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Oprescu N, Micheu MM, Scafa-Udriste A, Popa-Fotea NM, Dorobantu M. Inflammatory markers in acute myocardial infarction and the correlation with the severity of coronary heart disease. Ann Med 2021; 53:1041-1047. [PMID: 34180324 PMCID: PMC8245096 DOI: 10.1080/07853890.2021.1916070] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 04/07/2021] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION The inflammatory hypothesis of atherosclerosis is appealing in acute coronary syndromes, but the dynamics and precise role are not established. OBJECTIVES The study investigates the levels of C reactive protein (CRP), interleukin 1β (IL-1β) and stromal-derived factor 1α (SDF-1α) at the time of acute myocardial infarction (AMI) and at 1 and 6 months afterwards, compared with a control group. RESULTS In the acute phase of AMI, CRP and SDF-1α were significantly higher, while IL-1β showed lower levels compared with controls. CRP positively correlated with coronary stenosis severity (rho = 0.3, p=.05) and negatively related with left ventricle ejection fraction (LVEF) at 1 month (rho= -0.43, p=.05). IL-1β weakly correlated with the severity of coronary lesions (rho =0.29, p=.02) and strongly with LVEF (rho= -0.8, p=.05). SDF-1α, slightly correlated with LVEF at 1 month (rho = 0.22, p=.01) and with the severity of coronary atherosclerosis (rho= -0.41, p=.003). CONCLUSIONS CRP, IL-1β and SDF-1α have important dynamic in the first 6 months after AMI and CRP and SDF-1α levels correlated with the severity of coronary lesions and LVEF at 1 month after the acute ischaemic event.
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Affiliation(s)
- Nicoleta Oprescu
- Department of Cardiology, Clinical Emergency Hospital of Bucharest, Romania
| | | | - Alexandru Scafa-Udriste
- Department of Cardiology, Clinical Emergency Hospital of Bucharest, Romania
- Cardio-thoracic Department, University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania
| | - Nicoleta-Monica Popa-Fotea
- Department of Cardiology, Clinical Emergency Hospital of Bucharest, Romania
- Cardio-thoracic Department, University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania
| | - Maria Dorobantu
- Department of Cardiology, Clinical Emergency Hospital of Bucharest, Romania
- Cardio-thoracic Department, University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania
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Owen DG, de Oliveira DC, Neale EK, Shepherd DET, Espino DM. Numerical modelling of blood rheology and platelet activation through a stenosed left coronary artery bifurcation. PLoS One 2021; 16:e0259196. [PMID: 34731193 PMCID: PMC8565790 DOI: 10.1371/journal.pone.0259196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 07/28/2021] [Accepted: 10/14/2021] [Indexed: 01/09/2023] Open
Abstract
Coronary bifurcations are prone to atherosclerotic plaque growth, experiencing regions of reduced wall shear stress (WSS) and increased platelet adhesion. This study compares effects across different rheological approaches on hemodynamics, combined with a shear stress exposure history model of platelets within a stenosed porcine bifurcation. Simulations used both single/multiphase blood models to determine which approach best predicts phenomena associated with atherosclerosis and atherothrombosis. A novel Lagrangian platelet tracking model was used to evaluate residence time and shear history of platelets indicating likely regions of thrombus formation. Results show a decrease in area of regions with pathologically low time-averaged WSS with the use of multiphase models, particularly in a stenotic bifurcation. Significant non-Newtonian effects were observed due to low-shear and varying hematocrit levels found on the outer walls of the bifurcation and distal to the stenosis. Platelet residence time increased 11% in the stenosed artery, with exposure times to low-shear sufficient for red blood cell aggregation (>1.5 s). increasing the risk of thrombosis. This shows stenotic artery hemodynamics are inherently non-Newtonian and multiphase, with variations in hematocrit (0.163-0.617) and elevated vorticity distal to stenosis (+15%) impairing the function of the endothelium via reduced time-averaged WSS regions, rheological properties and platelet activation/adhesion.
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Affiliation(s)
- David G. Owen
- Department of Mechanical Engineering, University of Birmingham, Birmingham, United Kingdom
| | - Diana C. de Oliveira
- Department of Mechanical Engineering, University of Birmingham, Birmingham, United Kingdom
| | - Emma K. Neale
- Department of Mechanical Engineering, University of Birmingham, Birmingham, United Kingdom
| | - Duncan E. T. Shepherd
- Department of Mechanical Engineering, University of Birmingham, Birmingham, United Kingdom
| | - Daniel M. Espino
- Department of Mechanical Engineering, University of Birmingham, Birmingham, United Kingdom
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Lou YM, Zheng ZL, Xie LY, Lian JF, Shen WJ, Zhou JQ, Shao GF, Hu DX. Effects of Spironolactone on Hypoxia-Inducible Factor-1α in the Patients Receiving Coronary Artery Bypass Grafting. J Cardiovasc Pharmacol 2021; 78:e101-e104. [PMID: 34173801 DOI: 10.1097/fjc.0000000000001040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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] [Received: 12/03/2020] [Accepted: 03/24/2021] [Indexed: 11/26/2022]
Abstract
ABSTRACT We explored the protective effect of spironolactone on cardiac function in the patients undergoing coronary artery bypass grafting (CABG) by determining serum hypoxia-inducible factor-1α (HIF-1α) before and after CABG. We used the propensity score matching method retrospectively to select 174 patients undergoing CABG in our hospital from March 2018 to December 2019. Of the 174 patients, 87 patients taking spironolactone for more than 3 months before CABG were used as a test group and other 87 patients who were not taking spironolactone as a control group. In all patients, serum HIF-1α and troponin I levels were determined before as well as 24 hours and 7 days after CABG, serum N-terminal probrain natriuretic peptide (NT-proBNP) level was determined before as well as 12, 24, and 36 hours after CABG, and electrocardiographic monitoring was performed within 36 hours after CABG. The results indicated that there were no significant differences in the HIF-1α level between the test group and the control group before and 7 days after CABG, but the HIF-1α level was significantly lower in the test group than that in the control group 24 hours after CABG (P < 0.01). The 2 groups were not significantly different in the troponin I level at any time point. There was no significant difference in the serum NT-proBNP level between the test group and the control group before CABG, but NT-proBNP (BNP) levels were all significantly lower in the test group than those in the control group at postoperative 12, 24, and 36 hour time points (all P <0.05). The incidence of postoperative atrial fibrillation was also significantly lower in the test group than that in the control group (P = 0.035). Spironolactone protects cardiac function probably by improving myocardial hypoxia and inhibiting myocardial remodeling.
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Affiliation(s)
- Yu-Mei Lou
- Department of Cardiovascular Disease, Ningbo Medical Centre Lihuili Hospital, Ningbo University, Ningbo, Zhejiang, China ; and
| | - Zhe-Lan Zheng
- Echocardiography and Vascular Ultrasound Center, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Lin-Yuan Xie
- Echocardiography and Vascular Ultrasound Center, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Jiang-Fang Lian
- Department of Cardiovascular Disease, Ningbo Medical Centre Lihuili Hospital, Ningbo University, Ningbo, Zhejiang, China ; and
| | - Wen-Jun Shen
- Department of Cardiovascular Disease, Ningbo Medical Centre Lihuili Hospital, Ningbo University, Ningbo, Zhejiang, China ; and
| | - Jian-Qing Zhou
- Department of Cardiovascular Disease, Ningbo Medical Centre Lihuili Hospital, Ningbo University, Ningbo, Zhejiang, China ; and
| | - Guo-Feng Shao
- Department of Cardiovascular Disease, Ningbo Medical Centre Lihuili Hospital, Ningbo University, Ningbo, Zhejiang, China ; and
| | - De-Xing Hu
- Department of Cardiovascular Disease, Ningbo Medical Centre Lihuili Hospital, Ningbo University, Ningbo, Zhejiang, China ; and
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Yamamoto H, Shinke T, Otake H, Kawamori H, Toba T, Kuroda M, Hirota Y, Sakaguchi K, Ogawa W, Hirata K. Impact of daily glucose fluctuations on cardiovascular outcomes after percutaneous coronary intervention for patients with stable coronary artery disease undergoing lipid-lowering therapy. J Diabetes Investig 2021; 12:1015-1024. [PMID: 33098191 PMCID: PMC8169349 DOI: 10.1111/jdi.13448] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Accepted: 10/20/2020] [Indexed: 12/20/2022] Open
Abstract
AIMS/INTRODUCTION Glucose fluctuation (GF) is a residual risk factor for coronary artery disease (CAD). We investigated whether GF influenced clinical outcomes and progression of coronary stenosis in stable CAD patients. MATERIALS AND METHODS In this prospective study, 101 consecutive lipid-controlled stable CAD patients underwent percutaneous coronary intervention were enrolled, and GF was expressed as the mean amplitude of glycemic excursion (MAGE) obtained by continuous glucose monitoring before the procedure was evaluated. At 9 months after enrollment, culprit and non-culprit (mild-to-moderate stenosis without ischemia) lesions were serially assessed by angiography. Cardiovascular events (CVE) consisting of cardiovascular death, non-fatal myocardial infarction or ischemia-driven revascularization during 2-year follow up, rapid progression in non-culprit lesions (defined as ≥10% luminal narrowing progression in lesions with stenosis ≥50%, ≥30% luminal narrowing progression in non-culprit lesions with stenosis <50% or normal segment, or progression to total occlusion) were evaluated. RESULTS CVE occurred in 25 patients, and MAGE was significantly higher in the CVE group (76.1 ± 24.8 mg/dL vs 59.3 ± 23.7 mg/dL; P = 0.003). Multivariate analysis showed that MAGE was an independent predictor of CVE (odds ratio 1.027, 95% confidence interval 1.008-1.047; P = 0.005). The optimal MAGE value to predict CVE was 70.7 mg/dL (area under the curve 0.687, 95% confidence interval 0.572-0.802; P = 0.005). Furthermore, MAGE was independently associated with rapid progression, and with the luminal narrowing progression in all non-culprit lesions (r = 0.400, P < 0.05). CONCLUSIONS Daily GF might influence future CVE in lipid-controlled stable CAD patients.
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Affiliation(s)
- Hiroyuki Yamamoto
- Division of Cardiovascular MedicineDepartment of Internal MedicineKobe University Graduate School of MedicineKobeJapan
| | - Toshiro Shinke
- Division of Cardiovascular MedicineDepartment of Internal MedicineKobe University Graduate School of MedicineKobeJapan
- Division of CardiologyDepartment of MedicineShowa University School of MedicineTokyoJapan
| | - Hiromasa Otake
- Division of Cardiovascular MedicineDepartment of Internal MedicineKobe University Graduate School of MedicineKobeJapan
| | - Hiroyuki Kawamori
- Division of Cardiovascular MedicineDepartment of Internal MedicineKobe University Graduate School of MedicineKobeJapan
| | - Takayoshi Toba
- Division of Cardiovascular MedicineDepartment of Internal MedicineKobe University Graduate School of MedicineKobeJapan
| | - Masaru Kuroda
- Division of Cardiovascular MedicineDepartment of Internal MedicineKobe University Graduate School of MedicineKobeJapan
| | - Yushi Hirota
- Division of Diabetes and EndocrinologyDepartment of Internal MedicineKobe University Graduate School of MedicineKobeJapan
| | - Kazuhiko Sakaguchi
- Division of Diabetes and EndocrinologyDepartment of Internal MedicineKobe University Graduate School of MedicineKobeJapan
| | - Wataru Ogawa
- Division of Diabetes and EndocrinologyDepartment of Internal MedicineKobe University Graduate School of MedicineKobeJapan
| | - Ken‐ichi Hirata
- Division of Cardiovascular MedicineDepartment of Internal MedicineKobe University Graduate School of MedicineKobeJapan
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Gao J, Yang YN, Cui Z, Feng SY, Ma J, Li CP, Liu Y. Pcsk9 is associated with severity of coronary artery lesions in male patients with premature myocardial infarction. Lipids Health Dis 2021; 20:56. [PMID: 34044829 PMCID: PMC8161665 DOI: 10.1186/s12944-021-01478-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 05/06/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Proprotein convertase subtilisin/kexin type 9 (Pcsk9) correlated with incidence and prognosis of coronary heart disease. However, it is unclear whether Pcsk9 contributed to coronary artery lesion severity in patients with premature myocardial infarction (PMI). The present study investigated associations between Pcsk9 and coronary artery lesion severity in PMI patients who underwent coronary angiography (CAG). METHODS This prospective cohort study included young men (age ≤ 45 years, n = 332) with acute MI who underwent CAG between January 2017 and July 2019. Serum Pcsk9 levels and clinical characteristics were evaluated. SYNTAX scores (SYNergy between percutaneous coronary intervention with [paclitaxel-eluting] TAXUS stent and cardiac surgery) were calculated to quantify coronary artery lesions. RESULTS Serum Pcsk9 levels were positively associated with SYNTAX scores (r = 0.173, P < 0.05). The diagnostic cutoff value of PSCK9 level was 122.9 ng/mL, yielding an area under the curve (AUC) of 0.63, sensitivity 81%, and specificity 40%. Serum Pcsk9, LDL-C, Apob, NT-proBnp, CK level, and diabetes history were independent predictors of high SYNTAX scores (P < 0.05). After stratifying by serum LDL-C level (cutoff = 2.6 mmol/L), medium-high Pcsk9 levels had increased risk of high SYNTAX scores in patients with high LDL-C (P < 0.05), and higher serum Pcsk9 levels had increased risk of major adverse cardiac events (MACE) after adjusting for confounding factors (P < 0.05). CONCLUSION Serum Pcsk9 levels correlates with severity of coronary artery lesion in PMI patients and may serve as a biomarker for severity of coronary artery stenosis in this patient population, which may contribute to risk stratification.
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Affiliation(s)
- Jing Gao
- Chest Hospital, Tianjin University, No.92 Weijin Road Nankai District, Tianjin, 300072, P.R. China
- Thoracic Clinical College, Tianjin Medical University, No.22 Qi xiang tai Road, Heping District, Tianjin, 300070, P.R. China
- Cardiovascular Institute, Tianjin Chest Hospital, No.261 Tai erzhuang Road, Jinnan District, Tianjin, 300222, P.R. China
| | - Ya-Nan Yang
- Tianjin Medical University, No.22 Qi xiangtai Road, Heping District, Tianjin, 300070, P.R. China
| | - Zhuang Cui
- Tianjin Medical University, No.22 Qi xiangtai Road, Heping District, Tianjin, 300070, P.R. China
| | - Si-Yuan Feng
- Tianjin Medical University, No.22 Qi xiangtai Road, Heping District, Tianjin, 300070, P.R. China
| | - Jing Ma
- Cardiovascular Institute, Tianjin Chest Hospital, No.261 Tai erzhuang Road, Jinnan District, Tianjin, 300222, P.R. China
| | - Chang-Ping Li
- Tianjin Medical University, No.22 Qi xiangtai Road, Heping District, Tianjin, 300070, P.R. China.
| | - Yin Liu
- Thoracic Clinical College, Tianjin Medical University, No.22 Qi xiang tai Road, Heping District, Tianjin, 300070, P.R. China.
- Department of Cardiology, Tianjin Chest Hospital, No.261 Tai erzhuang Road, Jinnan District, Tianjin, 300222, P.R. China.
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Noto D, Cefalù AB, Martinelli N, Giammanco A, Spina R, Barbagallo CM, Caruso M, Novo S, Sarullo F, Pernice V, Brucato F, Ingrassia V, Fayer F, Altieri GI, Scrimali C, Misiano G, Olivieri O, Girelli D, Averna MR. rs629301 CELSR2 polymorphism confers a ten-year equivalent risk of critical stenosis assessed by coronary angiography. Nutr Metab Cardiovasc Dis 2021; 31:1542-1547. [PMID: 33810964 DOI: 10.1016/j.numecd.2021.01.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 01/15/2021] [Accepted: 01/22/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND AND AIMS Novel genetic determinants associated with coronary artery disease (CAD) have been discovered by genome wide association studies. Variants encompassing the CELSR2- PSRC1-SORT1 gene cluster have been associated with CAD. This study is aimed to investigate the rs629301 polymorphism association with the extent of CAD evaluated by coronary angiography (CAG), and to evaluate its associations with an extensive panel of lipid and lipoprotein measurements in a large Italian cohort of 2429 patients. METHODS AND RESULTS The patients were collected by four Intensive Care Units located in Palermo and Verona (Italy). Clinical Records were filed, blood samples were collected, lipids and apolipoproteins (apo) were measured in separate laboratories. CAD was defined by the presence of stenotic arteries (>50% lumen diameter) by CAG. The presence of CAD was associated with the rs629301 genotype. Patients with CAD were 78% and 73% (p = 0.007) of the T/T vs. T/G + G/G genotype carriers respectively. T/T genotype was also correlated with the number of stenotic arteries, with a 1.29 (1.04-1.61) risk to have a three-arteries disease. T/T genotype correlated with higher levels of LDL-, non-HDL cholesterol, apoB, apoE and apoCIII, and lower HDL-cholesterol. Logistic Regression confirmed that rs629301was associated with CAD independently from the common risk factors, with a risk similar to that conferred by ten years of age [odds ratios were 1.43 (1.04-1.96) and 1.39 (1.22-1.58) respectively]. CONCLUSIONS rs629301 risk allele was independently associated with the extension and severity of CAD and positively with apoE and apoB containing lipoproteins.
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Affiliation(s)
- Davide Noto
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy.
| | - Angelo B Cefalù
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Nicola Martinelli
- Department of Medicine, Unit of Internal Medicine, University of Verona, Italy
| | - Antonina Giammanco
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Rossella Spina
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Carlo M Barbagallo
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Marco Caruso
- Intensive Care Unit, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Italy
| | - Salvatore Novo
- Intensive Care Unit, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Italy
| | - Filippo Sarullo
- Intensive Care Unit, "Buccheri La Ferla" Hospital, Palermo, Italy
| | - Vincenzo Pernice
- Intensive Care Unit, "Villa Maria Eleonora" Hospital, Palermo, Italy
| | - Federica Brucato
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Valeria Ingrassia
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Francesca Fayer
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Grazia I Altieri
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Chiara Scrimali
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Gabriella Misiano
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Oliviero Olivieri
- Department of Medicine, Unit of Internal Medicine, University of Verona, Italy
| | - Domenico Girelli
- Department of Medicine, Unit of Internal Medicine, University of Verona, Italy
| | - Maurizio R Averna
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
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Han Y, Hua S, Chen Y, Yang W, Zhao W, Huang F, Qiu Z, Yang C, Jiang J, Su X, Yang K, Jin W. Circulating PGLYRP1 Levels as a Potential Biomarker for Coronary Artery Disease and Heart Failure. J Cardiovasc Pharmacol 2021; 77:578-585. [PMID: 33760799 DOI: 10.1097/fjc.0000000000000996] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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] [Received: 10/11/2020] [Accepted: 01/28/2021] [Indexed: 11/26/2022]
Abstract
ABSTRACT Coronary artery disease (CAD) and associated comorbidities such as heart failure (HF) remain the leading cause of morbidity and mortality worldwide attributed to, at least partially, the lack of biomarkers for efficient disease diagnosis. Here, we evaluated the diagnostic potential of serum peptidoglycan recognition protein 1 (PGLYRP1), an important component of the innate immunity and inflammation system, for both CAD and HF. A machine-learning method (random forest) was used to evaluate the clinical utility of circulating PGLYRP1 for diagnosis of CAD and HF in a total of 370 individuals. Causal links of chronic serum PGLYRP1 elevation to both diseases were further explored in ApoE-/- mice. The serum levels of PGLYRP1 were significantly higher in individuals with either chronic CAD or acute coronary syndrome than those in those without coronary artery stenosis (the control group) and even more pronounced in CAD individuals with concomitant HF. Our random forest classifier revealed that this protein performed better than other recommended clinical indicators in distinguishing the CAD from the control individuals. In addition, this protein associates more with the biomarkers of HF including left ventricular ejection fraction than inflammation. Notably, our mice experiment indicated that long-term treatment with recombinant PGLYRP1 could significantly impair the cardiovascular system as reflected from both increased atherogenic lesions and reduced fractional shortening of the left ventricle. Our findings, therefore, supported the circulating levels of PGLYRP1 as a valuable biomarker for both CAD and HF.
