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1.
Braz J Med Biol Res ; 52(8): e8309, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31411246

RESUMO

This study aimed to detect the expression of the long non-coding RNA (lncRNA) antisense non-coding RNA in the INK4 locus (ANRIL) and evaluate its correlation with disease risk, stenosis degree, inflammation, as well as overall survival (OS) in coronary artery disease (CAD) patients. A total of 230 patients who underwent diagnostic coronary angiography were consecutively recruited and assigned to CAD group (n=125) or control group (n=105) according to presence or absence of CAD. Gensini score was calculated to assess the severity of coronary artery damage. Plasma samples were collected and the expression ANRIL was detected in all participants. High-sensitivity C-reactive protein (hs-CRP), erythrocyte sedimentation rate (ESR), and cytokines including tumor necrosis factor-α (TNF-α), interleukin (IL)-1ß, IL-6, IL-8, IL-10, and IL-17 in CAD patients were measured and OS was calculated. The relative expression of ANRIL was higher in CAD patients compared to controls (P<0.001). Receiver operating characteristic disclosed that ANRIL could distinguish CAD patients from controls with an area under the curve of 0.789 (95%CI: 0.731-0.847). Spearman's rank correlation test revealed that expression of ANRIL was positively correlated with Gensini score (P=0.001), levels of hs-CRP (P=0.001), ESR (P=0.038), TNF-α (P=0.004), and IL-6 (P<0.001), while negatively correlated with IL-10 level (P=0.008) in CAD patients. Kaplan-Meier curve revealed that high expression of ANRIL was associated with shorter OS (P=0.013). In conclusion, circulating ANRIL presented a good diagnostic value for CAD, and its high expression was associated with increased stenosis degree, raised inflammation, and poor OS in CAD patients.


Assuntos
Doença da Artéria Coronariana/diagnóstico , RNA Longo não Codificante/genética , Idoso , Sedimentação Sanguínea , Proteína C-Reativa/análise , Doença da Artéria Coronariana/sangue , Doença da Artéria Coronariana/complicações , Doença da Artéria Coronariana/genética , Estenose Coronária/complicações , Citocinas/sangue , Feminino , Humanos , Inflamação/diagnóstico , Masculino , Pessoa de Meia-Idade , Prognóstico , Medição de Risco , Análise de Sobrevida
2.
Bratisl Lek Listy ; 120(8): 581-585, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31379181

RESUMO

OBJECTIVES: The aim of this study was to evaluate the possible association of miR-206 serum as an indicator of diagnosis in patients with coronary artery disease. METHODS: In this study, 100 patients with coronary artery disease who had angiography and vascular transplantation were selected and evaluated. Extraction of microRNAs from peripheral blood plasma was performed using an exclusive microRNA extraction kit. Then the cDNA synthesis of the target microRNA was performed and its concentration and purity were evaluated. The expression level of miR-206 was performed using the real-time PCR technique and the SYBER Green method, using U6 snRNA as an internal control. In order to analyze the amount of microRNA expression and the significance of the patient sample, the t­test was used to compare the control sample. Also, Pearson correlation coefficient test was used to determine the relationship between the expression level of microRNAs. RESULTS: The results showed a positive correlation between miR-206 expression and coronary artery disease.While the average expression of 1 ± 0.18 in the control sample was increased to 8.76 according to the severity of involvement in the patient, the relative expression of miR-206 in the CAD + group was significantly increased compared to the control (p < 0. 03). CONCLUSIONS: It appears that miR-206 can be considered as an indicator of coronary endothelial cell function. As such, it can be used as a biomarker for prognosis and in controlling the treatment for coronary artery disease (Tab. 2, Fig. 3, Ref. 20).


