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Reith C, Preiss D, Blackwell L, Emberson J, Spata E, Davies K, Halls H, Harper C, Holland L, Wilson K, Roddick AJ, Cannon CP, Clarke R, Colhoun HM, Durrington PN, Goto S, Hitman GA, Hovingh GK, Jukema JW, Koenig W, Marschner I, Mihaylova B, Newman C, Probsfield JL, Ridker PM, Sabatine MS, Sattar N, Schwartz GG, Tavazzi L, Tonkin A, Trompet S, White H, Yusuf S, Armitage J, Keech A, Simes J, Collins R, Baigent C, Barnes E, Fulcher J, Herrington WG, Kirby A, O'Connell R, Amarenco P, Arashi H, Barter P, Betteridge DJ, Blazing M, Blauw GJ, Bosch J, Bowman L, Braunwald E, Bulbulia R, Byington R, Clearfield M, Cobbe S, Dahlöf B, Davis B, de Lemos J, Downs JR, Fellström B, Flather M, Ford I, Franzosi MG, Fuller J, Furberg C, Glynn R, Goldbourt U, Gordon D, Gotto, Jr A, Grimm R, Gupta A, Hawkins CM, Haynes R, Holdaas H, Hopewell J, Jardine A, Kastelein JJP, Kean S, Kearney P, Kitas G, Kjekshus J, Knatterud G, Knopp RH, Koren M, Krane V, Landray M, LaRosa J, Latini R, Lonn E, Lucci D, MacFadyen J, Macfarlane P, MacMahon S, Maggioni A, Marchioli R, Moyé L, Murphy S, Neil A, Nicolis EB, Packard C, Parish S, Pedersen TR, Peto R, Pfeffer M, Poulter N, Pressel S, Probstfield J, Rahman M, Robertson M, Sacks F, Schmieder R, Serruys P, Sever P, Shaw J, Shepherd J, Simpson L, Sleight P, Smeeth L, Tobert J, Tognoni G, Varigos J, Wanner C, Wedel H, Weis S, Welch KM, Wikstrand J, Wilhelmsen L, Wiviott S, Yamaguchi J, Young R, Zannad F. Effects of statin therapy on diagnoses of new-onset diabetes and worsening glycaemia in large-scale randomised blinded statin trials: an individual participant data meta-analysis. Lancet Diabetes Endocrinol 2024; 12:306-319. [PMID: 38554713 PMCID: PMC7615958 DOI: 10.1016/s2213-8587(24)00040-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 02/06/2024] [Accepted: 02/07/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND Previous meta-analyses of summary data from randomised controlled trials have shown that statin therapy increases the risk of diabetes, but less is known about the size or timing of this effect, or who is at greatest risk. We aimed to address these gaps in knowledge through analysis of individual participant data from large, long-term, randomised, double-blind trials of statin therapy. METHODS We conducted a meta-analysis of individual participant data from randomised controlled trials of statin therapy that participated in the CTT Collaboration. All double-blind randomised controlled trials of statin therapy of at least 2 years' scheduled duration and with at least 1000 participants were eligible for inclusion in this meta-analysis. All recorded diabetes-related adverse events, treatments, and measures of glycaemia were sought from eligible trials. Meta-analyses assessed the effects of allocation to statin therapy on new-onset diabetes (defined by diabetes-related adverse events, use of new glucose-lowering medications, glucose concentrations, or HbA1c values) and on worsening glycaemia in people with diabetes (defined by complications of glucose control, increased use of glucose-lowering medication, or HbA1c increase of ≥0·5%). Standard inverse-variance-weighted meta-analyses of the effects on these outcomes were conducted according to a prespecified protocol. FINDINGS Of the trials participating in the CTT Collaboration, 19 trials compared statin versus placebo (123 940 participants, 25 701 [21%] with diabetes; median follow-up of 4·3 years), and four trials compared more versus less intensive statin therapy (30 724 participants, 5340 [17%] with diabetes, median follow-up of 4·9 years). Compared with placebo, allocation to low-intensity or moderate-intensity statin therapy resulted in a 10% proportional increase in new-onset diabetes (2420 of 39 179 participants assigned to receive a statin [1·3% per year] vs 2214 of 39 266 participants assigned to receive placebo [1·2% per year]; rate ratio [RR] 1·10, 95% CI 1·04-1·16), and allocation to high-intensity statin therapy resulted in a 36% proportional increase (1221 of 9935 participants assigned to receive a statin [4·8% per year] vs 905 of 9859 participants assigned to receive placebo [3·5% per year]; 1·36, 1·25-1·48). For each trial, the rate of new-onset diabetes among participants allocated to receive placebo depended mostly on the proportion of participants who had at least one follow-up HbA1c measurement; this proportion was much higher in the high-intensity than the low-intensity or moderate-intensity trials. Consequently, the main determinant of the magnitude of the absolute excesses in the two types of trial was the extent of HbA1c measurement rather than the proportional increase in risk associated with statin therapy. In participants without baseline diabetes, mean glucose increased by 0·04 mmol/L with both low-intensity or moderate-intensity (95% CI 0·03-0·05) and high-intensity statins (0·02-0·06), and mean HbA1c increased by 0·06% (0·00-0·12) with low-intensity or moderate-intensity statins and 0·08% (0·07-0·09) with high-intensity statins. Among those with a baseline measure of glycaemia, approximately 62% of new-onset diabetes cases were among participants who were already in the top quarter of the baseline distribution. The relative effects of statin therapy on new-onset diabetes were similar among different types of participants and over time. Among participants with baseline diabetes, the RRs for worsening glycaemia were 1·10 (1·06-1·14) for low-intensity or moderate-intensity statin therapy and 1·24 (1·06-1·44) for high-intensity statin therapy compared with placebo. INTERPRETATION Statins cause a moderate dose-dependent increase in new diagnoses of diabetes that is consistent with a small upwards shift in glycaemia, with the majority of new diagnoses of diabetes occurring in people with baseline glycaemic markers that are close to the diagnostic threshold for diabetes. Importantly, however, any theoretical adverse effects of statins on cardiovascular risk that might arise from these small increases in glycaemia (or, indeed, from any other mechanism) are already accounted for in the overall reduction in cardiovascular risk that is seen with statin therapy in these trials. These findings should further inform clinical guidelines regarding clinical management of people taking statin therapy. FUNDING British Heart Foundation, UK Medical Research Council, and Australian National Health and Medical Research Council.
