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1.
Zhonghua Yi Xue Za Zhi ; 101(31): 2448-2453, 2021 Aug 17.
Artigo em Chinês | MEDLINE | ID: mdl-34399558

RESUMO

Objective: To investigate the diagnostic value of serum lipoprotein associated phospholipase A2 (Lp-PLA2), amyloid A (SAA) and immunoglobulin E (IgE) in patients with type 2 diabetes (T2DM) mellitus complicated with atherosclerotic disease. Methods: From June to December 2019, 224 patients with T2DM in the Second Hospital of Lanzhou University were selected, including 144 males and 80 females, aged (61±11) years. According to the results of imaging examination, the patients were divided into T2DM with AS group (T2DM-AS group, n=160) and T2DM group (n=64); Healthy subjects in the same period were selected as healthy control group (n=160). Lp-PLA2, IgE, SAA, hs-CRP, TC, TG, HDL-C, LDL-C and Hcy were detected in all patients and healthy controls. The correlation between the above indexes, gender, age and T2DM with AS was analyzed; Multivariate logistic regression was used to analyze the risk factors of T2DM with AS. Results: Compared with the healthy control group, the levels of IgE and Lp-PLA2 in T2DM-AS group and T2DM group were increased, and the levels of SAA in T2DM-AS group were increased (all P<0.05); Compared with T2DM group, the levels of Lp-PLA2, IgE and SAA were increased in T2DM-AS group (all P<0.05). T2DM with AS was positively correlated with age, IgE, Lp-PLA2 and SAA (r=0.468, 0.269, 0.486, 0.418, all P<0.05), and negatively correlated with HDL-C (r=-0.338, P<0.05). Multivariate logistic regression analysis showed that age (OR=0.865, 95%CI: 0.763-0.982, P<0.05), IgE (OR=0.910, 95%CI: 0.840-0.987, P<0.05) and Lp-PLA2 (OR=0.942, 95%CI: 0.910-0.986, P<0.05) were risk factors of T2DM with AS. ROC curve showed that the combined detection of Lp-PLA2, SAA and IgE could improve the diagnostic efficiency of T2DM with AS (AUC=0.895, P<0.05), the sensitivity was 80.0%, and the specificity was 93.7%. Conclusion: The levels of Lp-PLA2, IgE and SAA increase in T2DM patients with AS. The combined detection of Lp-PLA2, SAA and IgE can improve the diagnostic efficiency of T2DM patients with AS.


Assuntos
Aterosclerose , Diabetes Mellitus Tipo 2 , 1-Alquil-2-acetilglicerofosfocolina Esterase , Aterosclerose/diagnóstico , Biomarcadores , Proteína C-Reativa , Pré-Escolar , Diabetes Mellitus Tipo 2/complicações , Feminino , Humanos , Masculino , Fatores de Risco
2.
Clin Lab ; 67(8)2021 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-34383412

RESUMO

BACKGROUND: Lipoprotein-associated phospholipase A2 (Lp-PLA2) has been identified as an inflammatory marker tightly correlated with the onset of atherosclerosis. Although several methodologies have been developed to detect Lp-PLA2, including enzyme-linked immunosorbent assay, Lp-PLA2 detection is still time- and resource-consuming with poor antiinterference ability and low sensitivity. Thus, it is urgent to explore new methodology for Lp-PLA2 detection. METHODS: In the current study, we evaluated the clinical performance of a modified Lp-PLA2 quantitative assay kit based on magnetic particle chemiluminescence, and analyzed the levels of Lp-PLA2 in atherosclerosis patients using this kit. RESULTS: Our results showed that the magnetic particle chemiluminescence method could effectively dissociate Lp-PLA2 from lipoprotein and finish the test within 20 minutes with high accuracy and good repeatability, as demonstrated by the results of linear measurement range, precision, and recovery rate. Furthermore, our preliminary data revealed that serum Lp-PLA2 levels were correlated to the presence and degree of atherosclerotic plaques. CONCLUSIONS: Lp-PLA2 could be helpful in diagnosing atherosclerosis.


Assuntos
Aterosclerose , Placa Aterosclerótica , 1-Alquil-2-acetilglicerofosfocolina Esterase , Aterosclerose/diagnóstico , Biomarcadores , Humanos , Lipoproteínas
3.
Medicine (Baltimore) ; 100(32): e26916, 2021 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-34397932

