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Yang X, Zhang Z, Sun J, Zhang W. Global, regional, and national burden of ischemic heart disease attributable to secondhand smoke from 1990 to 2019. Tob Induc Dis 2024; 22:TID-22-123. [PMID: 38966818 PMCID: PMC11223517 DOI: 10.18332/tid/189771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2024] [Revised: 06/04/2024] [Accepted: 06/07/2024] [Indexed: 07/06/2024] Open
Abstract
INTRODUCTION Assessing the burden of ischemic heart disease (IHD) attributable to secondhand smoke (SHS) exposure is crucial for informing evidence-based healthcare practices, prevention strategies, and resource allocation planning. METHODS The burden of IHD attributable to SHS from 1990 to 2019 was assessed using the comparative risk assessment method as part of the Global Burden of Disease (GBD) study 2019. RESULTS Globally, the absolute number of deaths and disability-adjusted life-years (DALYs) from IHD due to SHS increased substantially from 270.0 thousand and 6971.3 thousand in 1990 to 397.4 thousand and 9566.1 thousand in 2019. The corresponding age-standardized mortality rates (ASMR) and age-standardized DALYs rates (ASDR) were both in a decreasing trend with estimate of the annual percentage change (EAPC) of -1.38 (-1.42 - -1.34) and -1.43 (-1.47 - -1.38). Central Asia has the highest ASMR (16 per 100000, 95% uncertainty interval, UI: 12.8-19.4), and Oceania has the highest ASDR (323.2 per 100000, 95% UI: 228.9-443.1 per 100000) in 2019. All sociodemographic index (SDI) category regions showed a decreasing trend in ASMR and ASDR, with the decrease being more obvious in high and high-middle SDI regions. Our analysis identified an escalating trend concerning ASMR and ASDR in Oceania from 1990 to 2019. In 2019, the most significant number of deaths and DALYs occurred in the age group of 80-84 years (5.4 thousand, 95% UI: 3.7-7.3 in thousands) and the age group of 55-59 years (1140.8 thousand, 95% UI: 876.1-1435 in thousands). CONCLUSIONS Our study reveals an absolute global increase in deaths and DALYs from IHD due to SHS from 1990 to 2019. Despite a declining trend in ASMR and ASDR, regional disparities persist. The elderly and middle-aged populations bore the most significant burden. These findings highlight the ongoing global health impact of SHS on IHD and emphasize the need for targeted interventions in regions with rising trends and vulnerable age groups.
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Affiliation(s)
- Xinyue Yang
- Department of Cardiovascular Medicine, Tianjin Medical University General Hospital, Tianjin, China
| | - Zhiqiang Zhang
- Department of Cardiovascular Medicine, Tianjin Medical University General Hospital, Tianjin, China
| | - Jiayi Sun
- Department of Cardiovascular Medicine, Tianjin Medical University General Hospital, Tianjin, China
| | - Wenjuan Zhang
- Department of Cardiovascular Medicine, Tianjin Medical University General Hospital, Tianjin, China
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Kijpaisalratana N, Ament Z, Patki A, Bhave VM, Jones AC, Couch CA, Guarniz ALG, Cushman M, Long DL, Judd SE, Irvin MR, Kimberly WT. Plasma Metabolites and Life's Simple 7 in REGARDS. Stroke 2024; 55:1191-1199. [PMID: 38482689 PMCID: PMC11039367 DOI: 10.1161/strokeaha.123.044714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 01/31/2024] [Indexed: 04/24/2024]
Abstract
BACKGROUND The American Heart Association's Life's Simple 7 (LS7) is a health metric that captures important factors associated with cardiovascular and cerebrovascular health. Previous studies highlight the potential of plasma metabolites to serve as a marker for lifestyle and health behavior that could be a target for stroke prevention. The objectives of this study were to identify metabolites that were associated with LS7 and incident ischemic stroke and mediate the relationship between the two. METHODS Targeted metabolomic profiling of 162 metabolites by liquid chromatography-tandem mass spectrometry was used to identify candidate metabolites in a stroke case-cohort nested within the REGARDS study (Reasons for Geographic and Racial Differences in Stroke). Weighted linear regression and weighted Cox proportional hazard models were used to identify metabolites that were associated with LS7 and incident ischemic stroke, respectively. Effect measures were based on a 1-SD change in metabolite level. Metabolite mediators were examined using inverse odds ratio weighting mediation analysis. RESULTS The study comprised 1075 ischemic stroke cases and 968 participants in the random cohort sample. Three out of 162 metabolites were associated with the overall LS7 score including guanosine (β, -0.46 [95% CI, -0.65 to -0.27]; P=2.87×10-6), cotinine (β, -0.49 [95% CI, -0.70 to -0.28]; P=7.74×10-6), and acetylneuraminic acid (β, -0.59 [95% CI, -0.77 to -0.42]; P=4.29×10-11). Guanosine (hazard ratio, 1.47 [95% CI, 1.31-1.65]; P=6.97×10-11), cotinine (hazard ratio, 1.30 [95% CI, 1.16-1.44]; P=2.09×10-6), and acetylneuraminic acid (hazard ratio, 1.29 [95% CI, 1.15-1.45]; P=9.24×10-6) were associated with incident ischemic stroke. The mediation analysis identified guanosine (27% mediation, indirect effect; P=0.002), cotinine (30% mediation, indirect effect; P=0.004), and acetylneurminic acid (22% mediation, indirect effect; P=0.041) partially mediated the relationship between LS7 and ischemic stroke. CONCLUSIONS We identified guanosine, cotinine, and acetylneuraminic acid that were associated with LS7, incident ischemic stroke, and mediated the relationship between LS7 and ischemic stroke.
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Affiliation(s)
- Naruchorn Kijpaisalratana
- Center for Genomic Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Division of Neurology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Division of Academic Affairs, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Zsuzsanna Ament
- Center for Genomic Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Amit Patki
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL
| | | | - Alana C Jones
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL
| | - Catharine A. Couch
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL
| | | | - Mary Cushman
- Department of Medicine, Larner College of Medicine at the University of Vermont, Burlington, VT
| | - D. Leann Long
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL
| | - Suzanne E. Judd
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL
| | - M. Ryan Irvin
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL
| | - W. Taylor Kimberly
- Center for Genomic Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA
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Abellán Alemán J, Sabaris RC, Pardo DE, García Donaire JA, Romanos FG, Iriso JI, Penagos LM, Iglesias LJN, de Salinas APM, Pérez-Monteoliva NRR, Lezcano PSR, Saborido MT, Roca FV. Documento de consenso sobre tabaquismo y riesgo vascular. HIPERTENSION Y RIESGO VASCULAR 2024; 41 Suppl 1:S1-S85. [PMID: 38729667 DOI: 10.1016/s1889-1837(24)00075-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2024]
Abstract
Consensus statement on smoking and vascular risk About 22% of the Spanish population are daily smokers. Men are more likely to smoke than women. In Spain, women between 15-25 years of age smoke as much or more than men. Every smoker should be assessed for: physical dependence on nicotine (Fagerström test), social and psychological dependence (Glover Nilsson test), level of motivation to quit (Richmond test), probability of therapy success (Henri-Mondor and Michael-Fiore tests), and stage of behavioral change development (Prochaska and DiClementi). Advice on smoking cessation is highly cost-effective and should always be provided. Smoking is an enhancer of cardiovascular risk because it acts as a pathogen agent in the development of arteriosclerosis and is associated with ischemic heart disease, stroke, and peripheral artery disease. Smoking increases the risk of chronic lung diseases (COPD) and is related to cancers of the lung, female genitalia, larynx, oropharynx, bladder, mouth, esophagus, liver and biliary tract, and stomach, among others. Combined oral contraceptives should be avoided in women smokers older than 35 years of age due to the risk of thromboembolism. In smoking cessation, the involvement of physicians, nurses, psychologists, etc. is important, and their multidisciplinary collaboration is needed. Effective pharmacological treatments for smoking cessation are available. Combined treatments are recommended when smoker's dependence is high. For individuals who are unable to quit smoking, a strategy based on tobacco damage management with a total switch to smokeless products could be a less dangerous alternative for their health than continuing to smoke.
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Affiliation(s)
- José Abellán Alemán
- Sociedad Murciana de Hipertensión Arterial y Riesgo Cardiovascular, Cátedra de Riesgo Cardiovascular, Universidad Católica de Murcia, Murcia, España.
| | - Rafael Crespo Sabaris
- Sociedad Riojana de Hipertensión y Riesgo Vascular, Centro de Salud de Entrena, La Rioja, España
| | - Daniel Escribano Pardo
- Sociedad Aragonesa de Hipertensión y Riesgo Vascular, Centro de Salud Oliver, Zaragoza, España
| | - José Antonio García Donaire
- Sociedad Española de Hipertensión, Unidad de Hipertensión, Servicio de Medicina Interna, Hospital Clínico Universitario San Carlos, Madrid, España
| | - Fernando García Romanos
- Sociedad de Hipertensión y Riesgo Vascular de las Illes Balears, Centro de Salud Santa Catalina, Palma de Mallorca, España
| | - Jesús Iturralde Iriso
- Sociedad Vasca de Hipertensión y Riesgo Vascular, Centro de Salud la Habana-Cuba, Vitoria-Gasteiz, España
| | - Luis Martín Penagos
- Sociedad Cántabra de Hipertensión y Riesgo Vascular, Servicio de Nefrología, Hospital Universitario Marqués de Valdecilla, Santander, España
| | - L Javier Nieto Iglesias
- Sociedad Castilla-La Mancha de Hipertensión y Riesgo Vascular, Unidad de Hipertensión y Riesgo Vascular, Servicio de Nefrología, Hospital General Universitario de Ciudad Real, Ciudad Real, España
| | - Alfonso Pobes Martínez de Salinas
- Sociedad Asturiana de Hipertensión y Riesgo Vascular, Área de Gestión Clínica, Interáreas de Nefrología VII y VIII del SESPA, Asturias, España
| | | | - Pablo Sánchez-Rubio Lezcano
- Sociedad Aragonesa de Hipertensión y Riesgo Vascular, Servicio de Medicina Interna, Hospital General Universitario San Jorge, Huesca, España
| | - Maribel Troya Saborido
- Sociedad Catalana de Hipertensión y Riesgo Vascular, Servicio de Nefrología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España
| | - Francisco Valls Roca
- Sociedad Valenciana de Hipertensión y Riesgo Vascular, Centro de Salud de Beniganim, Valencia, España
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4
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Holmes KR, Gulsin GS, Fairbairn TA, Hurwitz-Koweek L, Matsuo H, Nørgaard BL, Jensen JM, Sand NPR, Nieman K, Bax JJ, Pontone G, Chinnaiyan KM, Rabbat MG, Amano T, Kawasaki T, Akasaka T, Kitabata H, Rogers C, Patel MR, Payne GW, Leipsic JA, Sellers SL. Impact of Smoking on Coronary Volume-to-Myocardial Mass Ratio: An ADVANCE Registry Substudy. Radiol Cardiothorac Imaging 2024; 6:e220197. [PMID: 38483246 PMCID: PMC11056751 DOI: 10.1148/ryct.220197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 10/30/2023] [Accepted: 01/26/2024] [Indexed: 04/19/2024]
Abstract
Purpose To examine the relationship between smoking status and coronary volume-to-myocardial mass ratio (V/M) among individuals with coronary artery disease (CAD) undergoing CT fractional flow reserve (CT-FFR) analysis. Materials and Methods In this secondary analysis, participants from the ADVANCE registry evaluated for suspected CAD from July 15, 2015, to October 20, 2017, who were found to have coronary stenosis of 30% or greater at coronary CT angiography (CCTA) were included if they had known smoking status and underwent CT-FFR and V/M analysis. CCTA images were segmented to calculate coronary volume and myocardial mass. V/M was compared between smoking groups, and predictors of low V/M were determined. Results The sample for analysis included 503 current smokers, 1060 former smokers, and 1311 never-smokers (2874 participants; 1906 male participants). After adjustment for demographic and clinical factors, former smokers had greater coronary volume than never-smokers (former smokers, 3021.7 mm3 ± 934.0 [SD]; never-smokers, 2967.6 mm3 ± 978.0; P = .002), while current smokers had increased myocardial mass compared with never-smokers (current smokers, 127.8 g ± 32.9; never-smokers, 118.0 g ± 32.5; P = .02). However, both current and former smokers had lower V/M than never-smokers (current smokers, 24.1 mm3/g ± 7.9; former smokers, 24.9 mm3/g ± 7.1; never-smokers, 25.8 mm3/g ± 7.4; P < .001 [unadjusted] and P = .002 [unadjusted], respectively). Current smoking status (odds ratio [OR], 0.74 [95% CI: 0.59, 0.93]; P = .009), former smoking status (OR, 0.81 [95% CI: 0.68, 0.97]; P = .02), stenosis of 50% or greater (OR, 0.62 [95% CI: 0.52, 0.74]; P < .001), and diabetes (OR, 0.67 [95% CI: 0.56, 0.82]; P < .001) were independent predictors of low V/M. Conclusion Both current and former smoking status were independently associated with low V/M. Keywords: CT Angiography, Cardiac, Heart, Ischemia/Infarction Clinical trial registration no. NCT02499679 Supplemental material is available for this article. © RSNA, 2024.
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Affiliation(s)
- Kenneth R. Holmes
- From the Department of Radiology (K.R.H., G.S.G., J.A.L., S.L.S.) and
Centre for Heart Lung Innovation & Providence Research (G.S.G., J.A.L.,
S.L.S.), St Paul’s Hospital and University of British Columbia, 1081
Burrard St, Vancouver, BC, Canada V6Z 1Y6; Liverpool Heart and Chest Hospital,
Liverpool, England (T.A.F.); Department of Radiology, Duke University School of
Medicine, Durham, NC (L.H.K., M.R.P.); Wakayama Medical University, Wakayama,
Japan (H.M., T. Akasaka, H.K.); Department of Cardiology, Aarhus University
Hospital, Aarhus, Denmark (B.L.N., J.M.J.); Department of Cardiology, University
Hospital of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Department of
Regional Health Research, University of Southern Denmark, Esbjerg, Denmark
(N.P.R.S.); Erasmus Medical Center, Rotterdam, the Netherlands (K.N.);
Department of Cardiology, Leiden University Medical Center, Leiden, the
Netherlands (J.J.B.); Centro Cardiologico Monzino, Scientific Institute for
Research, Hospitalization and Healthcare (IRCCS), University of Milan, Milan,
Italy (G.P.); William Beaumont Hospital, Royal Oak, Mich (K.M.C.); Loyola
University Medical Center, Maywood, Ill (M.G.R.); Aichi Medical University,
Aichi, Japan (T. Amano); Department of Cardiology, Shin Koga Hospital, Fukuoka,
Japan (T.K.); HeartFlow, Redwood City, Calif (C.R.); and University of Northern
British Columbia, Prince George, British Columbia, Canada (G.W.P.)
| | - Gaurav S. Gulsin
- From the Department of Radiology (K.R.H., G.S.G., J.A.L., S.L.S.) and
Centre for Heart Lung Innovation & Providence Research (G.S.G., J.A.L.,
S.L.S.), St Paul’s Hospital and University of British Columbia, 1081
Burrard St, Vancouver, BC, Canada V6Z 1Y6; Liverpool Heart and Chest Hospital,
Liverpool, England (T.A.F.); Department of Radiology, Duke University School of
Medicine, Durham, NC (L.H.K., M.R.P.); Wakayama Medical University, Wakayama,
Japan (H.M., T. Akasaka, H.K.); Department of Cardiology, Aarhus University
Hospital, Aarhus, Denmark (B.L.N., J.M.J.); Department of Cardiology, University
Hospital of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Department of
Regional Health Research, University of Southern Denmark, Esbjerg, Denmark
(N.P.R.S.); Erasmus Medical Center, Rotterdam, the Netherlands (K.N.);
Department of Cardiology, Leiden University Medical Center, Leiden, the
Netherlands (J.J.B.); Centro Cardiologico Monzino, Scientific Institute for
Research, Hospitalization and Healthcare (IRCCS), University of Milan, Milan,
Italy (G.P.); William Beaumont Hospital, Royal Oak, Mich (K.M.C.); Loyola
University Medical Center, Maywood, Ill (M.G.R.); Aichi Medical University,
Aichi, Japan (T. Amano); Department of Cardiology, Shin Koga Hospital, Fukuoka,
Japan (T.K.); HeartFlow, Redwood City, Calif (C.R.); and University of Northern
British Columbia, Prince George, British Columbia, Canada (G.W.P.)
| | - Timothy A. Fairbairn
- From the Department of Radiology (K.R.H., G.S.G., J.A.L., S.L.S.) and
Centre for Heart Lung Innovation & Providence Research (G.S.G., J.A.L.,
S.L.S.), St Paul’s Hospital and University of British Columbia, 1081
Burrard St, Vancouver, BC, Canada V6Z 1Y6; Liverpool Heart and Chest Hospital,
Liverpool, England (T.A.F.); Department of Radiology, Duke University School of
Medicine, Durham, NC (L.H.K., M.R.P.); Wakayama Medical University, Wakayama,
Japan (H.M., T. Akasaka, H.K.); Department of Cardiology, Aarhus University
Hospital, Aarhus, Denmark (B.L.N., J.M.J.); Department of Cardiology, University
Hospital of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Department of
Regional Health Research, University of Southern Denmark, Esbjerg, Denmark
(N.P.R.S.); Erasmus Medical Center, Rotterdam, the Netherlands (K.N.);
Department of Cardiology, Leiden University Medical Center, Leiden, the
Netherlands (J.J.B.); Centro Cardiologico Monzino, Scientific Institute for
Research, Hospitalization and Healthcare (IRCCS), University of Milan, Milan,
Italy (G.P.); William Beaumont Hospital, Royal Oak, Mich (K.M.C.); Loyola
University Medical Center, Maywood, Ill (M.G.R.); Aichi Medical University,
Aichi, Japan (T. Amano); Department of Cardiology, Shin Koga Hospital, Fukuoka,
Japan (T.K.); HeartFlow, Redwood City, Calif (C.R.); and University of Northern
British Columbia, Prince George, British Columbia, Canada (G.W.P.)
| | - Lynne Hurwitz-Koweek
- From the Department of Radiology (K.R.H., G.S.G., J.A.L., S.L.S.) and
Centre for Heart Lung Innovation & Providence Research (G.S.G., J.A.L.,
S.L.S.), St Paul’s Hospital and University of British Columbia, 1081
Burrard St, Vancouver, BC, Canada V6Z 1Y6; Liverpool Heart and Chest Hospital,
Liverpool, England (T.A.F.); Department of Radiology, Duke University School of
Medicine, Durham, NC (L.H.K., M.R.P.); Wakayama Medical University, Wakayama,
Japan (H.M., T. Akasaka, H.K.); Department of Cardiology, Aarhus University
Hospital, Aarhus, Denmark (B.L.N., J.M.J.); Department of Cardiology, University
Hospital of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Department of
Regional Health Research, University of Southern Denmark, Esbjerg, Denmark
(N.P.R.S.); Erasmus Medical Center, Rotterdam, the Netherlands (K.N.);
Department of Cardiology, Leiden University Medical Center, Leiden, the
Netherlands (J.J.B.); Centro Cardiologico Monzino, Scientific Institute for
Research, Hospitalization and Healthcare (IRCCS), University of Milan, Milan,
Italy (G.P.); William Beaumont Hospital, Royal Oak, Mich (K.M.C.); Loyola
University Medical Center, Maywood, Ill (M.G.R.); Aichi Medical University,
Aichi, Japan (T. Amano); Department of Cardiology, Shin Koga Hospital, Fukuoka,
Japan (T.K.); HeartFlow, Redwood City, Calif (C.R.); and University of Northern
British Columbia, Prince George, British Columbia, Canada (G.W.P.)
| | - Hitoshi Matsuo
- From the Department of Radiology (K.R.H., G.S.G., J.A.L., S.L.S.) and
Centre for Heart Lung Innovation & Providence Research (G.S.G., J.A.L.,
S.L.S.), St Paul’s Hospital and University of British Columbia, 1081
Burrard St, Vancouver, BC, Canada V6Z 1Y6; Liverpool Heart and Chest Hospital,
Liverpool, England (T.A.F.); Department of Radiology, Duke University School of
Medicine, Durham, NC (L.H.K., M.R.P.); Wakayama Medical University, Wakayama,
Japan (H.M., T. Akasaka, H.K.); Department of Cardiology, Aarhus University
Hospital, Aarhus, Denmark (B.L.N., J.M.J.); Department of Cardiology, University
Hospital of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Department of
Regional Health Research, University of Southern Denmark, Esbjerg, Denmark
(N.P.R.S.); Erasmus Medical Center, Rotterdam, the Netherlands (K.N.);
Department of Cardiology, Leiden University Medical Center, Leiden, the
Netherlands (J.J.B.); Centro Cardiologico Monzino, Scientific Institute for
Research, Hospitalization and Healthcare (IRCCS), University of Milan, Milan,
Italy (G.P.); William Beaumont Hospital, Royal Oak, Mich (K.M.C.); Loyola
University Medical Center, Maywood, Ill (M.G.R.); Aichi Medical University,
Aichi, Japan (T. Amano); Department of Cardiology, Shin Koga Hospital, Fukuoka,
Japan (T.K.); HeartFlow, Redwood City, Calif (C.R.); and University of Northern
British Columbia, Prince George, British Columbia, Canada (G.W.P.)
