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1.
Medicine (Baltimore) ; 101(2): e28449, 2022 Jan 14.
Artigo em Inglês | MEDLINE | ID: mdl-35029186

RESUMO

BACKGROUND: The decrease in estrogen levels during the perimenopausal period can cause women to have various symptoms such as insomnia, emotional anxiety, and even depression. Therefore, whether the green therapy of acupuncture can improve the sleep quality and anxiety of perimenopausal women has attracted more and more attention. The purpose of this systematic evaluation was to assess the efficacy of acupuncture on insomnia and anxiety in perimenopausal women. METHODS: We will search for clinical observational pilot studies or cohort studies of acupuncture for insomnia, anxiety, or depression included in PubMed, Cochrane Library, Embase, Web of science, China Knowledge Network (CNKI), Wanfang, VIP and China Biomedical Database (CBM), etc. The search period will be from the establishment of the database until November 2021. Two researchers will independently perform literature screening, data extraction, and quality assessment. Finally, data analysis will be performed using Revman and Stata software. RESULTS: The purpose of this study was to evaluate the effectiveness and safety of acupuncture therapy for the treatment of insomnia, anxiety, and depression in perimenopausal women. CONCLUSION: This study will provide new evidence on the effectiveness and safety of acupuncture for the treatment of insomnia, anxiety, and depression in perimenopausal women, and provide additional options for clinicians and patients to improve insomnia and anxiety. REGISTRATION NUMBER: INPLASY2021120012.

2.
ACS Nano ; 2022 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-34995440

RESUMO

The controlled growth of metallic single-wall carbon nanotubes (m-SWCNTs) is very important for the fabrication of high-performance interconnecting wires, transparent conductive electrodes, light and conductive fibers, etc. However, it has been extremely difficult to synthesize m-SWCNTs due to their lower abundance and higher chemical reactivity than semiconducting SWCNTs (s-SWCNTs). Here, we report the kinetically controlled growth of m-SWCNTs by manipulating their binding energy with the catalyst and promoting their growth rate. We prepared CoRe4 nanoparticles with a hexagonal close-packed structure and an average size of ∼2.3 nm, which have a lower binding energy with m-SWCNTs than with s-SWCNTs. The selective growth of m-SWCNTs from the CoRe4 catalyst was achieved by using a low concentration of carbon source feed at a relative low temperature of 760 °C. The m-SWCNTs had a narrow diameter distribution of 1.1 ± 0.3 nm, and their content was over 80%.

3.
J Colloid Interface Sci ; 605: 1-12, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34303921

RESUMO

A series of BiO(OH)xI1-x solid solution (SS) catalysts were successfully prepared by ion exchange of I- and OH- between the [Bi2O2]2+ layers. The morphology and microstructure were studied in depth using X-ray diffraction (XRD), scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDS), and Brunauer-Emmett-Teller (BET) method, etc. Tunable absorption in the visible-light region was achieved by changing the proportion of OH- to I-. Due to the etching effect of OH-, oxygen vacancies (OVs) greatly increased for the SS catalysts, and were confirmed by X-ray photoelectron spectroscopy (XPS), UV-vis diffuse reflectance spectroscopy (DRS), and electron paramagnetic spectroscopy (EPR). The unique composition of OH-, I-, OV, and [Bi2O2]2+ layers in BiO(OH)xI1-x materials resulted in diverse photoexcitations. The BiO(OH)0.45I0.55 photocatalyst displayed a 10-fold-improved 2-chlorophenol (2-CP) degradation rate compared to BiOI. The interfacial reaction process by the photoinduced valence-band holes and conduction-band electrons proved to be a more efficient pathway for organic pollutant degradation by the BiO(OH)xI1-x SS photocatalyst. The OVs in the SS photocatalyst facilitated photoexcited and electron migration and transformation.