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Wu R, Williams C, Zhou J, Schlackow I, Emberson J, Reith C, Keech A, Robson J, Armitage J, Gray A, Simes J, Baigent C, Mihaylova B, Armitage J, Baigent C, Barnes E, Blackwell L, Collins R, Davies K, Emberson J, Fulcher J, Halls H, Herrington WG, Holland L, Keech A, Kirby A, Mihaylova B, O'Connell R, Preiss D, Reith C, Simes J, Wilson K, Blazing M, Braunwald E, Lemos JD, Murphy S, Pedersen TR, Pfeffer M, White H, Wiviott S, Clearfield M, Downs JR, Gotto A, Weis S, Fellström B, Holdaas H, Jardine A, Pedersen TR, Gordon D, Davis B, Furberg C, Grimm R, Pressel S, Probstfield JL, Rahman M, Simpson L, Koren M, Dahlöf B, Gupta A, Poulter N, Sever P, Wedel H, Knopp RH, Cobbe S, Fellström B, Holdaas H, Jardine A, Schmieder R, Zannad F, Betteridge DJ, Colhoun HM, Durrington PN, Fuller J, Hitman GA, Neil A, Braunwald E, Davis B, Hawkins CM, Moyé L, Pfeffer M, Sacks F, Kjekshus J, Wedel H, Wikstrand J, Wanner C, Krane V, Franzosi MG, Latini R, Lucci D, Maggioni A, Marchioli R, Nicolis EB, Tavazzi L, Tognoni G, Bosch J, Lonn E, Yusuf S, Armitage J, Bowman L, Collins R, Keech A, Landray M, Parish S, Peto R, Sleight P, Kastelein JJ, Pedersen TR, Glynn R, Gotto A, Kastelein JJ, Koenig W, MacFadyen J, Ridker PM, Keech A, MacMahon S, Marschner I, Tonkin A, Shaw J, Simes J, White H, Serruys PW, Knatterud G, Blauw GJ, Cobbe S, Ford I, Macfarlane P, Packard C, Sattar N, Shepherd J, Trompet S, Braunwald E, Cannon CP, Murphy S, Collins R, Armitage J, Bowman L, Bulbulia R, Haynes R, Parish S, Peto R, Sleight P, Amarenco P, Welch KM, Kjekshus J, Pedersen TR, Wilhelmsen L, Barter P, Gotto A, LaRosa J, Kastelein JJ, Shepherd J, Cobbe S, Ford I, Kean S, Macfarlane P, Packard C, Roberston M, Sattar N, Shepherd J, Young R, Arashi H, Clarke R, Flather M, Goto S, Goldbourt U, Hopewell J, Hovingh GK, Kitas G, Newman C, Sabatine MS, Schwartz GG, Smeeth L, Tobert J, Varigos J, Yamamguchi J. Long-term cardiovascular risks and the impact of statin treatment on socioeconomic inequalities: a microsimulation model. Br J Gen Pract 2024; 74:BJGP.2023.0198. [PMID: 38373851 PMCID: PMC10904120 DOI: 10.3399/bjgp.2023.0198] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 09/19/2023] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND UK cardiovascular disease (CVD) incidence and mortality have declined in recent decades but socioeconomic inequalities persist. AIM To present a new CVD model, and project health outcomes and the impact of guideline-recommended statin treatment across quintiles of socioeconomic deprivation in the UK. DESIGN AND SETTING A lifetime microsimulation model was developed using 117 896 participants in 16 statin trials, 501 854 UK Biobank (UKB) participants, and quality-of-life data from national health surveys. METHOD A CVD microsimulation model was developed using risk equations for myocardial infarction, stroke, coronary revascularisation, cancer, and vascular and non-vascular death, estimated using trial data. The authors calibrated and further developed this model in the UKB cohort, including further characteristics and a diabetes risk equation, and validated the model in UKB and Whitehall II cohorts. The model was used to predict CVD incidence, life expectancy, quality-adjusted life years (QALYs), and the impact of UK guideline-recommended statin treatment across socioeconomic deprivation quintiles. RESULTS Age, sex, socioeconomic deprivation, smoking, hypertension, diabetes, and cardiovascular events were key CVD risk determinants. Model-predicted event rates corresponded well to observed rates across participant categories. The model projected strong gradients in remaining life expectancy, with 4-5-year (5-8 QALYs) gaps between the least and most socioeconomically deprived quintiles. Guideline-recommended statin treatment was projected to increase QALYs, with larger gains in quintiles of higher deprivation. CONCLUSION The study demonstrated the potential of guideline-recommended statin treatment to reduce socioeconomic inequalities. This CVD model is a novel resource for individualised long-term projections of health outcomes of CVD treatments.
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Affiliation(s)
- Runguo Wu
- Health Economics and Policy Research Unit, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | - Claire Williams
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Junwen Zhou
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Iryna Schlackow
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Jonathan Emberson
- Nuffield Department of Population Health and Medical Research Council Population Health Research Unit, University of Oxford, Oxford, UK
| | - Christina Reith
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Anthony Keech
- National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Sydney, Australia
| | - John Robson
- Clinical Effectiveness Group, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | - Jane Armitage
- Nuffield Department of Population Health and Medical Research Council Population Health Research Unit, University of Oxford, Oxford, UK
| | - Alastair Gray
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - John Simes
- National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Sydney, Australia
| | - Colin Baigent
- Nuffield Department of Population Health and Medical Research Council Population Health Research Unit, University of Oxford, Oxford, UK
| | - Borislava Mihaylova
- Health Economics and Policy Research Unit, Wolfson Institute of Population Health, Queen Mary University of London, London; associate professor and senior health economist, Nuffield Department of Population Health, University of Oxford, Oxford, UK
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Meessen JMTA, Abete-Fornara G, Zarino B, Castori M, Tassi L, Carriero MR, D'Alessandris QG, Al-Shahi Salman R, Blanda A, Nicolis EB, Novelli D, Caruana M, Vasamì A, Lanfranconi S, Latini R. Patient-reported outcome measures in patients with familial cerebral cavernous malformations: results from the Treat_CCM trial. Front Neurol 2024; 15:1338941. [PMID: 38419711 PMCID: PMC10899450 DOI: 10.3389/fneur.2024.1338941] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 01/11/2024] [Indexed: 03/02/2024] Open
Abstract
Background The Phase 1/2 Treat_CCM randomized controlled trial for people with familial cerebral cavernous malformations (FCCMs) confirmed the safety of propranolol and suggested beneficial effects on intracerebral hemorrhage or new focal neurological deficits, but the effects on patient-reported outcome measures have not been reported. Methods Participants completed self-reported questionnaires at baseline, 1 and 2 years. Depression was assessed with the Beck Depression Inventory-II (BDI-2); Anxiety with the State-Trait Anxiety Inventory X1 and X2 (STAI X-1 and STAI X-2); and Quality of Life with the Short Form 36 (SF-36), split into the physical and mental component scales (PCS and MCS). Differences between treatment groups and the general population were assessed. Change over time by treatment was assessed by means of mixed models. Results In total, 71 participants (48 propranolol and 23 standard care) were enrolled, of whom 61 (73%) completed questionnaires at baseline and 2-year FU. At baseline, no differences between treatment groups for any of the questionnaires were present. Twenty (31.7%) patients were considered depressed at baseline, while this proportion was lower in the propranolol group after 2 years (28.6% vs. 55.5%, p = 0.047). The STAI X-1 and X-2 scores were stable over time. PCS was lower in FCCM patients as compared with the general Italian population, while the MCS was similar to the general population. No effect of propranolol was found for both PCS and MCS. Conclusion Depression is common among patients with FCCM. Patients randomized to propranolol had a lower proportion of participants with depression after 2 years.Clinical trial registration: https://clinicaltrials.gov/, identifier (NCT03589014).
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Affiliation(s)
- Jennifer M T A Meessen
- Department of Acute Brain and Cardiovascular Injury, Institute for Pharmacological Research Mario Negri IRCCS, Milan, Italy
| | - Giorgia Abete-Fornara
- Department of Neurochirurgia, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Barbara Zarino
- Department of Neurochirurgia, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Marco Castori
- Division of Medical Genetics, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Laura Tassi
- "Claudio Munari" Epilepsy Surgery Centre, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Maria R Carriero
- Cerebrovascular Disease Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Q G D'Alessandris
- Department of Neurosurgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - R Al-Shahi Salman
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Adriana Blanda
- Department of Acute Brain and Cardiovascular Injury, Institute for Pharmacological Research Mario Negri IRCCS, Milan, Italy
| | - Enrico B Nicolis
- Department of Acute Brain and Cardiovascular Injury, Institute for Pharmacological Research Mario Negri IRCCS, Milan, Italy
| | - Deborah Novelli
- Department of Acute Brain and Cardiovascular Injury, Institute for Pharmacological Research Mario Negri IRCCS, Milan, Italy
| | - Maria Caruana
- Department of Acute Brain and Cardiovascular Injury, Institute for Pharmacological Research Mario Negri IRCCS, Milan, Italy
| | - Antonella Vasamì
- Department of Acute Brain and Cardiovascular Injury, Institute for Pharmacological Research Mario Negri IRCCS, Milan, Italy
| | - Silvia Lanfranconi
- Department of Neurology, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Roberto Latini
- Department of Acute Brain and Cardiovascular Injury, Institute for Pharmacological Research Mario Negri IRCCS, Milan, Italy
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Lazzaroni F, Meessen JMTA, Sun Y, Lanfranconi S, Scola E, D'Alessandris QG, Tassi L, Carriero MR, Castori M, Marino S, Blanda A, Nicolis EB, Novelli D, Calabrese R, Agnelli NM, Bottazzi B, Leone R, Mazzola S, Besana S, Catozzi C, Nezi L, Lampugnani MG, Malinverno M, Grdseloff N, Rödel CJ, Rezai Jahromi B, Bolli N, Passamonti F, Magnusson PU, Abdelilah-Seyfried S, Dejana E, Latini R. Circulating biomarkers in familial cerebral cavernous malformation. EBioMedicine 2024; 99:104914. [PMID: 38113759 PMCID: PMC10767159 DOI: 10.1016/j.ebiom.2023.104914] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 11/27/2023] [Accepted: 11/30/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND Cerebral Cavernous Malformation (CCM) is a rare cerebrovascular disease, characterized by the presence of multiple vascular malformations that may result in intracerebral hemorrhages (ICHs), seizure(s), or focal neurological deficits (FND). Familial CCM (fCCM) is due to loss of function mutations in one of the three independent genes KRIT1 (CCM1), Malcavernin (CCM2), or Programmed Cell death 10 (PDCD10/CCM3). The aim of this study was to identify plasma protein biomarkers of fCCM to assess the severity of the disease and predict its progression. METHODS Here, we have investigated plasma samples derived from n = 71 symptomatic fCCM patients (40 female/31 male) and n = 17 healthy donors (HD) (9 female/8 male) of the Phase 1/2 Treat_CCM trial, using multiplexed protein profiling approaches. FINDINGS Biomarkers as sCD14 (p = 0.00409), LBP (p = 0.02911), CXCL4 (p = 0.038), ICAM-1 (p = 0.02013), ANG2 (p = 0.026), CCL5 (p = 0.00403), THBS1 (p = 0.0043), CRP (p = 0.0092), and HDL (p = 0.027), were significantly different in fCCM compared to HDs. Of note, sENG (p = 0.011), THBS1 (p = 0.011) and CXCL4 (p = 0.011), were correlated to CCM genotype. sROBO4 (p = 0.014), TM (p = 0.026) and CRP (p = 0.040) were able to predict incident adverse clinical events, such as ICH, FND or seizure. GDF-15, FLT3L, CXCL9, FGF-21 and CDCP1, were identified as predictors of the formation of new MRI-detectable lesions over 2-year follow-up. Furthermore, the functional relevance of ang2, thbs1, robo4 and cdcp1 markers was validated by zebrafish pre-clinical model of fCCM. INTERPRETATION Overall, our study identifies a set of biochemical parameters to predict CCM progression, suggesting biological interpretations and potential therapeutic approaches to CCM disease. FUNDING Italian Medicines Agency, Associazione Italiana per la Ricerca sul Cancro (AIRC), ERC, Leducq Transatlantic Network of Excellence, Swedish Research Council.
