1
|
Gong Z, Wen M, Zhang W, Yu L, Huang C, Xu Y, Xia Z, Xu M, Xu J, Liang Q, Bao H, Cheng X. Plasma exosomes induce inflammatory immune response in patients with acute myocardial infarction. Arch Physiol Biochem 2023; 129:1168-1176. [PMID: 33950771 DOI: 10.1080/13813455.2021.1912102] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 03/25/2021] [Accepted: 03/26/2021] [Indexed: 01/07/2023]
Abstract
Exosomes are a kind of nanoscale extracellular vesicles with diameters of 30-100 nm and act as intracellular communication vehicles to influence cellular activities. Emerging pieces of evidence have indicated that exosomes play important roles in inflammation. However, the biological roles of plasma exosomes in acute myocardial infarction (AMI) patients have remained largely unexplored. In the current study, we found the plasma exosome levels were notably increased in patients with AMI in comparison with healthy controls (HCs), and AMI exosomes could induce endothelial cell injury. Furthermore, our data demonstrated that AMI exosomes triggered a pro-inflammatory immune response, at least partly depending on the activation of the NF-ĸB signalling. Together, AMI exosomes have pro-inflammatory properties and play a significant role in inflammation in AMI patients.
Collapse
Affiliation(s)
- Zhijian Gong
- Department of General Medicine, Ganzhou People's Hospital, Ganzhou, China
| | - Minghua Wen
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Weifang Zhang
- Department of Pharmacy, the Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Lingling Yu
- Department of Rehabilitation Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Chahua Huang
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yan Xu
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Zilong Xia
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Minxuan Xu
- Department of Cardiology, Ji'an Central Hospital, Ji'an, China
| | - Jianqing Xu
- Department of Cardiology, Union Shenzhen Hospital of Huazhong University of Science and Technology, Shenzhen, China
| | - Qian Liang
- Jiangxi Key Laboratory of Molecular Medicine, Nanchang, China
| | - Huihui Bao
- Department of General Medicine, Ganzhou People's Hospital, Ganzhou, China
| | - Xiaoshu Cheng
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang, China
| |
Collapse
|
2
|
Del Rio-Pertuz G, Benjanuwattra J, Juarez M, Mekraksakit P, Argueta-Sosa E, Ansari MM. Efficacy of mechanical circulatory support used before versus after primary percutaneous coronary intervention in patients with cardiogenic shock from ST-elevation myocardial infarction: A systematic review and meta-analysis. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2022; 42:74-83. [DOI: 10.1016/j.carrev.2022.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 04/17/2022] [Accepted: 05/02/2022] [Indexed: 01/10/2023]
|
3
|
James D, London L. Case Report Detailing an Inferior Myocardial Infarction, Third-Degree Heart Block, and Cardiogenic Shock. J Emerg Nurs 2021; 47:557-562. [PMID: 34116865 DOI: 10.1016/j.jen.2021.04.003] [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: 12/07/2020] [Revised: 03/25/2021] [Accepted: 04/15/2021] [Indexed: 12/30/2022]
Abstract
An infarction in the right coronary artery affects the inferior wall of the heart and can also cause impedance to the cardiac conduction system. The right coronary artery perfuses the sinoatrial and atrioventricular nodes, and a loss of blood flow contributes to a breakdown in the communication system within the heart, causing associated bradycardias, heart blocks, and arrhythmias. This case report details the prehospital and emergency care of a middle-aged man who experienced an inferior myocardial infarction, concomitant third-degree heart block, and subsequent cardiogenic shock, with successful revascularization. This case is informative for emergency clinicians to review symptoms of acute coronary syndrome, rapid lifesaving diagnostics and intervention, and the unique treatment and monitoring considerations associated with right ventricular involvement and third-degree heart block.