Assuntos
Doença da Artéria Coronariana/diagnóstico , MicroRNAs/sangue , Biomarcadores/sangue , Doença da Artéria Coronariana/sangue , Humanos , Índice de Gravidade de Doença
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.
J Assoc Physicians India ; 67(4): 29-32, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31311215

RESUMO

Aim and Objectives: This study has been undertaken to determine and compare the levels of serum uric acid in cases with and without coronary artery disease (CAD), to study association between serum uric acid (SUA) level with presence and severity of coronary artery disease. Methods: Total 80 cases more than 13 years of age who presented to hospital with symptoms related to CAD were included in the study and divided into two groups based on coronary angiography reports. Serum uric acid level was measured in all patients by Uricase method. Presence and severity of CAD was assessed by coronary angiography. Association of SUA level with presence and severity of CAD were assessed by statistical analysis. Results: In total, 39 (48.75%) of the patients were diagnosed with CAD having mean age of 56.71 ± 10.36 years. The CAD patients had significantly higher SUA levels than those without CAD, (7.35 ± 1.61mg/dl vs. 4.08 ± 0.83 mg/dl, p=<0.001).There was statistically significant association between SUA and severity of CAD. Serum uric acid levels were increased in cases with CAD with increase in severity of CAD (p < 0.001). Conclusion: Serum uric acid was significantly associated with the presence and severity of CAD and can be used for assessing severity of CAD.


Assuntos
Doença da Artéria Coronariana/diagnóstico , Ácido Úrico/sangue , Adolescente , Idoso , Angiografia Coronária , Doença da Artéria Coronariana/sangue , Humanos , Pessoa de Meia-Idade
7.
Biomed Environ Sci ; 32(4): 250-259, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31217061

RESUMO

OBJECTIVE: Identification of new risk factors is needed to improve prediction of adverse outcomes in patients with three-vessel disease (TVD). The present study aimed to evaluate the prognostic values of serum chloride and sodium levels in patients with TVD. METHODS: We used data from a prospective cohort of consecutive patients with angiographically confirmed TVD. The primary endpoint was all-cause death. Cox proportional hazard regression was used to analyze the relationship of serum chloride and sodium levels with long-term outcomes of TVD patients. RESULTS: A total of 8,318 participants with available serum chloride and sodium data were included in this analysis. At baseline, patients in the low tertiles group of serum chloride level (⪕ 102.0 mmol/L) or serum sodium level (⪕ 139.0 mmol/L) had more severe disease conditions. During a median follow-up of 7.5-year, both low serum chloride level and low serum sodium level were found to be associated with an increased risk for mortality in univariate analysis. However, when both parameters were incorporated into a multivariate model, only low serum sodium level remained to be an independent predictor of all-cause death (hazard ratio: 1.16, 95% confidence interval: 1.01-1.34, P = 0.041). Modest but significant improvement of discrimination was observed after incorporating serum sodium level into the Synergy between percutaneous coronary intervention (PCI) with Taxus and Cardiac Surgery score. CONCLUSION: Serum sodium level is more strongly associated with long-term outcomes of TVD patients compared with serum chloride level. Low serum sodium level is an independent risk factor for mortality, but only provides modest prognostic information beyond an established risk model.


Assuntos
Cloretos/sangue , Doença da Artéria Coronariana/sangue , Sódio/sangue , Idoso , China/epidemiologia , Doença da Artéria Coronariana/diagnóstico , Doença da Artéria Coronariana/mortalidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Prospectivos
8.
Int Heart J ; 60(4): 1009-1012, 2019 Jul 27.
Artigo em Inglês | MEDLINE | ID: mdl-31204372

RESUMO

Spontaneous coronary artery rupture (SCAR) is an extremely rare, life-threatening entity without any previous underlying diseases. The clinical presentation may differ according to the site of the rupture and some patients may deteriorate early into sudden death due to the abrupt evolution of the associated cardiac tamponade and cardiogenic shock.1) The correct diagnosis of SCAR deserves a high level of suspicion. It may be confirmed as a differential diagnosis in patients with cardiac tamponade using transthoracic echocardiography (TTE) and computed tomography angiography (CTA) following emergency pericardiocentesis, and a definite diagnosis can be achieved by selective angiography. Although SCAR is associated with a dismal prognosis, some patients have recovered through emergency surgical operations or catheter interventions.2) We report the case of a patient presenting cardiac tamponade and cardiogenic shock due to spontaneous rupture of the circumflex branch of the left coronary artery, which was successfully isolated by bilateral ligation.