RESUMO

ABSTRACT: Asian Indians have a genetic predisposition to atherothrombotic risk. common carotid intima-media thickness (CCIMT) measured by ultrasound is a quantitative marker for atherosclerotic burden and a derived variable, that is, "CCIMT statistical Z-score (Z-score)" is useful for better quantification. The association between vitamin D deficiency and atherosclerosis is inconclusive. Since, vitamin D deficiency is highly prevalent in India, there is a need to study its relative contribution to subclinical atherosclerotic burden.This prospective cross-sectional study (n = 117) in apparently healthy individuals aged 20 to 60 years sought to identify the determinants of CCIMT Z score with CCIMT measured by "echo-tracking" method. A multivariable linear regression analysis was done with CCIMT Z score as dependent variable and the following as independent variables: age, body mass index, waist-to-height ratio, total cholesterol to HDL ratio (TC-HDL ratio), serum vitamin D3 levels (ng/mL), sex, diabetes mellitus, current cigarette smoking status. A diagnostic prediction model was also developed with a threshold value of 1.96 for CCIMT Z score.The mean (SD) for calendar age (y) was 40 (8). There were 26 (22.22%) individuals in sample with CCIMT Z score ≥1.96 (advanced stage) of whom 14 (23.33%) were <40 y (n = 60). The mean score was 1.28 (90th percentile) in the entire sample. Vitamin D3 deficiency with a mean (SD) blood level (ng/mL) of 14.3 (6.4) was noted and prevalence of deficiency was 81%. The final model wasCCIMT Z-score = 0.80 +  (0.841 × current smoking = 1) + (0.156 × TC-HDL ratio) - (0.0263 × vitamin D3 blood level in ng/mL).The decreasing order of association is smoking, TC-HDL ratio, and vitamin D3. With the model, likelihood ratio (95% CIs) was better for positive test 3.5 (1.23-9.94) than that for a negative test 0.83 (0.66-1.02).Internal validation with Bootstrap resampling revealed stability of baseline diagnostic variables.There is substantial subclinical atherosclerotic burden in Indian setting with independent contribution by vitamin D deficiency. The model is valuable in "ruling-in" of the underlying advanced atherosclerosis. The study is limited by convenient sampling and lack of external validation of the model.


Assuntos
Aterosclerose/etiologia , Ultrassonografia/métodos , Deficiência de Vitamina D/complicações , Vitamina D/sangue , Adulto , Aterosclerose/diagnóstico , Aterosclerose/epidemiologia , Biomarcadores/sangue , Espessura Intima-Media Carotídea , Estudos Transversais , Feminino , Humanos , Incidência , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Risco , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/epidemiologia
4.
Autoimmun Rev ; 20(9): 102887, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34237422

RESUMO

OBJECTIVE: Cardiovascular (CV) morbidity is a well-established problem in systemic lupus erythematosus (SLE). Antimalarial (AM) therapy has been seen as a potential atheroprotective agent. The aim was to assess the impact of AM therapy on traditional and novel atherosclerosis (AT) biomarkers in patients with SLE. METHODS: A search of MEDLINE, EMbase, and Cochrane library for studies evaluating the impact of AM on AT biomarkers in SLE was conducted. Data extraction included serum, functional and structural traditional and novel biomarkers. A narrative synthesis of the findings and a meta-analysis with random effects was conducted estimating mean differences (MD), OR, HR and 95% CIs. RESULTS: The search strategy produced 148 articles, of which 64 were extracted for analysis. The MD in VLDL-cholesterol (-10.29, 95% CI -15.35, 5.24), triglycerides (-15.68, 95% CI -27.51, -3.86), and diastolic BP (-3.42, 95% CI -5.62, -1.23) differed significantly in patients on AM therapy compared with those without AM therapy. Patients on AM had a lower prevalence and incidence of diabetes mellitus than patients not on AM (HR: 0.39, 95% CI 0.17, 0.88). HCQ use was associated with lower blood pressure (BP) variability. Structural markers like carotid intima-media thickness (IMT), carotid plaque (CP) and coronary artery calcification (CAC) were not influenced by AM. For functional markers like endothelial and arterial stiffness the benefit was unclear. The GRADE approach showed a very low-to-low quality of evidence (QoE) per outcome. CONCLUSIONS: There is some evidence on the associations between AM therapy and some AT markers. However, the data on which this conclusion was based was of low to very low evidence.


Assuntos
Antimaláricos , Aterosclerose , Lúpus Eritematoso Sistêmico , Antimaláricos/uso terapêutico , Aterosclerose/diagnóstico , Aterosclerose/epidemiologia , Biomarcadores , Espessura Intima-Media Carotídea , Humanos , Lúpus Eritematoso Sistêmico/complicações , Lúpus Eritematoso Sistêmico/diagnóstico , Lúpus Eritematoso Sistêmico/tratamento farmacológico , Fatores de Risco
5.
Int J Mol Sci ; 22(13)2021 Jun 22.
Artigo em Inglês | MEDLINE | ID: mdl-34206708

RESUMO

Atherosclerosis has complex pathogenesis, which involves at least three serious aspects: inflammation, lipid metabolism alterations, and endothelial injury. There are no effective treatment options, as well as preventive measures for atherosclerosis. However, this disease has various severe complications, the most severe of which is cardiovascular disease (CVD). It is important to note, that CVD is among the leading causes of death worldwide. The renin-angiotensin-aldosterone system (RAAS) is an important part of inflammatory response regulation. This system contributes to the recruitment of inflammatory cells to the injured site and stimulates the production of various cytokines, such as IL-6, TNF-a, and COX-2. There is also an association between RAAS and oxidative stress, which is also an important player in atherogenesis. Angiotensin-II induces plaque formation at early stages, and this is one of the most crucial impacts on atherogenesis from the RAAS. Importantly, while stimulating the production of ROS, Angiotensin-II at the same time decreases the generation of NO. The endothelium is known as a major contributor to vascular function. Oxidative stress is the main trigger of endothelial dysfunction, and, once again, links RAAS to the pathogenesis of atherosclerosis. All these implications of RAAS in atherogenesis lead to an explicable conclusion that elements of RAAS can be promising targets for atherosclerosis treatment. In this review, we also summarize the data on treatment approaches involving cytokine targeting in CVD, which can contribute to a better understanding of atherogenesis and even its prevention.


