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1.
Cardiovasc Ther ; 2021: 5577218, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34239605

RESUMO

Cellular stress response plays an important role in the pathophysiology of coronary artery disease (CAD). Inhibition of cellular stress may provide a novel clinical approach regarding the diagnosis and treatment of CAD. Fibroblasts constitute 60-70% of cardiac cells and have a crucial role in cardiovascular function. Hence, the aim of this study was to show a potential therapeutic application of proteins derived from heat-stressed fibroblast in CAD patients. Fibroblasts were isolated from the foreskin and cultured under heat stress conditions. Surprisingly, 1.06% of the cells exhibited a necrotic death pattern. Furthermore, heat-stressed fibroblasts produced higher level of total proteins than control cells. In SDS-PAGE analysis, a 70 kDa protein band was observed in stressed cell culture supernatants which appeared as two acidic spots with close pI in the two-dimensional electrophoresis. To evaluate the immunogenic properties of fibroblast-derived heat shock proteins (HSPs), the serum immunoglobulin-G (IgG) was measured by ELISA in 50 CAD patients and 50 normal subjects who had been diagnosed through angiography. Interestingly, the level of anti-HSP antibody was significantly higher in non-CAD individuals in comparison with the patient's group (p < 0.05). The odds ratio for CAD was 5.06 (95%CI = 2.15-11.91) in cut-off value of 30 AU/mL of anti-HSP antibody. Moreover, ROC analysis showed that anti-HSP antibodies had a specificity of 74% and a sensitivity of 64%, which is almost equal to 66% sensitivity of exercise stress test (EST) as a CAD diagnostic method. These data revealed that fibroblast-derived HSPs are suitable for the diagnosis and management of CAD through antibody production.


Assuntos
Doença da Artéria Coronariana/fisiopatologia , Fibroblastos/imunologia , Resposta ao Choque Térmico/imunologia , Idoso , Doença da Artéria Coronariana/sangue , Doença da Artéria Coronariana/imunologia , Ensaio de Imunoadsorção Enzimática , Feminino , Fibroblastos/fisiologia , Proteínas de Choque Térmico/biossíntese , Proteínas de Choque Térmico/imunologia , Resposta ao Choque Térmico/fisiologia , Humanos , Imunoglobulina G/sangue , Masculino , Pessoa de Meia-Idade , Razão de Chances
2.
J Cardiothorac Surg ; 16(1): 198, 2021 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-34284809

RESUMO

BACKGROUND: Poor glycemic control has been associated with an increased risk of wound complications after various types of operations. However, it remains unclear how hemoglobin A1c (HbA1c) and preoperative glycemia can be used in clinical decision-making to prevent sternal wound complications (SWC) following off-pump coronary artery bypass grafting (OPCAB). METHODS: We conducted a retrospective study of 1774 consecutive patients who underwent OPCAB surgery between January 2010 and November 2016. A new four-grade classification for SWC was used. The associations of HbA1c and preoperative glycemia with incidence and grade of SWC were analysed using logistic regression analysis and proportional odds models, respectively. RESULTS: During a median follow-up of 326 days (interquartile range (IQR) 21-1261 days), SWC occurred in 133/1316 (10%) of non-diabetes and 82/458 (18%) of diabetes patients (p < 0.001). Higher HbA1c was significantly associated with a higher incidence of SWC (odds ratio, OR 1.24 per 1% increase, 95% confidence interval, CI 1.04;1.48, p = 0.016) as well as a higher grade of SWC (OR 1.25, 95% CI 1.06;1.48, p = 0.010). There was no association between glycemia and incidence (p = 0.539) nor grade (p = 0.607) of SWC. Significant modifiers of these effects were found: HbA1c was associated with SWC in diabetes patients younger than 70 years (OR 1.41, 95% CI 1.17;1.71, p < 0.001), whereas it was not in those older than 70 years. Glycemia was associated with SWC in patients who underwent non-urgent surgery (OR 2.48, 95% CI 1.26;4.88, p = 0.009), in diabetes patients who received skeletonised grafts (OR 4.83, 95% CI 1.28;18.17, p = 0.020), and in diabetes patients with a BMI < 30 (OR 2.19, 95% CI 1.01;4.76, p = 0.047), whereas it was not in the counterparts of these groups. CONCLUSIONS: Under certain conditions, HbA1c and glycemia are associated SWC following OPCAB. These findings are helpful in planning the procedure with minimal risk of SWC.


Assuntos
Ponte de Artéria Coronária sem Circulação Extracorpórea/efeitos adversos , Doença da Artéria Coronariana/cirurgia , Tomada de Decisões , Diabetes Mellitus/epidemiologia , Hemoglobina A Glicada/metabolismo , Idoso , Biomarcadores/sangue , Glicemia/metabolismo , Comorbidade , Doença da Artéria Coronariana/sangue , Doença da Artéria Coronariana/epidemiologia , Diabetes Mellitus/sangue , Feminino , Humanos , Incidência , Masculino , Razão de Chances , Período Pré-Operatório , Estudos Retrospectivos , Resultado do Tratamento
3.
Artigo em Inglês | MEDLINE | ID: mdl-33991953

