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Zheng J, Li T, Hu F, Chen B, Xu M, Yan S, Lu C. Predictive value of peripheral neutrophil count on admission for young patients with acute coronary syndrome. Am J Med Sci 2024:S0002-9629(24)01389-2. [PMID: 39084522 DOI: 10.1016/j.amjms.2024.07.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 07/18/2024] [Accepted: 07/19/2024] [Indexed: 08/02/2024]
Abstract
OBJECTIVE The present study aimed to explore the relationship between neutrophil count on admission and major adverse cardiovascular and cerebrovascular events (MACCE) and left ventricular ejection fraction (LVEF) during hospitalization in young ACS patients, which have rarely been investigated in previous studies. METHODS This study included 400 young ACS patients (<45 years old) who underwent coronary angiography. According to the median neutrophil count at admission, the patients were divided into two groups. The relationship between neutrophil count and MACCE and LVEF during hospitalization was analyzed by regression analysis. The receiver operating characteristic (ROC) curve and the Youden index was used to determine the optimal cut-off value of neutrophil count. RESULTS Neutrophil count at admission was an independent risk factor of in-hospital MACCE (OR: 1.33, 95 % CI: 1.13-1.56, P<0.001) and LVEF <50 % (OR: 1.28, 95 % CI: 1.12-1.47, P<0.001) in young ACS patients.The cutoff value of neutrophil count for predicting the occurrence of in-hospital MACCE was 6.935 × 10^9/L with a sensitivity of 92.1 %, specificity of 59.4 %, and AUC is 0.820 (95 % CI: 0.7587-0.8804, P<0.001), and for identifying the LVEF <50 % was 8.660 × 10^9/L with a sensitivity of 69.8 %, specificity of 76.8 %, and AUC is 0.775 (95 % CI: 0.6997-0.8505, P<0.001). CONCLUSION The neutrophil count upon admission is an independent predictor of in-hospital MACCE and LVEF in young ACS patients, giving important information for predicting the poor prognosis of young ACS patients.
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Affiliation(s)
- Jia Zheng
- The First Central Clinical School, Tianjin Medical University, Tianjin, China; Department of Cardiology, Tianjin First Center Hospital, Tianjin, China
| | - Tingting Li
- Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Fang Hu
- Department of Cardiology, Tianjin First Center Hospital, Tianjin, China
| | - Bingwei Chen
- Department of Cardiology, Tianjin First Center Hospital, Tianjin, China
| | - Mengping Xu
- Department of Cardiology, Tianjin First Center Hospital, Tianjin, China
| | - Shuangbing Yan
- Department of Cardiology, Tianjin First Center Hospital, Tianjin, China
| | - Chengzhi Lu
- Department of Cardiology, Tianjin First Center Hospital, Tianjin, China.
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Pan L, Li Z, Li C, Dong X, Hidru TH, Liu F, Xia Y, Yang X, Zhong L, Liu Y. Stress hyperglycemia ratio and neutrophil to lymphocyte ratio are reliable predictors of new-onset atrial fibrillation in patients with acute myocardial infarction. Front Cardiovasc Med 2022; 9:1051078. [PMID: 36440053 PMCID: PMC9681791 DOI: 10.3389/fcvm.2022.1051078] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 10/24/2022] [Indexed: 11/10/2022] Open
Abstract
Background The occurrence of new-onset atrial fibrillation (NOAF) post-acute myocardial infarction (AMI) is associated with worse outcomes. In this study, we sought to assess the predictive effect of stress hyperglycemia ratio (SHR) and neutrophil to lymphocyte ratio (NLR) to predict NOAF in patients with AMI. Materials and methods We recruited 3,194 individuals with AMI but free of atrial fibrillation (AF). AMI cases were stratified into groups according to SHR and NLR quartiles and were further categorized based on diabetes status. High SHR and high NLR were defined as the highest quartile of SHR and NLR. A nomogram incorporating risk factors for NOAF was constructed using multivariate logistic regression analyses. The performance of the novel nomogram was tested for predictive performance, agreement between the actual and predicted probability, and clinical utility using area under the curve (AUC), bootstrapped calibration curves, and decision curve analysis, respectively. Result A total of 245 (7.67%) patients developed NOAF post-AMI. The NOAF cases had higher values of SHR and NLR than non-NOAF patients after AMI regardless of diabetes status. After adjusting for potential confounders, high SHR and NLR were independently associated with NOAF post-AMI. Moreover, the novel nomogram incorporating high NLR and high SHR for NOAF risk estimation in patients with AMI showed satisfactory performance assessed by the AUC, calibration curves, decision curve analysis. Conclusion SHR and NLR were independently associated with NOAF in AMI patients. The constructed novel nomogram that incorporates SHR and NLR might assist in NOAF risk stratification post-AMI.
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Wang Y, Li C, Yuan M, Ren B, Liu C, Zheng J, Lin Z, Ren F, Gao D. Development of a complete blood count with differential-based prediction model for in-hospital mortality among patients with acute myocardial infarction in the coronary care unit. Front Cardiovasc Med 2022; 9:1001356. [PMID: 36277791 PMCID: PMC9581274 DOI: 10.3389/fcvm.2022.1001356] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 09/21/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose In recent years, the complete blood count with differential (CBC w/diff) test has drawn strong interest because of its prognostic value in cardiovascular diseases. We aimed to develop a CBC w/diff-based prediction model for in-hospital mortality among patients with severe acute myocardial infarction (AMI) in the coronary care unit (CCU). Materials and methods This single-center retrospective study used data from a public database. The neural network method was applied. The performance of the model was assessed by discrimination and calibration. The discrimination performance of our model was compared to that of seven other classical machine learning models and five well-studied CBC w/diff clinical indicators. Finally, a permutation test was applied to evaluate the importance rank of the predictor variables. Results A total of 2,231 patient medical records were included. With a mean area under the curve (AUC) of 0.788 [95% confidence interval (CI), 0.736-0.838], our model outperformed all other models and indices. Furthermore, it performed well in calibration. Finally, the top three predictors were white blood cell count (WBC), red blood cell distribution width-coefficient of variation (RDW-CV), and neutrophil percentage. Surprisingly, after dropping seven variables with poor prediction values, the AUC of our model increased to 0.812 (95% CI, 0.762-0.859) (P < 0.05). Conclusion We used a neural network method to develop a risk prediction model for in-hospital mortality among patients with AMI in the CCU based on the CBC w/diff test, which performed well and would aid in early clinical decision-making. The top three important predictors were WBC, RDW-CV and neutrophil percentage.
