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Scigliano NM, Puga TB, Scigliano NM, Williams YK, Boin MA. The Effect of COVID-19 Infection on Clinical Outcomes in Patients Undergoing Surgical Repair of Humerus Fractures. Cureus 2024; 16:e56780. [PMID: 38650794 PMCID: PMC11034398 DOI: 10.7759/cureus.56780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2024] [Indexed: 04/25/2024] Open
Abstract
Introduction Limited research exists on the association between coronavirus 2019 (COVID-19) infection and outcomes following surgical fixation for humerus fractures. The objective of this study was to evaluate the effects of COVID-19 on the clinical outcomes of patients undergoing humerus fracture surgery. Methods Approval to utilize insurance claim data from the Change Healthcare dataset was obtained from the Datavant COVID-19 Research Database. Patients older than 55 years old who underwent humerus fracture surgery from April 1, 2020, to March 1, 2022, were included in the analysis. COVID-19 status, comorbidities, and adverse events were identified using the International Classification of Diseases, 10th Revision (ICD-10) diagnostic codes. Propensity score matching with age, sex, and comorbidities was completed to create a 1:10 matched COVID-19-negative cohort. Univariate and multivariate logistic regressions were performed to assess the association of COVID-19 positivity with perioperative adverse events. Results A total of 18,365 patients underwent humerus fracture surgery in this study, of which 132 (0.72%) tested positive for COVID-19. Univariate analysis found that COVID-19-positive patients were at higher risk for myocardial infarction (5.30% vs. 1.74%, p = 0.015) and acute kidney injury (28.79% vs. 12.50%, p < 0.001) when compared to the 1:10 matched COVID-19-negative cohort. In addition, multivariate logistic regression found that COVID-19-positive patients had higher odds of experiencing any adverse event (2.57; 95% CI: 1.69-3.91; p < 0.001) or a minor adverse event (2.44; 95% CI: 1.57-3.79; p < 0.001). Conclusion COVID-19-positive patients have increased odds of experiencing adverse events after undergoing humerus fracture surgery in comparison to a matched COVID-19-negative control. Findings from this study stress the importance of using COVID-19 status as a factor in predicting outcomes following orthopedic surgery in this patient population.
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Affiliation(s)
| | - Troy B Puga
- Osteopathic Medicine, Kansas City University, Kansas, USA
| | | | - Yale K Williams
- Orthopedic Surgery Residency Program, HCA Research Medical Center, Kansas City University - Graduate Medical Education (GME) Consortium, Kansas, USA
| | - Michael A Boin
- Orthopedic Surgery (Shoulder and Elbow), Orthopedic Health of Kansas City, Kansas, USA
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2
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Binu AJ, Kapoor N, Bhattacharya S, Kishor K, Kalra S. Sarcopenic Obesity as a Risk Factor for Cardiovascular Disease: An Underrecognized Clinical Entity. Heart Int 2023; 17:6-11. [PMID: 38419720 PMCID: PMC10897945 DOI: 10.17925/hi.2023.17.2.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 09/15/2023] [Indexed: 03/02/2024] Open
Abstract
Sarcopenic obesity (SO) is a chronic condition and an emerging health challenge, in view of the growing elderly population and the obesity epidemic. Due to a lack of awareness among treating doctors and the non-specific nauture of the associated symptoms, SO remains grossly underdiagnosed. There is no consensus yet on a standard definition or diagnostic criteria for SO, which limits the estimation of the global prevalence of this condition. It has been linked to numerous metabolic derangements, cardiovascular disease (CVD) and mortality. The treatment of SO is multimodal and requires expertise across multiple specialties. While dietary modifications and exercise regimens have shown a potential therapeutic benefit, there is currently no proven pharmacological management for SO. However, numerous drugs and the role of bariatric surgery are still under trial, and have great scope for further research. This article covers the available literature regarding the definition, diagnostic criteria, and prevalence of SO, with available evidence linking it to CVD, metabolic disease and mortality, and an overview of current directives on management.