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Affiliation(s)
- Yanxin Han
- Department of Cardiology, Institute of Cardiovascular Diseases, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China ; and
| | - Sha Hua
- Department of Cardiology, RuiJin Hospital/Lu Wan Branch, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yanjia Chen
- Department of Cardiology, Institute of Cardiovascular Diseases, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China ; and
| | - Wenbo Yang
- Department of Cardiology, Institute of Cardiovascular Diseases, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China ; and
| | - Weilin Zhao
- Department of Cardiology, Institute of Cardiovascular Diseases, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China ; and
| | - Fanyi Huang
- Department of Cardiology, Institute of Cardiovascular Diseases, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China ; and
| | - Zeping Qiu
- Department of Cardiology, Institute of Cardiovascular Diseases, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China ; and
| | - Chendie Yang
- Department of Cardiology, Institute of Cardiovascular Diseases, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China ; and
| | - Jie Jiang
- Department of Cardiology, Institute of Cardiovascular Diseases, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China ; and
| | - Xiuxiu Su
- Department of Cardiology, Institute of Cardiovascular Diseases, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China ; and
| | - Ke Yang
- Department of Cardiology, Institute of Cardiovascular Diseases, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China ; and
| | - Wei Jin
- Department of Cardiology, Institute of Cardiovascular Diseases, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China ; and
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Siepmann R, Nilius H, Mueller F, Mueller K, Luisi C, Dadfar SM, Straub M, Schulz V, Reinartz SD. Image-derived mean velocity measurement for prediction of coronary flow reserve in a canonical stenosis phantom using magnetic particle imaging. PLoS One 2021; 16:e0249697. [PMID: 33886607 PMCID: PMC8061921 DOI: 10.1371/journal.pone.0249697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 07/01/2020] [Accepted: 03/24/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Aim of this study is to evaluate whether magnetic particle imaging (MPI) is capable of measuring velocities occurring in the coronary arteries and to compute coronary flow reserve (CFR) in a canonical phantom as a preliminary study. METHODS For basic velocity measurements, a circulation phantom was designed containing replaceable glass tubes with three varying inner diameters, matching coronary-vessel diameters. Standardised boluses of superparamagnetic-iron-oxide-nanoparticles were injected and visualised by MPI. Two image-based techniques were competitively applied to calibrate the respective glass tube and to compute the mean velocity: full-duration-at-half-maximum (FDHM) and tracer dilution (TD) method. For CFR-calculation, four necessary settings of the circulation model of a virtual vessel with an inner diameter of 4 mm were generated using differently sized glass tubes and a stenosis model. The respective velocities in stenotic glass tubes were computed without recalibration. RESULTS On velocity level, comparison showed a good agreement (rFDHM = 0.869, rTD = 0.796) between techniques, preferably better for 4 mm and 6 mm inner diameter glass tubes. On CFR level MPI-derived CFR-prediction performed considerably inferior with a relative error of 20-44%. CONCLUSIONS MPI has the ability to reliably measure coronary blood velocities at rest as well as under hyperaemia and therefore may be suitable for CFR calculation. Calibration-associated accuracy of CFR-measurements has to be improved substantially in further studies.
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Affiliation(s)
- Robert Siepmann
- Physics of Molecular Imaging Systems, RWTH Aachen University, Aachen, Germany
| | - Henning Nilius
- Physics of Molecular Imaging Systems, RWTH Aachen University, Aachen, Germany
| | - Florian Mueller
- Physics of Molecular Imaging Systems, RWTH Aachen University, Aachen, Germany
| | - Katrin Mueller
- Physics of Molecular Imaging Systems, RWTH Aachen University, Aachen, Germany
| | - Claudio Luisi
- Applied Medical Engineering, RWTH Aachen University, Aachen, Germany
| | | | - Marcel Straub
- Physics of Molecular Imaging Systems, RWTH Aachen University, Aachen, Germany
| | - Volkmar Schulz
- Physics of Molecular Imaging Systems, RWTH Aachen University, Aachen, Germany
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Wang Z, Liu Y, Wang W, Qu H, Han Y, Hou Y. Association of dipeptidyl peptidase IV polymorphism, serum lipid profile, and coronary artery stenosis in patients with coronary artery disease and type 2 diabetes. Medicine (Baltimore) 2021; 100:e25209. [PMID: 33787603 PMCID: PMC8021284 DOI: 10.1097/md.0000000000025209] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 02/24/2021] [Indexed: 01/04/2023] Open
Abstract
Cardiovascular disease (CAD) is a devastating illness, but to date there are limited means of predicting a person's coronary stenosis severity and their prognosis. The study was performed to investigate the relationship between dipeptidyl peptidase 4(DPP4) gene polymorphisms and serum lipid profiles, as well as the severity of coronary artery stenosis in patients with CAD and type 2 diabetes (T2DM) for the first time.Herein, 201 patients with CAD and T2DM were enrolled in the Department of Cardiology, Shandong Provincial Qianfoshan Hospital. DPP4 rs3788979 and rs7608798 single nucleotide polymorphisms (SNPs) were genotyped. The general information of all patients was collected, and the associations between DPP4 SNPs and lipid profiles were detected. At the same time, association between SNP polymorphisms and the degree of coronary artery stenosis were analyzed.There was a significant difference in apolipoprotein B (ApoB) levels (P = .011) for the rs3788979 polymorphism, while no difference was identified in other blood lipids or with other mutations. SNP mutation of A to G in rs3788979 was associated with a reduced percentage of severe coronary artery stenosis in female patients (P = .023) as well as those with nosmoking (P = .030), nodrinking (P = 0.007), and nocardiovascular family history (P = 0.015).G allele of rs3788979 is associated with a reduced ApoB level. Besides, we suggest that G allele in rs3788979 may have a cardioprotective effect and prove to be a useful and specific measure when predicting a patient's coronary stenosis severity if diagnosed with CAD and T2DM.
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Affiliation(s)
- Zhongsu Wang
- Department of Cardiology, Shandong Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, PR China
- Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, PR China
| | - Yang Liu
- Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, PR China
- Department of Cardiology, Tengzhou Central People's Hospital, Shandong Province, PR China
| | - Weizong Wang
- Department of Cardiology, Shandong Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, PR China
| | - Haiyan Qu
- Department of Cardiology, Shandong Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, PR China
| | - Yi Han
- Department of Pharmacy, Shandong Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, PR China
| | - Yinglong Hou
- Department of Cardiology, Shandong Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, PR China
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Dai H, Wang J, Shi Z, Ji X, Huang Y, Zhou R. Predictive value of miRNA-21 on coronary restenosis after percutaneous coronary intervention in patients with coronary heart disease: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e24966. [PMID: 33725861 PMCID: PMC7969307 DOI: 10.1097/md.0000000000024966] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 02/10/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Evidence reveals that microRNA (miRNA) can predict coronary restenosis in patients suffering from coronary heart disease (CHD) after percutaneous coronary intervention (PCI). Perhaps, miRNA-21 is a promising biomarker for the diagnosis of coronary restenosis after PCI. However, the accuracy of miRNA-21 has not been systematically evaluated. Therefore, it is necessary to perform meta-analysis to certify the diagnostic values of miRNA-21 on coronary restenosis after PCI. METHODS China National Knowledge Infrastructure, Wanfang, VIP, and China Biology Medicine disc, PubMed, EMBASE, Cochrane Library, and Web of Science were searched for relevant studies to explore the potential diagnostic values of miRNA-21 on coronary restenosis after PCI from inception to January 2021. All data were extracted by 2 experienced researchers independently. The risk of bias about the meta-analysis was confirmed by the Quality Assessment of Diagnostic Accuracy Studies-2. The data extracted were synthesized and heterogeneity was investigated as well. All of the above statistical analyses were carried out with Stata 16.0. RESULTS This study proved the pooled diagnostic performance of miRNA-21 on coronary restenosis after PCI. CONCLUSION This study clarified confusions about the specificity and sensitivity of miRNA-21 on coronary restenosis after PCI, thus further guiding their promotion and application. ETHICS AND DISSEMINATION Ethical approval is not required for this study. The systematic review will be published in a peer-reviewed journal, presented at conferences, and shared on social media platforms. This review would be disseminated in a peer-reviewed journal or conference presentations. OSF REGISTRATION NUMBER DOI 10.17605/OSF.IO/356QK.
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Affiliation(s)
| | | | | | | | | | - Rui Zhou
- Third Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou People's Hospital, Wenzhou, Zhejiang province, China
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Ghamar Talepoor A, Khosropanah S, Doroudchi M. Functional subsets of circulating follicular helper T cells in patients with atherosclerosis. Physiol Rep 2020; 8:e14637. [PMID: 33230950 PMCID: PMC7683878 DOI: 10.14814/phy2.14637] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 10/11/2020] [Accepted: 10/13/2020] [Indexed: 12/14/2022] Open
Abstract
Frequencies of circulating T follicular helper (cTfh) functional subsets vary in autoimmune diseases. We evaluated the frequencies and clinical relevance of functional subsets of cTfhs in patients with different degrees of stenosis. Blood samples were collected from high (≥50%) (n = 12) and low (<50%) stenosis (n = 12) groups and healthy controls (n = 6). Three subsets of cTfh cells including cTfh1 (CXCR3+ CCR6- ), cTfh2 (CXCR3- CCX6- ), and cTfh17 (CXCR3- CCR6+ ) were detected by flow cytometry. The frequency of cTfh1 cells was higher in control (p = .0006) and low-stenosis groups (p = .005) compared to high-stenosis group. The percentages of cTfh2 and cTfh17 cells were increased in high-stenosis compared to low-stenosis (p = .002 and p = .007) and control groups (p = .0004 and p = .0005), respectively. The frequency of cTfh1 cells negatively correlated with cholesterol (p = .040; r = -.44), C-reactive protein (CRP) (p = .015; r = -.68), erythrocyte sedimentation rate (ESR) (p = .002; r = -.79), neutrophil/lymphocyte ratio (NLR) (p = .028; r = -.67), and cTfh17 (p = .017; r = -.7244) in the high-stenosis group. The percentages of cTfh2 and cTfh17 cells positively correlated with cholesterol (p = .025; r = .77 and p = .033; r = .71), CRP (p = .030; r = .61 and p = .020; r = .73), ESR (p = .027; r = .69 and p = .029; r = .70), NLR (p = .004; r = .76 and p = .005; r = .74), and with each other (p = .022; r = .7382), respectively, in the high-stenosis group. The increased frequencies of cTfh2 and cTfh17 subsets and their correlation with laboratory parameters in patients with atherosclerosis may suggest their role in promoting the inflammatory response and atherosclerosis progression.
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Affiliation(s)
- Atefe Ghamar Talepoor
- Department of ImmunologySchool of MedicineShiraz University of Medical SciencesShirazIran
| | - Shahdad Khosropanah
- Department of CardiologySchool of MedicineShiraz University of Medical SciencesShirazIran
| | - Mehrnoosh Doroudchi
- Department of ImmunologySchool of MedicineShiraz University of Medical SciencesShirazIran
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Teren A, Vogel A, Beutner F, Gielen S, Burkhardt R, Scholz M, Thiery J, Ceglarek U. Relationship between fermented dairy consumption, circulating short-chain acylcarnitines and angiographic severity of coronary artery disease. Nutr Metab Cardiovasc Dis 2020; 30:1662-1672. [PMID: 32684363 DOI: 10.1016/j.numecd.2020.05.031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 05/13/2020] [Accepted: 05/27/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND AIMS Current epidemiologic data suggest beneficial cardiovascular effects of fermented dairy products (FDP). However, the relationship between FDP consumption and angiographic coronary status has not been previously studied. Furthermore, the role of novel metabolomic biomarkers of cardiovascular risk in this context is unclear. We hypothesize that short-chain acylcarnitines (SCA) reflect the link between FDP intake and angiographic extent of stable coronary artery disease (CAD). METHODS AND RESULTS We recruited 1185 patients admitted for suspected CAD [median age 62 years (interquartile range: 54-69); 714 men (60.3%)]. Prior to coronary angiography, each patient completed a validated Food Frequency Questionnaire. In addition, venous blood was collected from each patient for whole blood metabolomic analysis, using targeted mass-spectrometry. CAD was defined by the presence of ≥1 coronary stenosis ≥50%. Patients with CAD (n = 441) reported lower median FDP intake [86.8 g/day (IQR: 53.4-127.6)] than patients without CAD [n = 744; 103.9 g/day (IQR: 62.9-152.7); p < 0.001]. Upon adjustment for relevant confounders, increased circulating SCA, particularly level of acetylcarnitine (C2) associated with both higher CAD probability [SCA:β(SE) = 0.584 (0.235), p = 0.013; C2:β(SE) = 0.575 (0.242), p = 0.017] and decreased FDP consumption [SCA:β/100 g FDP-increment/day (SE) = -0.785 (0.242), p = 0.001; C2:β(SE) = -0.560 (0.230), p = 0.015]. By mediation analysis, neither SCA nor C2 showed relevant mediator effect linking FDP consumption to the risk of CAD. CONCLUSION Increased consumption of fermented milk was associated with lower prevalence of CAD and correlated inversely with circulating SCA, in particular with acetylcarnitine. No substantial mediator effect of SCA linking fermented milk intake with risk of CAD was found. CLINICAL TRIAL REGISTRY NCT00497887.
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Affiliation(s)
- Andrej Teren
- LIFE - Leipzig Research Center for Civilization Diseases, Germany; University Leipzig, Germany; Department of Cardiology, Angiology and Intensive Care, Detmold, Germany; Klinikum Lippe, Detmold, Germany.
| | - Anika Vogel
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Leipzig, Germany
| | - Frank Beutner
- LIFE - Leipzig Research Center for Civilization Diseases, Germany; University Leipzig, Germany; Department of Internal Medicine/Cardiology, Germany; Heart Center University Leipzig, Germany; Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Leipzig, Germany
| | - Stephan Gielen
- LIFE - Leipzig Research Center for Civilization Diseases, Germany; University Leipzig, Germany; Department of Cardiology, Angiology and Intensive Care, Detmold, Germany; Klinikum Lippe, Detmold, Germany
| | - Ralph Burkhardt
- LIFE - Leipzig Research Center for Civilization Diseases, Germany; University Leipzig, Germany; Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Leipzig, Germany
| | - Markus Scholz
- LIFE - Leipzig Research Center for Civilization Diseases, Germany; University Leipzig, Germany; Institute of Medical Informatics, Statistics and Epidemiology, Germany
| | - Joachim Thiery
- LIFE - Leipzig Research Center for Civilization Diseases, Germany; University Leipzig, Germany; Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Leipzig, Germany
| | - Uta Ceglarek
- LIFE - Leipzig Research Center for Civilization Diseases, Germany; University Leipzig, Germany; Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Leipzig, Germany
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Elad B, Koren O, slim W, Turgeman Y, Avraham G, Schwartz N, Elias M. Thrombin generation's role in predicting coronary disease severity. PLoS One 2020; 15:e0237024. [PMID: 32764787 PMCID: PMC7413409 DOI: 10.1371/journal.pone.0237024] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Accepted: 07/17/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Thrombin, a key enzyme of the clotting system, is involved in thrombus formation, platelet activation, and atherosclerosis, thereby possessing a central role in the pathogenesis of ischemic heart disease. Studies have shown an association between thrombin generation (TG) and cardiovascular morbidity and mortality, but results have been equivocal. Our aim was to study the predictive ability of TG assay in evaluating coronary stenosis severity. METHODS In this prospective study we recruited patients with acute coronary syndrome (ACS) or acute chest pain (without evidence of myocardial injury) planned for coronary angiography. Thrombin generation was evaluated by Calibrated Automated Thrombogram (CAT) prior to angiography. Primary end points were significant coronary stenosis and the Syntax I score evaluated by coronary angiography. RESULTS From April 2018 through September 2019, we recruited 128 patients. In the primary analysis there was no significant association between TG and significant coronary stenosis nor between TG and syntax I score, however, there was a positive correlation between peak height and troponin peak (Spearman correlation coefficient 0.194, P-value = 0.035). In sub-group analysis, the chest pain group bare no association between TG and coronary stenosis. In unstable angina group there was an association between peak height and significant coronary stenosis (P-value = 0.029), and in non ST-elevation myocardial infarction group, TG values possessed a relatively good predictive ability of significant coronary stenosis (area under the receiver operating characteristic curve of ~65%) and a positive correlation between both lag time and ttpeak with the syntax I score was noticed (Spearman correlation coefficient 0.31, P-value = 0.099 and Spearman correlation coefficient 0.37, P-value = 0.045 respectively). CONCLUSION In patients with acute chest pain, TG values, evaluated by CAT, do not predict severity of coronary stenosis, nor do they possess prognostic value. Yet, in ACS patients, TG may have the ability to predict coronary disease severity.
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Affiliation(s)
- Boaz Elad
- Internal Medicine C, Emek Medical Center, Afula, Israel
- * E-mail:
| | - Ofir Koren
- Heart Institute, Emek Medical Center, Afula, Israel
- Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Wasin slim
- Emergency Department, Emek Medical Center, Afula, Israel
| | - Yoav Turgeman
- Heart Institute, Emek Medical Center, Afula, Israel
- Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Gilat Avraham
- Internal Medicine C, Emek Medical Center, Afula, Israel
| | - Naama Schwartz
- School of Public Health, University of Haifa, Haifa, Israel
| | - Mazen Elias
- Internal Medicine C, Emek Medical Center, Afula, Israel
- Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
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Lima A, Ferin R, Fontes A, Santos E, Martins D, Baptista J, Pavão ML. Cysteine is a better predictor of coronary artery disease than conventional homocysteine in high-risk subjects under preventive medication. Nutr Metab Cardiovasc Dis 2020; 30:1281-1288. [PMID: 32522470 DOI: 10.1016/j.numecd.2020.04.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 04/01/2020] [Accepted: 04/08/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND AND AIMS In Portugal, The Azores Archipelago has the highest standardized mortality rate for CAD. Therefore, the aim of this study was to evaluate conventional risk factors, as well as plasma and erythrocyte aminothiol concentration in high-risk Azorean patients undergoing elective coronary angiography and to investigate whether any aminothiol was associated with CAD risk and severity. METHODS AND RESULTS 174 subjects with symptomatic CAD (age 56±9y; 68% men) submitted to coronary angiography were split into 2 groups: one formed by CAD patients (≥50% stenosis in at least one major coronary vessel) and the other by non-CAD patients (<50% stenosis). Both groups were age-, sex- and BMI-matched. Plasma and erythrocyte aminothiol profiles were evaluated by RP-HPLC/FLD. CAD patients significantly exhibited both higher concentrations of plasma Cys and hypercysteinemia (Cys ≥ 300 μM) prevalence than those in the non-CAD group (261 ± 58 μM vs. 243 ± 56 μM; 22% vs. 10%, respectively). No differences were observed between groups regarding plasma Hcy levels or hyperhomocysteinemia prevalence. After adjustment for several confounders (including Hcy), subjects in the highest quartile of plasma Cys had a 3.31 (95% CI, 1.32-8.30, p = 0.011) fold risk for CAD, compared with those in the lowest quartiles. Furthermore, plasma Cys levels (but not Hcy) tended to increase with the number of stenotic vessels (1VD: 253 ± 64 μM; 2VD: 262 ± 52 μM; 3VD: 279 ± 57 μM, p = 0.129). CONCLUSION Hypercysteinemia revealed to be a better predictor of CAD than hyperhomocysteinemia. Moreover, plasma Cys showed to be a useful biomarker for CAD both in primary and secondary preventions, seeming to resist better than Hcy to oral medication therapy.
