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1.
Medicine (Baltimore) ; 99(2): e18752, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31914096

RESUMEN

The high prevalence of hepatitis B virus (HBV) infection and intracranial atherosclerotic stenosis (ICAS) in Asia raises the question as to whether HBV infection is associated with ICAS. To answer this question, we tested the association between HBV infection and ICAS. Totally, 3072 in-hospital subjects were retrospectively enrolled. All subjects underwent computed tomography angiography (CTA) and serological testing for HBV infection. Based on the results of CTA, all subjects were categorized into 4 groups including ICAS, extracranial atherosclerotic stenosis (ECAS), ICAS/ECAS (both ICAS and ECAS), and normal. HBV infection was divided into 4 patterns including hepatitis B core antibody (anti-HBc) positive/hepatitis B surface antigen (HBsAg) positive, anti-HBc-positive/HBsAg-negative, anti-HBc-negative/HBsAg-positive, and anti-HBc-negative/HBsAg-negative. Risk factors for atherosclerosis were collected based on medical records. Multiple logistic regression models were used to determine the association between infection patterns and ICAS. We found that the anti-HBc-positive / HBsAg-negative pattern was associated with the increased risk of ICAS (OR = 1.462) and not associated with ECAS or ICAS / ECAS. The HBc-positive/HBsAg-positive pattern was not associated with ICAS, ECAS or ICAS/ECAS. In conclusions, the anti-HBc-positive/HBsAg-negative pattern was associated with the increased risk of ICAS. Anti-HBc should be employed to investigate the association between HBV infection and cerebrovascular diseases.


Asunto(s)
Aterosclerosis/epidemiología , Anticuerpos contra la Hepatitis B/sangre , Antígenos de Superficie de la Hepatitis B/sangre , Hepatitis B/epidemiología , Arteriosclerosis Intracraneal/epidemiología , Anciano , Aterosclerosis/diagnóstico por imagen , China/epidemiología , Angiografía por Tomografía Computarizada , Constricción Patológica , Femenino , Hepatitis B/sangre , Hepatitis B/inmunología , Humanos , Arteriosclerosis Intracraneal/diagnóstico por imagen , Modelos Logísticos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores de Riesgo
2.
Int Heart J ; 61(1): 103-108, 2020 Jan 31.
Artículo en Inglés | MEDLINE | ID: mdl-31956154

RESUMEN

Waist circumference (WC) is measured for the assessment of abdominal obesity, whereas carotid intima-media thickness (IMT) is a marker of preclinical atherosclerosis. The relationship between WC and carotid IMT in the general population is not fully understood. In this study, we examined 1,182 subjects (658 men and 524 women, 62.3 ± 11.7 years on average) who underwent voluntary health check-ups and sought to determine the optimal cut-off value of WC for predicting carotid IMT thickness. Receiver operating characteristic curve analysis of WC was utilized to predict high carotid IMT (defined as carotid IMT ≥ 1.1 mm). We determined that the appropriate WC cut-off value was a WC ≥ 79 cm for men and women. There was a statistically significant difference in the prevalence of high carotid IMT between WC ≥ 79 cm and WC < 79 cm in both men and women. However, multivariable logistic regression analysis demonstrated that the WC category was independently associated with high carotid IMT in men, but not in women. Our study indicates that the optimal cut-off value of WC to identify preclinical atherosclerosis may be lower than the current Japanese diagnostic criteria for metabolic syndrome (MetS) in both men and women. Compared to women, the association between WC and preclinical atherosclerosis may be more pronounced in men.


Asunto(s)
Aterosclerosis/diagnóstico , Obesidad Abdominal/diagnóstico , Anciano , Aterosclerosis/epidemiología , Grosor Intima-Media Carotídeo , Femenino , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Obesidad Abdominal/epidemiología , Prevalencia , Curva ROC , Factores Sexuales , Circunferencia de la Cintura
3.
World Neurosurg ; 133: e31-e61, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31415895

RESUMEN

BACKGROUND: The association between matrix metalloproteinase 9 (MMP-9) gene -1562C/T (rs3918242) polymorphism and the susceptibility of ischemic stroke (IS) has been investigated. However, results were ambiguous and inconsistent. Therefore, we performed this study to better assess the potential relationship between rs3918242 polymorphism and susceptibility risk of IS. METHODS: We included case-control studies concerning the relationship between the rs3918242 polymorphism and IS, and odds ratios with corresponding 95% confidence intervals were used to describe the associations. Furthermore, meta-regression analyses, heterogeneity, cumulative analyses, sensitivity analyses, and publication bias were examined. RESULTS: A total of 19 studies were included for analysis. Significant associations with the risk of IS were detected for the rs3918242 polymorphism in overall population, Asians, and whites. When available data were stratified by gender, we found a significant correlation with the risk of IS in both males and females. Further subgroup analysis by the subtypes of IS showed that the rs3918242 polymorphism was significantly correlated with the risk of patients with large artery atherosclerosis. When stratified by age, we found that the rs3918242 polymorphism was significantly correlated with the risk of IS in patients both aged ≥65 years and >65 years. Both the diabetes and the nondiabetes subgroups reached significant results, and in an analysis stratified by smoking status, an increased risk of IS was associated with smoking. CONCLUSIONS: The rs3918242 polymorphism may be a susceptible predictor of susceptibility of IS. Further large-scale studies are needed to verify the results of our findings.