RESUMO

Ceramides are key-role lipids involved in numerous central cellular processes. A plethora of studies have demonstrated that the levels of ceramides in blood circulation are related to different disease states, such as type 2 diabetes, cardiovascular diseases, ovarian cancer, multiple sclerosis and others. Herein, a RPLC-MS/MS method for the rapid quantification of ceramides Cer(d18:1/16:0), Cer(d18:1/18:0), Cer(d18:1/24:0) and Cer(d18:1/24:1) in human blood serum was developed and validated. Different sample preparation strategies including SLE, LLE and QuECheRS were tested with the aim to attain effective, accurate and reproducible determination of ceramides in serum samples. Intra and inter-day accuracy were found to be between 80.0-111% and 87.8-106%, respectively, for all ceramides, while intra and inter-day precision were found to vary from 0.05% to 10.2% %RSD and 2.2% to 14.0% %RSD, respectively. The lower limits of quantification were 2.3 ng/mL for Cer(d18:1/16:0) and Cer(d18:1/18:0) and 1.4 ng/mL for Cer(d18:1/24:0) and Cer(d18:1/24:1). The method was evaluated in accordance to bioanalytical method guidelines and was used for the determination of serum ceramides of patients with coronary artery disease to evaluate its utility in clinical analyses.


Assuntos
Ceramidas/sangue , Cromatografia Líquida de Alta Pressão/métodos , Cromatografia de Fase Reversa/métodos , Soro/química , Espectrometria de Massas em Tandem/métodos , Doença da Artéria Coronariana/sangue , Humanos , Limite de Detecção , Sensibilidade e Especificidade
4.
J Interv Cardiol ; 2021: 6641887, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33958976

RESUMO

Background: Contrast-associated acute kidney injury (CA-AKI) is a common complication in patients undergoing coronary angiography (CAG). However, few studies demonstrate the association between the prognosis and developed CA-AKI in the different periods after the operation. Methods: We retrospectively enrolled 3206 patients with preoperative serum creatinine (Scr) and at least twice SCr measurement after CAG. CA-AKI was defined as an increase ≥50% or ≥0.3 mg/dL from baseline in the 72 hours after the procedure. Early CA-AKI was defined as having the first increase in SCr within the early phase (<24 hours), and late CA-AKI was defined as an increase in SCr that occurred for the first time in the late phase (24-72 hours). The first endpoint of this study was long-term all-cause mortality. Kaplan-Meier analysis was used to count the cumulative mortality, and the log-rank test was used to assess differences between curves. Univariate and multivariate cox regression analyses were performed to assess whether patients who developed different type CA-AKI were at increased risk of long-term mortality. Results: The number of deaths in the 3 groups was 407 for normal (12.7%), 106 for early CA-AKI (32.7%) and 57 for late CA-AKI (17.7%), during a median follow-up period of 3.95 years. After adjusting for important clinical variables, early CA-AKI (HR = 1.33, 95% CI: 1.02-1.74, P=0.038) was significantly associated with mortality, while late CA-AKI (HR = 0.92, 95% CI: 0.65-1.31, P=0.633) was not. The same results were found in patients with coronary artery disease, chronic kidney disease, diabetes mellitus, and percutaneous coronary intervention. Conclusions: Early increases in Scr, i.e., early CA-AKI, have better predictive value for long-term mortality. Therefore, in clinical practice, physicians should pay more attention to patients with early renal injury related to long-term prognosis and give active treatment.


Assuntos
Injúria Renal Aguda , Meios de Contraste/efeitos adversos , Angiografia Coronária , Doença da Artéria Coronariana , Efeitos Adversos de Longa Duração , Injúria Renal Aguda/induzido quimicamente , Injúria Renal Aguda/diagnóstico , China/epidemiologia , Angiografia Coronária/efeitos adversos , Angiografia Coronária/métodos , Angiografia Coronária/mortalidade , Doença da Artéria Coronariana/sangue , Doença da Artéria Coronariana/diagnóstico , Doença da Artéria Coronariana/mortalidade , Creatinina/sangue , Feminino , Humanos , Efeitos Adversos de Longa Duração/etiologia , Efeitos Adversos de Longa Duração/mortalidade , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Risco Ajustado/métodos , Fatores de Risco
5.
Nutr Metab Cardiovasc Dis ; 31(6): 1840-1844, 2021 06 07.
Artigo em Inglês | MEDLINE | ID: mdl-33992511

RESUMO

BACKGROUND AND AIMS: Glycine is involved in a wide range of metabolic pathways and increased circulating glycine is associated with reduced risk of cardio-metabolic diseases in Europeans but the genetic association between circulating glycine and cardiovascular risk is largely unknown in East Asians. METHODS AND RESULTS: We conducted a genome-wide association study (GWAS) in Singaporean Chinese participants and investigated if genetically determined serum glycine were associated with incident coronary artery disease (CAD) (711 cases and 1,246 controls), cardiovascular death (1,886 cases and 21,707 controls) and angiographic CAD severity (as determined by the Modified Gensini score, N = 1,138). CONCLUSION: Our study, a first in East Asians, suggest a protective role of glycine against CAD.


