Effects of sleep habits on acute myocardial infarction risk and severity of coronary artery disease in Chinese population.

BACKGROUND: Growing evidence indicates that poor sleep harms health. Early to bed and early to rise is considered as a healthy lifestyle in Chinese population. The current study aimed to examine the effects of sleep habits on acute myocardial infarction (AMI) risk and severity of coronary artery disease (CAD) in Chinese population from two centers. METHODS: A total of 873 patients including 314 AMI cases and 559 controls were recruited from the inpatient cardiology department of the Affiliated Jiangning Hospital and the First Affiliated Hospital of Nanjing Medical University. 559 controls included 395 CAD cases and 164 non-CAD cases. We used a 17-item sleep factors questionnaire (SFQ) to evaluate sleep habits comprehensively by face-to-face interview. The severity of CAD was assessed by Gensini score in AMI and CAD groups. The effects of sleep factors on AMI risk and Gensini score were examined by unconditional logistic regression. RESULTS: After mutually adjustment for other sleep factors and demographic characteristics, the timing of sleep (24:00 and after) and morning waking (after 7:00) and sleep duration (< 6 h) were associated with increased risk of AMI (OR = 4.005, P < 0.001, OR = 2.544, P = 0.011 and OR = 2.968, P < 0.001, respectively). Lower level of light exposure at night was correlated with reduced risk of AMI (OR = 0.243, P = 0.009). In subgroup analysis by age, both late sleep timing and short sleep duration were associated with increased risk of AMI regardless of age. In subjects with age ≤ 65 years, daytime napping was related to reduced risk of AMI (OR = 0.645, P = 0.046). In subjects with age > 65 years, the frequency of night-time waking (3 times) was associated with increased risk of AMI (OR = 3.467, P = 0.035). Short sleep duration was correlated with increased risk of high Gensini score (OR = 2.374, P < 0.001). CONCLUSION: Sleep insufficiency is an important risk factor both for AMI risk and CAD severity. Late sleeping is also associated with increased risk of AMI. In young and middle-aged people, regular naps may have a protective effect.

PTPRO Promotes Oxidized Low-Density Lipoprotein Induced Oxidative Stress and Cell Apoptosis through Toll-Like Receptor 4/Nuclear Factor κB Pathway.

BACKGROUND/AIMS: Critical roles of phosphatase receptor type O (PTPRO) and toll-like receptor 4 (TLR4) have been implicated in inflammation. However, little is known about their functional effects on atherosclerosis (AS). We aim to study their potential function in AS. METHODS: An oxidized low-density lipoprotein (ox-LDL) induced AS model constructed with PTPRO over-expressing RAW264.7 cells and PTPRO knockout macrophages. Cell apoptosis was assayed by flow cytometry and fatty accumulation was evaluated by oil red staining. The production of ROS (reactive oxygen species), SOD (superoxide dismutase), MDA (malondialdehyde), TC (Triglyceride), and TG (total cholesterol) was evaluated. Western blot was performed to detect the expression of CD36, TLR4 and nuclear factor kB (NF-κB). RESULTS: PTPRO expression was promoted in a dose-dependent and time-dependent manner following ox-LDL challenging. In PTPRO-over-expressing cells, CD36 expression and the level of oil-red staining, TC and TG were increased; ROS production, MDA and level of cell apoptosis were improved, but SOD was reduced. However, in PTPRO knockout cells opposite results were found. TLR4 and NF-κB/p65 phosphorylation was significantly enhanced in PTPRO over-expressing cells, while significantly down-regulated in PTPRO knockout cells. CONCLUSION: PTPRO plays ital roles in AS via promoting ox-LDL induced oxidative stress and cell apoptosis through TLR4/NF-κB pathway.

The influence of regular walking at different times of day on blood lipids and inflammatory markers in sedentary patients with coronary artery disease.

