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Yildiz C, Yuksel Y, Rakici IT, Katkat F, Ayça B, Turhan Çağlar FN. Assessment of Systemic Immune-Inflammation Index and Systemic Inflammation-Response Index in Different Coronary Artery Plaque Types. Angiology 2023; 74:536-544. [PMID: 36803083 DOI: 10.1177/00033197231158937] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
Coronary computed tomography angiography can evaluate coronary arterial plaque composition with high resolution. We aimed to determine and compare the values of systemic immune-inflammation index (SII) and systemic inflammation-response index (SIRI) in different plaque types. Highest values of SIRI and SII were found in mixed plaque type followed by non-calcified plaque type. SII value of 463.07 predicted one-year major adverse cardiac events (MACE) with a sensitivity of 72.7% and specificity of 64.3% and SIRI value of 1.14 predicted one-year MACE with a sensitivity of 93% and specificity of 62%. Paired analysis of area under the curve (AUC) of the receiver operating characteristic curves showed that SIRI had higher AUC than coronary calcium score and SII. Univariate logistic regression results showed that age, creatinine level, coronary calcium score, SII, and SIRI were the independent predictors of one-year MACE. According to the results of multivariate regression analysis, after adjusting other factors, age, creatinine level, and SIRI were the independent predictors of one-year MACE. SIRI seemed to improve the risk prediction in coronary artery disease. Therefore, special attention may need to be paid to patients who have a high SIRI.
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Affiliation(s)
- Cennet Yildiz
- Cardiology Department, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Yasin Yuksel
- Cardiology Department, 64160Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Ibrahim T Rakici
- Radiology Department, 64160Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Fahrettin Katkat
- Cardiology Department, 64160Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Burak Ayça
- Cardiology Department, 64160Istanbul Training and Research Hospital, Istanbul, Turkey
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Tang K, Lin J, Ji X, Lin T, Sun D, Zheng X, Wang L. Non-alcoholic fatty liver disease with reduced myocardial FDG uptake is associated with coronary atherosclerosis. J Nucl Cardiol 2021; 28:610-620. [PMID: 31077075 DOI: 10.1007/s12350-019-01736-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 04/16/2019] [Indexed: 01/08/2023]
Abstract
BACKGROUND Non-alcoholic fatty liver disease (NAFLD) has a significant role in the development of coronary atherosclerosis, independent of traditional cardiovascular and metabolic risk factors. However, the role of myocardial glucose uptake in NAFLD patients who develop coronary atherosclerosis was unclear. The aim of the present study thus was to investigate the association between NAFLD with characteristic of coronary atherosclerotic plaque and myocardial glucose uptake measured by using 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET). METHODS AND RESULTS A total of 418 consecutive subjects who had undergone FDG PET/computed tomography (CT) and coronary computed tomography angiography (CCTA) were retrospectively investigated. Fatty liver was assessed by unenhanced CT. Coronary atherosclerotic plaques and stenosis on CCTA were evaluated. The metabolic parameters were measured on PET images. The ratio of the maximum myocardium FDG value to the mean standardized uptake value of liver (SUVratio) was calculated to estimate myocardial glucose uptake. The association of myocardial glucose uptake with NAFLD and coronary atherosclerosis was determined by multivariate logistic regression analysis. The proportion of low SUVratio in patients with NAFLD was significantly higher compared to those without NAFLD (45.00% vs 19.82%, P < .001). There was a significantly negative correlation between myocardial FDG uptake and hepatic steatosis in association trend analysis (P < .001). When the proportion of individuals with non-calcified plaque on CCTA is stratified by quartiles of SUVratio, patients with low quartiles of SUVratio were more likely to have higher proportion of non-calcified plaque than those with high quartiles of SUVratio (Q1 and Q2 vs Q3 and Q4, P = .003). The trend analysis presented correlated inversely relationship between non-calcified plaque and myocardial SUVratio (P = .001). Moreover, multivariate regression analysis showed that the low SUVratio was independently associated with NAFLD, non-calcified plaque, and significant stenosis after adjusting for clinically important factors. CONCLUSION We demonstrated that the presence of reduced myocardial glucose uptake in patients with NAFLD was independently associated with non-calcified plaque and significant stenosis, suggesting an increased risk of coronary atherosclerosis and future cardiovascular events.