| | - Bjarne L. Nørgaard
- From the Department of Radiology (K.R.H., G.S.G., J.A.L., S.L.S.) and
Centre for Heart Lung Innovation & Providence Research (G.S.G., J.A.L.,
S.L.S.), St Paul’s Hospital and University of British Columbia, 1081
Burrard St, Vancouver, BC, Canada V6Z 1Y6; Liverpool Heart and Chest Hospital,
Liverpool, England (T.A.F.); Department of Radiology, Duke University School of
Medicine, Durham, NC (L.H.K., M.R.P.); Wakayama Medical University, Wakayama,
Japan (H.M., T. Akasaka, H.K.); Department of Cardiology, Aarhus University
Hospital, Aarhus, Denmark (B.L.N., J.M.J.); Department of Cardiology, University
Hospital of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Department of
Regional Health Research, University of Southern Denmark, Esbjerg, Denmark
(N.P.R.S.); Erasmus Medical Center, Rotterdam, the Netherlands (K.N.);
Department of Cardiology, Leiden University Medical Center, Leiden, the
Netherlands (J.J.B.); Centro Cardiologico Monzino, Scientific Institute for
Research, Hospitalization and Healthcare (IRCCS), University of Milan, Milan,
Italy (G.P.); William Beaumont Hospital, Royal Oak, Mich (K.M.C.); Loyola
University Medical Center, Maywood, Ill (M.G.R.); Aichi Medical University,
Aichi, Japan (T. Amano); Department of Cardiology, Shin Koga Hospital, Fukuoka,
Japan (T.K.); HeartFlow, Redwood City, Calif (C.R.); and University of Northern
British Columbia, Prince George, British Columbia, Canada (G.W.P.)
| | - Jesper M. Jensen
- From the Department of Radiology (K.R.H., G.S.G., J.A.L., S.L.S.) and
Centre for Heart Lung Innovation & Providence Research (G.S.G., J.A.L.,
S.L.S.), St Paul’s Hospital and University of British Columbia, 1081
Burrard St, Vancouver, BC, Canada V6Z 1Y6; Liverpool Heart and Chest Hospital,
Liverpool, England (T.A.F.); Department of Radiology, Duke University School of
Medicine, Durham, NC (L.H.K., M.R.P.); Wakayama Medical University, Wakayama,
Japan (H.M., T. Akasaka, H.K.); Department of Cardiology, Aarhus University
Hospital, Aarhus, Denmark (B.L.N., J.M.J.); Department of Cardiology, University
Hospital of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Department of
Regional Health Research, University of Southern Denmark, Esbjerg, Denmark
(N.P.R.S.); Erasmus Medical Center, Rotterdam, the Netherlands (K.N.);
Department of Cardiology, Leiden University Medical Center, Leiden, the
Netherlands (J.J.B.); Centro Cardiologico Monzino, Scientific Institute for
Research, Hospitalization and Healthcare (IRCCS), University of Milan, Milan,
Italy (G.P.); William Beaumont Hospital, Royal Oak, Mich (K.M.C.); Loyola
University Medical Center, Maywood, Ill (M.G.R.); Aichi Medical University,
Aichi, Japan (T. Amano); Department of Cardiology, Shin Koga Hospital, Fukuoka,
Japan (T.K.); HeartFlow, Redwood City, Calif (C.R.); and University of Northern
British Columbia, Prince George, British Columbia, Canada (G.W.P.)
| | - Niels-Peter Rønnow Sand
- From the Department of Radiology (K.R.H., G.S.G., J.A.L., S.L.S.) and
Centre for Heart Lung Innovation & Providence Research (G.S.G., J.A.L.,
S.L.S.), St Paul’s Hospital and University of British Columbia, 1081
Burrard St, Vancouver, BC, Canada V6Z 1Y6; Liverpool Heart and Chest Hospital,
Liverpool, England (T.A.F.); Department of Radiology, Duke University School of
Medicine, Durham, NC (L.H.K., M.R.P.); Wakayama Medical University, Wakayama,
Japan (H.M., T. Akasaka, H.K.); Department of Cardiology, Aarhus University
Hospital, Aarhus, Denmark (B.L.N., J.M.J.); Department of Cardiology, University
Hospital of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Department of
Regional Health Research, University of Southern Denmark, Esbjerg, Denmark
(N.P.R.S.); Erasmus Medical Center, Rotterdam, the Netherlands (K.N.);
Department of Cardiology, Leiden University Medical Center, Leiden, the
Netherlands (J.J.B.); Centro Cardiologico Monzino, Scientific Institute for
Research, Hospitalization and Healthcare (IRCCS), University of Milan, Milan,
Italy (G.P.); William Beaumont Hospital, Royal Oak, Mich (K.M.C.); Loyola
University Medical Center, Maywood, Ill (M.G.R.); Aichi Medical University,
Aichi, Japan (T. Amano); Department of Cardiology, Shin Koga Hospital, Fukuoka,
Japan (T.K.); HeartFlow, Redwood City, Calif (C.R.); and University of Northern
British Columbia, Prince George, British Columbia, Canada (G.W.P.)
| | - Koen Nieman
- From the Department of Radiology (K.R.H., G.S.G., J.A.L., S.L.S.) and
Centre for Heart Lung Innovation & Providence Research (G.S.G., J.A.L.,
S.L.S.), St Paul’s Hospital and University of British Columbia, 1081
Burrard St, Vancouver, BC, Canada V6Z 1Y6; Liverpool Heart and Chest Hospital,
Liverpool, England (T.A.F.); Department of Radiology, Duke University School of
Medicine, Durham, NC (L.H.K., M.R.P.); Wakayama Medical University, Wakayama,
Japan (H.M., T. Akasaka, H.K.); Department of Cardiology, Aarhus University
Hospital, Aarhus, Denmark (B.L.N., J.M.J.); Department of Cardiology, University
Hospital of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Department of
Regional Health Research, University of Southern Denmark, Esbjerg, Denmark
(N.P.R.S.); Erasmus Medical Center, Rotterdam, the Netherlands (K.N.);
Department of Cardiology, Leiden University Medical Center, Leiden, the
Netherlands (J.J.B.); Centro Cardiologico Monzino, Scientific Institute for
Research, Hospitalization and Healthcare (IRCCS), University of Milan, Milan,
Italy (G.P.); William Beaumont Hospital, Royal Oak, Mich (K.M.C.); Loyola
University Medical Center, Maywood, Ill (M.G.R.); Aichi Medical University,
Aichi, Japan (T. Amano); Department of Cardiology, Shin Koga Hospital, Fukuoka,
Japan (T.K.); HeartFlow, Redwood City, Calif (C.R.); and University of Northern
British Columbia, Prince George, British Columbia, Canada (G.W.P.)
| | - Jeroen J. Bax
- From the Department of Radiology (K.R.H., G.S.G., J.A.L., S.L.S.) and
Centre for Heart Lung Innovation & Providence Research (G.S.G., J.A.L.,
S.L.S.), St Paul’s Hospital and University of British Columbia, 1081
Burrard St, Vancouver, BC, Canada V6Z 1Y6; Liverpool Heart and Chest Hospital,
Liverpool, England (T.A.F.); Department of Radiology, Duke University School of
Medicine, Durham, NC (L.H.K., M.R.P.); Wakayama Medical University, Wakayama,
Japan (H.M., T. Akasaka, H.K.); Department of Cardiology, Aarhus University
Hospital, Aarhus, Denmark (B.L.N., J.M.J.); Department of Cardiology, University
Hospital of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Department of
Regional Health Research, University of Southern Denmark, Esbjerg, Denmark
(N.P.R.S.); Erasmus Medical Center, Rotterdam, the Netherlands (K.N.);
Department of Cardiology, Leiden University Medical Center, Leiden, the
Netherlands (J.J.B.); Centro Cardiologico Monzino, Scientific Institute for
Research, Hospitalization and Healthcare (IRCCS), University of Milan, Milan,
Italy (G.P.); William Beaumont Hospital, Royal Oak, Mich (K.M.C.); Loyola
University Medical Center, Maywood, Ill (M.G.R.); Aichi Medical University,
Aichi, Japan (T. Amano); Department of Cardiology, Shin Koga Hospital, Fukuoka,
Japan (T.K.); HeartFlow, Redwood City, Calif (C.R.); and University of Northern
British Columbia, Prince George, British Columbia, Canada (G.W.P.)
| | - Gianluca Pontone
- From the Department of Radiology (K.R.H., G.S.G., J.A.L., S.L.S.) and
Centre for Heart Lung Innovation & Providence Research (G.S.G., J.A.L.,
S.L.S.), St Paul’s Hospital and University of British Columbia, 1081
Burrard St, Vancouver, BC, Canada V6Z 1Y6; Liverpool Heart and Chest Hospital,
Liverpool, England (T.A.F.); Department of Radiology, Duke University School of
Medicine, Durham, NC (L.H.K., M.R.P.); Wakayama Medical University, Wakayama,
Japan (H.M., T. Akasaka, H.K.); Department of Cardiology, Aarhus University
Hospital, Aarhus, Denmark (B.L.N., J.M.J.); Department of Cardiology, University
Hospital of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Department of
Regional Health Research, University of Southern Denmark, Esbjerg, Denmark
(N.P.R.S.); Erasmus Medical Center, Rotterdam, the Netherlands (K.N.);
Department of Cardiology, Leiden University Medical Center, Leiden, the
Netherlands (J.J.B.); Centro Cardiologico Monzino, Scientific Institute for
Research, Hospitalization and Healthcare (IRCCS), University of Milan, Milan,
Italy (G.P.); William Beaumont Hospital, Royal Oak, Mich (K.M.C.); Loyola
University Medical Center, Maywood, Ill (M.G.R.); Aichi Medical University,
Aichi, Japan (T. Amano); Department of Cardiology, Shin Koga Hospital, Fukuoka,
Japan (T.K.); HeartFlow, Redwood City, Calif (C.R.); and University of Northern
British Columbia, Prince George, British Columbia, Canada (G.W.P.)
| | - Kavitha M. Chinnaiyan
- From the Department of Radiology (K.R.H., G.S.G., J.A.L., S.L.S.) and
Centre for Heart Lung Innovation & Providence Research (G.S.G., J.A.L.,
S.L.S.), St Paul’s Hospital and University of British Columbia, 1081
Burrard St, Vancouver, BC, Canada V6Z 1Y6; Liverpool Heart and Chest Hospital,
Liverpool, England (T.A.F.); Department of Radiology, Duke University School of
Medicine, Durham, NC (L.H.K., M.R.P.); Wakayama Medical University, Wakayama,
Japan (H.M., T. Akasaka, H.K.); Department of Cardiology, Aarhus University
Hospital, Aarhus, Denmark (B.L.N., J.M.J.); Department of Cardiology, University
Hospital of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Department of
Regional Health Research, University of Southern Denmark, Esbjerg, Denmark
(N.P.R.S.); Erasmus Medical Center, Rotterdam, the Netherlands (K.N.);
Department of Cardiology, Leiden University Medical Center, Leiden, the
Netherlands (J.J.B.); Centro Cardiologico Monzino, Scientific Institute for
Research, Hospitalization and Healthcare (IRCCS), University of Milan, Milan,
Italy (G.P.); William Beaumont Hospital, Royal Oak, Mich (K.M.C.); Loyola
University Medical Center, Maywood, Ill (M.G.R.); Aichi Medical University,
Aichi, Japan (T. Amano); Department of Cardiology, Shin Koga Hospital, Fukuoka,
Japan (T.K.); HeartFlow, Redwood City, Calif (C.R.); and University of Northern
British Columbia, Prince George, British Columbia, Canada (G.W.P.)
| | - Mark G. Rabbat
- From the Department of Radiology (K.R.H., G.S.G., J.A.L., S.L.S.) and
Centre for Heart Lung Innovation & Providence Research (G.S.G., J.A.L.,
S.L.S.), St Paul’s Hospital and University of British Columbia, 1081
Burrard St, Vancouver, BC, Canada V6Z 1Y6; Liverpool Heart and Chest Hospital,
Liverpool, England (T.A.F.); Department of Radiology, Duke University School of
Medicine, Durham, NC (L.H.K., M.R.P.); Wakayama Medical University, Wakayama,
Japan (H.M., T. Akasaka, H.K.); Department of Cardiology, Aarhus University
Hospital, Aarhus, Denmark (B.L.N., J.M.J.); Department of Cardiology, University
Hospital of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Department of
Regional Health Research, University of Southern Denmark, Esbjerg, Denmark
(N.P.R.S.); Erasmus Medical Center, Rotterdam, the Netherlands (K.N.);
Department of Cardiology, Leiden University Medical Center, Leiden, the
Netherlands (J.J.B.); Centro Cardiologico Monzino, Scientific Institute for
Research, Hospitalization and Healthcare (IRCCS), University of Milan, Milan,
Italy (G.P.); William Beaumont Hospital, Royal Oak, Mich (K.M.C.); Loyola
University Medical Center, Maywood, Ill (M.G.R.); Aichi Medical University,
Aichi, Japan (T. Amano); Department of Cardiology, Shin Koga Hospital, Fukuoka,
Japan (T.K.); HeartFlow, Redwood City, Calif (C.R.); and University of Northern
British Columbia, Prince George, British Columbia, Canada (G.W.P.)
| | - Tetsuya Amano
- From the Department of Radiology (K.R.H., G.S.G., J.A.L., S.L.S.) and
Centre for Heart Lung Innovation & Providence Research (G.S.G., J.A.L.,
S.L.S.), St Paul’s Hospital and University of British Columbia, 1081
Burrard St, Vancouver, BC, Canada V6Z 1Y6; Liverpool Heart and Chest Hospital,
Liverpool, England (T.A.F.); Department of Radiology, Duke University School of
Medicine, Durham, NC (L.H.K., M.R.P.); Wakayama Medical University, Wakayama,
Japan (H.M., T. Akasaka, H.K.); Department of Cardiology, Aarhus University
Hospital, Aarhus, Denmark (B.L.N., J.M.J.); Department of Cardiology, University
Hospital of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Department of
Regional Health Research, University of Southern Denmark, Esbjerg, Denmark
(N.P.R.S.); Erasmus Medical Center, Rotterdam, the Netherlands (K.N.);
Department of Cardiology, Leiden University Medical Center, Leiden, the
Netherlands (J.J.B.); Centro Cardiologico Monzino, Scientific Institute for
Research, Hospitalization and Healthcare (IRCCS), University of Milan, Milan,
Italy (G.P.); William Beaumont Hospital, Royal Oak, Mich (K.M.C.); Loyola
University Medical Center, Maywood, Ill (M.G.R.); Aichi Medical University,
Aichi, Japan (T. Amano); Department of Cardiology, Shin Koga Hospital, Fukuoka,
Japan (T.K.); HeartFlow, Redwood City, Calif (C.R.); and University of Northern
British Columbia, Prince George, British Columbia, Canada (G.W.P.)
| | - Tomohiro Kawasaki
- From the Department of Radiology (K.R.H., G.S.G., J.A.L., S.L.S.) and
Centre for Heart Lung Innovation & Providence Research (G.S.G., J.A.L.,
S.L.S.), St Paul’s Hospital and University of British Columbia, 1081
Burrard St, Vancouver, BC, Canada V6Z 1Y6; Liverpool Heart and Chest Hospital,
Liverpool, England (T.A.F.); Department of Radiology, Duke University School of
Medicine, Durham, NC (L.H.K., M.R.P.); Wakayama Medical University, Wakayama,
Japan (H.M., T. Akasaka, H.K.); Department of Cardiology, Aarhus University
Hospital, Aarhus, Denmark (B.L.N., J.M.J.); Department of Cardiology, University
Hospital of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Department of
Regional Health Research, University of Southern Denmark, Esbjerg, Denmark
(N.P.R.S.); Erasmus Medical Center, Rotterdam, the Netherlands (K.N.);
Department of Cardiology, Leiden University Medical Center, Leiden, the
Netherlands (J.J.B.); Centro Cardiologico Monzino, Scientific Institute for
Research, Hospitalization and Healthcare (IRCCS), University of Milan, Milan,
Italy (G.P.); William Beaumont Hospital, Royal Oak, Mich (K.M.C.); Loyola
University Medical Center, Maywood, Ill (M.G.R.); Aichi Medical University,
Aichi, Japan (T. Amano); Department of Cardiology, Shin Koga Hospital, Fukuoka,
Japan (T.K.); HeartFlow, Redwood City, Calif (C.R.); and University of Northern
British Columbia, Prince George, British Columbia, Canada (G.W.P.)
| | - Takashi Akasaka
- From the Department of Radiology (K.R.H., G.S.G., J.A.L., S.L.S.) and
Centre for Heart Lung Innovation & Providence Research (G.S.G., J.A.L.,
S.L.S.), St Paul’s Hospital and University of British Columbia, 1081
Burrard St, Vancouver, BC, Canada V6Z 1Y6; Liverpool Heart and Chest Hospital,
Liverpool, England (T.A.F.); Department of Radiology, Duke University School of
Medicine, Durham, NC (L.H.K., M.R.P.); Wakayama Medical University, Wakayama,
Japan (H.M., T. Akasaka, H.K.); Department of Cardiology, Aarhus University
Hospital, Aarhus, Denmark (B.L.N., J.M.J.); Department of Cardiology, University
Hospital of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Department of
Regional Health Research, University of Southern Denmark, Esbjerg, Denmark
(N.P.R.S.); Erasmus Medical Center, Rotterdam, the Netherlands (K.N.);
Department of Cardiology, Leiden University Medical Center, Leiden, the
Netherlands (J.J.B.); Centro Cardiologico Monzino, Scientific Institute for
Research, Hospitalization and Healthcare (IRCCS), University of Milan, Milan,
Italy (G.P.); William Beaumont Hospital, Royal Oak, Mich (K.M.C.); Loyola
University Medical Center, Maywood, Ill (M.G.R.); Aichi Medical University,
Aichi, Japan (T. Amano); Department of Cardiology, Shin Koga Hospital, Fukuoka,
Japan (T.K.); HeartFlow, Redwood City, Calif (C.R.); and University of Northern
British Columbia, Prince George, British Columbia, Canada (G.W.P.)
| | - Hironori Kitabata
- From the Department of Radiology (K.R.H., G.S.G., J.A.L., S.L.S.) and
Centre for Heart Lung Innovation & Providence Research (G.S.G., J.A.L.,
S.L.S.), St Paul’s Hospital and University of British Columbia, 1081
Burrard St, Vancouver, BC, Canada V6Z 1Y6; Liverpool Heart and Chest Hospital,
Liverpool, England (T.A.F.); Department of Radiology, Duke University School of
Medicine, Durham, NC (L.H.K., M.R.P.); Wakayama Medical University, Wakayama,
Japan (H.M., T. Akasaka, H.K.); Department of Cardiology, Aarhus University
Hospital, Aarhus, Denmark (B.L.N., J.M.J.); Department of Cardiology, University
Hospital of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Department of
Regional Health Research, University of Southern Denmark, Esbjerg, Denmark
(N.P.R.S.); Erasmus Medical Center, Rotterdam, the Netherlands (K.N.);
Department of Cardiology, Leiden University Medical Center, Leiden, the
Netherlands (J.J.B.); Centro Cardiologico Monzino, Scientific Institute for
Research, Hospitalization and Healthcare (IRCCS), University of Milan, Milan,
Italy (G.P.); William Beaumont Hospital, Royal Oak, Mich (K.M.C.); Loyola
University Medical Center, Maywood, Ill (M.G.R.); Aichi Medical University,
Aichi, Japan (T. Amano); Department of Cardiology, Shin Koga Hospital, Fukuoka,
Japan (T.K.); HeartFlow, Redwood City, Calif (C.R.); and University of Northern
British Columbia, Prince George, British Columbia, Canada (G.W.P.)