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Affiliation(s)
- Yu Wang
- Department of Cardiology, Xi’an Jiaotong University Second Affiliated Hospital, Xi’an, China
| | - Changfu Li
- Department of Digestive Medicine, Daqing Longnan Hospital, Daqing, China
| | - Miao Yuan
- Department of Cardiology, Xi’an Jiaotong University Second Affiliated Hospital, Xi’an, China
| | - Bincheng Ren
- Department of Cardiology, Xi’an Jiaotong University Second Affiliated Hospital, Xi’an, China
| | - Chang Liu
- Department of Cardiology, Xi’an Jiaotong University Second Affiliated Hospital, Xi’an, China
| | - Jiawei Zheng
- Department of Cardiology, Xi’an Jiaotong University Second Affiliated Hospital, Xi’an, China
| | - Zehao Lin
- Department of Cardiology, Xi’an Jiaotong University Second Affiliated Hospital, Xi’an, China
| | - Fuxian Ren
- Department of Cardiology, Meishan Branch of the Third Affiliated Hospital, Yanan University School of Medical, Meishan, China
| | - Dengfeng Gao
- Department of Cardiology, Xi’an Jiaotong University Second Affiliated Hospital, Xi’an, China
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Lin Y, Lin Y, Yue J, Zou Q. The neutrophil percentage-to-albumin ratio is associated with all-cause mortality in critically ill patients with acute myocardial infarction. BMC Cardiovasc Disord 2022; 22:115. [PMID: 35300600 PMCID: PMC8932161 DOI: 10.1186/s12872-022-02559-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Accepted: 03/09/2022] [Indexed: 12/02/2022] Open
Abstract
Aim In this study, we evaluated the utility of neutrophil percentage-to-albumin ratio (NPAR) in predicting in critically ill patients with acute myocardial infarction (AMI).
Methods The information of patients were collected from Medical Information Mart for Intensive Care III database. Admission NPAR was calculated as neutrophil percentage divided by serum albumin. The endpoints of this study were 30-day, 90-day, 180-day, and 365-day all-cause mortality. Cox proportional hazards models and subgroup analyses were used to determine the relationship between admission NPAR and these endpoints.
Results 798 critically ill patients with AMI were enrolled in. After adjustments for age, race and gender, higher admission NPAR was associated with increased risk of 30-day, 90-day, 180-day, and 365-day all-cause mortality in critically ill patients with AMI. And after adjusting for possible confounding variables, two different trends have emerged. Stratified by tertiles, high admission NPAR was independently associated with 180-day and 365-day all-cause mortality in critically ill patients with AMI (tertile 3 vs. tertile 1: adjusted HR, 95% CI 1.71, 1.10–2.66, p < 0.05; 1.66, 1.10–2.51, p < 0.05). In other hand, stratified by quartiles, highest admission NPAR levels were independently associated with 90-day, 180-day and 365-day all-cause mortality (quartile 4 vs. quartile 1: adjusted HR, 95% CI 2.36, 1.32–4.23, p < 0.05; 2.58, 1.49–4.47, p < 0.05; 2.61, 1.56–4.37, p < 0.05). ROC test showed that admission NPAR had a moderate ability to predict all-cause mortality of critically ill patients with AMI. No obvious interaction was found by subgroup analysis in most subgroups. Conclusions Admission NPAR was an independent predictor for 180-day and 365-day all-cause mortality in critically ill patients with AMI.
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Affiliation(s)
- Ya Lin
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang, China
| | - Yanhan Lin
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang, China
| | - Juanqing Yue
- Department of Pathology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, 310000, Zhejiang, China.
| | - Qianqian Zou
- Obstetrics and Gynecology Ultrasonic Department, Wenzhou People's Hospital, Wenzhou, 325000, Zhejiang, China.
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Sasmita BR, Zhu Y, Gan H, Hu X, Xue Y, Xiang Z, Huang B, Luo S. Prognostic value of neutrophil-lymphocyte ratio in cardiogenic shock complicating acute myocardial infarction: A cohort study. Int J Clin Pract 2021; 75:e14655. [PMID: 34320267 DOI: 10.1111/ijcp.14655] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 07/26/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUNDS Cardiogenic shock (CS) is the most severe complication after acute myocardial infarction (AMI) with mortality above 50%. Inflammatory response is involved in the pathology of CS and AMI. In this study, we aimed to evaluate the prognostic value of admission neutrophil-lymphocyte ratio (NLR) in patients with CS complicating AMI. METHODS Two hundred and seventeen consecutive patients with CS after AMI were divided into two groups according to the admission NLR cut-off value ≤7.3 and >7.3. The primary outcome was 30-day all-cause mortality and the secondary end-point was the composite events of major adverse cardiovascular events (MACE), including all-cause mortality, ventricular tachycardia/ventricular fibrillation, atrioventricular block, gastrointestinal haemorrhage and non-fatal stroke. Cox proportional hazard models were performed to analyse the association of NLR with the outcome. NLR cut-off value was determined by Youden index. RESULTS Patients with NLR > 7.3 were older and presented with lower lymphocyte count, higher admission heart rate, B-type natriuretic peptide, leucocyte, neutrophil and creatinine (all P < .05). During a period of 30-day follow-up after admission, mortality in patients with NLR > 7.3 was significantly higher than in patients with NLR ≤ 7.3 (73.7% vs. 26.3%, P < .001). The incidence of MACE was also remarkably higher in patients with NLR > 7.3 (87.9% vs. 53.4%, P < .001). After multivariable adjustment, NLR > 7.3 remained an independent predictor for higher risk of 30-day mortality (HR 2.806; 95%CI 1.784, 4.415, P < .001) and MACE (HR 2.545; 95%CI 1.791, 3.617, P < .001). CONCLUSIONS Admission NLR could be used as an important tool for short-term prognostic evaluation in patients with CS complicating AMI and higher NLR is an independent predictor for increased 30-day all-cause mortality and MACE.
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Affiliation(s)
- Bryan Richard Sasmita
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yuansong Zhu
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Hongbo Gan
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiankang Hu
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yuzhou Xue
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zhenxian Xiang
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Bi Huang
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Suxin Luo
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Bochaton T, Lassus J, Paccalet A, Derimay F, Rioufol G, Prieur C, Bonnefoy-Cudraz E, Crola Da Silva C, Bernelin H, Amaz C, Espanet S, de Bourguignon C, Dufay N, Cartier R, Croisille P, Ovize M, Mewton N. Association of myocardial hemorrhage and persistent microvascular obstruction with circulating inflammatory biomarkers in STEMI patients. PLoS One 2021; 16:e0245684. [PMID: 33507957 PMCID: PMC7842962 DOI: 10.1371/journal.pone.0245684] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 01/01/2021] [Indexed: 12/26/2022] Open
Abstract
INTRODUCTION Myocardial hemorrhage (IMH) and persistent microvascular obstruction (MVO) are associated with impaired myocardial recovery and adverse clinical outcomes in STEMI patients. However, their relationship with circulating inflammatory biomarkers is unclear in human patients. METHODS AND RESULTS Twenty consecutive patients referred for primary percutaneous coronary intervention of first STEMI were included in a prospective study. Blood sampling was performed at admission, 4, 12, 24, 48 hours, 7 and 30 days after reperfusion for inflammatory biomarker (C reactive protein, fibrinogen, interleukin-6 (IL-6) and neutrophils count) assessment. At seven days, cardiovascular magnetic resonance (CMR) was performed for infarct size, MVO and IMH assessment. Median infarct size was 24.6% Interquartile range (IQR) [12.0-43.5] of LV mass and edema was 13.2% IQR [7.7-36.1] of LV mass. IL-6 reached a peak at H24 (5.6 pg/mL interquartile range (IQR) [2.5-17.5]), CRP at H48 (11.7 mg/L IQR [7.1-69.2]), fibrinogen one week after admission (4.4 g/L IQR [3.8-6.7]) and neutrophils at H12 (9.0 G/L IQR [6.5-12.7]). MVO was present in 11 patients (55% of the study population) and hemorrhage in 7 patients (35%). Patients with IMH had significantly higher IL-6, CRP, fibrinogen, and neutrophils levels compared to patients without IMH. Patients with persistent MVO had significantly higher CRP, fibrinogen and neutrophils level compared to patients without MVO, but identical IL-6 kinetics. CONCLUSION In human patients with acute myocardial infarction, intramyocardial hemorrhage appears to have a stronger relationship with inflammatory biomarker release compared to persistent MVO. Attenuating myocardial hemorrhage may be a novel target in future adjunctive STEMI treatments.