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Affiliation(s)
- Francesca Lazzaroni
- Vascular Biology Unit, IFOM ETS-The AIRC Institute of Molecular Oncology, Milan, Italy; Hematology Department, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Jennifer M T A Meessen
- Department of Acute Brain and Cardiovascular Injury, Institute for Pharmacological Research Mario Negri IRCCS, Milan, Italy
| | - Ying Sun
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Silvia Lanfranconi
- Department of Neurology, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Elisa Scola
- Department of Neurology, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Neuroradiology, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Quintino Giorgio D'Alessandris
- Department of Neurosurgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy; Department of Neuroscience, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Laura Tassi
- Claudio Munari Epilepsy Surgery Centre, ASST Niguarda Hospital, Milan, Italy
| | - Maria Rita Carriero
- Cerebrovascular Disease Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Marco Castori
- Division of Medical Genetics, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Silvia Marino
- IRCCS Centro Neurolesi "Bonino Pulejo", Messina, Italy
| | - Adriana Blanda
- Department of Acute Brain and Cardiovascular Injury, Institute for Pharmacological Research Mario Negri IRCCS, Milan, Italy
| | - Enrico B Nicolis
- Department of Acute Brain and Cardiovascular Injury, Institute for Pharmacological Research Mario Negri IRCCS, Milan, Italy
| | - Deborah Novelli
- Department of Acute Brain and Cardiovascular Injury, Institute for Pharmacological Research Mario Negri IRCCS, Milan, Italy
| | - Roberta Calabrese
- Department of Acute Brain and Cardiovascular Injury, Institute for Pharmacological Research Mario Negri IRCCS, Milan, Italy
| | - Nicolò M Agnelli
- Department of Acute Brain and Cardiovascular Injury, Institute for Pharmacological Research Mario Negri IRCCS, Milan, Italy
| | | | | | - Selene Mazzola
- Laboratory Medicine, Desio Hospital, Università Milano Bicocca, Milan, Italy
| | - Silvia Besana
- Laboratory Medicine, Desio Hospital, Università Milano Bicocca, Milan, Italy
| | - Carlotta Catozzi
- Department of Experimental Oncology, Istituto Europeo di Oncologia IRCCS, Milano, Italy
| | - Luigi Nezi
- Department of Experimental Oncology, Istituto Europeo di Oncologia IRCCS, Milano, Italy
| | - Maria G Lampugnani
- Vascular Biology Unit, IFOM ETS-The AIRC Institute of Molecular Oncology, Milan, Italy; Department of Acute Brain and Cardiovascular Injury, Institute for Pharmacological Research Mario Negri IRCCS, Milan, Italy
| | - Matteo Malinverno
- Vascular Biology Unit, IFOM ETS-The AIRC Institute of Molecular Oncology, Milan, Italy
| | - Nastasja Grdseloff
- Department of Zoophysiology, Institute of Biochemistry and Biology, University of Potsdam, Germany
| | - Claudia J Rödel
- Department of Zoophysiology, Institute of Biochemistry and Biology, University of Potsdam, Germany
| | | | - Niccolò Bolli
- Hematology Department, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Oncology and Hemato-Oncology, University of Milan, 20122, Milan, Italy
| | - Francesco Passamonti
- Hematology Department, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Oncology and Hemato-Oncology, University of Milan, 20122, Milan, Italy
| | - Peetra U Magnusson
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Salim Abdelilah-Seyfried
- Department of Zoophysiology, Institute of Biochemistry and Biology, University of Potsdam, Germany
| | - Elisabetta Dejana
- Vascular Biology Unit, IFOM ETS-The AIRC Institute of Molecular Oncology, Milan, Italy; Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Roberto Latini
- Department of Acute Brain and Cardiovascular Injury, Institute for Pharmacological Research Mario Negri IRCCS, Milan, Italy
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Lanfranconi S, Scola E, Meessen JMTA, Pallini R, Bertani GA, Al-Shahi Salman R, Dejana E, Latini R, Agnelli NM, Albanese A, Awad I, Bagnati R, Balconi G, Ballabio E, Beghi E, Bernasconi R, Bertani GA, Besana S, Blanda A, Bossi C, Bresolin N, Buratti MG, Calabrese R, Carriero MR, Castori M, Ciceri EF, Ciurleo R, Comi GP, Contarino V, Conte G, D'Agruma L, D'Alessandris GQ, de Grazia U, Di Bonaventura R, d'Orio P, Farago' G, Foresta A, Fusco C, Gaudino C, Lampugnani MG, Lanno A, Lazzaroni F, Lee C, Locatelli M, Maggioni AP, Magnusson P, Malinverno M, Mangiavacchi M, Mangraviti A, Marino S, Mazzola S, Nicolis EB, Novelli D, Ojeda Fernandez ML, Petracca A, Pignotti F, Pogliani S, Poloni M, Prelle A, Raggi P, Raucci F, Regna-Gladin C, Ronchi D, Scelzo E, Seyfried S, Simeone A, Sturiale CL, Tassi L, Tettamanti M, Torri V, Tournier-Lasserve E, Treglia R, Triulzi FM, Ungaro C, Ursi E, Valcamonica G, Vasami' A, Zarino B. Safety and efficacy of propranolol for treatment of familial cerebral cavernous malformations (Treat_CCM): a randomised, open-label, blinded-endpoint, phase 2 pilot trial. Lancet Neurol 2023; 22:35-44. [PMID: 36403580 DOI: 10.1016/s1474-4422(22)00409-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 09/20/2022] [Accepted: 09/28/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Observations in people with cerebral cavernous malformations, and in preclinical models of this disorder, suggest that the β-blocker propranolol might reduce the risk of intracerebral haemorrhage. We aimed to evaluate the safety and efficacy of prolonged treatment with propranolol to reduce the incidence of symptomatic intracerebral haemorrhage or focal neurological deficit in people with familial cerebral cavernous malformations. METHODS We conducted a randomised, open-label, blinded-endpoint, phase 2 pilot trial (Treat_CCM) at six national reference centres for rare diseases in Italy. People aged 18 years or older with symptomatic familial cerebral cavernous malformation were eligible for enrolment. Participants were randomly assigned (2:1) to receive either oral propranolol (20-320 mg daily) plus standard care (intervention group), or standard care alone (control group), for 24 months. Participants, caregivers, and investigators were aware of treatment group assignment. Participants had clinical assessments and 3 T brain MRI at baseline and at 12 and 24 months. The primary outcome was new occurrence of symptomatic intracerebral haemorrhage or focal neurological deficit attributable to cerebral cavernous malformation over 24 months. Outcome assessors were masked to treatment group assignment. The primary analysis was done in the intention-to-treat population. Because of the pilot study design, we chose a one-sided 80% CI, which could either exclude a clinically meaningful effect or show a signal of efficacy. This trial is registered with EudraCT, 2017-003595-30, and ClinicalTrials.gov, NCT03589014, and is closed to recruitment. FINDINGS Between April 11, 2018, and Dec 5, 2019, 95 people were assessed for eligibility and 83 were enrolled, of whom 57 were assigned to the propranolol plus standard care group and 26 to the standard care alone group. The mean age of participants was 46 years (SD 15); 48 (58%) were female and 35 (42%) were male. The incidence of symptomatic intracerebral haemorrhage or focal neurological deficit was 1·7 (95% CI 1·4-2·0) cases per 100 person-years (two [4%] of 57 participants) in the propranolol plus standard care group and 3·9 (3·1-4·7) per 100 person-years (two [8%] of 26) in the standard care alone group (univariable hazard ratio [HR] 0·43, 80% CI 0·18-0·98). The univariable HR showed a signal of efficacy, according to predefined criteria. The incidence of hospitalisation did not differ between groups (8·2 cases [95% CI 7·5-8·9] per 100 person-years in the propranolol plus standard care group vs 8·2 [95% CI 7·1-9·3] per 100 person-years in the standard care alone group). One participant in the standard care alone group died of sepsis. Three participants in the propranolol plus standard care group discontinued propranolol due to side-effects (two reported hypotension and one reported weakness). INTERPRETATION Propranolol was safe and well tolerated in this population. Propranolol might be beneficial for reducing the incidence of clinical events in people with symptomatic familial cerebral cavernous malformations, although this trial was not designed to be adequately powered to investigate efficacy. A definitive phase 3 trial of propranolol in people with symptomatic familial cerebral cavernous malformations is justified. FUNDING Italian Medicines Agency, Associazione Italiana per la Ricerca sul Cancro, Swedish Science Council, Knut and Alice Wallenberg Foundation, CARIPLO Foundation, Italian Ministry of Health.