Assuntos
Aterosclerose/etiologia , Aterosclerose/metabolismo , Suscetibilidade a Doenças , Sistema Renina-Angiotensina , Inibidores da Enzima Conversora de Angiotensina/farmacologia , Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Animais , Aterosclerose/diagnóstico , Aterosclerose/terapia , Biomarcadores , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/metabolismo , Ensaios Clínicos como Assunto , Gerenciamento Clínico , Avaliação Pré-Clínica de Medicamentos , Endotélio/metabolismo , Humanos , Terapia de Alvo Molecular , Estresse Oxidativo , Espécies Reativas de Oxigênio/metabolismo , Sistema Renina-Angiotensina/efeitos dos fármacos
6.
Atherosclerosis ; 329: 44-49, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34183170

RESUMO

BACKGROUND AND AIMS: The low density lipoprotein cholesterol to Apolipoprotein B (LDL-C/ApoB) ratio is a validated proxy for low density lipoprotein (LDL) particle size that can be easily calculated from a standard lipid/apolipoprotein profile. Whether it is predictive of cardiovascular events in patients with established atherosclerosis is not known and is addressed in the present investigation. METHODS: We determined the LDL-C/ApoB ratio in a cohort of 1687 subjects with established atherosclerosis. Prospectively, major cardiovascular events (MACE) including cardiovascular death, non-fatal myocardial infarction and non-fatal stroke were recorded over a period of 9.9 ± 4.6 years. The study covers >16,000 patient-years. RESULTS: At baseline, the LDL-C/ApoB ratio was 1.36 ± 0.28 in our cohort. During follow up, a total of 558 first MACE were recorded. The LDL-C/ApoB ratio predicted MACE in univariate Cox proportional hazard analysis (HR 0.90 [0.82-0.98]; p = 0.014); this finding was confirmed after adjustment for age, gender, intensity of statin treatment, hypertension, history of smoking, type 2 diabetes, body mass index and ApoB (HR 0.87 [0.78-0.97]; p = 0.013). CONCLUSIONS: The LDL-C/ApoB ratio is independently predictive of MACE in subjects with established atherosclerosis.


Assuntos
Aterosclerose , Doenças Cardiovasculares , Diabetes Mellitus Tipo 2 , Apolipoproteínas B , Aterosclerose/diagnóstico , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , LDL-Colesterol , Humanos
7.
Analyst ; 146(14): 4674-4682, 2021 Jul 21.
Artigo em Inglês | MEDLINE | ID: mdl-34190228

RESUMO

With the existing medical diagnostic technology, the diagnosis of atherosclerosis (AS) is mainly focused on the later stage of AS development rather than plaque imaging in the period before plaque formation. It is impractical to apply the existing theoretical methods for the purpose of early detection of AS. Herein, this study uses a naphthalimide-based fluorescent probe for recognition of cellular reactive oxygen species (ROS). A platelet membrane (Mp) with foam cell targeting was wrapped around the probes to prepare two vesicle structures TBNG@Mp and GNTB@Mp. The animal experiment results show that the screened nano-detection system TBNG@Mp could accumulate in the thoracic aorta of early AS rats. Under the effect of intracellular ROS, fluorescence signals can be observed. In addition, acute biological toxicity was not observed in pathological sections. Therefore, the foam cell targeting system TBNG@Mp with acceptable biocompatibility can realize the detection of AS one to two decades in advance as well as has a good application prospect.


Assuntos
Aterosclerose , Animais , Aterosclerose/diagnóstico , Diagnóstico Precoce , Corantes Fluorescentes , Naftalimidas , Ratos , Espécies Reativas de Oxigênio
8.
Int J Cardiol ; 338: 127-135, 2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-34089770

RESUMO

OBJECTIVE: Most previous studies have examined associations between metabolic disorders measured at a single point in time and risk of heart failure (HF). However, there are many situations where the values of exposures vary over time before HF occurs. We aimed to examine the associations of time-varying obesity and metabolic syndrome (MetSyn) measured at multiple points in time with HF. METHODS: A total of 6750 participants in the Multi-Ethnic Study of Atherosclerosis from 2000 were included in the study. Follow-up was completed through December 2015. MetSyn was defined using the American Heart Association criteria. Incident HF was diagnosed by clinical criteria. Subtypes HF (reduced ejection fraction (HFrEF) and preserved (HFpEF) were classified by left ventricular EF. RESULTS: A total of 331 HF cases were identified during 82,609 person-years of observation. The incidence (95%CI) of total HF was 4.0 (3.4-4.4) per 1000 person-years. Of the total HF cases, 45.6% were HFrEF (n = 151), 40.8% HFpEF (n = 135), and 13.6% were unclassified HF subtypes (n = 45). After adjusting for key covariates, time-varying obesity (BMI ≥ 30 kg/m2) and MetSyn were significantly associated with HF, with a stronger association for HFpEF than for HFrEF. The corresponding hazards ratios (HR, 95%CI) were 1.97 (1.43-2.72) and 1.86 (1.43-2.42) for HFpEF, and 1.46 (1.07-1.98), and 1.39 (1.06-1.82) for HFrEF respectively. Time-varying large waist circumference was significantly associated with for HFpEF, but not with HFrEF. CONCLUSION: Time-varying obesity and MetSyn were significantly associated with HF risk, with a stronger association with HFpEF than with HFrEF. Continued effort to control these risk factors is recommended.