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Affiliation(s)
- Aditya John Binu
- Department of Cardiology, Christian Medical College, Vellore, India
| | - Nitin Kapoor
- Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, India
- Non-communicable Disease Unit, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | | | - Kamal Kishor
- Department of Cardiology, Rama Hospital, Karnal, India
| | - Sanjay Kalra
- Department of Endocrinology, Bharti Hospital, Karnal, India
- University Center for Research & Development, Chandigarh University, Mohali, India
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3
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Hart WK, Klick JC, Tsai MH. Efficiency, Safety, Quality, and Empathy: Balancing Competing Perioperative Challenges in the Elderly. Anesthesiol Clin 2023; 41:657-670. [PMID: 37516501 DOI: 10.1016/j.anclin.2023.02.011] [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: 07/31/2023]
Abstract
Although baby boomer generation accounts for a little more than 15% of the US population, the cohort represents a disproportionate percentage of patients undergoing surgery. As this group continues to age, a multitude of challenges have arisen in health care regarding the safest and most effective means of providing anesthesia services to these patients. Many elderly patients may be exquisitely sensitive to the effects of anesthesia and surgery and may experience cognitive and physical decline before, during, or after hospital admission. In this review article, the authors briefly examine the physiologic processes underlying aging and explore steps necessary to deliver safe, empathetic care.
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Affiliation(s)
- William K Hart
- Department of Anesthesiology, University of Vermont Larner College of Medicine, Burlington, VT, USA
| | - John C Klick
- Department of Anesthesiology, University of Vermont Larner College of Medicine, Burlington, VT, USA
| | - Mitchell H Tsai
- Department of Anesthesiology, University of Vermont Larner College of Medicine, Burlington, VT, USA; Department of Orthopaedics and Rehabilitation (by courtesy), University of Vermont Larner College of Medicine, Burlington, VT, USA; Department of Surgery (by courtesy), University of Vermont Larner College of Medicine, Burlington, VT, USA.
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4
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Chung Wong Y, Kit Lau T, Wang Chau W, On Kwok K, Wai Law S. Safety of Continuing Aspirin Use in Cervical Laminoplasty: A Propensity Score-Matched Analysis. Spine Surg Relat Res 2023; 7:142-148. [PMID: 37041877 PMCID: PMC10083087 DOI: 10.22603/ssrr.2022-0163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 09/10/2022] [Indexed: 04/03/2023] Open
Abstract
Introduction Aspirin is commonly used for the primary and secondary prevention of cardiovascular disease and stroke. Controversy exists concerning whether and when is the optimal time to stop aspirin before spinal surgery. Previous studies on this topic mainly focused on patients who received thoracolumbar spine surgeries. There are only a few literatures concerning the safety of aspirin use in cervical spine surgery patients. Methods This pilot study recruited patients who received cervical laminoplasty from January 2010 to December 2021. The operation time, intraoperative blood loss, and postoperative complications of the patients who had taken aspirin during the perioperative period were compared with age, sex, and comorbidity-matched control patients. Propensity score matching was utilized in the selection of control to minimize bias. Results Twenty-one patients who have received cervical laminoplasty while taking aspirin during the perioperative period were included. The control group included 21 age, sex, and comorbidity-matched patients who have not taken aspirin. The operation time and intraoperative and postoperative blood loss were higher in patients taking aspirin but were not statistically significant. There was no statistically significant difference in the wound infection rate. No case of epidural hematoma was found. Conclusions In patients undergoing cervical laminoplasty, a continuation of aspirin is safe and does not increase the difficulty of the surgery, wound complication, or hemorrhage.
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Sumin AN. Assessment and Correction of the Cardiac Complications Risk in Non-cardiac Operations – What's New? RATIONAL PHARMACOTHERAPY IN CARDIOLOGY 2022. [DOI: 10.20996/1819-6446-2022-10-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Cardiovascular complications after non-cardiac surgery are the leading cause of 30-day mortality. The need for surgical interventions is approximately 5,000 procedures per 100,000 population, according to experts, the risks of non-cardiac surgical interventions are markedly higher in the elderly. It should be borne in mind that the aging of the population and the increased possibilities of medicine inevitably lead to an increase in surgical interventions in older people. Recent years have been characterized by the appearance of national and international guidelines with various algorithms for assessing and correcting cardiac risk, as well as publications on the validation of these algorithms. The purpose of this review was to provide new information about the assessment and correction of the risk of cardiac complications in non-cardiac operations. Despite the proposed new risk assessment scales, the RCRI scale remains the most commonly used, although for certain categories of patients (with oncopathology, in older age groups) the possibility of using specific questionnaires has been shown. In assessing the functional state, it is proposed to use not only a subjective assessment, but also the DASI questionnaire, 6-minute walking test and cardiopulmonary exercise test). At the next stage, it is proposed to evaluate biomarkers, primarily BNP or NT-proBNP, with a normal level – surgery, with an increased level – either an additional examination by a cardiologist or perioperative troponin screening. Currently, the prevailing opinion is that there is no need to examine patients to detect hidden lesions of the coronary arteries (non-invasive tests, coronary angiography), since this leads to excessive examination of patients, delaying the implementation of non-cardiac surgery. The extent to which this approach has an advantage over the previously used one remains to be studied.