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Affiliation(s)
- Silvia Lanfranconi
- Department of Neurology, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Elisa Scola
- and Department of Neuroradiology, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Jennifer M T A Meessen
- Department of Cardiovascular Medicine, Institute for Pharmacological Research Mario Negri IRCCS, Milan, Italy
| | - Roberto Pallini
- Department of Neurosurgery, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giulio A Bertani
- Department of Neurosurgery, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Elisabetta Dejana
- Laboratory of Vascular Biology, IFOM, Firc Institute for Molecular Oncology, Milan, Italy
| | - Roberto Latini
- Department of Cardiovascular Medicine, Institute for Pharmacological Research Mario Negri IRCCS, Milan, Italy.
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Meessen JMTA, Bär C, di Dona FM, Staszewsky LI, Di Giulio P, Di Tano G, Costa A, Leonardy J, Novelli D, Nicolis EB, Masson S, Pinet F, Thum T, Latini R. LIPCAR Is Increased in Chronic Symptomatic HF Patients. A Sub-Study of the GISSI-HF Trial. Clin Chem 2021; 67:1721-1731. [PMID: 34751777 DOI: 10.1093/clinchem/hvab197] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 08/26/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND The long noncoding RNA LIPCAR (Long Intergenic noncoding RNA Predicting CARdiac remodeling) has emerged as a promising biomarker in cardiac disease and cardiac remodeling. To determine whether LIPCAR levels help for a molecular phenotyping of chronic heart failure (HF) patients, this study assessed the association of LIPCAR with severity of the disease and its progression, and with risk of death or hospitalization in HF patients. METHODS LIPCAR was measured in plasma of 967 HF patients with symptomatic heart failure participating in the Gruppo Italiano per lo Studio della Sopravvivenza nell'Insufficienza Cardiaca - Heart Failure (GISSI-HF) biohumoral sub-study. RESULTS Plasma levels of LIPCAR were significantly associated with functional impairment as assessed by the New York Heart Association (NYHA) class, kidney function as reflected by estimated glomerular filtration rate, and creatinine, hemoglobin and mitral insufficiency. In females, these associations were more marked as compared to males. LIPCAR plasma levels were significantly related to the two cardiac markers, N-terminal pro-B type natriuretic peptide and high-sensitivity cardiac troponin T, but not to inflammatory markers such as high sensitivity C-reactive protein and pentraxin-3, nor to patient reported outcomes such as depression and quality of life. HF patients with high LIPCAR levels univariately showed significantly higher incidence of cardiovascular hospitalizations but not of death; after adjusting for covariates, no significant effects of LIPCAR were found for cardiovascular hospitalizations. CONCLUSION The circulating long noncoding RNA LIPCAR was increased in HF patients with higher NYHA class, impaired kidney function, and lower hemoglobin, which are indicators of patients' overall state.
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Affiliation(s)
- Jennifer M T A Meessen
- Department of Cardiovascular Medicine, Mario Negri Institute for Pharmacological Research IRCCS, Milan, Italy
| | - Christian Bär
- Institute of Molecular and Translational Therapeutic Strategies, Hannover Medical School, Hannover, Germany.,REBIRTH Center for Translational Regenerative Medicine, Hannover Medical School, Hannover, Germany
| | - Filippo M di Dona
- Department of Cardiovascular Medicine, Mario Negri Institute for Pharmacological Research IRCCS, Milan, Italy
| | - Lidia I Staszewsky
- Department of Cardiovascular Medicine, Mario Negri Institute for Pharmacological Research IRCCS, Milan, Italy
| | - Paola Di Giulio
- Department of Public Health and Pediatrics, University of Turin, Turin, Italy
| | | | - Alessia Costa
- Institute of Molecular and Translational Therapeutic Strategies, Hannover Medical School, Hannover, Germany.,REBIRTH Center for Translational Regenerative Medicine, Hannover Medical School, Hannover, Germany
| | - Julia Leonardy
- Institute of Molecular and Translational Therapeutic Strategies, Hannover Medical School, Hannover, Germany.,REBIRTH Center for Translational Regenerative Medicine, Hannover Medical School, Hannover, Germany
| | - Deborah Novelli
- Department of Cardiovascular Medicine, Mario Negri Institute for Pharmacological Research IRCCS, Milan, Italy
| | - Enrico B Nicolis
- Department of Cardiovascular Medicine, Mario Negri Institute for Pharmacological Research IRCCS, Milan, Italy
| | - Serge Masson
- Department of Cardiovascular Medicine, Mario Negri Institute for Pharmacological Research IRCCS, Milan, Italy
| | - Florence Pinet
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1167 - RID-AGE-Facteurs de Risque et Déterminants Moléculaires des Maladies Liées au Vieillissement, Lille, France
| | - Thomas Thum
- Institute of Molecular and Translational Therapeutic Strategies, Hannover Medical School, Hannover, Germany.,REBIRTH Center for Translational Regenerative Medicine, Hannover Medical School, Hannover, Germany
| | - Roberto Latini
- Department of Cardiovascular Medicine, Mario Negri Institute for Pharmacological Research IRCCS, Milan, Italy
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7
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Meessen JMTA, Cardinale D, Ciceri F, Sandri MT, Civelli M, Bottazzi B, Cucchi G, Menatti E, Mangiavacchi M, Condorelli G, Barbieri E, Gori S, Colombo A, Curigliano G, Salvatici M, Pastori P, Ghisoni F, Bianchi A, Falci C, Cortesi P, Farolfi A, Monopoli A, Milandri C, Bregni M, Malossi A, Nassiacos D, Verusio C, Staszewsky L, Leone R, Novelli D, Balconi G, Nicolis EB, Franzosi MG, Masson S, Garlanda C, Mantovani A, Cipolla CM, Latini R. Circulating biomarkers and cardiac function over 3 years after chemotherapy with anthracyclines: the ICOS-ONE trial. ESC Heart Fail 2020; 7:1452-1466. [PMID: 32358917 PMCID: PMC7373944 DOI: 10.1002/ehf2.12695] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 01/10/2020] [Accepted: 03/12/2020] [Indexed: 12/21/2022] Open
Abstract
AIMS A multicentre trial, ICOS-ONE, showed increases above the upper limit of normality of cardiac troponin (cTn) in 27% of patients within 12 months after the end of cancer chemotherapy (CT) with anthracyclines, whether cardiac protection with enalapril was started at study entry in all (prevention arm) or only upon first occurrence on supra-normal cTn (troponin-triggered arm). The aims of the present post hoc analysis were (i) to assess whether anthracycline-based treatment could induce cardiotoxicity over 36 month follow-up and (ii) to describe the time course of three cardiovascular biomarkers (i.e. troponin I cTnI-Ultra, B-type natriuretic peptide BNP, and pentraxin 3 PTX3) and of left ventricular (LV) function up to 36 months. METHODS AND RESULTS Eligible patients were those prescribed first-in-life CT, without evidence of cardiovascular disease, normal cTn, LV ejection fraction (EF) >50%, not on renin-angiotensin aldosterone system antagonists. Patients underwent echocardiography and blood sampling at 24 and 36 months. No differences were observed in biomarker concentration between the two study arms, 'prevention' vs. 'troponin-triggered'. During additional follow-up 13 more deaths occurred, leading to a total of 23 (9.5%), all due to a non-cardiovascular cause. No new occurrences of LV-dysfunction were reported. Two additional patients were admitted to the hospital for cardiovascular causes, both for acute pulmonary embolism. No first onset of raised cTnI-Ultra was reported in the extended follow-up. BNP remained within normal range: at 36 months was 23.4 ng/L, higher (N.S.) than at baseline, 17.6 ng/L. PTX3 peaked at 5.2 ng/mL 1 month after CT and returned to baseline values thereafter. cTnI-Ultra peaked at 26 ng/L 1 month after CT and returned to 3 ng/L until the last measurement at 36 months. All echocardiographic variables remained stable during follow-up with a median LVEF of 63% and left atrial volume index about 24 mL/m2 . CONCLUSIONS First-in-life CT with median cumulative dose of anthracyclines of 180 mg/m2 does not seem to cause clinically significant cardiac injury, as assessed by circulating biomarkers and echocardiography, in patients aged 51 years (median), without pre-existing cardiac disease. This may suggest either a 100% efficacy of enalapril (given as preventive or troponin-triggered) or a reassuringly low absolute cardiovascular risk in this cohort of patients, which may not require intensive cardiologic follow-up.