Assuntos
Luz , Oxigênio , Catálise , Espectroscopia Fotoeletrônica , Difração de Raios X
4.
Fish Shellfish Immunol ; 120: 507-514, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34920131

RESUMO

The lack of high-throughput sequencing data makes the research progress of Heliocidaris crassispina slow. Therefore, we used PacBio single-molecule real-time sequencing to generate the first full-length transcriptome. Here, 31,181 isoforms were obtained, with an average length of 2383.20 and a N50 length of 2732 bp. Meanwhile, 764 alternative splicing (AS) events, 5098 long-noncoding RNAs (LncRNAs), 6978 simple sequence repeats (SSRs), and 950 hypothetical transcript factors (TFs) were identified. Moreover, five key innate immune pattern recognition receptors (PRRs), including toll-like receptor (TLR), NACHT domain and leucine-rich repeat (NLR), scavenger receptor cysteine-rich (SRCR), peptidoglycan recognition proteins (PGRP), and gram-negative binding proteins (GNBP), were searched in the transcriptome. In addition, 37 isoforms enriched in KEGG and GO immune systems were also detected. The study provid abundant data support for the current research on H. crassispina.

5.
J Am Heart Assoc ; 11(1): e023707, 2022 Jan 04.
Artigo em Inglês | MEDLINE | ID: mdl-34927442

RESUMO

Background Aging is associated with central fat redistribution and skeletal muscle decline, yet the relationships of tissue compartments with heart failure (HF) remain incompletely characterized. We assessed the contribution of body composition to incident HF in elders. Methods and Results Participants from 2 older cohorts who completed dual-energy X-ray absorptiometry (DEXA) and, in one cohort, computed tomography were included. We evaluated associations with incident HF for DEXA principal components (PCs) and total lean, appendicular lean, total fat and trunk fat mass; and for computed tomography measures of abdominal visceral and subcutaneous fat, thigh muscle, intermuscular fat area and thigh muscle density. DEXA analysis included 3621, and computed tomography analysis 2332 participants. During median follow-up of 11.8 years, 927 participants developed HF. DEXA principal components showed no relationship with HF. After adjustment for height, weight, and cardiovascular risk factors, total lean mass was near significantly associated with higher HF (hazard ratio [HR], 1.25 per SD [1.00-1.56]), whereas total fat mass and thigh muscle density were significantly related to lower HF (HR, 0.82 [0.68-0.99] and HR, 0.87 [0.78-0.97], respectively). Patterns were similar for HF subtypes. The relationships with HF for total lean and fat mass were attenuated after adjusting for intercurrent atrial fibrillation or excluding high natriuretic peptide levels. Conclusions Total lean mass was positively associated, while total fat mass and thigh muscle density were inversely associated, with incident HF. These findings highlight the limitations of DEXA for assessment of HF risk in elders and support the preeminence of computed tomography-measured skeletal muscle quality over mass as a determinant of HF incidence.

6.
Carbohydr Polym ; 277: 118897, 2022 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-34893299

RESUMO

To develop a facile and low-cost nanofibrils process with excellent feedstock adaptability, high-yield lignocellulose nanofibrils (LCNF) are produced directly from wood and non-wood biomass using glycerol solvent via screw extrusion pretreatment. Different LCNFs are obtained from four classical raw materials (polar, pine, bamboo, and wheat straw) in this research, followed by comparing their morphological, thermochemical, and mechanical properties. More than 70 wt% of LCNF could be obtained from low-cost substrates except for LCNF from wheat straw with 62.3 wt% yield. Besides, the morphology property of wood LCNF exhibit more uniform distribution over that of non-wood LCNF due to narrower size distribution. Strikingly, despite of the slightly lower LCNF crystallinity various from 52.4% to 62.6% obtained from four substrates, all the LCNFs separated from wood and non-wood biomass exhibit high thermal stability (Tmax over 330 °C), which is higher than conventional nanocellulose, indicating that the crystal area could be well maintained during the pretreated process. Moreover, all the LCNF films show excellent tensile strength which is close to nanocellulose materials. Besides, the Young's modulus of wood-based LCNF films is higher than that of non-wood based LCNF films. Overall, LCNF with excellent performance could be achieved from low-cost biomass by our facile process, which provides a feasible route for industrial production of bio-based nanofilms.

