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1.
Medicine (Baltimore) ; 98(42): e17620, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31626142

RESUMO

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.


Assuntos
Antropometria/métodos , Aterosclerose/epidemiologia , Espessura Intima-Media Carotídea , Síndrome Metabólica/epidemiologia , Medição de Risco/métodos , Aterosclerose/diagnóstico , Aterosclerose/etiologia , Estudos Transversais , Feminino , Seguimentos , Humanos , Incidência , Masculino , Síndrome Metabólica/complicações , Síndrome Metabólica/diagnóstico , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Curva ROC , República da Coreia/epidemiologia , Estudos Retrospectivos
2.
Br J Radiol ; 92(1103): 20180309, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31502858

RESUMO

Atherosclerosis is a chronic immunomodulated disease that affects multiple vascular beds and results in a significant worldwide disease burden. Conventional imaging modalities focus on the morphological features of atherosclerotic disease such as the degree of stenosis caused by a lesion. Modern CT, MR and positron emission tomography scanners have seen significant improvements in the rapidity of image acquisition and spatial resolution. This has increased the scope for the clinical application of these modalities. Multimodality imaging can improve cardiovascular risk prediction by informing on the constituency and metabolic processes within the vessel wall. Specific disease processes can be targeted using novel biological tracers and "smart" contrast agents. These approaches have the potential to inform clinicians of the metabolic state of atherosclerotic plaque. This review will provide an overview of current imaging techniques for the imaging of atherosclerosis and how various modalities can provide information that enhances the depiction of basic morphology.


Assuntos
Aterosclerose/diagnóstico , Diagnóstico por Imagem/tendências , Doenças da Aorta/diagnóstico , Doenças das Artérias Carótidas/diagnóstico , Meios de Contraste , Doença das Coronárias/diagnóstico , Humanos , Angiografia por Ressonância Magnética/tendências , Espectroscopia de Ressonância Magnética , Nanopartículas de Magnetita , Imagem Molecular/tendências , Espectrofotometria Infravermelho/tendências , Tomografia de Coerência Óptica/tendências , Tomografia Computadorizada por Raios X/tendências , Ultrassonografia de Intervenção/tendências , Calcificação Vascular/diagnóstico
3.
Vasc Health Risk Manag ; 15: 209-220, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31371977

RESUMO

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.


Assuntos
Aterosclerose , Colesterol/sangue , Embolia de Colesterol , Corticosteroides/uso terapêutico , Animais , Anti-Inflamatórios/uso terapêutico , Aterosclerose/sangue , Aterosclerose/diagnóstico , Aterosclerose/tratamento farmacológico , Aterosclerose/epidemiologia , Biomarcadores/sangue , Cristalização , Embolia de Colesterol/sangue , Embolia de Colesterol/diagnóstico , Embolia de Colesterol/epidemiologia , Embolia de Colesterol/prevenção & controle , Humanos , Imunossupressores/uso terapêutico , Inflamassomos/sangue , Mediadores da Inflamação/sangue , Interleucina-1/sangue , Proteína 3 que Contém Domínio de Pirina da Família NLR/sangue , Placa Aterosclerótica , Prognóstico , Fatores de Risco , Síndrome
4.
Medicine (Baltimore) ; 98(28): e15959, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31305390

RESUMO

The prognostic significance of systemic atherothrombosis in heart failure (HF) with preserved ejection fraction (HFpEF) remains unclear. This study aimed to investigate the relation between the presence of polyvascular disease (PVD) and cardiovascular outcomes in HFpEF patients.A total of 510 consecutive HFpEF patients were prospectively observed for up to 1500 days or until occurrence of cardiovascular events. PVD was defined as ≥2 coexistence of coronary artery disease, peripheral arterial disease, and cerebrovascular disease.Overall, 124 cardiovascular events were observed during follow-up (median: 1430 days). Kaplan-Meier curve showed HFpEF with PVD (n = 84) experienced more cardiovascular events than did those without PVD patients (44.0% vs 20.4%, log-rank: P < .001). Multivariable Cox proportional hazards analysis with significant factors from univariate analysis showed the presence of PVD (hazard ratio [HR]: 2.875, 95% [CI]: 1.894-4.365, P < .001), previous HF hospitalization (HR: 1.578, 95% CI: 1.031-2.414, P = .036), hemoglobin (HR: 0.889, 95% CI: 0.805-0.983, P = .021), serum sodium (HR: 0.946, 95% CI 0.896-1.000, P = .048), ln-BNP (per 1.0, HR: 1.255, 95% CI: 1.055-1.494, P = .010), and E/e' (HR: 1.047, 95% CI: 1.020-1.075, P < .001) significantly predicted future cardiovascular events. Multivariable Cox hazard analysis with 4 established factors (age, BNP, diabetes mellitus, and previous HF hospitalization) from the I-PRESERVE (Irbesartan in HFpEF) study showed PVD was independently associated with cardiovascular events in HFpEF patients (HR: 2.562, 95% CI: 1.715-3.827, P < .001).The presence of PVD is significantly associated with cardiovascular events in HFpEF, suggesting the importance of screening PVD in HFpEF.