Assuntos
Carbamoil-Fosfato Sintase (Amônia)/genética , Doença da Artéria Coronariana/genética , Glicina/sangue , Polimorfismo de Nucleotídeo Único , Grupo com Ancestrais do Continente Asiático/genética , Biomarcadores/sangue , Estudos de Casos e Controles , China/etnologia , Angiografia Coronária , Doença da Artéria Coronariana/sangue , Doença da Artéria Coronariana/diagnóstico por imagem , Doença da Artéria Coronariana/etnologia , Predisposição Genética para Doença , Estudo de Associação Genômica Ampla , Fatores de Risco de Doenças Cardíacas , Humanos , Incidência , Prognóstico , Estudos Prospectivos , Medição de Risco , Singapura/epidemiologia
6.
J Cardiothorac Surg ; 16(1): 120, 2021 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-33933109

RESUMO

BACKGROUND: Renal function plays a significant role in the prognosis and management of patients with multi-vessel coronary artery disease (CAD) referred for revascularization. Current data lack precise risk stratification using estimated glomerular filtration rate (eGFR) and creatinine clearance. METHODS: This prospective study includes a three-year follow-up of 1112 consecutive patients with multi-vessel CAD enrolled in the 22 hospitals in Israel that perform coronary angiography. RESULTS: The Mayo formula yielded the highest mean eGFR (90 ± 26 mL/min per 1.73m2) and chronic kidney disease-epidemiology collaboration (CKD-EPI) the lowest (76 ± 24 mL/min per 1.73m2). Consequently, the Mayo formula classified more patients (56%) as having normal renal function. There was a significant and strong correlation between the values obtained from all five formulas using Cockcroft-Gault as the reference formula: Mayo: r = 0.80, p < 0.001; CKD-EPI: r = 0.87, p < 0.001; modification of diet in renal disease (MDRD): r = 0.84, p < 0.001; inulin clearance-based: r = 0.99, p < 0.001). Multivariable analysis demonstrated that decreased renal function is an independent predictor of 3-year mortality in all five formulas, with risk increasing by 15-25% for each 10-unit decrease in eGFR. Despite the similarities between the formulas, the ability to predict mortality was highest in the Mayo formula and lowest in MDRD. CONCLUSIONS: Our data suggest that while the Mayo formula is not currently recommended by any nephrology guidelines, it may be an alternative formula to predict mortality among patients with multivessel CAD, including to the widely used MDRD formula.


Assuntos
Angiografia Coronária/métodos , Doença da Artéria Coronariana/cirurgia , Creatinina/sangue , Revascularização Miocárdica/métodos , Insuficiência Renal Crônica/complicações , Idoso , Doença da Artéria Coronariana/sangue , Doença da Artéria Coronariana/mortalidade , Feminino , Seguimentos , Taxa de Filtração Glomerular , Humanos , Israel , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Revascularização Miocárdica/mortalidade , Valor Preditivo dos Testes , Prognóstico , Estudos Prospectivos , Sistema de Registros , Insuficiência Renal Crônica/sangue , Insuficiência Renal Crônica/mortalidade , Risco
7.
Int Heart J ; 62(3): 528-533, 2021 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-33952807

RESUMO

This study aimed to identify the serum copeptin levels in patients diagnosed with unstable angina (UA) and evaluate the relationship between the patients' copeptin levels and angiographic severity.A total of 200 patients who were diagnosed with UA and underwent coronary angiography were included in the study. Clinical, electrocardiographic, echocardiographic, and laboratory data (high-sensitivity cardiac troponin T and copeptin levels) as well as The Global Registry of Acute Coronary Events (GRACE) 1.0 risk score were recorded upon admission. Moreover, the Synergy Between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) score was calculated following coronary angiography.We isolated and defined two subgroups within our study population: group 1 included patients with non-significant coronary artery disease (CAD) (< 50% diameter stenosis, n = 105); group 2 included patients with significant CAD (≥ 50% diameter stenosis, n = 95). The number of cases with a GRACE score higher than 140 was significantly higher in group 2 than in group 1 (P < 0.001). The SYNTAX scores and copeptin levels were significantly higher in group 2 than in group 1 (P < 0.001 for both). A positive correlation was observed between the copeptin levels and SYNTAX scores (r = 0.683; P < 0.001), and the cut-off level of copeptin was 18.3 pmol/L (sensitivity of 74.7%, specificity of 83.8%, and area under the curve of 0.795).This study suggests that it may be beneficial to use conventional scoring systems and serum copeptin levels when identifying high-risk UA patients.


Assuntos
Angina Instável/sangue , Doença da Artéria Coronariana/sangue , Glicopeptídeos/sangue , Idoso , Angina Instável/complicações , Biomarcadores/sangue , Doença da Artéria Coronariana/complicações , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
9.
Am J Med Sci ; 361(6): 751-758, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33892918

RESUMO

INTRODUCTION: Some studies indicate an association between coronary artery disease (CAD) and osteoporosis. This case-control study examined the association between body composition and bone mineral content (BMC) and density (BMD) among patients with CAD. MATERIALS AND METHODS: A group of men (n = 73) with established CAD and age and sex matched controls (n=65) were included in the study. Data collected included socio-demographic information, disease related data (from cases), anthropometric measurements, serum vitamin D, calcium and phosphorous and body composition analysis using DEXA. Two groups were compared using independent sample t-test, Mann Whitney U-test or Chi square test. Pearson correlation and regression models were used to test the associations between body compartments. RESULTS: Among cases, the mean disease duration was 29 (range 5-192) months and 15% had triple vessel disease. Patients had higher mean total body fat mass (TBFM) (18869.7 vs 16733.0) g, p = 0.018), truncal fat mass (TRFM) (9259.1 vs 7992.5 g, p = 0.009) and fat percentage (28.6 vs 25.9%, p = 0.001) compared to controls. Median serum vitamin D level was significantly lower among patients (20.0 ng/mL) compared to controls (27.1 ng/mL) (p = 0.003). In both groups, TBFM and total body lean mass (TBLM) both showed significant positive correlations with total body BMD/BMC and regional BMDs. Of the two, TBLM emerged the best predictor of TBBMC/TBBMD. These associations were greater among patients than controls. CONCLUSIONS: TBLM appears to be the strongest predictor of TBBMD and TBBMC in patients and controls. The strength of associations was greater among patients compared to controls even after adjusting for possible confounders .


