos K. Abstract: 105 INCREASED PLASMA CERAMIDES FOLLOW STATIN-INDUCED MUSCLE TOXICITY. ATHEROSCLEROSIS SUPP 2009. [DOI: 10.1016/s1567-5688(09)70234-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
37
|
Färkkilä MA, Iivanainen MV, Bergström L, Roine RO, Laaksonen R, Niemi ML, Cantell K. Interferon treatment in amyotrophic lateral sclerosis. Acta Neurol Scand 2009. [DOI: 10.1111/j.1600-0404.1984.tb02429.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
38
|
Kotila M, Waltimo O, Niemi ML, Laaksonen R. Does a single stroke precede dementia? Acta Neurol Scand 2009. [DOI: 10.1111/j.1600-0404.1984.tb02505.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
39
|
Paiva H, Kahonen M, Lehtimaki T, Raitakari OT, Jula A, Viikari J, Alfthan G, Juonala M, Laaksonen R, Hutri-Kahonen N. Asymmetric dimethylarginine (ADMA) has a role in regulating systemic vascular tone in young healthy subjects: the cardiovascular risk in young Finns study. Am J Hypertens 2008; 21:873-8. [PMID: 18551100 DOI: 10.1038/ajh.2008.215] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND This study was designed to evaluate whether plasma asymmetric dimethylarginine (ADMA) has any role in predicting hemodynamic responses in clinically healthy young subjects. ADMA, as an endogenous nitric oxide (NO) synthase inhibitor, has been demonstrated to associate with hypertension and vascular reactivity in experimental but not undoubtedly in physiological settings. METHODS A total of 199 subjects aged 31.4 years (range 24-39 years) were studied. Plasma ADMA and symmetric dimethylarginine (SDMA) were assessed by isocratic high-pressure liquid chromatography using precolumn derivatization with o-phtaldialdehyde at baseline. Blood pressure (BP) was measured by casual measurements in the beginning of the study and after a follow-up period of 2.45 +/- 0.42 years (range, 1.86-3.19 years). Hemodynamic regulation was assessed by noninvasive methods after a follow-up. RESULTS Plasma ADMA had a negative association with resting systemic vascular resistance index (SVRI) (r = -0.23, P < 0.01) and pulse wave velocity (PWV) (r = -0.17, P < 0.05) and positive association with cardiac index (CI) (r = 0.21, P < 0.01) after the follow-up. Plasma ADMA had also negative association with responses of SVRI (r = -0.19, P < 0.01) and positive association with CI (r = 0.25, P < 0.001) in a hemodynamic reactivity test. In a multivariate linear model (R2 = 0.20, P < 0.00001), diastolic BP (R = 0.37, P < 0.00001) and ADMA (R = -0.20, P < 0.01) were significant predictors of SVRI. CONCLUSIONS These results suggest that plasma ADMA seems to play a role in the regulation of vascular tone in young healthy subjects.