Assuntos
Transtornos Cerebrovasculares/diagnóstico , Doença da Artéria Coronariana/diagnóstico , Insuficiência Cardíaca/diagnóstico , Doença Arterial Periférica/diagnóstico , Idoso , Aterosclerose/diagnóstico , Aterosclerose/epidemiologia , Biomarcadores/sangue , Transtornos Cerebrovasculares/epidemiologia , Doença da Artéria Coronariana/epidemiologia , Feminino , Seguimentos , Insuficiência Cardíaca/epidemiologia , Insuficiência Cardíaca/fisiopatologia , Insuficiência Cardíaca/terapia , Humanos , Masculino , Doença Arterial Periférica/epidemiologia , Prevalência , Prognóstico , Estudos Prospectivos , Análise de Sobrevida , Resultado do Tratamento , Função Ventricular Esquerda
5.
Medicine (Baltimore) ; 98(28): e16464, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31305479

RESUMO

Atherosclerosis is the primary etiological factor associated with acute coronary syndrome (ACS). Kidneys have a highly arterial vascular structure and are therefore commonly affected by atherosclerosis, including those affecting the coronary arteries. Renal shear wave elastography (SWE) is an ultrasonographic method, which provides reliable information regarding the condition of the renal parenchyma.We investigated the relationship between SWE findings and the severity of coronary atherosclerosis.We calculated the following: the renal cortical stiffness (rCS) evaluated via SWE, the renal resistive index, the renal pulsatility index, the acceleration time, and the mean Syntax score (SS). Patients with a mean SS <12 were categorized into a low-risk (LR) and those with a mean SS ≥12 were categorized into the high-risk (HR) group.Our study included 132 patients-76 in the LR and 56 in the HR group. Creatinine, high-sensitivity C-reactive protein (hs-CRP), and rCS were significantly higher, but the glomerular filtration rate (GFR) was significantly lower in the HR group. The Hs-CRP (odds ratio [OR] 1.220), GFR (OR 0.967), and rCS (OR 1.316) were observed to be independent predictors for the HR group. The cutoff value of rCS using receiver-operating characteristic curve analysis was 4.43 for the prediction of HR patients and showed 60.7% sensitivity and 57.9% specificity (area under the curve 0.642).SWE which shows renal parenchymal injury and atherosclerosis in renal vessels may give an idea about the severity of coronary atherosclerosis.


Assuntos
Síndrome Coronariana Aguda/diagnóstico , Aterosclerose/diagnóstico , Doença da Artéria Coronariana/diagnóstico , Técnicas de Imagem por Elasticidade , Córtex Renal/diagnóstico por imagem , Biomarcadores/sangue , Proteína C-Reativa/metabolismo , Angiografia Coronária , Creatinina/sangue , Elasticidade , Feminino , Taxa de Filtração Glomerular , Humanos , Córtex Renal/irrigação sanguínea , Masculino , Pessoa de Meia-Idade , Tecido Parenquimatoso/diagnóstico por imagem , Sensibilidade e Especificidade , Índice de Gravidade de Doença
6.
Int J Nanomedicine ; 14: 2609-2618, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31043777

RESUMO

Background: EGFP-EGF1-conjugated poly(lactic-co-glycolic acid) (PLGA) nanoparticle (ENP) has a specific affinity to tissue factor (TF). The aim of this study was to investigate the target delivery of ENP to plaques and its uptake in a mouse model of atherosclerosis in vivo and in vitro. Materials and methods: Coumarin-6- and 1,1'-dioctadecyl-3,3,3',3'-tetramethylindotricarbo cyanine iodide (DiR)-loaded ENPs were synthesized using a double-emulsion method. Mouse vascular smooth muscle cells (VSMCs) were induced with MCP-1 to obtain an increased TF expression. Fluorescence microscopy and flow cytometry assay were performed to examine the uptake of coumarin-6-loaded ENPs in cellular models. An animal model of atherosclerosis was established with an ApoE (-/-) mouse fed with continuous high-fat diets for 14 weeks. DiR-loaded ENPs (DiR-ENPs) were injected via the caudal vein. The distribution of DiR-ENPs was examined through organ imaging and confocal laser scanning microscopy. Results: Results indicated TFs were highly expressed in the cellular model. The uptake of coumarin-6-loaded ENPs was significantly higher than that of common PLGA nanoparticles. Thickening of intima and lipid deposition in the aorta could be observed in atherosclerosis mouse models. Confocal laser scanning microscopy organ imaging showed ENPs accumulated in vessels with atherosclerotic plaques, which coincided with high expressions of TF. Conclusion: This study showed that EGFP-EGF1-conjugated PLGA nanoparticles could be effectively delivered to atherosclerotic plaques in vivo and taken up by VSMCs with high TF expressions in vitro. Thus, it could be a promising carrier for targeted therapy of atherosclerosis.