Assuntos
Tecido Adiposo/fisiopatologia , Composição Corporal/fisiologia , Densidade Óssea/fisiologia , Doença da Artéria Coronariana/diagnóstico , Doença da Artéria Coronariana/fisiopatologia , Antropometria/métodos , Estudos de Casos e Controles , Doença da Artéria Coronariana/sangue , Estudos Transversais , Humanos , Masculino , Pessoa de Meia-Idade , Osteoporose/sangue , Osteoporose/diagnóstico , Osteoporose/fisiopatologia
10.
Crit Care ; 25(1): 158, 2021 04 26.
Artigo em Inglês | MEDLINE | ID: mdl-33902676

RESUMO

BACKGROUND: COVID-19 has resulted in high mortality worldwide. Information regarding cardiac markers for precise risk-stratification is limited. We aim to discover sensitive and reliable early-warning biomarkers for optimizing management and improving the prognosis of COVID-19 patients. METHODS: A total of 2954 consecutive COVID-19 patients who were receiving treatment from the Wuhan Huoshenshan Hospital in China from February 4 to April 10 were included in this retrospective cohort. Serum levels of cardiac markers were collected after admission. Coronary artery disease diagnosis and survival status were recorded. Single-cell RNA-sequencing and bulk RNA-sequencing from different cohorts of non-COVID-19 were performed to analyze SARS-CoV-2 receptor expression. RESULTS: Among 2954 COVID-19 patients in the analysis, the median age was 60 years (50-68 years), 1461 (49.5%) were female, and 1515 (51.3%) were severe/critical. Compared to mild/moderate (1439, 48.7%) patients, severe/critical patients showed significantly higher levels of cardiac markers within the first week after admission. In severe/critical COVID-19 patients, those with abnormal serum levels of BNP (42 [24.6%] vs 7 [1.1%]), hs-TNI (38 [48.1%] vs 6 [1.0%]), α- HBDH (55 [10.4%] vs 2 [0.2%]), CK-MB (45 [36.3%] vs 12 [0.9%]), and LDH (56 [12.5%] vs 1 [0.1%]) had a significantly higher mortality rate compared to patients with normal levels. The same trend was observed in the ICU admission rate. Severe/critical COVID-19 patients with pre-existing coronary artery disease (165/1,155 [10.9%]) had more cases of BNP (52 [46.5%] vs 119 [16.5%]), hs-TNI (24 [26.7%] vs 9.6 [%], α- HBDH (86 [55.5%] vs 443 [34.4%]), CK-MB (27 [17.4%] vs 97 [7.5%]), and LDH (65 [41.9%] vs 382 [29.7%]), when compared with those without coronary artery disease. There was enhanced SARS-CoV-2 receptor expression in coronary artery disease compared with healthy controls. From regression analysis, patients with five elevated cardiac markers were at a higher risk of death (hazards ratio 3.4 [95% CI 2.4-4.8]). CONCLUSIONS: COVID-19 patients with pre-existing coronary artery disease represented a higher abnormal percentage of cardiac markers, accompanied by high mortality and ICU admission rate. BNP together with hs-TNI, α- HBDH, CK-MB and LDH act as a prognostic biomarker in COVID-19 patients with or without pre-existing coronary artery disease.


Assuntos
Biomarcadores/sangue , COVID-19/sangue , COVID-19/terapia , Doença da Artéria Coronariana/sangue , Idoso , COVID-19/epidemiologia , China/epidemiologia , Doença da Artéria Coronariana/epidemiologia , Feminino , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Medição de Risco/métodos
11.
Nutrients ; 13(5)2021 Apr 28.
Artigo em Inglês | MEDLINE | ID: mdl-33924952

RESUMO

We aimed to investigate the causal effects of n-3 and n-6 polyunsaturated fatty acids (PUFAs) on the risk of coronary artery disease (CAD) through Mendelian randomization (MR) analysis. This MR study utilized a genetic instrument developed from previous genome-wide association studies for various serum n-3 and n-6 PUFA levels. First, we calculated the allele scores for genetic predisposition of PUFAs in individuals of European ancestry in the UK Biobank data (N = 337,129). The allele score-based MR was obtained by regressing the allele scores to CAD risks. Second, summary-level MR was performed with the CARDIoGRAMplusC4D data for CAD (N = 184,305). Higher genetically predicted eicosapentaenoic acid and dihomo-gamma-linolenic acid levels were significantly associated with a lower risk of CAD both in the allele-score-based and summary-level MR analyses. Higher allele scores for linoleic acid level were significantly associated with lower CAD risks, and in the summary-level MR, the causal estimates by the pleiotropy-robust MR methods also indicated that higher linoleic acid levels cause a lower risk of CAD. Arachidonic acid showed significant causal estimates for a higher risk of CAD. This study supports the causal effects of certain n-3 and n-6 PUFA types on the risk of CAD.