OBJECTIVE: To examine the influence of walking at different times of day on lipids and inflammatory markers in sedentary patients with coronary artery disease (CAD). METHODS: A total of 330 patients recruited from Nanjing between September 2011 and November 2012 were randomly assigned to a control group (n=110), morning (n=110) or evening walking group (n=110). Both the walking groups were asked to walk 30 min/day or more on at least 5 days/week either in the morning or evening for 12 weeks. Lipids and inflammatory markers were measured before and after exercise intervention. RESULTS: Compared with baseline, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were improved in all groups. Significances were shown in the changes of fibrinogen, high sensitivity C-reactive protein (hsCRP), white blood cell (WBC) count, TC, triglycerides, LDL-C, lipoprotein(a) between groups. The evening walking group had a larger decrease in fibrinogen (0.16 ± 0.19 g/L, P<0.001), hsCRP (1.16 ± 1.07 mg/L, P<0.001), WBC count (0.76 ± 1.53·10(9)/L, P=0.004) and LDL-C (0.34 ± 0.31 mmol/L, P<0.001) than the other two groups. CONCLUSIONS: Our walking program successfully resulted in a favorable change in lipids and inflammatory markers. Patients in the evening walking group gained more benefits than those walking in the morning walking group. NCT01887093.

Relationship between time of day physical exercise and the reduced risk of coronary artery disease in a Chinese population.

PURPOSE: Exercise leads to a lower risk of coronary artery disease (CAD). However, whether time of day physical exercise has effects on CAD is still unclear. The present study is to investigate the relationship between time of day physical exercise and angiography determined CAD in a Chinese population. SUBJECTS: A total of 1,129 consecutive participants who underwent coronary angiography for the first time were enrolled in our study. Participants were divided into non-CAD group and CAD group according to the result of coronary angiography. We used a predesigned questionnaire-the work-related activity, leisure-time activity, and physical exercise information were recorded in the form of self-reporting. RESULTS: Doing physical exercise was associated with a reduced risk of CAD, after adjusting the established and potential confounders, with an adjusted odds ratio (OR) of 0.48 (95% CI, 0.35-0.67) compared with those who did not any physical exercise. Moreover, the risk of CAD could linearly decrease with increase of intensity, duration and frequency of exercise. Further stratification analysis revealed that the protective effects of exercise were more significant in the afternoon and evening group than in the morning and forenoon group. The adjusted ORs of doing physical exercise in morning, forenoon, afternoon, and evening groups were 0.53 (0.36-0.78), 0.51(0.27-0.96), 0.46(0.25-0.85), 0.43(0.28-0.66), respectively, compared with nonexerciser (p < .05). CONCLUSIONS: Doing physical exercise can decrease the risk of CAD, and exercising in the afternoon or evening may have more significant effects on the prevention of CAD than in other time of day.

Advancing the Boundary of Pre-trained Models for Drug Discovery: Interpretable Fine-Tuning Empowered by Molecular Physicochemical Properties.

In the field of drug discovery, a proliferation of pre-trained models has surfaced, exhibiting exceptional performance across a variety of tasks. However, the extensive size of these models, coupled with the limited interpretative capabilities of current fine-tuning methods, impedes the integration of pre-trained models into the drug discovery process. This paper pushes the boundaries of pre-trained models in drug discovery by designing a novel fine-tuning paradigm known as the Head Feature Parallel Adapter (HFPA), which is highly interpretable, high-performing, and has fewer parameters than other widely used methods. Specifically, this approach enables the model to consider diverse information across representation subspaces concurrently by strategically using Adapters, which can operate directly within the model's feature space. Our tactic freezes the backbone model and forces various small-size Adapters' corresponding subspaces to focus on exploring different atomic and chemical bond knowledge, thus maintaining a small number of trainable parameters and enhancing the interpretability of the model. Moreover, we furnish a comprehensive interpretability analysis, imparting valuable insights into the chemical area. HFPA outperforms over seven physiology and toxicity tasks and achieves state-of-the-art results in three physical chemistry tasks. We also test ten additional molecular datasets, demonstrating the robustness and broad applicability of HFPA.

Combination of D-dimer level and neutrophil to lymphocyte ratio predicts long-term clinical outcomes in acute coronary syndrome after percutaneous coronary intervention.