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Affiliation(s)
- Thomas Bochaton
- INSERM U1060, CarMeN Laboratory, Université de Lyon, Groupement Hospitalier Est, Bron, France
- Unité de Soins Intensifs Cardiologiques, Hôpital Louis Pradel et Université Claude Bernard, Hospices Civils de Lyon, Bron, France
- * E-mail:
| | - Jules Lassus
- Centre Hospitalier Universitaire de Martinique, Université des Antilles, Fort de France, France
| | - Alexandre Paccalet
- INSERM U1060, CarMeN Laboratory, Université de Lyon, Groupement Hospitalier Est, Bron, France
| | - François Derimay
- Department of Interventional Cardiology, Cardiovascular Hospital and Claude-Bernard University, Bron, France
| | - Gilles Rioufol
- Department of Interventional Cardiology, Cardiovascular Hospital and Claude-Bernard University, Bron, France
| | - Cyril Prieur
- Unité de Soins Intensifs Cardiologiques, Hôpital Louis Pradel et Université Claude Bernard, Hospices Civils de Lyon, Bron, France
| | - Eric Bonnefoy-Cudraz
- Unité de Soins Intensifs Cardiologiques, Hôpital Louis Pradel et Université Claude Bernard, Hospices Civils de Lyon, Bron, France
| | - Claire Crola Da Silva
- INSERM U1060, CarMeN Laboratory, Université de Lyon, Groupement Hospitalier Est, Bron, France
| | - Hugo Bernelin
- Unité de Soins Intensifs Cardiologiques, Hôpital Louis Pradel et Université Claude Bernard, Hospices Civils de Lyon, Bron, France
| | - Camille Amaz
- Centre d’investigation Clinique de Lyon, Hôpital Louis Pradel, Hospices Civils de Lyon, Bron, France
| | - Sylvie Espanet
- Centre d’investigation Clinique de Lyon, Hôpital Louis Pradel, Hospices Civils de Lyon, Bron, France
| | - Charles de Bourguignon
- Centre d’investigation Clinique de Lyon, Hôpital Louis Pradel, Hospices Civils de Lyon, Bron, France
| | - Nathalie Dufay
- NeuroBioTec, Groupement Hospitalier Est, Hôpital Neurologique Pierre Wertheimer, Bron, France
| | - Régine Cartier
- Centre de biologie Est, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron, France
| | - Pierre Croisille
- Université de Lyon, Université Jean-Monnet Saint-Etienne, INSA, Centre National de la Recherche Scientifique, Unité Mixte de Recherche, Creatis, Saint-Etienne, France
| | - Michel Ovize
- INSERM U1060, CarMeN Laboratory, Université de Lyon, Groupement Hospitalier Est, Bron, France
- Centre d’investigation Clinique de Lyon, Hôpital Louis Pradel, Hospices Civils de Lyon, Bron, France
- Service d’explorations Fonctionnelles Cardiovasculaires, Hôpital Louis Pradel, Hospices Civils de Lyon, Bron, France
| | - Nathan Mewton
- INSERM U1060, CarMeN Laboratory, Université de Lyon, Groupement Hospitalier Est, Bron, France
- Centre d’investigation Clinique de Lyon, Hôpital Louis Pradel, Hospices Civils de Lyon, Bron, France
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Wang Z, Wang J, Cao D, Han L. Correlation of neutrophil-to-lymphocyte ratio with the prognosis of non-ST-segment elevation in patients with acute coronary syndrome undergoing selective percutaneous coronary intervention. J Int Med Res 2020; 48:300060520959510. [PMID: 33050747 PMCID: PMC7570302 DOI: 10.1177/0300060520959510] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 08/26/2020] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE We aimed to explore the relationship between neutrophil-to-lymphocyte ratio (NLR) at three timepoints and prognosis of patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) undergoing elective percutaneous coronary intervention (PCI) within 1 year of PCI. METHODS This retrospective study enrolled 231 patients with NSTE-ACS who received PCI and were followed for 1 year after PCI. The study population was divided into major adverse cardiovascular and cerebrovascular events (MACE) and non-MACE groups. RESULTS In total, 214 patients completed the 1-year follow-up; 32 patients (15.0%) had MACE and 182 (85.0%) had no MACE. The MACE and non-MACE groups differed significantly in age, preoperative neutrophil count, preoperative and postoperative NLR, proportion of three-vessel lesion disease, preoperative lymphocyte count, postoperative lymphocyte count within 24 hours, postoperative lymphocyte count over 24 hours, and left ventricular ejection fraction (LVEF). Multivariate logistic regression analysis showed that preoperative NLR, postoperative NLR within 24 hours, age, and LVEF values were independent risk factors for MACE in patients with NSTE-ACS after elective PCI. CONCLUSION Compared with preoperative NLR, postoperative NLR (within 24 hours) may have a stronger ability to predict the occurrence of MACE in NSTE-ACS patients within 1 year after elective PCI.
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Affiliation(s)
- Zhisong Wang
- Department of Cardiology, Changshu Hospital affiliated to Soochow University, Changshu No. 1 People’s Hospital, Changshu, Jiangsu Province, China
| | - Juan Wang
- Department of Cardiology, Changshu Hospital affiliated to Soochow University, Changshu No. 1 People’s Hospital, Changshu, Jiangsu Province, China
| | - Donglai Cao
- Department of Cardiology, Changshu Hospital affiliated to Soochow University, Changshu No. 1 People’s Hospital, Changshu, Jiangsu Province, China
| | - Leng Han
- Department of Cardiology, Changshu Hospital affiliated to Soochow University, Changshu No. 1 People’s Hospital, Changshu, Jiangsu Province, China
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Nehra S, Gumina RJ, Bansal SS. Immune cell Dilemma in Ischemic Cardiomyopathy: To Heal or Not to Heal. CURRENT OPINION IN PHYSIOLOGY 2020; 19:39-46. [PMID: 33103020 DOI: 10.1016/j.cophys.2020.09.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Inflammation is a double-edged sword for sterile tissue injury such as in myocardial infarction (MI). After ischemic injury, inflammatory immune responses activate repair processes, clear tissue-debris, form a stable scar and initiate angiogenesis in the myocardium for efficient wound-healing. However, incomplete immune resolution or sustained low-grade inflammation lead to ischemic cardiomyopathy (IC) characterized by maladaptive tissue remodeling and left-ventricular dilatation. It is clear that a delicate balance of cytokines, chemokines, prostaglandins, resolvins, and the innate and adaptive immune systems is critical for adequate healing as both insufficient- or overt-activation of inflammatory responses can either enhance rupture incidence or exacerbate cardiac dysfunction in the long-term. Among all the players, immune cells are the most critical as they are not only a source for all of the inflammatory protein mediators, but are also a target. However, phenotypic complexities associated with different immune subtypes, their interdependence, phasic-activations and varied functionalities often make it difficult to segregate the effects of one immune cell from another. In this review, we briefly summarize the role of several innate and adaptive immune cells to acquaint readers with complex immune-networks that dictate the extent of wound-healing post-MI and maladaptive remodeling during IC.
