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Schmid A, Pankuweit S, Vlacil AK, Koch S, Berge B, Gajawada P, Richter M, Troidl K, Schieffer B, Schäffler A, Grote K. Decreased circulating CTRP3 levels in acute and chronic cardiovascular patients. J Mol Med (Berl) 2024; 102:667-677. [PMID: 38436713 PMCID: PMC11055757 DOI: 10.1007/s00109-024-02426-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 01/24/2024] [Accepted: 01/29/2024] [Indexed: 03/05/2024]
Abstract
C1q/TNF-related protein 3 (CTRP3) represents an adipokine with various metabolic and immune-regulatory functions. While circulating CTRP3 has been proposed as a potential biomarker for cardiovascular disease (CVD), current data on CTRP3 regarding coronary artery disease (CAD) remains partially contradictory. This study aimed to investigate CTRP3 levels in chronic and acute settings such as chronic coronary syndrome (CCS) and acute coronary syndrome (ACS). A total of 206 patients were classified into three groups: CCS (n = 64), ACS having a first acute event (ACS-1, n = 75), and ACS having a recurrent acute event (ACS-2, n = 67). The control group consisted of 49 healthy individuals. ELISA measurement in peripheral blood revealed decreased CTRP3 levels in all patient groups (p < 0.001) without significant differences between the groups. This effect was exclusively observed in male patients. Females generally exhibited significantly higher CTRP3 plasma levels than males. ROC curve analysis in male patients revealed a valuable predictive potency of plasma CTRP3 in order to identify CAD patients, with a proposed cut-off value of 51.25 ng/mL. The sensitivity and specificity of prediction by CTRP3 were congruent for the subgroups of CCS, ACS-1, and ACS-2 patients. Regulation of circulating CTRP3 levels in murine models of cardiovascular pathophysiology was found to be partly opposite to the clinical findings, with male mice exhibiting higher circulating CTRP3 levels than females. We conclude that circulating CTRP3 levels are decreased in both male CCS and ACS patients. Therefore, CTRP3 might be useful as a biomarker for CAD but not for distinguishing an acute from a chronic setting. KEY MESSAGES: CTRP3 levels were found to be decreased in both male CCS and ACS patients compared to healthy controls. Plasma CTRP3 has a valuable predictive potency in order to identify CAD patients among men and is therefore proposed as a biomarker for CAD but not for distinguishing between acute and chronic settings. Regulation of circulating CTRP3 levels in murine models of cardiovascular pathophysiology was found to be partly opposite to the clinical findings in men.
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Affiliation(s)
- Andreas Schmid
- Department of Internal Medicine III, Giessen University Hospital, Giessen, Germany.
| | - Sabine Pankuweit
- Cardiology and Angiology, Philipps-University Marburg, Marburg, Germany
| | | | - Sören Koch
- Cardiology and Angiology, Philipps-University Marburg, Marburg, Germany
| | - Benedikt Berge
- Department of Cardiac Surgery, Kerckhoff Heart Center, Bad Nauheim, Germany
| | - Praveen Gajawada
- Department of Cardiac Surgery, Kerckhoff Heart Center, Bad Nauheim, Germany
| | - Manfred Richter
- Department of Cardiac Surgery, Kerckhoff Heart Center, Bad Nauheim, Germany
| | - Kerstin Troidl
- Department of Life Sciences and Engineering, TH Bingen, University of Applied Sciences, Bingen Am Rhein, Germany
- Department of Vascular and Endovascular Surgery, Cardiovascular Surgery Clinic, University Hospital Frankfurt and Wolfgang Goethe University Frankfurt, Frankfurt, Germany
| | | | - Andreas Schäffler
- Department of Internal Medicine III, Giessen University Hospital, Giessen, Germany
| | - Karsten Grote
- Cardiology and Angiology, Philipps-University Marburg, Marburg, Germany
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Yuan R, Tong Z, Chen JX, Wang Y, Zhou YF. Global Burden of Ischemic Heart Disease in Adolescents and Young Adults, 1990-2019. Am J Prev Med 2024; 66:751-759. [PMID: 38104848 DOI: 10.1016/j.amepre.2023.12.009] [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: 06/26/2023] [Revised: 12/08/2023] [Accepted: 12/10/2023] [Indexed: 12/19/2023]
Abstract
INTRODUCTION Few studies have evaluated the global burden of ischemic heart disease (IHD) in adolescents and young adults (AYAs). METHODS Age-standardized rates (ASRs) of incidence (ASIR), mortality (ASMR) and Disability-Adjusted Life Years (DALYs) (ASDR) were used to describe the burden of IHD in AYAs. Estimated Annual Percentage Changes (EAPCs) of ASRs were used to describe the trend from 1990 to 2019. Risk factors were calculated by population attributable fractions (PAFs). Analyses were conducted in 2023. RESULTS In 2019, the ASIR, ASMR, and ASDR of IHD in AYAs were 26.81 (95% uncertainty interval [UI]: 20.36-34.54) per 100,000, 7.15 (95% UI: 6.56-7.87) per 100,000 and 409.51 (95% UI: 376.57-449.59) per 100,000. The ASIR and ASMR were higher among men than among women. From 1990 to 2019, the ASIR increased (EAPC=0.18%, 95% CI 0.14%-0.22%), while the ASMR (EAPC=-0.39%, -0.50% to -0.27%) and ASDR (EAPC=-0.40%, -0.52% to -0.29%) decreased. The largest increase in ASIR was observed in countries with a middle sociodemographic index (SDI) (EAPC=0.56%, 0.51%-0.60%). Globally, the proportional contribution of risk factors for DALY varied across regions, with the highest proportions of high low-density lipoprotein cholesterol in high SDI regions (PAF=74.26%) and high-middle (PAF=71.30%) and the highest proportions of air pollution in low (PAF=41.79%) and low-middle SDI regions (PAF=40.90%). CONCLUSIONS The burden of IHD in AYAs remains high globally, and varies by age, sex, (male/female), region, and country. Targeted measures are needed to address the rising burden of IHD in AYAs, focusing on prevention, early diagnosis, and reduction in disparities.
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Affiliation(s)
- Ruixia Yuan
- Clinical Big Data Center, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zhuang Tong
- Clinical Big Data Center, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jun-Xiang Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Yi Wang
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Yan-Feng Zhou
- Department of Social Medicine, School of Public Health, Guangxi Medical University, Nanning, Guangxi Province, China; Key Laboratory of Emergency and Trauma of Ministry of Education, Hainan Medical University, Haikou, China.
