Superior predictive value of estimated pulse wave velocity for all-cause and cardiovascular disease mortality risk in U.S. general adults.

BACKGROUND: Estimated pulse wave velocity (ePWV) has been proposed as a potential approach to estimate carotid-femoral pulse wave velocity. However, the potential of ePWV in predicting all-cause mortality (ACM) and cardiovascular disease mortality (CVM) in the general population is unclear. METHODS: We conducted a prospective cohort study using the data of 33,930 adults (age ≥ 20 years) from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2014 until the end of December 2019. The study outcomes included ACM and CVM. Survey-weighted Cox proportional hazards models were used to assess hazard ratios (HRs) and 95% confidence intervals (CIs) to determine the association between ePWV and ACM and CVM. To further investigate whether ePWV was superior to traditional risk factors in predicting ACM and CVM, comparisons between ePWV and the Framingham Risk Score (FRS) and Pooled Cohort Equations (PCE) models were performed. Integrated Discriminant Improvement (IDI) and Net Reclassification Improvement (NRI) were employed to analyze differences in predictive ability between models. RESULTS: The weighted mean age of the 33,930 adults included was 45.2 years, and 50.28% of all participants were men. In the fully adjusted Cox regression model, each 1 m/s increase in ePWV was associated with 50% and 49% increases in the risk of ACM (HR 1.50; 95% CI, 1.45-1.54) and CVM (HR 1.49; 95% CI, 1.41-1.57), respectively. After adjusting for FRS, each 1 m/s increase in ePWV was still associated with 29% (HR 1.29; 95% CI, 1.24-1.34) and 34% (HR 1.34; 95% CI, 1.23-1.45) increases in the risk of ACM and CVM, respectively. The area under the curve (AUC) predicted by ePWV for 10-year ACM and CVM were 0.822 and 0.835, respectively. Compared with the FRS model, the ePWV model improved the predictive value of ACM and CVM by 5.1% and 3.8%, respectively, with no further improvement in event classification. In comparison with the PCE model, the ePWV model's ability to predict 10-year ACM and CVM was improved by 5.1% and 3.5%, and event classification improvement was improved by 34.5% and 37.4%. CONCLUSIONS: In the U.S. adults, ePWV is an independent risk factor for ACM and CVM and is independent of traditional risk factors. In the general population aged 20 to 85 years, ePWV has a robust predictive value for the risk of ACM and CVM, superior to the FRS and PCE models. The predictive power of ePWV likely originates from the traditional risk factors incorporated into its calculation, rather than from an indirect association with measured pulse wave velocity.

Identification and exploration of aging-related subtypes and distinctive role of SERPINE1 in heart failure based on single-cell and bulk RNA sequencing data.

Aging is a major risk factor for heart failure (HF) and is the leading cause of death worldwide. Currently, the nature of the relationship between aging and HF is not entirely clear. Herein, this study aimed to explore new diagnostic biomarkers, molecular typing and therapeutic strategies for HF by investigating the biological significance of aging-related genes in HF. A total of 157 differentially expressed genes (DEGs) were screened totally between HF and normal samples, and functional enrichment analysis of DEGs revealed the strong association of HF progression with aging, immune processes and metabolism. Six HF-specific aging-related genes were further identified, and a diagnostic model was developed and validated for good diagnostic efficacy. In addition, we collected blood samples from 10 normal controls and 10 HF patients for RT-qPCR analysis to verify the bioinformation. We also identified two aging-associated subtypes with distinctly different immune infiltration and metabolic microenvironment. Further single-cell sequencing analysis conducted in the study identified SERPINE1 as a key gene in HF. The distinctive role of SERPINE1 fibroblasts was revealed, including three main findings: (I) fibroblasts had a higher proportion and expression of SERPINE1 levels in HF; (II) the ligand-receptor pair MDK-LRP1 made the most contributions in high interactions with other cell types in SERPINE1 fibroblasts; and (III) SERPINE1 fibroblasts were associated with the interaction of extracellular matrix and receptor and may be regulated by the transcription factor EGR1. In conclusion, this study highlights the importance of aging-related genes in diagnosing HF and regulating immune infiltration. We also identified different HF subtypes and a potentially crucial gene, which may provide a better understanding of the molecular-level mechanisms of aging-related HF and aid in developing effective therapeutic strategies.

System inflammation response index: a novel inflammatory indicator to predict all-cause and cardiovascular disease mortality in the obese population.