Assuntos
Doença da Artéria Coronariana/sangue , Ácidos Graxos Ômega-3/sangue , Ácidos Graxos Ômega-6/sangue , Análise da Randomização Mendeliana/métodos , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reino Unido
12.
Nutr Metab Cardiovasc Dis ; 31(5): 1454-1466, 2021 05 06.
Artigo em Inglês | MEDLINE | ID: mdl-33810955

RESUMO

BACKGROUND AND AIMS: Host-microbiota interactions involving metabolic pathways have been linked to the pathogenesis of atherosclerotic disease and type 2 diabetes. As stable coronary artery disease (SCAD) patients combined with type 2 diabetes have significantly increased risk for cardiac event, we focused on elucidating the role of microbiota affecting cardiometabolic disease development. METHODS AND RESULTS: We used multi-omics analyses (metagenomics and metabolomics) of fecal and serum samples from a prospective cohort including stable coronary artery disease combined with diabetes mellitus (SCAD + T2DM, n = 38), SCAD (n = 71), and healthy control (HC, n = 55). We linked microbiome features to disease severity in a three-pronged association analysis and identified prognostic bacterial biomarkers. We identified that bacterial and metabolic signatures varied significantly between SCAD and SCAD + T2DM groups. SCAD + T2DM individuals were characterized by increased levels of aromatic amino acids and carbohydrates, which correlate with a gut microbiome with enriched biosynthetic potential. Our study also addressed how metformin may confound gut dysbiosis and increase the potential for nitrogen metabolism. In addition, we found that specific bacterial taxa Ruminococcus torques [HR: 2.363 (08-4.56), P = 0.03] was predictive of cardiac survival outcomes. CONCLUSION: Overall, our study identified relationships between features of the gut microbiota (GM) and circulating metabolites, providing a new direction for future studies aiming to understand the host-GM interplay in atherosclerotic cardiovascular pathogenesis.


Assuntos
Bactérias/metabolismo , Doença da Artéria Coronariana/microbiologia , Diabetes Mellitus Tipo 2/microbiologia , Microbioma Gastrointestinal , Intestinos/microbiologia , Idoso , Bactérias/efeitos dos fármacos , Bactérias/crescimento & desenvolvimento , Biomarcadores/sangue , Estudos de Casos e Controles , Clostridiales/crescimento & desenvolvimento , Clostridiales/metabolismo , Doença da Artéria Coronariana/sangue , Doença da Artéria Coronariana/diagnóstico , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/tratamento farmacológico , Disbiose , Feminino , Microbioma Gastrointestinal/efeitos dos fármacos , Interações Hospedeiro-Patógeno , Humanos , Hipoglicemiantes/uso terapêutico , Masculino , Metabolômica , Metagenômica , Metformina/uso terapêutico , Pessoa de Meia-Idade , Prognóstico , Estudos Prospectivos
13.
Nutr Metab Cardiovasc Dis ; 31(5): 1533-1541, 2021 05 06.
Artigo em Inglês | MEDLINE | ID: mdl-33810961

RESUMO

BACKGROUND AND AIMS: Atherosclerotic calcification is a powerful predictor of cardiovascular disease. This study aims to determine whether circulating levels of a local/systemic calcification inhibitor or a marker of bone formation correlate with measures of coronary or extracoronary calcification. METHODS AND RESULTS: Clinical computed tomography (CT) was performed on 64 arterial disease participants undergoing carotid and lower extremity endarterectomy. Coronary artery calcium (CAC) scores and volumes were acquired from the CT scans (n = 42). CAC scores and volumes were used to derive CAC density scores. Micro-CT was performed on excised carotid (n = 36) and lower extremity (n = 31) plaques to quantify the volume and volume fraction of extracoronary calcification. Circulating levels of dephospho-uncarboxylated Matrix Gla Protein (dp-ucMGP), fetuin-A, carboxylated and uncarboxylated osteocalcin (ucOC) were quantified using commercial immunoassays. Carotid participant CAC density scores were moderately negatively correlated with plasma dp-ucMGP (rs = -0.592, P = 0.008). A weak negative association was found between CAC scores and %ucOC for all participants (rs = -0.335, P = 0.040). Another weak negative correlation was observed between fetuin-A and the volume of calcification within excised carotid specimens (rs = -0.366, P = 0.031). Despite substantial differences in coronary and extracoronary calcium measurements, the levels of circulating biomarkers did not vary significantly between carotid and lower extremity subgroups. CONCLUSION: Correlations identified between circulating biomarkers and measures of coronary and extracoronary calcium were not consistent among participant subgroups. Further research is required to determine the association between circulating biomarkers, coronary and extracoronary calcium.