| | - Campbell Rogers
- From the Department of Radiology (K.R.H., G.S.G., J.A.L., S.L.S.) and
Centre for Heart Lung Innovation & Providence Research (G.S.G., J.A.L.,
S.L.S.), St Paul’s Hospital and University of British Columbia, 1081
Burrard St, Vancouver, BC, Canada V6Z 1Y6; Liverpool Heart and Chest Hospital,
Liverpool, England (T.A.F.); Department of Radiology, Duke University School of
Medicine, Durham, NC (L.H.K., M.R.P.); Wakayama Medical University, Wakayama,
Japan (H.M., T. Akasaka, H.K.); Department of Cardiology, Aarhus University
Hospital, Aarhus, Denmark (B.L.N., J.M.J.); Department of Cardiology, University
Hospital of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Department of
Regional Health Research, University of Southern Denmark, Esbjerg, Denmark
(N.P.R.S.); Erasmus Medical Center, Rotterdam, the Netherlands (K.N.);
Department of Cardiology, Leiden University Medical Center, Leiden, the
Netherlands (J.J.B.); Centro Cardiologico Monzino, Scientific Institute for
Research, Hospitalization and Healthcare (IRCCS), University of Milan, Milan,
Italy (G.P.); William Beaumont Hospital, Royal Oak, Mich (K.M.C.); Loyola
University Medical Center, Maywood, Ill (M.G.R.); Aichi Medical University,
Aichi, Japan (T. Amano); Department of Cardiology, Shin Koga Hospital, Fukuoka,
Japan (T.K.); HeartFlow, Redwood City, Calif (C.R.); and University of Northern
British Columbia, Prince George, British Columbia, Canada (G.W.P.)
| | - Manesh R. Patel
- From the Department of Radiology (K.R.H., G.S.G., J.A.L., S.L.S.) and
Centre for Heart Lung Innovation & Providence Research (G.S.G., J.A.L.,
S.L.S.), St Paul’s Hospital and University of British Columbia, 1081
Burrard St, Vancouver, BC, Canada V6Z 1Y6; Liverpool Heart and Chest Hospital,
Liverpool, England (T.A.F.); Department of Radiology, Duke University School of
Medicine, Durham, NC (L.H.K., M.R.P.); Wakayama Medical University, Wakayama,
Japan (H.M., T. Akasaka, H.K.); Department of Cardiology, Aarhus University
Hospital, Aarhus, Denmark (B.L.N., J.M.J.); Department of Cardiology, University
Hospital of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Department of
Regional Health Research, University of Southern Denmark, Esbjerg, Denmark
(N.P.R.S.); Erasmus Medical Center, Rotterdam, the Netherlands (K.N.);
Department of Cardiology, Leiden University Medical Center, Leiden, the
Netherlands (J.J.B.); Centro Cardiologico Monzino, Scientific Institute for
Research, Hospitalization and Healthcare (IRCCS), University of Milan, Milan,
Italy (G.P.); William Beaumont Hospital, Royal Oak, Mich (K.M.C.); Loyola
University Medical Center, Maywood, Ill (M.G.R.); Aichi Medical University,
Aichi, Japan (T. Amano); Department of Cardiology, Shin Koga Hospital, Fukuoka,
Japan (T.K.); HeartFlow, Redwood City, Calif (C.R.); and University of Northern
British Columbia, Prince George, British Columbia, Canada (G.W.P.)
| | - Geoffrey W. Payne
- From the Department of Radiology (K.R.H., G.S.G., J.A.L., S.L.S.) and
Centre for Heart Lung Innovation & Providence Research (G.S.G., J.A.L.,
S.L.S.), St Paul’s Hospital and University of British Columbia, 1081
Burrard St, Vancouver, BC, Canada V6Z 1Y6; Liverpool Heart and Chest Hospital,
Liverpool, England (T.A.F.); Department of Radiology, Duke University School of
Medicine, Durham, NC (L.H.K., M.R.P.); Wakayama Medical University, Wakayama,
Japan (H.M., T. Akasaka, H.K.); Department of Cardiology, Aarhus University
Hospital, Aarhus, Denmark (B.L.N., J.M.J.); Department of Cardiology, University
Hospital of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Department of
Regional Health Research, University of Southern Denmark, Esbjerg, Denmark
(N.P.R.S.); Erasmus Medical Center, Rotterdam, the Netherlands (K.N.);
Department of Cardiology, Leiden University Medical Center, Leiden, the
Netherlands (J.J.B.); Centro Cardiologico Monzino, Scientific Institute for
Research, Hospitalization and Healthcare (IRCCS), University of Milan, Milan,
Italy (G.P.); William Beaumont Hospital, Royal Oak, Mich (K.M.C.); Loyola
University Medical Center, Maywood, Ill (M.G.R.); Aichi Medical University,
Aichi, Japan (T. Amano); Department of Cardiology, Shin Koga Hospital, Fukuoka,
Japan (T.K.); HeartFlow, Redwood City, Calif (C.R.); and University of Northern
British Columbia, Prince George, British Columbia, Canada (G.W.P.)
| | - Jonathon A. Leipsic
- From the Department of Radiology (K.R.H., G.S.G., J.A.L., S.L.S.) and
Centre for Heart Lung Innovation & Providence Research (G.S.G., J.A.L.,
S.L.S.), St Paul’s Hospital and University of British Columbia, 1081
Burrard St, Vancouver, BC, Canada V6Z 1Y6; Liverpool Heart and Chest Hospital,
Liverpool, England (T.A.F.); Department of Radiology, Duke University School of
Medicine, Durham, NC (L.H.K., M.R.P.); Wakayama Medical University, Wakayama,
Japan (H.M., T. Akasaka, H.K.); Department of Cardiology, Aarhus University
Hospital, Aarhus, Denmark (B.L.N., J.M.J.); Department of Cardiology, University
Hospital of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Department of
Regional Health Research, University of Southern Denmark, Esbjerg, Denmark
(N.P.R.S.); Erasmus Medical Center, Rotterdam, the Netherlands (K.N.);
Department of Cardiology, Leiden University Medical Center, Leiden, the
Netherlands (J.J.B.); Centro Cardiologico Monzino, Scientific Institute for
Research, Hospitalization and Healthcare (IRCCS), University of Milan, Milan,
Italy (G.P.); William Beaumont Hospital, Royal Oak, Mich (K.M.C.); Loyola
University Medical Center, Maywood, Ill (M.G.R.); Aichi Medical University,
Aichi, Japan (T. Amano); Department of Cardiology, Shin Koga Hospital, Fukuoka,
Japan (T.K.); HeartFlow, Redwood City, Calif (C.R.); and University of Northern
British Columbia, Prince George, British Columbia, Canada (G.W.P.)
| | - Stephanie L. Sellers
- From the Department of Radiology (K.R.H., G.S.G., J.A.L., S.L.S.) and
Centre for Heart Lung Innovation & Providence Research (G.S.G., J.A.L.,
S.L.S.), St Paul’s Hospital and University of British Columbia, 1081
Burrard St, Vancouver, BC, Canada V6Z 1Y6; Liverpool Heart and Chest Hospital,
Liverpool, England (T.A.F.); Department of Radiology, Duke University School of
Medicine, Durham, NC (L.H.K., M.R.P.); Wakayama Medical University, Wakayama,
Japan (H.M., T. Akasaka, H.K.); Department of Cardiology, Aarhus University
Hospital, Aarhus, Denmark (B.L.N., J.M.J.); Department of Cardiology, University
Hospital of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Department of
Regional Health Research, University of Southern Denmark, Esbjerg, Denmark
(N.P.R.S.); Erasmus Medical Center, Rotterdam, the Netherlands (K.N.);
Department of Cardiology, Leiden University Medical Center, Leiden, the
Netherlands (J.J.B.); Centro Cardiologico Monzino, Scientific Institute for
Research, Hospitalization and Healthcare (IRCCS), University of Milan, Milan,
Italy (G.P.); William Beaumont Hospital, Royal Oak, Mich (K.M.C.); Loyola
University Medical Center, Maywood, Ill (M.G.R.); Aichi Medical University,
Aichi, Japan (T. Amano); Department of Cardiology, Shin Koga Hospital, Fukuoka,
Japan (T.K.); HeartFlow, Redwood City, Calif (C.R.); and University of Northern
British Columbia, Prince George, British Columbia, Canada (G.W.P.)
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5
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Hidalgo Santiago JC, Perelló Martínez J, Vargas Romero J, Luis Pallares J, Michan Doña A, Gómez-Fernández P. Association of aortic stiffness with abdominal vascular and coronary calcifications in patients with stage 3 and 4 chronic kidney disease. Nefrologia 2024; 44:256-267. [PMID: 38555207 DOI: 10.1016/j.nefroe.2024.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 06/03/2023] [Indexed: 04/02/2024] Open
Abstract
RATIONALE AND OBJECTIVES Increased central (aortic) arterial stiffness has hemodynamic repercussions that affect the incidence of cardiovascular and renal disease. In chronic kidney disease (CKD) there may be an increase in aortic stiffness secondary to multiple metabolic alterations including calcification of the vascular wall (VC). The objective of this study was to analyze the association of central aortic pressures and aortic stiffness with the presence of VC in abdominal aorta (AAC) and coronary arteries(CAC). MATERIALS AND METHODS We included 87 pacientes with CKD stage 3 and 4. Using applanation tonometry, central aortic pressures and aortic stiffness were studied. We investigated the association of aortic pulse wave velocity (Pvc-f) and Pvc-f adjusted for age, blood pressure, sex and heart rate (Pvc-f index) with AAC obtained on lumbar lateral radiography and CAC assessed by multidetector computed tomography. AAC and CAC were scored according to Kauppila and Agatston methods, respecti-vely. For the study of the association between Pvc-f index, Kauppila score, Agatston score, central aortic pressures, clinical parameters and laboratory data, multiple and logistic regression were used. We investigated the diagnosis performance of the Pvc-f index for prediction of VC using receiver-operating characteristic (ROC). RESULTS Pvc-f and Pvc-f index were 11.3 ± 2.6 and 10.6 m/s, respectively. The Pvc-f index was higher when CKD coexisted with diabetes mellitus (DM). AAC and CAC were detected in 77% and 87%, respectively. Albuminuria (β = 0.13, p = 0.005) and Kauppila score (β = 0.36, p = 0.001) were independently associated with Pvc-f index. In turn, Pvc-f index (β = 0.39, p = 0.001), DM (β = 0.46, p = 0.01), and smoking (β = 0.53; p = 0.006) were associated with Kauppila score, but only Pvc-f index predicted AAC [OR: 3.33 (95% CI: 1.6-6.9; p = 0.001)]. The Kauppila score was independently associated with the Agatston score (β = 1.53, p = 0.001). The presence of AAC identified patients with CAC with a sensitivity of 73%, a specificity of 100%, a positive predictive value of 100% and a negative predictive value of 38%. The Vpc-f index predicted the presence of CAC [OR: 3.35 (95% CI: 1.04-10.2, p = 0.04)]. In the ROC curves, using the Vpc-f index, the AUC for AAC and CAC was 0.82 (95%CI: 0.71-0.93, p = 0.001) and 0.81 (95% CI: 0.67-0.96, p = 0.02), respectively. CONCLUSIONS When stage 3-4 CKD coexists with DM there is an increase in aortic stiffness determined by the Vpc-f index. In stage 3-4 CKD, AAC and CAC are very prevalent and both often coexist. The Vpc-f index is independently associated with AAC and CAC and may be useful in identifying patients with VC in these territories.
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Affiliation(s)
| | | | - Javier Vargas Romero
- Unidad de Radiodiagnóstico, Hospital Universitario de Jerez, Jerez de la Frontera, Spain
| | - José Luis Pallares
- Unidad de Radiodiagnóstico, Hospital Universitario de Jerez, Jerez de la Frontera, Spain
| | - Alfredo Michan Doña
- Unidad de medicina Interna, Hospital Universitario de Jerez, Biomedical Research and Innovation Institute of Cadiz (INiBICA), Jerez de la Frontera, Spain
| | - Pablo Gómez-Fernández
- Unidad de Factores de Riesgo Vascular, Hospital Universitario de Jerez, Jerez de la Frontera, Spain.
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6
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Bhardwaj G, Riadi Y, Afzal M, Bansal P, Kaur H, Deorari M, Tonk RK, Almalki WH, Kazmi I, Alzarea SI, Kukreti N, Thangavelu L, Saleem S. The hidden threat: Environmental toxins and their effects on gut microbiota. Pathol Res Pract 2024; 255:155173. [PMID: 38364649 DOI: 10.1016/j.prp.2024.155173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 01/23/2024] [Accepted: 01/24/2024] [Indexed: 02/18/2024]
Abstract
The human gut microbiota (GM), which consists of a complex and diverse ecosystem of bacteria, plays a vital role in overall wellness. However, the delicate balance of this intricate system is being compromised by the widespread presence of environmental toxins. The intricate connection between contaminants in the environment and human well-being has garnered significant attention in recent times. Although many environmental pollutants and their toxicity have been identified and studied in laboratory settings and animal models, there is insufficient data concerning their relevance to human physiology. Consequently, research on the toxicity of environmental toxins in GM has gained prominence in recent years. Various factors, such as air pollution, chemicals, heavy metals, and pesticides, have a detrimental impact on the composition and functioning of the GM. This comprehensive review aims to comprehend the toxic effects of numerous environmental pollutants, including antibiotics, endocrine-disrupting chemicals, heavy metals, and pesticides, on GM by examining recent research findings. The current analysis concludes that different types of environmental toxins can lead to GM dysbiosis and have various potential adverse effects on the well-being of animals. We investigate the alterations to the GM composition induced by contaminants and their impact on overall well-being, providing a fresh perspective on research related to pollutant exposure.
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Affiliation(s)
- Gautam Bhardwaj
- Department of Pharmaceutical Chemistry, School of Pharmaceutical Sciences, Delhi Pharmaceutical Sciences and Research University, Pushp Vihar sector-3, M-B Road, New Delhi 110017, India
| | - Yassine Riadi
- Department of Pharmaceutical Chemistry, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al Kharj 11942, Saudi Arabia
| | - Muhammad Afzal
- Department of Pharmaceutical Sciences, Pharmacy Program, Batterjee Medical College, P.O. Box 6231, Jeddah 21442, Saudi Arabia
| | - Pooja Bansal
- Department of Biotechnology and Genetics, Jain (Deemed-to-be) University, Bengaluru, Karnataka 560069, India; Department of Allied Healthcare and Sciences, Vivekananda Global University, Jaipur, Rajasthan 303012, India
| | - Harpreet Kaur
- School of Basic & Applied Sciences, Shobhit University, Gangoh, Uttar Pradesh 247341, India; Department of Health & Allied Sciences, Arka Jain University, Jamshedpur, Jharkhand 831001, India
| | - Mahamedha Deorari
- Uttaranchal Institute of Pharmaceutical Sciences, Uttaranchal University, Dehradun, India
| | - Rajiv Kumar Tonk
- Department of Pharmaceutical Chemistry, School of Pharmaceutical Sciences, Delhi Pharmaceutical Sciences and Research University, Pushp Vihar sector-3, M-B Road, New Delhi 110017, India.
| | - Waleed Hassan Almalki
- Department of Pharmacology, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Imran Kazmi
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, 21589 Jeddah, Saudi Arabia
| | - Sami I Alzarea
- Department of Pharmacology, College of Pharmacy, Jouf University, 72341 Sakaka, Aljouf, Saudi Arabia
| | - Neelima Kukreti
- School of Pharmacy, Graphic Era Hill University, Dehradun 248007, India
| | - Lakshmi Thangavelu
- Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Shakir Saleem
- Department of Public Health. College of Health Sciences, Saudi Electronic University, Riyadh, Saudi Arabia.
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Saito M, Miyake Y, Tanaka K, Nagata C, Senba H, Hasebe Y, Miyata T, Higaki T, Kimura E, Matsuura B, Yamaguchi O, Kawamoto R. Smoking and secondhand smoke exposure and carotid intima-media thickness: Baseline data from the Aidai Cohort Study in Japan. Tob Induc Dis 2024; 22:TID-22-17. [PMID: 38250629 PMCID: PMC10798226 DOI: 10.18332/tid/175632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 11/17/2023] [Accepted: 11/21/2023] [Indexed: 01/23/2024] Open
Abstract
INTRODUCTION Epidemiological evidence regarding the relationship between smoking and secondhand smoke (SHS) exposure and carotid intima-media thickness (CIMT) has been limited in Asian populations. Employing baseline data from the Aidai Cohort Study, Japan, we evaluated the evidence in this cross-sectional study. METHODS Study subjects were 727 men aged 35-88 years and 1297 women aged 34-85 years. Information on smoking, SHS exposure, and confounders was obtained through a self-administered questionnaire. An automated carotid ultrasonography device was used to measure the right and left CIMT. The greatest CIMT measurement in the left or right common carotid artery was considered the maximum CIMT, and a maximum CIMT >1.0 mm was indicative of carotid wall thickening. Age, alcohol consumption, leisure time physical activity, hypertension, dyslipidemia, diabetes mellitus, body mass index, waist circumference, employment, and education level were adjusted at one time. RESULTS The prevalence of carotid wall thickening was 13.0%. The prevalence of never smoking was 30.5% in men and 90.1% in women. Among those who had never smoked, the prevalence of never SHS exposure at home and work was 74.3% and 48.2% in men and 38.3% and 56.3% in women, respectively. Active smoking and pack-years of smoking were independently positively related to carotid wall thickening regardless of sex, although the association with current smoking in women was not significant. Independent positive relationships were shown between former smoking and pack-years of smoking and maximum CIMT in men but not in women. No significant relationships were found between SHS exposure at home and work and carotid wall thickening or maximum CIMT in either men or women. CONCLUSIONS Active smoking, especially pack-years of smoking, was positively associated with carotid wall thickening in both sexes. Such positive associations with maximum CIMT were found only in men; however, interactions between smoking and sex were not significant.
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Affiliation(s)
- Makoto Saito
- Integrated Medical and Agricultural School of Public Health, Ehime University, Toon, Japan
- Department of Cardiology, Kitaishikai Hospital, Ozu, Japan
| | - Yoshihiro Miyake
- Integrated Medical and Agricultural School of Public Health, Ehime University, Toon, Japan
- Department of Epidemiology and Public Health, Ehime University Graduate School of Medicine, Toon, Japan
- Research Promotion Unit, Translation Research Center, Ehime University Hospital, Toon, Japan
- Center for Data Science, Ehime University, Matsuyama, Japan
| | - Keiko Tanaka
- Integrated Medical and Agricultural School of Public Health, Ehime University, Toon, Japan
- Department of Epidemiology and Public Health, Ehime University Graduate School of Medicine, Toon, Japan
- Research Promotion Unit, Translation Research Center, Ehime University Hospital, Toon, Japan
- Center for Data Science, Ehime University, Matsuyama, Japan
| | - Chisato Nagata
- Department of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Hidenori Senba
- Department of Epidemiology and Public Health, Ehime University Graduate School of Medicine, Toon, Japan
- Department of Internal Medicine, Matsuyama Shimin Hospital, Matsuyama, Japan
| | | | - Toyohisa Miyata
- Department of Epidemiology and Public Health, Ehime University Graduate School of Medicine, Toon, Japan
- Department of Regional Pediatrics and Perinatology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Takashi Higaki
- Department of Regional Pediatrics and Perinatology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Eizen Kimura
- Integrated Medical and Agricultural School of Public Health, Ehime University, Toon, Japan
- Center for Data Science, Ehime University, Matsuyama, Japan
- Department of Medical Informatics, Ehime University Graduate School of Medicine, Toon, Japan
| | - Bunzo Matsuura
- Department of Lifestyle-Related Medicine and Endocrinology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Osamu Yamaguchi
- Integrated Medical and Agricultural School of Public Health, Ehime University, Toon, Japan
- Department of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Ryuichi Kawamoto
- Integrated Medical and Agricultural School of Public Health, Ehime University, Toon, Japan
- Department of Community Medicine, Ehime University Graduate School of Medicine, Toon, Japan
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Hong C, Liu M, Wojdyla DM, Hickey J, Pencina M, Henao R. Trans-Balance: Reducing demographic disparity for prediction models in the presence of class imbalance. J Biomed Inform 2024; 149:104532. [PMID: 38070817 PMCID: PMC10850917 DOI: 10.1016/j.jbi.2023.104532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 10/21/2023] [Accepted: 10/28/2023] [Indexed: 12/21/2023]
Abstract
INTRODUCTION Risk prediction, including early disease detection, prevention, and intervention, is essential to precision medicine. However, systematic bias in risk estimation caused by heterogeneity across different demographic groups can lead to inappropriate or misinformed treatment decisions. In addition, low incidence (class-imbalance) outcomes negatively impact the classification performance of many standard learning algorithms which further exacerbates the racial disparity issues. Therefore, it is crucial to improve the performance of statistical and machine learning models in underrepresented populations in the presence of heavy class imbalance. METHOD To address demographic disparity in the presence of class imbalance, we develop a novel framework, Trans-Balance, by leveraging recent advances in imbalance learning, transfer learning, and federated learning. We consider a practical setting where data from multiple sites are stored locally under privacy constraints. RESULTS We show that the proposed Trans-Balance framework improves upon existing approaches by explicitly accounting for heterogeneity across demographic subgroups and cohorts. We demonstrate the feasibility and validity of our methods through numerical experiments and a real application to a multi-cohort study with data from participants of four large, NIH-funded cohorts for stroke risk prediction. CONCLUSION Our findings indicate that the Trans-Balance approach significantly improves predictive performance, especially in scenarios marked by severe class imbalance and demographic disparity. Given its versatility and effectiveness, Trans-Balance offers a valuable contribution to enhancing risk prediction in biomedical research and related fields.