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Affiliation(s)
- Ana Lima
- DCFQE/ Faculty of Sciences and Technology, University of the Azores, 9501-855, Ponta Delgada, Azores, Portugal
| | - Rita Ferin
- DCFQE/ Faculty of Sciences and Technology, University of the Azores, 9501-855, Ponta Delgada, Azores, Portugal
| | - António Fontes
- Cardiology Department, Hospital Divino Espírito Santo de Ponta Delgada-EPER, Avenida D. Manuel, 9500-782, Ponta Delgada, Azores, Portugal
| | - Emília Santos
- Cardiology Department, Hospital Divino Espírito Santo de Ponta Delgada-EPER, Avenida D. Manuel, 9500-782, Ponta Delgada, Azores, Portugal
| | - Dinis Martins
- Cardiology Department, Hospital Divino Espírito Santo de Ponta Delgada-EPER, Avenida D. Manuel, 9500-782, Ponta Delgada, Azores, Portugal
| | - José Baptista
- DCFQE/ Faculty of Sciences and Technology, University of the Azores, 9501-855, Ponta Delgada, Azores, Portugal
| | - Maria L Pavão
- DCFQE/ Faculty of Sciences and Technology, University of the Azores, 9501-855, Ponta Delgada, Azores, Portugal.
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15
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Tu C, Xie L, Wang Z, Zhang L, Wu H, Ni W, Li C, Li L, Zeng Y. Association between ceramides and coronary artery stenosis in patients with coronary artery disease. Lipids Health Dis 2020; 19:151. [PMID: 32586390 PMCID: PMC7315545 DOI: 10.1186/s12944-020-01329-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 06/16/2020] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Coronary artery stenosis induces heart diseases including acute coronary syndrome (ACS). Some studies reported the ceramide species are associated with the ACS and major adverse cardia and cerebrovascular events (MACE). However, few studies investigated the association between plasma ceramide levels and the severity of stenosis, together with the onset of diseases. This aim of the present study was to investigate the association betweencertain ceramide species, coronary artery stenosis and acute coronary syndrome. METHODS Five hundred fifty-three patients with definite or suspected CAD were recruited and received angiography. Subjects were assigned into 4 groups according to the severity of coronary artery stenosis. The measurements of 4 plasma ceramide species, namely, Cer (d18:1/16:0), Cer (d18:1/18:0), Cer (d18:1/24:1), Cer (d18:1/24:0) were carried out by Liquid chromatography-tandem mass spectrometry (LC-MS/MS) and the ratio of Cer (d18:1/16:0), Cer (d18:1/18:0) and Cer (d18:1/24:1) to Cer (18:1/24:0), respectively, were calculated as index to evaluate the association between plasma ceramides levels and coronary artery stenosis. Multiple logistic regression analysis was used to establish the prognostic model for the prediction of ACS risk. RESULTS After the adjustment by multiple clinical risk factors including age, gender, pre-existing myocardial/cerebral infarction, hemoglobin A1c% (HbA1c%), smoking and the diagnosis during index hospitalization, multiple logistic regression analysis showed that the high ratio of Cer (d18:1/24:1) to Cer (d18:1/24:0), female gender, HbA1c%, unstable angina (UAP) and acute myocardial infarction (AMI) diagnosis (compared with atherosclerosis) during index hospitalization were associated with more severe coronary artery stenosis. Furthermore, the prognostic model was established after adjustment of risk factors and the area under curve (AUC) of receiver operating characteristics (ROC) for the prognostic model was 0.732 and 95% CI was 0.642-0.822. CONCLUSION The severity of coronary artery stenosis is associated with high ratio of Cer (d18:1/24:1) to Cer (d18:1/24:0), female gender, HbA1c% and AMI. Although the reported prognostic model showed a good discrimination, further investigation on long term MACE is needed to evaluate the role of ceramide for the prediction of MACE risk.
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Affiliation(s)
- Chenchen Tu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Rd, Chaoyang District, Beijing, 100029, China
| | - Lan Xie
- Beijing Health Biotech Co. Ltd., yard 7, science park road, Huilongguan, Changping district, Beijing, 102206, China
| | - Zhenjie Wang
- Health Examination Center, Peking Union Medical College Hospital, No. 41 Damucang Hutong, Xicheng District, Beijing, 100032, China
| | - Lili Zhang
- Beijing Health Biotech Co. Ltd., yard 7, science park road, Huilongguan, Changping district, Beijing, 102206, China
| | - Hongmei Wu
- Beijing Health Biotech Co. Ltd., yard 7, science park road, Huilongguan, Changping district, Beijing, 102206, China
| | - Wei Ni
- Beijing Health Biotech Co. Ltd., yard 7, science park road, Huilongguan, Changping district, Beijing, 102206, China
| | - Caixia Li
- Beijing Health Biotech Co. Ltd., yard 7, science park road, Huilongguan, Changping district, Beijing, 102206, China
| | - Lin Li
- Beijing Health Biotech Co. Ltd., yard 7, science park road, Huilongguan, Changping district, Beijing, 102206, China
| | - Yong Zeng
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Rd, Chaoyang District, Beijing, 100029, China.
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Dai R, Liu Y, Zhou Y, Xiong X, Zhou W, Li W, Zhou W, Chen M. Potential of circulating pro-angiogenic microRNA expressions as biomarkers for rapid angiographic stenotic progression and restenosis risks in coronary artery disease patients underwent percutaneous coronary intervention. J Clin Lab Anal 2020; 34:e23013. [PMID: 31495986 PMCID: PMC6977144 DOI: 10.1002/jcla.23013] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 08/05/2019] [Accepted: 08/07/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND This study aimed to investigate the correlation of pro-angiogenic microRNA (miRNA) expressions with rapid angiographic stenotic progression (RASP) and restenosis risks in coronary artery disease (CAD) patients underwent percutaneous coronary intervention (PCI) with drug-eluting stents (DES). METHODS A total of 286 CAD patients underwent PCI with DES were consecutively recruited in this study. Plasma samples were collected before PCI operation, and 14 pro-angiogenic miRNAs were measured by real-time quantitative reverse transcription-polymerase chain reaction. Rapid angiographic stenotic progression at nontarget lesions and restenosis at stented lesions were evaluated by quantitative coronary angiography at 12 months after PCI operation. RESULTS The occurrence rates of RASP and restenosis were 39.5% and 22.4%, respectively. Let-7f, miR-19a, miR-19b-1, miR-92a, miR-126, miR-210, and miR-296 were decreased in RASP patients than non-RASP patients, among which let-7f, miR-19a, miR-126, miR-210, and miR-296 independently correlated with lower RASP occurrence by multivariate analysis, followed by receiver-operating characteristic (ROC) curve exhibited that these five miRNAs showed great value in predicting RASP risk with area under curve (AUC) 0.879 (95% CI: 0.841-0.917). Besides, let-7f, miR-19a, miR-92a, miR-126, miR-130a, and miR-210 were reduced in restenosis patients than non-restenosis patients, among them miR-19a, miR-126, miR-210, and miR-378 independently correlated with lower restenosis occurrence by multivariate analysis, followed by ROC curve disclosed that these four miRNAs had good value in predicting restenosis risk with AUC 0.776 (95% CI: 0.722-0.831). CONCLUSIONS Circulating let-7f, miR-19a, miR-126, miR-210, and miR-296 independently correlate with reduced RASP risk, while miR-19a, miR-126, miR-210, and miR-378 independently correlate with decreased restenosis risk in CAD patients underwent PCI with DES.
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Affiliation(s)
- Rui Dai
- Department of Cardiology, Tongji Medical CollegeThe Central Hospital of Wuhan, Huazhong University of Science & TechnologyWuhanChina
| | - Yijue Liu
- Emergency Department, Tongji Medical CollegeThe Central Hospital of Wuhan, Huazhong University of Science & TechnologyWuhanChina
| | - Yi Zhou
- Department of Cardiology, Tongji Medical CollegeThe Central Hospital of Wuhan, Huazhong University of Science & TechnologyWuhanChina
| | - Xiaoju Xiong
- Department of Cardiology, Tongji Medical CollegeThe Central Hospital of Wuhan, Huazhong University of Science & TechnologyWuhanChina
| | - Wei Zhou
- Department of Cardiology, Tongji Medical CollegeThe Central Hospital of Wuhan, Huazhong University of Science & TechnologyWuhanChina
| | - Weijuan Li
- Department of Cardiology, Tongji Medical CollegeThe Central Hospital of Wuhan, Huazhong University of Science & TechnologyWuhanChina
| | - Wenping Zhou
- Department of Cardiology, Tongji Medical CollegeThe Central Hospital of Wuhan, Huazhong University of Science & TechnologyWuhanChina
| | - Manhua Chen
- Department of Cardiology, Tongji Medical CollegeThe Central Hospital of Wuhan, Huazhong University of Science & TechnologyWuhanChina
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Ewid M, Sherif H, Billah SMB, Saquib N, AlEnazy W, Ragab O, Enabi S, Rajab T, Awad Z, Abazid R. Glycated hemoglobin predicts coronary artery disease in non-diabetic adults. BMC Cardiovasc Disord 2019; 19:309. [PMID: 31864310 PMCID: PMC6925462 DOI: 10.1186/s12872-019-01302-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 12/08/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Coronary artery disease (CAD) is a major cause of morbidity and mortality worldwide. Due to increased CAD risk factors in Saudi Arabia, research on more feasible and predictive biomarkers is needed. We aimed to evaluate glycated hemoglobin (HbA1c) as a predictor of CAD in low-risk profile non-diabetic patients living in the Al Qassim region of Saudi Arabia. METHODS Thirty-eight patients with no history of CAD were enrolled in this cross-sectional study. They provided demographic data, and their HbA1c estimation followed the National Glycohemoglobin Standardization Program parameters. All patients underwent coronary computed tomography angiography (CCTA) for evaluation of chest pain. The extent of coronary artery stenosis (CAS) was quantified as percentage for each patient based on plaques detected in CCTA. RESULTS Mean blood pressure of the patients was (91.2 ± 11.9 mmHg), BMI (28.3 ± 5.8 kg/m2), serum cholesterol level (174 ± 33.1 mg/dl), and HbA1c levels (mean 5.7 ± 0.45, median 5.7 and range 4.7-6.4%). Eighteen patients showed no CAS (47.4%), 12 showed minimal stenosis (31.6%), 3 showed mild stenosis (7.9%), 3 showed moderate stenosis (7.9%) and 2 showed severe stenosis (5.3%). A moderate correlation was detected between HbA1c and CAS percentages (r = 0.47, p < 0.05) as well as between HbA1c and the number of affected coronary vessels (r = 0.53, p < 0.001). CONCLUSION Glycated hemoglobin can be used as a predictive biomarker for CAD in non-diabetic low-risk patients.
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Affiliation(s)
- Mohammed Ewid
- College of Medicine, Sulaiman Al Rajhi Colleges, P.O. Box 777, Al Bukayriah, Qassim 51941, Saudi Arabia
- Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, 11562 Egypt
| | - Hossam Sherif
- College of Medicine, Sulaiman Al Rajhi Colleges, P.O. Box 777, Al Bukayriah, Qassim 51941, Saudi Arabia
- Critical Care Medicine Department, Faculty of Medicine, Cairo University, Critical Care, Kasr A. Ainy St, Cairo, 11562 Egypt
| | | | - Nazmus Saquib
- College of Medicine, Sulaiman Al Rajhi Colleges, P.O. Box 777, Al Bukayriah, Qassim 51941, Saudi Arabia
| | - Wael AlEnazy
- College of Medicine, Sulaiman Al Rajhi Colleges, P.O. Box 777, Al Bukayriah, Qassim 51941, Saudi Arabia
| | - Omer Ragab
- College of Medicine, Sulaiman Al Rajhi Colleges, P.O. Box 777, Al Bukayriah, Qassim 51941, Saudi Arabia
| | - Saed Enabi
- College of Medicine, Sulaiman Al Rajhi Colleges, P.O. Box 777, Al Bukayriah, Qassim 51941, Saudi Arabia
| | - Tawfik Rajab
- College of Medicine, Sulaiman Al Rajhi Colleges, P.O. Box 777, Al Bukayriah, Qassim 51941, Saudi Arabia
| | - Zaki Awad
- Prince Sultan Cardiac Center, Ministry of Health, Al Qassim, Qassim 52366, Buraydah, 7430 An Naziyah Saudi Arabia
| | - Rami Abazid
- Prince Sultan Cardiac Center, Ministry of Health, Al Qassim, Qassim 52366, Buraydah, 7430 An Naziyah Saudi Arabia
- Department of Nuclear Medicine, London Health Sciences Center, 800 Commissioners Road East, PO Box 5010, London, ON N6A 5W9 Canada
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TOPAL S, SEZENÖZ B, CANDEMİR M, AÇIKGÖZ E, AÇIKGÖZ SK, BOYACI NB. An old friend: uric acid and its association with fractional flow reserve. Turk J Med Sci 2019; 49:1614-1619. [PMID: 31655503 PMCID: PMC7518665 DOI: 10.3906/sag-1903-91] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 07/22/2019] [Indexed: 11/04/2022] Open
Abstract
Background/aim The aim of this study was to investigate the importance of preprocedural uric acid (UA) level in predicting fractional flow reserve (FFR) results of intermediate coronary lesions in patients with stable coronary artery disease undergoing coronary angiography. Materials and methods We retrospectively analyzed 293 patients who underwent FFR measurement to determine the significance of intermediate coronary stenosis detected by conventional coronary angiography. Patients were divided into 2 groups: Group 1 (n = 127) included patients with FFR of <0.80 (hemodynamically significant lesions), and Group 2 (n = 169) consisted of patients with FFR of >0.80 (hemodynamically nonsignificant lesions). Uric acid levels were assessed in both groups with the enzymatic colorimetric method by clinical chemistry autoanalyzer. Results The mean UA level was significantly higher in patients whose FFR indicated hemodynamically significant coronary lesions (UA: 5.43 ± 1.29 mg/dL in Group 1 vs. 4.51 ± 1.34 mg/dL in Group 2, P < 0.001). Conclusion Elevated UA levels are associated with hemodynamically significant coronary lesions measured with FFR. Uric acid may be used as a predictor of hemodynamically compromised coronary lesions before FFR procedures.
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Affiliation(s)
- Salih TOPAL
- Department of Cardiology, Faculty of Medicine, Gazi University, AnkaraTurkey
- * To whom correspondence should be addressed. E-mail:
| | - Burak SEZENÖZ
- Department of Cardiology, Faculty of Medicine, Gazi University, AnkaraTurkey
| | | | - Eser AÇIKGÖZ
- Department of Cardiology, Abdurrahman Yurtarslan Ankara Oncology Education and Research Hospital, AnkaraTurkey
| | - Sadık Kadri AÇIKGÖZ
- Department of Cardiology, Kahraman Kazan Hamdi Eriş State Hospital, KahramankazanTurkey
| | - Nuri Bülent BOYACI
- Department of Cardiology, Faculty of Medicine, Gazi University, AnkaraTurkey
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Li C, Zhang Z, Peng Y, Gao H, Wang Y, Zhao J, Pan C. Plasma neutrophil gelatinase-associated lipocalin levels are associated with the presence and severity of coronary heart disease. PLoS One 2019; 14:e0220841. [PMID: 31387110 PMCID: PMC6684288 DOI: 10.1371/journal.pone.0220841] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 07/24/2019] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE This study aimed to compare the levels of plasma neutrophil gelatinase-associated lipocalin (NGAL), matrix metalloproteinase (MMP)-9, high-sensitivity C-reactive protein (hs-CRP), and interleukin (IL)-1β across different clinical presentations of coronary artery disease and to evaluate the relationship between those biomarkers and the severity of coronary artery lesions in patients without kidney disease. METHODS We examined 365 eligible patients who underwent coronary angiography. A total of 124 ST-segment elevation myocardial infarction (STEMI) patients, 117 stable angina pectoris (SAP) patients and 124 patients without atherosclerotic plaques were enrolled in the study. Plasma NGAL, MMP-9, hs-CRP, and IL-1β were measured in all patients using the enzyme-linked immunosorbent assay (ELISA) method. According to the SYNTAX score, the STEMI patients and SAP patients were divided into another set of 2 groups: a high score group (≥ 33, n = 29) and a low score group (<33, n = 212). The relationship between those biomarkers and the severity of coronary stenosis was examined by Spearman correlation analysis; the ability for NGAL to discriminate severe coronary stenosis was examined by receiver operating characteristic (ROC) curve; the influencing factors for the SYNTAX score were determined by logistic regression analysis. RESULTS Plasma NGAL, MMP-9, and hs-CRP levels in STEMI patients were higher than in the SAP patients and control subjects (P<0.05, respectively), and plasma NGAL and hs-CRP levels were significantly higher in the SAP patients than in control subjects (P<0.05, respectively), while plasma IL-1β was similar among the 3 groups (P>0.05, respectively). The SYNTAX score was positively related to NGAL (r = 0.363, P<0.001), MMP-9 (r = 0.377, P<0.001), and hs-CRP (r = 0.163, P<0.011); the SYNTAX score was not related to IL-1β (r = -0.043, P = 0.510). Plasma NGAL was positively related to MMP-9 (r = 0.601, P<0.001) and IL-1β (r = 0.159, P = 0.014). The area under the ROC curve for NGAL discriminating severe coronary stenosis was 0.838 (95% CI: 0.752-0.923, P<0.001), which was greater than that for MMP-9 [0.818, (95% CI: 0.724-0.912, P<0.001)], IL-1β [0.485, (95% CI: 0.369-0.601, P = 0.791)], and hs-CRP [0.607, (95% CI: 0.492-0.722, P = 0.061)]. Multivariate regression analysis showed that plasma NGAL levels were independently related to high SYNTAX scores [OR = 1.109, (95% CI: 1.104-1.114), P<0.001]. CONCLUSION Plasma NGAL, MMP-9, and hs-CRP levels in STEMI patients were higher than those in the SAP patients and control subjects. NGAL had a better ability to discriminate severe coronary stenosis than MMP-9, IL-1β, and hs-CRP. NGAL may be a novel biomarker to aid in risk stratification in coronary heart disease patients.