Assuntos
Aterosclerose , Insuficiência Cardíaca , Síndrome Metabólica , Aterosclerose/diagnóstico , Aterosclerose/epidemiologia , Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/epidemiologia , Humanos , Síndrome Metabólica/diagnóstico , Síndrome Metabólica/epidemiologia , Obesidade/diagnóstico , Obesidade/epidemiologia , Prognóstico , Fatores de Risco , Volume Sistólico , Estados Unidos/epidemiologia
9.
Angiol Sosud Khir ; 27(2): 17-24, 2021.
Artigo em Russo | MEDLINE | ID: mdl-34166340

RESUMO

AIM: The purpose of the study was to determine the level of substances damaging the vascular endothelium, as well as to assess their effect on the functional state of the endothelium and the course of obliterating atherosclerosis of lower limb arteries. PATIENTS AND METHODS: The study included a total of 112 people, subdivided into three groups: those with an unfavourable course of obliterating atherosclerosis of lower limbs arteries (n=48) - group 1, patients with obliterating atherosclerosis of lower limbs arteries with a conventionally favourable course (n=48) - group 2, and apparently healthy volunteers (n=16). In all subjects, the following parameters were analysed: stable metabolites of nitric oxide II, endothelin-1, homocysteine and basal insulin. RESULTS: The level of stable nitric oxide metabolites (p<0.001 as compared with group 1; p<0.045 compared with group 2) was lower in the groups of patients with obliterating atherosclerosis of lower limb arteries (88.5±7.3 µmol/L in group 1; 161.5±8.6 µmol/L in group 2) as compared with healthy volunteers (226.0±28.6 µmol/L). In its turn, the level of nitric oxide was statistically significantly lower (p<0.001) in group 1 patients as compared with those of group 2. The level of endothelin-1 turned out to be higher (p<0.001) in group 1 (2.1±0.1 ng/ml) as compared with group 2 (1.6±0.1 ng/ml). Comparing group 1 patients with healthy volunteers (1.4±0.1 ng/ml), the level of endothelin-1 had also higher values (p<0.001). The level of endothelin-1 did not differ (p=0.270) as compared with group 2 and healthy volunteers. Comparing the homocysteine level in patients of the examined groups (20.7±0.8 µmol/L in group 1 patients and 18.1±0.6 µmol/L in group 2 patients) with healthy volunteers (13.0±0.4 µmol/L) demonstrated an increase in the parameters (p<0.001). The level of homocysteine turned out to be higher in group 1 patients than in those of group 2 (p<0.001). The level of basal insulin turned out to be significantly higher in the studied groups of patients with obliterating atherosclerosis of lower limb arteries (24.9±4.6 mIU/L in group 1; 8.0±0.7 mIU/L in group 2) than in healthy volunteers (5.1±0.5 mIU/L). Statistically significant (p<0.001) hyperinsulinemia was observed in group 1 as compared with group 2. CONCLUSION: Hyperhomocysteinemia and hyperinsulinemia are predictors of an unfavourable course of the disease. In a high level of these parameters, one may predict an unfavourable course of obliterating atherosclerosis of lower limb arteries.


Assuntos
Aterosclerose , Artérias , Aterosclerose/diagnóstico , Endotélio Vascular , Humanos , Extremidade Inferior , Óxido Nítrico
10.
Atherosclerosis ; 329: 36-43, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34020783

RESUMO

BACKGROUND AND AIMS: Psychosocial factors are associated with increased risk of cardiovascular disease (CVD). However, associations with peripheral artery disease (PAD) remain uncharacterized. We aimed to compare associations of psychosocial factors with the risk of PAD and two other major atherosclerotic CVD: coronary heart disease (CHD) and ischemic stroke, in the Atherosclerosis Risk in Communities (ARIC) Study. METHODS: In 11,104 participants (mean age 56.7 [SD 5.7] years) without a clinical history of PAD and CHD/stroke at baseline (1990-1992), we evaluated four psychosocial domains: depressive/fatigue symptoms by the Maastricht Questionnaire, social support by the Interpersonal Evaluation List, social networks by the Lubben Scale, and trait anger by the Spielberger Scale. PAD was defined as hospitalizations with diagnosis or related procedures. CHD included adjudicated coronary heart disease and stroke included ischemic stroke. RESULTS: We observed 397 PAD and 1940 CHD/stroke events during a median follow-up of 23.1 years. Higher depressive/fatigue symptoms and less social support were significantly associated with incident PAD (adjusted hazard ratios for top vs. bottom quartile 1.65 [95%CI, 1.25-2.19] and 1.40 [1.05-1.87], respectively). When these factors were simultaneously modeled, only depressive/fatigue symptoms remained significant. Incident CHD/stroke was not associated with either of depressive/fatigue symptoms or social support. Social networks and trait anger were not independently associated with PAD or CHD/stroke. CONCLUSIONS: Depressive/fatigue symptoms and social support (especially the former) were independently associated with the risk of hospitalizations with PAD but not CHD/stroke in the general population. Our results support the importance of depressive/fatigue symptoms in vascular health and suggest the need of including PAD when studying the impact of psychosocial factors on CVD.