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Affiliation(s)
- A. N. Sumin
- Research Institute for Complex Issues of Cardiovascular Diseases
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Esper G, Anil U, Konda S, Furgiuele D, Zaretsky J, Egol K. Standardized Preoperative Pathways Determining Preoperative Echocardiogram Usage Continue to Improve Hip Fracture Quality. Geriatr Orthop Surg Rehabil 2022; 13:21514593221094730. [PMID: 35450301 PMCID: PMC9016569 DOI: 10.1177/21514593221094730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 03/30/2022] [Indexed: 11/15/2022] Open
Abstract
Introduction The purpose of this study was to assess the hospital quality measures and
outcomes of operative hip fracture patients before and after implementation
of an anesthesiology department protocol assigning decision for a
preoperative transthoracic echocardiogram (TTE) to the hospitalist
co-managing physician. Materials and Methods Demographics, injury details, hospital quality measures, and outcomes were
reviewed for a consecutive series of patients presenting to our institution
with an operative hip fracture. In May of 2019, a new protocol assigning the
responsibility to indicate a patient for preoperative TTE was mandated to
the co-managing hospitalist at the institution. Patients were split into
pre-protocol and post-protocol cohorts. Linear regression modeling and
comparative analyses were conducted with a Bonferroni adjusted alpha as
appropriate. Results Between September 2015 and June 2021, 1002 patients presented to our
institution and were diagnosed with a hip fracture. Patients in the
post-protocol cohort were less likely to undergo a preoperative
echocardiogram, experienced a shorter time (days) to surgery, shorter length
of stay, an increase in amount of home discharges, and lower complication
risks for urinary tract infection and acute blood loss anemia as compared to
those in the pre-protocol cohort. There were no differences seen in
inpatient or 30-day mortality. Multivariable linear regression demonstrated
a patient’s comorbidity profile (Charlson Comorbidity Index (CCI)) and their
date of presentation (pre- or post-protocol), were both associated with
(P<0.01) a patients' time to surgery. Conclusion A standardized preoperative work flow protocol regarding which physician
evaluates and determines which patients require a preoperative TTE allows
for a streamlined perioperative course for hip fracture patients. This
allows for a shortened time to surgery and length of stay with an increase
in home discharges and was associated with a reduced risk of common index
hospitalization complications including UTI and anemia.
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Affiliation(s)
- Garrett Esper
- Department of Orthopedic Surgery, NYU Langone Health, Grossman School of Medicine, New York, NY, USA
| | - Utkarsh Anil
- Department of Orthopedic Surgery, NYU Langone Health, Grossman School of Medicine, New York, NY, USA
| | - Sanjit Konda
- Department of Orthopedic Surgery, NYU Langone Health, Grossman School of Medicine, New York, NY, USA
| | - David Furgiuele
- Department of Anesthesia, NYU Langone Health, Grossman School of Medicine, New York, NY, USA
| | - Jonah Zaretsky
- Department of Medicine, NYU Langone Health, Grossman School of Medicine, New York, NY, USA
| | - Kenneth Egol
- Department of Orthopedic Surgery, NYU Langone Health, Grossman School of Medicine, New York, NY, USA
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7
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Ortiz RM, Golijanin B, O'Rourke TK, Sobel DW, Pillsbury L, T Tucci C, Caffery P, Golijanin D. Direct Oral Anticoagulants for Venous Thromboembolism Prophylaxis Following Robot-assisted Radical Cystectomy: A Retrospective Feasibility Study at a Single Academic Medical Center. Urology 2021; 156:154-162. [PMID: 34171347 DOI: 10.1016/j.urology.2021.04.054] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 04/11/2021] [Accepted: 04/15/2021] [Indexed: 12/17/2022]
Abstract