Assuntos
Tamponamento Cardíaco/etiologia , Doença da Artéria Coronariana/complicações , Vasos Coronários/diagnóstico por imagem , Choque Cardiogênico/etiologia , Doença Aguda , Tamponamento Cardíaco/diagnóstico , Tamponamento Cardíaco/cirurgia , Angiografia por Tomografia Computadorizada , Doença da Artéria Coronariana/diagnóstico , Doença da Artéria Coronariana/cirurgia , Vasos Coronários/cirurgia , Humanos , Ligadura/métodos , Masculino , Pessoa de Meia-Idade , Pericardiocentese , Ruptura Espontânea , Choque Cardiogênico/diagnóstico , Choque Cardiogênico/cirurgia , Procedimentos Cirúrgicos Vasculares/métodos
9.
Stud Health Technol Inform ; 261: 199-204, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31156116

RESUMO

Clinical decision support is very important especially in such a wide-spread disease as a coronary artery disease. A large variety of prediction methods can potentially solve the classification problem to support clinical decisions. However, not all of them provide similar efficiency for the classification of patients with coronary artery disease. We have analyzed prediction the efficiency of classifiers (Ridge Classifier, XGB Classifier and Logistic Regression) depending on the number and combination of features. We have tested 24 sets of features on 4 classifiers to proof the hypothesis that using optimized features sets with a higher Pearson ratio results in more efficient classifiers than using all available data.


Assuntos
Doença da Artéria Coronariana , Sistemas de Apoio a Decisões Clínicas , Modelos Logísticos , Algoritmos , Doença da Artéria Coronariana/diagnóstico , Doença da Artéria Coronariana/terapia , Humanos
10.
Ter Arkh ; 91(4): 130-135, 2019 May 16.
Artigo em Inglês | MEDLINE | ID: mdl-31094487

RESUMO

Obesity is closely associated with metabolic and cardiovascular diseases, including dyslipidemia, coronary artery disease, hypertension, and heart failure. Adipose tissue (AT) is identified as a complex endocrine organ, with a wide range of regulatory functions at the cellular, tissue and systemic levels. Various terms, including paracardiac, epicardial and pericardial, are used to describe the fatty deposits surrounding the heart. Among all the fat depots, perivascular AT (PVAT) is of great biological significance for the cardiovascular system due to its anatomical proximity to the vessels. Recent studies have shown the presence of a complex, bidirectional paracrine and vasocardial signaling system between the vascular wall and PVAT. In the review, we will discuss the biological role of PVAT in both the physiological state and cardiovascular pathology, emphasizing its dual proatherogenic and antiatherogenic role. Let us consider PVAT as a target for various therapeutic agents in cardiovascular diseases. We will also analyze data on the role of non-invasive techniques as a diagnostic tool for assessing coronary artery inflammation.


Assuntos
Tecido Adiposo , Vasos Sanguíneos/metabolismo , Doenças Cardiovasculares/diagnóstico , Doença da Artéria Coronariana , Tecido Adiposo/metabolismo , Tecido Adiposo/patologia , Tecido Adiposo/fisiologia , Vasos Sanguíneos/fisiologia , Doenças Cardiovasculares/metabolismo , Doenças Cardiovasculares/patologia , Doença da Artéria Coronariana/diagnóstico , Doença da Artéria Coronariana/metabolismo , Insuficiência Cardíaca , Humanos , Obesidade/patologia , Pericárdio
11.
Vasc Health Risk Manag ; 15: 109-113, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31118652