Collapse
|
40
|
Ozsait B, Komurcu-Bayrak E, Jylha M, Perola M, Kristiansson K, Mononen N, Hurme M, Laaksonen R, Hervonen A, Erginel-Unaltuna N, Karhunen P, Lehtimaki T. USF1 GENE IS INVOLVED IN THE REGULATION OF HUMAN LONGEVITY. ATHEROSCLEROSIS SUPP 2008. [DOI: 10.1016/s1567-5688(08)70412-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
41
|
Komurcu-Bayrak E, Ozsait B, Mononen N, Laaksonen R, Onat A, Hergenc G, Lehtimaki T, Erginel-Unaltuna N. CRP GENE POLYMORPHISMS ARE INVOLVED IN THE REGULATION OF PLASMA CRP CONCENTRATIONS IN TURKISH POPULATION: TURKISH ADULT RISK FACTOR STUDY. ATHEROSCLEROSIS SUPP 2008. [DOI: 10.1016/s1567-5688(08)70419-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
42
|
Berthold HK, Laaksonen R, Lehtimäki T, Gylling H, Krone W, Gouni-Berthold I. SREBP-1c gene polymorphism is associated with increased inhibition of cholesterol-absorption in response to ezetimibe treatment. Exp Clin Endocrinol Diabetes 2007; 116:262-7. [PMID: 18072016 DOI: 10.1055/s-2007-993144] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Sterol regulatory binding proteins 1 and 2 (SREBPs) are transcription factors regulating lipid metabolism. A recent study has associated the CC genotype of the SREBP-1c polymorphism G952G with increased cholesterol synthesis. Further evidence suggests that SREBPs play a role in cholesterol absorption and that SREBP polymorphisms modulate the response to statin therapy. The present study examines whether the G952G polymorphism alters cholesterol synthesis and/or absorption and whether it modulates the response to widely used lipid-lowering drugs such as inhibitors of cholesterol synthesis (simvastatin) or absorption (ezetimibe). METHODS Seventy-two healthy male subjects with LDL cholesterol <190 mg/dL participated in the study. Twenty four subjects were treated with ezetimibe (10 mg), simvastatin (40 mg) or their combination, respectively, for two weeks. Blood was drawn before and after the 2-week treatment period. RESULTS Eleven CC homozygous carriers of the gene were found (15%). There were no differences in cholesterol synthesis or absorption between the CC homozygotes and the G allele-carriers, as measured by the ratios to cholesterol of serum lathosterol, desmosterol and cholestenol (synthesis markers) and cholestanol, sitosterol and campesterol (absorption markers). Ezetimibe had a significantly more potent effect in blocking cholesterol absorption in the CC homozygotes compared to the G-carriers ( P=0.002). CONCLUSIONS The G/C (G952G) polymorphism of the SREBP-1 gene is not associated with cholesterol synthesis or absorption in a German male population. The CC homozygotes have a significantly increased response to the effects of ezetimibe on cholesterol absorption compared to the G allele-carriers, suggesting that SREBP-1 may be implicated in ezetimibe's mechanism of action.
Collapse
Affiliation(s)
- H K Berthold
- Medical Faculty of the University of Bonn, Clinical Pharmacology, Bonn, Germany
| | | | | | | | | | | |
Collapse
|
43
|
Kähönen M, Lehtimäki T, Laaksonen R, Janatuinen T, Vesalainen R, Laine H, Raitakari OT, Nuutila P, Knuuti J, Nieminen T. Angiotensin-converting enzyme gene polymorphism and coronary reactivity in young men. Scand J Clin Lab Invest 2007; 67:596-603. [PMID: 17852816 DOI: 10.1080/00365510701213461] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
The purpose of the study was to examine whether the insertion/deletion (I/D) polymorphism of the angiotensin-converting enzyme (ACE) gene affects the vasodilatory properties of coronary arteries in healthy men. The ACE genotypes of 128 men (mean age 35 +/- 4 years) were determined and related to myocardial blood flow. The blood flow was measured by positron emission tomography at rest and during vasodilation caused by adenosine or dipyridamole infusion. The coronary flows and resistances at rest and during stimulation with adenosine or dipyridamole did not differ between the ACE genotypes. Furthermore, this polymorphism had no effect on coronary flow reserve corrected by a rate-pressure product. In conclusion, the ACE I/D polymorphism does not seem to affect myocardial reactivity--an early indicator of atherosclerosis--in healthy subjects.
Collapse
Affiliation(s)
- M Kähönen
- Department of Clinical Physiology, Tampere University Hospital and Medical School, University of Tampere, Finland
| | | | | | | | | | | | | | | | | | | |
Collapse
|
44
|
Schick B, Laaksonen R, Frohlich J, Paiva H, Lehtimaki T, Humphries K, Cote H. PO23-750 DECREASED SKELETAL MUSCLE MITOCHONDRIAL DNA IN PATIENTS TREATED WITH HIGH-DOSE SIMVASTATIN. ATHEROSCLEROSIS SUPP 2007. [DOI: 10.1016/s1567-5688(07)71760-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
45
|
Schick BA, Laaksonen R, Frohlich JJ, Päivä H, Lehtimäki T, Humphries KH, Côté HCF. Decreased Skeletal Muscle Mitochondrial DNA in Patients Treated with High-Dose Simvastatin. Clin Pharmacol Ther 2007; 81:650-3. [PMID: 17329991 DOI: 10.1038/sj.clpt.6100124] [Citation(s) in RCA: 80] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Statins are generally well tolerated, but can cause myopathy and have been associated with mitochondrial abnormalities. The aim of this study was to determine whether muscle mitochondrial DNA (mtDNA) levels are altered during statin therapy. We retrospectively quantified mtDNA in 86 skeletal muscle biopsy specimens collected as part of a previously published clinical trial of high-dose simvastatin or atorvastatin versus placebo.