Assuntos
Aterosclerose , Doença das Coronárias , Doença Arterial Periférica , Acidente Vascular Cerebral , Aterosclerose/diagnóstico , Aterosclerose/epidemiologia , Doença das Coronárias/diagnóstico , Doença das Coronárias/epidemiologia , Hospitalização , Humanos , Incidência , Pessoa de Meia-Idade , Doença Arterial Periférica/diagnóstico , Doença Arterial Periférica/epidemiologia , Fatores de Risco , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/epidemiologia
11.
Front Immunol ; 12: 622216, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33936038

RESUMO

Background and aims: Patients with systemic lupus erythematosus (SLE) have a significantly higher incidence of atherosclerosis than the general population. Studies on atherosclerosis prediction models specific for SLE patients are very limited. This study aimed to build a risk prediction model for atherosclerosis in SLE. Methods: RNA sequencing was performed on 67 SLE patients. Subsequently, differential expression analysis was carried out on 19 pairs of age-matched SLE patients with (AT group) or without (Non-AT group) atherosclerosis using peripheral venous blood. We used logistic least absolute shrinkage and selection operator regression to select variables among differentially expressed (DE) genes and clinical features and utilized backward stepwise logistic regression to build an atherosclerosis risk prediction model with all 67 patients. The performance of the prediction model was evaluated by area under the curve (AUC), calibration curve, and decision curve analyses. Results: The 67 patients had a median age of 42.7 (Q1-Q3: 36.6-51.2) years, and 20 (29.9%) had atherosclerosis. A total of 106 DE genes were identified between the age-matched AT and Non-AT groups. Pathway analyses revealed that the AT group had upregulated atherosclerosis signaling, oxidative phosphorylation, and interleukin (IL)-17-related pathways but downregulated T cell and B cell receptor signaling. Keratin 10, age, and hyperlipidemia were selected as variables for the risk prediction model. The AUC and Hosmer-Lemeshow test p-value of the model were 0.922 and 0.666, respectively, suggesting a relatively high discrimination and calibration performance. The prediction model had a higher net benefit in the decision curve analysis than that when predicting with age or hyperlipidemia only. Conclusions: We built an atherosclerotic risk prediction model with one gene and two clinical factors. This model may greatly assist clinicians to identify SLE patients with atherosclerosis, especially asymptomatic atherosclerosis.


Assuntos
Aterosclerose/diagnóstico , Lúpus Eritematoso Sistêmico/diagnóstico , Modelos Estatísticos , Adulto , Fatores Etários , Aterosclerose/epidemiologia , Feminino , Humanos , Interleucina-17/genética , Queratina-10/metabolismo , Modelos Logísticos , Lúpus Eritematoso Sistêmico/epidemiologia , Masculino , Pessoa de Meia-Idade , Fosforilação Oxidativa , Prognóstico , Risco , Análise de Sequência de RNA , Transdução de Sinais , Transcriptoma
12.
Diabetes Res Clin Pract ; 176: 108858, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34015391

RESUMO

AIMS: Atherogenic dyslipidemia, associated with small, dense low-density lipoprotein-cholesterol (S-LDL) particles and impaired metabolism of triglycerides (TGs) and high-density lipoprotein-cholesterol (HDL-c), leads to the development of atherosclerosis-related complications of type 2 diabetes mellitus. Based on the hypothesis that an LDL-c-to-apolipoprotein B ratio (LDL/ApoB) < 1.2 may predict the prevalence of S-LDL, this study aimed to evaluate the LDL/ApoB ratio in patients with type 2 diabetes with moderately elevated TG levels. METHODS: The study population consisted of 121 outpatients with type 2 diabetes (S-LDL group, LDL/ApoB < 1.2, n = 79; L-LDL group, LDL/ApoB > 1.2, n = 42) and 58 healthy subjects. The LDL/ApoB ratio was calculated from the measured LDL-c and ApoB levels in participants with TG levels lower than 4.5 mmol/L. Since TGs and HDL-c are included in the atherogenic index of plasma (AIP), we evaluated the relationship between LDL/ApoB and the AIP. RESULTS: Higher levels of AIP, TG (both P < 0.0001), and lipid hydroperoxides (LOOH) (P < 0.001) and lower levels of HDL-c, total cholesterol, and non-HDL-c (P < 0.001, <0.01, <0.05, respectively) were found in the S-LDL group compared to the L-LDL group. There were significant relationships between the LDL/ApoB ratio and the AIP, TG (both P < 0.0001), LOOH (P < 0.0005), and HDL-c levels (P < 0.05) in the S-LDL group. CONCLUSIONS: The prevalence of S-LDL particles (65%) and the close association of LDL/ApoB with the AIP suggest that this ratio may be a potential indicator of increased cardiovascular risk in patients with type 2 diabetes.