Assuntos
Aterosclerose/diagnóstico , Aterosclerose/tratamento farmacológico , Portadores de Fármacos/química , Proteínas de Fluorescência Verde/metabolismo , Nanopartículas/química , Fator G para Elongação de Peptídeos/metabolismo , Copolímero de Ácido Poliláctico e Ácido Poliglicólico/química , Animais , Aorta/patologia , Cumarínicos/química , Modelos Animais de Doenças , Portadores de Fármacos/administração & dosagem , Sistemas de Liberação de Medicamentos , Fluorescência , Humanos , Camundongos Endogâmicos C57BL , Músculo Liso Vascular/citologia , Miócitos de Músculo Liso/metabolismo , Nanopartículas/administração & dosagem , Tamanho da Partícula , Eletricidade Estática , Tiazóis/química
7.
Acta Diabetol ; 56(7): 749-754, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30980187

RESUMO

AIM: The impact of cholesteryl ester transfer protein (CETP) on atherosclerotic development in humans remains unclear. Plasma cholesteryl ester transfer was shown to be associated with carotid intima-media thickness in type 2 diabetic (T2D) patients with adequate metabolic control. Since glycation of CETP may influence cholesteryl ester transfer processes, it is important to determine if plasma cholesteryl ester transfer is still a determinant of carotid intima-media thickness (IMT) in patients with poorly controlled diabetes. The aim of the present study was to determine whether CETP activity influences carotid IMT in T2D patients with poor metabolic control. METHODS: In 110 individuals with T2D, we measured CETP mass concentration with ELISA, CETP activity with a radioactivity method and carotid intima-media thickness with high-resolution real-time B-mode ultrasonography. RESULTS: The mean HbA1C was 8.8 ± 1.7%. Carotid IMT did not correlate with CETP activity in the total population. In T2D patients with HbA1C < 8% (n = 33), mean HbA1C was 6.9% and the correlation between carotid IMT and CETP activity was not significant (p = 0.09). In a multivariable analysis that included the total population, carotid intima-media thickness was positively associated with diabetes duration (p = 0.02) but not with CETP activity or HbA1C. CONCLUSIONS: We observed no correlation between carotid intima-media thickness, a marker of early atherosclerosis, and CETP activity in T2D patients with poor metabolic control. Disease duration, which reflects accumulated metabolic abnormalities, may have blunted the potential effect of CETP on atherosclerosis. Metabolic control appears essential to determine the pro- or anti-atherogenic influence of CETP in patients with T2D.


Assuntos
Glicemia/metabolismo , Espessura Intima-Media Carotídea , Proteínas de Transferência de Ésteres de Colesterol/metabolismo , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/metabolismo , Angiopatias Diabéticas/diagnóstico , Idoso , Aterosclerose/complicações , Aterosclerose/diagnóstico , Aterosclerose/metabolismo , Aterosclerose/fisiopatologia , Estudos de Casos e Controles , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/fisiopatologia , Angiopatias Diabéticas/metabolismo , Angiopatias Diabéticas/fisiopatologia , Progressão da Doença , Feminino , Hemoglobina A Glicada/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Ultrassonografia
8.
Angiology ; 70(8): 737-746, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31030528

RESUMO

GlycA, a composite biomarker of systemic inflammation, is associated with cardiovascular disease (CVD) and mortality, but its relationship with peripheral artery disease (PAD) is unknown. We assessed whether plasma GlycA is associated with ankle-brachial index (ABI), carotid plaque (CP), and incident clinical PAD among 6466 Multi-Ethnic Study of Atherosclerosis participants without CVD at baseline. GlycA, ABI, and CP were measured at baseline. Both ABI and CP were remeasured at 10 years. Incident clinical PAD was ascertained from hospital records. We used logistic, Cox, and linear mixed regression models adjusted for demographic and lifestyle factors. Mean (standard deviation, SD) was 62 (10) years for age and 381 (61) µmol/L for GlycA; 53% were women. GlycA was associated with both prevalent low ABI ≤0.8 (prevalence odds ratio [95% confidence interval, CI] per SD increment in GlycA, 1.65 [1.39-1.97]) and CP (1.19 [1.11-1.27]) at baseline. There were no significant associations of GlycA with incident low ABI, incident CP, or 10-year change in ABI or CP score. We identified 110 incident cases of PAD after 79 590 person-years. The hazard ratio (95% CI) of incident PAD per SD increment in GlycA was 1.38 (1.14-1.66). In conclusion, GlycA was associated with prevalent low ABI, prevalent CP, and incident PAD after a median of 14 years.