7.
J Hazard Mater ; 424(Pt B): 127502, 2022 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-34673391

RESUMO

Herein, a novel BiOBr photocatalyst with partial surface modification by graphitized C (BiOBr-Cg) was synthesized through a hydrothermal method with hydrothermal carbonation carbon (HTCC) as a slow-releasing carbon source and characterized by experimental and theoretical methods. BiOBr-Cg exhibited excellent visible-light photocatalytic performance toward various refractory pollutants, such as bisphenol A, ibuprofen, ciprofloxacin, 2,4-dichlorophenoxyacetic acid, and diphenhydramine. The characterization results demonstrate that a strong molecular orbital interaction occurs between graphitized C and BiOBr, resulting in the formation of a new surface valence band on graphitized C. This not only promotes the oxidation of pollutants by surface holes but also reduces the recombination of carriers during the bulk phase transfer process, thereby increasing the number of photogenerated carriers. Intriguingly, the analytical results for degradation intermediates and other characterization techniques demonstrate that the pollutants adsorbed on the graphitized C of BiOBr-Cg can be directly excited through light irradiation and react along the organic radical degradation pathway in addition to pollutant degradation by holes and HO2•/O2•-.

8.
J Affect Disord ; 297: 553-558, 2022 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-34728292

RESUMO

BACKGROUND: Although the association between sleep problems and suicidal behaviors were found in many studies, their associations are not built until now. One of the reasons may be the identified differences among different suicide behaviors, which also implied that sleep quality may play different roles on these suicidal behaviors. However, absent study explores the possible distinguishing associations between sleep quality and different suicidal behaviors. METHODS: This is a population-based study conducted in Hebei province, China. Totally, 21,376 valid questionnaires were analyzed in this study. Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality. Suicidal behaviors, living alone, and social-demographic variables were assessed for all the participants. RESULTS: The prevalence of suicidal ideation, plan, and attempt were 1.4%, 0.3%, and 0.2%, respectively. The PSQI scores were separately associated with suicidal ideation (OR=1.25, p<0.001), plan (OR=1.19, p<0.001), and attempt (OR=1.18, p<0.001). The similar results were also supported when we compared conditional suicidal behaviors with general population without any suicidal behaviors. However, when we compared suicide attempters with suicidal ideators (with or without suicide plan), the associations between PSQI scores and suicide attempt were not supported (OR=1.93, P>0.05 or OR=1.02, p>0.05). LIMITATIONS: The cross-sectional design made us cannot get any causal relationships. The self-reported sleep quality may also produce some influence on the results. CONCLUSION: The results imply us that improving sleep quality may be not effective to control further suicidal behaviors, when people have considered or planned to suicide. The findings also can be translated into the clinical and preventive practice for suicide control.

9.
J Hazard Mater ; 421: 126822, 2022 01 05.
Artigo em Inglês | MEDLINE | ID: mdl-34396972

RESUMO

Antibiotic mycelial dregs (AMDs) have been listed as industrial hazardous wastes. With the aim of reducing the environmental risk, the integrated-omics and qPCR approaches were used to reveal the dynamics and removal mechanisms of antibiotic and antibiotic resistance genes (ARGs) during the fermentation of different spectinomycin mycelial dregs (SMDs). The results showed that the removal efficiency of antibiotic in the fermentation of high moisture SMDs reached up to 98%. The high abundance of aadA1 gene encoded by Streptomyces, Lactobacillus, and Pseudomonas was associated with the efficient degradation of spectinomycin, and the inactivating enzymes secreted by degradative bacteria were identified. Furthermore, the dominant microbiota was impacted by moisture content significantly under high temperature environments. In the fermentation of low moisture SMDs, Saccharopolyspora was the dominant microbiota which secreted S8 endopeptidase, M14, M15, S10, S13 carboxypeptidases, M1, M28, S15 aminopeptidases, and antioxidant enzymes, while in the fermentation of high moisture SMDs, Bacillus and Cerasibacillus were dominant genera which mainly secreted S8 endopeptidase and antioxidant enzymes. The abundance of ARGs and mobile genetic elements decreased significantly at thermophilic phase, with maximum drops of 93.7% and 99.9%, respectively. Maintaining moisture content below 30% at the end phase could prevent the transmission of ARGs effectively.