BACKGROUND: High D-dimer (DD) is associated with short-term adverse outcomes in patients with acute coronary syndrome (ACS). In ACS patients who underwent percutaneous coronary intervention (PCI), however, the value of DD (or combined with neutrophil to lymphocyte ratio [NLR]) to predict long-term major adverse cardiovascular events (MACEs) has not been fully evaluated. METHODS: Patients diagnosed with ACS and receiving PCI were included. The primary outcome was MACEs. Cox proportional hazards regression and logistic regression were used to illustrate the relationship between clinical risk factors, biomarkers and MACEs. Survival models were developed based on significant factors and evaluated by the Concordance-index (C-index). RESULTS: The final study cohort was comprised of 650 patients (median age, 64 years; 474 males), including 98 (15%) with MACEs during a median follow-up period of 40 months. According to the cut-off value of DD and NLR, the patients were separated into four groups: high DD or nonhigh DD with high or nonhigh NLR. After adjusting for confounding variables, DD (adjusted hazard ratio [aHR]: 2.39, 95% confidence interval [CI]: 1.52-3.76) and NLR (aHR: 2.71, 95% CI: 1.78-4.11) were independently associated with long-term MACEs. Moreover, patients with both high DD and NLR had a significantly higher risk in MACEs when considering patients with nonhigh DD and NLR as reference (aHR: 6.19, 95% CI: 3.30-11.61). The area under curve increased and reached 0.70 in differentiating long-term MACEs when DD and NLR were combined, and survival models incorporating the two exhibited a stronger predictive power (C-index: 0.75). CONCLUSIONS: D-dimer (or combined with NLR) can be used to predict long-term MACEs in ACS patients undergoing PCI.

Plasma levels of lipometabolism-related miR-122 and miR-370 are increased in patients with hyperlipidemia and associated with coronary artery disease.

BACKGROUND: Hyperlipidemia plays a crucial role in the development and progression of coronary artery disease (CAD). Recent studies have identified that microRNAs (miRNAs) are important regulators of lipid metabolism, but little is known about the circulating levels of lipometabolism-related miRNAs and their relationship with the presence of CAD in patients with hyperlipidemia. METHODS: In the present study, we enrolled a total of 255 hyperlipidemia patients with or without CAD and 100 controls with normal blood lipids. The plasma levels of four known lipometabolism-related miRNAs, miR-122, miR-370, miR-33a, and miR-33b were quantified by real-time quantitative PCR. Blood levels of total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), and high density lipoprotein cholesterol were determined. Furthermore, the severity of CAD was assessed with the Gensini score system based on the degree of luminal narrowing and its geographic importance. RESULTS: Our results revealed for the first time that plasma levels of miR-122 and miR-370 were significantly increased in hyperlipidemia patients compared with controls, and the levels of miR-122 and miR-370 were positively correlated with TC, TG, and LDL-C levels in both hyperlipidemia patients and controls. Multiple logistic regression analysis demonstrated that the increased levels of miR-122 and miR-370 were associated with CAD presence, even after adjustment for other cardiovascular risk factors. Furthermore, miR-122 and miR-370 levels were positively correlated with the severity of CAD quantified by the Gensini score. However, both miR-33a and miR-33b were undetectable in plasma. CONCLUSIONS: Our results suggest that increased plasma levels of miR-122 and miR-370 might be associated with the presence as well as the severity of CAD in hyperlipidemia patients.

Mechanical Properties of Reactive Powder Concrete with Coal Gangue as Sand Replacement.

Coal gangue (CG) represents a huge amount of industrial solid waste in China, and usually is used as a coarse aggregate to produce low-strength coal-gangue-based concrete. In this paper, in order to prove the possibility to obtain a higher-strength concrete with a higher CG utilization rate, reactive powder concrete (RPC) with coal gangue as a sand replacement at different replacement ratios was studied. RPC samples were prepared by replacing natural river sand (RS) with CG sand at different CG/RS weight ratios from 0-100% at intervals of 25%. Mechanical tests were carried out, and the microstructure features of RPC samples at 28 days were characterized. The test results showed that strong back shrinkage of strength existed. On days 7 and 14, the flexural strengths of samples with CG/RS replacement ratios of 0-75% fluctuated around the mean value. Strengths of samples with a CG/RS replacement ratio of 100% dropped off. However, on day 28, the flexural strengths of samples with CG were all lower than the strengths of samples on days 7 and 14. The flexural strengths and compressive strengths of the RPC with a CG/RS replacement ratio of 100% on day 14 were 14.09 MPa and 37.03 MPa, respectively, which decreased to 6.42 MPa and 28.44 MPa, respectively, on day 28. Compared with natural river sand, CG sand reduced the working performance, compressive strength, and flexural strength of RPC. Microscopic analysis showed that on day 28, increasing the CG replacement ratio could inhibit cement hydration, weaken the interface transition zone, and lead to the degradation of the RPC's performance. Modification of CG sand would be helpful to obtain higher-strength concrete.

Mechanical Properties of Ultra-High Performance Concrete with Coal Gasification Coarse Slag as River Sand Replacement.