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Ruan Y, Bao Q, Wang L, Wang Z, Zhu W, Wang J. Cardiovascular diseases burden attributable to ambient PM 2.5 pollution from 1990 to 2019: A systematic analysis for the global burden of disease study 2019. ENVIRONMENTAL RESEARCH 2024; 241:117678. [PMID: 37984788 DOI: 10.1016/j.envres.2023.117678] [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: 03/10/2023] [Revised: 11/08/2023] [Accepted: 11/13/2023] [Indexed: 11/22/2023]
Abstract
BACKGROUND Ambient PM2.5 pollution (APMP2.5) was the leading environmental risk factor for cardiovascular diseases (CVDs) worldwide. An up-to-date comprehensive study is needed to provide global epidemiological patterns. METHODS Detailed data on CVDs burden attributable to APMP2.5 were obtained from the Global Burden of Disease Study (GBD) 2019. We calculated the estimated annual percentage change (EAPC) to assess temporal trends in age-standardized rates of deaths and disability-adjusted life years (DALYs) over 30 years. RESULTS Globally, CVDs attributable to APMP2.5 resulted in 2.48 million deaths and 60.91 million DALYs, with an increase of 122%, respectively from 1990 to 2019. In general, men suffered markedly higher burden than women, but the gap will likely turn narrow. As for age distribution, CVDs deaths and DALYs attributable to APMP2.5 mainly occurred in the elder group (>70 years). Low- and middle-income regions endured the higher CVDs burden due to the higher exposure to APMP2.5, and the gap may potentially expand further compared with high-income regions. For regions, the highest age-standardized rates of APMP2.5-related CVDs deaths and DALYs were observed mainly in Central Asia, while the lowest was observed in Australasia. At the national level, countries with the largest ASDR decline were clustered in western Europe, while Equatorial Guinea, Timor-Leste and Bhutan exhibited relatively rapid increases over this period. CONCLUSIONS The global CVDs burden attributable to APMP2.5 has contributed to the heterogeneity of spatial and temporal distribution. APMP2.5-related CVDs deaths have largely shifted from higher SDI regions to those with a lower SDI. Globally, APMP2.5-attributable CVDs pose a significant threat to public health and diseases burden has increased over time, particularly in male, old-aged populations. The governments and health systems should take measures to reduce air pollution to impede this rising trend.
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Affiliation(s)
- Yixin Ruan
- Department of Cardiology of the Second Affiliated Hospital, School of Medicine, Zhejiang University, China; State Key Laboratory of Transvascular Implantation Devices, China; Cardiovascular Key Laboratory of Zhejiang Province, Hangzhou, 310009, China
| | - Qinyi Bao
- Department of Cardiology of the Second Affiliated Hospital, School of Medicine, Zhejiang University, China; State Key Laboratory of Transvascular Implantation Devices, China; Cardiovascular Key Laboratory of Zhejiang Province, Hangzhou, 310009, China
| | - Lingjun Wang
- Department of Cardiology of the Second Affiliated Hospital, School of Medicine, Zhejiang University, China; State Key Laboratory of Transvascular Implantation Devices, China; Cardiovascular Key Laboratory of Zhejiang Province, Hangzhou, 310009, China
| | - Zhuo Wang
- Department of Cardiology of the Second Affiliated Hospital, School of Medicine, Zhejiang University, China; State Key Laboratory of Transvascular Implantation Devices, China; Cardiovascular Key Laboratory of Zhejiang Province, Hangzhou, 310009, China
| | - Wei Zhu
- Department of Cardiology of the Second Affiliated Hospital, School of Medicine, Zhejiang University, China; State Key Laboratory of Transvascular Implantation Devices, China; Cardiovascular Key Laboratory of Zhejiang Province, Hangzhou, 310009, China
| | - Jian'an Wang
- Department of Cardiology of the Second Affiliated Hospital, School of Medicine, Zhejiang University, China; State Key Laboratory of Transvascular Implantation Devices, China; Cardiovascular Key Laboratory of Zhejiang Province, Hangzhou, 310009, China.
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Lambrakis K, Khan E, van den Merkhof A, Papendick C, Chuang A, Zhai Y, Eng-Frost J, Rocheleau S, Lehman SJ, Blyth A, Briffa T, Quinn S, French JK, Cullen L, Chew DP. Impacts of high sensitivity troponin T reporting on care and outcomes in clinical practice: Interactions between low troponin concentrations and participant sex within two randomized clinical trials. Int J Cardiol 2023; 393:131396. [PMID: 37769972 DOI: 10.1016/j.ijcard.2023.131396] [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: 12/07/2022] [Revised: 09/10/2023] [Accepted: 09/22/2023] [Indexed: 10/03/2023]
Abstract
BACKGROUND The impacts of high sensitivity cardiac troponin (hs-cTn) reporting on downstream interventions amongst suspected acute coronary syndrome (ACS) in the emergency department (ED), especially amongst those with newly identified hs-cTn elevations and in consideration of well-established sex-related disparities, has not been critically evaluated to date. This investigation explores the impact of hs-cTnT reporting on care and outcomes, particularly by participant sex. METHODS Two similarly ED-based randomized controlled trials conducted between July 2011 to March 2013 (n = 1988) and August 2015 to April 2019 (n = 3378) were comparatively evaluated. Clinical outcomes were adjudicated to the Fourth Universal Definition of MI. Changes in practice were assessed at 30 days, and death or MI were explored to 12 months. RESULTS The HS-Troponin study demonstrated no difference in death or MI with unmasking amongst those with hs-cTnT <30 ng/L, whereas the RAPID TnT study demonstrated a significantly higher rate. In RAPID TnT, there was significant increase in death or MI associated with unmasking for females with hs-cTnT <30 ng/L (masked: 11[1.5%], unmasked: 25[3.4%],HR: 2.27,95%C.I.:1.87-2.77,P < 0.001). Less cardiac stress testing with unmasking amongst those <30 ng/L was observed in males in both studies, which was significant in RAPID TnT (masked: 92[12.0%], unmasked: 55[7.0%], P = 0.008). In RAPID TnT, significantly higher rates of angiography in males were observed with unmasking, with no such changes amongst females <30 ng/L (masked: 28[3.7%], unmasked: 51[6.5%],P = 0.01). CONCLUSION Compared with males, there were no evident impacts on downstream practices for females with unmasking in RAPID TnT, likely representing missed opportunities to reduce late death or MI.