Asunto(s)
Isquemia Encefálica/genética , Metaloproteinasa 9 de la Matriz/genética , Polimorfismo de Nucleótido Simple , Adulto , Distribución por Edad , Anciano , Aterosclerosis/epidemiología , Isquemia Encefálica/enzimología , Isquemia Encefálica/epidemiología , Estudios de Casos y Controles , Fumar Cigarrillos/epidemiología , Comorbilidad , Intervalos de Confianza , Diabetes Mellitus/epidemiología , Grupos Étnicos , Femenino , Predisposición Genética a la Enfermedad , Genotipo , Humanos , Embolia Intracraneal/epidemiología , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Distribución por Sexo
4.
Environ Health Prev Med ; 24(1): 69, 2019 Nov 30.
Artículo en Inglés | MEDLINE | ID: mdl-31785607

RESUMEN

BACKGROUND: Even though there is bidirectional association between hypertension and atherosclerosis, atherosclerosis itself is involved in the process of endothelial repair. To clarify the association of endothelial repair with hypertension, a cross-sectional study was conducted. METHODS: We conducted a cross-sectional study of 562 elderly Japanese men aged 60-69. As gamma-glutamyl transpeptidase (γ-GTP) could act as a marker of oxidative stress that injures endothelial cell and higher levels of CD34-positive cell indicate a higher activity of endothelial repair, we therefore performed a CD34-positive level specific analysis of γ-GTP on atherosclerosis and hypertension. RESULTS: In the present study population, hypertension was independently and positively associated with atherosclerosis (multivariable odds ratio (OR) = 2.09 (1.30, 3.35)). Among participants with high CD34-positive cells, γ-GTP showed significant and positive association with atherosclerosis (OR of the log-transformed value of γ-GTP (OR) = 2.26 (1.32, 3.86)) but not with hypertension (OR = 0.77 (0.51, 1.17)). Among participants with low CD34-positive cells, even γ-GTP showed no significant association with atherosclerosis (OR = 0.92 (0.51, 1.68)), but was significantly and positively associated with hypertension (OR = 1.99 (1.27, 3.12)). CONCLUSIONS: γ-GTP revealed to have ambivalent association with hypertension and atherosclerosis. Active endothelial repair that is associated with atherosclerosis might have beneficial association with hypertension.


Asunto(s)
Aterosclerosis/enzimología , Hipertensión/enzimología , gamma-Glutamiltransferasa/sangre , Anciano , Antígenos CD34/análisis , Aterosclerosis/sangre , Aterosclerosis/epidemiología , Aterosclerosis/patología , Biomarcadores/sangre , Estudios Transversales , Células Endoteliales/química , Células Endoteliales/patología , Humanos , Hipertensión/sangre , Hipertensión/epidemiología , Hipertensión/patología , Japón/epidemiología , Masculino , Persona de Mediana Edad , Oportunidad Relativa
5.
Prog Cardiovasc Dis ; 62(5): 414-422, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31669498

RESUMEN

Familial hypercholesterolemia (FH) is a frequent genetic disorder characterized by elevated low-density lipoprotein (LDL)-cholesterol (LDL-C) levels and early onset of atherosclerotic cardiovascular disease. FH is caused by mutations in genes that regulate LDL catabolism, mainly the LDL receptor (LDLR), apolipoprotein B (APOB) and gain of function of proprotein convertase subtilisin kexin type 9 (PCSK9). However, the phenotype may be encountered in individuals not carrying the latter monogenic defects, in approximately 20% of these effects of polygenes predominate, and in many individuals no molecular defects are encountered at all. These so-called FH phenocopy individuals have an elevated atherosclerotic cardiovascular disease risk in comparison with normolipidemic individuals but this risk is lower than in those with monogenic disease. Individuals with FH are exposed to elevated LDL-C levels since birth and this explains the high cardiovascular, mainly coronary heart disease, burden of these subjects. However, recent studies show that this risk is heterogenous and depends not only on high LDL-C levels but also on presence of previous cardiovascular disease, a monogenic cause, male sex, smoking, hypertension, diabetes, low HDL-cholesterol, obesity and elevated lipoprotein(a). This heterogeneity in risk can be captured by risk equations like one from the SAFEHEART cohort and by detection of subclinical coronary atherosclerosis. High dose high potency statins are the main stain for LDL-C lowering in FH, however, in most situations these medications are not powered enough to reduce cholesterol to adequate levels. Ezetimibe and PCSK9 inhibitors should also be used in order to better treat LDL-C in FH patients.