Assuntos
Antibacterianos , Espectinomicina , Resistência Microbiana a Medicamentos/genética , Fermentação , Genes Bacterianos
10.
Gene ; 806: 145929, 2022 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-34461150

RESUMO

The body color of Neocaridina denticulate sinensis is a compelling phenotypic trait, in which a cascade of carotenoid metabolic processes plays an important role. The study was conducted to compare the transcriptome of cephalothoraxes among three pigmentation phenotypes (red, blue, and chocolate) of N. denticulate sinensis. The purpose of this study was to explore the candidate genes associated with different colors of N. denticulate sinensis. Nine cDNA libraries in three groups were constructed from the cephalothoraxes of shrimps. After assembly, 75022 unigenes were obtained in total with an average length of 1026 bp and N50 length of 1876 bp. There were 45977, 25284, 23605, 21913 unigenes annotated in the Nr, Swissprot, KOG, and KEGG databases, respectively. Differential expression analysis revealed that there were 829, 554, and 3194 differentially expressed genes (DEGs) in RD vs BL, RD vs CH, and BL vs CH, respectively. These DEGs may play roles in the absorption, transport, and metabolism of carotenoids. We also emphasized that electron transfer across the inner mitochondrial membrane (IMM) was a key process in pigment metabolism. In addition, a total of 6328 simple sequence repeats (SSRs) were also detected in N. denticulate sinensis. The results laid a solid foundation for further research on the molecular mechanism of integument pigmentation in the crustacean and contributed to developing more attractive aquatic animals.


Assuntos
Proteínas de Artrópodes/genética , Carotenoides/metabolismo , Decápodes/genética , Pigmentação/genética , Transcriptoma , Animais , Organismos Aquáticos , Proteínas de Artrópodes/classificação , Proteínas de Artrópodes/metabolismo , Transporte Biológico , Cor , Bases de Dados Genéticas , Decápodes/anatomia & histologia , Decápodes/metabolismo , Água Doce , Regulação da Expressão Gênica , Biblioteca Gênica , Ontologia Genética , Repetições de Microssatélites , Mitocôndrias/metabolismo , Membranas Mitocondriais/metabolismo , Anotação de Sequência Molecular , Característica Quantitativa Herdável
11.
Hum Fertil (Camb) ; : 1-11, 2021 Dec 02.
Artigo em Inglês | MEDLINE | ID: mdl-34854361

RESUMO

This study aimed to uncover the specific role of micro RNA-16 (miR-16) in granulosa cell function in polycystic ovarian syndrome (PCOS). After sample collection, the expression levels of miR-16 and Apelin13 in the granulosa cells of PCOS patients and controls were determined. Subsequently, miR-16 mimic, miR-16 inhibitor, pcDNA3.1-Apelin13, sh-Apelin13, and their corresponding negative controls were transfected into granulosa cell lines (KGN and SVOG) to monitor alterations in miR-16 expression, Apelin13, and PI3K/Akt signalling pathway-related proteins (p-Akt and Akt). MTT assay was used to detect cell viability, clone formation assay to detect cell proliferation, and flow cytometry to detect cell apoptosis rate. In addition, a luciferase assay was performed to test the targeting relationship between miR-16 and Apelin13. After miR-16 overexpression or Apelin13 knockdown was achieved in granulosa cells, granulosa cell proliferation was suppressed and cell apoptosis was enhanced. Additionally, Apelin13 is a potential target of miR-16. Functionally, overexpression of Apelin13 could partly reverse the effect of miR-16 overexpression on granulosa cell proliferation and apoptosis. Moreover, inhibits granulosa cell proliferation and enhances blocking the PI3K/Akt pathway by suppressing Apelin13. Our study revealed miR-16 regulates Apelin13 to mediate the PI3K/Akt signalling pathway and, thereby mediates PCOS progression.