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Affiliation(s)
- Kun Tang
- Department of PET/CT, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang, China
| | - Jie Lin
- Department of PET/CT, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang, China
| | - Xiaowei Ji
- Department of PET/CT, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang, China
| | - Tingting Lin
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang, China
| | - Dongrui Sun
- Department of Radiology, The People's Hospital of Yuhuan, Yuhuan, 317600, Zhejiang, China
| | - Xiangwu Zheng
- Department of PET/CT, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang, China
| | - Ling Wang
- Department of Nuclear Medicine, The First Affiliated Hospital of Wenzhou Medical University, Xuefu North Road, Wenzhou, 325000, Zhejiang, China.
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Lee YJ, Baik SJ, Park H, Park JJ, Han D, Lee HS, Lee BK. The association between progression of coronary artery calcium and colorectal adenoma: A retrospective follow-up study of asymptomatic Koreans. Medicine (Baltimore) 2019; 98:e17629. [PMID: 31626147 PMCID: PMC6824637 DOI: 10.1097/md.0000000000017629] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The potential relationship between coronary artery calcium (CAC) and colorectal adenoma has been widely indicated. This study aimed to investigate the relationship between the risk of colorectal adenoma and CAC progression in asymptomatic Korean adults who underwent serial assessments by colonoscopy and CAC scan.A total of 754 asymptomatic participants, who had undergone serial CAC scans and colonoscopies for screening, were enrolled. Changes in CAC were assessed according to the absolute change between baseline and follow-up results. CAC progression was defined using Multi-Ethnic Study of Atherosclerosis method. Risk for adenoma at follow-up colonoscopy was determined using hazard ratio (HR) by Cox regression. The area under the receiver operating characteristic (ROC) curve was measured.The mean follow-up duration was 3.4 ± 2.5 years. CAC progression was found in 215 participants (28.5%). Participants with adenoma at index colonoscopy showed a higher rate of CAC progression than those without (38.8% vs 23.6%, P < .01). In participants with adenoma at index colonoscopy, CAC progression significantly increased the cumulative risk for adenoma at follow-up colonoscopy (HR = 1.48, 95% confidence interval [CI] 1.06-2.06, log-rank P = .021). In multivariate analysis, male sex (HR = 2.57, 95% CI 1.22-5.42, P = .013), ≥3 adenomas at index colonoscopy (HR = 2.60, 95% CI 1.16-5.85, P = .021), and CAC progression (HR = 2.74, 95% CI 1.48-5.08, P = .001) increased the risk of adenoma at follow-up colonoscopy. In participants without adenoma at index colonoscopy, neither baseline CAC presence nor CAC progression increased the risk of adenoma at follow-up colonoscopy. The interaction between CAC progression and adenoma at index colonoscopy was significant in multivariable model (P = .005). In the ROC analysis, AUC of CAC progression for adenoma at follow-up colonoscopy was 0.625 (95% CI 0.567-0.684, P < .001) in participants with adenoma at index colonoscopy.Participants with CAC progression, who are at high risk of coronary atherosclerosis, may need to be considered for follow-up evaluation of colorectal adenoma, especially those with adenoma at index colonoscopy.