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Affiliation(s)
- Chao Li
- The First Clinical College of Lanzhou University, Lanzhou, Gansu, China
- Department of Cardiology, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
- Gansu Key Laboratory of Cardiovascular Disease, Lanzhou, Gansu, China
| | - Zheng Zhang
- Department of Cardiology, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
- * E-mail:
| | - Yu Peng
- Department of Cardiology, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Hanxiang Gao
- Department of Cardiology, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Yongxiang Wang
- Department of Cardiology, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Jing Zhao
- Department of Cardiology, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Chenliang Pan
- Department of Cardiology, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
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20
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Bashyal R, Koirala B, Jha B, Gautam B, Khadka M. Relationship Between Serum Total Testosterone and Coronary Artery Disease in Men. J Nepal Health Res Counc 2019; 17:26-31. [PMID: 31110372 DOI: 10.33314/jnhrc.1207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 04/24/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Male sex has always been considered as an independent risk factor for cardiovascular disease. But recent studies have shown controversial results. This study aimed to investigate the relation of serum testosterone withrisk factors of coronary artery diseasesand with degree of severity of coronary artery stenosisin men with coronary artery diseases. METHODS After applying inclusion and exclusion criteria 102 men (aged 60.42 += 11.11), were included. Fasting blood sample were obtained and blood sugar, total testosterone and lipid profile were measured. Severity of coronary stenosis was estimated by Gensini score. The relationships were assessed using chi-square test, one way analysis of variance and Pearson's Correlation. RESULTS Of the total 102 patients, majority of them 42 (41.2%) had triple vessel disease. Testosterone (nmol/L) was found to be 12.01 ± 6.1. Cardiovascular diseaserisk factors like age, body mass index etc. were found to be negatively correlated with testosterone but not statistically significant. Likewise, Gensini score also correlated negatively with testosteronebut not up to the threshold of statistical significance (r=-0.069, p-value = 0.496). Similar results were obtained when number of vessels involved and testosterone were compared. However, the number of diabetic patients gradually decreased with the increasing value of testosterone in the three tertile group (p-value = 0.040). CONCLUSIONS This study could not find significant association between testosterone and coronary artery diseases, however low testosterone was associated with diabetes mellitus.
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Affiliation(s)
- Ritu Bashyal
- Department of Biochemistry, Patan Academy of Health Sciences, School of Medicine, Lagankhel, Lalitpur, Nepal
| | - Bhagawan Koirala
- Department of Cardiac Surgery, Man Mohan Center for Cardio-Thoracic, Vascular and Transplant Surgery, Institute of Medicine, Maharajgunj, Kathmandu, Nepal
| | - Bharat Jha
- Department of Biochemistry, OM Hospital and Research Center P. Ltd, Chabahil, Kathmandu Nepal
| | - Bijaya Gautam
- Department of Biochemistry, Western Regional Hospital, Pacchimanchal Academy of Health Sciences, Pokhara, Nepal
| | - Mira Khadka
- Association of Medical Doctors of Asia - Primary Health Care Project for Bhutanese Refugees, Damak, Nepal
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Zhang HW, Zhao X, Guo YL, Gao Y, Zhu CG, Wu NQ, Li JJ. Elevated lipoprotein (a) levels are associated with the presence and severity of coronary artery disease in patients with type 2 diabetes mellitus. Nutr Metab Cardiovasc Dis 2018; 28:980-986. [PMID: 30030022 DOI: 10.1016/j.numecd.2018.05.010] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 05/04/2018] [Accepted: 05/22/2018] [Indexed: 01/06/2023]
Abstract
BACKGROUND AND AIMS The role of lipoprotein (a) [Lp(a)] in coronary artery diseases (CAD) with special clinical background such as type 2 diabetes mellitus (T2DM) has not been fully determined. The aim of the present study was to investigate the relation of Lp(a) to type 2 diabetic patients with or without CAD. METHODS AND RESULTS A total of 2040 consecutive patients with T2DM who received selective coronary angiography (CAG) due to angina-like chest pain were enrolled. The patients were subsequently divided into CAD and non-CAD groups according to the results of CAG. The severity of CAD was evaluated by the Gensini Score (GS), number of stenotic vessels, and history of myocardial infarction (MI). Data showed that Lp(a) levels were higher in the CAD group than in the non-CAD group (median: 15.00 mg/dL vs. 11.88 mg/dL, P = 0.025). The results from CAD subgroup analysis indicated that the patients with MI, multiple-vessel disease and high GS had higher Lp(a) levels compared with those in their matched subgroups (P < 0.05, respectively). After adjustment for confounders, Lp(a) levels were independently related to the presence and severity of CAD (CAD:OR = 1.564; MI:OR = 1.523; high GS:OR = 1.388; multiple-vessel disease:OR = 1.455; P < 0.05, respectively). CONCLUSION Elevated Lp(a) levels were independently associated with the presence and severity of CAD in patients with T2DM. More studies are necessary to confirm our findings.
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Affiliation(s)
- H-W Zhang
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No 167 BeiLiShi Road, XiCheng District, Beijing, 100037, China
| | - X Zhao
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No 167 BeiLiShi Road, XiCheng District, Beijing, 100037, China
| | - Y-L Guo
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No 167 BeiLiShi Road, XiCheng District, Beijing, 100037, China
| | - Y Gao
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No 167 BeiLiShi Road, XiCheng District, Beijing, 100037, China
| | - C-G Zhu
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No 167 BeiLiShi Road, XiCheng District, Beijing, 100037, China
| | - N-Q Wu
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No 167 BeiLiShi Road, XiCheng District, Beijing, 100037, China
| | - J-J Li
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No 167 BeiLiShi Road, XiCheng District, Beijing, 100037, China.
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Li L, Liu QW, Li Z, Wang L, Wang JH, Song L, Li B. The utility of high-sensitivity C-reactive protein levels in patients with moderate coronary lesions and gray-zone fractional flow reserve. Anatol J Cardiol 2018; 20:143-151. [PMID: 30109863 PMCID: PMC6237940 DOI: 10.14744/anatoljcardiol.2018.80148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/19/2018] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVE It remains controversial whether patients with fractional flow reserve (FFR) values of 0.75-0.80 (gray-zone) should be treated with percutaneous coronary intervention (PCI). This study aimed to evaluate the prediction of high-sensitivity C-reactive protein (hs-CRP) levels to guide treatment selection in gray-zone patients. METHODS This prospective interventional trial was conducted between January 2015 and March 2016. A total of 785 patients with stable angina and single-vessel stenosis with moderate coronary lesions were admitted to hospital in this period. After measurement of hs-CRP levels, coronary angiography, and FFR, gray-zone patients (n=308) were included in the study and were divided into four groups on the basis of a cutoff hs-CRP level of 3 mg/L and then on the basis of whether they underwent PCI or not. Patients in groups I (≥3 mg/L, n=70) and III (<3 mg/L, n=84) underwent PCI, whereas those in groups II (≥3 mg/L, n=70) and IV (<3 mg/L, n=84) were administered only drugs. Major adverse clinical events (MACEs) included cardiac death, nonfatal myocardial infarction (MI), target vessel revascularization (TVR), and PCI or coronary artery bypass grafting (CABG). These parameters were also evaluated during follow-up. RESULTS The total Kaplan-Meier curves showed macrodistribution differences among the four groups (p<0.05). There was a significantly increased MACE incidence in group II compared with group I or IV (p=0.039 or 0.006, respectively), and an increased incidence in group I compared with group III (p=0.028). However, there were no differences in MACE incidence between groups III and IV (p=0.095) despite the fact that these patients received different treatments. CONCLUSION Among FFR gray-zone patients, hs-CRP level was a predictor of MACE and risk stratification could guide treatment selection. Increased hs-CRP levels (≥3 mg/L) are an indication for urgent PCI whereas normal levels (<3 mg/L) are an indication for delayed PCI treatment. Patients with identical FFR values could require different treatment.
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Affiliation(s)
| | | | | | | | | | | | - Bin Li
- Department of Surgery Center, Shandong Provincial Hospital Affiliated to Shandong University; Jinan-China.
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Fischer K, Yamaji K, Luescher S, Ueki Y, Jung B, von Tengg-Kobligk H, Windecker S, Friedrich MG, Eberle B, Guensch DP. Feasibility of cardiovascular magnetic resonance to detect oxygenation deficits in patients with multi-vessel coronary artery disease triggered by breathing maneuvers. J Cardiovasc Magn Reson 2018; 20:31. [PMID: 29730991 PMCID: PMC5937049 DOI: 10.1186/s12968-018-0446-y] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Accepted: 03/20/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hyperventilation with a subsequent breath-hold has been successfully used as a non-pharmacological vasoactive stimulus to induce changes in myocardial oxygenation. The purpose of this pilot study was to assess if this maneuver is feasible in patients with multi-vessel coronary artery disease (CAD), and if it is effective at detecting coronary artery stenosis > 50% determined by quantitative coronary angiography (QCA). METHODS Twenty-six patients with coronary artery stenosis (QCA > 50% diameter stenosis) underwent a contrast-free cardiovascular magnetic resonance (CMR) exam in the time interval between their primary coronary angiography and a subsequent percutaneous coronary intervention (PCI, n = 24) or coronary artery bypass (CABG, n = 2) revascularization procedure. The CMR exam involved standard function imaging, myocardial strain analysis, T2 mapping, native T1 mapping and oxygenation-sensitive CMR (OS-CMR) imaging. During OS-CMR, participants performed a paced hyperventilation for 60s followed by a breath-hold to induce a vasoactive stimulus. Ten healthy subjects underwent the CMR protocol as the control group. RESULTS All CAD patients completed the breathing maneuvers with an average breath-hold duration of 48 ± 23 s following hyperventilation and without any complications or adverse effects. In comparison to healthy subjects, CAD patients had a significantly attenuated global myocardial oxygenation response to both hyperventilation (- 9.6 ± 6.8% vs. -3.1 ± 6.5%, p = 0.012) and apnea (11.3 ± 6.1% vs. 2.1 ± 4.4%, p < 0.001). The breath-hold maneuver unmasked regional oxygenation differences in territories subtended by a stenotic coronary artery in comparison to remote territory within the same patient (0.5 ± 3.8 vs. 3.8 ± 5.3%, p = 0.011). CONCLUSION Breathing maneuvers in conjunction with OS-CMR are clinically feasible in CAD patients. Furthermore, OS-CMR demonstrates myocardial oxygenation abnormalities in regional myocardium related to CAD without the use of pharmacologic vasodilators or contrast agents. A larger trial appears warranted for a better understanding of its diagnostic utility. TRIAL REGISTRATION Clinical Trials Identifier: NCT02233634 , registered 8 September 2014.
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Affiliation(s)
- Kady Fischer
- Department of Anaesthesiology and Pain Medicine, Bern University Hospital, Inselspital, University of Bern, 3010 Bern, Switzerland
- Research Institute of the McGill University Health Centre, Montreal, QC Canada
- Institute for Diagnostic, Interventional and Paediatric Radiology, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland
| | - Kyohei Yamaji
- Department of Cardiology, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland
| | - Silvia Luescher
- Department of Anaesthesiology and Pain Medicine, Bern University Hospital, Inselspital, University of Bern, 3010 Bern, Switzerland
| | - Yasushi Ueki
- Department of Cardiology, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland
| | - Bernd Jung
- Institute for Diagnostic, Interventional and Paediatric Radiology, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland
| | - Hendrik von Tengg-Kobligk
- Institute for Diagnostic, Interventional and Paediatric Radiology, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland
| | - Stephan Windecker
- Department of Cardiology, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland
| | - Matthias G. Friedrich
- Research Institute of the McGill University Health Centre, Montreal, QC Canada
- Department of Cardiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Balthasar Eberle
- Department of Anaesthesiology and Pain Medicine, Bern University Hospital, Inselspital, University of Bern, 3010 Bern, Switzerland
| | - Dominik P. Guensch
- Department of Anaesthesiology and Pain Medicine, Bern University Hospital, Inselspital, University of Bern, 3010 Bern, Switzerland
- Institute for Diagnostic, Interventional and Paediatric Radiology, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland
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Adamson PD, Hunter A, Madsen DM, Shah ASV, McAllister DA, Pawade TA, Williams MC, Berry C, Boon NA, Flather M, Forbes J, McLean S, Roditi G, Timmis AD, van Beek EJR, Dweck MR, Mickley H, Mills NL, Newby DE. High-Sensitivity Cardiac Troponin I and the Diagnosis of Coronary Artery Disease in Patients With Suspected Angina Pectoris. Circ Cardiovasc Qual Outcomes 2018; 11:e004227. [PMID: 29444926 PMCID: PMC5837016 DOI: 10.1161/circoutcomes.117.004227] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 12/22/2017] [Indexed: 01/16/2023]
Abstract
BACKGROUND We determined whether high-sensitivity cardiac troponin I can improve the estimation of the pretest probability for obstructive coronary artery disease (CAD) in patients with suspected stable angina. METHODS AND RESULTS In a prespecified substudy of the SCOT-HEART trial (Scottish Computed Tomography of the Heart), plasma cardiac troponin was measured using a high-sensitivity single-molecule counting assay in 943 adults with suspected stable angina who had undergone coronary computed tomographic angiography. Rates of obstructive CAD were compared with the pretest probability determined by the CAD Consortium risk model with and without cardiac troponin concentrations. External validation was undertaken in an independent study population from Denmark comprising 487 patients with suspected stable angina. Higher cardiac troponin concentrations were associated with obstructive CAD with a 5-fold increase across quintiles (9%-48%; P<0.001) independent of known cardiovascular risk factors (odds ratio, 1.35; 95% confidence interval, 1.25-1.46 per doubling of troponin). Cardiac troponin concentrations improved the discrimination and calibration of the CAD Consortium model for identifying obstructive CAD (C statistic, 0.788-0.800; P=0.004; χ2=16.8 [P=0.032] to 14.3 [P=0.074]). The updated model also improved classification of the American College of Cardiology/American Heart Association pretest probability risk categories (net reclassification improvement, 0.062; 95% confidence interval, 0.035-0.089). The revised model achieved similar improvements in discrimination and calibration when applied in the external validation cohort. CONCLUSIONS High-sensitivity cardiac troponin I concentration is an independent predictor of obstructive CAD in patients with suspected stable angina. Use of this test may improve the selection of patients for further investigation and treatment. CLINICAL TRIAL REGISTRATION URL: https://www.clinicaltrials.gov. Unique identifier: NCT01149590.
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Affiliation(s)
- Philip D Adamson
- From the British Heart Foundation Centre for Cardiovascular Science (P.D.A., A.H., A.S.V.S., T.A.P., N.A.B., E.J.R.v.B., M.R.D., N.L.M., D.E.N.) and Clinical Research Imaging Centre (M.C.W.), University of Edinburgh, United Kingdom; Department of Cardiology, Odense University Hospital, Denmark (D.M.M., H.M.); Institute of Health and Wellbeing (D.A.M.) and Institute of Clinical Sciences (C.B., G.R.), University of Glasgow, United Kingdom; Norwich Medical School, University of East Anglia, Norwich, United Kingdom (M.F.); Health Research Institute, University of Limerick, Ireland (J.F.); National Health Service, Fife, United Kingdom (S.M.); and William Harvey Research Institute, Queen Mary University of London, United Kingdom (A.D.T.).
| | - Amanda Hunter
- From the British Heart Foundation Centre for Cardiovascular Science (P.D.A., A.H., A.S.V.S., T.A.P., N.A.B., E.J.R.v.B., M.R.D., N.L.M., D.E.N.) and Clinical Research Imaging Centre (M.C.W.), University of Edinburgh, United Kingdom; Department of Cardiology, Odense University Hospital, Denmark (D.M.M., H.M.); Institute of Health and Wellbeing (D.A.M.) and Institute of Clinical Sciences (C.B., G.R.), University of Glasgow, United Kingdom; Norwich Medical School, University of East Anglia, Norwich, United Kingdom (M.F.); Health Research Institute, University of Limerick, Ireland (J.F.); National Health Service, Fife, United Kingdom (S.M.); and William Harvey Research Institute, Queen Mary University of London, United Kingdom (A.D.T.)
| | - Debbie M Madsen
- From the British Heart Foundation Centre for Cardiovascular Science (P.D.A., A.H., A.S.V.S., T.A.P., N.A.B., E.J.R.v.B., M.R.D., N.L.M., D.E.N.) and Clinical Research Imaging Centre (M.C.W.), University of Edinburgh, United Kingdom; Department of Cardiology, Odense University Hospital, Denmark (D.M.M., H.M.); Institute of Health and Wellbeing (D.A.M.) and Institute of Clinical Sciences (C.B., G.R.), University of Glasgow, United Kingdom; Norwich Medical School, University of East Anglia, Norwich, United Kingdom (M.F.); Health Research Institute, University of Limerick, Ireland (J.F.); National Health Service, Fife, United Kingdom (S.M.); and William Harvey Research Institute, Queen Mary University of London, United Kingdom (A.D.T.)
| | - Anoop S V Shah
- From the British Heart Foundation Centre for Cardiovascular Science (P.D.A., A.H., A.S.V.S., T.A.P., N.A.B., E.J.R.v.B., M.R.D., N.L.M., D.E.N.) and Clinical Research Imaging Centre (M.C.W.), University of Edinburgh, United Kingdom; Department of Cardiology, Odense University Hospital, Denmark (D.M.M., H.M.); Institute of Health and Wellbeing (D.A.M.) and Institute of Clinical Sciences (C.B., G.R.), University of Glasgow, United Kingdom; Norwich Medical School, University of East Anglia, Norwich, United Kingdom (M.F.); Health Research Institute, University of Limerick, Ireland (J.F.); National Health Service, Fife, United Kingdom (S.M.); and William Harvey Research Institute, Queen Mary University of London, United Kingdom (A.D.T.)
| | - David A McAllister
- From the British Heart Foundation Centre for Cardiovascular Science (P.D.A., A.H., A.S.V.S., T.A.P., N.A.B., E.J.R.v.B., M.R.D., N.L.M., D.E.N.) and Clinical Research Imaging Centre (M.C.W.), University of Edinburgh, United Kingdom; Department of Cardiology, Odense University Hospital, Denmark (D.M.M., H.M.); Institute of Health and Wellbeing (D.A.M.) and Institute of Clinical Sciences (C.B., G.R.), University of Glasgow, United Kingdom; Norwich Medical School, University of East Anglia, Norwich, United Kingdom (M.F.); Health Research Institute, University of Limerick, Ireland (J.F.); National Health Service, Fife, United Kingdom (S.M.); and William Harvey Research Institute, Queen Mary University of London, United Kingdom (A.D.T.)