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Affiliation(s)
- Kristina Lambrakis
- College of Medicine & Public Health, Flinders University of South Australia, Adelaide, Australia; South Australian Department of Health, Adelaide, Australia.
| | - Ehsan Khan
- College of Medicine & Public Health, Flinders University of South Australia, Adelaide, Australia; South Australian Department of Health, Adelaide, Australia
| | - Anke van den Merkhof
- College of Medicine & Public Health, Flinders University of South Australia, Adelaide, Australia; Faculty of Medical Sciences, University of Groningen, the Netherlands
| | - Cynthia Papendick
- South Australian Department of Health, Adelaide, Australia; School of Medicine, University of Adelaide, Adelaide, Australia
| | - Anthony Chuang
- College of Medicine & Public Health, Flinders University of South Australia, Adelaide, Australia; South Australian Department of Health, Adelaide, Australia
| | - Yuze Zhai
- College of Medicine & Public Health, Flinders University of South Australia, Adelaide, Australia
| | | | | | - Sam J Lehman
- College of Medicine & Public Health, Flinders University of South Australia, Adelaide, Australia; South Australian Department of Health, Adelaide, Australia
| | - Andrew Blyth
- College of Medicine & Public Health, Flinders University of South Australia, Adelaide, Australia; South Australian Department of Health, Adelaide, Australia
| | - Tom Briffa
- School of Population and Global Health, University of Western Australia, Perth, Australia
| | - Stephen Quinn
- Department of Statistics, Data Science and Epidemiology, Swinburne University of Technology, Melbourne, Australia
| | - John K French
- Department of Cardiology, Liverpool Hospital, University of New South Wales, Sydney, Australia
| | - Louise Cullen
- Emergency and Trauma Centre, Royal Brisbane and Women's Hospital, Brisbane, Australia; School of Public Health, Queensland University of Technology, Brisbane, Australia; School of Medicine, University of Queensland, Brisbane, Australia
| | - Derek P Chew
- College of Medicine & Public Health, Flinders University of South Australia, Adelaide, Australia; South Australian Department of Health, Adelaide, Australia
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Wu S, Xu W, Guan C, Lv M, Jiang S, Jinhua Z. Global burden of cardiovascular disease attributable to metabolic risk factors, 1990-2019: an analysis of observational data from a 2019 Global Burden of Disease study. BMJ Open 2023; 13:e069397. [PMID: 37173115 DOI: 10.1136/bmjopen-2022-069397] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/15/2023] Open
Abstract
OBJECTIVES An up-to-date, detailed global analysis of the current status of the metabolic-attributed cardiovascular disease (CVD) burden has not been reported. Therefore, we investigated the global burden of metabolic-attributed CVD and its association with socioeconomic development status over the past 30 years. METHODS Data on the burden of metabolic-attributed CVD were taken from the 2019 Global Burden of Disease (GBD) study. Metabolic risk factors of CVD included high fasting plasma glucose, high low-density lipoprotein cholesterol (LDL-c), high systolic blood pressure (SBP), high body mass index (BMI) and kidney dysfunction. Numbers and age-standardised rates (ASR) of disability-adjusted life-years (DALYs) and deaths were extracted and stratified by sex, age, Socio-demographic Index (SDI) level, country and region. RESULTS The ASR of metabolic-attributed CVD DALYs and deaths decreased by 28.0% (95% UI 23.8% to 32.5%) and 30.4% (95% UI 26.6% to 34.5%), respectively, from 1990 to 2019. The highest burden of metabolic-attributed total CVD and intracerebral haemorrhage was mainly in low SDI locations, while the highest burden of ischaemic heart disease and IS was mainly in high SDI locations. The burden of DALYs and deaths in CVD was higher in men than women. In addition, the number and ASR of DALYs and deaths were highest in those over 80 years old. CONCLUSION Metabolic-attributed CVD threatens public health, especially in low-SDI locations and among the elderly. Low SDI location should strengthen the control of metabolic factors such as high SBP, high BMI, and high LDL-c and increase the knowledge of metabolic risk factors for CVD. Countries and regions should enhance screening and prevention of metabolic risk factors of CVD in the elderly. Policy-makers should use 2019 GBD data to guide cost-effective interventions and resource allocation.
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Affiliation(s)
- Shuyi Wu
- Department of Pharmacy, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
| | - Wenlin Xu
- Department of Pharmacy, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
| | - Chengfu Guan
- Department of Pharmacy, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
| | - Meina Lv
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, China
| | - Shaojun Jiang
- Department of Pharmacy, First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Zhang Jinhua
- Department of Pharmacy, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
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Chang RW. Closing the gap in sex-based care disparities in vascular surgery. J Vasc Surg 2023; 77:1512. [PMID: 37087149 DOI: 10.1016/j.jvs.2023.01.180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 01/03/2023] [Indexed: 04/24/2023]
Affiliation(s)
- Robert W Chang
- Department of Vascular Surgery, The Permanente Medical Group, South San Francisco, CA
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Fu X, Wang J, Jiang S, Wu J, Mu Z, Tang Y, Wang S, Fu H, Ma H, Zhao Y. Mortality trend analysis of ischemic heart disease in China between 2010 and 2019: a joinpoint analysis. BMC Public Health 2023; 23:644. [PMID: 37016366 PMCID: PMC10071740 DOI: 10.1186/s12889-023-15549-3] [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: 08/17/2022] [Accepted: 03/28/2023] [Indexed: 04/06/2023] Open
Abstract
BACKGROUND This study presented the mortality trend of ischemic heart disease (IHD) in Chinese residents from 2010 to 2019 and provided a basis for further establishment of relevant interventions. METHODS Data, such as sex, age, urban and rural areas, and death status, were extracted from the China Death Surveillance Dataset from 2010 to 2019, with mortality and age-adjusted death rates (AADRs) as the main indicators. The joinpoint regression model was used to analyze mortality and AADRs trends in IHD. A semi-structured expert interview was conducted to propose targeted intervention measures and countermeasures. RESULTS We observed an overall upward trend in IHD mortality rates and AADRs in China from 2010 to 2019 (average annual percentage change [AAPC] = 5.14%, AAPCAADRs = 1.60%, P < 0.001). Mortality rates and AADRs increased for both males (AAPC = 4.91%, AAPCAADRs = 1.09%, P < 0.05) and females (AAPC = 5.57%, AAPCAADRs = 1.84%, P < 0.001), with higher mortality rate for males than females but higher variation for females than males. Urban (AAPC = 4.80%, AAPCAADRs = 1.76%, P < 0.05) and rural (AAPC = 5.31%, P < 0.001; AAPCAADRs = 0.99%, P > 0.05) mortality rates increased, with the mortality rate higher in rural areas than in urban areas. In the age analysis, mortality rate was higher in middle-aged and older adults than in other age groups. The age-sex cross-analysis found the highest trend in mortality rates among females aged ≥ 75 years (annual percentage change [APC] = 2.43%, P < 0.05). CONCLUSIONS The upward trend in IHD mortality in China from 2010 to 2019, especially among female residents aged ≥ 75 years, poses continuing challenges to public health policies and actions.