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Affiliation(s)
- Chuan Hong
- Duke University, Department of Biostatistics and Bioinformatics, Durham, NC, USA; Duke Clinical Research Institute, Durham, NC, USA.
| | - Molei Liu
- Columbia University, Department of Biostatistics, New York, NY, USA
| | | | - Jimmy Hickey
- North Carolina State University, Department of Statistics, Raleigh, NC, USA
| | - Michael Pencina
- Duke University, Department of Biostatistics and Bioinformatics, Durham, NC, USA; Duke Clinical Research Institute, Durham, NC, USA
| | - Ricardo Henao
- Duke University, Department of Biostatistics and Bioinformatics, Durham, NC, USA; Duke Clinical Research Institute, Durham, NC, USA
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Kanamori K, Suzuki T, Tatsuta N, Ota C. Environments affect blood pressure in toddlers: The Japan Environment and Children's Study. Pediatr Res 2024; 95:367-376. [PMID: 37634037 PMCID: PMC10798899 DOI: 10.1038/s41390-023-02796-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 08/11/2023] [Accepted: 08/16/2023] [Indexed: 08/28/2023]
Abstract
BACKGROUND The primary objective of this study was to examine risk factors for toddler's hypertension. METHODS Subjects of this study were children and parents participating in a national birth cohort study in Japan, the Japan Environment and Children's Study. We measured the children's blood pressure (BP) at 2 and 4 years old. We obtained children's and parents' backgrounds from the questionnaire. We investigated the factors that affect BP elevation. RESULTS Within 4988 participants, the mean systolic BP at 2 years old was 91.2 mmHg for boys and 90.0 mmHg for girls. The mean systolic BP at 4 years old was 93.8 mmHg for boys and 93.1 mmHg for girls. Parental smoking was associated with elevated values of BP at 2 and 4 years old. Obesity, gestational hypertension, and parental lower education were associated with elevated values of BP at 4 years old. Hypertensive group had a significantly higher obesity rate. The mother's lower education and parental smoking were involved in hypertensive groups. CONCLUSION Parental smoking had a significant effect on BP even in early toddlers. We emphasize the importance of avoiding second-hand smoking from early infancy to prevent future lifestyle-related illnesses including hypertension. IMPACT The mean systolic BP at 2 years old was 91.2 mmHg for boys and 90.0 mmHg for girls. The mean systolic BP at 4 years old was 93.8 mmHg for boys and 93.1 mmHg for girls. Obesity, parental smoking, and lower education were associated with hypertension at 4 years old. Parental smoking was associated with hypertension at 2 and 4 years old. We emphasize the importance of avoiding second-hand smoking from early infancy.
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Affiliation(s)
- Keita Kanamori
- Department of Development and Environmental Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
- Department of Pediatrics, Iwate Prefectural Iwai Hospital, Ichinoseki, Japan.
| | - Tomohisa Suzuki
- Department of Pediatrics, Tohoku University Hospital, Sendai, Japan
| | - Nozomi Tatsuta
- Department of Development and Environmental Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Chiharu Ota
- Department of Development and Environmental Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
- Department of Pediatrics, Tohoku University Hospital, Sendai, Japan
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine, Sendai, Japan
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Charchar FJ, Prestes PR, Mills C, Ching SM, Neupane D, Marques FZ, Sharman JE, Vogt L, Burrell LM, Korostovtseva L, Zec M, Patil M, Schultz MG, Wallen MP, Renna NF, Islam SMS, Hiremath S, Gyeltshen T, Chia YC, Gupta A, Schutte AE, Klein B, Borghi C, Browning CJ, Czesnikiewicz-Guzik M, Lee HY, Itoh H, Miura K, Brunström M, Campbell NR, Akinnibossun OA, Veerabhadrappa P, Wainford RD, Kruger R, Thomas SA, Komori T, Ralapanawa U, Cornelissen VA, Kapil V, Li Y, Zhang Y, Jafar TH, Khan N, Williams B, Stergiou G, Tomaszewski M. Lifestyle management of hypertension: International Society of Hypertension position paper endorsed by the World Hypertension League and European Society of Hypertension. J Hypertens 2024; 42:23-49. [PMID: 37712135 PMCID: PMC10713007 DOI: 10.1097/hjh.0000000000003563] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 08/12/2023] [Accepted: 08/22/2023] [Indexed: 09/16/2023]
Abstract
Hypertension, defined as persistently elevated systolic blood pressure (SBP) >140 mmHg and/or diastolic blood pressure (DBP) at least 90 mmHg (International Society of Hypertension guidelines), affects over 1.5 billion people worldwide. Hypertension is associated with increased risk of cardiovascular disease (CVD) events (e.g. coronary heart disease, heart failure and stroke) and death. An international panel of experts convened by the International Society of Hypertension College of Experts compiled lifestyle management recommendations as first-line strategy to prevent and control hypertension in adulthood. We also recommend that lifestyle changes be continued even when blood pressure-lowering medications are prescribed. Specific recommendations based on literature evidence are summarized with advice to start these measures early in life, including maintaining a healthy body weight, increased levels of different types of physical activity, healthy eating and drinking, avoidance and cessation of smoking and alcohol use, management of stress and sleep levels. We also discuss the relevance of specific approaches including consumption of sodium, potassium, sugar, fibre, coffee, tea, intermittent fasting as well as integrated strategies to implement these recommendations using, for example, behaviour change-related technologies and digital tools.
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Affiliation(s)
- Fadi J. Charchar
- Health Innovation and Transformation Centre, Federation University Australia, Ballarat, Australia
- Department of Physiology, University of Melbourne, Melbourne, Australia
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
| | - Priscilla R. Prestes
- Health Innovation and Transformation Centre, Federation University Australia, Ballarat, Australia
| | - Charlotte Mills
- Department of Food and Nutritional Sciences, University of Reading, Reading, UK
| | - Siew Mooi Ching
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang
- Department of Medical Sciences, School of Medical and Live Sciences, Sunway University, Bandar Sunway, Selangor, Malaysia
| | - Dinesh Neupane
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA
| | - Francine Z. Marques
- Hypertension Research Laboratory, School of Biological Sciences, Monash University
- Heart Failure Research Group, Baker Heart and Diabetes Institute, Melbourne
| | - James E. Sharman
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Liffert Vogt
- Department of Internal Medicine, Section Nephrology, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Microcirculation, Amsterdam, The Netherlands
| | - Louise M. Burrell
- Department of Medicine, University of Melbourne, Austin Health, Melbourne, Australia
| | - Lyudmila Korostovtseva
- Department of Hypertension, Almazov National Medical Research Centre, St Petersburg, Russia
| | - Manja Zec
- School of Nutritional Sciences and Wellness, University of Arizona, Tucson, USA
- Colorado Program for Musculoskeletal Research, Department of Orthopedics, University of Colorado Anschutz Medical Campus, Aurora, USA
| | - Mansi Patil
- Department of Nutrition and Dietetics, Asha Kiran JHC Hospital, Chinchwad
- Hypertension and Nutrition, Core Group of IAPEN India, India
| | - Martin G. Schultz
- Department of Internal Medicine, Section Nephrology, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Microcirculation, Amsterdam, The Netherlands
| | | | - Nicolás F. Renna
- Unit of Hypertension, Hospital Español de Mendoza, School of Medicine, National University of Cuyo, IMBECU-CONICET, Mendoza, Argentina
| | | | - Swapnil Hiremath
- Department of Medicine, University of Ottawa and the Ottawa Hospital, Ottawa, Canada
| | - Tshewang Gyeltshen
- Graduate School of Public Health, St. Luke's International University, Tokyo, Japan
| | - Yook-Chin Chia
- Department of Medical Sciences, School of Medical and Life Sciences, Sunway University, Selangor
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Abhinav Gupta
- Department of Medicine, Acharya Shri Chander College of Medical Sciences and Hospital, Jammu, India
| | - Aletta E. Schutte
- School of Population Health, University of New South Wales, The George Institute for Global Health, Sydney, New South Wales, Australia
- Hypertension in Africa Research Team, SAMRC Unit for Hypertension and Cardiovascular Disease, North-West University
- SAMRC Developmental Pathways for Health Research Unit, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Britt Klein
- Health Innovation and Transformation Centre, Federation University Australia, Ballarat, Australia
| | - Claudio Borghi
- Department of Medical and Surgical Sciences, Faculty of Medicine, University of Bologna, Bologna, Italy
| | - Colette J. Browning
- Health Innovation and Transformation Centre, Federation University Australia, Ballarat, Australia
| | - Marta Czesnikiewicz-Guzik
- School of Medicine, Dentistry and Nursing-Dental School, University of Glasgow, UK
- Department of Periodontology, Prophylaxis and Oral Medicine; Jagiellonian University, Krakow, Poland
| | - Hae-Young Lee
- Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Hiroshi Itoh
- Department of Internal Medicine (Nephrology, Endocrinology and Metabolism), Keio University, Tokyo
| | - Katsuyuki Miura
- NCD Epidemiology Research Center, Shiga University of Medical Science, Otsu, Japan
| | - Mattias Brunström
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Norm R.C. Campbell
- Libin Cardiovascular Institute, Department of Medicine, University of Calgary, Calgary, Canada
| | | | - Praveen Veerabhadrappa
- Kinesiology, Division of Science, The Pennsylvania State University, Reading, Pennsylvania
| | - Richard D. Wainford
- Department of Pharmacology and Experimental Therapeutics, The Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston
- Division of Cardiology, Emory University, Atlanta, USA
| | - Ruan Kruger
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom
- MRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | - Shane A. Thomas
- Health Innovation and Transformation Centre, Federation University Australia, Ballarat, Australia
| | - Takahiro Komori
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Udaya Ralapanawa
- Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | | | - Vikas Kapil
- William Harvey Research Institute, Centre for Cardiovascular Medicine and Devices, NIHR Barts Biomedical Research Centre, BRC, Faculty of Medicine and Dentistry, Queen Mary University London
- Barts BP Centre of Excellence, Barts Heart Centre, Barts Health NHS Trust, London, UK
| | - Yan Li
- Department of Cardiovascular Medicine, Shanghai Institute of Hypertension, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai
| | - Yuqing Zhang
- Department of Cardiology, Fu Wai Hospital, Chinese Academy of Medical Sciences, Chinese Hypertension League, Beijing, China
| | - Tazeen H. Jafar
- Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore
- Duke Global Health Institute, Duke University, Durham, North Carolina, USA
| | - Nadia Khan
- Department of Medicine, University of British Columbia, Vancouver, Canada
| | - Bryan Williams
- University College London (UCL), Institute of Cardiovascular Science, National Institute for Health Research (NIHR), UCL Hospitals Biomedical Research Centre, London, UK
| | - George Stergiou
- Hypertension Centre STRIDE-7, School of Medicine, Third Department of Medicine, Sotiria Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Maciej Tomaszewski
- Division of Cardiovascular Sciences, Faculty of Medicine, Biology and Health, University of Manchester
- Manchester Academic Health Science Centre, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, UK
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Mou Y, Liao W, Liang Y, Li Y, Zhao M, Guo Y, Sun Q, Tang J, Wang Z. Environmental pollutants induce NLRP3 inflammasome activation and pyroptosis: Roles and mechanisms in various diseases. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 900:165851. [PMID: 37516172 DOI: 10.1016/j.scitotenv.2023.165851] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 07/26/2023] [Accepted: 07/26/2023] [Indexed: 07/31/2023]
Abstract
Environmental pollution is changing with economic development. Most environmental pollutants are characterized by stable chemical properties, strong migration, potential toxicity, and multiple exposure routes. Harmful substances are discharged excessively, and large quantities of unknown new compounds are emerging, being transmitted and amplifying in the food chain. The increasingly severe problems of environmental pollution have forced people to re-examine the relationship between environmental pollution and health. Pyroptosis and activation of the NLRP3 inflammasome are critical in maintaining the immune balance and regulating the inflammatory process. Numerous diseases caused by environmental pollutants are closely related to NLRP3 inflammasome activation and pyroptosis. We intend to systematically explain the steps and important events that are common in life but easily overlooked by which environmental pollutants activate the NLRP3 inflammasome and pyroptosis pathways. This comprehensive review also discusses the interaction network between environmental pollutants, the NLRP3 inflammasome, pyroptosis, and diseases. Thus, research progress on the impact of decreasing oxidative stress levels to inhibit the NLRP3 inflammasome and pyroptosis, thereby repairing homeostasis and reshaping health, is systematically examined. This review aims to deepen the understanding of the impact of environmental pollutants on life and health and provide a theoretical basis and potential programs for the development of corresponding treatment strategies.
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Affiliation(s)
- Yu Mou
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China
| | - Wenhao Liao
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China
| | - Yun Liang
- The Third People's Hospital of Chengdu, Chengdu 610014, China
| | - Yuchen Li
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China; College of Medical Technology, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
| | - Mei Zhao
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China; School of Basic Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
| | - Yaoyao Guo
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China
| | - Qin Sun
- National Traditional Chinese Medicine Clinical Research Base of the Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou 646000, China
| | - Jianyuan Tang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China; TCM Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China.
| | - Zhilei Wang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China; TCM Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China.
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Ki YJ, Han K, Kim HS, Han JK. Smoking and cardiovascular outcomes after percutaneous coronary intervention: a Korean study. Eur Heart J 2023; 44:4461-4472. [PMID: 37757448 DOI: 10.1093/eurheartj/ehad616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 08/02/2023] [Accepted: 09/07/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND AND AIMS The authors investigated the impact of smoking and its cessation after percutaneous coronary intervention (PCI) on cardiovascular outcomes. METHODS Using a nationwide database from the Korean National Health Insurance System, 74 471 patients undergoing PCI between 2009 and 2016 were classified as non-, ex-, or current smokers, depending on smoking status at the first health check-up within 1 year after PCI. The primary outcome was major adverse cardiovascular and cerebrovascular event (MACCE), a composite of all-cause death, myocardial infarction, coronary revascularization, and stroke. RESULTS During 4.0 years of follow-up, current smokers had a 19.8% higher rate of MACCE than non-smokers [adjusted hazard ratio (aHR) 1.198; 95% confidence interval (CI) 1.137-1.263], and ex-smokers tended to have a comparable rate with that of non-smokers (aHR 1.036; 95% CI .992-1.081). For 31 887 patients with both pre- and post-PCI health check-up data, the effects of smoking cessation were analysed. Among quitters who stopped smoking after PCI, quitters with cumulative smoking exposure of <20 pack-years (PYs) tended to have a comparable rate of MACCE with that of persistent non-smokers. However, the rate in quitters with cumulative exposure of ≥20 PYs was comparable with that of persistent smokers [aHR (95% CI) for <10 PY, 1.182 (.971-1.438); 10-20 PYs 1.114 (.963-1.290); 20-30 PYs 1.206 (1.054-1.380); ≥ 30 PYs 1.227 (1.113-1.352); persistent smokers 1.223 (1.126-1.328), compared with persistent non-smokers, respectively, P for interaction <.001]. CONCLUSIONS Smoking is associated with a higher risk of adverse outcomes in patients undergoing PCI. Quitters after PCI with <20 PYs were associated with a risk comparable with that of non-smokers.
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Affiliation(s)
- You-Jeong Ki
- Cardiovascular Center, Uijeongbu Eulji Medical Center, Uijeongbu-si, Gyeonggi-do, Republic of Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Hyo-Soo Kim
- Cardiovascular Center, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea
- Department of Internal Medicine, College of Medicine, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea
| | - Jung-Kyu Han
- Cardiovascular Center, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea
- Department of Internal Medicine, College of Medicine, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea
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Varghese J, Muntode Gharde P. A Comprehensive Review on the Impacts of Smoking on the Health of an Individual. Cureus 2023; 15:e46532. [PMID: 37927763 PMCID: PMC10625450 DOI: 10.7759/cureus.46532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 10/05/2023] [Indexed: 11/07/2023] Open
Abstract
Long-term smoking for several years has been known to cause severe ailments in humans from the beginning. Even after knowing that this dangerous addiction is a life-threatening deal, still, ironically, the prevalence of smoking is more or less not getting reduced to a desirable extent. Those who smoke are becoming miserable because of their habit of smoking. Still, on the other hand, due to passive smoking, many more innocent lives are also adversely affected for no fault. This aspect of smoking, i.e., passive or second-hand smoking, is a fearful complication of smoking which is seldom seen with other modes of addiction. Time and again, numerous researches have highlighted the adverse effects of smoking on the human body and the interference it does bring in one's life. Smoking contributes to the deterioration of many preexisting ailments and depletes many valuable aspects of the human body. Smoking thus has a devastating effect on almost all of the tissues of our body and thus exerts its effect on nearly all the major organs. This review article is made by analysing various findings from many researches conducted across the globe by having a thorough search of Pubmed database, which in turn is the main methodology of the article. This review article aims to provide a simple and subtle understanding of the ill effects of smoking on the human body by serving the readers with a readymade platter of comprehensive knowledge about smoking coupled with efforts to eliminate the associated myths.
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Affiliation(s)
- Jerin Varghese
- Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Pramita Muntode Gharde
- Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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You J, Ouyang S, Xie Z, Zhi C, Yu J, Tan X, Li P, Lin X, Ma W, Liu Z, Hou Q, Xie N, Peng T, Chen X, Li L, Xie W. The suppression of hyperlipid diet-induced ferroptosis of vascular smooth muscle cells protests against atherosclerosis independent of p53/SCL7A11/GPX4 axis. J Cell Physiol 2023; 238:1891-1908. [PMID: 37269460 DOI: 10.1002/jcp.31045] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 04/16/2023] [Accepted: 05/11/2023] [Indexed: 06/05/2023]
Abstract
Ferroptosis as a novel programmed cell death that involves metabolic dysfunction due to iron-dependent excessive lipid peroxidation has been implicated in atherosclerosis (AS) development characterized by disrupted lipid metabolism, but the atherogenic role of ferroptosis in vascular smooth muscle cells (VSMCs), which are principal components of atherosclerotic plaque fibrous cap, remains unclear. The aim of this study was to determine the effects of ferroptosis on AS induced by lipid overload, and the effects of that on VSMCs ferroptosis. We found intraperitoneal injection of Fer-1, a ferroptosis inhibitor, ameliorated obviously high-fat diet-induced high plasma levels of triglycerides, total cholesterol, low-density lipoprotein, glucose and atherosclerotic lesions in ApoE-/- mice. Moreover, in vivo and in vitro, Fer-1 reduced the iron accumulation of atherosclerotic lesions through affecting the expression of TFR1, FTH, and FTL in VSMCs. Interestingly, Fer-1 did augment nuclear factor E2-related factor 2/ferroptosis suppressor protein 1 to enhance endogenous resistance to lipid peroxidation, but not classic p53/SCL7A11/GPX4. Those observations indicated inhibition of VSMCs ferroptosis can improve AS lesions independent of p53/SLC7A11/GPX4, which preliminarily revealed the potential mechanism of ferroptosis in aortic VSMCs on AS and provided new therapeutic strategies and targets for AS.