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Affiliation(s)
- Sarita Nehra
- Department of Physiology and Cell Biology, The Ohio State University Wexner Medical Center, Columbus, OH
- The Dorothy M. Davis Heart & Lung Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH
| | - Richard J Gumina
- Department of Physiology and Cell Biology, The Ohio State University Wexner Medical Center, Columbus, OH
- The Dorothy M. Davis Heart & Lung Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH
- Division of Cardiovascular Medicine, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH
| | - Shyam S Bansal
- Department of Physiology and Cell Biology, The Ohio State University Wexner Medical Center, Columbus, OH
- The Dorothy M. Davis Heart & Lung Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH
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Martí-Masanet M, Codoñer-Franch P, Orden S, Álvarez Á, Esplugues JV, Martí-Cabrera M. Leukocyte-Endothelium Interaction Is Associated with Fat Mass in Children. J Pediatr 2020; 221:181-187.e1. [PMID: 32446478 DOI: 10.1016/j.jpeds.2020.02.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 02/13/2020] [Accepted: 02/14/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To study leukocyte-endothelium interaction, a measure of the initial phase of atheromatosis, in children with overweight or obesity. STUDY DESIGN A prospective study was conducted in 77 children aged 7-16 years; 47 were children with overweight/obesity and 30 were normal weight. Polymorphonuclear neutrophils (PMNs) and peripheral blood mononuclear cells were isolated from venous blood samples and the interaction of leukocytes over a monolayer of human umbilical vein endothelial cells was analyzed using flow chamber microscopy. The variables studied included leukocyte rolling velocity, rolling flux, and adhesion to endothelial cells. These were compared between children with overweight/obesity and control children. Correlation between the measures of leukocyte-endothelium interaction and anthropometric and biochemical variables was evaluated. RESULTS In comparison with normal weight children, the PMNs and peripheral blood mononuclear cells of the overweight/obesity group showed a reduction in rolling velocity (P = .000 and P = .001, respectively) and an increase in rolling flux (P = .001 and P = .004), and adhesion (P = .003 and P = .002). The homeostasis model of insulin resistance was correlated inversely with rolling velocity and positively with rolling flux in PMNs. C-reactive protein was correlated positively with rolling flux and adhesion in both types of leucocytes. Fat mass index was correlated with all measures of leukocyte-endothelial interaction and proved to be the main predictor of leukocyte adhesion in the multiple regression analysis (P = .001 for PMNs and P = .006 for peripheral blood mononuclear cells). CONCLUSIONS Excess fat mass in children is related to the activation of the leukocyte-endothelium interaction, potentially contributing to the development of atherosclerosis.
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Affiliation(s)
- Miguel Martí-Masanet
- Department of Pediatrics, University Hospital Dr. Peset, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Valencia, Spain
| | - Pilar Codoñer-Franch
- Department of Pediatrics, University Hospital Dr. Peset, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Valencia, Spain; Department of Pediatrics, Obstetrics and Gynecology, University of Valencia, Valencia, Spain.
| | - Samuel Orden
- Department of Pharmacology, Faculty of Medicine and Odontology, University of Valencia, Valencia, Spain; Centro de Investigación Biomédica en Red of Hepatic and Digestive Disease (CIBERehd), Valencia, Spain
| | - Ángeles Álvarez
- Department of Pharmacology, Faculty of Medicine and Odontology, University of Valencia, Valencia, Spain; Centro de Investigación Biomédica en Red of Hepatic and Digestive Disease (CIBERehd), Valencia, Spain
| | - Juan V Esplugues
- Department of Pharmacology, Faculty of Medicine and Odontology, University of Valencia, Valencia, Spain; Centro de Investigación Biomédica en Red of Hepatic and Digestive Disease (CIBERehd), Valencia, Spain; University Hospital Dr. Peset, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Valencia, Spain
| | - Miguel Martí-Cabrera
- Department of Pharmacology, Faculty of Medicine and Odontology, University of Valencia, Valencia, Spain; Centro de Investigación Biomédica en Red of Hepatic and Digestive Disease (CIBERehd), Valencia, Spain
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Circulating Neutrophils Do Not Predict Subclinical Coronary Artery Disease in Women with Former Preeclampsia. Cells 2020; 9:cells9020468. [PMID: 32085575 PMCID: PMC7072843 DOI: 10.3390/cells9020468] [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] [Received: 01/28/2020] [Revised: 02/13/2020] [Accepted: 02/14/2020] [Indexed: 01/30/2023] Open
Abstract
: Introduction: Preeclampsia (PE) represents a hypertensive pregnancy disorder that is associated with increased cardiovascular disease (CVD) risk. This increased risk has been attributed to accelerated atherosclerosis, with inflammation being a major contributor. Neutrophils play an important role in the onset and progression of atherosclerosis and have been associated with vascular damage in the placenta as well as the chronic inflammatory state in women with PE. We therefore investigated whether circulating neutrophil numbers or reactivity were associated with the presence and severity of subclinical atherosclerosis in women with a history of PE. METHODS Women aged 45-60 years with a 10 to 20 years earlier history of early onset preeclampsia (delivery <34 weeks of gestation) (n = 90), but without symptomatic CVD burden were screened for the presence of subclinical coronary artery disease (CAD) using both contrast-enhanced and non-contrast coronary CT angiography. Subclinical CAD was defined as a coronary artery calcium (CAC) score ≥100 Agatston Units and/or ≥50% coronary luminal stenosis. We assessed whether the numbers and activity of circulating neutrophils were associated with the presence of subclinical CAD and as secondary outcome measurements, with the presence of any calcium (CAC score > 0 AU) or stenosis, categorized as absent (0%), minimal to mild (>0 and <50%), and moderate to severe (≥50%) narrowing of the coronary artery. Blood was drawn just before CT and neutrophil numbers were assessed by flow cytometry. In addition, the presence of the chemokine receptors CXCR2 and CXCR4, which are known to be instrumental in neutrophil recruitment, and neutrophil activity upon stimulation with the bacterial peptide N-Formylmethionyl-leucyl-phenylalanine (fMLF) was assessed by flow cytometry. RESULTS Of the participating women, with an average age of 49 years, 13% (12 out of 90) presented with subclinical signs of CAD (CAC score ≥100 AU and/or ≥50% luminal stenosis), and 37% (33 out of 90) had a positive CAC score (>0). Total white blood cell count and neutrophil counts were not associated with the presence of subclinical CAD or with a positive CAC score. When assessing the presence of the chemokine receptors CXCR4 and CXCR2, we observed a slight decrease of neutrophil CXCR2 expression in women with CAC (median MFI 22.0 [interquartile range (IQR) 20.2-23.8]) compared to women without CAC (23.8 [IQR 21.6-25.6], p = 0.02). We observed no differences regarding neutrophil CXCR4 expression. In addition, expression of the early activity marker CD35 was slightly lower on neutrophils of women with subclinical CAD (median MFI 1.6 [IQR 1.5-1.9] compared to 1.9 [IQR 1.7-2.1] in women without CAD, p = 0.02). However, for all findings, statistical significance disappeared after adjustment for multiple testing. CONCLUSION Our findings indicate that neutrophil counts and (re)activity are not directly associated with silent CAD disease burden and as such are not suitable as biomarkers to predict the presence of subclinical CAD in a high-risk population of women with a history of preeclampsia.