| | - Tania A Pawade
- From the British Heart Foundation Centre for Cardiovascular Science (P.D.A., A.H., A.S.V.S., T.A.P., N.A.B., E.J.R.v.B., M.R.D., N.L.M., D.E.N.) and Clinical Research Imaging Centre (M.C.W.), University of Edinburgh, United Kingdom; Department of Cardiology, Odense University Hospital, Denmark (D.M.M., H.M.); Institute of Health and Wellbeing (D.A.M.) and Institute of Clinical Sciences (C.B., G.R.), University of Glasgow, United Kingdom; Norwich Medical School, University of East Anglia, Norwich, United Kingdom (M.F.); Health Research Institute, University of Limerick, Ireland (J.F.); National Health Service, Fife, United Kingdom (S.M.); and William Harvey Research Institute, Queen Mary University of London, United Kingdom (A.D.T.)
| | - Michelle C Williams
- From the British Heart Foundation Centre for Cardiovascular Science (P.D.A., A.H., A.S.V.S., T.A.P., N.A.B., E.J.R.v.B., M.R.D., N.L.M., D.E.N.) and Clinical Research Imaging Centre (M.C.W.), University of Edinburgh, United Kingdom; Department of Cardiology, Odense University Hospital, Denmark (D.M.M., H.M.); Institute of Health and Wellbeing (D.A.M.) and Institute of Clinical Sciences (C.B., G.R.), University of Glasgow, United Kingdom; Norwich Medical School, University of East Anglia, Norwich, United Kingdom (M.F.); Health Research Institute, University of Limerick, Ireland (J.F.); National Health Service, Fife, United Kingdom (S.M.); and William Harvey Research Institute, Queen Mary University of London, United Kingdom (A.D.T.)
| | - Colin Berry
- From the British Heart Foundation Centre for Cardiovascular Science (P.D.A., A.H., A.S.V.S., T.A.P., N.A.B., E.J.R.v.B., M.R.D., N.L.M., D.E.N.) and Clinical Research Imaging Centre (M.C.W.), University of Edinburgh, United Kingdom; Department of Cardiology, Odense University Hospital, Denmark (D.M.M., H.M.); Institute of Health and Wellbeing (D.A.M.) and Institute of Clinical Sciences (C.B., G.R.), University of Glasgow, United Kingdom; Norwich Medical School, University of East Anglia, Norwich, United Kingdom (M.F.); Health Research Institute, University of Limerick, Ireland (J.F.); National Health Service, Fife, United Kingdom (S.M.); and William Harvey Research Institute, Queen Mary University of London, United Kingdom (A.D.T.)
| | - Nicholas A Boon
- From the British Heart Foundation Centre for Cardiovascular Science (P.D.A., A.H., A.S.V.S., T.A.P., N.A.B., E.J.R.v.B., M.R.D., N.L.M., D.E.N.) and Clinical Research Imaging Centre (M.C.W.), University of Edinburgh, United Kingdom; Department of Cardiology, Odense University Hospital, Denmark (D.M.M., H.M.); Institute of Health and Wellbeing (D.A.M.) and Institute of Clinical Sciences (C.B., G.R.), University of Glasgow, United Kingdom; Norwich Medical School, University of East Anglia, Norwich, United Kingdom (M.F.); Health Research Institute, University of Limerick, Ireland (J.F.); National Health Service, Fife, United Kingdom (S.M.); and William Harvey Research Institute, Queen Mary University of London, United Kingdom (A.D.T.)
| | - Marcus Flather
- From the British Heart Foundation Centre for Cardiovascular Science (P.D.A., A.H., A.S.V.S., T.A.P., N.A.B., E.J.R.v.B., M.R.D., N.L.M., D.E.N.) and Clinical Research Imaging Centre (M.C.W.), University of Edinburgh, United Kingdom; Department of Cardiology, Odense University Hospital, Denmark (D.M.M., H.M.); Institute of Health and Wellbeing (D.A.M.) and Institute of Clinical Sciences (C.B., G.R.), University of Glasgow, United Kingdom; Norwich Medical School, University of East Anglia, Norwich, United Kingdom (M.F.); Health Research Institute, University of Limerick, Ireland (J.F.); National Health Service, Fife, United Kingdom (S.M.); and William Harvey Research Institute, Queen Mary University of London, United Kingdom (A.D.T.)
| | - John Forbes
- From the British Heart Foundation Centre for Cardiovascular Science (P.D.A., A.H., A.S.V.S., T.A.P., N.A.B., E.J.R.v.B., M.R.D., N.L.M., D.E.N.) and Clinical Research Imaging Centre (M.C.W.), University of Edinburgh, United Kingdom; Department of Cardiology, Odense University Hospital, Denmark (D.M.M., H.M.); Institute of Health and Wellbeing (D.A.M.) and Institute of Clinical Sciences (C.B., G.R.), University of Glasgow, United Kingdom; Norwich Medical School, University of East Anglia, Norwich, United Kingdom (M.F.); Health Research Institute, University of Limerick, Ireland (J.F.); National Health Service, Fife, United Kingdom (S.M.); and William Harvey Research Institute, Queen Mary University of London, United Kingdom (A.D.T.)
| | - Scott McLean
- From the British Heart Foundation Centre for Cardiovascular Science (P.D.A., A.H., A.S.V.S., T.A.P., N.A.B., E.J.R.v.B., M.R.D., N.L.M., D.E.N.) and Clinical Research Imaging Centre (M.C.W.), University of Edinburgh, United Kingdom; Department of Cardiology, Odense University Hospital, Denmark (D.M.M., H.M.); Institute of Health and Wellbeing (D.A.M.) and Institute of Clinical Sciences (C.B., G.R.), University of Glasgow, United Kingdom; Norwich Medical School, University of East Anglia, Norwich, United Kingdom (M.F.); Health Research Institute, University of Limerick, Ireland (J.F.); National Health Service, Fife, United Kingdom (S.M.); and William Harvey Research Institute, Queen Mary University of London, United Kingdom (A.D.T.)
| | - Giles Roditi
- From the British Heart Foundation Centre for Cardiovascular Science (P.D.A., A.H., A.S.V.S., T.A.P., N.A.B., E.J.R.v.B., M.R.D., N.L.M., D.E.N.) and Clinical Research Imaging Centre (M.C.W.), University of Edinburgh, United Kingdom; Department of Cardiology, Odense University Hospital, Denmark (D.M.M., H.M.); Institute of Health and Wellbeing (D.A.M.) and Institute of Clinical Sciences (C.B., G.R.), University of Glasgow, United Kingdom; Norwich Medical School, University of East Anglia, Norwich, United Kingdom (M.F.); Health Research Institute, University of Limerick, Ireland (J.F.); National Health Service, Fife, United Kingdom (S.M.); and William Harvey Research Institute, Queen Mary University of London, United Kingdom (A.D.T.)
| | - Adam D Timmis
- From the British Heart Foundation Centre for Cardiovascular Science (P.D.A., A.H., A.S.V.S., T.A.P., N.A.B., E.J.R.v.B., M.R.D., N.L.M., D.E.N.) and Clinical Research Imaging Centre (M.C.W.), University of Edinburgh, United Kingdom; Department of Cardiology, Odense University Hospital, Denmark (D.M.M., H.M.); Institute of Health and Wellbeing (D.A.M.) and Institute of Clinical Sciences (C.B., G.R.), University of Glasgow, United Kingdom; Norwich Medical School, University of East Anglia, Norwich, United Kingdom (M.F.); Health Research Institute, University of Limerick, Ireland (J.F.); National Health Service, Fife, United Kingdom (S.M.); and William Harvey Research Institute, Queen Mary University of London, United Kingdom (A.D.T.)
| | - Edwin J R van Beek
- From the British Heart Foundation Centre for Cardiovascular Science (P.D.A., A.H., A.S.V.S., T.A.P., N.A.B., E.J.R.v.B., M.R.D., N.L.M., D.E.N.) and Clinical Research Imaging Centre (M.C.W.), University of Edinburgh, United Kingdom; Department of Cardiology, Odense University Hospital, Denmark (D.M.M., H.M.); Institute of Health and Wellbeing (D.A.M.) and Institute of Clinical Sciences (C.B., G.R.), University of Glasgow, United Kingdom; Norwich Medical School, University of East Anglia, Norwich, United Kingdom (M.F.); Health Research Institute, University of Limerick, Ireland (J.F.); National Health Service, Fife, United Kingdom (S.M.); and William Harvey Research Institute, Queen Mary University of London, United Kingdom (A.D.T.)
| | - Marc R Dweck
- From the British Heart Foundation Centre for Cardiovascular Science (P.D.A., A.H., A.S.V.S., T.A.P., N.A.B., E.J.R.v.B., M.R.D., N.L.M., D.E.N.) and Clinical Research Imaging Centre (M.C.W.), University of Edinburgh, United Kingdom; Department of Cardiology, Odense University Hospital, Denmark (D.M.M., H.M.); Institute of Health and Wellbeing (D.A.M.) and Institute of Clinical Sciences (C.B., G.R.), University of Glasgow, United Kingdom; Norwich Medical School, University of East Anglia, Norwich, United Kingdom (M.F.); Health Research Institute, University of Limerick, Ireland (J.F.); National Health Service, Fife, United Kingdom (S.M.); and William Harvey Research Institute, Queen Mary University of London, United Kingdom (A.D.T.)
| | - Hans Mickley
- From the British Heart Foundation Centre for Cardiovascular Science (P.D.A., A.H., A.S.V.S., T.A.P., N.A.B., E.J.R.v.B., M.R.D., N.L.M., D.E.N.) and Clinical Research Imaging Centre (M.C.W.), University of Edinburgh, United Kingdom; Department of Cardiology, Odense University Hospital, Denmark (D.M.M., H.M.); Institute of Health and Wellbeing (D.A.M.) and Institute of Clinical Sciences (C.B., G.R.), University of Glasgow, United Kingdom; Norwich Medical School, University of East Anglia, Norwich, United Kingdom (M.F.); Health Research Institute, University of Limerick, Ireland (J.F.); National Health Service, Fife, United Kingdom (S.M.); and William Harvey Research Institute, Queen Mary University of London, United Kingdom (A.D.T.)
| | - Nicholas L Mills
- From the British Heart Foundation Centre for Cardiovascular Science (P.D.A., A.H., A.S.V.S., T.A.P., N.A.B., E.J.R.v.B., M.R.D., N.L.M., D.E.N.) and Clinical Research Imaging Centre (M.C.W.), University of Edinburgh, United Kingdom; Department of Cardiology, Odense University Hospital, Denmark (D.M.M., H.M.); Institute of Health and Wellbeing (D.A.M.) and Institute of Clinical Sciences (C.B., G.R.), University of Glasgow, United Kingdom; Norwich Medical School, University of East Anglia, Norwich, United Kingdom (M.F.); Health Research Institute, University of Limerick, Ireland (J.F.); National Health Service, Fife, United Kingdom (S.M.); and William Harvey Research Institute, Queen Mary University of London, United Kingdom (A.D.T.)
| | - David E Newby
- From the British Heart Foundation Centre for Cardiovascular Science (P.D.A., A.H., A.S.V.S., T.A.P., N.A.B., E.J.R.v.B., M.R.D., N.L.M., D.E.N.) and Clinical Research Imaging Centre (M.C.W.), University of Edinburgh, United Kingdom; Department of Cardiology, Odense University Hospital, Denmark (D.M.M., H.M.); Institute of Health and Wellbeing (D.A.M.) and Institute of Clinical Sciences (C.B., G.R.), University of Glasgow, United Kingdom; Norwich Medical School, University of East Anglia, Norwich, United Kingdom (M.F.); Health Research Institute, University of Limerick, Ireland (J.F.); National Health Service, Fife, United Kingdom (S.M.); and William Harvey Research Institute, Queen Mary University of London, United Kingdom (A.D.T.)
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Chen S, Liu Y, Islam SMS, Yao H, Zhou Y, Chen JY, Li Q. A simple prediction model to estimate obstructive coronary artery disease. BMC Cardiovasc Disord 2018; 18:7. [PMID: 29338684 PMCID: PMC5771201 DOI: 10.1186/s12872-018-0745-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Accepted: 01/10/2018] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND A simple noninvasive model to predict obstructive coronary artery disease (OCAD) may promote risk stratification and reduce the burden of coronary artery disease (CAD). This study aimed to develop pre-procedural, noninvasive prediction models that better estimate the probability of OCAD among patients with suspected CAD undergoing elective coronary angiography (CAG). METHODS We included 1262 patients, who had reliable Framingham risk variable data, in a cohort without known CAD from a prospective registry of patients referred for elective CAG. We investigated pre-procedural OCAD (≥50% stenosis in at least one major coronary vessel based on CAG) predictors. RESULTS A total of 945 (74.9%) participants had OCAD. The final modified Framingham scoring (MFS) model consisted of anemia, high-sensitivity C-reactive protein, left ventricular ejection fraction, and five Framingham factors (age, sex, total and high-density lipoprotein cholesterol, and hypertension). Bootstrap method (1000 times) revealed that the model demonstrated a good discriminative power (c statistic, 0.729 ± 0.0225; 95% CI, 0.69-0.77). MFS provided adequate goodness of fit (P = 0.43) and showed better performance than Framingham score (c statistic, 0.703 vs. 0.521; P < 0.001) in predicting OCAD, thereby identifying patients with high risks for OCAD (risk score ≥ 27) with ≥70% predictive value in 68.8% of subjects (range, 37.2-87.3% for low [≤17] and very high [≥41] risk scores). CONCLUSION Our data suggested that the simple MFS risk stratification tool, which is available in most primary-level clinics, showed good performance in estimating the probability of OCAD in relatively stable patients with suspected CAD; nevertheless, further validation is needed.
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Affiliation(s)
- Shiqun Chen
- Department of Cardiology, Provincial Key Laboratory of Coronary Heart Disease, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510100 China
- Guangdong General Hospital Zhuhai Hospital, Guangdong Academy of Medical Sciences, Zhuhai, 519000 China
- The George Institute for Global Health, University of Sydney, Camperdown, NSW 2050 Australia
| | - Yong Liu
- Department of Cardiology, Provincial Key Laboratory of Coronary Heart Disease, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510100 China
- The George Institute for Global Health, University of Sydney, Camperdown, NSW 2050 Australia
| | | | - Hua Yao
- Department of Cardiology, Provincial Key Laboratory of Coronary Heart Disease, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510100 China
| | - Yingling Zhou
- Department of Cardiology, Provincial Key Laboratory of Coronary Heart Disease, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510100 China
- Guangdong General Hospital Zhuhai Hospital, Guangdong Academy of Medical Sciences, Zhuhai, 519000 China
| | - Ji-yan Chen
- Department of Cardiology, Provincial Key Laboratory of Coronary Heart Disease, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510100 China
| | - Qiang Li
- The George Institute for Global Health, University of Sydney, Camperdown, NSW 2050 Australia
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26
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Daffara V, Verdoia M, Rolla R, Nardin M, Marino P, Bellomo G, Carriero A, De Luca G. Impact of polymorphism rs7041 and rs4588 of Vitamin D Binding Protein on the extent of coronary artery disease. Nutr Metab Cardiovasc Dis 2017; 27:775-783. [PMID: 28779988 DOI: 10.1016/j.numecd.2017.06.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 06/02/2017] [Accepted: 06/08/2017] [Indexed: 12/18/2022]
Abstract
BACKGROUND AND AIM 25-hydroxyvitamin D deficiency represents a widespread social problem but also an emerging risk factor for cardiovascular disease. Genetic variants of the Vitamin D Binding Protein (VDBP), the main transporter of vitamin D in the bloodstream, have been shown to account for a significant variability in the levels and systemic effects of vitamin D. We investigated whether the single nucleotide polymorphisms, rs7041 and rs4588, of VDBP are associated to the prevalence and extent of coronary artery disease. METHODS AND RESULTS A consecutive cohort of patients undergoing coronary angiography in a single centre were included. Significant CAD was defined as at least 1 stenosis >50%, severe CAD for as left main and/or three-vessel disease. VDBP genetic status was assessed by polymerase chain reaction and restriction fragment length polymorphism technique. We included 1080 patients, 57% carried the mutated G allele of rs7041, whereas 22% carried the A allele of rs4588. Higher levels of C- reactive protein were observed in the carriers of G allele of rs7041 (p = 0.02), whereas 25-hydroxyvitamin D levels were similar across groups. A higher prevalence of lesions in the left anterior descending artery and a longer lesion length were observed in "A" carriers for rs4588 (p = 0.04 and p = 0.03, respectively). On the contrary, a higher prevalence of bifurcation lesions and chronic occlusions was observed in G carriers (p = 0.002 and p = 0.01 respectively). Both polymorphisms of VDBP did not affect the prevalence of CAD (rs7041: 79.1% TT vs 80.3% TG vs 78.5% GG, p = 0.81; rs4588 = 80.3% CC vs 78.5% AC + AA, p = 0.49) and severe CAD, (rs7041: 31.1% TT % vs 31.3% TG vs 30.6% GG, p = 0.88; rs4588: 32.2% CC vs 29.3% AC + AA, p = 0.31). Results were confirmed at multivariate analysis, for both rs7041 and rs4588. However, when including the levels of 25-hydroxyvitamin D in the multivariate model, we observed that 25(OH)D status and not genetic variants of VDBP were significantly associated with CAD (25-hydroxyvitamin D OR [95% CI] = 0.99 [0.97-1.0], p = 0.05; rs7041 TG: OR [95% CI] = 1.26 [0.73-2.19], p = 0.41; rs7041 GG: OR [95% CI] = 1.25 [0.82-1.91], p = 0.30; rs4588 AC + AA: OR [95% CI] = 0.76 [0.51-1.13], p = 0.18). CONCLUSION This study showed in a large cohort of patients undergoing coronary angiography, that the polymorphisms rs7041 and rs4588 of VDBP are not associated with the levels of 25-hydroxyvitamin D nor with the prevalence and extent of CAD. In fact, 25-hydroxyvitamin D levels but not VDBP genetic status independently predicted the occurrence of coronary lesions at angiography.
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Affiliation(s)
- V Daffara
- Division of Cardiology, Azienda Ospedaliera-Universitaria "Maggiore della Carità", Università del Piemonte Orientale, Novara, Italy
| | - M Verdoia
- Division of Cardiology, Azienda Ospedaliera-Universitaria "Maggiore della Carità", Università del Piemonte Orientale, Novara, Italy
| | - R Rolla
- Clinical Chemistry, Azienda Ospedaliera-Universitaria "Maggiore della Carità", Università del Piemonte Orientale, Novara, Italy
| | - M Nardin
- Division of Cardiology, Azienda Ospedaliera-Universitaria "Maggiore della Carità", Università del Piemonte Orientale, Novara, Italy; Department of Medicine, ASST "Spedali Civili", University of Brescia, Italy
| | - P Marino
- Division of Cardiology, Azienda Ospedaliera-Universitaria "Maggiore della Carità", Università del Piemonte Orientale, Novara, Italy
| | - G Bellomo
- Clinical Chemistry, Azienda Ospedaliera-Universitaria "Maggiore della Carità", Università del Piemonte Orientale, Novara, Italy
| | - A Carriero
- Radiology, Azienda Ospedaliera-Universitaria "Maggiore della Carità", Università del Piemonte Orientale, Novara, Italy
| | - G De Luca
- Division of Cardiology, Azienda Ospedaliera-Universitaria "Maggiore della Carità", Università del Piemonte Orientale, Novara, Italy.