Assuntos
Aterosclerose/sangue , Biomarcadores/sangue , Inflamação/sangue , Doença Arterial Periférica/sangue , Idoso , Aterosclerose/diagnóstico , Aterosclerose/terapia , Feminino , Humanos , Inflamação/diagnóstico , Masculino , Pessoa de Meia-Idade , Doença Arterial Periférica/diagnóstico , Placa Aterosclerótica/sangue , Placa Aterosclerótica/diagnóstico , Modelos de Riscos Proporcionais , Medição de Risco , Fatores de Risco
9.
Mol Med Rep ; 19(5): 4222-4228, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30942415

RESUMO

Transforming growth factor (TGF)­ß1 is reported to be associated with the occurrence of atherosclerosis, although the mechanism remains unclear. Therefore, the present study aimed to investigate the involvement of TGF­ß1 signaling in atherosclerosis. A total of 56 patients with atherosclerosis and 44 healthy volunteers were involved in this study. Serum expression of TGF­ß1 and long non­coding RNA­ATB was detected by ELISA and quantitative polymerase chain reaction (qPCR). Receiver operating characteristic curve analysis was performed to analyze the diagnostic value of serum TGF­ß1 and lncRNA­ATB for atherosclerosis. A human umbilical vein endothelial cell (HUVEC) line overexpressing lncRNA­ATB was constructed. The effects of TGF­ß1 treatment and lncRNA­ATB overexpression on HUVEC cell proliferation and viability was detected with Cell Counting Kit­8 and MTT assays, respectively. Expression of TGF­ß1 and pro­apoptotic Caspase­3 in lncRNA­ATB­overexpressing HUVECs was detected by western blotting. In addition, the expression of lncRNA­ATB in TGF­ß1­treated HUVECs was detected by qPCR. It was demonstrated that serum TGF­ß1 and lncRNA­ATB expression was significantly higher in atherosclerosis patients, compared with controls, and could be used to effectively distinguish patients from healthy individuals. TGF­ß1 treatment and lncRNA­ATB overexpression reduced HUVEC viability and proliferation. TGF­ß1 treatment increased the expression of lncRNA­ATB in HUVECs, while lncRNA­ATB overexpression had no significant effect on TGF­ß1 expression. LncRNA­ATB silencing with small interfering RNA significantly reduced the effects of TGF­ß1 treatment on the proliferation and viability of HUVECs. Furthermore, LncRNA­ATB overexpression upregulated the expression of caspase­3 in HUVECs. Therefore, it was concluded that TGF­ß1 may have upregulated the expression of lncRNA­ATB to promote atherosclerosis, and lncRNA­ATB may serve as a potential therapeutic target for atherosclerosis. However, the mechanism remains to be further investigated.


Assuntos
Aterosclerose/genética , Aterosclerose/metabolismo , Regulação da Expressão Gênica , RNA Longo não Codificante/genética , Fator de Crescimento Transformador beta1/metabolismo , Adolescente , Adulto , Aterosclerose/diagnóstico , Estudos de Casos e Controles , Caspase 3/metabolismo , Proliferação de Células , Sobrevivência Celular , Feminino , Células Endoteliais da Veia Umbilical Humana/metabolismo , Humanos , Masculino , Interferência de RNA , RNA Interferente Pequeno , Adulto Jovem
10.
Fa Yi Xue Za Zhi ; 35(1): 58-62, 2019 Feb.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-30896121

RESUMO

OBJECTIVES: To investigate the value of optical coherence tomography (OCT) in the diagnosis of coronary atherosclerosis and myocardial infarction in forensic identification. METHODS: OCT and hematoxylin-eosin (HE) examination were performed to examine the pathological samples of coronary artery and myocardial infarction in 5 cases of sudden coronary death. The morphological and local measurement indexes were compared. RESULTS: In the OCT images, the layers of coronary artery could be distinguishably featured, and the atheroma plaques had a good morphological correspondence with HE slices. The normal myocardia in the OCT image showed weak light signals with high absorbance, while the fiber scar tissues in the myocardial infarction areas showed strong light signals with low absorbance. There were no significant differences on the fibrous cap thickness in coronary atherosclerotic plaques or intima-media thickness between the OCT images and the HE slices (P>0.05). In the OCT images, the optical densities of the old myocardial infarction areas (1 226.24±622.66) and those of normal myocardia (3 707.90±962.98) were significantly different ( P<0.05). CONCLUSIONS: The OCT image has a good morphological consistency with HE slice, thus is expected to be the primary screening method for the forensic pathology examination of coronary artery atherosclerosis and myocardial infarction, which can help to improve the diagnostic accuracy.