Collapse
|
4
|
Complete Revascularization in Patients With STEMI and Multivessel Coronary Artery Disease: Is It Beneficial? CURRENT TREATMENT OPTIONS IN CARDIOVASCULAR MEDICINE 2021. [DOI: 10.1007/s11936-020-00887-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
5
|
Regular Statin Use and Incidence of Postendoscopic Retrograde Cholangiopancreatography Pancreatitis. J Clin Gastroenterol 2020; 54:905-910. [PMID: 31895166 DOI: 10.1097/mcg.0000000000001312] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
GOALS AND BACKGROUND Endoscopic retrograde cholangiopancreatography is widely utilized to diagnose and treat various pancreaticobiliary diseases, but postendoscopic retrograde cholangiopancreatography pancreatitis (PEP) can be a fatal adverse event. Evidence suggests that statins may exhibit suppressive effects on inflammation in the pancreas. We carried out an observational cohort study to examine the protective effect of statins on PEP. STUDY We retrospectively identified consecutive patients who underwent endoscopic retrograde cholangiopancreatography at a tertiary care center in Japan between January 2010 and January 2019. The incidences of PEP were compared between regular and nonregular statin users. Using the multivariable logistic regression model, we examined the association of regular statin use with the incidence of PEP controlling for potential risk factors for PEP. RESULTS We included 2664 patients (328 regular statin users and 2336 nonregular users). The incidence of PEP did not differ by statin use status (P=0.52): 8.8% in regular statin users and 7.9% in nonregular users. The multivariable-adjusted odds ratio for PEP comparing regular statin use with nonregular use was 1.08 (95% confidence interval, 0.67-1.72; P=0.76). When we examined specific statin types (hydrophilic and lipophilic statins), we consistently observed the null association: 6.8% of 132 hydrophilic statin users and 10% of 196 lipophilic statin users (P=0.74 and 0.27, respectively, compared with nonregular users). CONCLUSIONS Regular statin use was not shown to be protective against PEP. A further investigation is warranted before this medication is tested in prospective randomized trials.
Collapse
|
6
|
Izadpanah P, Falahati F, Mokhtari AM, Hosseinpour F, Faham B, Sheidaee R, Jalali S, Zare H, Hassanipour S. The survival rate of patients with ST-Segment elevation myocardial infarction treated with primary percutaneous coronary intervention and thrombolysis. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2020. [DOI: 10.1016/j.cegh.2020.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
|
7
|
Li JX, Weng L, Li XQ, Li Y, Yan SJ, Song ZY, Zhang XY, Cha L, Lin L, Yang TS, Lv WJ, Dai YN, Chen YP, Xia DJ, Li X, Jin EZ. An Observational Study of the Relationship Between Outcome and Platelet Reactivity in Chinese Patients Undergoing PCI Loading with 600 mg Clopidogrel. CARDIOVASCULAR INNOVATIONS AND APPLICATIONS 2020. [DOI: 10.15212/cvia.2019.0580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objectives: We sought to determine whether high posttreatment platelet reactivity (HPPR) to a 600 mg loading dose of clopidogrel affects outcomes in Chinese patients with acute coronary syndrome (ACS) following percutaneous coronary intervention (PCI) and to investigate whether
there is a relationship between the number of platelet reactivity units (PRUs) and the characteristics of the patients.Background: Although impaired platelet response to clopidogrel is a strong predictor of unfavorable outcome after PCI, the impact of HPPR to a 600 mg loading dose
of clopidogrel in Chinese patients with ACS undergoing PCI is still unknown.Methods: We performed observational research on 134 unselected patients with ACS undergoing urgent or planned PCI with a 600 mg loading dose of clopidogrel. Platelet activation was expressed as the PRU value
measured by the VerifyNow assay.Results: Among the 134 patients (mean age 60.62 years [standard deviation 9.13 years], 60.4% male), there were 46 patients with HPPR (34.3%) and 88 patients without HPPR (65.7%). At a mean follow-up of 6 months (standard deviation 1 month), the rates
of cardiac death, unstable angina, and rehospitalization for target lesion revascularization were higher in the HPPR group (19.6% vs. 6.8%, P=0.029). Multivariate analysis identified hemoglobin level and sex as independent predictors of the PRU value (y=456.355−1.736x1−31.880x2,
P<0.05). On receiver operating characteristic curve analysis, PRU values could significantly discriminate between patients with and patients without cardiac death, unstable angina, and rehospitalization for target lesion revascularization (area under the curve 0.758, 95% confidence interval
0.62‐0.85, P=0.001, P<0.05).Conclusion: In patients with ACS, HPPR to a 600 mg loading dose of clopidogrel is associated with worse outcomes after PCI. There is some relationship between the PRU value and the hemoglobin level and sex. PRU values can predict the prognosis.