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Popovic D, Damjanovic S, Djordjevic T, Martic D, Ignjatovic S, Milinkovic N, Banovic M, Lasica R, Petrovic M, Guazzi M, Arena R. Stress hormones at rest and following exercise testing predict coronary artery disease severity and outcome. Stress 2017; 20:523-531. [PMID: 28845719 DOI: 10.1080/10253890.2017.1368488] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES Despite considerable knowledge regarding the importance of stress in coronary artery disease (CAD) pathogenesis, its underestimation persists in routine clinical practice, in part attributable to lack of a standardized, objective assessment. The current study examined the ability of stress hormones to predict CAD severity and prognosis at basal conditions as well as during and following an exertional stimulus. MATERIALS AND METHODS Forty Caucasian subjects with significant coronary artery lesions (≥50%) were included. Within 2 months of coronary angiography, cardiopulmonary exercise testing (CPET) on a recumbent ergometer was performed in conjunction with stress echocardiography (SE). At rest, peak and after 3 min of recovery following CPET, plasma levels of cortisol, adrenocorticotropic hormone (ACTH) and NT-pro-brain natriuretic peptide (NT-pro-BNP) were measured by immunoassay sandwich technique, radioimmunoassay, and radioimmunometric technique, respectively. Subjects were subsequently followed a mean of 32 ± 10 months. RESULTS AND DISCUSSION Mean ejection fraction was 56.7 ± 9.6%. Subjects with 1-2 stenotic coronary arteries (SCA) demonstrated a significantly lower plasma cortisol levels during CPET compared to those with 3-SCA (p < .05), whereas ACTH and NT-pro-BNP were not significantly different (p > .05). Among CPET, SE, and hormonal parameters, cortisol at rest and during CPET recovery demonstrated the best predictive value in distinguishing between 1-, 2-, and 3-SCA [area under ROC curve 0.75 and 0.77 (SE = 0.11, 0.10; p = .043, .04) for rest and recovery, respectively]. ΔCortisol peak/rest predicted cumulative cardiac events (area under ROC curve 0.75, SE = 0.10, p = .049). CONCLUSIONS Cortisol at rest and following an exercise test holds predictive value for CAD severity and prognosis, further demonstrating a link between stress and unwanted cardiac events.
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Affiliation(s)
- Dejana Popovic
- a Division of Cardiology , University of Belgrade , Belgrade , Serbia
- b Faculty of Pharmacy , University of Belgrade , Belgrade , Serbia
| | | | - Tea Djordjevic
- b Faculty of Pharmacy , University of Belgrade , Belgrade , Serbia
| | - Dejana Martic
- b Faculty of Pharmacy , University of Belgrade , Belgrade , Serbia
| | | | - Neda Milinkovic
- b Faculty of Pharmacy , University of Belgrade , Belgrade , Serbia
| | - Marko Banovic
- a Division of Cardiology , University of Belgrade , Belgrade , Serbia
| | - Ratko Lasica
- a Division of Cardiology , University of Belgrade , Belgrade , Serbia
| | - Milan Petrovic
- a Division of Cardiology , University of Belgrade , Belgrade , Serbia
| | - Marco Guazzi
- d Heart Failure Unit and Cardiopulmonary Laboratory, Cardiology , I.R.C.C.S, Policlinico San Donato University Hospital , Milan , Italy
| | - Ross Arena
- e Department of Physical Therapy, College of Applied Health Sciences , University of Illinois Chicago , Chicago , IL , USA
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Liu T, Wang G, Li P, Dai X. Risk classification of highly sensitive troponin I predict presence of vulnerable plaque assessed by dual source coronary computed tomography angiography. Int J Cardiovasc Imaging 2017; 33:1831-1839. [PMID: 28528430 DOI: 10.1007/s10554-017-1174-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 05/17/2017] [Indexed: 01/10/2023]
Abstract
Patients presenting to the emergency department with acute chest pain, negative conventional troponin and electrocardiogram require serial testing to rule out acute coronary syndrome (ACS). We studied the association of highly sensitive troponin (hsTn) I with vulnerable plaque features as detected by coronary dual source computed tomography angiography (DSCTA) and determined whether hsTn I at the time of presentation combined with early DSCTA could improve classification of patients as high-risk or low risk for ACS. We included 220 patients with acute chest pain, negative electrocardiogram and conventional troponin who underwent DSCTA and had hsTn I measured at the time of presentation. The patients were categorized as having hsTn I below the limit of detection (low risk), intermediate and above the 99th percentile (high risk). Readers assessed DSCTA qualitatively for the presence of significant CAD (≥50% stenosis), calcified and non-calcified coronary plaque, and vulnerable plaque features (positive remodeling, low CT attenuation plaque, napkin-ring sign, spotty calcium). The mean age of the population was 50.3 ± 8.2 years (43% women). ACS during the index hospitalization occurred in 36 (16.3%) patients (myocardial infarction n = 8, unstable angina pectoris n = 28). HsTn I was below the limit of detection, intermediate, and above 99th percentile in 39 (17.7%), 139 (86.9%), and 42 (19.1%) patients, respectively. Across the categories of low risk, intermediate and high risk of hsTn I, there was increase in prevalence of ≥50% stenosis (0, 11.5, and 61.9% of patients; p < 0.001), any plaque (35.9, 51.1, and 85.7% of patients; p < 0.001) and high-risk plaque (0, 36.0, and 85.7% of patients; p < 0.001). None of the patients in low risk HsTn I group had ACS. ACS occurred in 10.1% of the intermediate hsTn I group and in 52.3% of the patients with high risk hsTnI group. Severity of stenosis and presence of vunerable plaque as detected by DSCTA are associated with increasing levels of hsTn I. DSCTA at the time of presentation with the assessment for both stenosis and high-risk plaque improved the diagnostic accuracy for ACS in the intermediate hsTn I group patients.
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Affiliation(s)
- Ting Liu
- Department of Radiology, The First Affiliated Hospital of China Medical University, 155 Nanjing Bei St, Heping District, Shenyang, China
| | - Guan Wang
- Department of Radiology, The First Affiliated Hospital of China Medical University, 155 Nanjing Bei St, Heping District, Shenyang, China
| | - Peiling Li
- Department of Radiology, The First Affiliated Hospital of China Medical University, 155 Nanjing Bei St, Heping District, Shenyang, China
| | - Xu Dai
- Department of Radiology, The First Affiliated Hospital of China Medical University, 155 Nanjing Bei St, Heping District, Shenyang, China.
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Özyüncü N, Güleç S, Özdöl Ç, Candemir B, Ongun A, Tulunay Kaya C, Erol Ç. Impact of serum erythropoietin level on collateral vessel development in patients with coronary artery disease. Anatol J Cardiol 2017; 17:386-391. [PMID: 28315563 PMCID: PMC5469086 DOI: 10.14744/anatoljcardiol.2017.7419] [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] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/02/2017] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE Experimental data have shown that Erythropoietin (EPO) stimulates angiogenesis and neovascularization which may result in improved collateral development. The aim of this study was to investigate the association between serum EPO levels and the extent of coronary collaterals. Patient characteristics possibly related with coronary collaterals were also sought. METHODS A total of 256 patients with high grade coronary stenosis or occlusion were evaluated for the extent of coronary collaterals using Rentrop classification. Patients with grade 0 or 1 collaterals were grouped as poor collaterals, while grade 2 or 3 collaterals were grouped as good collaterals. RESULTS Mean age of the study population was 63 years, 77% were males. Subjects with good collaterals were significantly more likely to have anemia (p=0.038) and stable angina pectoris as clinical presentation (p=0.40). Serum EPO levels were not different among good and poor collateral groups (10.4±9.4 mU/mL vs. 9.7±11 mU/mL, p=0.397). The prevalence of all other cardiovascular risk factors, medications, and angiographic characteristics were similar between the two groups. After adjusting for age, gender, and clinical presentation with stable angina pectoris, presence of anemia persisted to be a significant correlate of the good collateral formation (OR: 1.95; 95%; CI: 1.07-3.54, p=0.029). CONCLUSION There has been conflicting results from trials studying the effects of serum EPO on coronary collateral development. The present study, with the largest patient population studying this topic, suggests that presence of anemia, but not serum EPO level, is associated with good collateral development.
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Affiliation(s)
- Nil Özyüncü
- Department of Cardiology, Faculty of Medicine, Ankara University; Ankara-Turkey.
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Li K, Yang X, Wang L, Chen M, Zhao W, Xu L, Yang X. Modification of the association between smoking status and severity of coronary stenosis by vitamin D in patients suspected of coronary heart disease. Medicine (Baltimore) 2016; 95:e4817. [PMID: 27603397 PMCID: PMC5023920 DOI: 10.1097/md.0000000000004817] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Given both smoking and vitamin D are associated with coronary heart disease (CHD) via inflammation and smoking may interfere with the local antiinflammatory effects of vitamin D. We hypothesized that the relationship between smoking and severity of CHD may be modified by vitamin D.A cross-sectional study was conducted. 25-OH vitamin D values were determined in 348 consecutive patients (mean age 62.4 ± 10.5 years; 56.3% male) undergoing coronary angiography at the Heart Center of Chaoyang Hospital affiliated to Capital Medical University between the period of September 2014 and May 2015. We categorized the patients into 2 groups based on 25-OH vitamin D levels, that is, severe hypovitaminosis D (25-OH vitamin D < 10 ng/mL) and higher vitamin D (25-OH vitamin D > = 10 ng/mL). Multivariable logistic regression models were used to estimate odds ratios (ORs) of severe coronary stenosis or higher Gensini score across three smoking status, that is, never smokers, former smokers, and current smokers in severe hypovitaminosis D and higher vitamin D groups, respectively.Of these patients, we identified 212 (60.9%) cases of severe CHD and 161 (46.3%) cases of severe hypovitaminosis D. Multivariable logistic regression model showed the ORs of severe CHD were 1.94 (95% confidence interval [CI]: 0.47, 7.98) for former smokers and 2.62 (95% CI: 0.83, 8.24) for current smokers, compared with never smokers in group with severe hypovitaminosis D (P-trend = 0.005). In contrast, smoking was not found to be significantly associated with severe CHD in group with higher 25-OH vitamin D (P-trend = 0.115). We found a significant interaction between smoking status and vitamin D on presence of severe CHD (P-interaction = 0.015). In terms of Gensini score as a dependent variable, similar results were identified.Our finding indicated the association between smoking and severity of CHD appeared to be substantially stronger among patients with severe hypovitaminosis D as compared with those with higher vitamin D levels. This suggests vitamin D sufficiency may have a protective effect against the damaging effects of smoking on coronary artery. Future cohort studies are warranted to confirm this finding.
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Affiliation(s)
| | | | | | | | | | | | - Xinchun Yang
- Heart Center of Beijing Chaoyang Hospital Affiliated to Capital Medical University, Chaoyang District, Beijing, China
- Correspondence: Xinchun Yang, Heart Center of Chaoyang Hospital Affiliated to Capital Medical University, Beijing City, Beijing 100020, China (e-mail: )
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Hromadka M, Baxa J, Seidlerova J, Suchy D, Sedivy J, Stepankova L, Rajdl D, Rokyta R. Incidence of severe coronary stenosis in asymptomatic patients with peripheral arterial disease scheduled for major vascular surgery. INT ANGIOL 2016; 35:411-417. [PMID: 25972137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND Peripheral arterial disease (PAD) has the risk equivalent of coronary heart disease. The biochemical parameters associated with functionally significant coronary artery stenosis were investigated in asymptomatic patients with PAD who were scheduled for major vascular intervention. METHODS A total of 50 PAD patients asymptomatic for coronary heart disease were examined using coronary computed tomography angiography (CTA). A stress myocardial CT perfusion (CTP) test was performed in patients who exhibited coronary stenosis >40%. In patients with stress-induced perfusion defects, the severity of stenosis was assessed using invasive coronary angiography including fractional flow reserve assessment. The CT findings were correlated with both classical and more recently developed parameters of atherosclerosis. RESULTS According to the combined CT examination (CTA and stress CT perfusion), 36% of patients exhibited significant coronary stenosis. Stress-induced hypoperfusion was observed in 95.7% of severe stenotic lesions. After adjustment for confounders, the level of high-sensitivity troponin I was associated with severe coronary stenosis (OR 1.260 [95% CI 1.054 to 1.505]). Other biochemical parameters did not correlate with coronary stenosis. The annual mortality rate was 4%. CONCLUSIONS The results of the present study confirm a significant diagnostic contribution of a complex cardiac CT examination in patients scheduled for major vascular surgery. A high prevalence of asymptomatic coronary heart disease was observed in this particular patient group. High-sensitivity measurements of troponin I correlated with the extent of the coronary stenosis.
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Affiliation(s)
- Milan Hromadka
- Cardiology Department, University Hospital and Faculty of Medicine in Pilsen, Czech Republic -
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Kawabe M, Sato A, Hoshi T, Endo M, Yoshida I, Aonuma K. Incremental value of B-type natriuretic peptide for detection and risk reclassification of obstructive coronary artery disease on computed tomography angiography. J Cardiol 2016; 69:671-677. [PMID: 27443597 DOI: 10.1016/j.jjcc.2016.06.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Revised: 06/14/2016] [Accepted: 06/19/2016] [Indexed: 01/19/2023]
Abstract
BACKGROUND B-type natriuretic peptide (BNP) is well known to increase as a result of left ventricular systolic dysfunction and is a useful diagnostic marker for heart failure. The purpose of this study was to assess the incremental value of BNP for predicting obstructive coronary artery disease (CAD) on computed tomography angiography (CTA) in patients with suspected CAD. METHODS This was an observational analysis of patients with stable CAD undergoing CTA in our institution between April 2008 and June 2014. Consecutive 947 patients with suspected CAD who underwent 64-slice CTA were enrolled. Obstructive CAD was defined as more than 50% luminal narrowing. We divided the patients into 2 groups according to median BNP value (20.3pg/ml). Duke clinical score for obstructive CAD was calculated for each patient. RESULTS Obstructive CAD was found in 273 (28.0%) patients. Median follow-up period was 37 months (interquartile range 21-55 months). Kaplan-Meier curves showed that BNP above median was significantly associated with major adverse cardiac events (p=0.001). In multivariable logistic analysis, patients with BNP above median were associated with the presence of obstructive CAD, as compared with BNP below median [odds ratio, 2.55; 95% confidence interval (CI), 1.79-3.63; p<0.001]. Analyzing the incremental value of the Duke clinical score and BNP, the predictive value of the Duke clinical score [area under the curve (AUC), 0.714] could be increased by BNP (AUC 0.745 for the combined model; p<0.001). Addition of BNP to a model containing the Duke clinical score resulted in net reclassification improvement index of 0.14 (95% CI: 0.053-0.205, p<0.001). CONCLUSIONS BNP might provide an incremental improvement in the detection of obstructive CAD on CTA when combined with a conventional cardiovascular risk score.
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Affiliation(s)
- Masayuki Kawabe
- Cardiovascular Division, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Akira Sato
- Cardiovascular Division, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
| | - Tomoya Hoshi
- Cardiovascular Division, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Masae Endo
- Department of Cardiology, Moriya General Hospital, Moriya, Japan
| | - Ikuo Yoshida
- Department of Cardiology, Moriya General Hospital, Moriya, Japan
| | - Kazutaka Aonuma
- Cardiovascular Division, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
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Saboori S, Koohdani F, Nematipour E, Yousefi Rad E, Saboor-Yaraghi AA, Javanbakht MH, Eshraghian MR, Ramezani A, Djalali M. Beneficial effects of omega-3 and vitamin E coadministration on gene expression of SIRT1 and PGC1α and serum antioxidant enzymes in patients with coronary artery disease. Nutr Metab Cardiovasc Dis 2016; 26:489-494. [PMID: 27033026 DOI: 10.1016/j.numecd.2015.11.013] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 11/26/2015] [Accepted: 11/26/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND AND AIM SIRT1 and PGC1α are two important genes, which play critical roles in regulating oxidative stress and inflammation processes. The study aimed assess the effects of coadministration of omega-3 and vitamin E supplements on SIRT1 and PGC1α gene expression and serum levels of antioxidant enzymes in coronary artery disease (CAD) patients. METHODS AND RESULTS Participants of this randomized controlled trial included 60 CAD male patients who were categorized into three groups: Group 1 received omega-3 (4 g/day) and vitamin E placebo (OP), group 2 omega-3 (4 g/day) and vitamin E (400 IU/day; OE), and group 3 omega-3 and vitamin E placebos (PP) for 2 months. Gene expression of SIRT1 and PGC1α in peripheral blood mononuclear cells (PBMCS) was assessed by reverse transcription polymerase chain reaction (RT-PCR). Furthermore, serum antioxidant enzyme and high-sensitivity C-reactive protein (hsCRP) levels were assessed at the beginning and end of the intervention. Gene expression of SIRT1 and PGC1α increased significantly in the OE group (P = 0.039 and P = 0.050, respectively). Catalase and hsCRP levels increased significantly in the OE and OP groups. However, glutathione peroxidase (GPX) and superoxide dismutase (SOD) levels did not statistically change in all groups. The total antioxidant capacity (TAC) increased significantly in the OE group (P = 0.009) but not in OP and PP groups. CONCLUSION Supplementation of omega-3 fatty acids in combination with vitamin E may have beneficial effects on CAD patients by increasing gene expression of SIRT1 and PGC1α and improving oxidative stress and inflammation in these patients.
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Affiliation(s)
- S Saboori
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, HojatDoost St, Tehran, Iran; Nutritional Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - F Koohdani
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, HojatDoost St, Tehran, Iran
| | - E Nematipour
- Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - E Yousefi Rad
- Nutritional Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - A A Saboor-Yaraghi
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, HojatDoost St, Tehran, Iran
| | - M H Javanbakht
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, HojatDoost St, Tehran, Iran
| | - M R Eshraghian
- Department of Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - A Ramezani
- Department of Basic sciences and Nutrition, Cardiovascular Research Center, School of public Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - M Djalali
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, HojatDoost St, Tehran, Iran.
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Baars T, Neumann U, Jinawy M, Hendricks S, Sowa JP, Kälsch J, Riemenschneider M, Gerken G, Erbel R, Heider D, Canbay A. In Acute Myocardial Infarction Liver Parameters Are Associated With Stenosis Diameter. Medicine (Baltimore) 2016; 95:e2807. [PMID: 26871849 PMCID: PMC4753945 DOI: 10.1097/md.0000000000002807] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Detection of high-risk subjects in acute myocardial infarction (AMI) by noninvasive means would reduce the need for intracardiac catheterization and associated complications. Liver enzymes are associated with cardiovascular disease risk. A potential predictive value for liver serum markers for the severity of stenosis in AMI was analyzed.Patients with AMI undergoing percutaneous coronary intervention (PCI; n = 437) were retrospectively evaluated. Minimal lumen diameter (MLD) and percent stenosis diameter (SD) were determined from quantitative coronary angiography. Patients were classified according to the severity of stenosis (SD ≥ 50%, n = 357; SD < 50%, n = 80). Routine heart and liver parameters were associated with SD using random forests (RF). A prediction model (M10) was developed based on parameter importance analysis in RF.Age, alkaline phosphatase (AP), aspartate aminotransferase (AST), and MLD differed significantly between SD ≥ 50 and SD < 50. Age, AST, alanine aminotransferase (ALT), and troponin correlated significantly with SD, whereas MLD correlated inversely with SD. M10 (age, BMI, AP, AST, ALT, gamma-glutamyltransferase, creatinine, troponin) reached an AUC of 69.7% (CI 63.8-75.5%, P < 0.0001).Routine liver parameters are associated with SD in AMI. A small set of noninvasively determined parameters can identify SD in AMI, and might avoid unnecessary coronary angiography in patients with low risk. The model can be accessed via http://stenosis.heiderlab.de.