Assuntos
Aterosclerose , Doença da Artéria Coronariana , Patologia Legal , Infarto do Miocárdio , Aterosclerose/diagnóstico , Aterosclerose/patologia , Espessura Intima-Media Carotídea , Angiografia Coronária , Doença da Artéria Coronariana/diagnóstico , Doença da Artéria Coronariana/patologia , Vasos Coronários , Humanos , Infarto do Miocárdio/diagnóstico , Infarto do Miocárdio/patologia , Tomografia de Coerência Óptica
11.
Turk J Med Sci ; 49(2): 604-609, 2019 04 18.
Artigo em Inglês | MEDLINE | ID: mdl-30889943

RESUMO

Background/aim: In the present study we aimed to investigate whether the earlobe crease (ELC) might provide predictive information about white matter intensities (WMIs) in the brain that reflect brain aging. Materials and methods: A total of 350 individuals examined from January 2016 to July 2016 were screened. Patients with known demyelinating white matter disease, neurodegenerative disorders, cerebrovascular event history, or brain tumors were excluded from the study. Finally, 285 cases were included in the study. The four-point cerebral intensity classification system of Fazekas was used in the evaluation of the brain. The ELC was evaluated by inspection. Results: A total of 285 patients were enrolled consecutively. The incidence of WMI was significantly higher in patients with ELC than the others. Age (95% CI: 1.105­1.213, P < 0.001) and ELC (95% CI: 0.098­0.783, P = 0.015) were found as an independent determinants of abnormal WMI. ELC predicted abnormal WMIs with 89% specificity and 62% sensitivity. Conclusion: The presence of an ELC may provide predictive information in terms of detecting abnormal WMIs with prognostic impact in apparently healthy subjects.


Assuntos
Pavilhão Auricular/anormalidades , Voluntários Saudáveis , Substância Branca/anormalidades , Substância Branca/patologia , Adulto , Idoso , Aterosclerose/diagnóstico , Aterosclerose/diagnóstico por imagem , Aterosclerose/patologia , Feminino , Predisposição Genética para Doença , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Neuroimagem , Valor Preditivo dos Testes , Estudos Prospectivos , Rigidez Vascular , Substância Branca/diagnóstico por imagem
12.
High Blood Press Cardiovasc Prev ; 26(2): 85-100, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30877603

RESUMO

Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of death worldwide. Despite the clinical long-term and near-term benefits of lowering cholesterol in, respectively, primary and secondary prevention of ASCVD, cholesterol levels remain under-treated, with many patients not achieving their recommended targets. The present article will review the latest updates on lipid management with emphases on the different classes of cholesterol-lowering agents and their clinical uses.


Assuntos
Anticolesterolemiantes/uso terapêutico , Aterosclerose/tratamento farmacológico , Colesterol/sangue , Dislipidemias/tratamento farmacológico , Triglicerídeos/sangue , Anticolesterolemiantes/efeitos adversos , Aterosclerose/sangue , Aterosclerose/diagnóstico , Aterosclerose/mortalidade , Biomarcadores/sangue , Dislipidemias/sangue , Dislipidemias/diagnóstico , Dislipidemias/mortalidade , Exercício , Dieta Saudável , Humanos , Fatores de Proteção , Fatores de Risco , Comportamento de Redução do Risco , Resultado do Tratamento
14.
Arch Endocrinol Metab ; 63(1): 16-21, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30864627

RESUMO

OBJECTIVE: In this study, we aimed to evaluate serum irisin and apelin levels in patients with subclinical hypothyroidism (SCH) when they were subclinical hypothyroid and become euthyroid after levothyroxine therapy and association of these adipokines with markers of atherosclerosis such as serum homocysteine levels and carotid intima-media thickness (IMT). SUBJECTS AND METHODS: The study included 160 patients with newly diagnosed subclinical hypothyroidism due to Hashimoto's thyroiditis and 86 euthyroid healty subjects. Serum glucose and lipid profile, insulin, HOMA, TSH, free T3, free T4, anti-thyroperoxidase and anti-thyroglobulin antibodies, homocysteine, apelin and irisin levels were measured in all study subjects. Thyroid and carotid ultrasound examinations were performed. The subclinical hypothyroid group was reevaluated after 12-weeks of levothyroxine therapy when they became euthyroid. RESULTS: Clinical characteristics of the patient and control group were similar. Glucose, insulin and HOMA levels, lipid parameters and free T3 were similar between the two groups.. Serum homocystein was higher and apelin was lower in patients with SCH, but irisin levels were similar between the two groups. While thyroid volume was lower, carotid IMT was significantly greater in patients with SCH (pCarotidIMT:0,01). After 12-weeks of levothyroxine therapy, all the studied parameters remained unchanged except, serum freeT4, TSH, homocystein and apelin. While homocystein decreased (p: 0,001), apelin increased significantly (p = 0,049). In multivariate analysis, low apelin levels significantly contributed to carotid IMT (p = 0,041). CONCLUSIONS: Apelin-APJ system may play a role in vascular and cardiac dysfunction in patients with SCH and treatment of this condition may improve the risk of cardiovascular disease.