Collapse
Affiliation(s)
- B A Schick
- Department of Pathology & Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada, and Research Unit, Tampere University Hospital, Finland
| | | | | | | | | | | | | |
Collapse
|
46
|
Abboud S, Viiri L, Luetjohann D, Blecic S, Friedrichs S, Karhunen P, Lehtimäki T, Pandolfo M, Laaksonen R. Mo-W4:4 ApoE gene promoter polymorphisms as determinant of middle age ischemic stroke. ATHEROSCLEROSIS SUPP 2006. [DOI: 10.1016/s1567-5688(06)80047-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
47
|
Laaksonen R, Janatuinen T, Vesalainen R, Lehtimäki T, Elovaara I, Jaakkola O, Jokela H, Laakso J, Nuutila P, Punnonen K, Raitakari O, Saikku P, Salminen K, Knuuti J. High oxidized LDL and elevated plasma homocysteine contribute to the early reduction of myocardial flow reserve in healthy adults. Eur J Clin Invest 2002; 32:795-802. [PMID: 12423319 DOI: 10.1046/j.1365-2362.2002.01051.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Impairment of coronary blood flow reserve has been shown to be an early manifestation of atherosclerosis and coronary artery disease (CAD). We studied more closely the contribution of various risk factors on early deterioration of coronary function. MATERIALS AND METHODS Fifty-one young, apparently healthy adults, with normal or mildly elevated serum cholesterol levels but without other major risk factors for CAD, such as diabetes or hypertension, underwent positron emission tomography (PET) studies. Coronary flow reserve (CFR) was measured using O15-water. In addition to the classical risk factors, the role of several new risk indicators, such as low-density lipoprotein (LDL) oxidation, infection (Chlamydia pneumoniae antibodies), and inflammation parameters (adhesion molecules, ICAM, VCAM, selectin, and C-reactive protein), homocysteine and body iron stores were investigated. RESULTS Elevated lipid and lipoprotein levels were not associated with reduced coronary reactivity. However, high autoantibody titers against oxidized LDL (oxLDL) were associated with 21% lower CFR than low oxLDL (P < 0.05). Furthermore, high homocysteine levels predicted low CFR (P < 0.05). The other measured parameters, Chlamydia pneumoniae antibody levels, C-reactive protein and adhesion molecule concentrations did not associate with myocardial blood flow. In a stepwise regression model, oxLDL (P = 0.03), homocysteine (P = 0.04) and triglycerides (P = 0.018) were significant predictors of CFR. CONCLUSIONS The present study suggests an important role for oxidized LDL and plasma homocysteine on early impairment of coronary reactivity in young adults.