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Affiliation(s)
- Yun Jeong Lee
- Division of Cardiology, Gangnam Severance Hospital Cardiovascular Center, Yonsei University Health System
| | - Su Jung Baik
- Healthcare Research Team, Health Promotion Center, Gangnam Severance Hospital
| | - Hyojin Park
- Department of Internal Medicine, Division of Gastroenterology, Gangnam Severance Hospital, Yonsei University College of Medicine
| | - Jae Jun Park
- Department of Internal Medicine, Division of Gastroenterology, Gangnam Severance Hospital, Yonsei University College of Medicine
| | - Donghee Han
- Integrative Cardiovascular Imaging Center, Yonsei University Health System, Seoul, South Korea
- Department of Imaging and Medicine and Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Hye Sun Lee
- Biostatistics Collaboration Unit, Medical Research Center, Yonsei University College of Medicine, Seoul, South Korea
| | - Byoung Kwon Lee
- Division of Cardiology, Gangnam Severance Hospital Cardiovascular Center, Yonsei University Health System
- Healthcare Research Team, Health Promotion Center, Gangnam Severance Hospital
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Evidence of association of circulating epigenetic-sensitive biomarkers with suspected coronary heart disease evaluated by Cardiac Computed Tomography. PLoS One 2019; 14:e0210909. [PMID: 30673762 PMCID: PMC6343931 DOI: 10.1371/journal.pone.0210909] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 01/03/2019] [Indexed: 12/22/2022] Open
Abstract
Circulating biomarkers available in clinical practice do not allow to stratify patients with coronary heart disease (CHD) prior the onset of a clinically relevant event. We evaluated the methylation status of specific genomic segments and gene expression in peripheral blood of patients undergoing Cardiac Computed Tomography (CCT) for CHD (n = 95). We choose to investigate cholesterol metabolism. Methylation and gene expression of low density lipoprotein receptor (LDLR), sterol regulatory element-binding factor 2 (SREBF2) and ATP-binding cassette transporter 1 (ABCA1) were evaluated by qRT-PCR. Calcium score (CACS), stenosis degree, total plaque volume (TPV), calcified plaque volume (CPV), non-calcified plaque volume (NCPV) and plaque burden (PB) were assessed in all CHD patients (n = 65). The percentage of methylation at the specific analyzed segment of LDLR promoter was higher in CHD patients vs healthy subjects (HS) (n = 30) (p = 0.001). LDLR, SREBF2 and ABCA1 mRNAs were up-regulated in CHD patients vs HS (p = 0.02; p = 0.019; p = 0.008). SREBF2 was overexpressed in patients with coronary stenosis ≥50% vs subjects with stenosis <50% (p = 0.036). After adjustment for risk factors and clinical features, ABCA1 (p = 0.005) and SREBF2 (p = 0.010) gene expression were identified as independent predictors of CHD and severity. ROC curve analysis revealed a good performance of ABCA1 on predicting CHD (AUC = 0.768; p<0.001) and of SREBF2 for the prediction of disease severity (AUC = 0.815; p<0.001). Moreover, adjusted multivariate analysis demonstrated SREBF2 as independent predictor of CPV, NCPV and TPV (p = 0.022; p = 0.002 and p = 0.006) and ABCA1 as independent predictor of NCPV and TPV (p = 0.002 and p = 0.013). CHD presence and characteristics are related to selected circulating transcriptional and epigenetic-sensitive biomarkers linked to cholesterol pathway. More extensive analysis of CHD phenotypes and circulating biomarkers might improve and personalize cardiovascular risk stratification in the clinical settings.
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Goldwater D, Karlamangla A, Merkin SS, Watson K, Seeman T. Interleukin-10 as a predictor of major adverse cardiovascular events in a racially and ethnically diverse population: Multi-Ethnic Study of Atherosclerosis. Ann Epidemiol 2018; 30:9-14.e1. [PMID: 30249450 DOI: 10.1016/j.annepidem.2018.08.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 08/20/2018] [Accepted: 08/30/2018] [Indexed: 12/14/2022]
Abstract
PURPOSE To understand if baseline levels of the anti-inflammatory cytokine interleukin-10 (IL-10) are associated with either subclinical atherosclerosis or risk for adverse cardiovascular (CV) events. METHODS The study included 930 adults from the Multi-Ethnic Study of Atherosclerosis (MESA) ancillary Stress Study. Participants, age 48-90 years at enrollment, were followed for an average of 10.2 years. IL-10 level was measured at the initial Stress Study visit. Cardiovascular outcomes were defined as composite CV death, myocardial infarction, stroke, stroke death, and resuscitated cardiac arrest. Coronary calcification was determined by Agatston coronary artery calcium (CAC) score. The association between IL-10 level and CV event risk was evaluated by Cox proportional hazard modeling, while that of IL-10 level and CAC presence and amount was determined with prevalence risk ratio (PRR) and linear regression modeling, respectively. Models were adjusted for CV risk factors and proinflammatory biomarkers. RESULTS After full adjustment, IL-10 level did not predict CV events (HR 1.19, 95%CI 0.89, 1.60) and was not associated with CAC prevalence (PRR 1.00, 95%CI 0.94, 1.07), nor amount of CAC in those with nonzero CAC (β -0.01, 95%CI -0.23, 0.21). CONCLUSION In individuals without clinical heart disease, baseline IL-10 level appears unrelated to risk of CV events and is a poor marker of subclinical coronary atherosclerosis.