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11
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Breheny CR, Handel I, Banner S, Milne EM, Morrison LR, Smith SH, Kilpatrick S, Gow A, Mellanby RJ. Neutrophilia is associated with a poorer clinical outcome in dogs with chronic hepatitis. Vet Rec 2020; 187:234. [PMID: 31974266 DOI: 10.1136/vr.105533] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 10/17/2019] [Accepted: 12/16/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Liver disease is a common cause of morbidity and mortality in dogs. Currently, it is challenging to prognosticate in these cases. The aim of this study was to evaluate the utility of the haematological variables in dogs with chronic hepatitis. METHODS Dogs with chronic hepatitis confirmed on histopathology had presenting haematological values retrospectively obtained and evaluated against survival time. Eighty-two dogs met the inclusion criteria and their data analysed. RESULTS Neutrophilic patients, with a count greater than 12×109/l, controlled for sex and age, had a shorter survival time (P≤0.01). In dogs, neutrophilia at presentation predicted a poor outcome, whereas the other haematological parameters were not prognostically informative. When the dogs were split into even quarters on the basis of their neutrophil count, those within the higher quartiles had poorer survival times. Neutrophilia was associated with a poorer survival time in comparison to those patients with a lower count. CONCLUSION The relationship between neutrophils, inflammation and clinical outcome is deserving of future study in dogs with chronic hepatitis.
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Affiliation(s)
- Craig R Breheny
- Hospital for Small Animals, University of Edinburgh Royal Dick School of Veterinary Studies, Easter Bush, UK
| | - Ian Handel
- Centre for Infectious Diseases, University of Edinburgh, Edinburgh, UK
| | | | - Elspeth M Milne
- Veterinary Pathology Unit, University of Edinburgh, Edinburgh, UK
| | - Linda R Morrison
- Veterinary Pathology Unit, University of Edinburgh, Edinburgh, UK
| | - Sionagh H Smith
- Veterinary Pathology Unit, University of Edinburgh, Edinburgh, UK
| | - Scott Kilpatrick
- Hospital for Small Animals, University of Edinburgh Royal Dick School of Veterinary Studies, Easter Bush, UK
| | - Adam Gow
- Hospital for Small Animals, University of Edinburgh Royal Dick School of Veterinary Studies, Easter Bush, UK
| | - Richard J Mellanby
- Hospital for Small Animals, University of Edinburgh Royal Dick School of Veterinary Studies, Easter Bush, UK
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12
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Luke K, Purwanto B, Herawati L, Al-Farabi MJ, Oktaviono YH. Predictive Value of Hematologic Indices in the Diagnosis of Acute Coronary Syndrome. Open Access Maced J Med Sci 2019; 7:2428-2433. [PMID: 31666841 PMCID: PMC6814467 DOI: 10.3889/oamjms.2019.666] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 08/09/2019] [Accepted: 08/11/2019] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Distinguishing between Acute Coronary Syndrom (ACS) and SCAD (Stable Coronary Artery Disease) requires advanced laboratory instrument and electrocardiogram. However, their availabilities in primary care settings in developing countries are limited. Hematologic changes usually occur in the ACS patient and might be valuable to distinguish ACS from SCAD. AIM This study compares the hematologic indices between ACS and SCAD patients and analyses its predictive value for ACS. MATERIAL AND METHODS A total of 191 patients (79 ACS and 112 SCAD) were enrolled in this study based on the inclusion criteria. Patient's characteristic, hematologic indices on admission, and the final diagnosis were obtained from medical records. Statistical analyses were done using SPSS 23.0. RESULTS In this research MCHC value (33.40 vs. 32.80 g/dL; p < 0.05); WBC (11.16 vs. 7.40 x109/L; p < 0.001); NLR (6.29 vs. 2.18; p < 0.001); and PLR (173.88 vs 122.46; p < 0.001) were significantly higher in ACS compared to SCAD patients. While MPV (6.40 vs. 10.00 fL; p < 0.001) was significantly lower in ACS patients. ROC curve analysis showed MPV had the highest AUC (95%) for ACS diagnosis with an optimum cut-off point at ≤ 8.35 fL (sensitivity 93.6% and specificity 97.3%). CONCLUSION There was a significant difference between hematologic indices between ACS and SCAD patients. MPV is the best indices to distinguish ACS.
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Affiliation(s)
- Kevin Luke
- Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Bambang Purwanto
- Department of Physiology, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Lilik Herawati
- Department of Physiology, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Makhyan Jibril Al-Farabi
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
- School of Management, Healthcare Entrepreneurship Division, University College London, Gower St, Bloomsbury, WC1E 6BT, London, UK
| | - Yudi Her Oktaviono
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
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13
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Mao S, Taylor S, Chen Q, Zhang M, Hinek A. Sodium tanshinone IIA sulfonate prevents the adverse left ventricular remodelling: Focus on polymorphonuclear neutrophil-derived granule components. J Cell Mol Med 2019; 23:4592-4600. [PMID: 31066232 PMCID: PMC6584480 DOI: 10.1111/jcmm.14306] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 03/05/2019] [Accepted: 03/11/2019] [Indexed: 12/21/2022] Open
Abstract
AIMS The aims of this study were to evaluate the effects of sodium tanshinone IIA sulfonate (STS) on left ventricular (LV) remodelling after for ST-elevated myocardial infarction (STEMI). METHODS AND RESULTS In this prospective, randomized clinical trial, 101 patients with the ST-elevated MI (STEMI) and a successful reperfusion were immediately randomized to receive STS (80 mg qd for 7 days) or saline control, along with standard therapy. The primary effectiveness endpoint is the % change in LV end diastolic volumes index (%∆ LVEDVi) as measured by echocardiography from baseline to 6 months. Secondary effectiveness endpoints include 6-month period for major adverse cardiac events (MACE), including the occurrence of recurrent myocardial infarction, death, hospitalization for heart failure and malignant arrhythmia. The 6-month changes in %∆ LVEDVi were significantly smaller in the STS group than in the control group [-5.05% vs 3.32%; P < 0.001]. With respect to MACE, there was a significant difference between those who received STS (8.16%) and those patients on control (26.00%) (P = 0.019). Meaningfully, results of parallel tests aimed at mechanistic explanation of the reported clinical effects, revealed a significantly reduced levels of neutrophils-derived granule components in the blood of STS treated patients. CONCLUSION We found that short-term treatment with STS reduced progressive left ventricular remodelling and subsequent better clinical outcome that could be mechanistically linked to the inhibition of the ultimate damage of infarcted myocardium by infiltrating neutrophils.