12.
Front Endocrinol (Lausanne) ; 12: 774244, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34867821

RESUMO

Background: Breast cancer (BC) is the most frequent cancer in women. The tumor microenvironment (TME), consisting of blood vessels, immune cells, fibroblasts, and extracellular matrix, plays a pivotal role in tumorigenesis and progression. Increasing evidence has emphasized the importance of TME, especially the immune components, in patients with BC. Nevertheless, we still lack a deep understanding of the correlation between tumor invasion and TME status. Methods: Transcriptome and clinical data were retrieved from The Cancer Genome Atlas (TCGA) database. ESTIMATE algorithm was applied for quantifying stromal and immune scores. Then we screened out the differentially expressed genes (DEGs) through the intersection analysis. Furthermore, the establishment of protein-protein interaction (PPI) network and univariate COX regression analysis were utilized to determine the core genes in DEGs. In addition, we also performed Gene Set Enrichment Analysis (GSEA) and CIBERSORT analysis to distinguish the function of crucial gene expression and the proportion of tumor-infiltrating immune cells (TICs), respectively. Results: A total of 1178 samples (112 normal samples and 1066 tumor samples) were extracted from TCGA for calculation, and 226 DEGs were obtained from this assessment. Further intersection analysis revealed eight key genes, including ITK, CD3E, CCL19, CD2, SH2D1A, CD5, SLAMF6, SPN, which were proven to correlate with BC status. Moreover, ITK was picked out for further study. The results illustrated that high expression of BC patients had a more prolonged overall survival (OS) time than ITK low expression BC patients (p = 0.009), and ITK expression also presented the statistical significance in age, TNM staging, tumor size classification, and metastasis classification. Additionally, GSEA and CIBERSORT analysis indicated that ITK expression had an association with immune activity in TME. Conclusion: ITK may be a potential indicator for prognosis prediction in patients with BC, and its biological behavior may promote our understanding of the molecular mechanism of tumor progression and targeted therapy.

13.
Chest ; 160(6): e665-e667, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34872683
14.
Artigo em Inglês | MEDLINE | ID: mdl-34873818

RESUMO

Manipulation of cell-cell interactions via cell surface engineering has potential biomedical applications in tissue engineering and cell therapy. However, manipulation of the comprehensive and multiple intercellular interactions remain a challenge and missing elements. Herein, utilizing DNA triangular prism (TP) and branched polymer (BP) as functional modules, we fabricate tunable DNA scaffold networks on cell surface. The responsiveness of cell-cell recognition, aggregation and dissociation could be modulated by aptamer-functionalized DNA scaffold networks with high accuracy and specificity. By regulating the DNA scaffold networks coated on cell surface, the controlled intercellular molecular transportation is achieved. Our tunable network provides a simple and extendible strategy which addresses a current need in cell surface engineering to precisely manipulate cell-cell interactions and shows a promise as a general tool for controllable cell behavior.