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Affiliation(s)
- Deena Goldwater
- Department of Medicine, Division of Geriatrics, University of California, Los Angeles, 10945 Le Conte Ave, Ste 2339, Los Angeles, CA 90095; Department of Medicine, Division of Cardiology, University of California, Los Angeles, 10833 Le Conte Ave, A2-237 Center for Health Sciences, Los Angeles, CA 90095.
| | - Arun Karlamangla
- Department of Medicine, Division of Geriatrics, University of California, Los Angeles, 10945 Le Conte Ave, Ste 2339, Los Angeles, CA 90095
| | - Sharon Stein Merkin
- Department of Medicine, Division of Geriatrics, University of California, Los Angeles, 10945 Le Conte Ave, Ste 2339, Los Angeles, CA 90095
| | - Karol Watson
- Department of Medicine, Division of Cardiology, University of California, Los Angeles, 10833 Le Conte Ave, A2-237 Center for Health Sciences, Los Angeles, CA 90095
| | - Teresa Seeman
- Department of Medicine, Division of Geriatrics, University of California, Los Angeles, 10945 Le Conte Ave, Ste 2339, Los Angeles, CA 90095
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Inoue S, Shibata Y, Kishi H, Nitobe J, Iwayama T, Yashiro Y, Nemoto T, Sato K, Sato M, Kimura T, Igarashi A, Tokairin Y, Kubota I. Decreased left ventricular stroke volume is associated with low-grade exercise tolerance in patients with chronic obstructive pulmonary disease. BMJ Open Respir Res 2017; 4:e000158. [PMID: 28176968 PMCID: PMC5278312 DOI: 10.1136/bmjresp-2016-000158] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Revised: 11/02/2016] [Accepted: 12/22/2016] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Low-grade exercise tolerance is associated with a poor prognosis in patients with chronic obstructive pulmonary disease (COPD). The 6 min walk test (6MWT) is commonly used to evaluate exercise tolerance in patients with COPD. However, little is known regarding the relationship between cardiac function and exercise tolerance in patients with COPD. The aim of this study was to identify predictive factors in cardiac function for low-grade exercise tolerance in patients with stable COPD. METHODS We recruited 57 patients with stable COPD (men 54, women 3) to perform the 6MWT. Patients with underlying orthopaedic disease or heart failure were excluded. Cardiac function was evaluated by echocardiography and contrast-enhanced cardiac CT. We also measured pulmonary function and the 6MWT distance. RESULTS Forced expiratory volume in 1 s (FEV1) and per cent predicted FEV, along with left ventricular end diastolic volume and left ventricular cardiac output as measured by cardiac CT, were significantly related to the 6MWT distance. On multivariate analysis, left ventricular stroke volume was the factor most closely associated with a decreased walked distance in the 6MWT. CONCLUSIONS Decreased left ventricular stroke volume was associated with low-grade exercise tolerance in patients with stable COPD without heart failure.