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Affiliation(s)
- Shuai Mao
- Key Discipline of Integrated Chinese and Western Medicine, Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China.,Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA
| | - Shalina Taylor
- Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA
| | - Qubo Chen
- Biological Resource Center, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Minzhou Zhang
- Key Discipline of Integrated Chinese and Western Medicine, Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Aleksander Hinek
- Translational Medicine, Hospital for Sick Children, Toronto, Canada
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14
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Zhang S, Bories G, Lantz C, Emmons R, Becker A, Liu E, Abecassis MM, Yvan-Charvet L, Thorp EB. Immunometabolism of Phagocytes and Relationships to Cardiac Repair. Front Cardiovasc Med 2019; 6:42. [PMID: 31032261 PMCID: PMC6470271 DOI: 10.3389/fcvm.2019.00042] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Accepted: 03/22/2019] [Indexed: 12/21/2022] Open
Abstract
Cardiovascular disease remains the leading cause of death worldwide. Myocardial ischemia is a major contributor to cardiovascular morbidity and mortality. In the case of acute myocardial infarction, subsequent cardiac repair relies upon the acute, and coordinated response to injury by innate myeloid phagocytes. This includes neutrophils, monocytes, macrophage subsets, and immature dendritic cells. Phagocytes function to remove necrotic cardiomyocytes, apoptotic inflammatory cells, and to remodel extracellular matrix. These innate immune cells also secrete cytokines and growth factors that promote tissue replacement through fibrosis and angiogenesis. Within the injured myocardium, macrophages polarize from pro-inflammatory to inflammation-resolving phenotypes. At the core of this functional plasticity is cellular metabolism, which has gained an appreciation for its integration with phagocyte function and remodeling of the transcriptional and epigenetic landscape. Immunometabolic rewiring is particularly relevant after ischemia and clinical reperfusion given the rapidly changing oxygen and metabolic milieu. Hypoxia reduces mitochondrial oxidative phosphorylation and leads to increased reliance on glycolysis, which can support biosynthesis of pro-inflammatory cytokines. Reoxygenation is permissive for shifts back to mitochondrial metabolism and fatty acid oxidation and this is ultimately linked to pro-reparative macrophage polarization. Improved understanding of mechanisms that regulate metabolic adaptations holds the potential to identify new metabolite targets and strategies to reduce cardiac damage through nutrient signaling.
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Affiliation(s)
- Shuang Zhang
- Departments of Pathology and Pediatrics, Feinberg Cardiovascular and Renal Research Institute, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Gael Bories
- UMR INSERM U1065/UNS, C3M, Bâtiment Universitaire ARCHIMED, Nice, France
| | - Connor Lantz
- Departments of Pathology and Pediatrics, Feinberg Cardiovascular and Renal Research Institute, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Russel Emmons
- Departments of Pathology and Pediatrics, Feinberg Cardiovascular and Renal Research Institute, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Amanda Becker
- Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University, Chicago, IL, United States
| | - Esther Liu
- Departments of Pathology and Pediatrics, Feinberg Cardiovascular and Renal Research Institute, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Michael M Abecassis
- Comprehensive Transplant Center, Northwestern Feinberg School of Medicine, Chicago, IL, United States
| | | | - Edward B Thorp
- Departments of Pathology and Pediatrics, Feinberg Cardiovascular and Renal Research Institute, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
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15
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Tahto E, Jadric R, Pojskic L, Kicic E. Neutrophil-to-lymphocyte Ratio and Its Relation with Markers of Inflammation and Myocardial Necrosis in Patients with Acute Coronary Syndrome. Med Arch 2018; 71:312-315. [PMID: 29284896 PMCID: PMC5723203 DOI: 10.5455/medarh.2017.71.312-315] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Introduction: Inflammation plays an important role in atherosclerosis which is the primary cause of acute coronary syndrome (ACS) that encompasses acute myocardial infarction (AMI) and unstable angina (UA). Objective: To investigate and characterize white blood cells (WBC) count, differential blood count in peripheral blood and neutrophil to lymphocyte ratio (NLR) in patients by the type of ACS. Patients and methods: The cross-sectional study included 100 patients with ACS (50 males, 50 females), aged 41 to 91 years, classified into two groups: AMI group (n=50) and UA group (n=50). Patients were hospitalized at the Clinic for Heart Diseases, University Clinical Center of Sarajevo. From patients’ medical histories the following data were obtained: WBC, neutrophil, eosinophil and basophil granulocytes count, monocyte and lymphocyte count, levels of high sensitive troponin I (hsTnI), creatine kinase MB (CK-MB) and C-reactive protein (CRP). The results were analyzed using software package SPSS, version 19.0. Results: Average WBC count, neutrophil granulocytes, and monocytes were significantly higher in AMI group than in UA group (p = 0.001, p < 0.0005, p = 0.03, respectively). Eosinophil count was significantly lower in patients with AMI (p = 0.022). NLR was significantly higher in AMI group in relation to patients with UA (p = 0.001). Significantly higher values of hsTnI and CK-MB were established in patients with AMI. NLR correlated significantly positive with the values of hsTnI, CK-MB, CRP, WBC and neutrophil count, and significantly negative with lymphocyte count. Conclusion: Average values of NLR were significantly higher in patients with AMI in relation to patients with UA, indicating the importance of this inflammatory marker in discrimination of clinical forms of ACS. A positive correlation was established between NLR and markers of myocardial necrosis, and between NLR and CRP, indicating the importance of NLR in the assessment of the extent of the myocardial lesion and in inflammation intensity assessment in ACS.
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Affiliation(s)
- Ema Tahto
- Department of Intensive Care Medicine and Cardiac Anesthesiology, Clinic for Cardiovascular Surgery, University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina
| | - Radivoj Jadric
- Department of Medical Biochemistry, Faculty of Medicine, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Lamija Pojskic
- Department of Internal Medicine, Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina
| | - Esmeralda Kicic
- Department of Epidemiology and Biostatistics, Faculty of Medicine, University of Tuzla, Tuzla, Bosnia and Herzegovina
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16
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Chami B, Jeong G, Varda A, Maw AM, Kim HB, Fong G, Simone M, Rayner B, Wang XS, Dennis J, Witting P. The nitroxide 4-methoxy TEMPO inhibits neutrophil-stimulated kinase activation in H9c2 cardiomyocytes. Arch Biochem Biophys 2017; 629:19-35. [DOI: 10.1016/j.abb.2017.07.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 06/23/2017] [Accepted: 07/03/2017] [Indexed: 12/12/2022]
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17
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Meeuwsen JAL, Wesseling M, Hoefer IE, de Jager SCA. Prognostic Value of Circulating Inflammatory Cells in Patients with Stable and Acute Coronary Artery Disease. Front Cardiovasc Med 2017; 4:44. [PMID: 28770211 PMCID: PMC5509763 DOI: 10.3389/fcvm.2017.00044] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Accepted: 06/26/2017] [Indexed: 12/22/2022] Open
Abstract
Atherosclerosis is a lipid driven chronic inflammatory disease underlying the majority of ischemic events such as myocardial infarction or stroke. Clinical management of ischemic events has improved considerably in the past decades. Accordingly, survival rates have increased. Nevertheless, 12% of patients die within 6 months after the initial event. To improve secondary prevention, appropriate risk prediction is key. However, up to date, there is no clinically available routine marker to identify patients at high risk for recurrent cardiovascular events. Due to the central role of inflammation in atherosclerotic lesion progression and destabilization, many studies have focused on the role of circulating inflammatory cells in these processes. This review summarizes the current evidence on the potential of circulating inflammatory cells as biomarkers for recurrent adverse manifestations in acute coronary syndrome and stable coronary artery disease patients.