Assuntos
Apolipoproteína B-100/sangue , Aterosclerose/diagnóstico , LDL-Colesterol/sangue , Diabetes Mellitus Tipo 2/sangue , Angiopatias Diabéticas/diagnóstico , Adulto , Aterosclerose/sangue , Biomarcadores/sangue , Estudos de Casos e Controles , HDL-Colesterol/sangue , Diabetes Mellitus Tipo 2/complicações , Angiopatias Diabéticas/sangue , Dislipidemias/sangue , Dislipidemias/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tamanho da Partícula , Prognóstico , Triglicerídeos/sangue
13.
Curr Oncol Rep ; 23(7): 79, 2021 05 03.
Artigo em Inglês | MEDLINE | ID: mdl-33937956

RESUMO

PURPOSE OF REVIEW: Immune checkpoint inhibitors (ICIs) have improved the survival of several cancers. However, they may cause a wide range of immune-related adverse events (irAEs). While most irAEs are manageable with temporary cessation of ICI and immunosuppression, cardiovascular toxicity can be associated with high rates of morbidity and mortality. As ICIs evolve to include high-risk patients with preexisting cardiovascular risk factors and disease, the risk and relevance of ICI-associated cardiotoxicity may be even higher. RECENT FINDINGS: Several cardiovascular toxicities such as myocarditis, stress cardiomyopathy, and pericardial disease have been reported in association with ICIs. Recent findings also suggest an increased risk of atherosclerosis with ICI use. ICI-associated myocarditis usually occurs early after initiation and can be fulminant. A high index of suspicion is required for timely diagnosis. Prompt treatment with high-dose corticosteroids is shown to improve outcomes. Although the overall incidence is rare, ICI cardiotoxicity, particularly myocarditis, is associated with significant morbidity and mortality, making it a major therapy-limiting adverse event. Early recognition and prompt treatment with the cessation of ICI therapy and initiation of high-dose corticosteroids are crucial to improve outcomes. Cardio-oncologists will need to play an important role not just in the management of acute cardiotoxicity but also to reduce the risk of long-term sequelae.


Assuntos
Aterosclerose/diagnóstico , Cardiotoxicidade/diagnóstico , Inibidores de Checkpoint Imunológico/uso terapêutico , Miocardite/diagnóstico , Neoplasias/tratamento farmacológico , Aterosclerose/induzido quimicamente , Aterosclerose/imunologia , COVID-19/epidemiologia , COVID-19/prevenção & controle , COVID-19/virologia , Cardiotoxicidade/etiologia , Cardiotoxicidade/imunologia , Humanos , Inibidores de Checkpoint Imunológico/efeitos adversos , Inibidores de Checkpoint Imunológico/imunologia , Miocardite/induzido quimicamente , Miocardite/imunologia , Neoplasias/imunologia , Pandemias , Fatores de Risco , SARS-CoV-2/isolamento & purificação , SARS-CoV-2/fisiologia
14.
Vasc Health Risk Manag ; 17: 175-185, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33953561

RESUMO

Purpose: Arterial stiffness describes the rigidity of the arterial walls and is associated with risk factors for cardiovascular disease (CVD). Arterial stiffness predicts future events and mortality, and the predictive value is stronger in younger versus older subjects. The aims of the present study were, firstly, to present data on physical activity (PA) and time spent sedentary, in the population of Swedish, young adults. Secondly, to explore the association between PA and arterial stiffness. Material and Methods: Self-reported healthy, non-smoking, Swedish, young adults, 18-25 years old, participated in the cross-sectional Lifestyle, Biomarkers and Atherosclerosis (LBA) study. The daily PA was objectively measured with an accelerometer for 1 week. Of the 834 participants, 658 individuals had valid registrations. The arterial stiffness measures, pulse wave velocity (PWV) and augmentation index (AIx) were measured with applanation tonometry. Results: Women were on overall more physically active than men, they spent 214 min/day in light PA (LPA) compared to men who spent 202 min/day. Women took significantly more steps per day than men, 7796 vs 7336 steps/day, and spent less time sedentary, 523 min/day, compared to men who spent 547 min/day sedentary. In total, 76% of the individuals spent on average at least 30 minutes per day in the recommended moderate and vigorous PA (MVPA). Lower arterial stiffness was associated with more MVPA and total PA in the total population. Conclusion: We conclude that in this age group of young, self-reported healthy adults 18-25 years, it is important to highlight the health-enhancing possibilities of time spent in physical activity on the vascular function, measured as PWV and AIx. It is of high relevance in a public health perspective to expand preventive efforts beyond the high-risk groups and encourage young adults to be physically active.


Assuntos
Aterosclerose/prevenção & controle , Exercício Físico , Estilo de Vida Saudável , Comportamento de Redução do Risco , Rigidez Vascular , Adolescente , Adulto , Fatores Etários , Aterosclerose/diagnóstico , Aterosclerose/epidemiologia , Aterosclerose/fisiopatologia , Estudos Transversais , Feminino , Humanos , Masculino , Fatores de Proteção , Análise de Onda de Pulso , Medição de Risco , Fatores de Risco , Fatores Sexuais , Suécia/epidemiologia , Fatores de Tempo , Adulto Jovem
15.
Biomater Sci ; 9(9): 3185-3208, 2021 May 04.
Artigo em Inglês | MEDLINE | ID: mdl-33949389

RESUMO

High-density lipoproteins (HDL) are key players in cholesterol metabolism homeostasis since they are responsible for transporting excess cholesterol from peripheral tissues to the liver. Imbalance in this process, due to either excessive accumulation or impaired clearance, results in net cholesterol accumulation and increases the risk of cardiovascular disease (CVD). Therefore, significant effort has been focused on the development of therapeutic tools capable of either directly or indirectly enhancing HDL-guided reverse cholesterol transport (RCT). More recently, in light of the emergence of precision nanomedicine, there has been renewed research interest in attempting to take advantage of the development of advanced recombinant HDL (rHDL) for both therapeutic and diagnostic purposes. In this review, we provide an update on the different approaches that have been developed using rHDL, focusing on the rHDL production methodology and rHDL applications in theranostics. We also compile a series of examples highlighting potential future perspectives in the field.