RESUMO

Aims: This study aimed to utilize a validated sleep questionnaire as a screening tool for symptoms and risk of obstructive sleep apnea in patients undergoing coronary catheterization in Jordan. Materials and methods: A cross-sectional design was used to screen adult patients undergoing coronary catheterization for obstructive sleep apnea (OSA). The Berlin sleep questionnaire was used to record nocturnal and daytime symptoms of OSA and to stratify patients into "low-risk" or "high-risk" for OSA. Coronary artery disease was defined as ≥50% intraluminal stenosis in at least one coronary vessel. Results: A total of 398 patients were studied, mean age was 58.7 years (SD=10.70), ranging from 21-92 years, and 68.6% were males. Based on the Berlin sleep questionnaire's definition, 176 patients (44.2%) were at high-risk for obstructive sleep apnea. Snoring was reported by 61%; loud in 42.1%, and frequent in 62%. Daytime sleepiness was reported by 36%, and 18.9% had fallen asleep while driving. Witnessed apnea during sleep was less reported (7.8%). Prevalence of symptoms and risk of OSA were not different between patients with and without coronary artery disease, P>0.05. In addition, logistic regression indicated that there was no significant association between risk of OSA and coronary artery disease, adjusted (odds ratio=0.93, 95% Confidence Interval=0.60-1.44, P=0.752). Conclusions: Symptoms and risk of obstructive sleep apnea were common among adult Jordanians undergoing coronary catheterization. There was no association between risk of obstructive sleep apnea and coronary artery disease. Larger studies are needed to assess the role of screening for obstructive sleep apnea in this patient population.


Assuntos
Cateterismo Cardíaco , Doença da Artéria Coronariana/diagnóstico , Estenose Coronária/diagnóstico por imagem , Apneia Obstrutiva do Sono/diagnóstico , Sono , Inquéritos e Questionários , Adulto , Idoso , Idoso de 80 Anos ou mais , Doença da Artéria Coronariana/epidemiologia , Estenose Coronária/epidemiologia , Estudos Transversais , Feminino , Humanos , Jordânia/epidemiologia , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prevalência , Medição de Risco , Fatores de Risco , Índice de Gravidade de Doença , Apneia Obstrutiva do Sono/epidemiologia , Apneia Obstrutiva do Sono/fisiopatologia , Adulto Jovem
12.
Angiology ; 70(9): 844-852, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31122026

RESUMO

This meta-analysis assessed the prognostic value of serum γ-glutamyltransferase (GGT) level for cardiovascular (CV) and all-cause mortality in patients with coronary artery disease (CAD). We conducted a systematic literature search of PubMed, Web of Science, Embase, China National Knowledge Infrastructure, Wanfang, and Weipu databases until December 2018. Observational studies investigating the prognostic role of serum GGT level for CV and all-cause mortality in patients with CAD were included. Pooled risk ratios (RR) with 95% confidence intervals (CI) for the highest versus the lowest GGT level were used to summarize the prognostic value. Twelve studies involving 12 531 patients with CAD were included. Meta-analysis showed that elevated GGT level was significantly associated with higher risk of CV mortality (RR: 2.04; 95% CI: 1.57-2.64) and all-cause mortality (RR: 1.49; 95% CI: 1.27-1.74) in patients with CAD. This meta-analysis suggests that elevated serum GGT levels are an independent predictor of CV and all-cause mortality in patients with CAD. Determination of GGT level may improve the prediction of CV and all-cause mortality in patients with CAD.


Assuntos
Doenças Cardiovasculares/sangue , Sistema Cardiovascular/metabolismo , Doença da Artéria Coronariana/sangue , gama-Glutamiltransferase/sangue , Doença da Artéria Coronariana/diagnóstico , Humanos , Prognóstico , Fatores de Risco
13.
Int J Cardiovasc Imaging ; 35(9): 1563-1572, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31053979