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Affiliation(s)
- John A L Meeuwsen
- Laboratory for Experimental Cardiology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Marian Wesseling
- Laboratory for Experimental Cardiology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Imo E Hoefer
- Laboratory for Clinical Chemistry and Hematology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Saskia C A de Jager
- Laboratory for Experimental Cardiology, University Medical Center Utrecht, Utrecht, Netherlands.,Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht, Netherlands
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18
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Halade GV, Kain V, Ingle KA, Prabhu SD. Interaction of 12/15-lipoxygenase with fatty acids alters the leukocyte kinetics leading to improved postmyocardial infarction healing. Am J Physiol Heart Circ Physiol 2017; 313:H89-H102. [PMID: 28411230 PMCID: PMC5538863 DOI: 10.1152/ajpheart.00040.2017] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 04/11/2017] [Accepted: 04/11/2017] [Indexed: 12/22/2022]
Abstract
The metabolic transformation of fatty acids to form oxylipids using 12/15-lipoxygenase (LOX) can promote either resolving or nonresolving inflammation. However, the mechanism of how 12/15-LOX interacts with polyunsaturated fatty acids (PUFA) in postmyocardial infarction (post-MI) healing is unclear. Here, we reported the role of 12/15-LOX in post-MI cardiac remodeling in a PUFA [10% (wt/wt), 22 kcal]-enriched environment. Wild-type (WT; C57BL/6J) and 12/15-LOX-null (12/15-LOX-/-) male mice of 8-12 wk of age were fed a PUFA-enriched diet for 1 mo and subjected to permanent coronary artery ligation. Post-MI mice were monitored for day 1 or until day 5 along with standard diet-fed MI controls. No-MI surgery mice served as naïve controls. PUFA-fed WT and 12/15-LOX-/- mice improved ejection fraction and reduced lung edema greater than WT mice at day 5 post-MI (P < 0.05). Post-MI, neutrophil density was decreased in PUFA-fed WT and 12/15-LOX-/- mice at day 1 (P < 0.05). Deletion of 12/15-LOX in mice led to increased cytochrome P-450-derived bioactive lipid mediator epoxyeicosatrienoic acids (EETs), i.e., 11,12-EpETrE and 14,15-EpETrE, which were further enhanced by acute PUFA intake post-MI. Macrophage density was decreased in WT + PUFA and 12/15-LOX-/- mice compared with their respective standard diet-fed WT controls at day 5 post-MI. 12/15-LOX-/- + PUFA mice displayed an increased expression of chemokine (C-C motif) ligand 2 and reparative macrophages markers (Ym-1, Mrc-1, and Arg-1, all P < 0.05) in the infarcted area. Furthermore, 12/15-LOX-/- mice, with or without PUFA, showed reduced collagen deposition at day 5 post-MI compared with WT mice. In conclusion, deletion of 12/15-LOX and short-term exposure of PUFA promoted leukocyte clearance, thereby limiting cardiac remodeling and promoting an effective resolution of inflammation.NEW & NOTEWORTHY This study determined that 1) deletion of 12/15-lipoxygenase (LOX) promotes the generation of epoxyeicosatrienoic acids, the cytochrome P-450-derived metabolites in postmyocardial infarction (post-MI) healing; 2) acute exposure of fatty acids to 12/15-LOX-/- mice drives leukocyte (neutrophils and macrophages) clearance post-MI; and 3) metabolic transformation of fats is the significant contributor in leukocyte clearance to drive either resolving or nonresolving inflammation post-MI.
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Affiliation(s)
- Ganesh V Halade
- Division of Cardiovascular Disease, Department of Medicine, The University of Alabama at Birmingham, Birmingham, Alabama
| | - Vasundhara Kain
- Division of Cardiovascular Disease, Department of Medicine, The University of Alabama at Birmingham, Birmingham, Alabama
| | - Kevin A Ingle
- Division of Cardiovascular Disease, Department of Medicine, The University of Alabama at Birmingham, Birmingham, Alabama
| | - Sumanth D Prabhu
- Division of Cardiovascular Disease, Department of Medicine, The University of Alabama at Birmingham, Birmingham, Alabama
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19
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The Immune System in Tissue Environments Regaining Homeostasis after Injury: Is "Inflammation" Always Inflammation? Mediators Inflamm 2016; 2016:2856213. [PMID: 27597803 PMCID: PMC4997018 DOI: 10.1155/2016/2856213] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2016] [Revised: 07/08/2016] [Accepted: 07/19/2016] [Indexed: 12/31/2022] Open
Abstract
Inflammation is a response to infections or tissue injuries. Inflammation was once defined by clinical signs, later by the presence of leukocytes, and nowadays by expression of "proinflammatory" cytokines and chemokines. But leukocytes and cytokines often have rather anti-inflammatory, proregenerative, and homeostatic effects. Is there a need to redefine "inflammation"? In this review, we discuss the functions of "inflammatory" mediators/regulators of the innate immune system that determine tissue environments to fulfill the need of the tissue while regaining homeostasis after injury.
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20
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Paquissi FC. The role of inflammation in cardiovascular diseases: the predictive value of neutrophil-lymphocyte ratio as a marker in peripheral arterial disease. Ther Clin Risk Manag 2016; 12:851-60. [PMID: 27313459 PMCID: PMC4892833 DOI: 10.2147/tcrm.s107635] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Peripheral arterial disease (PAD) is an important manifestation of atherosclerosis, with increasing prevalence worldwide. A growing body of evidence shows that the systemic inflammatory response is closely related to the development, progression, and prognosis of atherosclerosis. In the last decade, several studies have suggested the role of measured inflammatory biomarkers as predictors of severity and prognosis in PAD in an effort to stratify the risk of these patients, to improve treatment selection, and to predict the results after interventions. A simple inflammatory marker, more available than any other, is the neutrophil-lymphocyte ratio (NLR), which can be easily obtained in clinical practice, based on the absolute count of neutrophils and lymphocytes from the differential leukocytes count. Many researchers evaluated vigorously the NLR as a potential prognostic biomarker predicting pathological and survival outcomes in patients with atherosclerosis. In this work, we aim to present the role of NLR as a prognostic marker in patients with PAD through a thorough review of the literature.