Assuntos
Proteínas de Ligação ao Cálcio/sangue , Doenças das Artérias Carótidas/sangue , Doença da Artéria Coronariana/sangue , Proteínas da Matriz Extracelular/sangue , Extremidade Inferior/irrigação sanguínea , Osteocalcina/sangue , Doença Arterial Periférica/sangue , Calcificação Vascular/sangue , alfa-2-Glicoproteína-HS/análise , Idoso , Biomarcadores/sangue , Doenças das Artérias Carótidas/diagnóstico por imagem , Doenças das Artérias Carótidas/cirurgia , Angiografia por Tomografia Computadorizada , Angiografia Coronária , Doença da Artéria Coronariana/diagnóstico por imagem , Endarterectomia das Carótidas , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doença Arterial Periférica/diagnóstico , Doença Arterial Periférica/cirurgia , Placa Aterosclerótica , Valor Preditivo dos Testes , Calcificação Vascular/diagnóstico por imagem , Calcificação Vascular/cirurgia , Microtomografia por Raio-X
14.
Nutr Metab Cardiovasc Dis ; 31(5): 1501-1508, 2021 05 06.
Artigo em Inglês | MEDLINE | ID: mdl-33810962

RESUMO

BACKGROUND AND AIMS: Uric Acid (UA) has been related to the development of Cardio-Vascular (CV) events in patients affected by Chronic Coronary Syndromes (CCS). Among various hypothesis, two arise: UA may negatively act on coronary artery determining a higher degree of atherosclerotic disease, and/or on heart determining a higher prevalence of diastolic dysfunction. Both the above hypothesized effects are object of our investigation. METHODS AND RESULTS: 231 patients who were admitted to the cardiological department of the Niguarda Hospital (Milan, Italy) for CCS from January 2017 to June 2018 were enrolled. Coronary atherosclerotic burden was evaluated from coronary angiography as the number and type of involved vessels, as well as with both Gensini and Syntax scores. All subjects underwent a complete echocardiogram. At unadjusted and adjusted/multivariable analysis, UA levels were not significantly associated with variables analysed from the coronary angiography (number and type of vessels involved, neither the Gensini and Syntax scores) as well as with echocardiographic parameters regarding systolic and diastolic function. CONCLUSIONS: In conclusion, the main finding of our work is the absence of a role for UA in determining coronary arteries disease as well as LV diastolic dysfunction in CCS subjects. Taking together the results of previous studies with ours, we hypothesize that UA could act on heart (both on coronary arteries and on LV function) in an early phase of the disease, whereas while in the advanced stages other factors (previous myocardial infarction, previous myocardial revascularization and so on) may overshadow its effects.


Assuntos
Doença da Artéria Coronariana/sangue , Hiperuricemia/sangue , Ácido Úrico/sangue , Disfunção Ventricular Esquerda/sangue , Função Ventricular Esquerda , Idoso , Biomarcadores/sangue , Angiografia Coronária , Doença da Artéria Coronariana/diagnóstico por imagem , Doença da Artéria Coronariana/fisiopatologia , Estudos Transversais , Diástole , Ecocardiografia , Feminino , Humanos , Hiperuricemia/diagnóstico , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Índice de Gravidade de Doença , Disfunção Ventricular Esquerda/diagnóstico por imagem , Disfunção Ventricular Esquerda/fisiopatologia
15.
Nutr Metab Cardiovasc Dis ; 31(5): 1509-1515, 2021 05 06.
Artigo em Inglês | MEDLINE | ID: mdl-33810966

RESUMO

BACKGROUND & AIMS: Sarcopenia is a clinical syndrome that features muscle atrophy and weakness, and has been associated with cardiovascular events and poor clinical outcomes. Recently, the sarcopenia index (SI) was developed as a simple screening tool based upon the serum creatinine to cystatin C (CysC) ratio. We investigated the association between SI and the prevalence of major adverse cardiovascular events (MACE) in patients with obstructive CAD. METHODS & RESULTS: Between January 2010 and December 2018, patients with angina pectoris and obstructive CAD requiring coronary artery intervention were enrolled. Serum levels of CysC and other biomarkers were assessed. Patients were divided into two groups according to the SI ([Cr/CysC] x 100). Demographic characteristics and clinical outcomes of the two groups were evaluated. A total of 427 patients (79.6% men, mean age 69.55 ± 12.04 years) were enrolled. Patients with SI < 120 (n = 214, 28%) were older, more likely to be of the female gender, and to have more hypertension and congestive heart failure (all p < 0.05). The prevalence of major adverse cardiovascular events (MACE) composed of myocardial infarction, stroke, and all-cause mortality was higher in patients with lower SI (p = 0.026). After adjusting for potential confounding factors, multivariate Cox regression (hazard ratio 2.08, p = 0.045) and Kaplan-Meier analyses (log-rank p = 0.0371) revealed that lower SI was significantly associated with a higher prevalence of MACE. CONCLUSIONS: Serum creatinine to cystatin C ratio (SI) may be a useful surrogate marker to predict the future prevalence of MACE in patients with obstructive CAD.