Collapse
Affiliation(s)
- Jing-xiu Li
- Department of Cardiology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, 150001 Heilongjiang, China
| | - Ling Weng
- Department of Cardiology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, 150001 Heilongjiang, China
| | - Xue-qi Li
- Department of Cardiology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, 150001 Heilongjiang, China
| | - Yang Li
- Department of Cardiology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, 150001 Heilongjiang, China
| | - Shu-jun Yan
- Department of Cardiology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, 150001 Heilongjiang, China
| | - Zhao-yan Song
- Department of Cardiology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, 150001 Heilongjiang, China
| | - Xue-yan Zhang
- Department of Cardiology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, 150001 Heilongjiang, China
| | - Li Cha
- Department of Cardiology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, 150001 Heilongjiang, China
| | - Lin Lin
- Department of Cardiology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, 150001 Heilongjiang, China
| | - Tian-shu Yang
- School of Public Health of Harbin Medical University, Harbin, 150001 Heilongjiang, China
| | - Wei-jun Lv
- Internal Medicine, Harbin Daoli Traditional Chinese Medicine Hospital, Harbin, 150001 Heilongjiang, China
| | - Ying-nan Dai
- Department of Cardiology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, 150001 Heilongjiang, China
| | - Ye-ping Chen
- Department of Cardiology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, 150001 Heilongjiang, China
| | - De-Jun Xia
- Department of Cardiology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, 150001 Heilongjiang, China
| | - Xin Li
- Department of Cardiology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, 150001 Heilongjiang, China
| | - En-ze Jin
- Department of Cardiology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, 150001 Heilongjiang, China
| |
Collapse
|
8
|
Firoozabadi R, Gregg RE, Babaeizadeh S. Intelligent use of advanced capabilities of diagnostic ECG algorithms in a monitoring environment. J Electrocardiol 2017; 50:615-619. [PMID: 28476433 DOI: 10.1016/j.jelectrocard.2017.04.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2016] [Indexed: 01/10/2023]
Abstract
A large number of ST-elevation notifications are generated by cardiac monitoring systems, but only a fraction of them is related to the critical condition known as ST-segment elevation myocardial infarction (STEMI) in which the blockage of coronary artery causes ST-segment elevation. Confounders such as acute pericarditis and benign early repolarization create electrocardiographic patterns mimicking STEMI but usually do not benefit from a real-time notification. A STEMI screening algorithm able to recognize those confounders utilizing capabilities of diagnostic ECG algorithms in variation analysis of ST segments helps to avoid triggering a non-actionable ST-elevation notification. However, diagnostic algorithms are generally designed to analyze short ECG snapshots collected in low-noise resting position and hence are susceptible to high levels of noise common in a monitoring environment. We developed a STEMI screening algorithm which performs a real-time signal quality evaluation on the ECG waveform to select the segments with quality high enough for subsequent analysis by a diagnostic ECG algorithm. The STEMI notifications generated by this multi-stage STEMI screening algorithm are significantly fewer than ST-elevation notifications generated by a continuous ST monitoring strategy.
Collapse
Affiliation(s)
- Reza Firoozabadi
- Advanced Algorithm Research Center, Philips Healthcare, Andover, MA, USA.