Assuntos
Apelina/sangue , Aterosclerose/etiologia , Fibronectinas/sangue , Doença de Hashimoto/complicações , Hipotireoidismo/complicações , Adulto , Idoso , Aterosclerose/sangue , Aterosclerose/diagnóstico , Biomarcadores/sangue , Espessura Intima-Media Carotídea , Estudos de Casos e Controles , Feminino , Doença de Hashimoto/sangue , Doença de Hashimoto/tratamento farmacológico , Humanos , Hipotireoidismo/sangue , Hipotireoidismo/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Testes de Função Tireóidea , Tiroxina/uso terapêutico , Adulto Jovem
15.
J Stroke Cerebrovasc Dis ; 28(6): 1732-1743, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30878369

RESUMO

AIMS: The objective of this study was to perform a meta-analysis to evaluate the association between angiotensin-converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism and susceptibility to atherosclerosis (AS). METHODS: MEDLINE, EMBASE, and the ISI Web of Science were searched for all eligible published studies concerning the relationship of ACE gene polymorphism with AS without language restrictions. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated to evaluate this relationship under different genetic models using meta-analytic methods. RESULTS: A total of 15 articles (16 studies) were involved in this meta-analysis. The D allele of the ACE gene had a nonsignificant increase in the risk of AS (D versus I: OR = 1.23, 95% CI, .98-1.53, P = .07; I2 = 87.2%, Pheterogeneity < .01). Compared with the II genotype, the DI (relative risk [RR]: 1.35, 95% CI: 1.09, 1.67, P < .01; I2 = 47.8%, Pheterogeneity = .017) and (DD + DI) (RR = 1.38, 95% CI: 1.04, 1.82, P = .02; I2 = 73.3%, Pheterogeneity < .01) genotype of ACE was associated with higher risk of AS, respectively. Subjects with the DD genotype showed a statistically nonsignificant trend toward greater risk of AS (RR = 1.53, 95% CI: .97, 2.43, P = .07; I2 = 88.6%, Pheterogeneity < .01). Further subgroup analyses showed that significant relationships were only found in Europeans under different gene polymorphism or different genotype models rather than Asians. CONCLUSIONS: The present meta-analysis indicated that the D allele in the ACE gene was associated with the risk of AS, especially in Europeans. Furthermore, increased copy number of D allele was significantly associated with increased AS risk in a dose-dependent manner.


Assuntos
Aterosclerose/genética , Mutação INDEL , Peptidil Dipeptidase A/genética , Polimorfismo Genético , Adulto , Idoso , Aterosclerose/diagnóstico , Aterosclerose/enzimologia , Aterosclerose/etnologia , Variações do Número de Cópias de DNA , Feminino , Dosagem de Genes , Frequência do Gene , Estudos de Associação Genética , Predisposição Genética para Doença , Humanos , Masculino , Pessoa de Meia-Idade , Fenótipo , Prognóstico , Medição de Risco , Fatores de Risco
16.
BMC Public Health ; 19(1): 161, 2019 Feb 06.
Artigo em Inglês | MEDLINE | ID: mdl-30727990