OBJECTIVES To evaluate the use of direct oral anticoagulants following radical cystectomy for venous thromboembolism prophylaxis. We compared the experience of those who received venous thromboembolism prophylaxis following a robot-assisted radical cystectomy with either a direct oral anticoagulant or enoxaparin. METHODS Medical records of 66 patients who underwent robot-assisted radical cystectomy between July 2017 and May 2020 at a single academic institution were reviewed retrospectively. Patients received extended prophylaxis with either a direct oral anticoagulant or enoxaparin before or following surgical discharge. Venous thromboembolic events and complications resulting in emergency department visits and readmissions were reviewed over a 90-day postoperative period. RESULTS A total of 4 venous thromboembolic events within 90 days of surgery were observed. Among patients taking enoxaparin, 5% (2/37) developed a deep vein thrombosis and 3% (1/37) developed a pulmonary embolism. Among patients taking direct oral anticoagulants, 3% (1/29) developed a deep vein thrombosis. Zero patients in the enoxaparin group and 3% (1/29) of patients in the direct oral anticoagulant group experienced bleeding that required an emergency department visit. CONCLUSION Direct oral anticoagulants performed comparably to enoxaparin in this feasibility study following robot-assisted radical cystectomy in 66 patients. No significant differences in the number of venous thromboembolisms or bleeding complications were observed. These data encourage future studies and support the prospect of direct oral anticoagulants as a potentially suitable oral alternative to injectable low molecular weight heparins for venous thromboembolism prophylaxis following radical cystectomy.
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Affiliation(s)
- Rebecca M Ortiz
- Minimally Invasive Urology Institute, The Miriam Hospital, Providence, RI
| | - Borivoj Golijanin
- Minimally Invasive Urology Institute, The Miriam Hospital, Providence, RI
| | - Timothy K O'Rourke
- Minimally Invasive Urology Institute, The Miriam Hospital, Providence, RI; Warren Alpert Medical School of Brown University, Providence, RI
| | - David W Sobel
- Minimally Invasive Urology Institute, The Miriam Hospital, Providence, RI; Warren Alpert Medical School of Brown University, Providence, RI
| | - Lauren Pillsbury
- Minimally Invasive Urology Institute, The Miriam Hospital, Providence, RI
| | - Christopher T Tucci
- Minimally Invasive Urology Institute, The Miriam Hospital, Providence, RI; Warren Alpert Medical School of Brown University, Providence, RI
| | - Philip Caffery
- Minimally Invasive Urology Institute, The Miriam Hospital, Providence, RI
| | - Dragan Golijanin
- Minimally Invasive Urology Institute, The Miriam Hospital, Providence, RI; Warren Alpert Medical School of Brown University, Providence, RI.
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8
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Abstract
Cardiovascular disease complications are the leading cause of early (short-term) mortality among liver transplant recipients. The increasingly older candidate pool has multiple comorbidities necessitating cardiac and pulmonary vascular disease risk stratification of patients for optimal allocation of scarce donor livers. Arrhythmias, heart failure, stroke, and coronary artery disease are common pretransplant cardiovascular comorbidities and contribute to cardiovascular complications after liver transplant. Valvular heart disease and portopulmonary hypertension present intraoperative challenges during liver transplant surgery. The Cardiovascular Risk in Orthotopic Liver Transplantation score estimates the risk of cardiovascular complications in liver transplant candidates within the first year after transplant.
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9
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Prejean SP, Din M, Reyes E, Hage FG. Guidelines in review: Comparison of the 2014 AHA/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes and the 2015 ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. J Nucl Cardiol 2018; 25:769-776. [PMID: 29230658 DOI: 10.1007/s12350-017-1137-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2017] [Accepted: 11/14/2017] [Indexed: 01/08/2023]
Abstract
In this Guidelines in Review, we review side-by-side the recommendations provided by the 2014 AHA/ACC Guideline for the management of patients with non-ST-elevation acute coronary syndromes and the 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. We review the recommendations for imaging in the evaluation of patients with possible ACS followed by the diagnostic evaluation of patients with proven NSTE-ACS, based on their risk for adverse clinical events.