| | - Richard E Gregg
- Advanced Algorithm Research Center, Philips Healthcare, Andover, MA, USA
| | - Saeed Babaeizadeh
- Advanced Algorithm Research Center, Philips Healthcare, Andover, MA, USA
| |
Collapse
|
9
|
Bytyçi I, Bajraktari G, Bhatt DL, Morgan CJ, Ahmed A, Aronow WS, Banach M. Hydrophilic vs lipophilic statins in coronary artery disease: A meta-analysis of randomized controlled trials. J Clin Lipidol 2017; 11:624-637. [PMID: 28506385 DOI: 10.1016/j.jacl.2017.03.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 02/25/2017] [Accepted: 03/03/2017] [Indexed: 02/05/2023]
Abstract
INTRODUCTION Some available experimental studies have reported that hydrophilic statins might have advantages compared with lipophilic statins in patients with coronary artery disease (CAD). Therefore, we performed a meta-analysis of randomized controlled trials (RCTs) investigating the potential differences of lipophilic and hydrophilic statins in patients with CAD. METHODS We systematically searched selected electronic databases up to September 2016 to select RCTs, which compared clinical outcomes of hydrophilic vs lipophilic statins. Primary endpoints were cardiovascular (CV) events: major adverse cardiac events, myocardial infarction, cardiac revascularization, stroke, CV death, CV hospitalization, and all-cause mortality. Secondary endpoints were safety parameters: drug discontinuation, statin-associated muscle symptoms and alanine aminotransferase level increase. RESULTS A total of 11,697 patients from 11 RCTs, randomly allocated to lipophilic (n = 5736) or hydrophilic statins (n = 5961), with a mean follow-up 14 months, were included in the meta-analysis. In comparison with hydrophilic, the lipophilic statins showed similar risk reduction for major adverse cardiac events (relative risk = 0.969, 95% confidence interval [CI], 0.835-1.125, P = .682), myocardial infarction (0.880, 95% CI: 0.731-1.058, P = .174), CV death (0.757, 95% CI: 0.486-1.180, P = .219), and all-cause mortality (0.797, 95% CI: 0.590-1.075, P = .137), as well as cardiac revascularization, stroke, drug discontinuation, and statin-associated muscle symptoms. CV hospitalization was lower (0.789, 95% CI: 0.643-0.969, P = .024) and alanine aminotransferase elevation was higher (2.689, 95% CI: 1.841-3.954, P ≤ .001) in lipophilic than in hydrophilic-treated patients. CONCLUSIONS In conclusion, similarity between hydrophilic and lipophilic statins holds between various clinical CAD settings.
Collapse
Affiliation(s)
- Ibadete Bytyçi
- Clinic of Cardiology, University Clinical Centre of Kosovo, Prishtina, Kosovo
| | - Gani Bajraktari
- Clinic of Cardiology, University Clinical Centre of Kosovo, Prishtina, Kosovo; Medical Faculty, University of Prishtina, Prishtina, Kosovo
| | - Deepak L Bhatt
- Brigham and Women's Hospital Heart & Vascular Center, Harvard Medical School, Boston, MA, USA
| | - Charity J Morgan
- VA Medical Center and George Washington University, Washington, DC, USA
| | - Ali Ahmed
- University of Alabama at Birmingham, Birmingham, AL, USA
| | - Wilbert S Aronow
- Division of Cardiology, Department of Medicine, New York Medical College, Valhalla, NY, USA
| | - Maciej Banach
- Department of Hypertension, Medical University of Lodz, Lodz, Poland; Polish Mother's Memorial Hospital Research Institute (PMMHRI), Lodz, Poland; Cardiovascular Research Centre, University of Zielona Gora, Zielona Gora, Poland.
| | | |
Collapse
|
10
|
Zheng XY, Wang Y, Chen Y, Wang X, Chen L, Li J, Zheng ZG. The effectiveness of intra-aortic balloon pump for myocardial infarction in patients with or without cardiogenic shock: a meta-analysis and systematic review. BMC Cardiovasc Disord 2016; 16:148. [PMID: 27391391 PMCID: PMC4939027 DOI: 10.1186/s12872-016-0323-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Accepted: 06/24/2016] [Indexed: 12/03/2022] Open
Abstract
Background Conflicting reports on the efficacy of intra-aortic balloon pump (IABP) during percutaneous coronary intervention (PCI) incited us to evaluate the utility of IABP in patients with acute myocardial infarction (AMI). Methods Randomized clinical trials comparing patients, who received IABP vs. control (no IABP) during PCI, were hand-searched from MEDLINE, Cochrane, and EMBASE databases using the terms “intra-aortic balloon pump, percutaneous coronary intervention, myocardial infarction, acute coronary syndrome”. Mortality rate (30-day and 6-month mortality) was the primary outcome, while the secondary outcomes included 30-day bleeding rate, reinfarction rate, revascularization rate and stroke rate. Results Pooled results of the seven trials identified indicated that the 30-day and 6-month mortality rate were not significantly different between the IABP and control groups. However, in patients with MI, but without cardiogenic shock (CS), IABP was associated with lower odds of 30-day mortality (OR = 0.35, p = 0.015) and 6-month mortality (OR = 0.41, p = 0.020). The pooled results of 30-day bleeding rate was not significantly higher in patients with IABP than the control group, but for the patients with high risk PCI without CS, it was higher in patients with IABP than the control group (OR = 1.58, p = 0.009). The re-infarction, revascularization, and the stroke rate at 30 days of follow-up were not significantly different between the two groups. Conclusions The present results do not favor the clinical utility of IABP in patients suffering high-risk PCI without CS and AMI complicated with CS. However, in patients with AMI, but without CS, IABP may reduce the 30-day and 6-month mortality rate.