RESUMO

The measurement of fractional flow reserve (FFR) and superficial wall stress (SWS) identifies inducible myocardial ischemia and plaque vulnerability, respectively. A simultaneous evaluation of both FFR and SWS is still lacking, while it may have a major impact on therapy. A new computational model of one-way fluid-structure interaction (FSI) was implemented and used to perform a total of 54 analyses in virtual coronary lesion models, based on plaque compositions, arterial remodeling patterns, and stenosis morphologies under physiological conditions. Due to a greater lumen dilation and more induced strain, FFR in the lipid-rich lesions (0.81 ± 0.15) was higher than that in fibrous lesions (0.79 ± 0.16, P = 0.001) and calcified lesions (0.79 ± 0.16, P = 0.001). Four types of lesions were further defined, based on the combination of cutoff values for FFR (0.80) and maximum relative SWS (30 kPa): The level of risk increased from (1) plaques with mild-to-moderate stenosis but negative remodeling for lipid-rich (Type A: non-ischemic, stable) to (2) lipid-rich plaques with mild-to-moderate stenosis and without-to-positive remodeling (Type B: non-ischemic, unstable) or plaques with severe stenosis but negative remodeling for lipid-rich (Type C: ischemic, stable) to (3) lipid-rich plaques with severe stenosis and without-to-positive remodeling (Type D: ischemic, unstable). The analysis of FSI to simultaneously evaluate inducible myocardial ischemia and plaque stability may be useful to identify coronary lesions at a high risk and to ultimately optimize treatment. Further research is warranted to assess whether a more aggressive treatment may improve the prognosis of patients with non-ischemic, intermediate, and unstable lesions.


Assuntos
Cateterismo Cardíaco , Doença da Artéria Coronariana/diagnóstico , Estenose Coronária/diagnóstico por imagem , Vasos Coronários/patologia , Vasos Coronários/fisiopatologia , Reserva Fracionada de Fluxo Miocárdico , Hemodinâmica , Modelos Cardiovasculares , Placa Aterosclerótica , Fenômenos Biomecânicos , Doença da Artéria Coronariana/patologia , Doença da Artéria Coronariana/fisiopatologia , Doença da Artéria Coronariana/terapia , Estenose Coronária/patologia , Estenose Coronária/fisiopatologia , Estenose Coronária/terapia , Humanos , Valor Preditivo dos Testes , Prognóstico , Reprodutibilidade dos Testes , Medição de Risco , Fatores de Risco , Ruptura Espontânea , Índice de Gravidade de Doença
14.
Nat Commun ; 10(1): 1941, 2019 04 26.
Artigo em Inglês | MEDLINE | ID: mdl-31028273

RESUMO

Mendelian randomization (MR) has emerged as a major tool for the investigation of causal relationship among traits, utilizing results from large-scale genome-wide association studies. Bias due to horizontal pleiotropy, however, remains a major concern. We propose a novel approach for robust and efficient MR analysis using large number of genetic instruments, based on a novel spike-detection algorithm under a normal-mixture model for underlying effect-size distributions. Simulations show that the new method, MRMix, provides nearly unbiased or/and less biased estimates of causal effects compared to alternative methods and can achieve higher efficiency than comparably robust estimators. Application of MRMix to publicly available datasets leads to notable observations, including identification of causal effects of BMI and age-at-menarche on the risk of breast cancer; no causal effect of HDL and triglycerides on the risk of coronary artery disease; a strong detrimental effect of BMI on the risk of major depressive disorder.


Assuntos
Algoritmos , Neoplasias da Mama/genética , Doença da Artéria Coronariana/genética , Transtorno Depressivo Maior/genética , Genoma Humano , Análise da Randomização Mendeliana/estatística & dados numéricos , Fatores Etários , Índice de Massa Corporal , Neoplasias da Mama/sangue , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/etiologia , HDL-Colesterol/sangue , Doença da Artéria Coronariana/sangue , Doença da Artéria Coronariana/diagnóstico , Doença da Artéria Coronariana/etiologia , Conjuntos de Dados como Assunto , Transtorno Depressivo Maior/sangue , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/etiologia , Feminino , Estudo de Associação Genômica Ampla , Humanos , Menarca/sangue , Menarca/genética , Característica Quantitativa Herdável , Fatores de Risco , Triglicerídeos/sangue
15.
Nat Commun ; 10(1): 1776, 2019 04 16.
Artigo em Inglês | MEDLINE | ID: mdl-30992449