Assuntos
Doença da Artéria Coronariana/terapia , Creatinina/sangue , Cistatina C/sangue , Intervenção Coronária Percutânea/efeitos adversos , Sarcopenia/sangue , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Composição Corporal , Doença da Artéria Coronariana/sangue , Doença da Artéria Coronariana/diagnóstico , Doença da Artéria Coronariana/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Sarcopenia/diagnóstico , Sarcopenia/epidemiologia , Fatores de Tempo , Resultado do Tratamento
16.
Nutr Metab Cardiovasc Dis ; 31(5): 1604-1612, 2021 05 06.
Artigo em Inglês | MEDLINE | ID: mdl-33812731

RESUMO

BACKGROUND AND AIMS: Overweight is associated with increased cardiovascular disease in general populations. However, a similar relationship among Kawasaki Disease (KD) patients was unclear. The study aimed to investigate the relation between weight-for-height and coronary artery lesions (CAL) among KD patients, and whether laboratory indices modified this relation. METHODS AND RESULTS: All consecutive KD patients from January 2009 to December 2014 in a city in China were reviewed, and classified into overweight/obese and control groups. All patients were followed to assess the occurrence of CAL by echocardiography for two months from disease onset. The independent effect of overweight/obesity on CAL was evaluated after adjustment for confounders. The interaction effect between overweight and laboratory indices was examined. The prevalence of overweight/obesity among KD patients was 18.5% (95%CI: 16.0%, 21.0%). The proportion of male patients and the proportion of non-standard IVIG treatment were significantly higher in overweight/obese children in comparison with their counterparts. Overweight/obesity was associated with increased odds of total CAL (aOR = 1.69, 95%CI: 1.16, 2.45) and also increased odds of CAL after treatment (aOR = 1.96, 95%CI: 1.09, 3.51); after adjustment for age, gender, KD type, change of medical departments, number of days before admission, treatment regimen and laboratory index. Similar results were found using stratification analysis. In addition, patients at risk of overweight were also associated with significantly increased risk of CAL. There was interaction between weight-for-height and platelet, WBC, and albumin. CONCLUSIONS: Overweight/obesity may be an independent risk factor for CAL among KD patients. Some laboratory indicators may modify this association.


Assuntos
Doença da Artéria Coronariana/epidemiologia , Síndrome de Linfonodos Mucocutâneos/epidemiologia , Obesidade Pediátrica/epidemiologia , Biomarcadores/sangue , Estatura , Peso Corporal , Pré-Escolar , China/epidemiologia , Doença da Artéria Coronariana/sangue , Doença da Artéria Coronariana/diagnóstico por imagem , Feminino , Humanos , Incidência , Lactente , Contagem de Leucócitos , Masculino , Síndrome de Linfonodos Mucocutâneos/sangue , Síndrome de Linfonodos Mucocutâneos/diagnóstico , Obesidade Pediátrica/sangue , Obesidade Pediátrica/diagnóstico , Contagem de Plaquetas , Valor Preditivo dos Testes , Prevalência , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Albumina Sérica Humana/análise
17.
Mol Med Rep ; 23(5)2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33760184

RESUMO

It has previously been shown that the number of endothelial progenitor cells (EPCs) is negatively correlated with Syntax score in patients with coronary artery disease (CAD). However, the association between alterations in EPC function and Syntax score is still unknown. The present study evaluated the association between the activity of EPCs as well as endothelial function and Syntax score in patients with CAD and investigated the underlying mechanisms. A total of 60 patients with CAD were enrolled in 3 groups according to Syntax score, and 20 healthy subjects were recruited as the control group. The number and migratory, proliferative and adhesive activities of circulating EPCs were studied. The endothelial function was measured by flow­mediated dilatation (FMD) and the levels of nitric oxide (NO) in plasma or secreted by EPCs were detected. The number and activity of circulating EPCs were lower in patients with a high Syntax score, which was similar to the alteration in FMD. The level of NO in plasma or secreted by EPCs also decreased as Syntax score increased. There was a negative association between FMD or circulating EPCs and Syntax score. A similar association was observed between the levels of NO in plasma or secreted by EPCs and Syntax score. Patients with CAD who had a higher Syntax score exhibited lower EPC numbers or activity and weaker endothelial function, which may be associated with attenuated NO production. These findings provide novel surrogate parameters for evaluation of the severity and complexity of CAD.


Assuntos
Doença da Artéria Coronariana/sangue , Células Progenitoras Endoteliais/metabolismo , Óxido Nítrico/sangue , Idoso , Movimento Celular/genética , Proliferação de Células/genética , Doença da Artéria Coronariana/genética , Doença da Artéria Coronariana/patologia , Endotélio Vascular/crescimento & desenvolvimento , Endotélio Vascular/metabolismo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Vasodilatação/genética
18.
Am J Med Sci ; 362(1): 63-71, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33647285

RESUMO

BACKGROUND: Irisin is a new muscle factor discovered in recent years that shows a strong association with metabolic diseases. However, its role in coronary artery disease (CAD) is still controversial. We performed this study to determine the relationship of serum irisin with the characteristics and prognosis of CAD. MATERIALS AND METHODS: Patients with acute coronary syndrome (ACS) (n = 355), stable coronary artery disease (SCAD) (n = 162), nonobstructive coronary artery disease (NO-CAD) (n = 126) and normal coronary arteries (n = 109) were enrolled. An enzyme-linked immunosorbent assay kit was used to measure serum irisin concentrations. Major adverse cardiovascular events (MACEs) of patients with SCAD (n = 132) and ACS (n = 331) after percutaneous coronary intervention (PCI) were recorded during a 12-month follow-up. Receiver-operator characteristic (ROC) curve analysis was used to explore predictors of CAD. Kaplan-Meier survival analysis and the Cox proportional hazards regression model were used to explore the association between serum irisin levels and MACEs. RESULTS: Serum irisin levels in patients with ACS, SCAD, NO-CAD and normal coronary arteries were 196.62±72.05 ng/ml, 216.81±79.69 ng/ml, 245.26±77.92 ng/ml and 300.17±76.74 ng/ml, respectively (p<0.001). ROC curve analysis indicated that serum irisin concentrations were a valuable biomarker of coronary lesions (AUC=0.799), CAD (AUC=0.734) and ACS (AUC=0.681). Survival analysis demonstrated that patients with high irisin levels exhibited a higher event-free survival rate in both the SCAD and ACS groups after successful PCI. CONCLUSIONS: Serum irisin levels were significantly decreased in patients with CAD. Patients with ACS exhibited the lowest serum irisin levels. Furthermore, serum irisin levels were interrelated with prognosis in patients with CAD after PCI.