AIM: This study aims to investigate the relationship between two novel inflammatory markers, namely, the Systemic Inflammatory Response Index (SIRI) and the Systemic Immune Inflammatory Index (SII), as well as the all-cause and cardiovascular disease (CVD) mortality in the obese population. MATERIALS AND METHODS: We conducted a prospective cohort study based on the data of 13,026 obese adults (age ≥ 18 years) from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2014 and followed until December 2019. SIRI was calculated by the formula: (neutrophil count × monocyte count) / lymphocyte count, while that of SII was: (platelet count × neutrophil count)/lymphocyte count. The association of SIRI and SII with all-cause and CVD mortality was evaluated using Cox regression. In addition, the nomogram was performed to predict 10-year survival probability. RESULTS: During a median follow-up of 137 months, 1959 and 553 all-cause and CVD deaths were recorded, respectively. Spearman correlation analysis indicated that SIRI and SII were unrelated to almost all baseline characteristics (r < 0.15). Multivariate Cox regression models displayed that each standard deviation (SD) increase in SIRI was associated with a 16% (HR 1.16; 95% CI 1.09-1.24) and 22% (HR 1.22; 95% CI 1.10-1.36) increase in the risk of all-cause and CVD mortality, respectively. Likewise, every SD increase in SII was correlated with a 9% (HR 1.09; 95% CI 1.02-1.16) and 14% (HR 1.14; 95% CI 1.04-1.26) increase in the risk of all-cause and CVD mortality, respectively. The predictive value of SIRI for all-cause and CVD mortality (AUC = 0.601 and 0.624) exceeded that of SII (AUC = 0.528 and 0.539). Moreover, the nomogram displayed a substantial predictive value for 10-year survival (AUC = 0.847) with sensitivity and specificity exceeding 75%. CONCLUSIONS: In the obese population, SIRI and SII are independent risk factors for all-cause and CVD mortality. Notably, the predictive ability of SIRI for both all-cause and CVD mortality significantly outperforms that of SII, suggesting that SIRI is a more valuable marker of inflammation.

Higher systemic immune-inflammation index and systemic inflammation response index levels are associated with stroke prevalence in the asthmatic population: a cross-sectional analysis of the NHANES 1999-2018.

Background: Significant evidence suggests that asthma might originate from low-grade systemic inflammation. Previous studies have established a positive association between the systemic immune-inflammation index (SII) and the systemic inflammation response index (SIRI) levels and the risk of stroke. However, it remains unclear whether SII, SIRI and the prevalence of stroke are related in individuals with asthma. Methods: The present cross-sectional study used data from the National Health and Nutrition Examination Survey (NHANES) conducted between 1999 and 2018. SII was calculated using the following formula: (platelet count × neutrophil count)/lymphocyte count. SIRI was calculated using the following formula: (neutrophil count × monocyte count)/lymphocyte count. The Spearman rank correlation coefficient was used to determine any correlation between SII, SIRI, and the baseline characteristics. Survey-weighted logistic regression was employed to calculate odds ratios (ORs) and 95% confidence intervals (CIs) to determine the association between SII, SIRI, and stroke prevalence. The predictive value of SII and SIRI for stroke prevalence was assessed through receiver operating characteristic (ROC) curve analysis, with the area under the ROC curve (AUC) being indicative of its predictive value. Additionally, clinical models including SIRI, coronary heart disease, hypertension, age, and poverty income ratio were constructed to evaluate their clinical applicability. Results: Between 1999 and 2018, 5,907 NHANES participants with asthma were identified, of which 199 participants experienced a stroke, while the remaining 5,708 participants had not. Spearman rank correlation analysis indicated that neither SII nor SIRI levels exhibited any significant correlation with the baseline characteristics of the participants (r<0.1). ROC curves were used to determine the optimal cut-off values for SII and SIRI levels to classify participants into low- and high-level groups. Higher SII and SIRI levels were associated with a higher prevalence of stroke, with ORs of 1.80 (95% CI, 1.18-2.76) and 2.23 (95% CI, 1.39-3.57), respectively. The predictive value of SIRI (AUC=0.618) for stroke prevalence was superior to that of SII (AUC=0.552). Furthermore, the clinical model demonstrated good predictive value (AUC=0.825), with a sensitivity of 67.1% and specificity of 87.7%. Conclusion: In asthmatics, higher levels of SII and SIRI significantly increased the prevalence of stroke, with its association being more pronounced in individuals with coexisting obesity and hyperlipidaemia. SII and SIRI are relatively stable novel inflammatory markers in the asthmatic population, with SIRI having a better predictive value for stroke prevalence than SII.

Predictive value of estimated pulse wave velocity with all-cause and cause-specific mortality in the hypertensive population: the National Health and Nutrition Examination Surveys 1999-2014.