Collapse
Affiliation(s)
- Xiao-Yun Zheng
- Department of Senior Official Ward, China-Japan Friendship Hospital, 2 Yinghua Dongjie, Beijing, 100029, China.
| | - Yi Wang
- Department of Senior Official Ward, China-Japan Friendship Hospital, 2 Yinghua Dongjie, Beijing, 100029, China
| | - Yi Chen
- Department of Senior Official Ward, China-Japan Friendship Hospital, 2 Yinghua Dongjie, Beijing, 100029, China
| | - Xi Wang
- Department of Senior Official Ward, China-Japan Friendship Hospital, 2 Yinghua Dongjie, Beijing, 100029, China
| | - Lei Chen
- Department of Senior Official Ward, China-Japan Friendship Hospital, 2 Yinghua Dongjie, Beijing, 100029, China
| | - Jun Li
- Department of Senior Official Ward, China-Japan Friendship Hospital, 2 Yinghua Dongjie, Beijing, 100029, China
| | - Zhi-Gang Zheng
- Department of Senior Official Ward, China-Japan Friendship Hospital, 2 Yinghua Dongjie, Beijing, 100029, China
| |
Collapse
|
11
|
Managing Multivessel Coronary Artery Disease in Patients With ST-Elevation Myocardial Infarction: A Comprehensive Review. Cardiol Rev 2016; 25:179-188. [PMID: 27124268 DOI: 10.1097/crd.0000000000000110] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Multivessel coronary artery disease (CAD) is found in up to 60% of the patients presenting with an ST-elevation myocardial infarction (STEMI) and worsens the prognosis proportional to the extent of CAD severity. However, the 2013 American College of Cardiology/American Heart Association STEMI guidelines, based on mostly observational data, had recommended against a routine noninfarct-related artery percutaneous coronary intervention (PCI). After these guidelines were published, a handful of randomized trials became available, and they suggested that PCI of significant lesions in a noninfarct-related artery at the time of primary PCI might result in improved patient outcomes. The incidence of major adverse cardiac events was significantly reduced by 55% at 1 year and 65% at 2 years in patients undergoing angiographically guided PCI of nonculprit vessels at the time of primary PCI, in 2 different randomized trials. Fractional flow reserve-guided PCI of nonculprit vessels in this setting has also been shown to reduce cardiac events by 44% at 1 year. Meta-analyses of both nonrandomized and randomized trials have also suggested that complete revascularization at the time of STEMI significantly improves outcomes, including long-term all-cause mortality. In view of the emerging data, a focused update on primary PCI was published in 2015 and suggested that PCI of noninfarct-related arteries might be considered in selected patients. This article is a comprehensive review of the literature on the treatment of multivessel CAD in patients with STEMI, which provides the reader a critical analysis of the available information to determine the best therapeutic approach.