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Affiliation(s)
- Sumito Inoue
- Department of Cardiology, Pulmonology, and Nephrology , Yamagata University School of Medicine , Yamagata , Japan
| | - Yoko Shibata
- Department of Cardiology, Pulmonology, and Nephrology , Yamagata University School of Medicine , Yamagata , Japan
| | - Hiroyuki Kishi
- Department of Cardiology, Pulmonology, and Nephrology , Yamagata University School of Medicine , Yamagata , Japan
| | - Joji Nitobe
- Department of Cardiology, Pulmonology, and Nephrology , Yamagata University School of Medicine , Yamagata , Japan
| | - Tadateru Iwayama
- Department of Cardiology, Pulmonology, and Nephrology , Yamagata University School of Medicine , Yamagata , Japan
| | - Yoshinori Yashiro
- Department of Cardiology, Pulmonology, and Nephrology , Yamagata University School of Medicine , Yamagata , Japan
| | - Takako Nemoto
- Department of Cardiology, Pulmonology, and Nephrology , Yamagata University School of Medicine , Yamagata , Japan
| | - Kento Sato
- Department of Cardiology, Pulmonology, and Nephrology , Yamagata University School of Medicine , Yamagata , Japan
| | - Masamichi Sato
- Department of Cardiology, Pulmonology, and Nephrology , Yamagata University School of Medicine , Yamagata , Japan
| | - Tomomi Kimura
- Department of Cardiology, Pulmonology, and Nephrology , Yamagata University School of Medicine , Yamagata , Japan
| | - Akira Igarashi
- Department of Cardiology, Pulmonology, and Nephrology , Yamagata University School of Medicine , Yamagata , Japan
| | - Yoshikane Tokairin
- Department of Cardiology, Pulmonology, and Nephrology , Yamagata University School of Medicine , Yamagata , Japan
| | - Isao Kubota
- Department of Cardiology, Pulmonology, and Nephrology , Yamagata University School of Medicine , Yamagata , Japan
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Infante T, Forte E, Aiello M, Salvatore M, Cavaliere C. In Vivo and In Vitro Analysis in Coronary Artery Disease Related to Type 2 Diabetes. Front Endocrinol (Lausanne) 2017; 8:209. [PMID: 28871240 PMCID: PMC5566996 DOI: 10.3389/fendo.2017.00209] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 08/08/2017] [Indexed: 12/11/2022] Open
Abstract
AIM The leading cause of morbidity and mortality in patients with type 2 diabetes mellitus (DM) is coronary artery disease (CAD), a condition often asymptomatic but severe in these patients. Although glucose metabolism impairment and oxidative stress are known actors in the endothelial dysfunction/remodeling that occurs in diabetic patients, the relationship between cardiovascular disorders and DM is not fully understood. We have performed both an in vivo imaging and in vitro molecular analysis to investigate diabetic-specific CAD alterations. METHODS Computed tomography coronary angiography (CTCA) was performed in a group of 20 diabetic patients with CAD (DM+CAD+), 20 non-diabetic with CAD (DM-CAD+), 10 diabetic non-CAD patients (DM+CAD-), and 20 non-diabetic healthy subjects (HS). Imaging quantitative parameters such as calcium score (Cascore), calcified plaque volume (CPV), non-calcified plaque volume (NCPV), total plaque volume (TPV), remodeling index (RI), and plaque burden were extracted for each CAD subject. Moreover, the expression levels of superoxide dismutase 2 (SOD2) and liver X receptor alpha (LXRα) genes were analyzed in the peripheral blood mononuclear cells, whereas hyaluronan (HA) concentrations were evaluated in the plasma of each subject. RESULTS Imaging parameters, such as Cascore, CPV, RI, and plaque burden, were significantly higher in DM+CAD+ group, compared to DM-CAD+ (P = 0.019; P = 0.014; P < 0.001, P < 0.001, respectively). SOD2 mRNA was downregulated, while LXRα gene expression was upregulated in DM+CAD-, DM+CAD+, and DM-CAD+ groups compared to HS (P = 0.001, P = 0.03, and P = 0.001 for SOD2 and P = 0.006, P = 0.008, and P < 0.001 for LXRα, respectively). Plasmatic levels of HA were higher in DM-CAD+, DM+CAD-, and DM+CAD+ groups, compared to HS (P = 0.001 for the three groups). When compared to DM-CAD+, HA concentration was higher in DM+CAD- (P = 0.008) and DM+CAD+ (P < 0.001) with a significant difference between the two diabetic groups (P = 0.003). Moreover, HA showed a significant association with diabetes (P = 0.01) in the study population, and the correlation between HA levels and glycemia was statistically significant (ρ = 0.73, P < 0.001). CONCLUSION In our population, imaging parameters highlight a greater severity of CAD in diabetic patients. Among molecular parameters, HA is modulated by diabetic CAD-related alterations while SOD2 and LXRα are found to be more associated with CAD but do not discriminate between diabetic and non-diabetic subgroups.