15.
Virulence ; 12(1): 3032-3044, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34886764

RESUMO

The role of prokaryotic CRISPR/Cas system proteins as a defensive shield against invasive nucleic acids has been studied extensively. Non-canonical roles in pathogenesis involving intracellular targeting of certain virulence-associated endogenous mRNA have also been reported for some Type I and Type II CRISPR/Cas proteins, but no such roles have yet been established for Type III system proteins. Here, we demonstrate that M. tuberculosis (Type III-A system) CRISPR/Cas proteins Csm1, Csm3, Csm5, Csm6, and Cas6 are secreted and induce host immune responses. Using cell and animal experiments, we show that Cas6, in particular, provokes IFN-γ release from PBMCs from active tuberculosis (TB) patients, and its deletion markedly attenuates virulence in a murine M. tuberculosis challenge model. Recombinant MTBCas6 induces apoptosis of macrophages and lung fibroblasts, and interacts with the surface of cells in a caspase and TLR-2 independent manner. Transcriptomic and signal pathway studies using THP-1 macrophages stimulated with MTBCas6 indicated that MTBCas6 upregulates expression of genes associated with the NF-κB pathway leading to higher levels of IL-6, IL-1ß, and TNF-α release, cytokines known to activate immune system cells in response to M. tuberculosis infection. Our findings suggest that, in addition to their intracellular shielding role, M. tuberculosis CRISPR/Cas proteins have non-canonical extracellular roles, functioning like a virulent sword, and activating host immune responses.

17.
Artigo em Inglês | MEDLINE | ID: mdl-34899950

RESUMO

Methods: Individualized treatment of traditional Chinese medicine (TCM) provides a theoretical basis for the study of the personalized classification of complex diseases. Utilizing the TCM clinical electronic medical records (EMRs) of 7170 in patients with IS, a patient similarity network (PSN) with shared symptoms was constructed. Next, patient subgroups were identified using community detection methods and enrichment analyses were performed. Finally, genetic data of symptoms, herbs, and drugs were used for pathway and GO analysis to explore the characteristics of pathways of subgroups and to compare the similarities and differences in genetic pathways of herbs and drugs from the perspective of molecular pathways of symptoms. Results: We identified 34 patient modules from the PSN, of which 7 modules include 98.48% of the whole cases. The 7 patient subgroups have their own characteristics of risk factors, complications, and comorbidities and the underlying genetic pathways of symptoms, drugs, and herbs. Each subgroup has the largest number of herb pathways. For specific symptom pathways, the number of herb pathways is more than that of drugs. Conclusion: The research of disease classification based on community detection of symptom-shared patient networks is practical; the common molecular pathway of symptoms and herbs reflects the rationality of TCM herbs on symptoms and the wide range of therapeutic targets.

18.
J Int Med Res ; 49(12): 3000605211063713, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34939509

RESUMO

Extramedullary plasmacytoma (EMP) is a rare plasma cell neoplasm, with the majority (80-90% of cases) occurring in the upper aerodigestive tract. To our best knowledge, primary EMP from renal tissues is extremely rare. Herein, the diagnosis and treatment of a refractory primary EMP with renal involvement in a 53-year-old male patient is reported. The patient received radical nephrectomy followed by radiotherapy, and showed relapse 3 months after treatment. The cancer cells were sensitive to subsequent chemotherapy, however, the patient died of infection associated with the disease after almost 3.5 years following first presentation.


Assuntos
Mieloma Múltiplo , Plasmocitoma , Humanos , Rim , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Nefrectomia , Plasmocitoma/diagnóstico por imagem , Plasmocitoma/cirurgia
19.
Front Public Health ; 9: 736617, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34926368