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Affiliation(s)
- Jia You
- Clinical Anatomy & Reproductive Medicine Application Institute, Hengyang Medical School, University of South China, Hengyang, Hunan, China
| | - Siyu Ouyang
- Clinical Anatomy & Reproductive Medicine Application Institute, Hengyang Medical School, University of South China, Hengyang, Hunan, China
| | - Zhongcheng Xie
- Clinical Anatomy & Reproductive Medicine Application Institute, Hengyang Medical School, University of South China, Hengyang, Hunan, China
| | - Chenxi Zhi
- Clinical Anatomy & Reproductive Medicine Application Institute, Hengyang Medical School, University of South China, Hengyang, Hunan, China
| | - Jiang Yu
- Clinical Anatomy & Reproductive Medicine Application Institute, Hengyang Medical School, University of South China, Hengyang, Hunan, China
| | - Xiaoqian Tan
- Clinical Anatomy & Reproductive Medicine Application Institute, Hengyang Medical School, University of South China, Hengyang, Hunan, China
| | - Pin Li
- Clinical Anatomy & Reproductive Medicine Application Institute, Hengyang Medical School, University of South China, Hengyang, Hunan, China
| | - Xiaoyan Lin
- Clinical Anatomy & Reproductive Medicine Application Institute, Hengyang Medical School, University of South China, Hengyang, Hunan, China
| | - Wentao Ma
- Clinical Anatomy & Reproductive Medicine Application Institute, Hengyang Medical School, University of South China, Hengyang, Hunan, China
| | - Zhiyang Liu
- Clinical Anatomy & Reproductive Medicine Application Institute, Hengyang Medical School, University of South China, Hengyang, Hunan, China
| | - Qin Hou
- Clinical Anatomy & Reproductive Medicine Application Institute, Hengyang Medical School, University of South China, Hengyang, Hunan, China
| | - Nan Xie
- Clinical Anatomy & Reproductive Medicine Application Institute, Hengyang Medical School, University of South China, Hengyang, Hunan, China
| | - Tianhong Peng
- Clinical Anatomy & Reproductive Medicine Application Institute, Hengyang Medical School, University of South China, Hengyang, Hunan, China
| | - Xi Chen
- Clinical Anatomy & Reproductive Medicine Application Institute, Hengyang Medical School, University of South China, Hengyang, Hunan, China
| | - Liang Li
- Department of Physiology, Hengyang Medical School, University of South China, Hengyang, Hunan, China
| | - Wei Xie
- Clinical Anatomy & Reproductive Medicine Application Institute, Hengyang Medical School, University of South China, Hengyang, Hunan, China
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15
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Choi JH, Han S, Shin E, Oh M, Moon JE, Chae SY, Lee CW, Moon DH. Associations of cardiovascular and diabetes-related risk factors with myocardial perfusion reserve assessed by 201Tl/ 99mTc-tetrofosmin single-photon emission computed tomography in patients with diabetes mellitus and stable coronary artery disease. THE INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING 2023; 39:1605-1613. [PMID: 37261681 DOI: 10.1007/s10554-023-02859-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 04/21/2023] [Indexed: 06/02/2023]
Abstract
We aimed to examine the associations of cardiovascular risk factors with myocardial perfusion reserve (MPR) in patients with type 2 diabetes and stable coronary artery disease. The study patients were retrospectively identified from a database of patients with diabetes and stable coronary artery disease at Asan Medical Center (Seoul, Republic of Korea), covering the period from 2017 to 2019. The primary outcome variable was MPR assessed by dynamic stress 201Tl/rest 99mTc-tetrofosmin SPECT. Univariable and stepwise multivariable analyses were performed to assess the associations of cardiovascular risk factors with MPR. A total of 276 patients (236 men and 40 women) were included. The median global MPR was 2.4 (interquartile range 1.9-3.0). Seventy-five (27.2%) patients had an MPR < 2.0. Multivariable linear regression showed that smoking (ß = - 0.44, 95% confidence interval - 0.68 to - 0.21, P < 0.001), hypertension (ß = - 0.24, 95% confidence interval - 0.47 to - 0.02, P = 0.033), and summed difference score (ß = - 0.05, 95% confidence interval - 0.07 to - 0.03, P < 0.001) were independently associated with MPR. Abnormal MPR (< 2.0) was associated with a higher incidence of cardiac death or myocardial infarction (P = 0.034). MPR assessed by dynamic stress 201Tl/rest 99mTc-tetrofosmin SPECT was impaired in a large cohort of patients with diabetes. After adjusting for risk variables, including standard myocardial perfusion imaging characteristics, smoking, and hypertension were associated with MPR. Our results may aid in identifying patients with impaired MPR and stratifying patients with type 2 diabetes.
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Affiliation(s)
- Joon Ho Choi
- Department of Nuclear Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea
| | - Sangwon Han
- Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea
| | - Eonwoo Shin
- Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea
| | - Minyoung Oh
- Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea
| | - Ji Eun Moon
- Department of Biostatistics, Clinical Trial Center, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea
| | - Sun Young Chae
- Department of Nuclear Medicine, Uijeongbu Eulji Medical Center, Eulji University School of Medicine, Uijeongbu, Republic of Korea
| | - Cheol Whan Lee
- Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Dae Hyuk Moon
- Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea.
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Katahira M, Imai S, Ono S, Moriura S. Estimating Triglyceride Levels Using Total Cholesterol, Low-Density Lipoprotein Cholesterol, and High-Density Lipoprotein Cholesterol Levels: A Cross-Sectional Study. Metab Syndr Relat Disord 2023; 21:327-334. [PMID: 37405724 DOI: 10.1089/met.2023.0045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/06/2023] Open
Abstract
Objective: Triglyceride (TG) levels are affected by food intake, and the cutoff values for nonfasting TG levels vary. This study aimed to calculate fasting TG levels based on total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) levels. Methods: Multiple regression analysis was performed to determine estimated triglyceride (eTG) levels using data from 39,971 participants divided into six groups based on non-high-density lipoprotein cholesterol (nHDL-C) levels (<100, <130, <160, <190, <220, and ≥220 mg/dL). Results: Provided that fasting TG and eTG levels ≥150 mg/dL were positive and those <150 mg/dL were negative, the three groups (nHDL-C levels <100, <130, and <160 mg/dL) consisting of 28,616 participants had a false-positive rate of <5%. The coefficient and constant terms in the formula for the eTG in groups with nHDL-C levels <100, <130, and <160 mg/dL were as follows: constant terms, 12.193, 0.741, and -7.157; coefficients of LDL-C, -3.999, -4.409, and -5.145; coefficients of HDL-C, -3.869, -4.555, and -5.215; and coefficients of TC, 3.984, 4.547, and 5.231, respectively. The adjusted coefficients of determination were 0.547, 0.593, and 0.678, respectively (P < 0.001, P < 0.001, and P < 0.001, respectively). Conclusion: Fasting TG levels can be calculated from TC, LDL-C, and HDL-C levels when nHDL-C levels are <160 mg/dL. Using nonfasting TG and eTG levels as indicators of hypertriglyceridemia might eliminate the need for venous sampling after overnight fasting.
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Affiliation(s)
- Masahito Katahira
- Aichi Prefectural University School of Nursing and Health, Nagoya, Japan
- Checkup Center, Daiyukai Daiichi Hospital, Ichinomiya, Japan
| | - Shu Imai
- Checkup Center, Daiyukai Daiichi Hospital, Ichinomiya, Japan
| | - Satoko Ono
- Checkup Center, Daiyukai Daiichi Hospital, Ichinomiya, Japan
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Lin CJ, Chung CP, Liao NC, Chen PL, Chi NF, Lai YJ, Tang CW, Wu CH, Chang FC, Luo CB, Fay LY, Lin CF, Chou CH, Lee TH, Lee JT, Jeng JS, Lee IH. The 2023 Taiwan Stroke Society Guidelines for the management of patients with intracranial atherosclerotic disease. J Chin Med Assoc 2023; 86:697-714. [PMID: 37341526 DOI: 10.1097/jcma.0000000000000952] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/22/2023] Open
Abstract
Intracranial atherosclerotic disease (ICAD) is a major cause of ischemic stroke, especially in Asian populations, which has a high risk of recurrent stroke and cardiovascular comorbidities. The present guidelines aim to provide updated evidence-based recommendations for diagnosis and management of patients with ICAD. Taiwan Stroke Society guideline consensus group developed recommendations for management of patients with ICAD via consensus meetings based on updated evidences. Each proposed class of recommendation and level of evidence was approved by all members of the group. The guidelines cover six topics, including (1) epidemiology and diagnostic evaluation of ICAD, (2) nonpharmacological management of ICAD, (3) medical therapy for symptomatic ICAD, (4) endovascular thrombectomy and rescue therapy for acute ischemic stroke with underlying ICAD, (5) endovascular interventional therapy for postacute symptomatic intracranial arterial stenosis, and (6) surgical treatment of chronic symptomatic intracranial arterial stenosis. Intensive medical treatment including antiplatelet therapy, risk factor control, and life style modification are essential for patients with ICAD.
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Affiliation(s)
- Chun-Jen Lin
- Department of Neurology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Chih-Ping Chung
- Department of Neurology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Nien-Chen Liao
- Department of Neurology, Taichung Veterans General Hospital, Taichung, Taiwan, ROC
| | - Po-Lin Chen
- Department of Neurology, Taichung Veterans General Hospital, Taichung, Taiwan, ROC
| | - Nai-Fang Chi
- Department of Neurology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Yen-Jun Lai
- Radiology Department, Far-Eastern Memorial Hospital, New Taipei City, Taiwan, ROC
| | - Chih-Wei Tang
- Neurology Department and Stroke Center, Far-Eastern Memorial Hospital, New Taipei City, Taiwan, ROC
| | - Chia-Hung Wu
- Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Feng-Chi Chang
- Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Chao-Bao Luo
- Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Li-Yu Fay
- Department of Neurosurgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Chun-Fu Lin
- Department of Neurosurgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Chung-Hsing Chou
- Neurology Department, Tri-Service General Hospital, Taipei, Taiwan, ROC
| | - Tsong-Hai Lee
- Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, ROC
| | - Jiunn-Tay Lee
- Neurology Department, Tri-Service General Hospital, Taipei, Taiwan, ROC
| | - Jiann-Shing Jeng
- Department of Neurology and Stroke Center, National Taiwan University Hospital, Taipei, Taiwan, ROC
| | - I-Hui Lee
- Department of Neurology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
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18
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Beech BB, Doudt AD, Sjoberg DD, Clements MB, Tin AL, Atkinson TM, Li Y, Rapkin BD, Vickers AJ, Matulewicz RS, Bochner BH. Association of smoking history on health-related quality of life in patients undergoing radical cystecomy. Urol Oncol 2023; 41:325.e9-325.e14. [PMID: 36631370 PMCID: PMC10272017 DOI: 10.1016/j.urolonc.2022.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 11/29/2022] [Accepted: 12/24/2022] [Indexed: 01/11/2023]
Abstract
PURPOSE Radical cystectomy (RC) has the potential to impact health-related quality of life (HRQOL). Many patients who undergo RC are current or former smokers. To better inform preoperative patient counseling, we examined the association between smoking status and HRQOL after RC. MATERIALS AND METHODS A secondary analysis was performed on a prospective, longitudinal study (2008-2014) examining HRQOL in patients undergoing RC for bladder cancer. We analyzed 12 validated patient-reported outcome measures that focused on functional, symptomatic, psychosocial, and global HRQOL domains. Measures were collected pre-operatively and 3-, 6-, 12-, 18-, and 24-months postoperatively. For each HRQOL domain, we estimated the mean domain scores using a generalized estimation equation linear regression model. Each model included survey time, smoking status, and time-smoking interaction as covariates. Pairwise comparisons of current, former, and never smokers were estimated from the models. RESULTS Of the 411 patients available for analysis, 29% (n = 119) never smoked, 59% (n = 244) were former smokers, and 12% (n = 48) were current smokers. Over the follow-up period, never smokers compared to current smokers had better global QOL scores (mean difference = +8.9; 95% CI 1.3-16; p = 0.023) and lower pain levels (mean difference = -10; 95% CI -19 to -0.54; p = 0.036). Compared to current smokers, former smokers had marginal improvements in global QOL (+6.9 points) and pain (-7.5 points) during the follow-up period. CONCLUSIONS Current smokers reported worse HRQOL recovery in the 24-months after RC. These findings can be used to counsel patients who smoke on recovery expectations.
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Affiliation(s)
- Benjamin B Beech
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Alexander D Doudt
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.
| | - Daniel D Sjoberg
- Department of Epidemiology & Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY
| | | | - Amy L Tin
- Department of Epidemiology & Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Thomas M Atkinson
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Yuelin Li
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Bruce D Rapkin
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Andrew J Vickers
- Department of Epidemiology & Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Richard S Matulewicz
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Bernard H Bochner
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
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Mulla SA, Bedia AS, Nimmagadda HK, Bedia S, Patil AH. Evaluation of Salivary Alkaline Phosphatase Levels in Passive Smokers of Different Age Groups. Cureus 2023; 15:e41336. [PMID: 37546068 PMCID: PMC10397416 DOI: 10.7759/cureus.41336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/02/2023] [Indexed: 08/08/2023] Open
Abstract
Background The smoke inhaled by a nonsmoker from the smoldering end of a cigarette is referred to as passive smoke. The nicotine present in smoke is known to cause tissue damage and alter the enzymatic composition of the body. Alkaline phosphatase (ALP) is a group of intracellular hydrolytic enzymes known to partake in cellular metabolism. ALP levels are affected by smoking as well as passive smoking (PS) with a change in the pH of the oral cavity. The association of salivary alkaline phosphatase (S-ALP) levels in different age groups, gender, and times of exposure is not thoroughly explored yet, which was the primary aim of this study. Material and methods A total of 64 samples were collected from passive smokers and non-smokers. Unstimulated saliva (2-2.5 mL) was collected from each subject after obtaining their consent, followed by centrifuging and mixing with ALP reagent in a semi-autoanalyzer to obtain the S-ALP levels. Results Higher S-ALP levels were seen in passive smokers (34.70 IU/L) compared to healthy individuals (12 IU/L), which came to be statistically significant (p<0.01). S-ALP levels, when compared to different age groups and gender, were statistically insignificant (p>0.05). However, higher levels were seen in association with time of exposure in passive smokers where the data was statistically significant (p<0.01), suggesting tissue damage possibly due to oxidative stresses and tissue inflammation on continuous exposure for a minimum of 30-60 minutes daily as per our study. Conclusion Significantly high levels of S-ALP were found in passive smokers in comparison to non-smokers. This suggests that passive smoking has negative effects on the body tissues. Age, gender, and time of exposure of a non-smoker to tobacco smoke can lead to alterations in S-ALP levels. High levels of S-ALP were seen in individuals with prolonged exposure to tobacco smoke on a daily basis. Salivaomics can thus be used as a non-invasive, economical, and accurate alternative in tissue damage diagnosis.
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Affiliation(s)
- Sayem A Mulla
- Oral Medicine and Radiology, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Mumbai, IND
| | - Aarti S Bedia
- Oral Medicine and Radiology, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Mumbai, IND
| | - Haritha K Nimmagadda
- Anatomy, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Mumbai, IND
| | - Sumit Bedia
- Prosthodontics, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Mumbai, IND
| | - Amit H Patil
- Conservative Dentistry and Endodontics, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Mumbai, IND
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20
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Shi J, Xiong L, Guo J, Yang Y. The association between combustible/electronic cigarette use and stroke based on national health and nutrition examination survey. BMC Public Health 2023; 23:697. [PMID: 37059973 PMCID: PMC10103410 DOI: 10.1186/s12889-023-15371-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 03/03/2023] [Indexed: 04/16/2023] Open
Abstract
AIMS This study aims to analyze the association between combustible/electronic cigarettes and the risk of stroke. METHODS We obtained data from the 2017-2018 National Health and Nutrition Examination Survey (NHANES). The stroke history and combustible/electronic cigarette use were acquired by questionnaires. Considering the sole or dual use of combustible cigarettes and electronic cigarettes (e-cigarettes), we divided all the individuals into four subgroups, including nonsmokers (reference group), sole combustible cigarette, sole e-cigarette, and dual use of both combustible cigarettes and e-cigarettes. We performed multivariable logistic regression to determine the association between cigarette use with the prevalence of stroke. We used odds ratios (ORs) with 95% confidence intervals (CIs) to show the effect size. Finally, we developed a prediction model to evaluate the risk of stroke for individuals with combustible or electronic cigarette use based on a random forest model. RESULTS We included a total of 4022 participants in the study. The median age was 55, and 48.3% of the participants were males. When we adjusted for age, gender, education attainment, race, total-to-HDL cholesterol (< 5.9 or ≥ 5.9), diabetes, hypertension, and alcohol consumption, the groups of sole e-cigarette use, sole combustible cigarette use, and dual use of combustible and electronic cigarettes were significantly associated with the prevalence of stroke with ORs (with 95%CI) of 2.07 (1.04-3.81), 2.36 (1.52-3.59), 2.34 (1.44-3.68), respectively. In the testing set, the AUC was 0.74 (95%CI = 0.65-0.84), sensitivity was 0.68, and specificity was 0.75. CONCLUSION Sole e-cigarettes and dual use of e-cigarettes with combustible cigarettes might increase the risk of stroke.
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Affiliation(s)
- Jing Shi
- Health Management Center, Tongji Medical College, The Central Hospital of Wuhan, Huazhong University of Science and Technology, 430014, Wuhan, China
| | - Lijun Xiong
- Health Management Center, Tongji Medical College, The Central Hospital of Wuhan, Huazhong University of Science and Technology, 430014, Wuhan, China
| | - Jun Guo
- Health Management Center, Tongji Medical College, The Central Hospital of Wuhan, Huazhong University of Science and Technology, 430014, Wuhan, China
| | - Yan Yang
- Department of Neurology, Tongji Medical College, The Central Hospital of Wuhan, Huazhong University of Science and Technology, 430014, Wuhan, China.
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21
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Dogan A, Li Y, Peter Odo C, Sonawane K, Lin Y, Liu C. A utility-based machine learning-driven personalized lifestyle recommendation for cardiovascular disease prevention. J Biomed Inform 2023; 141:104342. [PMID: 36963450 DOI: 10.1016/j.jbi.2023.104342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 01/17/2023] [Accepted: 03/13/2023] [Indexed: 03/26/2023]
Abstract
In recent decades, cardiovascular disease (CVD) has become the leading cause of death in most countries of the world. Since many types of CVD are preventable by modifying lifestyle behaviors, the objective of this paper is to develop an effective personalized lifestyle recommendation algorithm for reducing the risk of common types of CVD. However, in practice, the underlying relationships between the risk factors (e.g., lifestyles, blood pressure, etc.) and disease onset is highly complex. It is also challenging to identify effective modification recommendations for different individuals due to individual's effort-benefits consideration and uncertainties in disease progression. Therefore, to address these challenges, this study developed a novel data-driven approach for personalized lifestyle behaviors recommendation based on machine learning and a personalized exponential utility function model. The contributions of this work can be summarized into three aspects: (1) a classification-based prediction model is implemented to predict the CVD risk based on the condition of risk factors; (2) the generative adversarial network (GAN) is incorporated to learn the underlying relationship between risk factors, as well as quantifying the uncertainty of disease progression under lifestyle modifications; and (3) a novel personalized exponential utility function model is proposed to evaluate the modifications' utilities with respect to CVD risk reduction, individual's effort-benefits consideration, and disease progression uncertainty, as well as identify the optimal modification for each individual. The effectiveness of the proposed method is validated through an open-access CVD dataset. The results demonstrate that the personalized lifestyle modification recommended by the proposed methodology has the potential to effectively reduce the CVD risk. Thus, it is promising to be further applied to real-world cases for CVD prevention.
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Affiliation(s)
- Ayse Dogan
- The School of Industrial Engineering & Management, Oklahoma State University, Stillwater, OK, United States
| | - Yuxuan Li
- The School of Industrial Engineering & Management, Oklahoma State University, Stillwater, OK, United States
| | - Chiwetalu Peter Odo
- Department of Industrial Engineering, University of Houston, Houston, TX, United States
| | - Kalyani Sonawane
- Center for Healthcare Data, Department of Management, Policy, and Community Health, UTHealth School of Public Health, Houston, TX, United States
| | - Ying Lin
- Department of Industrial Engineering, University of Houston, Houston, TX, United States
| | - Chenang Liu
- The School of Industrial Engineering & Management, Oklahoma State University, Stillwater, OK, United States
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22
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El Hajj S, Canabady-Rochelle L, Gaucher C. Nature-Inspired Bioactive Compounds: A Promising Approach for Ferroptosis-Linked Human Diseases? Molecules 2023; 28:molecules28062636. [PMID: 36985608 PMCID: PMC10059971 DOI: 10.3390/molecules28062636] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 03/02/2023] [Accepted: 03/08/2023] [Indexed: 03/16/2023] Open
Abstract
Ferroptosis is a type of cell death driven by iron overload and lipid peroxidation. It is considered a key mechanism in the development of various diseases such as atherosclerosis, Alzheimer, diabetes, cancer, and renal failure. The redox status of cells, such as the balance between intracellular oxidants (lipid peroxides, reactive oxygen species, free iron ions) and antioxidants (glutathione, glutathione Peroxidase 4), plays a major role in ferroptosis regulation and constitutes its principal biomarkers. Therefore, the induction and inhibition of ferroptosis are promising strategies for disease treatments such as cancer or neurodegenerative and cardiovascular diseases, respectively. Many drugs have been developed to exert ferroptosis-inducing and/or inhibiting reactions, such as erastin and iron-chelating compounds, respectively. In addition, many natural bioactive compounds have significantly contributed to regulating ferroptosis and ferroptosis-induced oxidative stress. Natural bioactive compounds are largely abundant in food and plants and have been for a long time, inspiring the development of various low-toxic therapeutic drugs. Currently, functional bioactive peptides are widely reported for their antioxidant properties and application in human disease treatment. The scientific evidence from biochemical and in vitro tests of these peptides strongly supports the existence of a relationship between their antioxidant properties (such as iron chelation) and ferroptosis regulation. In this review, we answer questions concerning ferroptosis milestones, its importance in physiopathology mechanisms, and its downstream regulatory mechanisms. We also address ferroptosis regulatory natural compounds as well as provide promising thoughts about bioactive peptides.