BACKGROUND: Estimated pulse wave velocity (ePWV) has been proposed as a potential approach to assess carotid-femoral pulse wave velocity (cfPWV). However, the potential ability of ePWV to predict all-cause and cause-specific mortality in the population group with hypertension remains unresolved. METHODS: We conducted a prospective cohort study using the data of 14 044 adults (age ≥18 years) from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2014, and followed this cohort until the end of December 2019. ePWV was calculated by using a regression equation for age and mean blood pressure (MBP), derived by the Arterial Stiffness Collaborative Group. RESULTS: The weighted mean age of the 14 044 adults included was 54.79 years; 49.42% of all participants were men. During the median follow-up period of 11 years, 3795 deaths were recorded. In the fully adjusted cox regression model, each 1 m/s increase in ePWV was associated with an increased risk of 56% [hazard ratio 1.61; 95% confidence interval (CI) 1.49-1.64] risk for all-cause mortality. Every 1 m/s increase in ePWV resulted in an increased risk of mortality from cardiovascular disease, cerebrovascular disease, respiratory disease, Alzheimer's disease, accidents, cancer, influenza and pneumonia by 60, 70, 47, 118, 73, 41 and 103%, respectively. ePWV has a robust predictive value for 5- and 10-year all-cause mortality in the hypertensive population with AUCs of 0.749 and 0.741, respectively. CONCLUSION: Elevated ePWV is positively correlated with all-cause mortality and most cause-specific mortalities, independent of traditional risk factors. Moreover, ePWV demonstrates high accuracy in predicting 5-year and 10-year all-cause mortality, outperforming Framingham Risk Score.

Association of arterial stiffness with all-cause and cause-specific mortality in the diabetic population: A national cohort study.

Background: Estimated pulse wave velocity (ePWV) has been proposed as a potential alternative to carotid-femoral pulse wave velocity to assess the degree of aortic stiffness, and may predict cardiovascular disease (CVD) outcomes and mortality in the general population. However, whether arterial stiffness estimated by ePWV predicts all-cause and cause-specific mortality in patients with diabetes mellitus (DM) has not been reported. Methods: This was a prospective cohort study with data from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2014 and followed up until the end of December 2019. 5,235U.S. adults with DM (age≥20years) were included in the study. Arterial stiffness was estimated by ePWV. Survey-weighted Cox proportional hazards models were performed to assess the hazard ratios (HRs), and 95% confidence intervals (CIs) for the associations of ePWV with all-cause and cause-specific mortality. Meanwhile, the generalized additive model was used to visually assess the dose-dependent relationship between ePWV and mortality. As a complementary analysis, the relationship between mean blood pressure (MBP) and risk of mortality was also examined. Multiple imputations accounted for missing data. Results: For the 5,235 DM patients, the weighted mean age was 57.4 years, and 51.07% were male. During a median follow-up period of 115 months (interquartile range 81-155 months; 53,159 person-years), 1,604 all-cause deaths were recorded. In the fully adjusted Cox regression model, every 1 m/s increase in ePWV was associated with 56% (HR 1.56; 95% CI, 1.44 to 1.69) increase in the risk of all-cause. In addition, a nonlinear relationship between ePWV and all-cause mortality was observed (P for non-linear=0.033). Similar results were obtained after subgroup analysis and multiple imputations. Besides, the risk of most cause-specific mortality, except for accident and renal disease-specific mortality, increased from 53% to 102% for every 1 m/s increase in ePWV. Conclusions: In the diabetic population, ePWV is independently associated with all-cause and most cause-specific mortality risks. ePWV may be a useful tool for assessing mortality risk.

Comparison of the predictive value of four insulin resistance surrogates for the prevalence of hypertension: a population-based study.

BACKGROUND: Several studies have investigated the association of insulin resistance (IR) surrogates and the risk of hypertension. However, it is unclear whether there exist differences between different IR surrogates and hypertension risk. Therefore, this study aimed to explore the association of four IR surrogates (triglyceride-glucose index (TyG index), triglyceride-glucose index with body mass index (TyG-BMI), triglycerides/high-density lipoprotein cholesterol ratio (TG/HDL-c), and metabolic score for IR (METS-IR)) with the prevalence of hypertension. METHODS: This is a cross-sectional study with a total of 117,056 participants. Data were extracted from a computerized database established by Rich Healthcare Group in China, which included all medical records of participants who received a health check-up from 2010 to 2016. IR surrogates were grouped into quartiles as continuous variables, and multivariate logistic regression was performed to estimate the association between different IR surrogate levels and the prevalence of hypertension. Results were expressed as odds ratios (ORs) and 95% confidence intervals (CIs). Missing data were accounted by multiple imputation. These analyses were considered as the sensitivity analysis. Meanwhile, the Bayesian network (BN) model was constructed to further evaluate the relationship between baseline characteristics and the four IR surrogates and the prevalence of hypertension, as well as the importance of every single variable for the prevalence of hypertension. RESULTS: Multivariate logistic regression analysis revealed that TyG-BMI and METS-IR were independent risk factors for the prevalence of hypertension that increased significantly with increasing TyG-BMI and METS-IR (p for trend < 0.001). The area under the TyG-BMI curve (AUC) was 0.681 [95% CI: 0.677-0.685], and the cut-off value was 199.5, with a sensitivity and specificity of 65.57% and 61.18%, respectively. While the area under the METS-IR curve (AUC) was 0.679 [95% CI: 0.674-0.683], and the cut-off value was 33.61, with a sensitivity and specificity of 69.67% and 56.67%, respectively. The BN model presented that among these four IR surrogates and related variables, TyG-BMI was the most important predictor of hypertension prevalence, with a significance of 34%. The results before and after multiple imputation were similar. CONCLUSION: TyG-BMI and METS-IR were independent risk factors for the prevalence of hypertension. TyG-BMI and METS-IR had good predictive value for the prevalence of hypertension, and TyG-BMI was superior to METS-IR.