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Affiliation(s)
- Shane P Prejean
- Division of Cardiovascular Disease, Department of Medicine, The University of Alabama at Birmingham, Lyons Harrison Research Building 306, 1900 University BLVD, Birmingham, AL, 35294, USA.
| | - Munaib Din
- The PET imaging Centre at St. Thomas' Hospital, King's College London, London, UK
| | - Eliana Reyes
- The PET imaging Centre at St. Thomas' Hospital, King's College London, London, UK
| | - Fadi G Hage
- Division of Cardiovascular Disease, Department of Medicine, The University of Alabama at Birmingham, Lyons Harrison Research Building 306, 1900 University BLVD, Birmingham, AL, 35294, USA
- Section of Cardiology, Birmingham Veterans Affairs Medical Center, Birmingham, AL, USA
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10
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Hill A, Nesterova E, Lomivorotov V, Efremov S, Goetzenich A, Benstoem C, Zamyatin M, Chourdakis M, Heyland D, Stoppe C. Current Evidence about Nutrition Support in Cardiac Surgery Patients-What Do We Know? Nutrients 2018; 10:nu10050597. [PMID: 29751629 PMCID: PMC5986477 DOI: 10.3390/nu10050597] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 05/03/2018] [Accepted: 05/08/2018] [Indexed: 12/27/2022] Open
Abstract
Nutrition support is increasingly recognized as a clinically relevant aspect of the intensive care treatment of cardiac surgery patients. However, evidence from adequate large-scale studies evaluating its clinical significance for patients’ mid- to long-term outcome remains sparse. Considering nutrition support as a key component in the perioperative treatment of these critically ill patients led us to review and discuss our understanding of the metabolic response to the inflammatory burst induced by cardiac surgery. In addition, we discuss how to identify patients who may benefit from nutrition therapy, when to start nutritional interventions, present evidence about the use of enteral and parenteral nutrition and the potential role of pharmaconutrition in cardiac surgery patients. Although the clinical setting of cardiac surgery provides advantages due to its scheduled insult and predictable inflammatory response, researchers and clinicians face lack of evidence and several limitations in the clinical routine, which are critically considered and discussed in this paper.
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Affiliation(s)
- Aileen Hill
- Department of Intensive Care Medicine, University Hospital RWTH, D-52074 Aachen, Germany.
- 3CARE-Cardiovascular Critical Care & Anesthesia Evaluation and Research, D-52074 Aachen, Germany.
| | - Ekaterina Nesterova
- Department of Anesthesiology and Intensive Care Medicine, National Pirogov Medical Center, 105203 Moscow, Russia.
| | - Vladimir Lomivorotov
- Department of Anesthesiology and Intensive Care Medicine, E. Meshalkin National Medical Research Center, 630055 Novosibirsk, Russia.
| | - Sergey Efremov
- Department of Anesthesiology and Intensive Care Medicine, E. Meshalkin National Medical Research Center, 630055 Novosibirsk, Russia.
| | - Andreas Goetzenich
- 3CARE-Cardiovascular Critical Care & Anesthesia Evaluation and Research, D-52074 Aachen, Germany.
- Department of Thoracic, Cardiac and Vascular Surgery, University Hospital RWTH, D-52074 Aachen, Germany.
| | - Carina Benstoem
- Department of Intensive Care Medicine, University Hospital RWTH, D-52074 Aachen, Germany.
- 3CARE-Cardiovascular Critical Care & Anesthesia Evaluation and Research, D-52074 Aachen, Germany.
| | - Mikhail Zamyatin
- Department of Anesthesiology and Intensive Care Medicine, National Pirogov Medical Center, 105203 Moscow, Russia.
| | - Michael Chourdakis
- Department of Medicine, School of Health Sciences, 54124 Thessaloniki, Greece.
| | - Daren Heyland
- Clinical Evaluation Research Unit, Kingston General Hospital, Kingston, ON K7L 2V7, Canada.
| | - Christian Stoppe
- Department of Intensive Care Medicine, University Hospital RWTH, D-52074 Aachen, Germany.
- 3CARE-Cardiovascular Critical Care & Anesthesia Evaluation and Research, D-52074 Aachen, Germany.