RESUMO

BACKGROUND: Physical activity and sedentary behavior are considered independent risk factors for chronic disease. However, we do not fully understand their interrelation with key health outcomes such as subclinical atherosclerosis. This study examines the combined effects of sedentary behavior and physical activity on carotid intima-media thickness (cIMT) and presence of carotid plaque in a Mexican American population on the Texas-Mexico border. METHODS: This cross-sectional study was conducted using retrospective data from a sample (n = 612) of participants from the Cameron County Hispanic Cohort. Carotid ultrasound was used to measure cIMT and presence of carotid plaque. Self-reported questionnaires were used to assess leisure time physical activity and sedentary behavior (TV/movie sitting and total sitting). A series of multivariable regression models were used to assess study aims. An interaction term between physical activity and sedentary behavior was included in models for each respective outcome. Models were controlled for demographic and health-related variables. RESULTS: There were no significant associations found between physical activity, sedentary behavior and mean cIMT, or cIMT thickness ≥ 75th percentile for age and gender. However, there was a significant interaction between physical activity and TV/movie sitting with presence of carotid plaque. Participants who reported moderate levels of physical activity had significantly lower odds for presence of plaque compared to participants with no activity when TV/movie sitting time was ≤3 h per day. However, there was no significant difference in odds for presence of plaque between physical activity groups when TV/movie sitting exceeded 3 h/day. These results were consistent with models examining total sitting time. CONCLUSIONS: Our results indicate that for Mexican Americans, there is a combined effect of sedentary behavior and physical activity on presence of carotid plaque. Participating in moderate physical activity is optimal for having lower levels of carotid plaque in addition to avoiding excessive levels of TV/movie sitting (≥3 h/day) and/or total sitting (≥8.5 h/day).


Assuntos
Aterosclerose/etnologia , Exercício , Americanos Mexicanos/estatística & dados numéricos , Comportamento Sedentário/etnologia , Adulto , Aterosclerose/diagnóstico , Espessura Intima-Media Carotídea , Estudos Transversais , Feminino , Humanos , Atividades de Lazer , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Autorrelato , Texas , Ultrassonografia
17.
Thromb Haemost ; 119(4): 576-585, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30703812

RESUMO

The most common causes of ischaemic stroke are represented by carotid artery atherosclerotic disease (CAAD) and atrial fibrillation. While oral anticoagulants substantially reduce the incidence of thromboembolic stroke (< 1%/year), the rate of ischaemic stroke and other cardiovascular disease events in patients with CAAD remains high, ranging from 8.4 to 18.1 events per 100 patient-years. Similar to any other atherosclerotic disease, anti-thrombotic therapies are proposed for CAAD to reduce stroke and other cardiovascular events. The 2017 European Society of Cardiology (ESC)/European Society for Vascular Surgery (ESVS) guidelines recommend for patients with asymptomatic CAAD ≥60% the use of aspirin 75 to 100 mg once daily or clopidogrel 75 mg once daily at the exception of patient at very high bleeding risk. For patients with symptomatic CAAD ≥50%, the use of aspirin 75 to 100 mg once daily or clopidogrel 75 mg once daily is recommended. New perspectives for anti-thrombotic therapy for the treatment of patients with CAAD come from the novel dual pathway strategy combining a low-dose anticoagulant (i.e. rivaroxaban) and aspirin that may help reduce long-term ischaemic complications in patients with CAAD. This review summarizes current evidence and recommendations for the anti-thrombotic management of patients with symptomatic or asymptomatic CAAD or those undergoing carotid revascularization.


Assuntos
Aterosclerose/tratamento farmacológico , Doenças das Artérias Carótidas/tratamento farmacológico , Inibidores da Agregação de Plaquetas/uso terapêutico , Idoso , Anticoagulantes/administração & dosagem , Anticoagulantes/uso terapêutico , Aspirina/administração & dosagem , Aterosclerose/diagnóstico , Aterosclerose/epidemiologia , Cardiologia/métodos , Doenças Cardiovasculares/complicações , Artérias Carótidas/patologia , Doenças das Artérias Carótidas/diagnóstico , Doenças das Artérias Carótidas/epidemiologia , Clopidogrel/uso terapêutico , Feminino , Hemorragia , Humanos , Masculino , Pessoa de Meia-Idade , Revascularização Miocárdica , Risco , Rivaroxabana/administração & dosagem
18.
Endocr J ; 66(3): 241-251, 2019 Mar 28.
Artigo em Inglês | MEDLINE | ID: mdl-30745500

RESUMO

The inflammatory biomarkers that fully characterize the metabolically unhealthy (MU) state-which is a risk factor for cardiovascular disease (CVD)-remain unclear. Recent studies suggest follistatin-like protein 1 (FSTL1) could be used as a biomarker for inflammation and CVD, however there is little information on FSTL1 levels in the MU state. We aimed to evaluate the associations between FSTL1, the presence of MU state and subclinical coronary atherosclerosis. In a cross-sectional study, we evaluated FSTL1 levels and their relationship with the presence of MU state and coronary artery plaques in 230 Korean patients. Significant increase in FSTL1 levels was observed in subjects with MU state (p = 0.020), but not those with obesity state according to body mass index criteria (p = 0.790). After adjusting for confounders, the odd ratio (OR) for the MU state among patients in the highest FSTL1 tertile (T3) was higher in comparison with the lowest tertile (T1) (OR = 3.60, 95% confidence interval [95% CI] = 1.20-10.83). In a subgroup (n = 66), FSTL1 levels were also marginally higher in patients with plaques (p = 0.098). The OR for plaque presence in patients with T3 was significantly higher in comparison with T1 after adjusting for confounders (OR = 12.51, 95% CI = 1.15-135.73). Plasma FSTL1 may be a useful biomarker for the risk of MU state and CVD.