Asunto(s)
Anticolesterolemiantes/uso terapéutico , Aterosclerosis/prevención & control , LDL-Colesterol/sangre , Hiperlipoproteinemia Tipo II/tratamiento farmacológico , Anticolesterolemiantes/efectos adversos , Aterosclerosis/epidemiología , Aterosclerosis/genética , Biomarcadores/sangre , Ezetimiba/uso terapéutico , Predisposición Genética a la Enfermedad , Humanos , Inhibidores de Hidroximetilglutaril-CoA Reductasas/uso terapéutico , Hiperlipoproteinemia Tipo II/sangre , Hiperlipoproteinemia Tipo II/epidemiología , Hiperlipoproteinemia Tipo II/genética , Fenotipo , Proproteína Convertasa 9/antagonistas & inhibidores , Proproteína Convertasa 9/metabolismo , Medición de Riesgo , Factores de Riesgo , Inhibidores de Serina Proteinasa/uso terapéutico , Resultado del Tratamiento
6.
Medicina (B Aires) ; 79(5): 373-383, 2019.
Artículo en Español | MEDLINE | ID: mdl-31671387

RESUMEN

Subclinical atherosclerosis is a powerful predictor of cardiovascular events, although it is unknown which of the risk scores is more useful to predict its presence in a Latin American population. The objective was to compare the performance of the risk scores: Framingham, Regicor and Atherosclerotic Cardiovascular Disease Risk Estimator to predict the presence of subclinical atherosclerosis in asymptomatic persons without known cardiovascular disease; as well as determining its prevalence and distribution in the different vascular beds. From 2014 to 2017, patients from 35 to 75 years, asymptomatic and without known cardiovascular disease who underwent a carotid and femoral Doppler echo and calcium score were evaluated. Subclinical atherosclerosis was defined as the presence of plaques in the carotid and/or femoral arteries or the presence of calcium in the coronary arteries (Agatston score > 0). A total of 212 patients were included. The mean age was 53 ± 7 years, of which 60% (128) were male. The prevalence of subclinical atherosclerosis was 62% (131 cases). Of these 131 subjects with a plaque in any of the territories, the Atherosclerotic Cardiovascular Disease Risk Estimator was the one that identified the highest number of cases with high cardiovascular risk (39%), Framingham detected 20%, and Regicor 0% (p < 0.01). The net reclassification was 41%, 50% and 60% respectively (< 0.01). The prevalence of subclinical atherosclerosis in asymptomatic persons without a history of cardiovascular disease was 62%. The Atherosclerotic Cardiovascular Disease Risk Estimator was the most effective predictor of subclinical atherosclerosis in this population.


Asunto(s)
Aterosclerosis/epidemiología , Aterosclerosis/etiología , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/etiología , Medición de Riesgo/métodos , Adulto , Anciano , Argentina/epidemiología , Enfermedades Asintomáticas , Femenino , Humanos , Hiperlipidemias/complicaciones , Hiperlipidemias/epidemiología , Hipertensión/complicaciones , Hipertensión/epidemiología , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Prevalencia , Valores de Referencia , Estudios Retrospectivos , Factores de Riesgo
7.
Nutr Metab Cardiovasc Dis ; 29(12): 1261-1272, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31653512

RESUMEN

BACKGROUND AND AIMS: Atherogenesis and endothelial dysfunction contribute to cardiovascular risk and vitamin D has been implemented in endothelial repair. This systematic review, meta-analysis and meta-regression aims to establish the effect of vitamin D supplementation on endothelial function. METHODS AND RESULTS: To conduct the systematic review we searched the Cochrane Library of Controlled Trials, PubMed, ProQuest and EMBASE for randomized controlled trials that investigated the effects of vitamin D supplementation on flow-mediated dilation (FMD%), pulse wave velocity (PWV), and central augmentation index (AIx). Meta-analysis was based on a random effects model and inverse-variance methods to calculate either mean difference (MD) or standardized mean difference (SMD) as effects sizes. This was followed by meta-regression investigating the effect of baseline vitamin D concentrations, vitamin D dosing and study duration. Risk of bias was assessed using the JADAD scale and funnel plots. We identified 1056 studies of which 26 studies met inclusion criteria for quantitative analysis. Forty-two percent of the 2808 participants had either deficient or insufficient levels of vitamin D. FMD% (MD 1.17% (95% CI -0.20, 2.54), p = 0.095), PWV (SMD -0.09 m/s (95% CI -0.24, 0.07), p = 0.275) and AIx (SMD 0.05% (95% CI -0.1, 0.19), p = 0.52) showed no improvement with vitamin D supplementation. Sub-analysis and meta-regression revealed a tendency for AIx and FMD% to increase as weekly vitamin doses increased; no other significant relationships were identified. CONCLUSIONS: Vitamin D supplementation showed no improvement in endothelial function. More evidence is required before recommendations for management of endothelial dysfunction can be made.


Asunto(s)
Aterosclerosis/tratamiento farmacológico , Suplementos Dietéticos , Endotelio Vascular/efectos de los fármacos , Vasodilatación/efectos de los fármacos , Deficiencia de Vitamina D/tratamiento farmacológico , Vitamina D/uso terapéutico , Adulto , Anciano , Aterosclerosis/epidemiología , Aterosclerosis/fisiopatología , Suplementos Dietéticos/efectos adversos , Endotelio Vascular/fisiopatología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Ensayos Clínicos Controlados Aleatorios como Asunto , Recuperación de la Función , Factores de Riesgo , Resultado del Tratamiento , Vitamina D/efectos adversos , Deficiencia de Vitamina D/epidemiología , Deficiencia de Vitamina D/fisiopatología
8.
Nutr Metab Cardiovasc Dis ; 29(12): 1337-1344, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31653515