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Affiliation(s)
| | - Ernesto Forte
- IRCCS SDN, Naples, Italy
- *Correspondence: Ernesto Forte,
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Lee BC, Lee WJ, Lo SC, Hsu HC, Chien KL, Chang YC, Chen MF. The ratio of epicardial to body fat improves the prediction of coronary artery disease beyond calcium and Framingham risk scores. Int J Cardiovasc Imaging 2016; 32 Suppl 1:117-27. [PMID: 27294836 DOI: 10.1007/s10554-016-0912-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Accepted: 05/10/2016] [Indexed: 11/25/2022]
Abstract
The association between epicardial fat and coronary artery disease (CAD) might be affected by general adiposity. We aimed to determine whether the percentage of epicardial adipose tissue (%EAT), defined as the mass ratio of epicardial fat to body fat, could improve prediction of asymptomatic CAD. We consecutively enrolled 846 adults who underwent coronary computed tomography angiography as part of a health check-up and assessed their coronary stenosis severity and epicardial fat mass. Body fat mass was measured by bioelectrical impedance analysis. Subjects with CAD history, hyperthyroidism, pitting edema, or subjects taking diuretics or thiazolidinedione were excluded. Obstructive CAD was defined as at least one coronary artery with 50 % or greater obstruction, and severe CAD was defined as 70 % or greater obstruction. The %EAT had the maximum area under the curve for predicting the presence of CAD and superior discriminative performance to EAT and other EAT-indexed parameters. Multivariable logistic regression analysis revealed that %EAT >0.41 % was a predictor of obstructive CAD [odds ratio 3.59 (95 % confidence interval 2.28-5.64)], and %EAT >0.47 % was a predictor of severe CAD [4.01 (2.01-7.99)] after adjustment for calcium score and Framingham risk score. This prediction was more pronounced in subjects with higher body fat percentage (≥25 % for men and ≥35 % for women), Framingham risk score (≥10 %), or calcium score (≥100). A spillover of body fat at epicardium over a critical threshold is associated with significant coronary stenosis. This association was independent of obesity, coronary calcium burden, and Framingham risk factors.
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Affiliation(s)
- Bai-Chin Lee
- Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, 7 Chung-Shan South Road, Taipei, Taiwan
| | - Wen-Jeng Lee
- Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan
- Department of Radiology, National Taiwan University College of Medicine, Taipei, Taiwan
- Department of Medical Imaging, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan
| | - Shyh-Chyi Lo
- Department of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Hsiu-Ching Hsu
- Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, 7 Chung-Shan South Road, Taipei, Taiwan
| | - Kuo-Liong Chien
- Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, 7 Chung-Shan South Road, Taipei, Taiwan
- Institute of Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Yeun-Chung Chang
- Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan
- Department of Radiology, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Ming-Fong Chen
- Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, 7 Chung-Shan South Road, Taipei, Taiwan.
- China Medical University Hospital, Taichung, Taiwan.
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Caselli C, De Graaf MA, Lorenzoni V, Rovai D, Marinelli M, Del Ry S, Giannessi D, Bax JJ, Neglia D, Scholte AJ. HDL cholesterol, leptin and interleukin-6 predict high risk coronary anatomy assessed by CT angiography in patients with stable chest pain. Atherosclerosis 2015; 241:55-61. [DOI: 10.1016/j.atherosclerosis.2015.04.811] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Revised: 04/21/2015] [Accepted: 04/29/2015] [Indexed: 12/18/2022]
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Inoue S, Shibata Y, Kishi H, Hasegawa H, Nitobe J, Iwayama T, Yashiro Y, Nemoto T, Sato K, Nakano H, Sato M, Nunomiya K, Aida Y, Yamauchi K, Igarashi A, Abe S, Kubota I. Low arterial blood oxygenation is associated with calcification of the coronary arteries in patients with chronic obstructive pulmonary disease. Respir Investig 2015; 53:111-116. [PMID: 25951097 DOI: 10.1016/j.resinv.2015.01.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Revised: 12/26/2014] [Accepted: 01/07/2015] [Indexed: 06/04/2023]
Abstract
BACKGROUND Cigarette smoking is a well-known major cause of both chronic obstructive pulmonary disease (COPD) and atherosclerosis. However, few studies have investigated the correlation between COPD and coronary atherosclerosis. METHODS We recruited 54 patients with stable COPD (51 men, 3 women) but without angina symptoms. Arterial blood gas analyses were performed, pulmonary function was assessed, and calcification of the coronary arteries was evaluated by computed tomography (CT). RESULTS Calcification of the coronary arteries was noted in 25 patients. There were no significant differences in age, body mass index, respiratory function, and levels of low-density lipoprotein cholesterol, hemoglobin A1c, glucose, or C-reactive protein between patients with or without calcification of the coronary arteries. Arterial blood oxygenation was significantly lower in patients with calcification of the coronary arteries. On both univariate and multivariate analyses, low arterial blood oxygenation was an independent risk factor for calcification of the coronary arteries. CONCLUSIONS In patients with COPD, low arterial blood oxygenation was strongly associated with calcification of the coronary arteries and may be a significant predictor of cardiovascular disease.