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Affiliation(s)
- Xiaoli Fu
- Department of Health Management of Public Health, Zhengzhou University, Henan, People's Republic of China
| | - Jing Wang
- Department of Health Management of Public Health, Zhengzhou University, Henan, People's Republic of China
| | - Shuai Jiang
- The First Affiliated Hospital of Zhengzhou University, Henan, People's Republic of China
- Institute for Hospital Management of Henan Province, Henan, People's Republic of China
| | - Jian Wu
- Department of Health Management of Public Health, Zhengzhou University, Henan, People's Republic of China
| | - Zihan Mu
- Department of Health Management of Public Health, Zhengzhou University, Henan, People's Republic of China
| | - Yanyu Tang
- Department of Health Management of Public Health, Zhengzhou University, Henan, People's Republic of China
| | - Suxian Wang
- Department of Health Management of Public Health, Zhengzhou University, Henan, People's Republic of China
| | - Hang Fu
- The First Affiliated Hospital of Zhengzhou University, Henan, People's Republic of China
- Institute for Hospital Management of Henan Province, Henan, People's Republic of China
| | - He Ma
- Health Service and Management, Shangzhen College, Henan University of Traditional Chinese Medicine, Henan, People's Republic of China
| | - Yaojun Zhao
- Operation Management Department, Central China Fuwai Hospital, Central China Fuwai Hospital of Zhengzhou University, Henan, People's Republic of China.
- Institute for Hospital Management of Henan Province, Henan, People's Republic of China.
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Mehta JK, Kaur G, Buttar HS, Bagabir HA, Bagabir RA, Bagabir SA, Haque S, Tuli HS, Telessy IG. Role of the renin-angiotensin system in the pathophysiology of coronary heart disease and heart failure: Diagnostic biomarkers and therapy with drugs and natural products. Front Physiol 2023; 14:1034170. [PMID: 36909245 PMCID: PMC9995912 DOI: 10.3389/fphys.2023.1034170] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 01/27/2023] [Indexed: 02/25/2023] Open
Abstract
The renin-angiotensin system (RAS) plays a pivotal role in blood pressure regulation. In some cases, this steering mechanism is affected by various deleterious factors (mainly via the overactivation of the RAS) causing cardiovascular damage, including coronary heart disease (CHD) that can ultimately lead to chronic heart failure (CHF). This not only causes cardiovascular disability and absenteeism from work but also imposes significant healthcare costs globally. The incidence of cardiovascular diseases has escalated exponentially over the years with the major outcome in the form of CHD, stroke, and CHF. The involvement of the RAS in various diseases has been extensively researched with significant limelight on CHD. The RAS may trigger a cascade of events that lead to atherosclerotic mayhem, which causes CHD and related aggravation by damaging the endothelial lining of blood vessels via various inflammatory and oxidative stress pathways. Although there are various diagnostic tests and treatments available in the market, there is a constant need for the development of procedures and therapeutic strategies that increase patient compliance and reduce the associated side effects. This review highlights the advances in the diagnostic and treatment domains for CHD, which would help in subjugating the side effects caused by conventional therapy.
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Affiliation(s)
- Jinit K Mehta
- Department of Pharmacology, Shobhaben Pratapbhai Patel School of Pharmacy and Technology Management, SVKM's NMIMS, Mumbai, India
| | - Ginpreet Kaur
- Department of Pharmacology, Shobhaben Pratapbhai Patel School of Pharmacy and Technology Management, SVKM's NMIMS, Mumbai, India
| | - Harpal S Buttar
- Department of Pathology and Laboratory Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Hala Abubaker Bagabir
- Department of Physiology, Faculty of Medicine, King Abdulaziz University, Rabigh, Saudi Arabia
| | - Rania Abubaker Bagabir
- Department of Hematology and Immunology, College of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Sali Abubaker Bagabir
- Genetics Unit, Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
| | - Shafiul Haque
- Research and Scientific Studies Unit, College of Nursing and Allied Health Sciences, Jazan University, Jazan, Saudi Arabia.,Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Beirut, Lebanon.,Centre of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates
| | - Hardeep S Tuli
- Department of Biotechnology, Maharishi Markandeshwar Engineering College, Maharishi Markandeshwar (Deemed to be University), Ambala, India
| | - Istvan G Telessy
- Department of Pharmaceutics, Faculty of Pharmacy, University of Pécs, Pécs, Hungary
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Chen J, Chen H, Zhu Q, Liu Q, Zhou Y, Li L, Wang Y. Age at menarche and ischemic heart disease: An update mendelian randomization study. Front Genet 2022; 13:942861. [PMID: 36406117 PMCID: PMC9671358 DOI: 10.3389/fgene.2022.942861] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 10/20/2022] [Indexed: 12/01/2023] Open
Abstract
Background: Although earlier menarche age has been associated with ischemic heart disease in previous observational studies, the relationship's causation has not been shown. Through two-sample Mendelian randomization (MR), we were able to define the causal connection. Methods: We performed Mendelian Randomization (MR) analysis to explore the associations between genetically predicted AAM and IHD. Summary-level databases for exposure and outcome were selected from the MR-Base database (https://gwas.mrcieu.ac.uk/). Single-nucleotide polymorphisms (SNPs) connected to AAM at genome-wide significance level (p < 5 × 10-8) were considered as instrumental variables (IVs). We used four methods to pool MR estimates, including fixed-effects inverse variance weighting (fe-IVW), multiplicative random-effects inverse variance weighting (mre-IVW), weighted median (WM), and MR-Egger regression methods. Sensitivity analyses were performed to evaluate the robustness of the results. PhenoScanner searches and Multivariable Mendelian randomization (MVMR) analysis was used for assessing confounders. Results: 117 SNPs significantly correlated with AAM were screened as instruments, the results of three main methods showed that genetically earlier AAM may have a causal effect on the higher risk of IHD (fe-IVW: OR = 0.80, 95% CI: 0.72-0.88, p < 0.001; mre-IVW: OR = 0.80, 95% CI: 0.70-0.90, p < 0.001; WE: OR = 0.79, 95% CI: 0.66-0.93, p = 0.006). These results were consistent across sensitivity analyses. MR analysis revealed that there was still a relationship between AAM and IHD even when pleiotropic SNPs of confounders were removed employing PhenoScanner searches. In MVMR, the significant association remained after adjusting for biological sex, but it was attenuated with adjustment of body mass index including childhood and adult. Conclusion: Our MR analysis revealed a substantial genetically determined confounder-mediated relationship between an increase in genetically predicted AAM and a lower risk of IHD. By addressing the intervention of body mass index, the risk of IHD may be lowered.