RESUMEN

BACKGROUND AND AIMS: Mac-2 binding protein (M2BP) plays an important role in cell adhesion. In a recent cross-sectional study we reported that serum M2BP concentrations may reflect silent atherosclerosis. The aim of the present prospective follow-up study was to investigate possible relationships between changes in concentrations of M2BP and other factors over a >3-year period. METHODS AND RESULTS: The present study enrolled subjects who visited Enshu hospital from 2014 to 2015 for a periodic physical check-up and then attended for another physical check-up after >3 years (n = 174). Factors affecting changes in M2BP concentrations were investigated at both baseline and follow-up. Subjects with liver dysfunction, a history of hepatic disease, malignant neoplasm, or cardiovascular events at baseline were excluded. Univariate and multivariate regression analyses showed that changes in serum M2BP concentrations during the follow-up period were significantly associated with changes in low-density lipoprotein cholesterol (LDL-C), triglyceride, and oxidative stress marker derivatives of reactive oxygen metabolites (d-ROM) concentrations. Moreover, the increase in LDL-C was significantly greater in subjects in whom M2BP concentrations increased during the follow-up period. Logistic regression analysis with an endpoint of increased M2BP revealed that increased LDL-C was an independent determinant of an increase in M2BP during the follow-up period. CONCLUSION: During the observation period of >3 years, serum M2BP concentrations were increased in subjects who also exhibited increases in levels of metabolic parameters, especially LDL-C, and the oxidative stress marker d-ROM. These results support that serum M2BP reflects one of the contributors to the progression of silent atherosclerosis.


Asunto(s)
Antígenos de Neoplasias/sangre , Aterosclerosis/sangre , Biomarcadores de Tumor/sangre , LDL-Colesterol/sangre , Estrés Oxidativo , Especies Reactivas de Oxígeno/sangre , Anciano , Enfermedades Asintomáticas , Aterosclerosis/diagnóstico , Aterosclerosis/epidemiología , Biomarcadores/sangre , Femenino , Humanos , Japón , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Pronóstico , Estudios Prospectivos , Factores de Riesgo , Factores de Tiempo , Regulación hacia Arriba
9.
Environ Pollut ; 255(Pt 2): 113320, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31610505

RESUMEN

Smoky coal burning is a predominant manner for heating and cooking in most rural areas, China. Air pollution is associated with the risk of atherosclerosis, however, the link between indoor air pollution induced by smoky coal burning and atherosclerosis is not very clear. Therefore, we designed a cross-sectional study to evaluate the association of long-term exposure to smoky coal burning pollutants with the risk of atherosclerosis. 426 and 326 participants were recruited from Nangong, China and assigned as the coal exposure and control group according to their heating and cooking way, respectively. The indoor air quality (PM2.5, CO, SO2) was monitored. The association between coal burning exposure and the prevalence of atherosclerosis was evaluated by unconditional logistic regression analysis, adjusted for confounding factors. The inflammatory cytokines mRNAs (IL-8, SAA1, TNF-α, CRP) expression in whole blood were examined by qPCR. People in the coal exposure group had a higher risk of carotid atherosclerosis compared with the control (risk ratio [RR], 1.434; 95% confidence interval [95%CI], 1.063 to 1.934; P = 0.018). The association was stronger in smokers, drinkers and younger (<45 years old) individuals. The elevation of IL-8 (0.24, 95%CI, 0.06-0.58; P < 0.05), CRP (0.37, 95%CI, 0.05-0.70; P < 0.05), TNF-α (0.41, 95%CI, 0.14-0.67; P < 0.01) mRNAs expression in whole blood were positively related to coal exposure. Our results suggested long-term exposure to smoky coal burning emissions could increase the risk of carotid atherosclerosis. The potential mechanism might relate that coal burning emissions exposure induced inflammatory cytokines elevation which had adverse effects on atherosclerotic plaque, and then promoted the development of atherosclerosis.


Asunto(s)
Contaminación del Aire Interior/análisis , Contaminación del Aire/análisis , Aterosclerosis/epidemiología , Enfermedades de las Arterias Carótidas/epidemiología , Carbón Mineral/análisis , Humo/análisis , Aterosclerosis/inducido químicamente , Enfermedades de las Arterias Carótidas/inducido químicamente , China/epidemiología , Culinaria/métodos , Estudios Transversales , Femenino , Calefacción/métodos , Humanos , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Población Rural
10.
Dis Markers ; 2019: 1045098, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31565096

RESUMEN

Purpose: This study is aimed at determining whether bone mineral density (BMD) values are related to atherogenic indexes (AIs) and could predict the risk of cardiovascular disease (CVD) in southern Taiwanese adults. Methods: Medical records of 3249 adults who underwent health examinations between June 2014 and February 2018 at a regional hospital in southern Taiwan were reviewed. Data collected included health history, anthropomorphic characteristics, exercise habits, diets (vegetarian or nonvegetarian), clinical laboratory results (lipid profile, systemic blood pressure (SBP), glucose level, creatinine (Cre) level, and hemoglobin (Hb) level), and bone mineral density (BMD), which were used to identify the associations of these parameters, especially BMD, with lipid profile and calculated AIs through simple and multiple linear regressions. Results: The mean age of the patients was 58.0 years, and 71.4% were male. Body mass index (BMI), SBP, glucose level, Cre level, Hb level, and all BMD values were positively correlated with triglyceride (TG) level and AIs and were negatively correlated with high-density lipoprotein cholesterol (HDL-C) level. The significant positive correlations of BMD at all the measured sites with AIs remained after adjusting for age, sex, SBP, glucose level, Cre level, Hb level, smoking, exercise habits, and vegetarian state. The expanded adjusting model for TG/HDL-C remained significant at all the BMD measured sites in nonobese men, at bilateral femoral neck and total hips in nonobese women, and at the bilateral total hips in obese women. Conclusions: AIs are predictive markers for CVD, and BMD values are predictors of AIs, especially the novel AI, i.e., TG/HDL-C ratio, in nonobese adult men and women after dividing the patients into subgroups to eliminate the effect of BMI as a confounding factor. Thus, BMD values could predict AIs of CVD, especially in nonobese adults.