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Affiliation(s)
- Jennifer M T A Meessen
- Department of Cardiovascular Medicine, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | | | - Fabio Ciceri
- Haematology/Transplant Unit, IRCCS Ospedale San Raffaele, Università Vita-Salute, Milan, Italy
| | - Maria Teresa Sandri
- Laboratory Medicine, Humanitas Clinical and Reseach Center - IRCCS - Rozzano, Milan, Italy
| | - Maurizio Civelli
- Department of Cardiology, European Institute of Oncology, Milan, Italy
| | - Barbara Bottazzi
- Department of Immunology, Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy
| | | | | | - Maurizio Mangiavacchi
- Department of Cardiology, Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy
| | - Gianluigi Condorelli
- Department of Cardiology, Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy
| | - Enrico Barbieri
- Department of Cardiology, IRCCS Ospedale Sacro Cuore Don Calabria, Negrar, Italy
| | - Stefania Gori
- Department of Oncology, IRCCS Ospedale Sacro Cuore Don Calabria, Negrar, Italy
| | | | - Giuseppe Curigliano
- Division of Early Drug Development for Innovative Therapy, Department of Oncology and Hemato-Oncology, University of Milano, European Institute of Oncology, Milan, Italy
| | - Michela Salvatici
- Laboratory Medicine, Humanitas Clinical and Reseach Center - IRCCS - Rozzano, Milan, Italy
| | - Paolo Pastori
- Department of Cardiology, Ospedale di Vaio, Fidenza, Italy
| | - Francesco Ghisoni
- Unità Operativa Complessa Cure Palliative, Ospedale di Vaio, Fidenza, Italy
| | - Alessandra Bianchi
- Department of Cardiology, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy
| | - Cristina Falci
- Department of Oncology, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy
| | - Pietro Cortesi
- Department of Cardiology, IRCCS - Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, IRST, Meldola, Italy
| | - Alberto Farolfi
- Department of Oncology, IRCCS - Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, IRST, Meldola, Italy
| | - Anna Monopoli
- Department of Cardiology, Nuovo Ospedale San Giuseppe, Empoli, Italy
| | - Carlo Milandri
- Department of Oncology, Nuovo Ospedale San Giuseppe, Empoli, Italy
| | - Marco Bregni
- Department of Oncology, Presidio Ospedaliero di Busto Arsizio, Busto Arsizio, Italy
| | | | - Daniele Nassiacos
- Department of Cardiology, Presidio Ospedaliero di Saronno, Saronno, Italy
| | - Claudio Verusio
- Department of Oncology, Presidio Ospedaliero di Saronno, Saronno, Italy
| | - Lidia Staszewsky
- Department of Cardiovascular Medicine, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Roberto Leone
- Department of Immunology, Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy
| | - Deborah Novelli
- Department of Cardiovascular Medicine, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Giovanna Balconi
- Department of Cardiovascular Medicine, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Enrico B Nicolis
- Department of Cardiovascular Medicine, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Maria Grazia Franzosi
- Department of Cardiovascular Medicine, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Serge Masson
- Department of Cardiovascular Medicine, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Cecilia Garlanda
- Department of Immunology, Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy.,Humanitas University, Milan, Italy
| | - Alberto Mantovani
- Department of Immunology, Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy.,Humanitas University, Milan, Italy.,The William Harvey Research Institute, Queen Mary University of London, London, UK
| | - Carlo M Cipolla
- Department of Cardiology, European Institute of Oncology, Milan, Italy
| | - Roberto Latini
- Department of Cardiovascular Medicine, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
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Cardinale D, Ciceri F, Latini R, Franzosi MG, Sandri MT, Civelli M, Cucchi G, Menatti E, Mangiavacchi M, Cavina R, Barbieri E, Gori S, Colombo A, Curigliano G, Salvatici M, Rizzo A, Ghisoni F, Bianchi A, Falci C, Aquilina M, Rocca A, Monopoli A, Milandri C, Rossetti G, Bregni M, Sicuro M, Malossi A, Nassiacos D, Verusio C, Giordano M, Staszewsky L, Barlera S, Nicolis EB, Magnoli M, Masson S, Cipolla CM. Anthracycline-induced cardiotoxicity: A multicenter randomised trial comparing two strategies for guiding prevention with enalapril: The International CardioOncology Society-one trial. Eur J Cancer 2018; 94:126-137. [PMID: 29567630 DOI: 10.1016/j.ejca.2018.02.005] [Citation(s) in RCA: 135] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 02/13/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND Troponin changes over time have been suggested to allow for an early diagnosis of cardiac injury ensuing cancer chemotherapy; cancer patients with troponin elevation may benefit of therapy with enalapril. It is unknown whether a preventive treatment with enalapril may further increase the benefit. METHODS The International CardioOncology Society-one trial (ICOS-ONE) was a controlled, open-label trial conducted in 21 Italian hospitals. Patients were randomly assigned to two strategies: enalapril in all patients started before chemotherapy (CT; 'prevention' arm), and enalapril started only in patients with an increase in troponin during or after CT ('troponin-triggered' arm). Troponin was assayed locally in 2596 blood samples, before and after each anthracycline-containing CT cycle and at each study visit; electrocardiogram and echocardiogram were done at baseline, and at 1, 3, 6 and 12-month follow-up. Primary outcome was the incidence of troponin elevation above the threshold. FINDINGS Of the 273 patients, 88% were women, mean age 51 ± 12 years. The majority (76%) had breast cancer, 3% had a history of hypertension and 4% were diabetic. Epirubicin and doxorubicin were most commonly prescribed, with median cumulative doses of 360 [270-360] and 240 [240-240] mg/m2, respectively. The incidence of troponin elevation was 23% in the prevention and 26% in the troponin-triggered group (p = 0.50). Three patients (1.1%) -two in the prevention, one in the troponin-triggered group-developed cardiotoxicity, defined as 10% point reduction of LV ejection fraction, with values lower than 50%. INTERPRETATION Low cumulative doses of anthracyclines in adult patients with low cardiovascular risk can raise troponins, without differences between the two strategies of giving enalapril. Considering a benefit of enalapril in the prevention of LV dysfunction, a troponin-triggered strategy may be more convenient.