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Affiliation(s)
- Sumito Inoue
- Yamagata University School of Medicine, Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, 2-2-2 Iida-Nishi, Yamagata 990-9585, Japan.
| | - Yoko Shibata
- Yamagata University School of Medicine, Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, 2-2-2 Iida-Nishi, Yamagata 990-9585, Japan.
| | - Hiroyuki Kishi
- Yamagata University School of Medicine, Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, 2-2-2 Iida-Nishi, Yamagata 990-9585, Japan.
| | - Hiromasa Hasegawa
- Yamagata University School of Medicine, Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, 2-2-2 Iida-Nishi, Yamagata 990-9585, Japan.
| | - Joji Nitobe
- Yamagata University School of Medicine, Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, 2-2-2 Iida-Nishi, Yamagata 990-9585, Japan.
| | - Tadateru Iwayama
- Yamagata University School of Medicine, Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, 2-2-2 Iida-Nishi, Yamagata 990-9585, Japan.
| | - Yoshinori Yashiro
- Yamagata University School of Medicine, Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, 2-2-2 Iida-Nishi, Yamagata 990-9585, Japan.
| | - Takako Nemoto
- Yamagata University School of Medicine, Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, 2-2-2 Iida-Nishi, Yamagata 990-9585, Japan.
| | - Kento Sato
- Yamagata University School of Medicine, Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, 2-2-2 Iida-Nishi, Yamagata 990-9585, Japan.
| | - Hiroshi Nakano
- Yamagata University School of Medicine, Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, 2-2-2 Iida-Nishi, Yamagata 990-9585, Japan.
| | - Masamichi Sato
- Yamagata University School of Medicine, Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, 2-2-2 Iida-Nishi, Yamagata 990-9585, Japan.
| | - Keiko Nunomiya
- Yamagata University School of Medicine, Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, 2-2-2 Iida-Nishi, Yamagata 990-9585, Japan.
| | - Yasuko Aida
- Yamagata University School of Medicine, Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, 2-2-2 Iida-Nishi, Yamagata 990-9585, Japan.
| | - Keiko Yamauchi
- Yamagata University School of Medicine, Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, 2-2-2 Iida-Nishi, Yamagata 990-9585, Japan.
| | - Akira Igarashi
- Yamagata University School of Medicine, Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, 2-2-2 Iida-Nishi, Yamagata 990-9585, Japan.
| | - Shuichi Abe
- Yamagata University School of Medicine, Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, 2-2-2 Iida-Nishi, Yamagata 990-9585, Japan.
| | - Isao Kubota
- Yamagata University School of Medicine, Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, 2-2-2 Iida-Nishi, Yamagata 990-9585, Japan.