Asunto(s)
Aterosclerosis/epidemiología , Densidad Ósea , Enfermedades Cardiovasculares/epidemiología , Obesidad/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Índice de Masa Corporal , HDL-Colesterol/sangre , Femenino , Humanos , Masculino , Persona de Mediana Edad , Taiwán
11.
Medicine (Baltimore) ; 98(42): e17620, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31626142

RESUMEN

Anthropometric measurements are simple and useful methods for predicting metabolic syndrome (MetS) because obesity is a predominant feature of MetS. Although carotid intima-medial thickness (IMT) is generally used to evaluate subclinical atherosclerosis, the relationship between the optimal cut-off anthropometric values for predicting MetS and carotid IMT has not been analyzed in a Korean population.Anthropometric measurements including waist circumference (WC), waist hip ratio (WHR), waist height ratio (WHtR), body mass index (BMI), and carotid IMT were assessed in 2560 Korean subjects without previous history of cardiovascular disease, cerebrovascular disease, neurological abnormalities, or malignancy who participated in baseline health examinations in a self-referral setting in the Seoul area between April 2010 and November 2012. MetS was defined using the National Cholesterol Education Program-Adult Treatment Panel III criteria.In both men and women, the levels of all anthropometric indices were significantly higher in subjects with MetS than in those without MetS. According to the receiver operating characteristic curve, the values of 80.8 cm for WC, 0.87 for WHR, 0.52 for WHtR, and 24.6 kg/m for BMI were the optimal cut-offs for predicting MetS in women. The values of 89.3 cm for WC, 0.90 for WHR, 0.52 for WHtR, and 25.1 kg/m for BMI were the optimal cut-offs for predicting MetS in men. After adjusting for confounding factors, the WC optimal cut-off values for predicting MetS were independently associated with carotid IMT in both women and men (women: ß = 0.016, P = .008; men: ß = 0.033, P = .009). The optimal BMI cut-off value was independently associated with carotid IMT in men only (ß = 0.027, P = .032).Among anthropometric indices including WC, WHR, WHtR, and BMI, the WC optimal cut-off values for MetS were independently associated with an increased carotid IMT in both women and men in a Korean population.


Asunto(s)
Antropometría/métodos , Aterosclerosis/epidemiología , Grosor Intima-Media Carotídeo , Síndrome Metabólico/epidemiología , Medición de Riesgo/métodos , Aterosclerosis/diagnóstico , Aterosclerosis/etiología , Estudios Transversales , Femenino , Estudios de Seguimiento , Humanos , Incidencia , Masculino , Síndrome Metabólico/complicaciones , Síndrome Metabólico/diagnóstico , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Curva ROC , República de Corea/epidemiología , Estudios Retrospectivos
12.
Vasc Health Risk Manag ; 15: 209-220, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31371977

RESUMEN

Cholesterol-embolization syndrome (CES) is a multisystemic disease with various clinical manifestations. CES is caused by embolization of cholesterol crystals (CCs) from atherosclerotic plaques located in the major arteries, and is induced mostly iatrogenically by interventional and surgical procedures; however, it may also occur spontaneously. Embolized CCs lead to both ischemic and inflammatory damage to the target organ. Therefore, anti-inflammatory agents, such as corticosteroids and cyclophosphamide, have been investigated as treatment for CES in several studies, with conflicting results. Recent research has revealed that CES is actually a kind of autoinflammatory disease in which inflammasome pathways, such as NLRP3 and IL1, are induced by CCs. These recent findings may have clinical implications such that colchicine and IL1 inhibitors, namely canakinumab, may be beneficial in the early stages of CES.


Asunto(s)
Aterosclerosis , Colesterol/sangre , Embolia por Colesterol , Corticoesteroides/uso terapéutico , Animales , Antiinflamatorios/uso terapéutico , Aterosclerosis/sangre , Aterosclerosis/diagnóstico , Aterosclerosis/tratamiento farmacológico , Aterosclerosis/epidemiología , Biomarcadores/sangre , Cristalización , Embolia por Colesterol/sangre , Embolia por Colesterol/diagnóstico , Embolia por Colesterol/epidemiología , Embolia por Colesterol/prevención & control , Humanos , Inmunosupresores/uso terapéutico , Inflamasomas/sangre , Mediadores de Inflamación/sangre , Interleucina-1/sangre , Proteína con Dominio Pirina 3 de la Familia NLR/sangre , Placa Aterosclerótica , Pronóstico , Factores de Riesgo , Síndrome
13.
Nutr Metab Cardiovasc Dis ; 29(11): 1214-1219, 2019 11.
Artículo en Inglés | MEDLINE | ID: mdl-31378627