Assuntos
Doença da Artéria Coronariana/sangue , Doença da Artéria Coronariana/diagnóstico por imagem , Fibronectinas/sangue , Idoso , Biomarcadores/sangue , Angiografia Coronária/métodos , Doença da Artéria Coronariana/fisiopatologia , Eletrocardiografia/métodos , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico
19.
Angiology ; 72(6): 575-581, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33685239

RESUMO

Systemic immune-inflammation index (SII; platelet count × neutrophil-to-lymphocyte ratio), a novel marker, predicts adverse clinical outcomes in coronary artery diseases (CAD). We hypothesized that SII could provide more valuable information in assessing the severity of CAD than ratios obtained from other white blood cell subtypes. Patients (n = 669) who underwent coronary angiography were analyzed in this retrospective study. We analyzed the relation between the SII and the angiographic severity of CAD. The severity of coronary atherosclerosis was determined by the SYNTAX score (SxS). Patients with CAD were divided into 3 groups according to the SxS. Multivariate logistic analysis was used to assess risk factors of CAD. In multivariate logistic regression analysis, the SII (odds ratio: 1.004; 95% CI: 1.001-1.007; P = .015) was an independent predictor of high SxS. Additionally, there was a positive correlation between SII and SxS (Rho: 0.630, P ≤ .001). In the receiver-operating characteristic curve analysis, SII with an optimal cutoff value of 750 × 103 predicted the severe coronary lesion with a sensitivity of 86.2% and specificity of 87.3%. The SII, an inexpensive and easily measurable laboratory variable, was significantly associated with the severity of CAD and high SxS in patients with stable angina pectoris.


Assuntos
Angina Estável/imunologia , Plaquetas/imunologia , Doença da Artéria Coronariana/imunologia , Inflamação/imunologia , Linfócitos/imunologia , Neutrófilos/imunologia , Idoso , Angina Estável/sangue , Angina Estável/diagnóstico por imagem , Angiografia Coronária , Doença da Artéria Coronariana/sangue , Doença da Artéria Coronariana/diagnóstico por imagem , Estudos Transversais , Feminino , Humanos , Inflamação/sangue , Inflamação/diagnóstico , Contagem de Linfócitos , Masculino , Pessoa de Meia-Idade , Contagem de Plaquetas , Valor Preditivo dos Testes , Prognóstico , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Índice de Gravidade de Doença
20.
Int Heart J ; 62(2): 396-406, 2021 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-33731537

RESUMO

Endothelial injury and inflammation have been found to be essential in the pathogenesis of coronary artery disease (CAD). Circulating exosomes are of great value as novel biomarkers for CAD. However, the role of circulating exosomes in the pathogenesis of CAD remains unclear. Thus, in this study, we aimed to examine whether circulating exosomes from CAD are involved in the endothelial injury and inflammation. The serum-derived exosomes were isolated from CAD and controls using an ExoQuick reagent, and these were then quantified by measuring the protein levels using BCA methods. The uptake of exosomes by human umbilical vein endothelial cells (HUVECs) was observed by laser scanning microscope and analyzed via flow cytometry. Then, HUVECs were treated with vehicle, exosomes from CAD (CAD-exo), and controls (ctrl-exo) in the absence and presence of vascular endothelial growth factor (VEGF). Cell viability, migration, and angiogenesis were evaluated using CCK-8 assay, scratch assay, and tube formation assay. Inflammatory factors including IL-1ß, IL-6, TNF-α, ICAM-1, and VCAM-1 levels were detected via qPCR. As per our findings, no significant differences were noted in uptake of ctrl-exo and CAD-exo by HUVECs. CAD-exo suppressed cell viability in a dose-dependent manner. Compared with ctrl-exo, CAD-exo-treated HUVECs significantly suppressed migration and angiogenesis. However, CAD-exo had a stronger inhibitory effect on VEGF-induced migration and angiogenesis compared with ctrl-exo. Moreover, IL-1ß, TNF-α, and ICAM-1 were determined to be significantly upregulated in HUVECs treated with CAD-exo, but IL-6 and VCAM-1 expressions were not affected. Overall, our results suggest that CAD-exo are involved in endothelial injury and inflammation, which may, in turn, cause endothelial dysfunction and potentially promote the development of CAD.


Assuntos
Doença da Artéria Coronariana/sangue , Exossomos/metabolismo , Movimento Celular , Proliferação de Células , Células Cultivadas , Doença da Artéria Coronariana/patologia , Feminino , Citometria de Fluxo , Células Endoteliais da Veia Umbilical Humana/metabolismo , Células Endoteliais da Veia Umbilical Humana/patologia , Humanos , Inflamação/metabolismo , Inflamação/patologia , Masculino , Pessoa de Meia-Idade
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