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Affiliation(s)
- Jing Chen
- The First College of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Heng Chen
- Department of Cardiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Qiaozhen Zhu
- Clinical Medical School, Henan University, Kaifeng, China
| | - Qiannan Liu
- The First College of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yan Zhou
- The First College of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Lan Li
- The First College of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
- Department of Pediatrics, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Yan Wang
- Department of Pediatrics, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
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Oknińska M, Mączewski M, Mackiewicz U. Ventricular arrhythmias in acute myocardial ischaemia-Focus on the ageing and sex. Ageing Res Rev 2022; 81:101722. [PMID: 36038114 DOI: 10.1016/j.arr.2022.101722] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 08/17/2022] [Accepted: 08/20/2022] [Indexed: 01/31/2023]
Abstract
Annually, approximately 17 million people die from cardiovascular diseases worldwide, half of them suddenly. The most common direct cause of sudden cardiac death is ventricular arrhythmia triggered by an acute coronary syndrome (ACS). The study summarizes the knowledge of the mechanisms of arrhythmia onset during ACS in humans and in animal models and factors that may influence the susceptibility to life-threatening arrhythmias during ACS with particular focus on the age and sex. The real impact of age and sex on the arrhythmic susceptibility within the setting of acute ischaemia is masked by the fact that ACSs result from coronary artery disease appearing with age much earlier among men than among women. However, results of researches show that in ageing process changes with potential pro-arrhythmic significance, such as increased fibrosis, cardiomyocyte hypertrophy, decrease number of gap junction channels, disturbances of the intracellular Ca2+ signalling or changes in electrophysiological parameters, occur independently of the development of cardiovascular diseases and are more severe in male individuals. A review of the literature also indicates a marked paucity of research in this area in female and elderly individuals. Greater awareness of sex differences in the aging process could help in the development of personalized prevention methods targeting potential pro-arrhythmic factors in patients of both sexes to reduce mortality during the acute phase of myocardial infarction. This is especially important in an era of aging populations in which women will predominate due to their longer lifespan.
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Affiliation(s)
- Marta Oknińska
- Department of Clinical Physiology, Centre of Postgraduate Medical Education, Marymoncka 99/103, 01-813 Warsaw, Poland
| | - Michał Mączewski
- Department of Clinical Physiology, Centre of Postgraduate Medical Education, Marymoncka 99/103, 01-813 Warsaw, Poland
| | - Urszula Mackiewicz
- Department of Clinical Physiology, Centre of Postgraduate Medical Education, Marymoncka 99/103, 01-813 Warsaw, Poland.
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11
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Darbà J, Marsà A. Burden of ischemic heart disease in Spain: incidence, hospital mortality and costs of hospital care. Expert Rev Pharmacoecon Outcomes Res 2022; 22:1147-1152. [PMID: 36001004 DOI: 10.1080/14737167.2022.2108794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Ischemic heart disease (IHD) is the leading global cause of death and is assumed to entail a significant social and economic burden globally. This study aimed to evaluate incidence and mortality trends of IHD in Spain and to estimate direct medical costs. METHODS Admission files corresponding to patients with IHD registered between 2011 and 2019 were obtained from a Spanish hospital discharge database and analyzed in a retrospective study. RESULTS Admission data corresponding to 814,740 patients with IHD was analyzed. The majority of patients were males, and about half of the hospitalizations were due to an acute myocardial infarction. Incidence decreased significantly in most age groups over time, while hospital mortality rate remained stable (4.4%). Additionally, mortality rate was significantly higher among females (6.6%). Median admission cost was €5175; the higher costs per admission were found in patients with an acute myocardial infarction and in admissions with an ICU stay. The annual cost of hospital care was €693.8 million. CONCLUSIONS Despite the decreasing trends described in the general population, hospital mortality rate was constant among hospitalized patients during the study period. The higher hospital mortality rate described among females should be considered in further studies and protocol revisions.
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Affiliation(s)
- Josep Darbà
- Department of Economics, Universitat de Barcelona, Barcelona, Spain
| | - Alicia Marsà
- Department of Health Economics, BCN Health Economics & Outcomes Research S.L, Barcelona, Spain
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12
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Li T, Jiang L, Xu L, Tian J, Zhao X, Feng X, Wang D, Zhang Y, Sun K, Xu J, Liu R, Xu B, Zhao W, Hui R, Gao R, Song L, Yuan J. Interaction Between Treatment and Age or Sex in Non-ST-Segment Elevation Acute Coronary Disease and Three-Vessel Disease. Front Cardiovasc Med 2022; 9:879834. [PMID: 35722116 PMCID: PMC9200996 DOI: 10.3389/fcvm.2022.879834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 04/25/2022] [Indexed: 11/28/2022] Open
Abstract
Aims To explore the effects of age and sex on the outcomes of coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) in non-ST-segment elevation acute coronary syndrome (NSTE-ACS) patients with the three-vessel disease (TVD). Methods and Results The study is a subanalysis of data from a prospective cohort of 8,943 patients with angiographically confirmed TVD at Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China. The primary end point was major adverse cardiac and cerebrovascular events (MACCEs), a composite of all-cause death, myocardial infarction, and stroke. In total, 2,819 patients with NSTE-ACS who received CABG (43.6%) or PCI (56.4%) were included, among whom 32.7% were of 65-74 years, 7.2% were ≥75 years, and 22.6% were women. The median follow-up duration was 6.8 years. The superiority of CABG relative to PCI in terms of MACCE was decreased with age (adjusted hazard ratio [HR] [95% confidence interval (CI)]: <65 years: 0.662 [0.495-0.885], p = 0.005; 65-74 years: 0.700 [0.512-0.956], p = 0.025; ≥75 years: 0.884 [0.529-1.479], p = 0.640) and was only seen in men (adjusted HR [95% CI]: men: 0.668 [0.526-0.848], p = 0.001; women: 0.713 [0.505-1.006], p = 0.054). Significant treatment-by-sex and treatment-by-age interactions were observed in patients ≥ 75 years and women, respectively, (p interaction with sex = 0.001; p interaction with age = 0.002). Conclusion Coronary artery bypass grafting is favorable for most NSTE-ACS patients with TVD. The preponderance of CABG over PCI disappeared in patients ≥ 75 years and women. PCI is superior in women ≥ 75 years.