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Nilsson L, Wieringa WG, Pundziute G, Gjerde M, Engvall J, Swahn E, Jonasson L. Neutrophil/Lymphocyte ratio is associated with non-calcified plaque burden in patients with coronary artery disease. PLoS One 2014; 9:e108183. [PMID: 25268632 PMCID: PMC4182451 DOI: 10.1371/journal.pone.0108183] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Accepted: 08/26/2014] [Indexed: 12/12/2022] Open
Abstract
Background Elevations in soluble markers of inflammation and changes in leukocyte subset distribution are frequently reported in patients with coronary artery disease (CAD). Lately, the neutrophil/lymphocyte ratio has emerged as a potential marker of both CAD severity and cardiovascular prognosis. Objectives The aim of the study was to investigate whether neutrophil/lymphocyte ratio and other immune-inflammatory markers were related to plaque burden, as assessed by coronary computed tomography angiography (CCTA), in patients with CAD. Methods Twenty patients with non-ST-elevation acute coronary syndrome (NSTE-ACS) and 30 patients with stable angina (SA) underwent CCTA at two occasions, immediately prior to coronary angiography and after three months. Atherosclerotic plaques were classified as calcified, mixed and non-calcified. Blood samples were drawn at both occasions. Leukocyte subsets were analyzed by white blood cell differential counts and flow cytometry. Levels of C-reactive protein (CRP) and interleukin(IL)-6 were measured in plasma. Blood analyses were also performed in 37 healthy controls. Results Plaque variables did not change over 3 months, total plaque burden being similar in NSTE-ACS and SA. However, non-calcified/total plaque ratio was higher in NSTE-ACS, 0.25(0.09–0.44) vs 0.11(0.00–0.25), p<0.05. At admission, levels of monocytes, neutrophils, neutrophil/lymphocyte ratios, CD4+ T cells, CRP and IL-6 were significantly elevated, while levels of NK cells were reduced, in both patient groups as compared to controls. After 3 months, levels of monocytes, neutrophils, neutrophil/lymphocyte ratios and CD4+ T cells remained elevated in patients. Neutrophil/lymphocyte ratios and neutrophil counts correlated significantly with numbers of non-calcified plaques and also with non-calcified/total plaque ratio (r = 0.403, p = 0.010 and r = 0.382, p = 0.024, respectively), but not with total plaque burden. Conclusions Among immune-inflammatory markers in NSTE-ACS and SA patients, neutrophil counts and neutrophil/lymphocyte ratios were significantly correlated with non-calcified plaques. Data suggest that these easily measured biomarkers reflect the burden of vulnerable plaques in CAD.
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Affiliation(s)
- Lennart Nilsson
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
- Department of Cardiology, Linköping University, Linköping, Sweden
- * E-mail:
| | - Wouter G. Wieringa
- University of Groningen, University Medical Center Groningen, Department of Cardiology, Groningen, The Netherlands
| | - Gabija Pundziute
- University of Groningen, University Medical Center Groningen, Department of Cardiology, Groningen, The Netherlands
| | - Marcus Gjerde
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
- Department of Cardiology, Linköping University, Linköping, Sweden
| | - Jan Engvall
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
- Department of Clinical Physiology, Linköping University, Linköping, Sweden
| | - Eva Swahn
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
- Department of Cardiology, Linköping University, Linköping, Sweden
| | - Lena Jonasson
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
- Department of Cardiology, Linköping University, Linköping, Sweden
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12
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Chiang JK. Short duration of sleep is associated with elevated high-sensitivity C-reactive protein level in Taiwanese adults: a cross-sectional study. J Clin Sleep Med 2014; 10:743-9. [PMID: 25024651 DOI: 10.5664/jcsm.3862] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Elevated plasma levels of high-sensitivity C-reactive protein (hs-CRP) have been associated with increased adverse health outcomes. The aim of this study was to investigate the association of sleep duration with risk of elevated hs-CRP levels in Taiwanese adults. METHODS We examined the association between sleep duration and hs-CRP in 353 healthy adults recruited from the physical examination center at a regional hospital in southern Taiwan. Elevated hs-CRP was defined as a plasma level ≥ 0.20 mg/dL. Short sleep duration was defined as ≤ 5.5 h per day. Multiple logistic regression analysis was used to assess the association of short duration of sleep with elevated hs-CRP levels. RESULTS In this study, short duration of sleep (odds ratio [OR] = 2.20; 95% confidence interval [CI]: 1.11-4.30), aged 70 years or older (OR = 4.58; 95% CI: 1.70-12.66), menopause (OR = 2.81; 95% CI: 1.52-5.3), higher heart rate (OR = 1.38; 95% CI: 1.10-1.75), higher body mass index (OR = 1.20; 95% CI: 1.09-1.34), higher white blood cell count (OR = 1.38; 95% CI: 1.14-1.66), and higher uric acid level (OR = 1.31; 95% CI: 1.06-1.63) were significantly associated with an increased risk of elevated hs-CRP levels. CONCLUSIONS In this study of healthy Taiwanese adults, short duration of sleep was significantly associated with elevated hs-CRP levels. Activation of pro-inflammatory pathways might represent a mechanism by which short sleep duration affects health.
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Affiliation(s)
- Jui-Kun Chiang
- Department of Family Medicine, Buddhist Dalin Tzu Chi Hospital, Chiayi, Taiwan
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