Coal gasification coarse slag (CGCS) is a by-product of coal gasification. Despite its abundance, CGCS is mostly used in boiler blending, stacking, and landfill. Large-scale industrial applications of CGCS can be environment-friendly and cost saving. In this study, the application of CGCS as a substitute for river sand (RS) with different replacement ratios in ultra-high performance concrete (UHPC) was investigated. The effects of CGCS replacement ratios on the fluidity and mechanical properties of specimens were examined, and the effect mechanisms were explored on the basis of hydration products and the multi-scale (millimetre-scale and micrometre-scale) microstructure analysis obtained through X-ray diffraction (XRD), scanning electron microscopy, and X-ray energy-dispersive spectroscopy. With an increase in the CGCS replacement ratio, the water-binder ratio (w/b), flexural strength, and compressive strength decreased. Specimens containing CGCS of ≤25% can satisfy the strength requirement of non-structural UHPC, with flexure strength of 29 MPa and compressive strength of 111 MPa at day 28. According to the XRD results and multi-scale microstructure analysis, amorphous glass beads in CGCS positively influenced ettringite generation due to the pozzolanic activity. Porous carbon particles in CGCS showed strong interfacial bonding with cement slurry due to internal hydration; this bonding was conducive to improving the mechanical strength. However, CGCS hindered hydration in the later curing stage, leading to an increase in the unreacted cement and agglomeration of fly ash; in addition, at a CGCS replacement ratio of up to 50%, an apparent interfacial transition zone structure was observed, which was the main contributor to mechanical strength deterioration.

Long noncoding RNA H19 suppresses cardiac hypertrophy through the MicroRNA-145-3p/SMAD4 axis.

Sustained cardiac hypertrophy (CH) contributes to many heart diseases. Long noncoding RNAs (lncRNAs) collectively play critical roles in cardiovascular diseases (CVDs). However, the roles of lncRNA H19 in CH are still unclear. A CH model was constructed utilizing isoproterenol (ISO). We demonstrated H19 could participate in regulating ISO-induced CH development both in vivo and in vitro. The online databases DIANA and TargetScan were used to predict the targets of H19 and MicroRNA-145-3p (miR-145-3p), respectively. Luciferase reporter assay was used to verify the downstream targets. The results showed that H19 was decreased under ISO stimulation. The H19 overexpression resulted in significant decrease in mouse heart size and weight, left ventricular systolic dysfunction, left ventricular posterior wall thickness and cardiac hypertrophic growth, while promoted the increase of left ventricular ejection fraction and left ventricle fraction shortening. H19 also inhibited protein expression levels of CH markers, such as atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), and MYH7. Luciferase assays results showed that miR-145-3p was a target of H19 and SMAD4 was a target of miR-145-3p. We found that H19 regulated SMAD4 by sponging miR-145-3p. Knockout of miR-145-3p or overexpression of SMAD4 facilitated H19-induced decreases in ANP, BNP, and MYH7. Collectively, our findings have indicated that the H19/miR-145-3p/SMAD4 axis should be a negative regulator involved in CH progression.

In Situ Growth Behavior of SiC Whiskers with High Aspect Ratio in the Synthesis of ZrB2-SiC Composite Powders.

Aiming to provide key materials in order to improve the fracture toughness of ZrB2 ceramics, ZrB2-SiC composite powders with in situ grown SiC whiskers were successfully synthesized via a simple molten-salt-assisted ferrous-catalyzed carbothermal reduction method. Thermodynamic calculations on the ZrO2-SiO2-B2O3-C-Fe system were carried out. The effects of heating temperature and ferrous catalyst amount on the growth behavior of SiC whiskers in ZrB2-SiC composite powders were investigated using X-ray diffraction (XRD), scanning electron microscopy (SEM), X-ray energy dispersive spectroscopy (EDS), and transmission electron microscopy (TEM). The results showed that the aspect ratio of SiC whiskers and the relative content of ZrB2 particles increased with increasing heating temperature (1523-1723 K) and a molar ratio of Fe to ZrSiO4 from 0:1 to 0.2:1. Phase-pure ZrB2-SiC composite powders were obtained at 1723 K when the molar ratio of raw materials was 0.2:0.5:1:1.5:8.4 (Fe:NaCl:ZrSiO4:B2O3:C). Single crystalline ß-SiC whiskers with a mean diameter of 0.15 µm and an aspect ratio of 70-120 were homogeneously distributed in the final composite powders. A molten-salt-assisted iron-catalyzed vapor-solid mechanism was promoted for the growth mechanism of in situ grown SiC whiskers.