Collapse
|
12
|
Kang JE, Han NY, Oh JM, Jin HK, Kim HA, Son IJ, Rhie SJ. Pharmacist-involved care for patients with heart failure and acute coronary syndrome: a systematic review with qualitative and quantitative meta-analysis. J Clin Pharm Ther 2016; 41:145-57. [DOI: 10.1111/jcpt.12367] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2015] [Accepted: 02/01/2016] [Indexed: 11/27/2022]
Affiliation(s)
- J. E. Kang
- Division of Life and Pharmaceutical Sciences Graduate School and College of Pharmacy; Ewha Womans University; Seoul Korea
- Department of Pharmacy; National Medical Center; Seoul Korea
| | - N. Y. Han
- College of Pharmacy; Seoul National University; Seoul Korea
| | - J. M. Oh
- College of Pharmacy; Seoul National University; Seoul Korea
| | - H. K. Jin
- Division of Life and Pharmaceutical Sciences Graduate School and College of Pharmacy; Ewha Womans University; Seoul Korea
| | - H. A. Kim
- Division of Life and Pharmaceutical Sciences Graduate School and College of Pharmacy; Ewha Womans University; Seoul Korea
| | - I. J. Son
- Department of Pharmacy; National Medical Center; Seoul Korea
| | - S. J. Rhie
- Division of Life and Pharmaceutical Sciences Graduate School and College of Pharmacy; Ewha Womans University; Seoul Korea
| |
Collapse
|
13
|
Yu J, Liu RL, Luo XP, Shi HM, Ma D, Pan JJ, Ni HC. Tissue Factor Pathway Inhibitor-2 Gene Polymorphisms Associate With Coronary Atherosclerosis in Chinese Population. Medicine (Baltimore) 2015; 94:e1675. [PMID: 26496276 PMCID: PMC4620828 DOI: 10.1097/md.0000000000001675] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Tissue factor pathway inhibitor-2 (TFPI-2) may play critical roles in the pathogenesis of atherosclerosis. In this study, we aimed to investigate the association between TFPI-2 gene polymorphisms and coronary atherosclerosis.Four hundred and seven patients with coronary atherosclerosis and 306 individuals with normal coronary artery were enrolled in the present study. Nine single-nucleotide polymorphisms (SNPs) (rs3763473, rs59805398, rs60215632, rs59999573, rs59740167, rs34489123, rs4517, rs4264, and rs4271) were detected with polymerase chain reaction-direct sequencing method. Severity of coronary atherosclerosis was assessed by Gensini score. After the baseline investigation, patients with coronary atherosclerosis were followed up for incidence of cardiovascular events (CVEs).Eight SNPs were in accordance with the Hardy-Weinberg equilibrium, and 8 haplotypes were constructed based on rs59999573, rs59740167, and rs34489123 after linkage disequilibrium and haplotype analysis. Two SNPs (rs59805398 and rs34489123) and 5 haplotypes correlated with coronary atherosclerosis even after adjustment by Gensini score. At follow-up (median 53 months, range 1-60 months), 85 patients experienced CVE. However, there was no strong association between the gene polymorphisms and the occurrence of CVE.Tissue factor pathway inhibitor-2 gene polymorphisms were associated with coronary atherosclerosis in the Chinese population, suggesting that the information about TFPI-2 gene polymorphisms was useful for assessing the risk of developing coronary atherosclerosis, but there was not enough evidence showing it could predict occurrence of CVE.
Collapse
Affiliation(s)
- Jia Yu
- From the Department of Cardiology, Huashan Hospital, Fudan University, Shanghai, 200040, China (JY, R-IL, X-PL, H-MS, J-JP, H-CN); and Key Laboratory of Molecular Medicine, Ministry of Education, Department of Biochemistry and Molecular Biology, Shanghai Medical College, Fudan University, Shanghai, 200032, China (DM)
| | | | | | | | | | | | | |
Collapse
|
14
|
Gupta C, Bell SP, Schildcrout JS, Fletcher S, Goggins KM, Kripalani S. Predictors of health care system and physician distrust in hospitalized cardiac patients. JOURNAL OF HEALTH COMMUNICATION 2014; 19 Suppl 2:44-60. [PMID: 25315583 PMCID: PMC4318514 DOI: 10.1080/10810730.2014.934936] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Trusting relationships among patients, physicians, and the health care system is important in encouraging self-care behaviors in cardiovascular patients. This study aimed to assess the prevalence of health care system and physician distrust in this population, compare the 2 forms of distrust, and describe the demographic, socioeconomic, and psychosocial predictors of high distrust. A total of 1,232 hospitalized adults with acute coronary syndrome or heart failure were enrolled in a prospective, observational study assessing health care system distrust and physician distrust. High health care system distrust (35%) was observed across the population, with lower levels of interpersonal physician distrust (16%). In a multivariate analysis, poor social support and coping skills were strong predictors of both health care system (p=.026, p=.003) and physician distrust (p<.001, p=.006). Individuals with low or marginal health literacy had a higher likelihood of physician distrust (p<.001), but no relation was found between health literacy and health care system distrust. In conclusion, distrust is common among acutely ill cardiac patients. Those with low social support and low coping skills are more distrusting of physicians and the health care system.
Collapse
Affiliation(s)
- Charu Gupta
- a Division of Cardiovascular Medicine, Department of Medicine , Vanderbilt University School of Medicine , Nashville , Tennessee , USA
| | | | | | | | | | | |
Collapse
|