RESUMO

Objectives: During the coronavirus disease 2019 (COVID-19) self-quarantine period, the transition to online-course has profoundly changed the learning modes of millions of school-aged children and put them at an increased risk of asthenopia. Therefore, we aimed to determine associations of the total screen/online-course time with asthenopia prevalence among that children during the COVID-19 pandemic, and whether the associations were mediated by psychological stress. Methods: Asthenopia was defined according to a validated computer vision syndrome questionnaire (CVS-Q). We used CVS-Q to collect the frequency and intensity of 16 asthenopia-related eye symptoms of 25,781 children. Demographic features, eye care habits, visual disorders, lifestyle, psychological and environmental factors, were also collected. Results: The overall asthenopia prevalence was 12.1%, varying from 5.4 to 18.2% across grade/gender-classified subgroups. A 100-h increment of total screen/online-course time were associated with an increased risk of asthenopia by 9% [odds ratio (OR) = 1.09] and 11% (OR = 1.11), respectively. Mediation analysis showed that the proportions of total effects mediated by psychological stress were 23.5 and 38.1%, respectively. Age, female gender, having myopia or astigmatism, bad habits when watching screens were also risk factors. Conversely, keeping 34-65 cm between eyes and screen, increased rest time between classes, and increased eye exercise were all associated with a decreased risk. Conclusion: Our study indicated that the influence of long total screen or online-course time on psychological stress increases asthenopia risk. The findings of this study have provided a new avenue for intervening screen-related asthenopia in addition to incorporating a reasonable schedule of online courses into educational policy.


Assuntos
Astenopia , COVID-19 , Astenopia/epidemiologia , Astenopia/etiologia , Criança , Feminino , Humanos , Pandemias , SARS-CoV-2 , Estresse Psicológico/epidemiologia
20.
JAMA Cardiol ; 2021 Dec 22.
Artigo em Inglês | MEDLINE | ID: mdl-34935857

RESUMO

Importance: Race and ethnicity have been studied as risk factors in cardiovascular disease. How risk factors, epicardial coronary artery disease, and cardiac events differ between Black and White individuals undergoing noninvasive testing for coronary artery disease is not known. Objective: To assess differences in cardiovascular risk burden, coronary plaque, and major adverse cardiac events between Black and White individuals assigned to receive coronary computed tomography angiography (CCTA) or functional testing for stable chest pain. Design, Setting, and Participants: A nested observational cohort study within the PROMISE trial was conducted at 193 outpatient sites in North America. A total of 1071 non-Hispanic Black (hereafter Black) and 7693 non-Hispanic White (hereafter White) participants with stable chest pain undergoing noninvasive cardiovascular testing were included. This analysis was conducted from February 13, 2015, to November 2, 2021. Main Outcomes and Measures: The primary end point was the composite of death, myocardial infarction, or hospitalization for unstable angina over a median follow-up of 24.4 months. Results: Among 1071 Black individuals (12.2%) (women, 646 [60.3%]; mean [SD] age, 59 [8] years) and 7693 White individuals (87.8%) (women, 4029 [52.4%]; mean [SD] age, 61.1 [8.4] years), Black participants had a higher cardiovascular risk burden (more hypertension and diabetes), yet there was a similarly low major adverse cardiovascular events rate over a median 2-year follow-up (32 [3.0%] vs 243 [3.2%]; P = .84). Sensitivity analyses restricted to the 79.8% (6993 of 8764) individuals with a normal or mildly abnormal noninvasive testing result and the 54.3% (4559 of 8396) not receiving statin therapy yielded similar findings. In comparison of Black and White individuals in the CCTA group (n = 3323), significant coronary stenosis (hazard ratio [HR], 7.21; 95% CI, 1.94-26.76 vs HR, 4.30; 95% CI, 2.62-7.04) and high-risk plaque (HR, 3.47; 95% CI, 1.00-12.06 vs HR, 2.21; 95% CI, 1.37-3.57) were associated with major adverse cardiovascular events in both Black and White patients. However, with respect to epicardial coronary artery disease burden, Black individuals had a less-prevalent coronary artery calcium score greater than 0 (45.1% vs 63.2%; P < .001), coronary stenosis greater than or equal to 50% (32 [8.7%] vs 430 [14.6%]; P = .001), and high-risk plaque (139 [37.6%] vs 1547 [52.4%]; P < .001). Conclusions and Relevance: The findings of this study suggest that, despite a greater cardiovascular risk burden in Black persons, rates of coronary artery calcium, stenosis, and high-risk plaque observed via CCTA were lower in Black persons than White persons. This result suggests differences in cardiovascular risk burden and coronary plaque in Black and White individuals with stable chest pain.

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