Influence and significance of bilateral upper-extremity training on recovery of upper-extremity motor function for hemiplegic patients with mild-moderate cerebral apoplexy: a randomised controlled study.

Background: The recovery of coordination ability of both hands is conductive to improving the activity of daily living for hemiplegic patients. Objective: To explore the influence and significance of bilateral upper-extremity training on recovery of upper-extremity motor function for hemiplegic patients with mild-moderate cerebral apoplexy. Methods: Patients were divided into control group and experimental group. The patients in the control group only exercised the upper limbs on the affected side, while the patients in the experimental group exercised the upper limbs on both sides. The Fugl Mayer Assessment Upper Extremity Scale (FMA-UE), Upper Extermities Functional Test (UEFT), modified Barthel index (MBI) and Brunnstrom scores were evaluated in the two groups before and after treatment. Results: After four weeks, six weeks and eight weeks of treatment, scores of FMA-UE, UEFT, MBI and Brunnstrom for patients increased with the extension of training time, and FMA-UE, UEFT, MBI and Brunnstrom scores for patients of the two groups after four weeks six weeks and eight weeks of treatment showed a significant difference (P<0.05). Conclusion: The improvement of upper-extremity motor function can be facilitated via relatively conventional training of bilateral upper-extremity training adopted by hemiplegic patients with mild-moderate cerebral apoplexy.

Prognostic and clinicopathological significance of miR-638 in cancer patients: A meta-analysis.

INTRODUCTION: MiR-638 is believed to be involved in human cancers. However, the prognostic value of miR-638 in human carcinomas is controversial and inconclusive. Therefore, we conducted this meta-analysis to investigate the association between miR-638 expression and clinical outcomes in the patients with various cancers. METHODS: We searched Pubmed, Embase, Wanfang, and the China National Knowledge Infrastructure (CNKI) up to September 1, 2020 to identify relevant studies. Hazard ratios (HRs) and odds ratios (ORs) with 95% confidence intervals (CIs) were used to correlate expression of miR-638 with prognosis and clinicopathological features. RESULTS: A total of 18 studies involving 1886 patients were included in the meta-analysis. The results revealed that low miR-638 expression was significantly correlated with poor overall survival (OS) (HR = 2.09, 95% CI: 1.46-2.98, P < .001), but not with disease-free survival (DFS) (HR = 1.71, 95% CI: 0.31-9.56, P = .540). Subgroup analysis found that low miR-638 expression was associated with worse OS in patients with digestive system cancer (HR = 2.47, 95% CI: 1.85-3.30, P < .001), the reported directly from articles group (HR = 2.12, 95% CI: 1.34-3.33, P < .001), survival curves group (HR = 2.02, 95% CI: 1.07-3.80, P = .029), in studies with sample size ≥100 (HR = 2.12, 95% CI: 1.34-3.35, P = .001), and in studies with sample size <100 (HR = 2.02, 95%CI: 1.09-3.75, P = .025). Moreover, cancer patients with low miR-638 expression were prone to tumor size (OR = 1.47, 95% CI: 1.03-2.09, P = .035), earlier lymph node metastasis (present vs absent, OR = 2.26, 95% CI: 1.63-3.14, P < .001), earlier distant metastasis (present vs absent, OR = 2.60, 95% CI: 1.45-4.67, P < .001), TNM stage (III-IV vs I-II, OR = 2.01, 95% CI: 1.35-2.99, P = .001), and portal vein invasion (present vs absent, OR = 4.39, 95% CI:2.23-8.64, P < .001), but not associated with age, gender, tumor differentiation, and vascular invasion. CONCLUSIONS: MiR-638 may serve as a promising indicator in the prediction of prognosis and clinicopathological features in patients with different kinds of cancers.

Prognostic and clinicopathological significance of MicroRNA-153 in human cancers: A meta-analysis.