RESUMEN

BACKGROUND AND AIMS: The metabolic syndrome(Mets) is a multiplex risk factor for atheroselerotie cardiovascular disease. The aims of the study were to assess the association of the Mets with atherogenic index of plasma(AIP) and other atherogenic parameters in an urban Chinese population. METHODS AND RESULTS: The data were collected in 1992 and then again in 2007 from the same group of 582 individuals(359 men and 223 women) without Mets in 1992. During 15 years' follow-up, AIP was the lipid parameter that was most strongly associated with Mets, with an unadjusted odds ratio of 5.66 (95% CI:1.76-18.23, P = 0.004) in the univariate logistic regression analysis. Multivariate logistic regression analyses also revealed that AIP was an independent risk factor for Mets. AIP significantly predicted Mets in men, with an unadjusted odds ratio of 30.73 (95% CI: 5.62, 168.12 P = 0.012) in a univariate model. Associations remained significant after adjustment for smoking, drinking, physical exercise and components of Mets. The incidences of Mets adjusted for age according to the quartiles of AIP showed a statistical linear trend in men(P for trend = 0.007) rather than in women(P for trend = 0.529). CONCLUSIONS: AIP might be a strong and independent predictor for Mets in an urban Chinese population. The incidence of Mets increased with AIP elevated in men while not in women.


Asunto(s)
Aterosclerosis/sangre , Lípidos/sangre , Síndrome Metabólico/sangre , Salud Urbana , Adulto , Aterosclerosis/diagnóstico , Aterosclerosis/epidemiología , Biomarcadores/sangre , China/epidemiología , Femenino , Disparidades en el Estado de Salud , Humanos , Incidencia , Masculino , Síndrome Metabólico/diagnóstico , Síndrome Metabólico/epidemiología , Persona de Mediana Edad , Pronóstico , Estudios Prospectivos , Medición de Riesgo , Factores de Riesgo , Factores Sexuales , Factores de Tiempo
14.
J Atheroscler Thromb ; 26(9): 747-757, 2019 Sep 01.
Artículo en Inglés | MEDLINE | ID: mdl-31378756

RESUMEN

Metabolomics has developed as a powerful tool for investigating the complex pathophysiology underlying atherosclerosis and cardiovascular disease. Many epidemiological studies have applied this technique to accurately and comprehensively assess the effects of environmental factors on health outcomes, which used to be a perpetual challenge. Metabolites are defined as small molecules which are intermediate products of metabolic reactions catalyzed by numerous enzymes occurring within cells. Consequent to both genetic variation and environment, they allow us to explore the gene-environment interactions and to gain a better understanding of multifactorial diseases like cardiovascular disease. This review article highlights the findings of well-known prospective cohort studies around the world that have utilized metabolomics for a wide range of purposes, including biomarker discovery, improving cardiovascular risk prediction and early disease diagnosis, and exploring detailed mechanisms of disease onset and progression. However, technical challenges still exist in applying them clinically. One limitation is due to various analytical platforms that are used based on the judgment of each study; comparative assessments among different platforms need to be conducted in order to correctly interpret and validate each data externally. Secondly, metabolite levels obtained in most high-throughput metabolomics profiling studies are often semiquantitative rather than fully quantitative concentrations, which makes it difficult to compare and combine results among different studies and to determine the levels for practical use. In 2014, the Consortium of Metabolomics Studies was developed, which is expected to take the lead in overcoming these issues.


Asunto(s)
Aterosclerosis/epidemiología , Enfermedades Cardiovasculares/epidemiología , Metabolómica , Aterosclerosis/metabolismo , Aterosclerosis/patología , Enfermedades Cardiovasculares/metabolismo , Enfermedades Cardiovasculares/patología , Estudios Epidemiológicos , Humanos , Pronóstico
15.
Acta Med Indones ; 51(2): 169-176, 2019 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-31383833

RESUMEN

Cardiovascular disease (CVD) remain a leading cause of death globally. The concept of acute myocardial infarction in young adults was uncommon. Atherosclerosis is the leading cause of CVD, including myocardial infarction, stroke, heart failure and peripheral artery disease. This condition is initiated early in childhood and progressive in nature. CVD risk factors includes hypertension, dyslipidemia and obesity play a role in the development of atherosclerosis and  components in insulin resistance syndrome.One of many risk factors for insulin resistance in healthy individuals is a first-degree relative (FDR) of Type 2 Diabetes Mellitus (T2DM) patients. This group shows a higher risk of insulin resistance and pancreatic beta cells disruption even in adolescence, although they often remains asymptomatic. Clinical manifestations of metabolic disorders and atherosclerosis will appear earlier in the FDR T2DM group who have sedentary lifestyles and obesity, when compared to the non-FDR group. Several studies have attempted to detect metabolic disorders and subclinical atherosclerosis that might occur; therefore an early prevention can be carried out in these high-risk groups.  Unfortunately, factors that affect the onset and the severity of the prospective clinical manifestations from the previous studies remained inconclusive.