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Affiliation(s)
- Tianyu Li
- National Clinical Research Center for Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lin Jiang
- Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lianjun Xu
- Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jian Tian
- Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xueyan Zhao
- Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xinxing Feng
- Department of Endocrinology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Dong Wang
- Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yin Zhang
- Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Kai Sun
- Information Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jingjing Xu
- Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ru Liu
- Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Bo Xu
- Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wei Zhao
- Information Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Rutai Hui
- Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Runlin Gao
- Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lei Song
- National Clinical Research Center for Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jinqing Yuan
- National Clinical Research Center for Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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13
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Farrukh F, Abbasi A, Jawed M, Almas A, Jafar T, Virani SS, Samad Z. Hypertension in Women: A South-Asian Perspective. Front Cardiovasc Med 2022; 9:880374. [PMID: 36035921 PMCID: PMC9399392 DOI: 10.3389/fcvm.2022.880374] [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: 02/21/2022] [Accepted: 06/22/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Hypertension is an important contributor to cardiovascular disease related morbidity and mortality. Despite the magnitude of its negative impact on cardiovascular outcomes, treatment and control of hypertension remain suboptimal in both men and women. Materials and Methods Numerous databases, i.e., PubMed, ScienceDirect, etc., were searched using keywords to identify relevant studies to our narrative review. The findings from the most pertinent articles were summarized and integrated into our narrative review on hypertension in women. Results The pathophysiology of essential hypertension is still being delineated in both men and women; there are multiple sex specific factors in association with the development of hypertension in women, including age, combined oral contraceptives (COCs), polycystic ovarian syndrome (PCOS), preeclampsia, etc. There are several sex specific considerations in antihypertensives drug choices. Discussion Despite the magnitude of its negative impact on cardiovascular outcomes, treatment and control of hypertension remain suboptimal in women. Medical treatment and adherence is uniquely challenging for South Asian women due to a variety of socio-cultural-economic factors. Further research is warranted to identify optimal sex-specific treatment options that will improve the control of hypertension and decrease the risk of subsequent cardiovascular disease in both genders.
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Affiliation(s)
| | - Amin Abbasi
- Medical College, Aga Khan University, Karachi, Pakistan
| | - Misbah Jawed
- Medical College, Ziauddin University, Karachi, Pakistan
| | - Aysha Almas
- Medical College, Aga Khan University, Karachi, Pakistan
| | - Tazeen Jafar
- Medical College, Aga Khan University, Karachi, Pakistan.,Baylor College of Medicine, Houston, TX, United States
| | | | - Zainab Samad
- Medical College, Aga Khan University, Karachi, Pakistan.,Department of Medicine, Duke University, Durham, NC, United States
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14
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Faramand Z, Alrawashdeh M, Helman S, Bouzid Z, Martin-Gill C, Callaway C, Al-Zaiti S. Your neighborhood matters: A machine-learning approach to the geospatial and social determinants of health in 9-1-1 activated chest pain. Res Nurs Health 2021; 45:230-239. [PMID: 34820853 PMCID: PMC8930557 DOI: 10.1002/nur.22199] [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: 07/01/2021] [Revised: 11/10/2021] [Accepted: 11/11/2021] [Indexed: 11/09/2022]
Abstract
Healthcare disparities in the initial management of patients with acute coronary syndrome (ACS) exist. Yet, the complexity of interactions between demographic, social, economic, and geospatial determinants of health hinders incorporating such predictors in existing risk stratification models. We sought to explore a machine-learning-based approach to study the complex interactions between the geospatial and social determinants of health to explain disparities in ACS likelihood in an urban community. This study identified consecutive patients transported by Pittsburgh emergency medical service for a chief complaint of chest pain or ACS-equivalent symptoms. We extracted demographics, clinical data, and location coordinates from electronic health records. Median income was based on US census data by zip code. A random forest (RF) classifier and a regularized logistic regression model were used to identify the most important predictors of ACS likelihood. Our final sample included 2400 patients (age 59 ± 17 years, 47% Females, 41% Blacks, 15.8% adjudicated ACS). In our RF model (area under the receiver operating characteristic curve of 0.71 ± 0.03) age, prior revascularization, income, distance from hospital, and residential neighborhood were the most important predictors of ACS likelihood. In regularized regression (akaike information criterion = 1843, bayesian information criterion = 1912, χ2 = 193, df = 10, p < 0.001), residential neighborhood remained a significant and independent predictor of ACS likelihood. Findings from our study suggest that residential neighborhood constitutes an upstream factor to explain the observed healthcare disparity in ACS risk prediction, independent from known demographic, social, and economic determinants of health, which can inform future work on ACS prevention, in-hospital care, and patient discharge.
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Affiliation(s)
- Ziad Faramand
- Department of Acute and Tertiary Care Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Mohammad Alrawashdeh
- Department of Acute and Tertiary Care Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Department of Population Medicine, Boston, Massachusetts, USA.,School of Nursing, Jordan University of Science and Technology, Irbid, Jordan
| | - Stephanie Helman
- Department of Acute and Tertiary Care Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Department of Emergency Medicine, University of Pittsburgh Medical Center (UPMC), Pittsburgh, Pennsylvania, USA
| | - Zeineb Bouzid
- Department of Electrical and Computer Engineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Christian Martin-Gill
- Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Department of Emergency Medicine, University of Pittsburgh Medical Center (UPMC), Pittsburgh, Pennsylvania, USA.,UPMC Prehospital Care Division and Bureau of EMS, Pittsburgh, Pennsylvania, USA
| | - Clifton Callaway
- Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Department of Emergency Medicine, University of Pittsburgh Medical Center (UPMC), Pittsburgh, Pennsylvania, USA
| | - Salah Al-Zaiti
- Department of Acute and Tertiary Care Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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15
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Wang W, Hu M, Liu H, Zhang X, Li H, Zhou F, Liu YM, Lei F, Qin JJ, Zhao YC, Chen Z, Liu W, Song X, Huang X, Zhu L, Ji YX, Zhang P, Zhang XJ, She ZG, Yang J, Yang H, Cai J, Li H. Global Burden of Disease Study 2019 suggests that metabolic risk factors are the leading drivers of the burden of ischemic heart disease. Cell Metab 2021; 33:1943-1956.e2. [PMID: 34478633 DOI: 10.1016/j.cmet.2021.08.005] [Citation(s) in RCA: 60] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 06/21/2021] [Accepted: 08/09/2021] [Indexed: 10/20/2022]
Abstract
Metabolic dysfunction is becoming a predominant risk for the development of many comorbidities. Ischemic heart disease (IHD) still imposes the highest disease burden among all cardiovascular diseases worldwide. However, the contributions of metabolic risk factors to IHD over time have not been fully characterized. Here, we analyzed the global disease burden of IHD and 15 associated general risk factors from 1990 to 2019 by applying the methodology framework of the Global Burden of Disease Study. We found that the global death cases due to IHD increased steadily during that time frame, while the mortality rate gradually declined. Notably, metabolic risk factors have become the leading driver of IHD, which also largely contributed to the majority of IHD-related deaths shifting from developed countries to developing countries. These findings suggest an urgent need to implement effective measures to control metabolic risk factors to prevent further increases in IHD-related deaths.