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Affiliation(s)
- Sarah El Hajj
- Université de Lorraine, CITHEFOR, F-54505 Vandoeuvre Les Nancy, France
- Université de Lorraine, CNRS, LRGP, F-54000 Nancy, France
| | | | - Caroline Gaucher
- Université de Lorraine, CITHEFOR, F-54505 Vandoeuvre Les Nancy, France
- Université de Lorraine, CNRS, IMoPA, F-54000 Nancy, France
- Correspondence:
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23
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Alday EAP, Poian GD, Levantsevych O, Murrah N, Shallenberger L, Alkhalaf M, Haffar A, Kaseer B, Yi-An K, Goldberg J, Smith N, Lampert R, Bremner JD, Clifford GD, Vaccarino V, Shah AJ. Association of Autonomic Activation with traumatic reminder challenges in posttraumatic stress disorder: A co-twin control study. Psychophysiology 2023; 60:e14167. [PMID: 35959570 PMCID: PMC10157622 DOI: 10.1111/psyp.14167] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 06/04/2022] [Accepted: 07/31/2022] [Indexed: 01/04/2023]
Abstract
Post-traumatic stress disorder (PTSD) has been associated with cardiovascular disease (CVD), but the mechanisms remain unclear. Autonomic dysfunction, associated with higher CVD risk, may be triggered by acute PTSD symptoms. We hypothesized that a laboratory-based trauma reminder challenge, which induces acute PTSD symptoms, provokes autonomic dysfunction in a cohort of veteran twins. We investigated PTSD-associated real-time physiologic changes with a simulation of traumatic experiences in which the twins listened to audio recordings of a one-minute neutral script followed by a one-minute trauma script. We examined two heart rate variability metrics: deceleration capacity (DC) and logarithmic low frequency (log-LF) power from beat-to-beat intervals extracted from ambulatory electrocardiograms. We assessed longitudinal PTSD status with a structured clinical interview and the severity with the PTSD Symptoms Scale. We used linear mixed-effects models to examine twin dyads and account for cardiovascular and behavioral risk factors. We examined 238 male Veteran twins (age 68 ± 3 years old, 4% black). PTSD status and acute PTSD symptom severity were not associated with DC or log-LF measured during the neutral session, but were significantly associated with lower DC and log-LF during the traumatic script listening session. Long-standing PTSD was associated with a 0.38 (95% confidence interval, -0.83,-0.08) and 0.79 (-1.30,-0.29) standardized unit lower DC and log-LF, respectively, compared to no history of PTSD. Traumatic reminders in patients with PTSD lead to real-time autonomic dysregulation and suggest a potential causal mechanism for increased CVD risk, based on the well-known relationships between autonomic dysfunction and CVD mortality.
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Affiliation(s)
- Erick A. Perez Alday
- Department of Biomedical Informatics, School of Medicine, Emory University, Atlanta, Georgia, USA
| | - Giulia Da Poian
- Department of Health Sciences and Technology, ETH Zürich, Zürich, Switzerland
| | - Oleksiy Levantsevych
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Nancy Murrah
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Lucy Shallenberger
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Mhmtjamil Alkhalaf
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Ammer Haffar
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Belal Kaseer
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Ko Yi-An
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Jack Goldberg
- Seattle Epidemiologic Research and Information Center, United States Department of Veterans Affairs Office of Research and Development, Seattle, Washington, USA
| | - Nicholas Smith
- Seattle Epidemiologic Research and Information Center, United States Department of Veterans Affairs Office of Research and Development, Seattle, Washington, USA
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Rachel Lampert
- Yale University School of Medicine, New Haven, Connecticut, USA
| | - J. Douglas Bremner
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia, USA
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia, USA
- Atlanta Veterans Affairs Health Care System, Decatur, Georgia, USA
| | - Gari D. Clifford
- Department of Biomedical Informatics, School of Medicine, Emory University, Atlanta, Georgia, USA
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, Georgia, USA
| | - Viola Vaccarino
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Amit J. Shah
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
- Atlanta Veterans Affairs Health Care System, Decatur, Georgia, USA
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
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Shahin Y, Gofus J, Harrer J, Šorm Z, Voborník M, Čermáková E, Smolák P, Vojáček J. Impact of smoking on the outcomes of minimally invasive direct coronary artery bypass. J Cardiothorac Surg 2023; 18:43. [PMID: 36670443 PMCID: PMC9862783 DOI: 10.1186/s13019-023-02104-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 01/02/2023] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Tobacco smoking has been associated with an increased risk of complications after conventional coronary surgery. However, the impact of smoking on the risk of postoperative complications in minimally invasive coronary surgery is yet to be studied. We aimed to analyze the impact of the preoperative smoking status on the short- and long-term outcomes of minimally invasive direct coronary artery bypass grafting (MIDCAB) in the context of isolated surgical revascularization or in association with percutaneous coronary intervention. METHODS This was a retrospective observational study of all patients undergoing MIDCAB at our institution between 2006 and 2020. Patients were divided into three groups: active smokers, ex-smokers who have quit smoking for at least 1 month before surgery, and non-smokers. The groups were compared using conventional statistical methods. Multivariate analysis was then performed where significant differences were found to eliminate bias. RESULTS Throughout the study period, 541 patients underwent MIDCAB, of which 135 (25%) were active smokers, 183 (34%) were ex-smokers, and 223 (41%) were non-smokers. Smokers presented for surgery at a younger age (p < 0.0001), more frequently with a history of myocardial infarction (p < 0.001), peripheral artery disease (p < 0.001) and chronic obstructive pulmonary disease (p < 0.0001). Using multivariate analysis, active smoking was determined to be a significant risk factor for the need of urgent revascularization (odds ratio 2.36 [1.00-5.56], p = 0.049) and the composite of pulmonary complications (including pneumothorax, respiratory infection, respiratory dysfunction, subcutaneous emphysema and exacerbation of chronic obstructive pulmonary disease; odds ratio 2.84 [1.64-4.94], p < 0.001). Preoperative smoking status did not influence the long-term survival (p = 0.83). CONCLUSIONS In our study, active smokers presented for MIDCAB at a younger age and more often with signs of atherosclerotic disease (history of myocardial infarction and peripheral artery disease). Active smoking was found to be the most significant risk factor for postoperative pulmonary complications, and is also associated with a more frequent need for urgent surgery at diagnosis. Long-term postoperative survival is not affected by the preoperative smoking status.
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Affiliation(s)
- Youssef Shahin
- grid.4491.80000 0004 1937 116XDepartment of Cardiac Surgery, Faculty of Medicine and University Hospital in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic
| | - Ján Gofus
- grid.4491.80000 0004 1937 116XDepartment of Cardiac Surgery, Faculty of Medicine and University Hospital in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic
| | - Jan Harrer
- grid.4491.80000 0004 1937 116XDepartment of Cardiac Surgery, Faculty of Medicine and University Hospital in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic
| | - Zdeněk Šorm
- grid.4491.80000 0004 1937 116XDepartment of Cardiac Surgery, Faculty of Medicine and University Hospital in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic
| | - Martin Voborník
- grid.4491.80000 0004 1937 116XDepartment of Cardiac Surgery, Faculty of Medicine and University Hospital in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic
| | - Eva Čermáková
- grid.4491.80000 0004 1937 116XDepartment of Medical Biophysics, Faculty of Medicine in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic
| | - Petr Smolák
- grid.4491.80000 0004 1937 116XDepartment of Cardiac Surgery, Faculty of Medicine and University Hospital in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic
| | - Jan Vojáček
- grid.4491.80000 0004 1937 116XDepartment of Cardiac Surgery, Faculty of Medicine and University Hospital in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic
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The Correlation between the Vascular Calcification Score of the Coronary Artery and the Abdominal Aorta in Patients with Psoriasis. Diagnostics (Basel) 2023; 13:diagnostics13020274. [PMID: 36673084 PMCID: PMC9858225 DOI: 10.3390/diagnostics13020274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 12/22/2022] [Accepted: 01/09/2023] [Indexed: 01/15/2023] Open
Abstract
Psoriasis is known as an independent risk factor for cardiovascular disease due to its chronic inflammation. Studies have been conducted to evaluate the progress of atherosclerotic plaques in psoriasis. However, inadequate efforts have been made to clarify the relationship between atherosclerosis progress in coronary arteries and other important blood vessels. For that reason, we investigated the correlation and development of the coronary artery calcification score (CACS) and the abdominal aortic calcification score (AACS) during a follow-up examination. Eighty-three patients with psoriasis underwent coronary computed tomography angiography (CCTA) for total CACS and abdominal computed tomography (AbCT) for total AACS. PASI score, other clinical features, and blood samples were collected at the same time. The patients' medical histories were also retrieved for further analysis. Linear regression was used to analyze the CACS and AACS associations. There was a moderate correlation between CACS and AACS, while both calcification scores relatively reflected the coronary plaque number, coronary stenosis number, and stenosis severity observed with CCTA. Both calcification scores were independent of the PASI score. However, a significantly higher CACS was found in psoriatic arthritis, whereas no similar phenomenon was recorded for AACS. To conclude, both CACS and AACS might be potential alternative tests to predict the presence of coronary lesions as confirmed by CCTA.
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26
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Wang J, Yuan Q, Morovvati H, Goorani S. Green synthesis, characterization and anti-atherosclerotic properties of vanadium nanoparticles. INORG CHEM COMMUN 2022. [DOI: 10.1016/j.inoche.2022.110092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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27
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An integral perspective of canonical cigarette and e-cigarette-related cardiovascular toxicity based on the adverse outcome pathway framework. J Adv Res 2022:S2090-1232(22)00193-X. [PMID: 35998874 DOI: 10.1016/j.jare.2022.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 07/29/2022] [Accepted: 08/15/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Nowadays, cigarette smoking remains the leading cause of chronic disease and premature death, especially cardiovascular disease. As an emerging tobacco product, e-cigarettes have been advocated as alternatives to canonical cigarettes, and thus may be an aid to promote smoking cessation. However, recent studies indicated that e-cigarettes should not be completely harmless to the cardiovascular system. AIM OF REVIEW This review aimed to build up an integral perspective of cigarettes and e-cigarettes-related cardiovascular toxicity. KEY SCIENTIFIC CONCEPTS OF REVIEW This review adopted the adverse outcome pathway (AOP) framework as a pivotal tool and aimed to elucidate the association between the molecular initiating events (MIEs) induced by cigarette and e-cigarette exposure to the cardiovascular adverse outcome. Since the excessive generation of reactive oxygen species (ROS) has been widely approved to play a critical role in cigarette smoke-related CVD and may also be involved in e-cigarette-induced toxic effects, the ROS overproduction and subsequent oxidative stress are regarded as essential parts of this framework. As far as we know, this should be the first AOP framework focusing on cigarette and e-cigarette-related cardiovascular toxicity, and we hope our work to be a guide in exploring the biomarkers and novel therapies for cardiovascular injury.
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28
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Monasso GS, Felix JF, Gaillard R, Jaddoe VWV. Fetal and Childhood Exposure to Parental Tobacco Smoking and Arterial Health at Age 10 Years. Am J Hypertens 2022; 35:867-874. [PMID: 35882377 PMCID: PMC9527773 DOI: 10.1093/ajh/hpac084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 06/14/2022] [Accepted: 07/25/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Exposure to parental tobacco smoking during fetal life and childhood is associated with adverse cardiovascular health outcomes. It is not known whether these adverse parental lifestyle exposures are also associated with changes in the structure and function of the carotid arteries in children aged 10 years. METHODS In a population-based prospective cohort study among 4,639 healthy children, we examined the associations of fetal exposure to maternal (no, first trimester only, continued), paternal (no, yes), and combined parental tobacco smoking (nonsmoking parents, mother only, father only, both parents smoked) with carotid intima-media thickness and distensibility at 10 years. We also assessed the associations of exposure to any parental tobacco smoking at ages 6 and 10 years with these outcomes. RESULTS Compared with no exposure, fetal exposure to continued maternal smoking was not associated with carotid intima-media thickness (-0.04 standard deviation score (SDS); 95% confidence interval (CI): -0.13, 0.05); and distensibility (0 SDS, 95% CI: -0.09, 0.09) at age 10 years. Fetal exposure to two smoking parents was also not associated with carotid intima-media thickness (-0.07 SDS, 95% CI: -0.16, 0.02) and distensibility (0 SDS, 95% CI: -0.09, 0.10) at this age. Exposure to any parental smoking during childhood also was not associated with these outcomes at age 10 years. CONCLUSIONS Exposure to parental tobacco smoking during fetal life and childhood was not associated with markers of arterial health in children aged 10 years. Prevention strategies aiming at minimizing smoke exposure later in life are still relevant regarding arterial health.
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Affiliation(s)
- Giulietta S Monasso
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands,Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Janine F Felix
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands,Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Romy Gaillard
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands,Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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Anghel R, Adam CA, Marcu DTM, Mitu O, Roca M, Tinica G, Mitu F. Cardiac Rehabilitation in Peripheral Artery Disease in a Tertiary Center-Impact on Arterial Stiffness and Functional Status after 6 Months. Life (Basel) 2022; 12:life12040601. [PMID: 35455092 PMCID: PMC9024562 DOI: 10.3390/life12040601] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/07/2022] [Accepted: 04/15/2022] [Indexed: 12/12/2022] Open
Abstract
Background and Objectives: Cardiac rehabilitation (CR) plays an essential role in peripheral artery disease (PAD), leading to improved functional status, increased quality of life, and reduced arterial stiffness. We aimed to assess factors associated with clinical improvement 6 months after enrolment in a rehabilitation program at an academic medical center in north-eastern Europe. Materials and Methods: We conducted a prospective cohort study on 97 patients with PAD admitted to a single tertiary referral center. At the 6-months follow-up, 75 patients (77.3%) showed improved clinical status. We analyzed demographics and clinical and paraclinical parameters in order to explore factors associated with a favorable outcome. Results: Hypertension (p = 0.002), diabetes mellitus (p = 0.002), dyslipidemia (p = 0.045), and obesity (p = 0.564) were associated with no clinical improvement. Smoking cessation (p < 0.001), changing sedentary lifestyle (p = 0.032), and improvement of lipid and carbohydrate profile as well as functional status parameters and ambulatory arterial stiffness index (p = 0.008) were factors associated with clinical improvement at the 6-months follow-up. Conclusions: PAD patients require an integrative, multidisciplinary management to maintain functional status and increase quality of life. Improving carbohydrate and lipid profile, adopting a healthy lifestyle, quitting smoking and increasing exercise capacity are predictors for clinical improvement 6 months after enrolment in a CR program.
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Affiliation(s)
- Razvan Anghel
- Clinical Rehabilitation Hospital, Cardiovascular Rehabilitation Clinic, Pantelimon Halipa Street nr 14, 700661 Iași, Romania; (R.A.); (C.A.A.); (M.R.); (F.M.)
- Department of Internal Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, University Street nr 16, 700115 Iași, Romania;
| | - Cristina Andreea Adam
- Clinical Rehabilitation Hospital, Cardiovascular Rehabilitation Clinic, Pantelimon Halipa Street nr 14, 700661 Iași, Romania; (R.A.); (C.A.A.); (M.R.); (F.M.)
| | - Dragos Traian Marius Marcu
- Department of Internal Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, University Street nr 16, 700115 Iași, Romania;
| | - Ovidiu Mitu
- Department of Internal Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, University Street nr 16, 700115 Iași, Romania;
- “Sf. Spiridon” Clinical Emergency Hospital, Independence Boulevard nr 1, 700111 Iași, Romania
- Correspondence:
| | - Mihai Roca
- Clinical Rehabilitation Hospital, Cardiovascular Rehabilitation Clinic, Pantelimon Halipa Street nr 14, 700661 Iași, Romania; (R.A.); (C.A.A.); (M.R.); (F.M.)
- Department of Internal Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, University Street nr 16, 700115 Iași, Romania;
| | - Grigore Tinica
- Department of Cardiovascular Surgery, University of Medicine and Pharmacy “Grigore T. Popa”, University Street nr 16, 700115 Iași, Romania;
- Institute of Cardiovascular Diseases “Prof. Dr. George I.M. Georgescu”, 700503 Iași, Romania
| | - Florin Mitu
- Clinical Rehabilitation Hospital, Cardiovascular Rehabilitation Clinic, Pantelimon Halipa Street nr 14, 700661 Iași, Romania; (R.A.); (C.A.A.); (M.R.); (F.M.)
- Department of Internal Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, University Street nr 16, 700115 Iași, Romania;
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TXNIP: A Double-Edged Sword in Disease and Therapeutic Outlook. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:7805115. [PMID: 35450411 PMCID: PMC9017576 DOI: 10.1155/2022/7805115] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 02/17/2022] [Accepted: 03/21/2022] [Indexed: 12/15/2022]
Abstract
Thioredoxin-interacting protein (TXNIP) was originally named vitamin D3 upregulated protein-1 (VDUP1) because of its ability to bind to thioredoxin (TRX) and inhibit TRX function and expression. TXNIP is an alpha-arrestin protein that is essential for redox homeostasis in the human body. TXNIP may act as a double-edged sword in the cell. The balance of TXNIP is crucial. A study has shown that TXNIP can travel between diverse intracellular locations and bind to different proteins to play different roles under oxidative stress. The primary function of TXNIP is to induce apoptosis or pyroptosis under oxidative stress. TXNIP also inhibits proliferation and migration in cancer cells, although TXNIP levels decrease, and function diminishes in various cancers. In this review, we summarized the main structure, binding proteins, pathways, and the role of TXNIP in diseases, aiming to explore the double-edged sword role of TXNIP, and expect it to be helpful for future treatment using TXNIP as a therapeutic target.
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Kawasoe M, Kawasoe S, Kubozono T, Ojima S, Kawabata T, Ikeda Y, Oketani N, Miyahara H, Tokushige K, Miyata M, Ohishi M. Development of a risk prediction score for hypertension incidence using Japanese health checkup data. Hypertens Res 2022; 45:730-740. [PMID: 34961790 DOI: 10.1038/s41440-021-00831-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 10/06/2021] [Accepted: 11/03/2021] [Indexed: 11/09/2022]
Abstract
Hypertension is a risk factor for cardiovascular disease. We developed a simple scoring method for predicting future hypertension using health checkup data. A total of 41,902 participants aged 30-69 years without baseline hypertension who underwent annual health checkups (mean age, 52.3 ± 10.2 years; male, 47.7%) were included. They were randomly assigned to derivation (n = 27,935) and validation cohorts (n = 13,967) at a ratio of 2:1. In the derivation cohort, we performed multivariable logistic regression analysis and assigned scores to each factor significantly associated with 5-year hypertension. We evaluated the predictive ability of the scores using area under the curve (AUC) analysis and then applied them to the validation cohort to assess their validity. The score including items requiring blood sampling ranged from 0 to 14 and included seven indicators (age, body mass index, blood pressure, current smoking, family history of hypertension, diabetes, and hyperuricemia). The score not including items requiring blood sampling ranged from 0 to 12 and included five indicators (the above indicators, except diabetes and hyperuricemia). The score not including items requiring blood sampling was better; blood sampling did not improve diagnostic ability. The AUC of the score not including items requiring blood sampling was 0.76, with a sensitivity and specificity of 0.82 and 0.60, respectively, for scores ≥6 points. The incidence of hypertension gradually and constantly increased (from 0.9 to 49.6%) as the score increased from 0 to ≥10. Analysis in the validation cohort yielded similar results. We developed a simple and useful clinical prediction model to predict the 5-year incidence of hypertension among a general Japanese population. The model had reasonably high predictive ability and reproducibility.
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Affiliation(s)
- Mariko Kawasoe
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.,Kagoshima City Hospital, Kagoshima, Japan
| | - Shin Kawasoe
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Takuro Kubozono
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.
| | - Satoko Ojima
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Takeko Kawabata
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Yoshiyuki Ikeda
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | | | | | | | - Masaaki Miyata
- School of Health Sciences, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Mitsuru Ohishi
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
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Identification of Risk Factors for Coronary Artery Disease in Asymptomatic Patients with Type 2 Diabetes Mellitus. J Clin Med 2022; 11:jcm11051226. [PMID: 35268317 PMCID: PMC8910834 DOI: 10.3390/jcm11051226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 02/09/2022] [Accepted: 02/22/2022] [Indexed: 11/23/2022] Open
Abstract
Background: Patients with diabetes mellitus (DM) are a high-risk group for coronary artery disease (CAD). In the present study, we investigated predictive factors to identify patients at high risk of CAD among asymptomatic patients with type 2 DM based on coronary computed tomographic angiography (CCTA) findings. Methods: A single-center prospective study was performed on 452 consecutive patients with type 2 DM who were provided with a weekly hospital-based diabetes education program between 3 October 2015, and 31 March 2020. A total of 161 consecutive asymptomatic patients (male/female: 111/50, age: 57.3 ± 9.3 years) with type 2 DM without any known CAD underwent CCTA. Based on conventional coronary risk factors and non-invasive examination, i.e., measurement of intima-media thickness, subcutaneous and visceral fat area, a stress electrocardiogram test, and the Agatston score, patients with obstructive CAD, CT-verified high-risk plaques (CT-HRP), and optimal revascularization within 90 days were evaluated. Results: Current smoking (OR, 4.069; 95% C.I., 1.578–10.493, p = 0.0037) and the Agatston score ≥100 (OR, 18.034; 95% C.I., 6.337–51.324, p = 0.0001) were independent predictive factors for obstructive CAD, while current smoking (OR, 5.013; 95% C.I., 1.683–14.931, p = 0.0038) was an independent predictive factor for CT-HRP. Furthermore, insulin treatment (OR, 5.677; 95% C.I., 1.223–26.349, p = 0.0266) was the only predictive factor that correlated with optimal revascularization within 90 days. Conclusions: In asymptomatic patients with type 2 DM, current smoking, an Agatston score ≥100, and insulin treatment were independent predictive factors of patients being at high-risk for CAD. However, non-invasive examinations except for Agatston score were not independent predictors of patients being at high risk of CAD.