Assuntos
Aterosclerose/diagnóstico , Doenças Cardiovasculares/diagnóstico , Doença da Artéria Coronariana/diagnóstico , Proteínas Relacionadas à Folistatina/sangue , Inflamação/diagnóstico , Aterosclerose/sangue , Biomarcadores/sangue , Doenças Cardiovasculares/sangue , Doença da Artéria Coronariana/sangue , Estudos Transversais , Feminino , Humanos , Inflamação/sangue , Masculino , Pessoa de Meia-Idade , República da Coreia , Estudos Retrospectivos
19.
Anal Bioanal Chem ; 411(11): 2273-2282, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30806752

RESUMO

Coronary artery disease (CAD) is a manifestation of systemic atherosclerotic disease. It is assessed by intervention or traditional scoring risk factors. Diagnosis is limited by inaccurate and invasive methods. Developing noninvasive methods to screen for the risk of CAD is a major challenge. We aimed to identify urinary proteins associated with CAD. We utilized iTRAQ labeling followed by 2D LC-MS/MS to compare the urinary proteome of CAD patients to healthy cohorts. The multiple reaction monitoring (MRM) was used to verify the differential proteins. ROC analysis based on MRM data was used to evaluate the diagnostic application. A total of 876 proteins were quantified, and 100 differential proteins were found. Functional analysis revealed that the differential proteins were mainly associated with Liver X Receptor/Retinoid X Receptor (LXR/RXR) pathway activation, atherosclerosis signaling, production of nitric oxide and reactive oxygen species, and the top upstream regulator of the differential proteins by IPA analysis indicated to the APOE. Nineteen differential proteins were verified by MRM analysis. ROC based on MRM data revealed that the combination of two proteins (APOD and TFF1) could diagnose CAD with 85% sensitivity and 99% specificity (AUC 0.95). The urinary proteome might reflect the pathophysiological changes in CAD and be used for the clinical study of CAD.


Assuntos
Doença da Artéria Coronariana/diagnóstico , Doença da Artéria Coronariana/urina , Proteinúria/urina , Proteômica/métodos , Espectrometria de Massas em Tandem/métodos , Urinálise/métodos , Adulto , Aterosclerose/diagnóstico , Aterosclerose/urina , Biomarcadores/urina , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
20.
Artigo em Inglês | MEDLINE | ID: mdl-30759884

RESUMO

There is an abundance of literature reporting an association between shift work and cardiovascular disease (CVD). Few studies have examined early manifestation of CVD using advanced modern methodology. We established a group of 65 shift workers and 29 day workers (controls) in two industrial plants. For the shift workers, the shift schedule includes rotating shifts with day, evening and nightshifts, some day and nightshifts lasting for 12 h. The current paper describes cross-sectional data in a study running for three years. We collected background data by questionnaire and measured blood pressure, heart rate, lipids, glycosylated hemoglobin (HbA1c) and C-reactive protein (CRP). We examined arterial stiffness (central blood pressure, augmentation pressure and index, and pulse wave velocity) by the use of SphygmoCor® (AtCor Medical Pty Ltd, Sydney, Australia) and the carotid arteries by ultrasound. We assessed VO2max by bicycle ergometry. We applied linear and logistic regression to evaluate associations between total number of years in shift work and cardiovascular outcome measures. The day workers were older and had more pronounced arterial stiffness compared to the shift workers. Number of years as a shift worker was associated with increased carotid intima media thickness (max IMT) (B = 0.015, p = 0.009) and an elevated CRP (B = 0.06, p = 0.03). Within the normal range for this age group, VO2max was 41 (9) ml/kg/min. Rotating shift work including day and night shifts lasting up to 12 h and evening shifts are associated with CVD-risk factors. This could imply an increased risk for coronary heart disease and stroke among these workers. Therefore, preventive measures should be considered for these groups of workers in order to prevent such diseases.


Assuntos
Aterosclerose/etiologia , Jornada de Trabalho em Turnos , Adulto , Aterosclerose/diagnóstico , Aterosclerose/patologia , Austrália , Pressão Sanguínea , Proteína C-Reativa , Doenças Cardiovasculares , Espessura Intima-Media Carotídea , Estudos Transversais , Feminino , Frequência Cardíaca , Humanos , Modelos Logísticos , Masculino , Instalações Industriais e de Manufatura , Pessoa de Meia-Idade , Análise de Onda de Pulso , Fatores de Risco , Rigidez Vascular
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