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Affiliation(s)
| | - Fabio Ciceri
- Haematology/Transplant Unit, Istituto Scientifico H. San Raffaele, Milano, Italy
| | - Roberto Latini
- Department of Cardiovascular Research, IRCCS - Mario Negri Institute for Pharmacological Research, Milano, Italy.
| | - Maria Grazia Franzosi
- Department of Cardiovascular Research, IRCCS - Mario Negri Institute for Pharmacological Research, Milano, Italy
| | | | - Maurizio Civelli
- Cardioncology Division, European Institute of Oncology, Milano, Italy
| | | | | | | | | | | | | | | | - Giuseppe Curigliano
- Division of Early Drug Development for Innovative Therapy, Department of Oncology and Hemato-Oncology, University of Milano, European Institute of Oncology, Milano, Italy
| | - Michela Salvatici
- Laboratory Medicine Division, European Institute of Oncology, Milano, Italy
| | | | - Francesco Ghisoni
- Unità Operativa Complessa Cure Palliative, Ospedale di Vaio, Fidenza, Italy
| | | | | | - Michele Aquilina
- Cardiology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori - IRCCS, Meldola, Italy
| | - Andrea Rocca
- Oncology, IRCCS-Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Italy
| | - Anna Monopoli
- Cardiology, Nuovo Ospedale San Giuseppe, Empoli, Italy
| | | | | | - Marco Bregni
- Oncology, Presidio Ospedaliero di Busto Arsizio, Italy
| | - Marco Sicuro
- Cardiology, Ospedale Regionale Umberto Parini, Aosta, Italy
| | | | | | | | - Monica Giordano
- Oncology, Azienda Socio Sanitaria Territoriale Lariana, Como, Italy
| | - Lidia Staszewsky
- Department of Cardiovascular Research, IRCCS - Mario Negri Institute for Pharmacological Research, Milano, Italy
| | - Simona Barlera
- Department of Cardiovascular Research, IRCCS - Mario Negri Institute for Pharmacological Research, Milano, Italy
| | - Enrico B Nicolis
- Department of Cardiovascular Research, IRCCS - Mario Negri Institute for Pharmacological Research, Milano, Italy
| | - Michela Magnoli
- Department of Cardiovascular Research, IRCCS - Mario Negri Institute for Pharmacological Research, Milano, Italy
| | - Serge Masson
- Department of Cardiovascular Research, IRCCS - Mario Negri Institute for Pharmacological Research, Milano, Italy
| | - Carlo M Cipolla
- Cardioncology Division, European Institute of Oncology, Milano, Italy
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Clemenza F, Masson S, Conaldi PG, Di Carlo D, Boccanelli A, Mureddu GF, Gonzini L, Lucci D, Maggioni AP, Di Lenarda A, Nicolis EB, Vanasia M, Latini R. Galectin-3 and the Mineralocorticoid Receptor Antagonist Canrenone in Mild Heart Failure. Circ J 2017; 81:1543-1546. [PMID: 28855452 DOI: 10.1253/circj.cj-17-0656] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Galectin-3 (Gal-3) is involved in collagen deposition and inflammation and is a prognostic biomarker in heart failure (HF).Methods and Results:Gal-3 and other markers of fibrosis or cardiac stress were measured serially in 413 patients with mild HF randomized to the mineralocorticoid receptor antagonist canrenone or placebo to evaluate treatment effect and association with clinical outcome. Gal-3 increased slightly over 6 months in both arms of the study and was associated with clinical endpoints. CONCLUSIONS Although Gal-3 showed prognostic value, the effect of canrenone on clinical outcomes was unaffected by baseline concentrations of biomarkers of fibrosis or cardiac stress.
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Affiliation(s)
| | - Serge Masson
- Department of Cardiovascular Research, IRCCS-Istituto di Ricerche Farmacologiche "Mario Negri"
| | | | - Daniele Di Carlo
- Department of Laboratory Medicine and Advanced Biotechnologies, ISMETT
| | | | | | | | | | | | | | - Enrico B Nicolis
- Department of Cardiovascular Research, IRCCS-Istituto di Ricerche Farmacologiche "Mario Negri"
| | | | - Roberto Latini
- Department of Cardiovascular Research, IRCCS-Istituto di Ricerche Farmacologiche "Mario Negri"
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Parolo S, Lisa A, Gentilini D, Di Blasio AM, Barlera S, Nicolis EB, Boncoraglio GB, Parati EA, Bione S. Characterization of the biological processes shaping the genetic structure of the Italian population. BMC Genet 2015; 16:132. [PMID: 26553317 PMCID: PMC4640365 DOI: 10.1186/s12863-015-0293-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Accepted: 11/03/2015] [Indexed: 12/11/2022] Open
Abstract
Background The genetic structure of human populations is the outcome of the combined action of different processes such as demographic dynamics and natural selection. Several efforts toward the characterization of population genetic architectures and the identification of adaptation signatures were recently made. In this study, we provide a genome-wide depiction of the Italian population structure and the analysis of the major determinants of the current existing genetic variation. Results We defined and characterized 210 genomic loci associated with the first Principal Component calculated on the Italian genotypic data and correlated to the North–south genetic gradient. Using a gene-enrichment approach we identified the immune function as primarily involved in the Italian population differentiation and we described a locus on chromosome 13 showing combined evidence of North–south diversification in allele frequencies and signs of recent positive selection. In this region our bioinformatics analysis pinpointed an uncharacterized long intergenic non-coding (lincRNA), whose expression appeared specific for immune-related tissues suggesting its relevance for the immune function. Conclusions Our study, combining population genetic analyses with biological insights provides a description of the Italian genetic structure that in future could contribute to the evaluation of complex diseases risk in the population context. Electronic supplementary material The online version of this article (doi:10.1186/s12863-015-0293-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Silvia Parolo
- Computational Biology Unit, Institute of Molecular Genetics-National Research Council, Pavia, Italy.
| | - Antonella Lisa
- Computational Biology Unit, Institute of Molecular Genetics-National Research Council, Pavia, Italy.
| | - Davide Gentilini
- Molecular Biology Laboratory, Istituto Auxologico Italiano, Milan, Italy.
| | | | - Simona Barlera
- Department of Cardiovascular Research, IRCCS Mario Negri Institute for Pharmacological Research, Milan, Italy.
| | - Enrico B Nicolis
- Department of Cardiovascular Research, IRCCS Mario Negri Institute for Pharmacological Research, Milan, Italy.
| | - Giorgio B Boncoraglio
- Department of Cerebrovascular Diseases, IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
| | - Eugenio A Parati
- Department of Cerebrovascular Diseases, IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
| | - Silvia Bione
- Computational Biology Unit, Institute of Molecular Genetics-National Research Council, Pavia, Italy.
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Ohmann C, Canham S, Cornu C, Dreß J, Gueyffier F, Kuchinke W, Nicolis EB, Wittenberg M. Revising the ECRIN standard requirements for information technology and data management in clinical trials. Trials 2013; 14:97. [PMID: 23561034 PMCID: PMC3653810 DOI: 10.1186/1745-6215-14-97] [Citation(s) in RCA: 9] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2012] [Accepted: 03/08/2013] [Indexed: 11/10/2022] Open
Abstract
The pilot phase of the ECRIN (European Clinical Research Infrastructure Network) certification programme for European data centres, in late 2011, led to a substantial revision of the original ECRIN standards, completed by June 2012. The pilot phase, the conclusions drawn from it and the revised set of standards are described. Issues concerning the further development of standards and related material are discussed, as are the methods available to best support that development. A strategy is outlined based on short-lived specific task groups, established as necessary by a steering group drawn from ECRIN-ERIC. A final section discusses possible future developments.