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Affiliation(s)
- Wenxin Wang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China; Institute of Model Animal, Wuhan University, Wuhan, China
| | - Manli Hu
- Institute of Model Animal, Wuhan University, Wuhan, China; Medical Science Research Center, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Hui Liu
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China; Department of Gastroenterology, Tongren Hospital of Wuhan University & Wuhan Third Hospital, Wuhan, China
| | - Xingyuan Zhang
- School of Basic Medical Science, Wuhan University, Wuhan, China; Institute of Model Animal, Wuhan University, Wuhan, China
| | - Haomiao Li
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China; Institute of Model Animal, Wuhan University, Wuhan, China
| | - Feng Zhou
- Institute of Model Animal, Wuhan University, Wuhan, China; Medical Science Research Center, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Ye-Mao Liu
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China; Institute of Model Animal, Wuhan University, Wuhan, China
| | - Fang Lei
- School of Basic Medical Science, Wuhan University, Wuhan, China; Institute of Model Animal, Wuhan University, Wuhan, China
| | - Juan-Juan Qin
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China; Institute of Model Animal, Wuhan University, Wuhan, China
| | - Yan-Ci Zhao
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China; Institute of Model Animal, Wuhan University, Wuhan, China
| | - Ze Chen
- Institute of Model Animal, Wuhan University, Wuhan, China; Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Weifang Liu
- School of Basic Medical Science, Wuhan University, Wuhan, China; Institute of Model Animal, Wuhan University, Wuhan, China
| | - Xiaohui Song
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China; Institute of Model Animal, Wuhan University, Wuhan, China
| | - Xuewei Huang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China; Institute of Model Animal, Wuhan University, Wuhan, China
| | - Lihua Zhu
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China; Institute of Model Animal, Wuhan University, Wuhan, China
| | - Yan-Xiao Ji
- School of Basic Medical Science, Wuhan University, Wuhan, China; Institute of Model Animal, Wuhan University, Wuhan, China; Medical Science Research Center, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Peng Zhang
- School of Basic Medical Science, Wuhan University, Wuhan, China; Institute of Model Animal, Wuhan University, Wuhan, China
| | - Xiao-Jing Zhang
- School of Basic Medical Science, Wuhan University, Wuhan, China; Institute of Model Animal, Wuhan University, Wuhan, China
| | - Zhi-Gang She
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China; Institute of Model Animal, Wuhan University, Wuhan, China
| | - Juan Yang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China; Institute of Model Animal, Wuhan University, Wuhan, China.
| | - Hailong Yang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China; Institute of Model Animal, Wuhan University, Wuhan, China.
| | - Jingjing Cai
- Institute of Model Animal, Wuhan University, Wuhan, China; Department of Cardiology, the Third Xiangya Hospital, Central South University, Changsha, China.
| | - Hongliang Li
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China; Institute of Model Animal, Wuhan University, Wuhan, China; Medical Science Research Center, Zhongnan Hospital of Wuhan University, Wuhan, China.
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16
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Oknińska M, Paterek A, Bierła J, Czarnowska E, Mączewski M, Mackiewicz U. Effect of age and sex on the incidence of ventricular arrhythmia in a rat model of acute ischemia. Biomed Pharmacother 2021; 142:111983. [PMID: 34392089 DOI: 10.1016/j.biopha.2021.111983] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 07/23/2021] [Accepted: 07/26/2021] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND The impact of sex and age on the arrhythmic susceptibility within the setting of acute ischemia is masked by the fact that acute coronary events result from coronary artery disease appearing with age much earlier among men than among women. METHODS AND RESULTS LAD ligation or sham operations were performed in rats of both sexes at the age 3 and 24 months. An ECG was recorded continuously for 6 h after the operation. The number of early and late premature ventricular beats (PVBs), episodes of ventricular tachycardia (VT) and fibrillation (VF), heart rate, QRS, QT and Tpeak-Tend duration were analysed. Epicardial action potentials were recorded in vivo, Ca2+ signaling was evaluated in isolated cardiomyocytes, fibrosis and connexin-43 expression and localization were measured in the septum. PVBs, VT and VF episodes are much more common in older males than in young males and females independently from their age. Fibrosis with varying intensity in different muscle layers, hypertrophy of cardiomyocytes, reduced number of gap junctions and their appearance on the lateral myocyte membrane, QT prolongation, increase transmural dispersion of repolarisation and a decreased function of SERCA2a may increase the propensity to arrhythmia within the setting of acute ischemia. CONCLUSION We show that the male sex, especially in case of older individuals is a strong predictor of increased arrhythmic susceptibility within the acute ischemia setting regardless of its impact on the occurrence of cardiovascular diseases. A personalized sex-dependent prevention treatment is needed to reduce the mortality in acute phases of myocardial infarction.
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Affiliation(s)
- Marta Oknińska
- Department of Clinical Physiology, Centre of Postgraduate Medical Education, Marymoncka 99/103, 01-813 Warsaw, Poland
| | - Aleksandra Paterek
- Department of Clinical Physiology, Centre of Postgraduate Medical Education, Marymoncka 99/103, 01-813 Warsaw, Poland
| | - Joanna Bierła
- Department of Pathology, The Children's Memorial Health Institute, Aleja Dzieci Polskich 20, 04-730 Warsaw, Poland
| | - Elżbieta Czarnowska
- Department of Pathology, The Children's Memorial Health Institute, Aleja Dzieci Polskich 20, 04-730 Warsaw, Poland
| | - Michał Mączewski
- Department of Clinical Physiology, Centre of Postgraduate Medical Education, Marymoncka 99/103, 01-813 Warsaw, Poland
| | - Urszula Mackiewicz
- Department of Clinical Physiology, Centre of Postgraduate Medical Education, Marymoncka 99/103, 01-813 Warsaw, Poland.