Asunto(s)
Aterosclerosis/epidemiología , Diabetes Mellitus Tipo 2/fisiopatología , Resistencia a la Insulina , Padres , Aterosclerosis/metabolismo , Dislipidemias/complicaciones , Familia , Humanos , Hipertensión/complicaciones , Obesidad/complicaciones , Factores de Riesgo , Adulto Joven
16.
BMC Public Health ; 19(1): 1112, 2019 Aug 14.
Artículo en Inglés | MEDLINE | ID: mdl-31412823

RESUMEN

BACKGROUND: Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of death in Korea. According to a report of published by Statistics Korea in 2014, cerebrovascular disease and cardiovascular disease were the major/leading causes of mortality. However, it is more difficult to identify prevalence and incidence of a disease than the mortality owing to the lack of national-level statistics. Few studies have examined the prevalence and incidence of ASCVD and its risk factors since 2012. This study aimed to estimate the prevalence and incidence of ASCVD and its risk factors in Korea using national claims data. METHODS: We conducted a retrospective analysis using the national claims data of the Health Insurance Review and Assessment Service. Patients aged ≥18 years with ASCVD (defined as myocardial infarction, angina, coronary revascularization, peripheral artery disease, ischemic stroke, and transient ischemic attack) were identified between January 1, 2014 and December 31, 2015. Patients at high risk for ASCVD (defined as hypertension, diabetes mellitus, and dyslipidemia without ASCVD during the baseline period) were identified between January 1, 2015 and December 31, 2015. We estimated the prevalence, cumulative incidence, and incidence density. These were further stratified by age and sex. The respective denominators for prevalence and incidence were the census population and the at-risk population (defined as the population without respective disease 1 year prior to the respective disease identification). RESULTS: Among the included Korean adult patients, the overall prevalence of clinical ASCVD per 1000 individuals was 98.25 in 2014 and 101.11 in 2015. The respective cumulative incidence and incidence density rates of ASCVD per 1000 individuals were 65.30 and 68.03 in 2014, and 67.05 and 69.94 in 2015, respectively. Peripheral artery disease seemed to drive the increase in the total prevalence and incidence of ASCVD. The prevalence and incidence of ASCVD continued to increase with age until 79 years. CONCLUSIONS: This national population-based study confirmed the high prevalence and incidence of ASCVD and its risk factors in the adult population of South Korea. We suggest that more intensive treatment and prevention are needed to prevent ASCVD.


Asunto(s)
Aterosclerosis/epidemiología , Enfermedades Cardiovasculares/epidemiología , Anciano , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Prevalencia , República de Corea/epidemiología , Estudios Retrospectivos , Factores de Riesgo
17.
J Dermatol ; 46(10): 859-866, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31432567

RESUMEN

The association between psoriasis and risk of atherosclerotic cardiovascular disease has not been thoroughly evaluated in a large longitudinal cohort of an Asian population. We conducted a nationwide population-based retrospective cohort study encompassing more than 1.7 million Koreans with a 15-year follow-up period. The period prevalence of psoriasis was 0.33% among the baseline participants (1997-2000). In Cox proportional hazard analyses, the individuals with psoriasis had a higher adjusted hazard ratio (HR) for incidence of overall atherosclerotic cardiovascular disease (HR, 1.18; 95% confidence interval [CI], 1.09-1.27) compared with controls. Subgroup analyses revealed that the risk for myocardial infarction was commonly increased in both sexes with moderate to severe psoriasis (male: HR, 2.09; 95% CI, 1.35-3.24; female: HR, 3.23; 95% CI, 1.34-7.76), whereas the risk for ischemic stroke was specifically increased in female individuals with moderate to severe psoriasis (HR, 2.02; 95% CI, 1.24-3.30). Our data suggest that appropriate medical screening for possible cardiovascular comorbidities is warranted in Asian psoriatic patients according to disease severity and sex.


Asunto(s)
Angina de Pecho/epidemiología , Aterosclerosis/epidemiología , Infarto del Miocardio/epidemiología , Psoriasis/epidemiología , Accidente Cerebrovascular/epidemiología , Adulto , Comorbilidad , Femenino , Estudios de Seguimiento , Humanos , Incidencia , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Prevalencia , Modelos de Riesgos Proporcionales , Psoriasis/diagnóstico , República de Corea/epidemiología , Estudios Retrospectivos , Factores de Riesgo , Índice de Severidad de la Enfermedad , Factores Sexuales
18.
Int J Mol Sci ; 20(15)2019 Jul 30.
Artículo en Inglés | MEDLINE | ID: mdl-31366035

RESUMEN

Cervical cancer is associated with a causative role of human papillomavirus (HPV), which is a highly prevalent infection. Recently, women with a genital HPV infection were found to have increased incidence of cardiovascular diseases (CVD), including severe cardiovascular events such as myocardial infarction and stroke. The pathomechanisms of this relation are not yet fully understood, and may significantly affect the health of a large part of the population. Accelerated atherosclerosis is assumed to play a key role in the pathophysiology of this relationship. To identify high-risk groups of the population, it is necessary to stratify the CVD risk. Current algorithms, as widely used for the estimation of CVD risk, seem to be limited by the individual misclassification of high-risk subjects. However, personalised prediction of cardiovascular events is missing. Regarding HPV-related CVD, identification of novel sensitive biomarkers reflecting early atherosclerotic changes could be of major importance for such personalised cardiovascular risk prediction. Therefore, this review focuses on the pathomechanisms leading to HPV-related cardiovascular diseases with respect to atherosclerosis, and the description of potential novel biomarkers to detect the earliest atherosclerotic changes important for the prevention of CVD in HPV infection and cervical cancer.