RESUMO

Polygenic risk scores (PRS) have shown promise in predicting human complex traits and diseases. Here, we present PRS-CS, a polygenic prediction method that infers posterior effect sizes of single nucleotide polymorphisms (SNPs) using genome-wide association summary statistics and an external linkage disequilibrium (LD) reference panel. PRS-CS utilizes a high-dimensional Bayesian regression framework, and is distinct from previous work by placing a continuous shrinkage (CS) prior on SNP effect sizes, which is robust to varying genetic architectures, provides substantial computational advantages, and enables multivariate modeling of local LD patterns. Simulation studies using data from the UK Biobank show that PRS-CS outperforms existing methods across a wide range of genetic architectures, especially when the training sample size is large. We apply PRS-CS to predict six common complex diseases and six quantitative traits in the Partners HealthCare Biobank, and further demonstrate the improvement of PRS-CS in prediction accuracy over alternative methods.


Assuntos
Predisposição Genética para Doença , Modelos Genéticos , Herança Multifatorial/genética , Característica Quantitativa Herdável , Artrite Reumatoide/diagnóstico , Artrite Reumatoide/genética , Teorema de Bayes , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/genética , Simulação por Computador , Doença da Artéria Coronariana/diagnóstico , Doença da Artéria Coronariana/genética , Bases de Dados Genéticas/estatística & dados numéricos , Depressão/diagnóstico , Depressão/genética , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/genética , Feminino , Estudo de Associação Genômica Ampla , Humanos , Doenças Inflamatórias Intestinais/diagnóstico , Doenças Inflamatórias Intestinais/genética , Desequilíbrio de Ligação/genética , Masculino , Polimorfismo de Nucleotídeo Único/genética , Fatores de Risco
16.
Bratisl Lek Listy ; 120(3): 188-194, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31023036

RESUMO

We investigated the association between carotid intima-media thickness (CIMT) with clusterin (CLU), amylin, secreted frizzled-related protein-4 (SFRP-4), glucagon-like peptide-1 (GLP-1) levels, and dipeptidyl peptidase-4 (DPP-4) in type 2 diabetes mellitus (T2DM) individuals with or without coronary artery disease (CAD). This study consisted of four groups: control group (mean ages: 50.3±10.7 years; 20 females and 15 males), diabetic group (DM; mean ages: 53.9±11.1; 14 females and 23 males), CAD group (mean ages: 60.1±43.5; 17 females and 17 males) and CAD+DM group (mean ages: 62.6±11.8 years; 18 females and 18 males). CIMT levels in both CAD and CAD+DM groups are higher than those in controls. CIMT levels in CAD+DM group are also significantly higher than those in DM group. Left external carotid artery (ECA) was found different from controls only in DM group. The levels of SFRP-4 in control group were significantly lower than those in DM, CAD and CAD+DM groups. Serum GLP-1total levels were found to be significantly low in CAD+DM group when compared to control group. DPP-4 and SFRP-4 levels may be a predictive marker for atherosclerosis in diabetes while particularly in diabetes, they correlate well with HOMA-IR. CIMT has the potential to be a clinically useful predictor of vascular risk in diabetic patients with CAD (Tab. 3, Fig. 2, Ref. 39). Keywords: type 2 diabetes mellitus, carotid intima-media thickness, glucagon-like peptide-1, dipeptidyl peptidase-4, clusterin, amylin, secreted frizzled-related protein-4.