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33
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Olesen KKW, Thrane PG, Würtz M, Kristensen SD, Maeng M. Cardiovascular risks associated with smoking in patients without obstructive coronary artery disease. Eur J Prev Cardiol 2022; 29:e14-e17. [DOI: 10.1093/eurjpc/zwaa109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 10/04/2020] [Accepted: 10/13/2020] [Indexed: 11/14/2022]
Affiliation(s)
- Kevin Kris Warnakula Olesen
- Department of Cardiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark
| | - Pernille Gro Thrane
- Department of Cardiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark
| | - Morten Würtz
- Department of Cardiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark
| | - Steen Dalby Kristensen
- Department of Cardiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark
| | - Michael Maeng
- Department of Cardiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark
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Lin J, Xiang X, Qin Y, Gui J, Wan Q. Correlation of thyroid-related hormones with vascular complications in type 2 diabetes patients with euthyroid. Front Endocrinol (Lausanne) 2022; 13:1037969. [PMID: 36465631 PMCID: PMC9715611 DOI: 10.3389/fendo.2022.1037969] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 10/26/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND This study aimed to evaluate the relationship between thyroid-related hormones and vascular complications in type 2 diabetes mellitus (T2DM) patients with euthyroidism. METHODS We enrolled 849 patients with T2DM after screening out the ineligible. Multivariate logistic regression was used to analyze the relationship between fT3, fT4, the fT3/fT4 ratio, thyroid-stimulating hormone, and diabetic vascular complications. Spearman correlation analysis was used to determine the correlation between thyroid-related hormones and vascular complications. RESULTS In this cross-sectional study of T2DM, 538 patients with carotid atherosclerosis (CA) and 299 patients with diabetic peripheral neuropathy (DPN). The prevalence of DPN was negatively correlated with fT3 and the fT3/fT4 ratio but positively correlated with fT4 (all P<0.01). At the same time, the odds ratio for DPN decreased with increasing fT3 (T1: reference; T2: OR: 0.689, 95%CI: 0.477, 0.993; T3: OR: 0.426, 95% CI: 0.286, 0.633, all P<0.05) and fT3/fT4 ratio (T1: reference; T2: OR: 0.528, 95% CI: 0.365, 0.763; T3: OR: 0.413, 95% CI: 0.278, 0.613, all P<0.001). In terms of sensitivity and specificity, fT4 was found to be 39.5% and 71.4% accurate, respectively, with a 95% CI of 0.531-0.611. CONCLUSIONS We found a negative correlation between fT3 and fT3/fT4 ratio and the number of individuals with DPN, and a positive correlation between fT4 and the prevalence of DPN.
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Affiliation(s)
- Jie Lin
- Department of Endocrinology and Metabolism, Affiliated Hospital of Southwest Medical University, Luzhou, China
- Metabolic Vascular Disease Key Laboratory of Sichuan Province, Luzhou, China
- Sichuan Clinical Research Center for Nephropathy, Luzhou, China
- Cardiovascular and Metabolic Diseases Key Laboratory of Luzhou, Luzhou, China
| | - Xin Xiang
- Department of Endocrinology and Metabolism, Affiliated Hospital of Southwest Medical University, Luzhou, China
- Metabolic Vascular Disease Key Laboratory of Sichuan Province, Luzhou, China
- Sichuan Clinical Research Center for Nephropathy, Luzhou, China
- Cardiovascular and Metabolic Diseases Key Laboratory of Luzhou, Luzhou, China
| | - Yahui Qin
- Department of Endocrinology and Metabolism, Affiliated Hospital of Southwest Medical University, Luzhou, China
- Metabolic Vascular Disease Key Laboratory of Sichuan Province, Luzhou, China
- Sichuan Clinical Research Center for Nephropathy, Luzhou, China
- Cardiovascular and Metabolic Diseases Key Laboratory of Luzhou, Luzhou, China
| | - Jing Gui
- Department of Endocrinology and Metabolism, Affiliated Hospital of Southwest Medical University, Luzhou, China
- Metabolic Vascular Disease Key Laboratory of Sichuan Province, Luzhou, China
- Sichuan Clinical Research Center for Nephropathy, Luzhou, China
- Cardiovascular and Metabolic Diseases Key Laboratory of Luzhou, Luzhou, China
| | - Qin Wan
- Department of Endocrinology and Metabolism, Affiliated Hospital of Southwest Medical University, Luzhou, China
- Metabolic Vascular Disease Key Laboratory of Sichuan Province, Luzhou, China
- Sichuan Clinical Research Center for Nephropathy, Luzhou, China
- Cardiovascular and Metabolic Diseases Key Laboratory of Luzhou, Luzhou, China
- *Correspondence: Qin Wan,
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Brust JC. Stroke and Substance Abuse. Stroke 2022. [DOI: 10.1016/b978-0-323-69424-7.00039-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Bray MJ, Chen LS, Fox L, Ma Y, Grucza RA, Hartz SM, Culverhouse RC, Saccone NL, Hancock DB, Johnson EO, McKay JD, Baker TB, Bierut LJ. Studying the Utility of Using Genetics to Predict Smoking-Related Outcomes in a Population-Based Study and a Selected Cohort. Nicotine Tob Res 2021; 23:2110-2116. [PMID: 33991188 PMCID: PMC8570670 DOI: 10.1093/ntr/ntab100] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 05/10/2021] [Indexed: 01/20/2023]
Abstract
INTRODUCTION The purpose of this study is to examine the predictive utility of polygenic risk scores (PRSs) for smoking behaviors. AIMS AND METHODS Using summary statistics from the Sequencing Consortium of Alcohol and Nicotine use consortium, we generated PRSs of ever smoking, age of smoking initiation, cigarettes smoked per day, and smoking cessation for participants in the population-based Atherosclerosis Risk in Communities (ARIC) study (N = 8638), and the Collaborative Genetic Study of Nicotine Dependence (COGEND) (N = 1935). The outcomes were ever smoking, age of smoking initiation, heaviness of smoking, and smoking cessation. RESULTS In the European ancestry cohorts, each PRS was significantly associated with the corresponding smoking behavior outcome. In the ARIC cohort, the PRS z-score for ever smoking predicted smoking (odds ratio [OR]: 1.37; 95% confidence interval [CI]: 1.31, 1.43); the PRS z-score for age of smoking initiation was associated with age of smoking initiation (OR: 0.87; 95% CI: 0.82, 0.92); the PRS z-score for cigarettes per day was associated with heavier smoking (OR: 1.17; 95% CI: 1.11, 1.25); and the PRS z-score for smoking cessation predicted successful cessation (OR: 1.24; 95% CI: 1.17, 1.32). In the African ancestry cohort, the PRSs did not predict smoking behaviors. CONCLUSIONS Smoking-related PRSs were associated with smoking-related behaviors in European ancestry populations. This improvement in prediction is greatest in the lowest and highest genetic risk categories. The lack of prediction in African ancestry populations highlights the urgent need to increase diversity in research so that scientific advances can be applied to populations other than those of European ancestry. IMPLICATIONS This study shows that including both genetic ancestry and PRSs in a single model increases the ability to predict smoking behaviors compared with the model including only demographic characteristics. This finding is observed for every smoking-related outcome. Even though adding genetics is more predictive, the demographics alone confer substantial and meaningful predictive power. However, with increasing work in PRSs, the predictive ability will continue to improve.
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Affiliation(s)
- Michael J Bray
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Li-Shiun Chen
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
- The Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Louis Fox
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Yinjiao Ma
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Richard A Grucza
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Sarah M Hartz
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Robert C Culverhouse
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, USA
| | - Nancy L Saccone
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, USA
- Department of Genetics, Washington University School of Medicine, St. Louis, MO, USA
| | - Dana B Hancock
- GenOmics, Bioinformatics, and Translational Research Center, Biostatistics and Epidemiology Division, RTI International, Research Triangle Park, NC, USA
| | - Eric O Johnson
- GenOmics, Bioinformatics, and Translational Research Center, Biostatistics and Epidemiology Division, RTI International, Research Triangle Park, NC, USA
- Fellow Program, RTI International, Research Triangle Park, NC, USA
| | - James D McKay
- Genetic Cancer Susceptibility Group, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Timothy B Baker
- Department of Medicine, Center for Tobacco Research and Intervention, University of Wisconsin, School of Medicine and Public Health, Madison, WI, USA
| | - Laura J Bierut
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
- The Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USA
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Kim YE, Lee M, Lee YH, Kang ES, Cha BS, Lee BW. Proteinuria as a significant predictive factor for the progression of carotid artery atherosclerosis in non-albuminuric type 2 diabetes. Diabetes Res Clin Pract 2021; 181:109082. [PMID: 34627943 DOI: 10.1016/j.diabres.2021.109082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 09/27/2021] [Accepted: 10/05/2021] [Indexed: 11/23/2022]
Abstract
AIMS This study aimed to evaluate the clinical significance of urine protein to creatinine ratio (uPCR) in relation to the cardiovascular risk associated with carotid artery intima-media thickness (cIMT) progression in subjects with type 2 diabetes (T2D) and normoalbuminuria. METHODS In this retrospective longitudinal study on T2D, we recruited 927 participants with normoalbuminuria (urine albumin to creatinine ratio [uACR] < 30 mg/g) whose cIMT was measured at baseline and after at least 1 year, and whose initial uPCR and uACR data were available. RESULTS Higher initial uPCR was positively correlated with a greater increment in maximal cIMT (β = 0.074, p = 0.028), and this correlation was significant even after adjusting for multiple confounding factors (β = 0.074, p = 0.046). High baseline uPCR was an independent predictive factor for the increased risk of maximal cIMT progression in a simple logistic regression model (OR, 1.41; 95% CI, [1.08-1.86]; p = 0.013). Even after adjusting for several confounding variables, higher uPCR was significantly associated with a higher risk of cIMT progression (OR, 1.48; 95% CI, [1.08-2.03]; p = 0.014). CONCLUSIONS These results suggest that high uPCR may be a useful predictive marker for the progression of carotid artery atherosclerosis, even in subjects with T2D and without albuminuria.
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Affiliation(s)
- Young-Eun Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Minyoung Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Yong-Ho Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Eun Seok Kang
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Bong-Soo Cha
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Byung-Wan Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
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Carotid revascularization and cognitive impairment: the neglected role of cerebral small vessel disease. Neurol Sci 2021; 43:139-152. [PMID: 34596778 DOI: 10.1007/s10072-021-05629-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 09/22/2021] [Indexed: 10/20/2022]
Abstract
Carotid atherosclerosis is a pathological process that leads to narrowing of the vessel lumen and a consequent risk of stroke. Revascularization procedures such as carotid endarterectomy (CEA) and carotid stenting aim to reduce occurrence of stroke in selected patients. Due to the proven benefit and low intraoperative risk, CEA is currently the preferred choice in candidates for carotid revascularization. However, the risk of cognitive impairment subsequent to CEA has not been fully elucidated and is unclear whether certain conditions, such as frailty, may increase this risk. There is consistent evidence that shows that frail patients have higher risk of cognitive impairment after surgical procedure. Moreover, brain pre-existing conditions may play a role in cognitive impairment after CEA. Cerebral small vessel disease (SVD) is a pathology that involves microcirculation and is detectable with computed tomography or magnetic resonance. SVD shares common vascular risk factors with carotid atherosclerosis, is a major contributor to vascular cognitive impairment and vascular dementia, and has been proposed as a marker of brain frailty. In this review, we discuss the current evidence about the link between carotid revascularization and cognitive impairment and advance the hypothesis that SVD may play a relevant role in development of cognitive impairment after carotid revascularization.
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Zhang Y, Shi L, Chang H, Schwartz J, Di Q, Goldberg J, Vaccarino V. A Co-Twin control study of fine particulate matter and the prevalence of metabolic syndrome risk factors. ENVIRONMENTAL RESEARCH 2021; 201:111604. [PMID: 34186076 PMCID: PMC8478791 DOI: 10.1016/j.envres.2021.111604] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 06/20/2021] [Accepted: 06/23/2021] [Indexed: 06/13/2023]
Abstract
The relationship between ambient fine particulate matter (PM2.5) and metabolic syndrome (MetS) is understudied. It also remains unknown whether familial factors play a role in this relationship. In a study of 566 middle-aged twins, we examined the association of PM2.5 with MetS risk factors, measured by a MetS score as a summation of individual risk factors (range, 0 to 5). High-resolution PM2.5 estimates were obtained through previously validated models that incorporated monitor and satellite derived data. We estimated two-year average PM2.5 concentrations based on the ZIP code of each twin's residence. We used ordinal response models adapted for twin studies. When treating twins as individuals, the odds ratio of having 1-point higher MetS score was 1.78 for each 10 μg/m3-increase in exposure to PM2.5 (confidence interval [CI]: 1.01, 3.15), after adjusting for potential confounders. This association was mainly between pairs; the odds ratio was 1.97 (CI: 1.01, 3.84) for each 10 μg/m3-increase in the average pairwise exposure level. We found no significant difference in MetS scores within pairs who were discordant for PM2.5 exposure. In conclusion, higher PM2.5 in residence area is associated with more MetS risk factors. This association, however, is confounded by shared familial factors.
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Affiliation(s)
- Yuhan Zhang
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA
| | - Liuhua Shi
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA
| | - Howard Chang
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Qian Di
- Vanke School of Public Health, Tsinghua University, Beijing, 100084, China
| | - Jack Goldberg
- Vietnam Era Twin Registry, Seattle Epidemiologic Research and Information Center, US Department of Veterans Affairs, Seattle, WA, 98174, USA
| | - Viola Vaccarino
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA.
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Wang W, Zhao T, Geng K, Yuan G, Chen Y, Xu Y. Smoking and the Pathophysiology of Peripheral Artery Disease. Front Cardiovasc Med 2021; 8:704106. [PMID: 34513948 PMCID: PMC8429807 DOI: 10.3389/fcvm.2021.704106] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 07/31/2021] [Indexed: 12/15/2022] Open
Abstract
Smoking is one of the most important preventable factors causing peripheral artery disease (PAD). The purpose of this review is to comprehensively analyze and summarize the pathogenesis and clinical characteristics of smoking in PAD based on existing clinical, in vivo, and in vitro studies. Extensive searches and literature reviews have shown that a large amount of data exists on the pathological process underlying the effects of cigarette smoke and its components on PAD through various mechanisms. Cigarette smoke extracts (CSE) induce endothelial cell dysfunction, smooth muscle cell remodeling and macrophage phenotypic transformation through multiple molecular mechanisms. These pathological changes are the molecular basis for the occurrence and development of peripheral vascular diseases. With few discussions on the topic, we will summarize recent insights into the effect of smoking on regulating PAD through multiple pathways and its possible pathogenic mechanism.
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Affiliation(s)
- Weiming Wang
- The State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau, China.,Department of General Surgery (Vascular Surgery), The Affiliated Hospital of Southwest Medical University, Luzhou, China.,Key Laboratory of Medical Electrophysiology, Ministry of Education and Medical Electrophysiological Key Laboratory of Sichuan Province, Institute of Cardiovascular Research, Southwest Medical University, Luzhou, China
| | - Tingting Zhao
- The State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau, China
| | - Kang Geng
- The State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau, China
| | - Gang Yuan
- The State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau, China
| | - Yue Chen
- Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Youhua Xu
- The State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau, China
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Prasad K. Current Status of Primary, Secondary, and Tertiary Prevention of Coronary Artery Disease. Int J Angiol 2021; 30:177-186. [PMID: 34776817 PMCID: PMC8580611 DOI: 10.1055/s-0041-1731273] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Fifty percent of all death from cardiovascular diseases is due to coronary artery disease (CAD). This is avoidable if early identification is made. Preventive health care has a major role in the fight against CAD. Atherosclerosis and atherosclerotic plaque rupture are involved in the development of CAD. Modifiable risk factors for CAD are dyslipidemia, diabetes, hypertension, cigarette smoking, obesity, chronic renal disease, chronic infection, high C-reactive protein, and hyperhomocysteinemia. CAD can be prevented by modification of risk factors. This paper defines the primary, secondary, and tertiary prevention of CAD. It discusses the mechanism of risk factor-induced atherosclerosis. This paper describes the CAD risk score and its use in the selection of individuals for primary prevention of CAD. Guidelines for primary, secondary, and tertiary prevention of CAD have been described. Modification of risk factors and use of guidelines for prevention of CAD would prevent, regress, and slow down the progression of CAD, improve the quality of life of patient, and reduce the health care cost.
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Affiliation(s)
- Kailash Prasad
- Department of Physiology (APP), College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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Ferroptosis: the potential value target in atherosclerosis. Cell Death Dis 2021; 12:782. [PMID: 34376636 PMCID: PMC8355346 DOI: 10.1038/s41419-021-04054-3] [Citation(s) in RCA: 67] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 06/08/2021] [Accepted: 06/16/2021] [Indexed: 12/14/2022]
Abstract
In advanced atherosclerosis (AS), defective function-induced cell death leads to the formation of the characteristic necrotic core and vulnerable plaque. The forms and mechanisms of cell death in AS have recently been elucidated. Among them, ferroptosis, an iron-dependent form of necrosis that is characterized by oxidative damage to phospholipids, promotes AS by accelerating endothelial dysfunction in lipid peroxidation. Moreover, disordered intracellular iron causes damage to macrophages, vascular smooth muscle cells (VSMCs), vascular endothelial cells (VECs), and affects many risk factors or pathologic processes of AS such as disturbances in lipid peroxidation, oxidative stress, inflammation, and dyslipidemia. However, the mechanisms through which ferroptosis initiates the development and progression of AS have not been established. This review explains the possible correlations between AS and ferroptosis, and provides a reliable theoretical basis for future studies on its mechanism.
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Pérez-Olivares L, Soehnlein O. Contemporary Lifestyle and Neutrophil Extracellular Traps: An Emerging Link in Atherosclerosis Disease. Cells 2021; 10:1985. [PMID: 34440753 PMCID: PMC8394440 DOI: 10.3390/cells10081985] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 07/29/2021] [Accepted: 07/30/2021] [Indexed: 12/15/2022] Open
Abstract
Neutrophil extracellular traps (NETs) are networks of extracellular genetic material decorated with proteins of nuclear, granular and cytosolic origin that activated neutrophils expel under pathogenic inflammatory conditions. NETs are part of the host's innate immune defense system against invading pathogens. Interestingly, these extracellular structures can also be released in response to sterile inflammatory stimuli (e.g., shear stress, lipidic molecules, pro-thrombotic factors, aggregated platelets, or pro-inflammatory cytokines), as in atherosclerosis disease. Indeed, NETs have been identified in the intimal surface of diseased arteries under cardiovascular disease conditions, where they sustain inflammation via NET-mediated cell-adhesion mechanisms and promote cellular dysfunction and tissue damage via NET-associated cytotoxicity. This review will focus on (1) the active role of neutrophils and NETs as underestimated players of the inflammatory process during atherogenesis and lesion progression; (2) how these extracellular structures communicate with the main cell types present in the atherosclerotic lesion in the arterial wall; and (3) how these neutrophil effector functions interplay with lifestyle-derived risk factors such as an unbalanced diet, physical inactivity, smoking or lack of sleep quality, which represent major elements in the development of cardiovascular disease.