BACKGROUND: Several studies have explored the prognostic value of MicroRNA-153 (miR-153) in various cancers, but obtained inconsistent results. Thus, we conducted a meta-analysis to assess the prognostic significance of miR-153 for patients with cancer. METHODS: Eligible studies were identified by searching the online databases Pubmed, Embase, Web of Science, Medline,and the China National Knowledge Infrastructure (CNKI) up to March 2020. Hazard ratios (HRs) with 95% CIs and were calculated to clarify the correlation between miR-153 expression and prognosis of different cancers. Odds ratios (ORs) with 95% CI were selected to appraise the correlation between miR-153 with clinicopathological characteristics of cancer patients. RESULTS: In total, 933 patients from 11 articles were enrolled in our meta-analysis. The results revealed that low miR-153 expression was significantly correlated with poor overall survival (OS) (HR = 2.45, 95% CI = 1.66-3.63, P < .001), but not with disease-free survival (DFS) (HR = 1.67, 95% CI = 0.45-6.19, P = .442). Subgroup analysis found that low miR-153 expression was associated with worse OS in the reported directly from articles group (HR = 2.67, 95% CI: 1.32-5.37, P = .006), survival curves group (HR = 2.10, 95% CI: 1.56-2.84, P < .001), digestive system tumor (HR = 2.76, 95% CI: 1.73-4.41, P < .001), and breast cancer (HR = 4.01, 95% CI: 1.46-11.04, P = .007).Moreover, cancer patients with low miR-153 expression were prone to poor tumor differentiation(poor vs well+moderate, OR = 2.41, 95% CI = 1.52-3.82, P < .001), earlier lymph node metastasis (present vs absent, OR = 2.19, 95% CI = 1.12-4.25, P = .021) and earlier distant metastasis (present vs absent,OR = 8.24, 95% CI = 2.93-23.21, P < .001), but not associated with age,gender and TNM stage. CONCLUSIONS: This meta-analysis indicated that low miR-153 expression is associated with poor prognosis. miR-153 may serve as an effective predictive biomarker for tumor prognosis, especially for digestive system tumor and breast cancer.

Prognostic value of high stanniocalcin 2 expression in solid cancers: A meta-analysis.

BACKGROUND: Several studies have explored the prognostic value of stanniocalcin 2 (STC2) in various cancers, but obtained inconsistent results. Therefore, this meta-analysis was performed to determine the prognostic and clinicopathologic significance of STC2 in various cancers. METHODS: Eligible studies were identified by searching the online databases PubMed, Embase, Web of Science, and the China National Knowledge Infrastructure up to March 2019. Hazard ratios (HRs) with 95% confidence intervals (CIs) and were calculated to clarify the correlation between STC2 expression and prognosis of different cancers. Odds ratios (ORs) with 95% CI were selected to appraise the correlation between STC2 with clinicopathologic characteristics of patients with cancer. RESULTS: A total of 16 eligible studies with 4074 patients with cancer were included in our meta-analysis. The results showed that high STC2 expression can predict poor overall survival (OS) for cancer (HR = 1.48, 95% CI: 1.15-1.90, P = .002). Subgroup analysis found that high STC2 expression was associated with worse OS in Asian (HR = 1.85, 95% CI: 1.35-2.55), the reported directly from articles group (HR = 1.39, 95% CI: 1.05-1.84), survival curves group (HR = 1.93, 95% CI: 1.36-2.74), and gastric cancer (HR = 1.43, 95% CI: 1.04-1.95). Furthermore, high STC2 expression was significantly related to advanced T stage (OR = 1.83, 95% CI: 1.17-2.86, P = .008), lymph node metastasis (OR = 2.29, 95% CI: 1.51-3.45, P < .001), lymphatic invasion (OR = 2.15, 95% CI: 1.53-3.02, P < .001), venous invasion (OR = 1.97, 95% CI: 1.30-2.99, P = .001), and more advanced clinical stage (OR = 2.36, 95% CI: 1.74-3.19, P < .001) CONCLUSION:: Elevated expression of STC2 suggested a poor prognosis in patients with cancer and may serve as a new tumor marker to monitor cancer development and progression.

High Level of Lipoprotein(a) as Predictor for Recurrent Heart Failure in Patients with Chronic Heart Failure: a Cohort Study / Nível Alto de Lipoproteína (a) como Preditor de Insuficiência Cardíaca Recorrente em Pacientes com Insuficiência Cardíaca Crônica: um Estudo de Coorte