Assuntos
Aterosclerose , Lipoproteínas HDL , Aterosclerose/diagnóstico , Aterosclerose/tratamento farmacológico , Biologia , Colesterol , Humanos , Medicina de Precisão
16.
Int Heart J ; 62(3): 552-558, 2021 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-33994514

RESUMO

Preservation of the mitral valve (MV) size is essential for valve function, and a reduced MV coaptation-zone area increases the risk of developing functional mitral regurgitation (FMR). We aimed to determine if the MV leaflet and coaptation-zone areas were associated with the severity of atherosclerosis assessed by cardio-ankle vascular index (CAVI) in patients with normal left ventricle (LV) systolic function and size by real-time 3D echocardiography (RT3DE).We performed RT3DE analysis in 66 patients with normal LV size and ejection fraction who underwent 2D echocardiography and CAVI. MV coaptation-zone areas were measured by custom 3D software and indexed by body surface area (BSA). The associations of clinical factors and mean CAVI with MV leaflet and coaptation-zone areas were evaluated by univariable and multivariable linear regression analyses.On univariable analysis, MV leaflet area/BSA was significantly associated with age (r = -0.335, P = 0.0069) and mean CAVI (r = -0.464, P < 0.001), and MV coaptation-zone area was significantly associated with age (r = -0.626, P < 0.001), hypertension (r = -0.626, P < 0.001), dyslipidemia (r = -0.626, P < 0.001), E/e' (r = -0.626, P < 0.001), and CAVI (r = -0.740, P < 0.001). On multivariable analysis, mean CAVI was independently associated only with MV leaflet area/BSA (standardized coefficient = -0.611, P < 0.001) and MV coaptation-zone area/BSA (standardized coefficient = -0.74, P < 0.001).In patients with normal LV systolic function and size, MV leaflet and coaptation-zone areas might be reduced according to advancing atherosclerosis. Patients with atherosclerosis might be at increased risk of developing FMR.


Assuntos
Aterosclerose/complicações , Índice Vascular Coração-Tornozelo , Insuficiência da Valva Mitral/etiologia , Valva Mitral/diagnóstico por imagem , Idoso , Aterosclerose/diagnóstico , Ecocardiografia Tridimensional , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Insuficiência da Valva Mitral/diagnóstico por imagem
17.
BMJ ; 373: n776, 2021 05 04.
Artigo em Inglês | MEDLINE | ID: mdl-33947652

RESUMO

First developed in 1990, the Agatston coronary artery calcium (CAC) score is an international guideline-endorsed decision aid for further risk assessment and personalized management in the primary prevention of atherosclerotic cardiovascular disease. This review discusses key international studies that have informed this 30 year journey, from an initial coronary plaque screening paradigm to its current role informing personalized shared decision making. Special attention is paid to the prognostic value of a CAC score of zero (the so called "power of zero"), which, in a context of low estimated risk thresholds for the consideration of preventive therapy with statins in current guidelines, may be used to de-risk individuals and thereby inform the safe delay or avoidance of certain preventive therapies. We also evaluate current recommendations for CAC scoring in clinical practice guidelines around the world, and past and prevailing barriers for its use in routine patient care. Finally, we discuss emerging approaches in this field, with a focus on the potential role of CAC informing not only the personalized allocation of statins and aspirin in the general population, but also of other risk-reduction therapies in special populations, such as individuals with diabetes and people with severe hypercholesterolemia.


Assuntos
Aterosclerose/prevenção & controle , Cálcio/análise , Vasos Coronários/química , Guias de Prática Clínica como Assunto , Prevenção Primária/normas , Aterosclerose/diagnóstico , Aterosclerose/epidemiologia , Angiografia por Tomografia Computadorizada , Angiografia Coronária , Vasos Coronários/diagnóstico por imagem , Diabetes Mellitus/epidemiologia , Humanos , Hipercolesterolemia/epidemiologia , Programas de Rastreamento/métodos , Programas de Rastreamento/normas , Literatura de Revisão como Assunto , Medição de Risco/métodos , Fatores de Risco
18.
Blood Coagul Fibrinolysis ; 32(5): 312-316, 2021 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-33859114

RESUMO

The number of patients with diabetes with a risk of cardiovascular diseases (CVDs) is increasing worldwide, leading to a higher demand for evaluating atherosclerosis. Recently, the mean platelet volume (MPV) available from complete blood count is gaining attention as a marker of underlying atherosclerotic lesions. In the current study, we examined whether MPV can predict carotid atherosclerosis in patients with diabetes at an intermediate or high risk for CVD. A total of 224 patients with diabetes aged 36-85 years who underwent carotid ultrasound examination were assessed. The risk of CVD was evaluated using the Suita score. The greatest carotid intima-media thickness (IMT) in each common carotid artery (CCA Max-IMT), carotid bulb, internal carotid artery, or external carotid artery (Total Max-IMT) was measured. Subsequently, the relationship between MPV and IMT was analyzed. Patients were divided into three groups according to their MPV values (<9.5 fl, tertile 1; 9.5-10.2 fl, tertile 2; and >10.2 fl, tertile 3). A correlation was observed between MPV and platelet count (P < 0.001), platelet distribution width (P < 0.001), and glycated hemoglobin (P = 0.04); however, multivariate logistic regression analyses demonstrated no relationship between MPV and CCA Max-IMT [odds ratio, 0.89 (0.60-1.29), P = 0.54] or Total Max-IMT [odds ratio, 0.87 (0.61-1.24), P = 0.45]. MPV did not correlate with carotid artery thickness. Therefore, it is difficult to determine the significance of MPV in atherosclerotic conditions from this study.