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Affiliation(s)
- Laura Pérez-Olivares
- Center for Molecular Biology of Inflammation (ZMBE), Institute for Experimental Pathology (ExPat), Westfälische Wilhelms-Universität (WWU), 48149 Münster, Germany;
| | - Oliver Soehnlein
- Center for Molecular Biology of Inflammation (ZMBE), Institute for Experimental Pathology (ExPat), Westfälische Wilhelms-Universität (WWU), 48149 Münster, Germany;
- Department of Physiology and Pharmacology (FyFa), Karolinska Institute, 17165 Stockholm, Sweden
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Wang S, Shao W, Gao Y, Zhao H, Du D. Diagnostic and Prognostic Significance of miR-675-3p in Patients With Atherosclerosis. Clin Appl Thromb Hemost 2021; 27:10760296211024754. [PMID: 34320871 PMCID: PMC8327005 DOI: 10.1177/10760296211024754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
In recent years, a rising number of studies have confirmed that microRNA (miRNA)
plays a prominent role in the early diagnosis and prognostic value assessment of
cardiovascular diseases. The current study was conducted to examine the
expression of miR-675-3p in atherosclerosis (AS) patients and to evaluate its
clinical diagnosis and prognostic value. 110 AS patients and 70 healthy controls
were included in the study. Serum miR-675-3p levels were detected by
quantitative real-time PCR (qRT-PCR). The clinical diagnostic significance of
serum miR-675-3p in AS patients were investigated by the receiver operating
characteristic (ROC) curve. The correlation between miRNA and carotid
intima-media thickness (CIMT) was analyzed by the Spearman correlation
coefficient. The prognostic significance of serum miR-675-3p was evaluated by
the Kaplan-Meier method and Cox regression analysis. The patient’s serum
miR-675-3p was significantly increased than the healthy individuals
(P < 0.05). An increase of carotid intima-media
thickness (CIMT) was positively correlated with the promotion of serum
miR-675-3p levels. The area under the ROC curve (AUC) was 0.918, with high
sensitivity and specificity. miR-675-3p is a key independent predictor of
cardiovascular adverse events in AS patients (HR = 5.375, 95%CI = 1.590-18.170,
P = 0.007), and patients with elevated miR-675-3p were more
likely to have cardiovascular adverse events (log-rank P =
0.030). Increased miR-675-3p can be used as a potential marker for the diagnosis
of AS, and was associated with the poor prognosis of AS.
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Affiliation(s)
- Shuangquan Wang
- Department of Neurosurgery, Binzhou Medical University Hospital, Binzhou, Shandong, People's Republic of China
| | - Wei Shao
- Department of Neurosurgery, Binzhou Medical University Hospital, Binzhou, Shandong, People's Republic of China
| | - Yang Gao
- Department of Neurosurgery, Binzhou Medical University Hospital, Binzhou, Shandong, People's Republic of China
| | - Hongwei Zhao
- Department of Neurosurgery, Binzhou Medical University Hospital, Binzhou, Shandong, People's Republic of China
| | - Deyong Du
- Department of Neurosurgery, Binzhou Medical University Hospital, Binzhou, Shandong, People's Republic of China
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Smoking and Neuropsychiatric Disease-Associations and Underlying Mechanisms. Int J Mol Sci 2021; 22:ijms22147272. [PMID: 34298890 PMCID: PMC8304236 DOI: 10.3390/ijms22147272] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 06/28/2021] [Accepted: 07/03/2021] [Indexed: 01/02/2023] Open
Abstract
Despite extensive efforts to combat cigarette smoking/tobacco use, it still remains a leading cause of global morbidity and mortality, killing more than eight million people each year. While tobacco smoking is a major risk factor for non-communicable diseases related to the four main groups—cardiovascular disease, cancer, chronic lung disease, and diabetes—its impact on neuropsychiatric risk is rather elusive. The aim of this review article is to emphasize the importance of smoking as a potential risk factor for neuropsychiatric disease and to identify central pathophysiological mechanisms that may contribute to this relationship. There is strong evidence from epidemiological and experimental studies indicating that smoking may increase the risk of various neuropsychiatric diseases, such as dementia/cognitive decline, schizophrenia/psychosis, depression, anxiety disorder, and suicidal behavior induced by structural and functional alterations of the central nervous system, mainly centered on inflammatory and oxidative stress pathways. From a public health perspective, preventive measures and policies designed to counteract the global epidemic of smoking should necessarily include warnings and actions that address the risk of neuropsychiatric disease.
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García Pastor A, López-Cancio Martínez E, Rodríguez-Yáñez M, Alonso de Leciñana M, Amaro S, Arenillas JF, Ayo-Martín O, Castellanos M, Fuentes B, Freijo MM, Gomis M, Gómez Choco M, Martínez Sánchez P, Morales A, Palacio-Portilla EJ, Segura T, Serena J, Vivancos-Mora J, Roquer J. Recommendations of the Spanish Society of Neurology for the prevention of stroke. Interventions on lifestyle and air pollution. Neurologia 2021; 36:377-387. [PMID: 34714236 DOI: 10.1016/j.nrleng.2020.05.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 05/05/2020] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To update the recommendations of the Spanish Society of Neurology regarding lifestyle interventions for stroke prevention. DEVELOPMENT We reviewed the most recent studies related to lifestyle and stroke risk, including randomised clinical trials, population studies, and meta-analyses. The risk of stroke associated with such lifestyle habits as smoking, alcohol consumption, stress, diet, obesity, and sedentary lifestyles was analysed, and the potential benefits for stroke prevention of modifying these habits were reviewed. We also reviewed stroke risk associated with exposure to air pollution. Based on the results obtained, we drafted recommendations addressing each of the lifestyle habits analysed. CONCLUSIONS Lifestyle modification constitutes a cornerstone in the primary and secondary prevention of stroke. Abstinence or cessation of smoking, cessation of excessive alcohol consumption, avoidance of exposure to chronic stress, avoidance of overweight or obesity, a Mediterranean diet supplemented with olive oil and nuts, and regular exercise are essential measures in reducing the risk of stroke. We also recommend implementing policies to reduce air pollution.
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Affiliation(s)
- A García Pastor
- Servicio de Neurología, Hospital Universitario Gregorio Marañon, Madrid, Spain; Servicio de Neurología, Hospital Universitario Central de Asturias, Oviedo, Spain.
| | - E López-Cancio Martínez
- Servicio de Neurología, Hospital Universitario Gregorio Marañon, Madrid, Spain; Servicio de Neurología, Hospital Universitario Central de Asturias, Oviedo, Spain.
| | - M Rodríguez-Yáñez
- Servicio de Neurología, Hospital Universitario de Santiago de Compostela, A Coruña, Spain
| | | | - S Amaro
- Servicio de Neurología, Hospital Clinic i Universitari, Barcelona, Spain
| | - J F Arenillas
- Servicio de Neurología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - O Ayo-Martín
- Servicio de Neurología, Complejo Hospitalario Universitario de Albacete, Albacete, Spain
| | - M Castellanos
- Servicio de Neurología, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain
| | - B Fuentes
- Servicio de Neurología, Hospital Universitario La Paz, Madrid, Spain
| | - M M Freijo
- Servicio de Neurología, Hospital Universitario de Cruces, Baracaldo, Spain
| | - M Gomis
- Servicio de Neurología, Hospital Universitario Germans Trias i Pujol, Barcelona, Spain
| | - M Gómez Choco
- Servicio de Neurología, Hospital de Sant Joan Despí Moisès Broogi, Barcelona, Spain
| | | | - A Morales
- Servicio de Neurología, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
| | - E J Palacio-Portilla
- Servicio de Neurología, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - T Segura
- Servicio de Neurología, Complejo Hospitalario Universitario de Albacete, Albacete, Spain
| | - J Serena
- Servicio de Neurología, Biomedical Research Institute of Girona, Girona, Spain
| | - J Vivancos-Mora
- Servicio de Neurología, Hospital Universitario de La Princesa, Madrid, Spain
| | - J Roquer
- Servicio de Neurología, IMIM-Hospital del Mar, Barcelona, Spain
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47
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Kaze AD, Santhanam P, Erqou S, Bertoni AG, Ahima RS, Echouffo-Tcheugui JB. Cardiorespiratory Fitness and Atherosclerotic Cardiovascular Outcomes by Levels of Baseline-Predicted Cardiovascular Risk: The Look AHEAD Study. Am J Med 2021; 134:769-776.e1. [PMID: 33607087 PMCID: PMC8176653 DOI: 10.1016/j.amjmed.2021.01.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 01/08/2021] [Accepted: 01/11/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND We evaluated the associations of cardiorespiratory fitness with atherosclerotic cardiovascular disease (ASCVD) by levels of baseline-predicted ASCVD risk among adults with type 2 diabetes. METHODS We analyzed data from 4203 adults with type 2 diabetes in the Look AHEAD (Action for Health in Diabetes) study. Cardiorespiratory fitness was assessed using maximal exercise testing and categorized into low, moderate, and high; baseline-predicted. ASCVD risk was calculated using the American College of Cardiology/American Heart Association Pooled Cohort Equation. We used Cox regression models to estimate hazard ratios (HR) and 95% confidence intervals (CI) for ASCVD events (fatal and nonfatal myocardial infarction and stroke). RESULTS Over a median of 9.6 years, there were 295 ASCVD events. The effect of fitness on outcomes was different across levels of 10-year predicted ASCVD risk (P for interaction < .001). Among participants with a baseline-predicted risk of 7.5% to 20%, the HR of low (vs high) fitness group was 1.94 (95% CI, 1.12-3.35) for ASCVD events. Fitness was not significantly associated with ASCVD events in the groups with baseline-predicted risk <7.5% (HR 1.53; 95% CI, 0.49-4.76) or ≥20% (HR 1.40; 95% CI, 0.88-2.24). A similar pattern was observed for myocardial infarction and stroke separately. CONCLUSIONS In a large sample of type 2 diabetes individuals, the association of low fitness with incident ASCVD was modified by the baseline-predicted 10-year ASCVD risk. Our findings suggest the utility of assessing fitness in ASCVD risk stratification in type 2 diabetes, especially among those with intermediate predicted 10-year risk of ASCVD.
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Affiliation(s)
- Arnaud D Kaze
- Department of Medicine, University of Maryland Medical Center, Baltimore
| | - Prasanna Santhanam
- Department of Medicine, Division of Endocrinology, Diabetes & Metabolism, Johns Hopkins School of Medicine, Baltimore, Md
| | - Sebhat Erqou
- Department of Medicine, Providence VA Medical Center and Alpert Medical School of Brown University, Providence, RI
| | - Alain G Bertoni
- Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, NC
| | - Rexford S Ahima
- Department of Medicine, Division of Endocrinology, Diabetes & Metabolism, Johns Hopkins School of Medicine, Baltimore, Md
| | - Justin B Echouffo-Tcheugui
- Department of Medicine, Division of Endocrinology, Diabetes & Metabolism, Johns Hopkins School of Medicine, Baltimore, Md.
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48
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Kim JO, Park HS, Ko EJ, Sung JH, Kim J, Oh SH, Kim OJ, Kim NK. The 3'-UTR Polymorphisms in the Thymidylate Synthase (TS) Gene Associated with the Risk of Ischemic Stroke and Silent Brain Infarction. J Pers Med 2021; 11:jpm11030200. [PMID: 33809325 PMCID: PMC8000293 DOI: 10.3390/jpm11030200] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 03/05/2021] [Accepted: 03/09/2021] [Indexed: 11/16/2022] Open
Abstract
Thymidylate synthase (TS) is a key gene involved in the repair of DNA damage and DNA synthesis that plays an important role in vascular development and recovery. In particular, TS gene polymorphisms play a major role in the progression of vascular disease and cancer metastasis. Therefore, the aim of this study was to investigate the association of three TS polymorphisms (1100T>C [rs699517], 1170A>G [rs2790], and 1494ins/del [rs151264360]) with ischemic stroke and silent brain infarction (SBI) in Koreans. A total of 1299 participants (507 stroke patients, 383 SBI patients, and 409 controls) were enrolled in the study. Genotyping of the three TS polymorphisms was performed by polymerase chain reaction-restriction fragment length polymorphism analysis. To examine the association between TS gene polymorphisms and the diseases, we performed statistical analyses, including multivariable logistic regression and Fisher's exact tests. We found that TS 1100T>C and 1170A>G genotypes were strongly associated with ischemic stroke and SBI susceptibility. More specifically, the TS 1100T>C polymorphism was associated with the likelihood of ischemic stroke (TT vs. CC: AOR = 2.151, 95% CI = 1.275-3.628, P = 0.004) and SBI (TT vs. TC+CC: AOR = 1.443, 95 % CI = 1.009-2.063, P = 0.045). In contrast, the TS 1170A > G polymorphism exhibited lower correlation with the risk of stroke (AA vs. GG: AOR = 0.284, 95% CI = 0.151-0.537, P < 0.0001) and SBI (AA vs. GG: AOR = 0.070, 95% CI = 0.016-0.298, P = 0.0002). Furthermore, we confirmed that the TS 1100T>C polymorphism was synergistic with low folic acid levels (AOR = 6.749, P < 0.0001). Altogether, these results suggest that TS 1100T>C and 1170A > G polymorphisms are associated with the risk of ischemic stroke and SBI, and our study provides the first evidence that 3'-UTR variants in TS are potential biomarkers in ischemic stroke and SBI.
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Affiliation(s)
- Jung Oh Kim
- Theragen Bio Co., Ltd., Seongnam 13488, Korea;
- Department of Biomedical Science, College of Life Science, CHA University, Seongnam 13488, Korea; (H.S.P.); (E.J.K.)
| | - Han Sung Park
- Department of Biomedical Science, College of Life Science, CHA University, Seongnam 13488, Korea; (H.S.P.); (E.J.K.)
| | - Eun Ju Ko
- Department of Biomedical Science, College of Life Science, CHA University, Seongnam 13488, Korea; (H.S.P.); (E.J.K.)
| | - Jung Hoon Sung
- CHA Bundang Medical Center, Department of Neurology, School of Medicine, CHA University, Seongnam 13496, Korea; (J.H.S.); (J.K.); (S.H.O.)
| | - Jinkwon Kim
- CHA Bundang Medical Center, Department of Neurology, School of Medicine, CHA University, Seongnam 13496, Korea; (J.H.S.); (J.K.); (S.H.O.)
| | - Seung Hun Oh
- CHA Bundang Medical Center, Department of Neurology, School of Medicine, CHA University, Seongnam 13496, Korea; (J.H.S.); (J.K.); (S.H.O.)
| | - Ok Joon Kim
- CHA Bundang Medical Center, Department of Neurology, School of Medicine, CHA University, Seongnam 13496, Korea; (J.H.S.); (J.K.); (S.H.O.)
- Correspondence: (O.J.K.); (N.K.K.); Tel.: +82-31-780-5766 (N.K.K.)
| | - Nam Keun Kim
- Department of Biomedical Science, College of Life Science, CHA University, Seongnam 13488, Korea; (H.S.P.); (E.J.K.)
- Correspondence: (O.J.K.); (N.K.K.); Tel.: +82-31-780-5766 (N.K.K.)
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49
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Bloos SM, Kaur K, Lang K, Gavin N, Mills AM, Baugh CW, Patterson BW, Podolsky SR, Salazar G, Mumma BE, Tanski M, Hadley K, Roumie C, McNaughton CD, Yiadom MYAB. Comparing the Timeliness of Treatment in Younger vs. Older Patients with ST-Segment Elevation Myocardial Infarction: A Multi-Center Cohort Study. J Emerg Med 2021; 60:716-728. [PMID: 33676790 DOI: 10.1016/j.jemermed.2021.01.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 01/06/2021] [Accepted: 01/23/2021] [Indexed: 01/14/2023]
Abstract
BACKGROUND ST-segment elevation myocardial infarction (STEMI) predominantly affects older adults. Lower incidence among younger patients may challenge diagnosis. OBJECTIVES We hypothesize that among patients ≤ 50 years old, emergent percutaneous coronary intervention (PCI) for STEMI is delayed when compared with patients aged > 50 years. METHODS This 3-year, 10-center retrospective cohort study included emergency department (ED) STEMI patients ≥ 18 years of age treated with emergent PCI. We excluded patients with an electrocardiogram (ECG) completed prior to ED arrival or a nondiagnostic initial ECG. Our primary outcome was door-to-balloon (D2B) time. We compared characteristics and outcomes among younger vs. older STEMI patients, and among age subgroups. RESULTS There were 576 ED STEMI PCI patients, of whom 100 were ≤ 50 years old and 476 were > 50 years old. Median age was 44 years in the younger cohort (interquartile range [IQR] 41-47) vs. 62 years (IQR 57-70) among older patients. Median D2B time for the younger cohort was 76.5 min (IQR 67.5-102.5) vs. 81.0 min (IQR 65.0-105.5) in the older cohort (p = 0.91). This outcome did not change when ages 40 or 45 years were used to demarcate younger vs. older. The younger cohort had a higher prevalence of nonwhite races (38% vs. 21%; p < 0.001) and those currently smoking (36% vs. 23%; p = 0.005). The very young (≤30 years; 6/576) and very old (>80 years; 45/576) had 5.51 and 2.2 greater odds of delays. CONCLUSION We found no statistically significant difference in D2B times between patients ≤ 50 years old and those > 50 years old. Nonwhite patients and those who smoke were disproportionately represented within the younger population. The very young and very old had higher odds of D2B times > 90 min.
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Affiliation(s)
- Sean M Bloos
- Master of Public Health Program, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Karampreet Kaur
- Vanderbilt University School of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Kendrick Lang
- Department of Emergency Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, New York
| | - Nicholas Gavin
- Department of Emergency Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, New York
| | - Angela M Mills
- Department of Emergency Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, New York
| | - Christopher W Baugh
- Department of Emergency Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts
| | - Brian W Patterson
- Department of Emergency Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Seth R Podolsky
- Emergency Services Institute, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Gilberto Salazar
- Department of Emergency Medicine, University of Texas Southwestern, Parkland Hospital, Dallas, Texas
| | - Bryn E Mumma
- Department of Emergency Medicine, University of California, Davis, Sacramento, California
| | - Mary Tanski
- Department of Emergency Medicine, Oregon Health & Science University, Portland, Oregon
| | - Kelsea Hadley
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Christianne Roumie
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee; Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee; Veterans Health Administration, Tennessee Valley Healthcare System, Geriatric Research Education Clinical Center (GRECC), Nashville, Tennessee
| | - Candace D McNaughton
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tennessee; Veterans Health Administration, Tennessee Valley Healthcare System, Geriatric Research Education Clinical Center (GRECC), Nashville, Tennessee
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50
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Shipe ME, Maiga AW, Deppen SA, Edwards GC, Marmor HN, Pinkerman R, Smith GT, Lio E, Wright JL, Shah C, Nesbitt JC, Grogan EL. Preoperative coronary artery calcifications in veterans predict higher all-cause mortality in early-stage lung cancer: a cohort study. J Thorac Dis 2021; 13:1427-1433. [PMID: 33841935 PMCID: PMC8024847 DOI: 10.21037/jtd-20-2102] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background Lung cancer patients often have comorbidities that may impact survival. This observational cohort study examines whether coronary artery calcifications (CAC) impact all-cause mortality in patients with resected stage I non-small cell lung cancer (NSCLC). Methods Veterans with stage I NSCLC who underwent resection at a single institution between 2005 and 2018 were selected from a prospectively collected database. Radiologists blinded to patient outcomes graded CAC severity (mild, moderate, or severe) in preoperative CT scans using a visual estimation scoring system. Inter-rater reliability was calculated using the kappa statistic. All-cause mortality was the primary outcome. Kaplan-Meier survival analysis and Cox proportional hazards regression were used to compare time-to-death by varying CAC. Results The Veteran patients (n=195) were predominantly older (median age of 67) male (98%) smokers (96%). The majority (68%) were pathologic stage IA. Overall, 12% of patients had no CAC, 27% mild, 26% moderate, and 36% severe CAC. Median unadjusted survival was 8.8 years for patients with absent or mild CAC versus 6.3 years for moderate and 5.9 years for severe CAC (P=0.01). The adjusted hazard ratio for moderate CAC was 1.44 (95% CI, 0.85–2.46) and for severe CAC was 1.73 (95% CI, 1.03–2.88; P for trend <0.05). Conclusions The presence of severe CAC on preoperative imaging significantly impacted the all-cause survival of patients undergoing resection for stage I NSCLC. This impact on mortality should be taken into consideration by multidisciplinary teams when making treatment plans for patients with early-stage disease.
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Affiliation(s)
- Maren E Shipe
- Department of Thoracic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Amelia W Maiga
- Department of Thoracic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Surgery, Tennessee Valley Healthcare System, Nashville, TN, USA
| | - Stephen A Deppen
- Department of Thoracic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Surgery, Tennessee Valley Healthcare System, Nashville, TN, USA
| | - Gretchen C Edwards
- Department of Thoracic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Surgery, Tennessee Valley Healthcare System, Nashville, TN, USA
| | - Hannah N Marmor
- Department of Thoracic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Rhonda Pinkerman
- Department of Surgery, Tennessee Valley Healthcare System, Nashville, TN, USA
| | - Gary T Smith
- Department of Radiology, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Radiology, Tennessee Valley Healthcare System, Nashville, TN, USA
| | - Elizabeth Lio
- Department of Radiology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Johnny L Wright
- Department of Radiology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Chirayu Shah
- Department of Radiology, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Radiology, Tennessee Valley Healthcare System, Nashville, TN, USA
| | - Jonathan C Nesbitt
- Department of Thoracic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Surgery, Tennessee Valley Healthcare System, Nashville, TN, USA
| | - Eric L Grogan
- Department of Thoracic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Surgery, Tennessee Valley Healthcare System, Nashville, TN, USA
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