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Affiliation(s)
- Christian Ohmann
- Coordination Centre for Clinical Trials, Heinrich Heine University, Moorenstrasse 5, 40225, Düsseldorf, Germany
| | - Steve Canham
- Independent consultant, c/o Coordination Centre for Clinical Trials, Heinrich Heine University, Moorenstrasse 5, 40225, Düsseldorf, Germany
| | - Catherine Cornu
- INSERM, CIC201; CHU Lyon, Service de Pharmacologie Clinique, Université de Lyon, UMR 5558, 69000, Lyon, France
| | - Jochen Dreß
- Centre for Clinical Studies (ZKS), University of Cologne, Gleueler Strasse 269, 50935, Köln, Germany
| | - François Gueyffier
- Service de Pharmacologie Clinique et Essais Thérapeutiques, Hospices Civils de Lyon, Faculté de Médecine Laennec, 7 rue Guillaume Paradin, 69376, Lyon France
| | - Wolfgang Kuchinke
- Coordination Centre for Clinical Trials, Heinrich Heine University, Moorenstrasse 5, 40225, Düsseldorf, Germany
| | - Enrico B Nicolis
- Department of Cardiovascular Research, Mario Negri Institute- IRCCS, via la Masa 19, 20156, Milan, Italy
| | - Michael Wittenberg
- Coordination Centre for Clinical Trials, Philipps University Marburg, Biegenstrasse 10, 35032, Marburg, Germany
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12
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Staszewsky L, Wong M, Masson S, Raimondi E, Gramenzi S, Proietti G, Bicego D, Emanuelli C, Pulitanò G, Taddei F, Nicolis EB, Correale E, Fabbri G, Bertocchi F, Franzosi MG, Maggioni AP, Tognoni G, Disertori M, Latini R. Left Atrial Remodeling and Response to Valsartan in the Prevention of Recurrent Atrial Fibrillation. Circ Cardiovasc Imaging 2011; 4:721-8. [DOI: 10.1161/circimaging.111.965954] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Lidia Staszewsky
- From the Department of Cardiovascular Research, Istituto di Ricerche Farmacologiche “Mario Negri,” Milan, Italy (L.S., M.W., S.M., E.R., E.B.N., M.G.F., R.L.); Ospedale Fatebenefratelli e Oftalmico, Division of Cardiology, Milan, Italy (S.G.); Azienda USL 4, Cardiology Unit, Terni, Italy (G. Proietti); Ospedale Nuovo Girolamo Fracastoro, Cardiology Unit, San Bonifacio, Italy (D.B.); the Division of Cardiology, Presidio Ospedaliero di Cremona, Italy (C.E.); POL Madonna della Consolazione, Reggio
| | - Maylene Wong
- From the Department of Cardiovascular Research, Istituto di Ricerche Farmacologiche “Mario Negri,” Milan, Italy (L.S., M.W., S.M., E.R., E.B.N., M.G.F., R.L.); Ospedale Fatebenefratelli e Oftalmico, Division of Cardiology, Milan, Italy (S.G.); Azienda USL 4, Cardiology Unit, Terni, Italy (G. Proietti); Ospedale Nuovo Girolamo Fracastoro, Cardiology Unit, San Bonifacio, Italy (D.B.); the Division of Cardiology, Presidio Ospedaliero di Cremona, Italy (C.E.); POL Madonna della Consolazione, Reggio
| | - Serge Masson
- From the Department of Cardiovascular Research, Istituto di Ricerche Farmacologiche “Mario Negri,” Milan, Italy (L.S., M.W., S.M., E.R., E.B.N., M.G.F., R.L.); Ospedale Fatebenefratelli e Oftalmico, Division of Cardiology, Milan, Italy (S.G.); Azienda USL 4, Cardiology Unit, Terni, Italy (G. Proietti); Ospedale Nuovo Girolamo Fracastoro, Cardiology Unit, San Bonifacio, Italy (D.B.); the Division of Cardiology, Presidio Ospedaliero di Cremona, Italy (C.E.); POL Madonna della Consolazione, Reggio
| | - Elena Raimondi
- From the Department of Cardiovascular Research, Istituto di Ricerche Farmacologiche “Mario Negri,” Milan, Italy (L.S., M.W., S.M., E.R., E.B.N., M.G.F., R.L.); Ospedale Fatebenefratelli e Oftalmico, Division of Cardiology, Milan, Italy (S.G.); Azienda USL 4, Cardiology Unit, Terni, Italy (G. Proietti); Ospedale Nuovo Girolamo Fracastoro, Cardiology Unit, San Bonifacio, Italy (D.B.); the Division of Cardiology, Presidio Ospedaliero di Cremona, Italy (C.E.); POL Madonna della Consolazione, Reggio
| | - Silvana Gramenzi
- From the Department of Cardiovascular Research, Istituto di Ricerche Farmacologiche “Mario Negri,” Milan, Italy (L.S., M.W., S.M., E.R., E.B.N., M.G.F., R.L.); Ospedale Fatebenefratelli e Oftalmico, Division of Cardiology, Milan, Italy (S.G.); Azienda USL 4, Cardiology Unit, Terni, Italy (G. Proietti); Ospedale Nuovo Girolamo Fracastoro, Cardiology Unit, San Bonifacio, Italy (D.B.); the Division of Cardiology, Presidio Ospedaliero di Cremona, Italy (C.E.); POL Madonna della Consolazione, Reggio
| | - Gianni Proietti
- From the Department of Cardiovascular Research, Istituto di Ricerche Farmacologiche “Mario Negri,” Milan, Italy (L.S., M.W., S.M., E.R., E.B.N., M.G.F., R.L.); Ospedale Fatebenefratelli e Oftalmico, Division of Cardiology, Milan, Italy (S.G.); Azienda USL 4, Cardiology Unit, Terni, Italy (G. Proietti); Ospedale Nuovo Girolamo Fracastoro, Cardiology Unit, San Bonifacio, Italy (D.B.); the Division of Cardiology, Presidio Ospedaliero di Cremona, Italy (C.E.); POL Madonna della Consolazione, Reggio
| | - Dario Bicego
- From the Department of Cardiovascular Research, Istituto di Ricerche Farmacologiche “Mario Negri,” Milan, Italy (L.S., M.W., S.M., E.R., E.B.N., M.G.F., R.L.); Ospedale Fatebenefratelli e Oftalmico, Division of Cardiology, Milan, Italy (S.G.); Azienda USL 4, Cardiology Unit, Terni, Italy (G. Proietti); Ospedale Nuovo Girolamo Fracastoro, Cardiology Unit, San Bonifacio, Italy (D.B.); the Division of Cardiology, Presidio Ospedaliero di Cremona, Italy (C.E.); POL Madonna della Consolazione, Reggio
| | - Carlo Emanuelli
- From the Department of Cardiovascular Research, Istituto di Ricerche Farmacologiche “Mario Negri,” Milan, Italy (L.S., M.W., S.M., E.R., E.B.N., M.G.F., R.L.); Ospedale Fatebenefratelli e Oftalmico, Division of Cardiology, Milan, Italy (S.G.); Azienda USL 4, Cardiology Unit, Terni, Italy (G. Proietti); Ospedale Nuovo Girolamo Fracastoro, Cardiology Unit, San Bonifacio, Italy (D.B.); the Division of Cardiology, Presidio Ospedaliero di Cremona, Italy (C.E.); POL Madonna della Consolazione, Reggio
| | - Giancarlo Pulitanò
- From the Department of Cardiovascular Research, Istituto di Ricerche Farmacologiche “Mario Negri,” Milan, Italy (L.S., M.W., S.M., E.R., E.B.N., M.G.F., R.L.); Ospedale Fatebenefratelli e Oftalmico, Division of Cardiology, Milan, Italy (S.G.); Azienda USL 4, Cardiology Unit, Terni, Italy (G. Proietti); Ospedale Nuovo Girolamo Fracastoro, Cardiology Unit, San Bonifacio, Italy (D.B.); the Division of Cardiology, Presidio Ospedaliero di Cremona, Italy (C.E.); POL Madonna della Consolazione, Reggio
| | - Filippo Taddei
- From the Department of Cardiovascular Research, Istituto di Ricerche Farmacologiche “Mario Negri,” Milan, Italy (L.S., M.W., S.M., E.R., E.B.N., M.G.F., R.L.); Ospedale Fatebenefratelli e Oftalmico, Division of Cardiology, Milan, Italy (S.G.); Azienda USL 4, Cardiology Unit, Terni, Italy (G. Proietti); Ospedale Nuovo Girolamo Fracastoro, Cardiology Unit, San Bonifacio, Italy (D.B.); the Division of Cardiology, Presidio Ospedaliero di Cremona, Italy (C.E.); POL Madonna della Consolazione, Reggio
| | - Enrico B. Nicolis
- From the Department of Cardiovascular Research, Istituto di Ricerche Farmacologiche “Mario Negri,” Milan, Italy (L.S., M.W., S.M., E.R., E.B.N., M.G.F., R.L.); Ospedale Fatebenefratelli e Oftalmico, Division of Cardiology, Milan, Italy (S.G.); Azienda USL 4, Cardiology Unit, Terni, Italy (G. Proietti); Ospedale Nuovo Girolamo Fracastoro, Cardiology Unit, San Bonifacio, Italy (D.B.); the Division of Cardiology, Presidio Ospedaliero di Cremona, Italy (C.E.); POL Madonna della Consolazione, Reggio
| | - Ernesto Correale
- From the Department of Cardiovascular Research, Istituto di Ricerche Farmacologiche “Mario Negri,” Milan, Italy (L.S., M.W., S.M., E.R., E.B.N., M.G.F., R.L.); Ospedale Fatebenefratelli e Oftalmico, Division of Cardiology, Milan, Italy (S.G.); Azienda USL 4, Cardiology Unit, Terni, Italy (G. Proietti); Ospedale Nuovo Girolamo Fracastoro, Cardiology Unit, San Bonifacio, Italy (D.B.); the Division of Cardiology, Presidio Ospedaliero di Cremona, Italy (C.E.); POL Madonna della Consolazione, Reggio