Abstract Background: Elevated plasma levels of Lipoprotein(a) [Lp(a)] are recognized as a significant risk factor for atherosclerotic vascular disease. However, there are limited data regarding association between Lp(a) and recurrent heart failure (HF) in patients with chronic HF caused by coronary heart disease (CHD). Objective: Elevated levels of Lp(a) might have a prognostic impact on recurrent HF in patients with chronic HF caused by CHD. Methods: A total of 309 patients with chronic HF caused by CHD were consecutively enrolled in this study. The patients were divided into 2 groups according to whether Lp(a) levels were above or below the median level for the entire cohort (20.6 mg/dL): the high Lp(a) group (n = 155) and the low Lp(a) group (n = 154). A 2-sided p < 0.05 was statistically considered significant. Results: During the median follow-up period of 186 days, 31 cases out of a total of 309 patients (10.03%) could not be reached during follow-up. A Kaplan-Meier analysis demonstrated that patients with higher Lp(a) levels had a higher incidence of recurrent HF than those with lower Lp(a) levels (log-rank < 0.0001). A multivariate Cox regression analysis revealed that Lp(a) levels were independently correlated with the incidence of recurrent HF after adjustment of potential confounders (hazard ratio: 2.720, 95 % confidence interval: 1.730-4.277, p < 0.0001). Conclusions: In Chinese patients with chronic HF caused by CHD, elevated levels of Lp(a) are independently associated with recurrent HF.

Resumo Fundamento: Níveis plasmáticos elevados de lipoproteína (a) [Lp(a)] são reconhecidos como um fator de risco significativo para doença vascular aterosclerótica. No entanto, existem dados limitados sobre a associação entre a Lp(a) e insuficiência cardíaca (IC) recorrente em pacientes com IC crônica causada por doença arterial coronariana (DAC). Objetivo: Níveis elevados de Lp(a) podem ter um impacto prognóstico na IC recorrente em pacientes com IC crônica por DAC. Métodos: Um total de 309 pacientes com IC crônica causada por DAC foram consecutivamente incluídos neste estudo. Os pacientes foram divididos em 2 grupos de acordo com os níveis de Lp(a), acima ou abaixo do nível mediano de toda a coorte (20,6 mg/dL): o grupo Lp(a) alto (n = 155) e o grupo Lp ( a) baixo (n = 154). Um p < 0,05 bicaudal foi considerado estatisticamente significativo. Resultados: Durante a mediana do período de seguimento de 186 dias, 31 casos de um total de 309 pacientes (10,03%) não puderam ser contatados durante o acompanhamento. A análise de Kaplan-Meier demonstrou que pacientes com níveis mais elevados de Lp(a) apresentavam maior incidência de IC recorrente do que aqueles com níveis mais baixos de Lp(a) (log-rank < 0,0001). Uma análise de regressão multivariada de Cox revelou que os níveis de Lp(a) foram independentemente correlacionados com a incidência de IC recorrente após ajuste de potenciais fatores de confusão (hazard ratio 2,720, intervalo de confiança de 95%: 1,730-4,277, p < 0,0001). Conclusões: Em pacientes chineses com IC crônica causada por DAC, níveis elevados de Lp(a) estão associados de forma independente à IC recorrente.

Prognostic and clinicopathological significance of S100A14 expression in cancer patients: A meta-analysis.

BACKGROUND: The prognostic significance of S100A14 for survival of cancer patients remains controversial. Therefore, we conducted this meta-analysis to explore the association between S100A14 expression and cancer prognosis. METHOD: Eligible studies were identified by searching the online databases Pubmed and EMBASE up to August 2018. Odds ratios (ORs) with 95% confidence intervals (CIs) severed as the summarized statistics for clinicopathological assessments and hazard ratios (HRs) with 95% CIs were calculated to clarify the correlation between S100A14 expression and prognosis of different cancers. RESULTS: A total of 11 studies with 1651 cancer patients were enrolled. The results indicated that S100A14 expression was not significantly associated with overall survival (OS) in total various cancers (HR = 1.54, 95% CI:0.89-2.67, P = .121). Further subgroup analysis stratified by tumor type showed that elevated S100A14 expression was associated with poor OS in breast cancer (HR = 3.66, 95% CI: 1.75-7.62, P < .001) and in ovarian cancer patients (HR = 3.78, 95%CI: 1.63-8.73, P = .002). Interestingly, high S100A14 expression was correlated with poor tumor differentiation (OR = 2.51, 95% CI: 1.52-4.13, P < .001). However, there were no significant correlations between S100A14 expression and other clinicopathologic characteristics. Begg funnel plot and Egger test showed that no publication bias was detected. CONCLUSIONS: Our meta-analysis suggests that S100A14 overexpression might be a predictive biomarker for poor prognosis in patients with breast cancer and ovarian cancer. Large-scale studies are required to confirm these results.

High Level of Lipoprotein(a) as Predictor for Recurrent Heart Failure in Patients with Chronic Heart Failure: a Cohort Study.