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Velasco A, Stirrup J, Reyes E, Hage FG. Guidelines in review: Comparison between AHA/ACC and ESC guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. J Nucl Cardiol 2017; 24:1893-1901. [PMID: 28447282 DOI: 10.1007/s12350-017-0895-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 03/22/2017] [Indexed: 10/19/2022]
Affiliation(s)
- Alejandro Velasco
- Division of Cardiovascular Disease, Department of Medicine, The University of Alabama at Birmingham, Lyons Harrison Research Building 306, 1900 University Blvd, Birmingham, AL, 35294, USA.
| | - Jim Stirrup
- Royal Brompton and Harefield Hospitals, and King's College London, London, UK
| | - Eliana Reyes
- Royal Brompton and Harefield Hospitals, and King's College London, London, UK
| | - Fadi G Hage
- Division of Cardiovascular Disease, Department of Medicine, The University of Alabama at Birmingham, Lyons Harrison Research Building 306, 1900 University Blvd, Birmingham, AL, 35294, USA
- Section of Cardiology, Birmingham Veterans Affairs Medical Center, Birmingham, AL, USA
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12
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Xing T, Du L, Zhuang X, Zhang L, Hao J, Wang J. Upregulation of microRNA-206 induces apoptosis of vascular smooth muscle cells and decreases risk of atherosclerosis through modulating FOXP1. Exp Ther Med 2017; 14:4097-4103. [PMID: 29104627 PMCID: PMC5658685 DOI: 10.3892/etm.2017.5071] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Accepted: 12/09/2016] [Indexed: 01/14/2023] Open
Abstract
Forkhead box protein subfamily P (FOXP) 1 has an important role in the control of gene transcription and is also reported to function as a tumor suppressor. The aim of the present study was to explore the regulatory mechanisms of atherosclerosis by investigating the function of microRNA-206 (miR-206) and the regulatory association between miR-206 and its potential target gene, FOXP1, in vascular smooth muscle cells (VSMCs). Bioinformatics tools were utilized to identify FOXP1 as a target of miR-206. Luciferase reporter analysis was used to confirm this relationship and to identify the miR-206 binding site in the FOXP1 3′-untranslated region. It was demonstrated that the relative survival rate of VSMCs was suppressed by miR-206 compared with scramble controls. Furthermore, reduced expression of miR-206 in atherosclerosis tissue samples was observed, and the mRNA and protein expression levels of FOXP1 were upregulated in atherosclerosis tissue samples, both compared with the controls, indicating a negative correlation between miR-206 and FOXP1. Additionally, when treated with miR-206 mimics, the relative survival rate of VSMCs was notably reduced, which was rescued by overexpression of FOXP1. These findings increased the understanding of the regulatory role of miR-206 in atherosclerosis in VSMCs via targeting the FOXP1 gene; therefore, intervention with miR-206 as a therapeutic technique may be a strategy for atherosclerosis treatment in the future.
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Affiliation(s)
- Tao Xing
- Department of Neurosurgery, Liaocheng People's Hospital, Liaocheng, Shandong 252000, P.R. China
| | - Lixin Du
- Department of Neurology, Liaocheng People's Hospital, Liaocheng, Shandong 252000, P.R. China
| | - Xianbo Zhuang
- Department of Neurology, Liaocheng People's Hospital, Liaocheng, Shandong 252000, P.R. China
| | - Liyong Zhang
- Department of Neurosurgery, Liaocheng People's Hospital, Liaocheng, Shandong 252000, P.R. China
| | - Jiheng Hao
- Department of Neurosurgery, Brain Hospital of Liaocheng, Liaocheng, Shandong 252000, P.R. China
| | - Jiyue Wang
- Department of Neurosurgery, Brain Hospital of Liaocheng, Liaocheng, Shandong 252000, P.R. China
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13
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Li X, Fu Y, Miao J, Li H, Hu B. Video-assisted thoracoscopic lobectomy after percutaneous coronary intervention in lung cancer patients with concomitant coronary heart disease. Thorac Cancer 2017; 8:477-481. [PMID: 28749044 PMCID: PMC5582468 DOI: 10.1111/1759-7714.12471] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 06/07/2017] [Accepted: 06/07/2017] [Indexed: 12/26/2022] Open
Abstract
Background In recent years, based on clinical observations, the number of lung cancer patients with concomitant coronary heart disease (CHD) has gradually increased. However, because of the requirement of long‐term anticoagulant therapy after percutaneous coronary intervention (PCI), some of these patients lose the opportunity for surgical treatment, resulting in tumor progression. The objective of this study was to determine the appropriate timing of video‐assisted thoracic surgery (VATS) lobectomy after PCI without increasing perioperative cardiovascular risk. Methods This study retrospectively analyzed clinical data of patients with a combination of NSCLC and CHD who underwent selective pulmonary lobectomy by VATS in the early postoperative PCI period between 2010 and 2015 at Beijing Chaoyang Hospital, China. Results Fourteen patients received VATS lobectomy after PCI. The disease had progressed to T stage in two patients after PCI. No perioperative death occurred. Two patients suffered postoperative atrial fibrillation: one had a pulmonary infection, and the other had acute coronary syndrome. All patients recovered and were discharged. Conclusion For NSCLC patients with severe CHD, the use of VATS lobectomy in the early postoperative PCI period could not only advance the timing of surgery, but may also control perioperative hemorrhage and CHD event risks within acceptable ranges, which could provide more patients with an opportunity to undergo surgical treatment.