Assuntos
Biomarcadores , Doenças Cardiovasculares , Espessura Intima-Media Carotídea , Doença da Artéria Coronariana , Diabetes Mellitus Tipo 2 , Dipeptidil Peptidase 4 , Proteínas Proto-Oncogênicas , Adulto , Idoso , Biomarcadores/sangue , Artérias Carótidas , Doença da Artéria Coronariana/diagnóstico , Doença da Artéria Coronariana/etiologia , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/metabolismo , Dipeptidil Peptidase 4/sangue , Feminino , Humanos , Peptídeos e Proteínas de Sinalização Intracelular , Masculino , Pessoa de Meia-Idade , Proteínas Proto-Oncogênicas/sangue , Fatores de Risco
17.
Angiol Sosud Khir ; 25(1): 159-162, 2019.
Artigo em Russo | MEDLINE | ID: mdl-30994622

RESUMO

Improvement of surgical treatment for ischaemic heart disease is one of the main trends in modern medicine. After the operation of coronary bypass grafting, further functioning of blood flow in the grafts largely depends upon its domination over the native blood flow in the target coronary arteries. Therefore, intraoperative diagnosis of functional competence of coronary bypass grafts by means of flowmetry is currently of special importance. The purpose of this study was flowmetric quantitative assessment of the curves of blood flow through the coronary bypass grafts, depending on the degree of stenosis of the target coronary arteries. A total of 135 patients were examined during our study. We evaluated the curves of blood flow through the bypass grafts from the left internal thoracic artery to the anterior descending artery. The bypass grafts were divided into three groups: the 1st group (n=47) with moderate stenosis of the coronary arteries (from 50 to 75%); the 2nd group (n=42) with a more pronounced lesion of the target vessel (from 75 to 99%), and the 3rd group (n = 46) with occluded coronary arteries (100%). It was revealed that the flow rate (Q, ml/min) in group one was lower (17±3.1) than in group two (33±5.3) and group three (45±3.4). Also, differences were revealed in the resistance index of the grafts: it turned out to be higher in group one (5.2±1.1) and group two (4.5±0.9) as compared with group three (1.8±0.5). However, there was no between-group difference in diastolic filling of the grafts, which amounted to 58±13, 61±10 and 64±9% for groups one, two and three, respectively. By the shape of the curve, we assessed the reverse systolic peak whose presence prevailed in the grafts of group one (15 of 47; 31.9%) and group two (11 of 42; 26.2%) as compared with that in the grafts of group three (5 of 46; 10.8%). The obtained findings confirm higher frequency of the presence of competitive blood flow in the grafts used on non-occluded coronary arteries.


Assuntos
Doença da Artéria Coronariana , Circulação Coronária , Angiografia Coronária , Ponte de Artéria Coronária , Doença da Artéria Coronariana/diagnóstico , Doença da Artéria Coronariana/cirurgia , Humanos , Reologia , Grau de Desobstrução Vascular
19.
Vasc Health Risk Manag ; 15: 57-67, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30936712

RESUMO

Background: Acute myocardial infarction (AMI) with no evidence of relevant stenosis of the coronary artery, known as myocardial infarction (MI) with nonobstructive coronary arteries (MINOCA), has a prevalence of up to 14%. The various causes of MINOCA lead to damage of the myocardium, and there are marked differences in diagnoses, prognoses, and treatments. Although the number of patients affected is considerable owing to the high prevalence of acute coronary syndrome (ACS), the causes of MINOCA have received little attention with the result that some patients may not receive appropriate treatment. Awareness of this disease among clinicians has started only to improve since the beginning of the current century. The aim of this study was to develop a score that enables patients with MINOCA to be distinguished from patients with MI with coronary artery disease (MI-CAD) and thus to facilitate appropriate diagnosis and therapy. Patients and methods: A multicenter observational cohort study was designed. All patients aged ≥18 years from the ARIAM-SEMICYUC (Analysis of Delay in AMI-Spanish Society of Intensive Care Medicine and Coronary Unit) registry, diagnosed with AMI, and admitted to critical care units or coronary care units (CCUs) were included. Patients were classified into two groups: MINOCA, comprising patients with no significant lesions on angiography, and MI-CAD, comprising patients with lesions of the coronary artery tree. Results: A score based on standard variables to assess the probability of MINOCA on admission was designed, showing a maximum value corresponding to a 40% probability of MINOCA. The discriminative power of the model was 0.756 (P-value for the Hosmer-Lemeshow test was >0.05). At 30-day follow-up, the mortality rate was higher for MI-CAD patients. Conclusion: Patients with MINOCA constitute a population that differs from other patients with AMI. Their differential characteristics require a certain diagnostic effort to align therapy with the disease causing the ischemic event. This score could prove useful in establishing additional diagnostic procedures.