Assuntos
Aterosclerose/etiologia , Doenças Cardiovasculares/etiologia , Espessura Intima-Media Carotídea , Complicações do Diabetes/etiologia , Volume Plaquetário Médio , Adulto , Idoso , Idoso de 80 Anos ou mais , Aterosclerose/sangue , Aterosclerose/diagnóstico , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/diagnóstico , Complicações do Diabetes/sangue , Complicações do Diabetes/diagnóstico , Feminino , Fatores de Risco de Doenças Cardíacas , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico
19.
Am J Physiol Endocrinol Metab ; 320(5): E989-E998, 2021 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-33843281

RESUMO

Cardiovascular effects of glucagon-like peptide-1 receptor (GLP-1R) agonist therapies are potentially mediated by anti-inflammatory effects on atherosclerosis. Our study demonstrates that 68Ga-NODAGA-exendin-4, a radioligand specifically targeting GLP-1R, detects GLP-1R expression in inflamed atherosclerotic lesions in nondiabetic and diabetic hypercholesterolemic mice. Immunofluorescence staining suggests that GLP-1R is primarily localized in M2 macrophages in lesions. This study describes a new potential tool that may have translational relevance for studies of pharmacological modification of GLP-1R signaling in atherosclerosis.


Assuntos
Aterosclerose/metabolismo , Diabetes Mellitus Experimental/metabolismo , Receptor do Peptídeo Semelhante ao Glucagon 1/metabolismo , Acetatos/farmacocinética , Animais , Apolipoproteínas B/genética , Apolipoproteínas B/metabolismo , Aterosclerose/complicações , Aterosclerose/diagnóstico , Aterosclerose/genética , Diabetes Mellitus Experimental/complicações , Diabetes Mellitus Experimental/diagnóstico , Diabetes Mellitus Experimental/genética , Exenatida/farmacocinética , Feminino , Radioisótopos de Gálio/farmacocinética , Receptor do Peptídeo Semelhante ao Glucagon 1/agonistas , Receptor do Peptídeo Semelhante ao Glucagon 1/genética , Compostos Heterocíclicos com 1 Anel/farmacocinética , Hipercolesterolemia/complicações , Hipercolesterolemia/diagnóstico , Hipercolesterolemia/genética , Hipercolesterolemia/metabolismo , Fator de Crescimento Insulin-Like II/genética , Fator de Crescimento Insulin-Like II/metabolismo , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Tomografia por Emissão de Pósitrons/métodos , Receptores de LDL/genética , Receptores de LDL/metabolismo
20.
Expert Rev Cardiovasc Ther ; 19(6): 493-499, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33861939

RESUMO

INTRODUCTION: Hepatitis C virus (HCV) infection is an important cause of a variety of otherwise unexplained heart diseases and myocardial injury. A high prevalence of HCV infection has been noted in patients with hypertrophic cardiomyopathy, dilated cardiomyopathy, arrhythmogenic right ventricular dysplasia/cardiomyopathy and myocarditis. Various arrhythmias, conduction disturbances and QT prolongation were also associated with HCV infection. A possible role of HCV infection in the pathogenesis of diabetes and atherosclerosis, and the role of immunogenetics of HCV cardiomyopathies is discussed. Recent studies suggest that mononuclear cells may be the major target of HCV, and clinical applications to test this new hypothesis are discussed. AREAS COVERED: In this review, we will evaluate the evidence that HCV causes various cardiovascular diseases, and discuss on the pathogenesis of these disorders. EXPERT OPINION: HCV is the cause of many different forms of heart disease worldwide, but their existence has not been recognized by most of cardiologists. The recognition and diagnosis are indispensable for the early treatment of these diseases. The diverse clinical manifestation of HCV infection and the presence of multiple extrahepatic disease syndromes could be explained by a new hypothesis that the target of HCV is leukocytes.


Assuntos
Cardiopatias/diagnóstico , Hepatite C/complicações , Arritmias Cardíacas/diagnóstico , Arritmias Cardíacas/etiologia , Arritmias Cardíacas/terapia , Aterosclerose/diagnóstico , Aterosclerose/etiologia , Aterosclerose/terapia , Cardiomiopatias/diagnóstico , Cardiomiopatias/etiologia , Cardiomiopatias/terapia , Cardiopatias/etiologia , Cardiopatias/terapia , Hepacivirus , Humanos , Inflamação , Miocardite/diagnóstico , Miocardite/etiologia , Miocardite/terapia , Pericardite/diagnóstico , Pericardite/etiologia , Pericardite/terapia
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