| | - Gianna Fabbri
- From the Department of Cardiovascular Research, Istituto di Ricerche Farmacologiche “Mario Negri,” Milan, Italy (L.S., M.W., S.M., E.R., E.B.N., M.G.F., R.L.); Ospedale Fatebenefratelli e Oftalmico, Division of Cardiology, Milan, Italy (S.G.); Azienda USL 4, Cardiology Unit, Terni, Italy (G. Proietti); Ospedale Nuovo Girolamo Fracastoro, Cardiology Unit, San Bonifacio, Italy (D.B.); the Division of Cardiology, Presidio Ospedaliero di Cremona, Italy (C.E.); POL Madonna della Consolazione, Reggio
| | - Federico Bertocchi
- From the Department of Cardiovascular Research, Istituto di Ricerche Farmacologiche “Mario Negri,” Milan, Italy (L.S., M.W., S.M., E.R., E.B.N., M.G.F., R.L.); Ospedale Fatebenefratelli e Oftalmico, Division of Cardiology, Milan, Italy (S.G.); Azienda USL 4, Cardiology Unit, Terni, Italy (G. Proietti); Ospedale Nuovo Girolamo Fracastoro, Cardiology Unit, San Bonifacio, Italy (D.B.); the Division of Cardiology, Presidio Ospedaliero di Cremona, Italy (C.E.); POL Madonna della Consolazione, Reggio
| | - Maria Grazia Franzosi
- From the Department of Cardiovascular Research, Istituto di Ricerche Farmacologiche “Mario Negri,” Milan, Italy (L.S., M.W., S.M., E.R., E.B.N., M.G.F., R.L.); Ospedale Fatebenefratelli e Oftalmico, Division of Cardiology, Milan, Italy (S.G.); Azienda USL 4, Cardiology Unit, Terni, Italy (G. Proietti); Ospedale Nuovo Girolamo Fracastoro, Cardiology Unit, San Bonifacio, Italy (D.B.); the Division of Cardiology, Presidio Ospedaliero di Cremona, Italy (C.E.); POL Madonna della Consolazione, Reggio
| | - Aldo P. Maggioni
- From the Department of Cardiovascular Research, Istituto di Ricerche Farmacologiche “Mario Negri,” Milan, Italy (L.S., M.W., S.M., E.R., E.B.N., M.G.F., R.L.); Ospedale Fatebenefratelli e Oftalmico, Division of Cardiology, Milan, Italy (S.G.); Azienda USL 4, Cardiology Unit, Terni, Italy (G. Proietti); Ospedale Nuovo Girolamo Fracastoro, Cardiology Unit, San Bonifacio, Italy (D.B.); the Division of Cardiology, Presidio Ospedaliero di Cremona, Italy (C.E.); POL Madonna della Consolazione, Reggio
| | - Gianni Tognoni
- From the Department of Cardiovascular Research, Istituto di Ricerche Farmacologiche “Mario Negri,” Milan, Italy (L.S., M.W., S.M., E.R., E.B.N., M.G.F., R.L.); Ospedale Fatebenefratelli e Oftalmico, Division of Cardiology, Milan, Italy (S.G.); Azienda USL 4, Cardiology Unit, Terni, Italy (G. Proietti); Ospedale Nuovo Girolamo Fracastoro, Cardiology Unit, San Bonifacio, Italy (D.B.); the Division of Cardiology, Presidio Ospedaliero di Cremona, Italy (C.E.); POL Madonna della Consolazione, Reggio
| | - Marcello Disertori
- From the Department of Cardiovascular Research, Istituto di Ricerche Farmacologiche “Mario Negri,” Milan, Italy (L.S., M.W., S.M., E.R., E.B.N., M.G.F., R.L.); Ospedale Fatebenefratelli e Oftalmico, Division of Cardiology, Milan, Italy (S.G.); Azienda USL 4, Cardiology Unit, Terni, Italy (G. Proietti); Ospedale Nuovo Girolamo Fracastoro, Cardiology Unit, San Bonifacio, Italy (D.B.); the Division of Cardiology, Presidio Ospedaliero di Cremona, Italy (C.E.); POL Madonna della Consolazione, Reggio
| | - Roberto Latini
- From the Department of Cardiovascular Research, Istituto di Ricerche Farmacologiche “Mario Negri,” Milan, Italy (L.S., M.W., S.M., E.R., E.B.N., M.G.F., R.L.); Ospedale Fatebenefratelli e Oftalmico, Division of Cardiology, Milan, Italy (S.G.); Azienda USL 4, Cardiology Unit, Terni, Italy (G. Proietti); Ospedale Nuovo Girolamo Fracastoro, Cardiology Unit, San Bonifacio, Italy (D.B.); the Division of Cardiology, Presidio Ospedaliero di Cremona, Italy (C.E.); POL Madonna della Consolazione, Reggio
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Specchia C, Barlera S, Chiodini BD, Nicolis EB, Farrall M, Peden J, Collins R, Watkins H, Tognoni G, Franzosi MG. Quantitative trait genetic linkage analysis of body mass index in familial coronary artery disease. Hum Hered 2008; 66:19-24. [PMID: 18223314 DOI: 10.1159/000114162] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2007] [Accepted: 08/28/2007] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE Body mass index (BMI) is one of the most reproducible and commonly used proxies for obesity and is known to be influenced by many environmental causes as well as genetic factors. Identification of susceptibility genes for BMI regulation has been difficult. Reasons for these inconclusive results are both methodological and related to obesity aetiology. A genome-wide linkage analysis was performed to localise Quantitative trait loci influencing BMI in a large cohort collected in the PROCARDIS coronary heart disease study consisting of 1,812 informative families. METHODS Multipoint linkage analysis for BMI was conducted using both a variance component approach and a model-free regression method, and the resulting LOD scores were compared. RESULTS The strongest evidence for linkage was detected on chromosomes 13 (LOD 1.6). Other regions showing a LOD score greater than 1 were observed on chromosomes 3, 5, 11, 12 and 15. These results were mainly confirmed by the three different approaches used in the analysis. CONCLUSION Our study did not find any locus with strongly supporting evidence for linkage to BMI even in such a large sample. Our results confirm the substantial genetic heterogeneity influencing BMI regulation that has emerged from the majority of genome scans so far published.
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Affiliation(s)
- Claudia Specchia
- Department of Cardiovascular Research, Istituto di Ricerche Farmacologiche 'Mario Negri', Milano, Italy.
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Barlera S, Specchia C, Farrall M, Chiodini BD, Franzosi MG, Rust S, Green F, Nicolis EB, Peden J, Assmann G, Collins R, Hamsten A, Tognoni G, Watkins H. Multiple QTL influence the serum Lp(a) concentration: a genome-wide linkage screen in the PROCARDIS study. Eur J Hum Genet 2006; 15:221-7. [PMID: 17133260 DOI: 10.1038/sj.ejhg.5201732] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
The serum concentration of lipoprotein Lp (a) is known to be highly heritable and associated with cardiovascular risk. A genome-wide variance component linkage analysis was performed to localise quantitative trait loci (QTLs) influencing Lp(a) levels in a large cohort collected in the PROCARDIS coronary heart disease study. Highly significant linkage was detected at the previously described LP(a) locus on chromosome 6q27 (LOD 108). Taking into account the effect of the locus detected on chromosome 6, a highly significant LOD score was detected on chromosome 13q22-31 (LOD 7.0). Another significant region of linkage was observed on chromosomes 11p14-15 (LOD 3.5). The significant peak at 13q22-31 shows an essential overlap with a locus modulating cholesterol in familial hypercholesterolemia. If the gene underlying these loci is the same, it will be a promising candidate target for manipulating LDL-cholesterol and Lp(a). We also detected linkage at a previously identified locus influencing Lp(a) on chromosome 1q23 (LOD 1.5). Our findings provide new and confirmatory information about genomic regions involved in the quantitative variation of Lp(a) and serve as a basis for further studies of candidate genes in these regions.
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Affiliation(s)
- Simona Barlera
- Department of Cardiovascular Research, Istituto di Ricerche Farmacologiche Mario Negri, Milano, Italy.
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