Assuntos
Doença da Artéria Coronariana/diagnóstico , Estenose Coronária/diagnóstico , Técnicas de Apoio para a Decisão , Infarto do Miocárdio/diagnóstico , Fatores Etários , Idoso , Biomarcadores/sangue , Angiografia Coronária , Doença da Artéria Coronariana/sangue , Doença da Artéria Coronariana/epidemiologia , Doença da Artéria Coronariana/terapia , Estenose Coronária/sangue , Estenose Coronária/epidemiologia , Estenose Coronária/terapia , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/sangue , Infarto do Miocárdio/epidemiologia , Infarto do Miocárdio/terapia , Valor Preditivo dos Testes , Prognóstico , Sistema de Registros , Estudos Retrospectivos , Fatores de Risco , Fatores Sexuais , Espanha/epidemiologia , Troponina/sangue , Regulação para Cima
20.
Lipids Health Dis ; 18(1): 92, 2019 Apr 09.
Artigo em Inglês | MEDLINE | ID: mdl-30961613

RESUMO

BACKGROUND: This study investigated the pathways and genes involved in coronary artery disease (CAD) and the associated mechanisms. METHODS: Two array data sets of GSE19339 and GSE56885 were downloaded. The limma package was used to analyze the differentially expressed genes (DEGs) in normal and CAD specimens. Examination of DEGs through Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment and Gene Ontology annotation was achieved by Database for Annotation, Visualization and Integrated Discovery (DAVID). The Cytoscape software facilitated the establishment of the protein-protein interaction (PPI) network and Molecular Complex Detection (MCODE) was performed for the significant modules. RESULTS: We identified 413 DEGs (291 up-regulated and 122 down-regulated). Approximately 256 biological processes, only 1 cellular component, and 21 molecular functions were identified by GO analysis and 10 pathways were enriched by KEGG. Moreover, 264 protein pairs and 64 nodes were visualized by the PPI network. After the MCODE analysis, the top 4 high degree genes, including interleukin 1 beta (IL1B, degree = 29), intercellular adhesion molecule 1 (ICAM1, degree = 25), Jun proto-oncogene (JUN, degree = 23) and C-C motif chemokine ligand 2 (CCL2, degree = 20) had been identified to validate in RT-PCR and Cox proportional hazards regression between CAD and normals. CONCLUSIONS: The relative expression of IL1B, ICAM1 and CCL2 was higher in CAD than in normal controls (P < 0.05-0.001), but only IL1B and CCL2 genes were confirmed after testing the gene expression in blood and/or analyzing in Cox proportional hazards regression (P < 0.05-0.001), and the proper mechanism may involve in the AGE-RAGE signaling pathway, fluid shear stress, the tumor necrosis factor (TNF) and cytokine-cytokine receptor interaction.


Assuntos
Quimiocina CCL2/genética , Doença da Artéria Coronariana/genética , Molécula 1 de Adesão Intercelular/genética , Interleucina-1beta/genética , Proteínas Proto-Oncogênicas c-jun/genética , Transcriptoma , Idoso , Atlas como Assunto , Biomarcadores/sangue , Estudos de Casos e Controles , Quimiocina CCL2/sangue , Doença da Artéria Coronariana/sangue , Doença da Artéria Coronariana/diagnóstico , Doença da Artéria Coronariana/patologia , Feminino , Perfilação da Expressão Gênica , Regulação da Expressão Gênica , Ontologia Genética , Humanos , Molécula 1 de Adesão Intercelular/sangue , Interleucina-1beta/sangue , Masculino , Pessoa de Meia-Idade , Anotação de Sequência Molecular , Modelos de Riscos Proporcionais , Mapeamento de Interação de Proteínas , Proteínas Proto-Oncogênicas c-jun/sangue , Software
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