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17
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Batsi C, Gkika E, Astrakas L, Papadopoulos A, Iakovou I, Dogoritis A, Fotopoulos A, Sioka C. Vitamin D Deficiency as a Risk Factor for Myocardial Ischemia. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:medicina57080774. [PMID: 34440979 PMCID: PMC8400168 DOI: 10.3390/medicina57080774] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 07/21/2021] [Accepted: 07/27/2021] [Indexed: 12/11/2022]
Abstract
Background and Objectives: Vitamin D (Vit D) deficiency has been implicated in various conditions, including cardiovascular disease. The purpose of this retrospective study was to investigate the incidence of patients with myocardial ischemia in relation to their serum levels of vitamin D. Materials and Methods: A 64-month search (January 2016 to April 2021) in our database of the Nuclear Medicine Laboratory revealed 113 patients who had both myocardial perfusion imaging with single photon emission computed tomography (MPI SPECT) and Vit D measurements. MPI SPECT obtained myocardial images during both stress (summed stress score, SSS) and rest (summed rest score, SRS). Abnormal MPI SPECT was when the SSS was ≥4. Vit D was determined by radioimmunoassay (RIA). Patients with Vit D values <10 ng/mL, 10-29 ng/mL and ≥30 ng/mL were defined as having a deficiency, insufficiency and sufficiency, respectively. Results: Among patients, 46/113 (40.7%) were male and 67/113 (59.3%) were female. Abnormal MPI was found in 58/113 (51.3%) patients. Vit D deficiency was noted in 20/113 (17.7%) patients, insufficiency in 86/113 (76.1%) patients, and normal Vit D was noted in only 7/113 (6.2%) patients. Sixteen of the 20 patients (80%) with Vit D deficiency, and 38/86 (44.2%) with insufficiency had an abnormal MPI SPECT. In contrast, only 1/7 (14.3%) patients with sufficient Vit D levels had an abnormal MPI SPECT. The Mann-Whitney U-test showed that ischemia reduced the values of Vit D. Correlation analysis showed a negative association of Vit D levels with SSS (rho = -0.232, p = 0.014) and SRS (rho = -0.250, p = 0.008). Further evaluation with a Vit D cut off 20 ng/mL retrieved no statistical significance. Finally, Vit D and gender were independently associated with myocardial ischemia. Conclusions: Low Vit D levels may represent a risk factor for myocardial ischemia.
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Affiliation(s)
- Christina Batsi
- Department of Nuclear Medicine, University Hospital of Ioannina, 45500 Ioannina, Greece; (C.B.); (E.G.); (A.F.)
| | - Evangelia Gkika
- Department of Nuclear Medicine, University Hospital of Ioannina, 45500 Ioannina, Greece; (C.B.); (E.G.); (A.F.)
| | - Loukas Astrakas
- Department of Medical Physics, University Hospital of Ioannina, 45500 Ioannina, Greece; (L.A.); (A.P.)
| | - Athanassios Papadopoulos
- Department of Medical Physics, University Hospital of Ioannina, 45500 Ioannina, Greece; (L.A.); (A.P.)
| | - Ioannis Iakovou
- 2nd Nuclear Medicine Laboratory, AHEPA University Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece;
| | - Alexandros Dogoritis
- Neurosurgical Institute of Ioannina, University of Ioannina, 45500 Ioannina, Greece;
| | - Andreas Fotopoulos
- Department of Nuclear Medicine, University Hospital of Ioannina, 45500 Ioannina, Greece; (C.B.); (E.G.); (A.F.)
| | - Chrissa Sioka
- Department of Nuclear Medicine, University Hospital of Ioannina, 45500 Ioannina, Greece; (C.B.); (E.G.); (A.F.)
- Neurosurgical Institute of Ioannina, University of Ioannina, 45500 Ioannina, Greece;
- Correspondence:
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18
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Si Y, Fan W, Shan W, Zhang Y, Liu J, Han C, Sun L. Association between triglyceride glucose index and coronary artery disease with type 2 diabetes mellitus in middle-aged and elderly people. Medicine (Baltimore) 2021; 100:e25025. [PMID: 33655974 PMCID: PMC7939227 DOI: 10.1097/md.0000000000025025] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 11/18/2020] [Indexed: 01/04/2023] Open
Abstract
This study aimed to investigate the correlation between triglyceride glucose (TyG) index and coronary artery disease (CAD) with type 2 diabetes mellitus (T2DM) and identify the risk associated TyG index in different subgroups.A total of 1665 eligible inpatients (CAD with T2DM group [n = 680], non-coronary artery disease without T2DM [n = 985]) were consecutively enrolled in this study. They were assigned into 4 subgroups: middle-aged, elderly, male, and female subgroups. Receiver operating characteristic curve diagnostic test and a logistic regression model was established to analyze the risk factors for CAD with T2DM.TyG index is an independent risk factor for patients with CAD with T2DM. The risk of increased TyG index is greater in the middle-aged and male subgroups than in the elderly and female subgroups, respectively (all P < .05). The specificity and the positive predictive value of the TyG index is greater than the sensitivity and the negative predictive value, respectively (all P < .05).Increased TyG index is a new independent risk factor for CAD with T2DM, and its risk is higher in the middle-aged and male subgroups than in the elderly and female subgroups, respectively. TyG index may be used as a clinical predictor of CAD with T2DM.
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19
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Zhang D, Guan L, Li X. Bioinformatics analysis identifies potential diagnostic signatures for coronary artery disease. J Int Med Res 2020; 48:300060520979856. [PMID: 33356708 PMCID: PMC7840986 DOI: 10.1177/0300060520979856] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background Coronary artery disease (CAD) is the leading cause of mortality worldwide. We
aimed to screen out potential gene signatures and construct a diagnostic
model for CAD. Method We downloaded two mRNA profiles, GSE66360 and GSE60993, and performed
analyses of differential expression, gene ontology terms, and Kyoto
Encyclopedia of Genes and Genomes (KEGG) pathways. The STRING database was
used to identify protein–protein interactions (PPI). PPI network
visualization and screening out of key genes were performed using Cytoscape
software. Finally, a diagnostic model was constructed. Results A total of 2127 differentially expressed genes (DEGs) were identified in
GSE66360, and 527 DEGs in GSE60993. Of the 153 DEGs from both datasets that
showed differential expression between CAD patients and controls, 471
biological process terms, 35 cellular component terms, 17 molecular function
terms, and 49 KEGG pathways were significantly enriched. The top 20 key
genes in the PPI network were identified, and a diagnostic model constructed
from five optimal genes that could efficiently separate CAD patients from
controls. Conclusion We identified several potential biomarkers for CAD and built a logistic
regression model that will provide a valuable reference for future clinical
diagnoses and guide therapeutic strategies.
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Affiliation(s)
- Dong Zhang
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Liying Guan
- Health Management Center, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Xiaoming Li
- Health Management Center, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
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