Asunto(s)
Aterosclerosis/sangre , Biomarcadores/sangre , Infecciones por Papillomavirus/sangre , Medicina de Precisión/métodos , Neoplasias del Cuello Uterino/sangre , Aterosclerosis/epidemiología , Aterosclerosis/etiología , Aterosclerosis/prevención & control , Femenino , Humanos , Infecciones por Papillomavirus/complicaciones , Infecciones por Papillomavirus/epidemiología , Neoplasias del Cuello Uterino/complicaciones , Neoplasias del Cuello Uterino/epidemiología , Neoplasias del Cuello Uterino/virología
19.
Cardiovasc Intervent Radiol ; 42(9): 1293-1301, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31267151

RESUMEN

PURPOSE: To determine primary rates in small-diameter renal arteries, including complex bifurcation lesions, treated with drug-eluting stents (DES) in patients with atherosclerotic renal artery stenosis. MATERIALS AND METHODS: This is a retrospective single-institution study. A total of 37 patients with 39 stented renal arteries were included. Patient and procedural data were obtained from the electronic medical record. Survival free from restenosis was estimated using the Kaplan-Meier method with patients stratified into two groups based on renal artery diameters (≤ 3.5 mm or > 3.5 mm). Univariate Cox proportional models were used to estimate hazard ratios associated with clinical and angiographic variables. RESULTS: Average renal artery diameter at time of treatment was 3.4 mm ± 0.4 mm. The median survival free from restenosis was 992 days, with 11 out of 37 (29.7%) developing an in-stent restenosis. Renal arteries < 3.5 mm in diameter had similar patency rates as renal arteries > 3.5 mm (P = 0.33). The 1-, 2-, and 5-year patency rates were 71%, 63%, and 38%, respectively. History of stroke was the only comorbidity to portend a significantly greater rate of restenosis (hazard ratio 3.77; 95%CI, 1.05-13.6; P = 0.04). Medications did not statistically alter the risk of restenosis. CONCLUSION: Revascularization of renal arteries with DES achieved similar primary patency rates irrespective of renal artery diameter. Stent configuration was not associated with time to renal replacement therapy or all-cause mortality. LEVEL OF EVIDENCE: Level 3, Cohort Study.


Asunto(s)
Aterosclerosis/epidemiología , Aterosclerosis/terapia , Stents Liberadores de Fármacos , Obstrucción de la Arteria Renal/epidemiología , Obstrucción de la Arteria Renal/terapia , Arteria Renal/patología , Anciano , Anciano de 80 o más Años , Aterosclerosis/patología , Estudios de Cohortes , Constricción Patológica , Femenino , Humanos , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Modelos de Riesgos Proporcionales , Recurrencia , Obstrucción de la Arteria Renal/patología , Estudios Retrospectivos , Factores de Riesgo , Tiempo , Resultado del Tratamiento
20.
Acta Otolaryngol ; 139(9): 793-797, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31268381

RESUMEN

Background: Obstructive sleep apnea (OSA) is associated with several cardiovascular comorbidities including hypertension, arteriosclerosis, and heart failure. Uvulopalatopharyngoplasty (UPPP) is a frequently performed surgical treatment for OSA. Aims/Objectives: To analyze if UPPP can improve cardiac parameters associated with atherosclerosis and reduce the cardiac burden in OSA patients. Material and methods: A prospective cohort study was performed at a single tertiary care center where OSA patients undergoing UPPP were evaluated. Preoperative and 6-month postoperative cardiac parameters namely carotid artery intima-media thickness (CIMT), arterial stiffness parameters, echocardiography, and polysomnography (PSG) results were compared. Results: Fifty three patients were included in the study. The success and response rate of UPPP was 60.4%. Following the surgery, significant reduction in arterial stiffness index (ß) (12.4 ± 4.1 vs. 11.2 ± 4.0, p = .01), and elasticity modulus (Ep) (172.8 ± 68.3 vs. 156.6 ± 55.3, p = .05) was noticed. Additionally, echocardiographic parameters namely velocity across aortic valve (121.9 ± 22.9 vs. 109.4 ± 17.7, p = .01) and velocity across pulmonary valve (107.4 ± 16.4 vs. 94.2 ± 16.9, p < .01) significantly decreased following UPPP. Conclusions and significance: UPPP significantly improves parameters related to carotid atherosclerosis and has the potential to reduce cardiac burden in OSA patients.


Asunto(s)
Aterosclerosis/epidemiología , Enfermedades Cardiovasculares/epidemiología , Procedimientos Quirúrgicos Reconstructivos/métodos , Apnea Obstructiva del Sueño/epidemiología , Apnea Obstructiva del Sueño/cirugía , Úvula/cirugía , Adulto , Aterosclerosis/fisiopatología , Enfermedades Cardiovasculares/diagnóstico , Grosor Intima-Media Carotídeo , Estudios de Cohortes , Comorbilidad , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Paladar Blando/cirugía , Faringe/cirugía , Polisomnografía/métodos , Estudios Prospectivos , Medición de Riesgo , Apnea Obstructiva del Sueño/diagnóstico , Centros de Atención Terciaria , Resultado del Tratamiento
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