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Affiliation(s)
- Theodor Baars
- From the Department for Cardiology, West German Heart and Vascular Centre Essen, University Hospital, University Duisburg-Essen, Essen, Germany (TB, MJ, SH, RE); Department of Bioinformatics, Straubing Center of Science, University of Applied Science Weihenstephan-Triesdorf, Straubing, Germany (UN, MR, DH); and Department of Gastroenterology and Hepatology, University Hospital, University Duisburg-Essen (J-PS, JK, GG, AC), Essen, Germany
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Isma'eel HA, Cremer PC, Khalaf S, Almedawar MM, Elhajj IH, Sakr GE, Jaber WA. Artificial neural network modeling enhances risk stratification and can reduce downstream testing for patients with suspected acute coronary syndromes, negative cardiac biomarkers, and normal ECGs. Int J Cardiovasc Imaging 2015; 32:687-96. [PMID: 26626458 DOI: 10.1007/s10554-015-0821-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 11/27/2015] [Indexed: 11/26/2022]
Abstract
Despite uncertain yield, guidelines endorse routine stress myocardial perfusion imaging (MPI) for patients with suspected acute coronary syndromes, unremarkable serial electrocardiograms, and negative troponin measurements. In these patients, outcome prediction and risk stratification models could spare unnecessary testing. This study therefore investigated the use of artificial neural networks (ANN) to improve risk stratification and prediction of MPI and angiographic results. We retrospectively identified 5354 consecutive patients referred from the emergency department for rest-stress MPI after serial negative troponins and normal ECGs. Patients were risk stratified according to thrombolysis in myocardial infarction (TIMI) scores, ischemia was defined as >5 % reversible perfusion defect, and obstructive coronary artery disease was defined as >50 % angiographic obstruction. For ANN, the network architecture employed a systematic method where the number of neurons is changed incrementally, and bootstrapping was performed to evaluate the accuracy of the models. Compared to TIMI scores, ANN models provided improved discriminatory power. With regards to MPI, an ANN model could reduce testing by 59 % and maintain a 96 % negative predictive value (NPV) for ruling out ischemia. Application of an ANN model could also avoid 73 % of invasive coronary angiograms while maintaining a 98 % NPV for detecting obstructive CAD. An online calculator for clinical use was created using these models. The ANN models improved risk stratification when compared to the TIMI score. Our calculator could also reduce downstream testing while maintaining an excellent NPV, though further study is needed before the calculator can be used clinically.
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Affiliation(s)
- Hussain A Isma'eel
- Division of Cardiology, Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
- Vascular Medicine Program, American University of Beirut Medical Center, Riad el Solh, PO Box 11-023, Beirut, 11072020, Lebanon
- Visiting Clinical Scholar, Department of Cardiovascular Medicine, Cleveland Clinic Foundation, 9500 Euclid Ave, Desk J1-5, Cleveland, OH, 44195, USA
| | - Paul C Cremer
- Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Shaden Khalaf
- Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Mohamad M Almedawar
- Vascular Medicine Program, American University of Beirut Medical Center, Riad el Solh, PO Box 11-023, Beirut, 11072020, Lebanon
- Division of Vascular Endothelium and Microcirculation, Department of Medicine III, TU Dresden, Dresden, Germany
| | - Imad H Elhajj
- Vascular Medicine Program, American University of Beirut Medical Center, Riad el Solh, PO Box 11-023, Beirut, 11072020, Lebanon
- Department of Electrical and Computer Engineering, American University of Beirut, Beirut, Lebanon
| | - George E Sakr
- Vascular Medicine Program, American University of Beirut Medical Center, Riad el Solh, PO Box 11-023, Beirut, 11072020, Lebanon.
- Ecole Supérieure d'Ingénieurs de Beyrouth (ESIB), Faculty of Engineering, Saint Joseph University of Beirut, Beirut, Lebanon.
| | - Wael A Jaber
- Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, USA.
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Hung CS, Li HY, Kuo CH, Lin MS, Kuo TC, Tsai SJ, Liu PH, Lin CH, Yang CY, Chuang LM, Chen MF, Tseng YJ, Kao HL. Fasting but not changes of plasma metabolome during oral glucose tolerance tests improves the diagnosis of severe coronary arterial stenosis. Clin Endocrinol (Oxf) 2015; 83:483-9. [PMID: 25557422 DOI: 10.1111/cen.12713] [Citation(s) in RCA: 3] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Revised: 06/19/2014] [Accepted: 12/19/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND Noninvasive stress tests for the diagnosis of significant coronary arterial stenosis requiring intervention are not perfect. We investigated whether plasma metabolome during the oral glucose tolerance test (OGTT) can improve the diagnosis. METHODS A total of 117 subjects with positive stress test results who received coronary angiography were recruited. After excluding subjects with a history of myocardial infarction and subjects who did not receive OGTT, the 18 subjects without significant stenosis were selected as controls. Another 18 age- and sex-matched subjects with significant stenosis were selected as cases. Plasma metabolome from samples obtained in fasting, 30 and 120 min after OGTT was measured using liquid chromatography combined with time-of-flight mass spectrometry. RESULTS We found five metabolites which can identify patients with significant stenosis independent to clinical risk factors, including diabetes, hypertension, hypercholesterolaemia, smoking and history of percutaneous coronary intervention (all P < 0·05). The area under the receiver operating characteristic (AUROC) curve of these metabolites was 0·799-0·818 at fasting and 30 min after OGTT. The addition of metabolites to clinical factors increases the AUROC (0·616, 95%CI 0·429-0·803 for model with clinical factors only; 0·824, 95%CI 0·689-0·959 for model with four metabolites and clinical factors). The changes of plasma metabolite levels during OGTT did not significantly improve the diagnostic performance. CONCLUSIONS Fasting plasma metabolome, but not change of plasma metabolome during OGTT, can improve the diagnosis of significant stenosis in patients with positive noninvasive stress test results.
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Affiliation(s)
- Chi-Sheng Hung
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Hung-Yuan Li
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Ching-Hua Kuo
- The Metabolomics Core Laboratory, Center of Genomic Medicine, National Taiwan University, Taipei, Taiwan
- School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan
| | - Mao-Shin Lin
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Tien-Chueh Kuo
- Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan
| | - Sung-Jeng Tsai
- School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Pi-Hua Liu
- Clinical Informatics and Medical Statistics Research Center, Chang Gung University, Taoyuan, Taiwan
| | - Cheng-Hsin Lin
- Department of Surgery, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Chun-Yi Yang
- Department of Medical Imaging, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Lee-Ming Chuang
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Ming-Fong Chen
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Yufeng J Tseng
- School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan
- Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan
- Department of Computer Science and Information Engineering, National Taiwan University, Taipei, Taiwan
- The Metabolomics Core Laboratory, Center of Genomic Medicine, National Taiwan University, Taipei, Taiwan
| | - Hsien-Li Kao
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
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Chen J, Zhang Y, Liu J, Chen MH, Guo YL, Zhu CG, Xu RX, Dong Q, Li JJ. Role of lipoprotein(a) in predicting the severity of new on-set coronary artery disease in type 2 diabetics: A Gensini score evaluation. Diab Vasc Dis Res 2015; 12:258-64. [PMID: 25861813 DOI: 10.1177/1479164115579004] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The objective of the study was to investigate the usefulness of serum lipoprotein(a) level in predicting the severity of new on-set coronary artery disease in type 2 diabetics. A total of 1254 new on-set, consecutive coronary artery disease patients were classified into two groups: diabetes group (n = 380) and non-diabetes group (n = 874). The relationship between serum lipoprotein(a) levels and the severity of coronary artery disease assessed by Gensini score was analysed. Data showed that the diabetes group had higher serum triglyceride and high sensitivity C-reactive protein levels but lower high-density lipoprotein cholesterol levels (all p < 0.05). The multivariate logistic regression analysis suggested that lipoprotein(a) was an independent predictor for high Gensini score (odds ratio = 1.82, 95% confidence interval: 1.10-3.12, p = 0.029) after adjusting for traditional cardiovascular risk factors. Additionally, lipoprotein(a) levels were positively correlated with Gensini score (rho = 0.15, p = 0.014) and significantly elevated according to the tertiles of Gensini score (p = 0.008) in diabetics. However, no such results were observed in non-diabetics. Our data indicate that lipoprotein(a) is an independent predictor for the severity of new on-set coronary artery disease patients accompanied by type 2 diabetes, suggesting that these patients may benefit from lipoprotein(a) management in clinical assessment.
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Affiliation(s)
- Juan Chen
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China The Central Hospital of Wuhan, Wuhan, China
| | - Yan Zhang
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jun Liu
- The Central Hospital of Wuhan, Wuhan, China
| | | | - Yuan-Lin Guo
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Cheng-Gang Zhu
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Rui-Xia Xu
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qian Dong
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jian-Jun Li
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Sun XQ, Bao BN, Gao XY, Yan DE, Zhou YS. Effect of glycated hemoglobin on heart function of the patients with revascularization of coronary artery. Int J Clin Exp Pathol 2015; 8:7181-7188. [PMID: 26261612 PMCID: PMC4525946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Accepted: 05/28/2015] [Indexed: 06/04/2023]
Abstract
BACKGROUND Patients with diabetes after coronary artery bypass graft (CABG) or percutaneous coronary intervention (PCI) treatment for coronary artery disease (CAD) had higher mortality rates than those without diabetes. There were limited data comparing the cardiac and metabolic differences between diabetes and non-diabetes for CABG and PCI and about impact of pre-procedure GHb level on systolic heart function in patients with diabetes. AIMS To explore the cardio-metabolic differences and to evaluate their potential as significant risk factors. SUBJECTS AND METHOD 124 patients with diabetes and 170 patients without diabetes were enrolled. Coronary lesions (≥ 70% stenosis in at least one major coronary artery) were documented by angiography. Patients with diabetes were divided into different groups by GHb, Coronary lesions (≥ 70% stenosis in at least one major coronary artery) were documented by angiography. CABG and PCI were performed for all the patients. Cardio-metabolic risk factors before revascularization were compared between them. RESULTS Diabetics with GHb ≥ 8% had lower cardiac ejection fraction (EF) values than those with GHb<8% (P<0.05) or patients without diabetes (P<0.05). And count of vascular lesions between the groups was not statistically significant. Observed EF as a dependent variable negatively correlated to GHb levels (P<0.05). The levels of glycated hemoglobin A1c (GHbA1c) rose with increased fasted blood glucose (FBG) values (P<0.001). Even with treatment for hyperglycemia and dyslipidemia, overall levels of fasting blood sugar (FBG, P<0.001), GHbA1c (P<0.001), and triglycerides (TG, P<0.05) in patients with diabetes were still higher than those without diabetes respectively. CONCLUSION Poorer glucose control with GHb ≥ 8% and decreased systolic heart function are significant risk factors that potentially contribute to worse prognosis for CABG or PCI treatment. Elevated levels of FBG, GHbA1c, and TG are evident for patients with diabetes compared to patients without diabetes prior to revascularization.
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Affiliation(s)
- X Q Sun
- Department of Endocrinology & Metabolism, Beijing Anzhen Hospital Affiliated to Capital Medical University Beijing, China
| | - B N Bao
- Department of Endocrinology & Metabolism, Beijing Anzhen Hospital Affiliated to Capital Medical University Beijing, China
| | - X Y Gao
- Department of Endocrinology & Metabolism, Beijing Anzhen Hospital Affiliated to Capital Medical University Beijing, China
| | - D E Yan
- Department of Endocrinology & Metabolism, Beijing Anzhen Hospital Affiliated to Capital Medical University Beijing, China ; Beijing Institute of Heart, Lung, and Blood Vessel Diseases Beijing, China
| | - Y S Zhou
- Department of Endocrinology & Metabolism, Beijing Anzhen Hospital Affiliated to Capital Medical University Beijing, China ; Beijing Institute of Heart, Lung, and Blood Vessel Diseases Beijing, China
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Najafi M, Mohammadi P. System study of MPO promoter high-frequency polymorphic variants on transcription factor network. Gene 2015; 560:143-8. [PMID: 25637720 DOI: 10.1016/j.gene.2015.01.055] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2014] [Revised: 01/22/2015] [Accepted: 01/27/2015] [Indexed: 11/19/2022]
Abstract
The neutrophil myeloperoxidase (MPO) promotes the oxidative stress by the production of active chlorinated molecules. The aim of this study was to investigate the association between MPO promoter polymorphic variants (rs2243827 and rs2333227) and, its serum level in patients with the stenosis of coronary arteries. Furthermore, a system approach was applied to create the MPO transcription factor network. A total of one hundred fifty six subjects (controls, stenosis<5%, n=71 and patients, stenosis>70%, n=85) undergoing coronary angiography were recruited. The polymorphic haplotypes and serum MPO level were identified using ARMS-PCR and ELISA techniques, respectively. The MPO transcription factor network was primarily created with PSICQUIC and ChIP data and, was improved with the predicted transcription factors. The regression analyses did not show an association between the serum MPO level and the extent of stenosis in coronary arteries. The network showed that the predicted transcription factors at the flanking regions of polymorphic variants are not directly interacted to MPO. In conclusion, the population and prediction studies showed no association between the serum MPO level, the promoter high-frequency polymorphic frequencies and the extent of stenosis in coronary arteries. A gene sub-cluster with MYB as central node was suggested to be involved with MPO on the transcription factor network.
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Affiliation(s)
- Mohammad Najafi
- Cellular and Molecular Research Center, Biochemistry Department, Iran University of Medical Sciences, Tehran, Iran.
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Voros S, Maurovich-Horvat P, Marvasty IB, Bansal AT, Barnes MR, Vazquez G, Murray SS, Voros V, Merkely B, Brown BO, Warnick GR. Precision phenotyping, panomics, and system-level bioinformatics to delineate complex biologies of atherosclerosis: rationale and design of the "Genetic Loci and the Burden of Atherosclerotic Lesions" study. J Cardiovasc Comput Tomogr 2014; 8:442-51. [PMID: 25439791 DOI: 10.1016/j.jcct.2014.08.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Revised: 08/25/2014] [Accepted: 08/27/2014] [Indexed: 01/24/2023]
Abstract
BACKGROUND Complex biological networks of atherosclerosis are largely unknown. OBJECTIVE The main objective of the Genetic Loci and the Burden of Atherosclerotic Lesions study is to assemble comprehensive biological networks of atherosclerosis using advanced cardiovascular imaging for phenotyping, a panomic approach to identify underlying genomic, proteomic, metabolomic, and lipidomic underpinnings, analyzed by systems biology-driven bioinformatics. METHODS By design, this is a hypothesis-free unbiased discovery study collecting a large number of biologically related factors to examine biological associations between genomic, proteomic, metabolomic, lipidomic, and phenotypic factors of atherosclerosis. The Genetic Loci and the Burden of Atherosclerotic Lesions study (NCT01738828) is a prospective, multicenter, international observational study of atherosclerotic coronary artery disease. Approximately 7500 patients are enrolled and undergo non-contrast-enhanced coronary calcium scanning by CT for the detection and quantification of coronary artery calcium, as well as coronary artery CT angiography for the detection and quantification of plaque, stenosis, and overall coronary artery disease burden. In addition, patients undergo whole genome sequencing, DNA methylation, whole blood-based transcriptome sequencing, unbiased proteomics based on mass spectrometry, as well as metabolomics and lipidomics on a mass spectrometry platform. The study is analyzed in 3 subsequent phases, and each phase consists of a discovery cohort and an independent validation cohort. For the primary analysis, the primary phenotype will be the presence of any atherosclerotic plaque, as detected by cardiac CT. Additional phenotypic analyses will include per patient maximal luminal stenosis defined as 50% and 70% diameter stenosis. Single-omic and multi-omic associations will be examined for each phenotype; putative biomarkers will be assessed for association, calibration, discrimination, and reclassification.
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Affiliation(s)
- Szilard Voros
- Global Genomics Group, LLC, 737 N. 5th Street, Richmond, VA 23219, USA.
| | | | - Idean B Marvasty
- Global Genomics Group, LLC, 737 N. 5th Street, Richmond, VA 23219, USA
| | | | | | | | - Sarah S Murray
- University of California at San Diego, San Diego, CA, USA
| | - Viktor Voros
- Global Genomics Group, LLC, 737 N. 5th Street, Richmond, VA 23219, USA
| | | | - Bradley O Brown
- Global Genomics Group, LLC, 737 N. 5th Street, Richmond, VA 23219, USA
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Sun Q, Jia X, Gao J, Mou W, Tong H, Wen X, Tian Y. Association of serum homocysteine levels with the severity and calcification of coronary atherosclerotic plaques detected by coronary CT angiography. INT ANGIOL 2014; 33:316-323. [PMID: 25056163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
AIM In this study, we aim to evaluate the association of risk factors including homocysteine (Hcy) with the severity and burden of coronary atherosclerotic plaques detected by computed tomography angiography (CTA). METHODS Six hundred fifty-nine subjects who underwent CTA for the assessment of coronary artery disease (CAD) were studied. All the subjects enrolled had no clinical cardiovascular disease symptoms. Logistic regression showed apart from age, hypertension, smoking, triglyceride, low-density lipoprotein (LDL) cholesterol, and total bilirubin, Hcy was an independently risk factor of the severity of coronary disease. And Hcy was also found an independent predictor for the presence of calcified plaque. When the participants were divided into 4 groups according to serum Hcy quartiles (Q1-Q4 groups), both the percentage of patients with >50% stenosis and the percentage of patients with calcified plaque were higher in Q4 compared to other groups. The OR of Hcy (>15 µmol/L) for >50% stenosis was 2.212 (95% CI=1.119 to 4.375, P=0.022) and the OR for Hcy (>15 µmol/L) for calcification was 1.668 (95% CI=1.030 to 2.699, P=0.037) respectively. CONCLUSION Our study shows Hcy is independently associated with both the severity and calcified plaque detected by CTA. Hcy may provide additional information about CAD in the subjects without clinical symptoms.