BACKGROUND: Elevated plasma levels of Lipoprotein(a) [Lp(a)] are recognized as a significant risk factor for atherosclerotic vascular disease. However, there are limited data regarding association between Lp(a) and recurrent heart failure (HF) in patients with chronic HF caused by coronary heart disease (CHD). OBJECTIVE: Elevated levels of Lp(a) might have a prognostic impact on recurrent HF in patients with chronic HF caused by CHD. METHODS: A total of 309 patients with chronic HF caused by CHD were consecutively enrolled in this study. The patients were divided into 2 groups according to whether Lp(a) levels were above or below the median level for the entire cohort (20.6 mg/dL): the high Lp(a) group (n = 155) and the low Lp(a) group (n = 154). A 2-sided p < 0.05 was statistically considered significant. RESULTS: During the median follow-up period of 186 days, 31 cases out of a total of 309 patients (10.03%) could not be reached during follow-up. A Kaplan-Meier analysis demonstrated that patients with higher Lp(a) levels had a higher incidence of recurrent HF than those with lower Lp(a) levels (log-rank < 0.0001). A multivariate Cox regression analysis revealed that Lp(a) levels were independently correlated with the incidence of recurrent HF after adjustment of potential confounders (hazard ratio: 2.720, 95 % confidence interval: 1.730-4.277, p < 0.0001). CONCLUSIONS: In Chinese patients with chronic HF caused by CHD, elevated levels of Lp(a) are independently associated with recurrent HF.

Association between IL-17A G197A polymorphism and gastric cancer risk: an updated meta-analysis based on 6,624 cases and 7,631 controls.

PURPOSE: Previous studies investigating the association between interleukin-17A (IL-17A) G197A polymorphism and gastric cancer risk have provided inconsistent results. We, therefore, conducted this meta-analysis to clarify the association between IL-17A G197A polymorphism and gastric cancer risk. METHODS: We searched PubMed, Excerpta Medica Database, and CNKI databases to identify relevant studies up to June 10, 2017. A total of 16 case-control studies including 6,624 cases and 7,631 controls were identified. RESULTS: Overall, significant associations between IL-17A G197A polymorphism and gastric cancer risk were observed (A vs G: OR =1.24, 95% CI =1.14-1.36; AA vs GG: OR =1.63, 95% CI =1.35-1.96; GA vs GG: OR =1.12, 95% CI =1.01-1.25; AA+GA vs GG: OR =1.23, 95% CI =1.11-1.35; AA vs GA+GG: OR =1.54, 95% CI =1.27-1.87). Similar associations were also observed in Asian population (A vs G: OR =1.25, 95% CI =1.15-1.37; AA vs GG: OR =1.62, 95% CI =1.33-1.97; GA vs GG: OR =1.16, 95% CI =1.07-1.25; AA+GA vs GG: OR =1.24, 95% CI =1.15-1.33; AA vs GA+GG: OR =1.51, 95% CI =1.23-1.85), in Caucasian population (AA vs GA+GG: OR =2.19, 95% CI =1.40-3.44), and in the hospital-based controls' subgroup (A vs G: OR =1.30, 95% CI =1.17-1.45; AA vs GG: OR =1.81, 95% CI =1.46-2.25; AA+GA vs GG: OR =1.27, 95% CI =1.12-1.43; AA vs GA+GG: OR =1.71, 95% CI =1.34-2.18). CONCLUSIONS: The current meta-analysis suggests that IL-17A G197A polymorphism might enhance gastric cancer risk.

Prognostic role of LSD1 in various cancers: evidence from a meta-analysis.

The prognostic value of lysine-specific demethylase 1 (LSD1) overexpression in various cancers has been investigated by many studies with inconsistent results. A meta-analysis was performed to assess the association between LSD1 and overall survival (OS) in cancer patients. Eligible studies were identified by searching the online databases PubMed and China National Knowledge Infrastructure up to February 2015. Hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated to clarify the correlation between LSD1 expression and prognosis of different cancers. In total, nine studies with 1,149 cancer patients were included for final analysis. The meta-analysis suggested that LSD1 overexpression was associated with poor OS in cancer patients (HR =1.80, 95% CI: 1.39-2.34, P=0.000). Subgroup analysis by ethnicity, cancer type and HR estimate also showed that high levels of LSD1 were significantly correlated with OS. The meta-analysis showed that LSD1 overexpression may be associated with a worse prognosis in cancer patients.

Association between RAD51 polymorphisms and susceptibility of head and neck cancer: a meta-analysis.