Hyperplasia suppressor gene polymorphisms and essential hypertension: a case-control association study in a central Han Chinese population.

BACKGROUND: HSG (hyperplasia suppressor gene, also named Mitofusion-2, Mfn-2) gene polymorphisms have been studied as a candidate gene in essential hypertension, but no clear consensus has been reached in the Chinese population. To systematically explore their possible association, a case-control study was conducted in a central Chinese population. METHODS AND RESULTS: We recruited 402 EH patients and 267 normotensive (NT) control subjects. A total of 6 tag SNPs of HSG gene were genotyped successfully by TaqMan assay. The results showed that genotype distribution and the allelic frequency of rs873457, rs2236384, rs4846085, and rs1474868 in the EH and NT groups were significantly different (P < 0.05), although those of rs2295281 and rs17037564 were not. rs2336384, rs873457, rs4846085 and rs1474868 were also closely associated with EH under the dominant genetic model (P < 0.05). Gender-based subgroup analyses showed that significant associations between rs873457, rs2336384, rs4846085, and rs1474868 and EH could be found in males, but not in females. Haplotype analysis indicated that the C-G-T-T-T-G haplotype was positively correlated with EH. CONCLUSION: Our study suggested that HSG gene polymorphisms were significantly associated with EH in a central Han Chinese population, especially in male subjects.

Circulating Exosomal SOCS2-AS1 Acts as a Novel Biomarker in Predicting the Diagnosis of Coronary Artery Disease.

BACKGROUND AND AIMS: Critical roles of circulating exosomal long noncoding RNAs (lncRNAs) have been implicated in multiple diseases. However, little is known about their roles in coronary artery disease (CAD). The aim of the present study was to investigate the relationships between circulating exosomal lncRNAs and CAD and identify the aberrantly expressed disease-related lncRNAs as biomarkers in diagnosing CAD. METHODS: The aberrantly expressed lncRNAs in plasma exosomes from CAD patients and controls were identified by microarray analysis and verified by quantitative real-time PCR (qRT-PCR). Then, the correlation between the expression level of candidate biomarker and clinic features in CAD patients, mild coronary artery stenosis (mCAS) patients, and controls was analyzed. Finally, we used the receiver operating characteristic (ROC) curve to examine the diagnosis value of candidate biomarkers. RESULTS: The downregulated SOCS2-AS1 was determined by microarray analysis and verified by qRT-PCR in plasma from CAD patients in contrast to controls. The SOCS2-AS1 expression level in plasma exosomes was negatively correlated with PLT and Lpa. Moreover, CAD patients with elevated levels of plasma exosome-encapsulated SOCS2-AS1 were susceptible to multicoronary artery lesions. Additionally, the area under ROC (AUC) of SOCS2-AS1 was 0.704 (95% CI = 0.607-0.801, P < 0.001) for diagnosis of CAD. CONCLUSIONS: Plasma exosome-encapsulated SOCS2-AS1 was an independent protective factor against CAD and could be potentially used as a novel biomarker for the diagnosis of CAD.

Increased risk of cerebrovascular accident related to non-alcoholic fatty liver disease: a meta-analysis.

Recent published studies on the association between non-alcoholic fatty liver disease (NAFLD) and cerebrovascular accident (CVA) risk have yielded conflicting findings. The aim of our study was to identify the potential association by pooling all available publications. A total of nine independent studies were included into our study. The pooled odd ratio (OR) with 95% confidence interval (95% CI) was calculated to weigh the strength for the relationship between NAFLD and CVA risk. We also conducted stratified analyses by study design, ethnicity and disease classification for further elucidation. The pooled results of the present meta-analysis showed that NAFLD was related to increased risk of CVA (OR = 2.32, 95% CI 1.84-2.93, P < 0.001). Besides, NAFLD is associated with increased risk of CVA among both Caucasians (OR = 2.27, 95% CI 1.77-2.90, P < 0.001) and Asians (OR = 2.81, 95% CI 1.43-5.51, P = 0.003). Moreover, the significant association was also observed in case-control studies (OR = 2.73, 95% CI 1.67-4.48, P < 0.001) and cohort studies (OR = 2.22, 95% CI 1.71-2.89, P < 0.001), respectively. In addition, NAFLD was shown to correlate with increased risk of cerebral hemorrhage (OR = 1.85, 95% CI 1.05-3.27, P = 0.034) and the ischemic stroke (OR = 2.51, 95% CI 1.92-3.28, P < 0.001). In conclusion, our findings firstly provide strong evidence for a risk effect of NAFLD on CVA development.