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Affiliation(s)
- Xin Li
- Department of Thoracic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - YiLi Fu
- Department of Thoracic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - JinBai Miao
- Department of Thoracic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Hui Li
- Department of Thoracic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Bin Hu
- Department of Thoracic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
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14
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McElwee SK, Hage FG. Guidelines in review: 2016 ACC/AATS/AHA/ASNC/SCAI/SCCT/STS appropriate use criteria for coronary revascularization in patients with acute coronary syndromes. J Nucl Cardiol 2017; 24:464-467. [PMID: 28144906 DOI: 10.1007/s12350-017-0798-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 01/11/2017] [Indexed: 10/20/2022]
Affiliation(s)
- Samuel K McElwee
- Division of Cardiovascular Disease, Department of Medicine, The University of Alabama at Birmingham, BDB 201, 1808 7th Avenue South, Birmingham, AL, 35294, USA.
| | - Fadi G Hage
- Division of Cardiovascular Disease, Department of Medicine, The University of Alabama at Birmingham, BDB 201, 1808 7th Avenue South, Birmingham, AL, 35294, USA
- Section of Cardiology, Birmingham Veterans Affairs Medical Center, Birmingham, AL, USA
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Velasco A, Reyes E, Hage FG. Guidelines in review: Comparison of the 2014 ACC/AHA guidelines on perioperative cardiovascular evaluation and management of patients undergoing noncardiac surgery and the 2014 ESC/ESA guidelines on noncardiac surgery: Cardiovascular assessment and management. J Nucl Cardiol 2017; 24:165-170. [PMID: 27549425 DOI: 10.1007/s12350-016-0643-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2016] [Accepted: 08/01/2016] [Indexed: 10/21/2022]
Affiliation(s)
- Alejandro Velasco
- Division of Cardiovascular Disease, Department of Medicine, The University of Alabama at Birmingham, Lyons Harrison Research Building 306, 1900 University Blvd, Birmingham, AL, 35294, USA
| | - Eliana Reyes
- Royal Brompton and Harefield Hospitals, London, United Kingdom
| | - Fadi G Hage
- Division of Cardiovascular Disease, Department of Medicine, The University of Alabama at Birmingham, Lyons Harrison Research Building 306, 1900 University Blvd, Birmingham, AL, 35294, USA.
- Section of Cardiology, Birmingham Veterans Affairs Medical Center, Birmingham, AL, USA.
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Yoshinaga K, Tamaki N. Current status of nuclear cardiology in Japan: Ongoing efforts to improve clinical standards and to establish evidence. J Nucl Cardiol 2015; 22:690-9. [PMID: 25896679 DOI: 10.1007/s12350-015-0136-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Accepted: 03/27/2015] [Indexed: 11/25/2022]
Abstract
Nuclear cardiology imaging tests are widely performed in Japan as clinical practice. The Japanese nuclear cardiology community has developed new diagnostic imaging tests using (123)I-beta-methyl-p-iodophenyl-pentadecanoic acid, (123)I-metaiodobenzylguanidine, and (18)F-fluorodeoxyglucose PET for detecting cardiac involvement in sarcoidosis. These tests have become popular worldwide. The Japanese Circulation Society and the Japanese Society of Nuclear Cardiology have published clinical imaging guidelines showing indications and standards for the new imaging tests. JSNC is currently striving to improve the standard of clinical practice and is promoting research activities.
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Affiliation(s)
- Keiichiro Yoshinaga
- Molecular Imaging Research Center, National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-Ku, Chiba, 263-8555, Japan,
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