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Affiliation(s)
- Q Sun
- Department of Clinical Biochemistry, Chinese PLA General Hospital, Beijing, China -
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Kerkeni M, Weiss IS, Jaisson S, Dandana A, Addad F, Gillery P, Hammami M. Increased serum concentrations of pentosidine are related to presence and severity of coronary artery disease. Thromb Res 2014; 134:633-8. [PMID: 25065554 DOI: 10.1016/j.thromres.2014.07.008] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Revised: 05/26/2014] [Accepted: 07/03/2014] [Indexed: 11/18/2022]
Abstract
BACKGROUND There are limited data regarding the contribution of advanced glycation end products (AGEs) in the presence of coronary artery disease (CAD). We investigated whether serum pentosidine and Nε-carboxymethyllysine (CML) were related to the presence and the severity of CAD. METHODS 69 Tunisian patients with CAD (≥ 50% obstruction in ≥ 1 coronary artery), 32 Tunisian patients without CAD but with potential cardiovascular risk factors and 60 Tunisian control subjects were included in a cross-sectional study. Patients were classified as CAD and non CAD patients according to angiographic results. The severity of CAD was assessed using the Gensini score. Serum pentosidine and CML were measured by LC-MS/MS. RESULTS Serum pentosidine and CML concentrations were significantly higher in non-CAD patients vs control subjects (P<0.001). Serum pentosidine concentrations were significantly higher in CAD patients vs non-CAD patients (P<0.001). A multiple logistic regression analysis demonstrated that pentosidine was independently associated with the presence of CAD (OR=1.52, 95% CI: 1.12-2.07, P=0.007). The area under curve (AUC) determined by ROC analysis was 0.74 (95% CI: 0.64-0.84, P<0.001) and the optimal cut-off value of pentosidine to predict the presence of CAD was 3.2 μmol/mol Lys, with 64% sensitivity and 78% specificity. Furthermore, in a multivariate stepwise regression analysis, pentosidine was independently correlated with Gensini score (standardized β= 0.46, 95% CI: 0.70-1.99, P<0.001). CONCLUSIONS High concentrations of pentosidine show the presence and the severity of CAD with high sensitivity.
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Affiliation(s)
- Mohsen Kerkeni
- Laboratory of Biochemistry, LR12ES05, Faculty of Medicine, University of Monastir, Tunisia.
| | - Izabella Santos Weiss
- Laboratory of Paediatric Biology and Research, American Memorial Hospital, University Hospital of Reims, Faculty of Medicine, Reims, France; Laboratory of Biochemistry and Molecular Biology, UMR CNRS/URCA n°7369, Faculty of Medicine, Reims, France
| | - Stephane Jaisson
- Laboratory of Paediatric Biology and Research, American Memorial Hospital, University Hospital of Reims, Faculty of Medicine, Reims, France; Laboratory of Biochemistry and Molecular Biology, UMR CNRS/URCA n°7369, Faculty of Medicine, Reims, France
| | - Azza Dandana
- Laboratory of Biochemistry, CHU-Farhat Hached, Sousse, Tunisia
| | - Faouzi Addad
- Department of Cardiology-University Hopital A. Mami, Ariana, Tunisia
| | - Philippe Gillery
- Laboratory of Paediatric Biology and Research, American Memorial Hospital, University Hospital of Reims, Faculty of Medicine, Reims, France; Laboratory of Biochemistry and Molecular Biology, UMR CNRS/URCA n°7369, Faculty of Medicine, Reims, France
| | - Mohamed Hammami
- Laboratory of Biochemistry, LR12ES05, Faculty of Medicine, University of Monastir, Tunisia
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Zambon A, Zhao XQ, Brown BG, Brunzell JD. Effects of niacin combination therapy with statin or bile acid resin on lipoproteins and cardiovascular disease. Am J Cardiol 2014; 113:1494-8. [PMID: 24641964 DOI: 10.1016/j.amjcard.2014.01.426] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2013] [Revised: 01/30/2014] [Accepted: 01/30/2014] [Indexed: 11/29/2022]
Abstract
Two large studies in populations selected for cardiovascular disease (CVD) demonstrated that raising high-density lipoprotein (HDL) cholesterol with niacin added to statin therapy did not decrease CVD. We examine the association of lipoprotein subfractions with niacin and changes in coronary stenosis and CVD event risk. One hundred and seven patients from 2 previous studies using niacin in combination with either statin or bile acid-binding resin were selected to evaluate changes in lipoproteins separated by density-gradient ultracentrifugation to progression of coronary artery disease as assessed by quantitative coronary angiography. Improvement in coronary stenosis was significantly associated with the decrease of cholesterol in the dense low-density lipoprotein (LDL) particles and across most of the intermediate density lipoprotein (IDL) and very low density lipoprotein particle density range, but, not with any of the HDL fraction or of the more buoyant LDL fractions. Event-free survival was significantly associated with the decrease of cholesterol in the dense LDL and IDL; there was no association with changes in cholesterol in the HDL and buoyant LDL fractions. Niacin combination therapy raises HDL cholesterol and decreases dense LDL and IDL cholesterol levels. Changes in LDL and IDL are related to improvement in CVD. Lipoprotein subfraction analysis should be performed in larger studies utilizing niacin in combination with statins.
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Affiliation(s)
- Alberto Zambon
- Department of Medicine-DIMED, University of Padua, Padua, Italy
| | - Xue-Qiao Zhao
- Division of Cardiology, Department of Medicine, University of Washington, Seattle, Washington.
| | - B Greg Brown
- Division of Cardiology, Department of Medicine, University of Washington, Seattle, Washington
| | - John D Brunzell
- Division of Metabolism, Endocrinology and Nutrition, Department of Medicine, University of Washington, Seattle, Washington
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Najafi M, Roustazadeh A, Amirfarhangi A, Kazemi B. Matrix Gla protein (MGP) promoter polymorphic variants and its serum level in stenosis of coronary artery. Mol Biol Rep 2014; 41:1779-86. [PMID: 24445527 DOI: 10.1007/s11033-014-3027-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Accepted: 01/03/2014] [Indexed: 01/07/2023]
Abstract
Although the role of matrix Gla protein (MGP) is not completely known but, its expression within subendothelial macrophages and vascular smooth muscle cells is suggested to be involved in vascular calcification. In this study, we investigated the associations between the serum MGP levels and the MGP promoter high minor allele frequency (MAF) variants with the development of stenosis in coronary arteries. Moreover, we evaluated the allele changes within predicted transcription factor elements with bioinformatics tools. 182 subjects were recruited from who underwent coronary angiography. The MGP promoter rs1800801, rs1800802 and rs1800799 genotypes and haplotypes were detected by ARMS-RFLP PCR techniques. The serum MGP concentration was measured using ELISA method. Jaspar profiles were used for scoring the polymorphic variations within the transcription factor elements. The genotype and two-allelic haplotype distributions were not significant between the patient and control groups (P > 0.05). The serum MGP levels had not significant differences between the genotypes (P > 0.1) and haplotypes (P > 0.4). Based on the prediction studies, we did not observe significant differences between the polymorphic scores in the predicted elements (P > 0.05). We concluded that the genotype and haplotype distributions of the MGP promoter high-MAF polymorphisms, as confirmed in the prediction studies and the serum MGP level are not significantly associated with the coronary artery disease. Based on the study results, the MGP protein did not play an important role in the development of stenosis of coronary arteries.
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Affiliation(s)
- Mohammad Najafi
- Biochemistry Department, Cellular and Molecular Research Center, Iran University of Medical Sciences, Tehran, Iran,
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Xu L, Qian W, Li W, Liu J, He H, Li G, Cao Y, Yu Y. The severity of coronary artery disease and reversible ischemia revealed by N-terminal pro-brain natriuretic peptide in patients with unstable angina and preserved left ventricular function. Peptides 2014; 52:143-8. [PMID: 24412773 DOI: 10.1016/j.peptides.2013.12.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2013] [Revised: 12/27/2013] [Accepted: 12/28/2013] [Indexed: 11/19/2022]
Abstract
The association between the levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) and the severity of coronary artery disease (CAD) diagnosed by coronary angiography and other approaches has been investigated. The clinical application of NT-proBNP is restricted by the drawbacks of these techniques now available in screening out patients who need intensive or conservative treatment. Fractional flow reserve (FFR) is superior to coronary angiography and other functional indicators. Accordingly, we designed to investigate the association between NT-proBNP and myocardial ischemia from the perspective of anatomy and physiology in patients with unstable angina and preserved left ventricular function. Plasma samples were collected from 110 patients and NT-proBNP levels were measured by radioimmunoassay. The severity of coronary artery stenosis in patients was measured by coronary angiography and FFR. Stenosis ≥50% in the left main artery or stenosis of 70%, and fractional flow reserve (FFR) ≤0.80 in one or more coronary branches with diameter ≥2mm were defined as "positive", which require revascularization. NT-proBNP levels increased progressively between patients with negative and positive angiographic results (p<0.05), and between FFR-negative and FFR-positive patients (p<0.05). A significant correlation was observed between logNT-proBNP and logGS (GS=Gensini score, p<0.001). NT-proBNP level serves as a predictor of positive results of angiographic stenosis and FFR, with the area under the receiver operating characteristic curve being 0.697 and 0.787, respectively. NT-proBNP levels are correlated with the severity of anatomic coronary obstruction and inducible myocardial ischemia, but NT-proBNP per se is insufficient to identify clinically significant angiographic and physiological stenoses.
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Affiliation(s)
- Luhong Xu
- Institute of Cardiovascular Disease Research, Xuzhou Medical College, 84 West Huaihai Road, Xuzhou, Jiangsu 221002, China
| | - Wenhao Qian
- Department of Cardiology, The Affiliated Hospital of Xuzhou Medical College, 99 West Huaihai Road, Xuzhou, Jiangsu 221002, China.
| | - Wenhua Li
- Department of Cardiology, The Affiliated Hospital of Xuzhou Medical College, 99 West Huaihai Road, Xuzhou, Jiangsu 221002, China
| | - Jiali Liu
- Department of Cardiology, The Affiliated Hospital of Xuzhou Medical College, 99 West Huaihai Road, Xuzhou, Jiangsu 221002, China
| | - Haiyan He
- Institute of Cardiovascular Disease Research, Xuzhou Medical College, 84 West Huaihai Road, Xuzhou, Jiangsu 221002, China
| | - Gonghao Li
- Institute of Cardiovascular Disease Research, Xuzhou Medical College, 84 West Huaihai Road, Xuzhou, Jiangsu 221002, China
| | - Yan Cao
- Institute of Cardiovascular Disease Research, Xuzhou Medical College, 84 West Huaihai Road, Xuzhou, Jiangsu 221002, China
| | - Yaren Yu
- Institute of Cardiovascular Disease Research, Xuzhou Medical College, 84 West Huaihai Road, Xuzhou, Jiangsu 221002, China
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Sels JWEM, Rutten B, van Holten TC, Hillaert MAK, Waltenberger J, Pijls NHJ, Pasterkamp G, de Groot PG, Roest M. The relationship between fractional flow reserve, platelet reactivity and platelet leukocyte complexes in stable coronary artery disease. PLoS One 2013; 8:e83198. [PMID: 24391745 PMCID: PMC3877034 DOI: 10.1371/journal.pone.0083198] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2013] [Accepted: 11/10/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The presence of stenoses that significantly impair blood flow and cause myocardial ischemia negatively affects prognosis of patients with stable coronary artery disease. Altered platelet reactivity has been associated with impaired prognosis of stable coronary artery disease. Platelets are activated and form complexes with leukocytes in response to microshear gradients caused by friction forces on the arterial wall or flow separation. We hypothesized that the presence of significantly flow-limiting stenoses is associated with altered platelet reactivity and formation of platelet-leukocyte complexes. METHODS One hundred patients with stable angina were studied. Hemodynamic significance of all coronary stenoses was assessed with Fractional Flow Reserve (FFR). Patients were classified FFR-positive (at least one lesion with FFR≤0.75) or FFR-negative (all lesions FFR>0.80). Whole blood samples were stimulated with increasing concentrations of ADP, TRAP, CRP and Iloprost with substimulatory ADP. Expression of P-selectin as platelet activation marker and platelet-leukocyte complexes were measured by flowcytometry. Patients were stratified on clopidogrel use. FFR positive and negative patient groups were compared on platelet reactivity and platelet-leukocyte complexes. RESULTS Platelet reactivity between FFR-positive patients and FFR-negative patients did not differ. A significantly lower percentage of circulating platelet-neutrophil complexes in FFR-positive patients and a similar non-significant decrease in percentage of circulating platelet-monocyte complexes in FFR-positive patients was observed. CONCLUSION The presence of hemodynamically significant coronary stenoses does not alter platelet reactivity but is associated with reduced platelet-neutrophil complexes in peripheral blood of patients with stable coronary artery disease.
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Affiliation(s)
- Jan-Willem E. M. Sels
- Department of Cardiology, Catharina Hospital Eindhoven, Eindhoven, The Netherlands
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Bert Rutten
- Department of Clinical Chemistry and Hematology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Thijs C. van Holten
- Department of Clinical Chemistry and Hematology, University Medical Center Utrecht, Utrecht, The Netherlands
| | | | - Johannes Waltenberger
- Department of Cardiology, Maastricht University Medical Center, Maastricht. The Netherlands
- Department of Cardiovascular Medicine, University of Muenster, Muenster, Germany
| | - Nico H. J. Pijls
- Department of Cardiology, Catharina Hospital Eindhoven, Eindhoven, The Netherlands
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Gerard Pasterkamp
- Laboratory of Experimental Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Philip G. de Groot
- Department of Clinical Chemistry and Hematology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Mark Roest
- Department of Clinical Chemistry and Hematology, University Medical Center Utrecht, Utrecht, The Netherlands
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Shao L, Zhang P, Zhang Y, Lu Q, Ma A. TLR3 and TLR4 as potential clinically biomarkers of cardiovascular risk in coronary artery disease (CAD) patients. Heart Vessels 2013; 29:690-8. [PMID: 24146036 DOI: 10.1007/s00380-013-0421-3] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [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] [Received: 06/10/2013] [Accepted: 09/27/2013] [Indexed: 11/26/2022]
Abstract
Coronary artery disease (CAD), as a lipid-driven and inflammation-driven disease, has threatened thousands of patients' lives. Toll-like receptors, the most characterized innate immune receptors, have recently been demonstrated to play a key role in coronary artery disease, particularly Toll-like receptor (TLR) 3 and TLR4. We examined TLR3, TLR4, and associated inflammatory factors expression in monocytes and their signaling pathway proteins in patients with varying degrees of coronary artery atherosclerosis [group S (single diseased vessel), n = 36; group D (double diseased vessels), n = 36; group T (three diseased vessels), n = 33 compared with controls (n = 35)]. In mononuclear cells, TLR3 mRNA and protein, and IRF-3 were significantly down-regulated as the coronary arteries stenosis number increased. However, TLR4 mRNA and protein, and MyD88 were significantly increased in patients with coronary artery stenosis compared with controls, and were associated with the number of stenoses. In serum, there was significant up-regulation in TNF-α, IL-8, and MCP-1 and obvious down-regulation in INF-β and IP-10 with severity of CAD. This study demonstrates differential expression of TLR3 and TLR4 at both the mRNA and protein level in both mononuclear cells and downstream serum readouts of patients with CAD compared with the control. The expression of TLR4 and TLR3 closely correlated with the severity of coronary artery disease as reflected by the number of coronary artery stenoses. TLR3 and TLR4 have the potential to be a clinically useful biomarker of cardiovascular risk.
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Affiliation(s)
- Liang Shao
- Department of Cardiovascular Medicine, First Affiliated Hospital of Medical College of Xi'an Jiaotong University, No. 277 Yanta West Road, Xi'an, 710061, Shaanxi, People's Republic of China,
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Onat A, Yuksel H. Autoimmune activation, a fundamental mechanism of coronary artery disease risk, missed by inadequate analysis. Turk Kardiyol Dern Ars 2013; 41:566-567. [PMID: 24367809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
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Yamashita K, Yamamoto MH, Ebara S, Okabe T, Saito S, Hoshimoto K, Yakushiji T, Isomura N, Araki H, Obara C, Ochiai M. Association between increased epicardial adipose tissue volume and coronary plaque composition. Heart Vessels 2013; 29:569-77. [PMID: 23982316 PMCID: PMC4160569 DOI: 10.1007/s00380-013-0398-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Accepted: 08/02/2013] [Indexed: 11/25/2022]
Abstract
To assess the relationship between epicardial adipose tissue volume (EATV) and plaque vulnerability in significant coronary stenosis using a 40-MHz intravascular ultrasound (IVUS) imaging system (iMap-IVUS), we analyzed 130 consecutive patients with coronary stenosis who underwent dual-source computed tomography (CT) and cardiac catheterization. Culprit lesions were imaged by iMap-IVUS before stenting. The iMAP-IVUS system classified coronary plaque components as fibrous, lipid, necrotic, or calcified tissue, based on the radiofrequency spectrum. Epicardial adipose tissue was measured as the tissue ranging from -190 to -30 Hounsfield units. EATV, calculated as the sum of the fat areas on short-axis images, was 85.0 ± 34.0 cm(3). There was a positive correlation between EATV and the percentage of necrotic plaque tissue (R (2) = 0.34, P < 0.01), while there was a negative correlation between EATV and the percentage of fibrous tissue (R (2) = 0.24, P < 0.01). Multivariate analysis revealed that an increased low-density lipoprotein cholesterol level (β = 0.15, P = 0.03) and EATV (β = 0.14, P = 0.02) were independently associated with the percentage of necrotic plaque tissue. An increase in EATV was associated with the development of coronary atherosclerosis and, potentially, with the most dangerous type of plaque.
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Affiliation(s)
- Kennosuke Yamashita
- Division of Cardiology and Cardiac Catheterization Laboratories, Showa University Northern Yokohama Hospital, 35-1, Chigasaki-chuo, Tsuzuki, Yokohama, Kanagawa, 224-8503, Japan,
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Saffari B, Senemar S, Karimi M, Bahari M, Jooyan N, Yavarian M. An MTHFR variant, plasma homocysteine levels and late-onset coronary artery disease in subjects from southern Iran. Pak J Biol Sci 2013; 16:788-795. [PMID: 24498831 DOI: 10.3923/pjbs.2013.788.795] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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: 06/03/2023]
Abstract
There have been many controversial debates on the role of Hyperhomocysteinaemia (HHcy) as an independent risk factor for Coronary Artery Disease (CAD) during recent years. Furthermore, an alanine/valine (Ala/Val) gene polymorphism at 222nd amino acid of 5,10-methylenetetrahydrofolate reductase (MTHFR) has been considered as a factor that could render this enzyme thermolabile and less active which in turn may yield a subsequent increase in plasma total homocysteine (tHcy) levels. To assess whether this polymorphism is associated with increased risk of CAD and plasma levels of tHcy in a population from southern Iran, a total of 457 patients with angiographically documented multi-vessel CAD were compared with a control group comprised of 371 subjects with <30% stenosis in all major vessels. Nevertheless our results failed to admit a significant difference between CAD individuals and control subjects for Ala/Val polymorphism and plasma Hcy concentrations. However, plasma Hcy concentrations were significantly higher in individuals with Val/Val genotype than subjects with Ala/Ala genotype, but it didn't show a significant association with CAD in our population. Moreover, as the multiple linear regression analysis indicated, smoking habit, folate levels and the MTHFR Val/Val genotype were the only major predictors of tHcy concentrations in the current investigation.
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Affiliation(s)
- Babak Saffari
- Iranian Academic Center for Education, Culture and Research (ACECR), Fars Province Branch, Shiraz 71347, Iran
| | - Sara Senemar
- Iranian Academic Center for Education, Culture and Research (ACECR), Fars Province Branch, Shiraz 71347, Iran
| | - Mehran Karimi
- Hematology Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz 71937, Iran
| | - Marzieh Bahari
- Iranian Academic Center for Education, Culture and Research (ACECR), Fars Province Branch, Shiraz 71347, Iran
| | - Najmeh Jooyan
- Iranian Academic Center for Education, Culture and Research (ACECR), Fars Province Branch, Shiraz 71347, Iran
| | - Majid Yavarian
- Hematology Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz 71937, Iran
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