Association between Time of Day of Sports-Related Physical Activity and the Onset of Acute Myocardial Infarction in a Chinese Population.

OBJECTIVE: To investigate the association between the time of day of sports-related physical activity and the onset of acute myocardial infarction (AMI) in a coronary artery disease (CAD) population in China. METHODS: Between February 2014 and March 2015, a total of 696 patients from Nanjing, China, who had CAD were studied and divided into two groups (Non-AMI and AMI groups). The work-related activity and sports-related physical activity information were obtained from a self-reporting predesigned patient questionnaire. RESULTS: Sports-related physical activity was associated with a lower risk of the onset of AMI, after adjusting the established and potential confounders, with an adjusted odds ratio (OR) of 0.67 (95% CI, 0.47-0.94) compared with those who did not have any sports-related physical activity. A dose-response relationship was observed for intensity, duration, and frequency of sports-related physical activity. Further stratification analysis revealed that the protective effects of sports-related physical activity were significant in the morning and evening groups, and patients who exercised in the evening were at a lower risk of AMI than those doing sports-related physical activity in the morning. The adjusted ORs for doing sports-related physical activity in the morning and evening groups were 0.60(0.36-0.98) and 0.56(0.37-0.87), respectively, compared with inactivity (all P<0.05). On the occurrence of AMI, doing sports-related physical activity in the evening had an adjusted OR of 0.93 (95% CI, 0.54-1.64, P = 0.824) compared with in the morning group. CONCLUSIONS: Sports-related physical activity is associated with a lower risk of onset of AMI than inactivity in Chinese people. For CAD patients, we suggest they participate in sports-related physical activity of high intensity, long duration, and high frequency. Doing sports-related physical activity in the evening and in the morning have similar benefits on the prevention of the onset of AMI.

Altered long noncoding RNA expression profiles in the myocardium of rats with ischemic heart failure.

AIMS: Despite significant advances in the treatment of coronary artery disease, the prevalence of ischemic heart failure is still increasing rapidly. Long noncoding RNAs are a novel class of gene regulators and may contribute to disease cause. The aim of the present study was to investigate the expression profiles of long noncoding RNAs and their potential functional roles in ischemic heart failure. METHODS: We applied a well-established ischemic heart failure rat model and performed long noncoding RNA microarray experiments on the left ventricular tissue of rats with ischemic heart failure and under sham control. Differentially expressed long noncoding RNAs and mRNAs were identified through fold-change filtering. Bioinformatic analyses were performed to predict the potential biological roles of key long noncoding RNAs. RESULTS: We found that 1197 long noncoding RNAs and 2066 mRNAs were upregulated, whereas 1403 long noncoding RNAs and 2871 mRNAs were downregulated in failing hearts (fold-change > 2.0). We also identified 331 pairs of differentially expressed long noncoding RNAs and nearby coding genes, which contained 291 long noncoding RNAs and 296 mRNAs. Expression levels of four long noncoding RNA-mRNA pairs, which might be involved in the pathogenesis of ischemic heart failure were confirmed by quantitative real-time PCR. CONCLUSION: Our study identified a set of long noncoding RNAs that were aberrantly expressed in rats with ischemic heart failure and might be involved in the pathogenesis of ischemic heart failure. The results of our study may provide a novel perspective for better understanding the molecular basis of ischemic heart failure.

Flavonols intake and the risk of coronary heart disease: a meta-analysis of cohort studies.

OBJECTIVE: Prospective cohort are inconsistent regarding the association between flavonols intake and the risk of coronary heart disease (CHD). The aim was to perform a meta-analysis to determine whether an association exists between them in observational studies. METHODS: We searched PUBMED and EMBASE databases for studies conducted from 1966 through January 2012. Data were independently abstracted by 2 investigators using a standardized protocol. Study-specific risk estimates were combined by using a random-effects model. RESULTS: A total of nine general population cohorts with 216,908 participants and more than 5249 CHD cases were included in the meta-analysis. The summary relative risk (RR) did not indicate a significant association between the highest flavonols intake and reduced risk of CHD (summary RR: 0.91; 95% CI: 0.83, 1.01). Furthermore, no significant association was found through the dose-response analysis (an increment of 20mg/day, summary RR: 0.96; 95% CI: 0.90, 1.03). CONCLUSIONS: Our results do not support a protective role of flavonols intake against CHD.