Collapse
Affiliation(s)
- R Laaksonen
- Department of Medicine, University of Tampere, Finland
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Laaksonen R, Duggan C, Bates I. Desire for information about drugs: relationships with patients' characteristics and adverse effects. Pharm World Sci 2002; 24:205-10. [PMID: 12426966 DOI: 10.1023/a:1020542502118] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Adverse effects of drugs are known to cause problems both in hospital and general practice settings, contributing to longer stays in a hospital, and increased costs of hospitalisation. By developing both a greater understanding of adverse drug reactions and effects and developing ways to reduce them will assist pharmacists in managing medicines more effectively. The aim of this study was to explore the relationships between patient characteristics, information requirements and perceptions about adverse drug effects to assist pharmacists in identifying patients most at risk of ADRs. METHODS The study took place on medical wards at a London teaching hospital during an eight week period in Autumn 2000. Patients were recruited using convenience sampling during the recruitment period. Once eligible patients consented to take part, standardised interviews were conducted at their bedside. The interviews included the use of the previously validated scale which measures the extent of information desired (EID), patient characteristics including age, gender, socio-economic status etc and the presence of an adverse drug effect was assessed using the Naranjo algorithm. Patients were also asked semi-structured questions to explore past and present experiences of adverse drug effects. RESULTS 82 patients were recruited, 80 were eligible for adverse effects of drugs assessment. Fifteen percent (12/80) of patients were assessed as having "definite" and "probable" adverse drug effects, based on the Naranjo algorithm. The previously validated EID scale was found to be both valid and reliable in this patient sample. There was an association between high scores on the EID scale and the presence of an adverse drug effect (chi-squared = 4.97, p = 0.02). CONCLUSION The results show an association between the occurrence of an adverse drug effect on admission (identified by the Naranjo scale), the experience of an adverse drug effect in the past and a patient's desire for information. The EID-scale could be developed into a useful tool for assessing and addressing patients' drug information needs for pharmacists to use when assessing adverse drug effects in everyday practice.
Collapse
Affiliation(s)
- R Laaksonen
- Academic Department of Pharmacy, Barts & the London NHS Trust, West Smithfield, London EC1A 7BE, UK
| | | | | |
Collapse
|
49
|
Lehtimäki T, Laaksonen R, Mattila KM, Janatuinen T, Vesalainen R, Nuutila P, Laakso J, Jaakkola O, Koivula T, Knuuti J. Oestrogen receptor gene variation is a determinant of coronary reactivity in healthy young men. Eur J Clin Invest 2002; 32:400-4. [PMID: 12059984 DOI: 10.1046/j.1365-2362.2002.01010.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Oxidised low-density lipoprotein (ox-LDL) is a determinant of impaired coronary function and oestrogens inhibit its formation probably throughout genetically-variable oestrogen receptor 1 (ESR1) in artery wall. We hypothesized that the ESR1 polymorphism might influence coronary function and reactivity as measured by positron emission tomography (PET), which allows the detection of coronary dysfunction before appearance of angiographic lesions. MATERIALS AND METHODS Fifty-one healthy young men (aged 35 +/- 4 years), with normal or slightly-elevated serum cholesterol, underwent PET with intravenous adenosine. ESR1 PvuII genotypes P/P, P/p, and p/p in addition to the plasma autoantibody titre against ox-LDL, a marker of in vivo oxidation, were determined. RESULTS The ESR1 genotype persisted as the only significant predictor of adenosine stimulated coronary flow (P = 0.035) after adjustment for other coronary risk factors. Subjects with P/P genotype had 33.4 and 41.8% lower adenosine-stimulated flow values than subjects with P/p and p/p genotypes (P = 0.030). Furthermore, plasma levels of ox-LDL titre were on average 59 and 77% higher in subjects with P/P genotype than in subjects with P/p or p/p genotypes (P = 0.049). CONCLUSIONS These tentative findings from our pilot study provide evidence that genetic variation in ESR1 may modify coronary reactivity and LDL oxidation and reflect differences in the early pathogenesis of coronary dysfunction in these healthy young men.
Collapse
Affiliation(s)
- T Lehtimäki
- Department of Clinical hemistry, Centre for Laboratory Medicine, Tampere University Hospital and Tampere University Medical School, Tampere, Finland.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
50
|
Abstract
Asymmetrical dimethylarginine (ADMA) is an endogenous nitric oxide synthase inhibitor, which has been suggested to be a novel independent risk factor for endothelial dysfunction and coronary heart disease. We investigated the association of ADMA concentration in serum with risk of acute coronary events. We did a prospective, nested, case-control study in middle-aged men from eastern Finland. In an analysis of men who did not smoke, those who were in the highest quartile for ADMA (>0.62 micromol/L) had a 3.9-fold (95% CI 1.25-12.3, p=0.02) increase in risk of acute coronary events compared with the other quartiles. Our findings suggest that ADMA is a predictor of acute coronary events.
Collapse
Affiliation(s)
- V P Valkonen
- Research Institute of Public Health, University of Kuopio, Kuopio, Finland
| | | | | | | | | | | | | |
Collapse
|