BACKGROUND: The associations between RAD51 gene polymorphisms (G135C and G172T) and risk of head and neck cancer (HNC) have been investigated, but the results are controversial. The aim of this study was to provide a more precise estimation of its relationship with HNC using a meta-analysis. METHODS: Relevant studies were retrieved from the PubMed, Excerpta Medica Database, and China National Knowledge Infrastructure. Strict selection and exclusion criteria were determined, and the odds ratio (OR) with a 95% confidence interval (CI) was used to assess the strength of the association between RAD51 polymorphisms and HNC risk. RESULTS: Six studies were eligible for RAD51 G135C (1593 cases and 1719 controls), and three studies were eligible for RAD51 G172T (997 cases and 979 controls). In the overall population, significant association between RAD51 G135C polymorphism and HNC risk was observed under allele model (C vs G: OR = 1.21, 95% CI = 1.04-1.41, P = 0.015). In the subgroup analysis by smoking status, a significant association was found among smokers (C vs G: OR = 1.59, 95% CI = 1.25-2.04; GC vs GG: OR = 2.29, 95% CI = 1.29-4.05; GC + CC vs GG: OR = 2.08, 95% CI = 1.56-2.78). When stratified based on drinking status, a significant association was found among drinkers(C vs G: OR = 1.60, 95% CI = 1.21-2.11; GC vs GG: OR = 2.50, 95% CI = 1.16-5.38; GC + CC vs GG: OR = 2.17,95% CI = 1.56-3.01). However, no significant association with HNC risk was demonstrated when stratified based on source of control and ethnicity. For G172T polymorphism, the results showed no significant risk association in overall analysis. In the subgroup analysis by ethnicity, the result suggested that a decreased HNC risk was found among Caucasians (T vs G: OR = 0.82, 95% CI = 0.72-0.95; TT vs GG: OR = 0.62, 95% CI = 0.46-0.84; TT vs GT + GG: OR = 0.64, 95% CI = 0.49-0.84). CONCLUSION: This meta-analysis suggested that RAD51 G135C is associated with increased HNC risk, especially among smokers and drinkers, while G172T polymorphism may play a protective role against HNC among Caucasians. Larger-scale and well-designed studies are needed to further clarify the association.

Lack of association between vitamin D receptor gene BsmI polymorphism and breast cancer risk: an updated meta-analysis involving 23,020 subjects.

The vitamin D receptor (VDR) is a crucial mediator for the cellular effects of vitamin D. A great number of studies regarding the association between BsmI polymorphism in the VDR gene and breast cancer have been published. However, the results have been contradicting. Therefore, we conducted a meta-analysis to re-examine the controversy. Published literatures from PubMed, Embase, and Chinese Biomedical Literature Database (CBM) were searched (updated to July 10, 2013). The principal outcome measure was the odds ratio (OR) with 95% confidence interval (CI) for breast cancer risk associated with VDR BsmI polymorphism. With all studies involved, the meta-analysis results suggest no statistically significant association between VDR BsmI polymorphism and breast cancer risk (B vs. b, OR = 0.922, 95% CI = 0.836-1.018, P = 0.108, I (2) = 80.0%; BB vs. bb, OR = 0.843, 95% CI = 0.697-1.021, P = 1.75, I (2) = 75.5%; Bb vs. bb, OR = 0.930, 95% CI = 0.814-1.063, P = 0.31, I (2) = 73.1%; BB+Bb vs. bb, OR = 0.906, 95% CI = 0.787-1.043, P = 1.37, I (2) = 78.7%; BB vs. bb+Bb, OR = 0.899, 95% CI = 0.786-1.028, P = 1.56, I (2) = 61.0%). The results were not changed when studies were stratified by ethnicity or source of controls. This meta-analysis suggested that there were no associations between VDR BsmI polymorphism and breast cancer.

Rapid detection and antimicrobial resistance gene profiling of Yersinia pestis using pyrosequencing technology.

When a bioterrorism attack is attempted or perpetrated there is considerable risk for public health and large scale socioeconomic consequences. It is imperative that we possess established assays for the rapid identification of biothreat agents with high sensitivity and specificity to ensure emergency response measures can be deployed appropriately. Highly trustworthy information within a relevant timeframe is required to make a rapid and informed decision. Obtaining DNA sequence data from a suspected agent provides an added layer of confidence compared to a presumptive positive PCR amplicon. Sequencing based technologies, such as pyrosequencing, have sufficient discrimination potential to be used for microbial identification and can also be used to identify antimicrobial resistance (AMR) genes. We have shown in this study the power of pyrosequencing in the unambiguous detection and identification of nine Yersinia pestis strains based on virulence genes. Furthermore, we developed assays to characterize their AMR gene profiles. Sequence results ranging from 40 to 84bp were generated in about 60 min following initial PCR amplification and provide a rapid method for determining the AMR profile as compared to the conventional plate method which takes several days. The high sequence identities (95-100%) and specificity observed indicate the high level of accuracy of pyrosequencing technology. In addition, the read lengths of up to 84 bp observed in this study are unprecedented for pyrosequencing using the Pyromark Q24. We propose this method as a novel, rapid, sequence based detection and identification tool for Y. pestis with a potential application in biodefence.