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Abstract
Myocardial remodeling following myocardial infarction (MI) is emerging as key causes of chronic infarct mortality. Interleukin-6 is a classic pro-inflammatory cytokine needed to mount an effective immune response. It seems that interleukin-6 acts as an important role in the dynamic and superbly orchestrated process of innate immunity after MI. Interleukin-6 timely suppresses of innate immune signals to prevent the catastrophic consequences of uncontrolled inflammation on cardiac geometry and function, and thus tunes myocardial remodeling. A comprehensive understanding of biological processes of interleukin-6 in innate immunity leading to inflammatory response and disease-related ventricular remodeling is helpful to find the solution of chronic heart failure. To accomplish this, we reviewed the articles of interleukin-6 regard to inflammation, innate immunity, and cardiac remodeling. This review focuses on the role of interleukin-6 that dominates cell-mediated immunity, especially on neutrophils, monocytes, macrophages, and fibroblasts. In addition, we will also briefly discuss other inflammatory cytokines involved in this process within the paper.
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22
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Liebetrau C, Hoffmann J, Dörr O, Gaede L, Blumenstein J, Biermann H, Pyttel L, Thiele P, Troidl C, Berkowitsch A, Rolf A, Voss S, Hamm CW, Nef H, Möllmann H. Release Kinetics of Inflammatory Biomarkers in a Clinical Model of Acute Myocardial Infarction. Circ Res 2015; 116:867-75. [DOI: 10.1161/circresaha.116.304653] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Rationale:
Inflammation in the setting of acute myocardial infarction (MI) has been linked to risk stratification; however, the release kinetics of inflammatory biomarkers in patients with acute MI has been difficult to establish.
Objective:
The aim of this study was to determine the kinetics of changes in the levels of several biomarkers specifically linked to inflammation after transcoronary ablation of septal hypertrophy, a procedure that mimics acute MI.
Methods and Results:
We analyzed release kinetics of C-reactive protein, high-sensitivity C-reactive protein, interleukin-6, soluble CD40 ligand, and peripheral blood leukocyte subsets in patients (n=21) undergoing transcoronary ablation of septal hypertrophy. Blood samples were collected before transcoronary ablation of septal hypertrophy and at various times after transcoronary ablation of septal hypertrophy. Serum levels of C-reactive protein were increased at 24 hours (1.0 mg/dL [interquartile range [IQR], 0.7–1.75] versus 0.2 mg/dL [IQR, 0.1–1.05] at baseline [BL];
P
<0.001), whereas high-sensitivity C-reactive protein increased as early as 8 hours (2.68 mg/L [IQR, 1.23–11.80] versus 2.17 mg/L [IQR, 1.15–5.06] at BL;
P
=0.002). Interleukin-6 was significantly increased at 45 minutes (2.59 pg/mL [IQR, 1.69–5.0] versus 1.5 pg/mL [IQR, 1.5–2.21] at BL;
P
=0.002), and soluble CD40 ligand was significantly decreased at 60 minutes (801.6 pg/mL [IQR, 675.0–1653.5] versus 1750.0 pg/mL [IQR, 1151.0–2783.0] at BL;
P
=0.016). Elevated counts of polymorphonuclear neutrophils were detectable at 15 minutes, with a significant increase at 2 hours (6415 cells/μL [IQR, 5288–7827] versus 4697 cells/μL [IQR, 2892–5620] at BL;
P
=0.004). Significant monocytosis was observed at 24 hours (729 cells/μL [IQR, 584–1344] versus 523 cells/μL [IQR, 369–701] at BL;
P
=0.015).
Conclusions:
Interleukin-6 and neutrophil granulocytes showed a continuous rise at all prespecified time points after induction of MI. Our results provide valuable additional evidence of the diagnostic value of inflammatory biomarkers in the setting of early acute MI.
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Affiliation(s)
- Christoph Liebetrau
- From the Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany (C.L., J.H., L.G., J.B., H.B., L.P., P.T., C.T., A.B., A.R., S.V., C.W.H., H.M.); DZHK (German Centre for Cardiovascular Research), partner site Rheine-Main, Bad Nauheim, Germany (C.L., J.H., L.G., J.B., H.B., L.P., P.T., C.T., A.B., A.R., S.V., C.W.H., H.M.); and Department of Internal Medicine I, Division of Cardiology, University of Giessen, Giessen, Germany (C.L., O.D., C.W.H., H.N.)
| | - Jedrzej Hoffmann
- From the Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany (C.L., J.H., L.G., J.B., H.B., L.P., P.T., C.T., A.B., A.R., S.V., C.W.H., H.M.); DZHK (German Centre for Cardiovascular Research), partner site Rheine-Main, Bad Nauheim, Germany (C.L., J.H., L.G., J.B., H.B., L.P., P.T., C.T., A.B., A.R., S.V., C.W.H., H.M.); and Department of Internal Medicine I, Division of Cardiology, University of Giessen, Giessen, Germany (C.L., O.D., C.W.H., H.N.)
| | - Oliver Dörr
- From the Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany (C.L., J.H., L.G., J.B., H.B., L.P., P.T., C.T., A.B., A.R., S.V., C.W.H., H.M.); DZHK (German Centre for Cardiovascular Research), partner site Rheine-Main, Bad Nauheim, Germany (C.L., J.H., L.G., J.B., H.B., L.P., P.T., C.T., A.B., A.R., S.V., C.W.H., H.M.); and Department of Internal Medicine I, Division of Cardiology, University of Giessen, Giessen, Germany (C.L., O.D., C.W.H., H.N.)
| | - Luise Gaede
- From the Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany (C.L., J.H., L.G., J.B., H.B., L.P., P.T., C.T., A.B., A.R., S.V., C.W.H., H.M.); DZHK (German Centre for Cardiovascular Research), partner site Rheine-Main, Bad Nauheim, Germany (C.L., J.H., L.G., J.B., H.B., L.P., P.T., C.T., A.B., A.R., S.V., C.W.H., H.M.); and Department of Internal Medicine I, Division of Cardiology, University of Giessen, Giessen, Germany (C.L., O.D., C.W.H., H.N.)
| | - Johannes Blumenstein
- From the Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany (C.L., J.H., L.G., J.B., H.B., L.P., P.T., C.T., A.B., A.R., S.V., C.W.H., H.M.); DZHK (German Centre for Cardiovascular Research), partner site Rheine-Main, Bad Nauheim, Germany (C.L., J.H., L.G., J.B., H.B., L.P., P.T., C.T., A.B., A.R., S.V., C.W.H., H.M.); and Department of Internal Medicine I, Division of Cardiology, University of Giessen, Giessen, Germany (C.L., O.D., C.W.H., H.N.)
| | - Hannes Biermann
- From the Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany (C.L., J.H., L.G., J.B., H.B., L.P., P.T., C.T., A.B., A.R., S.V., C.W.H., H.M.); DZHK (German Centre for Cardiovascular Research), partner site Rheine-Main, Bad Nauheim, Germany (C.L., J.H., L.G., J.B., H.B., L.P., P.T., C.T., A.B., A.R., S.V., C.W.H., H.M.); and Department of Internal Medicine I, Division of Cardiology, University of Giessen, Giessen, Germany (C.L., O.D., C.W.H., H.N.)
| | - Lukas Pyttel
- From the Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany (C.L., J.H., L.G., J.B., H.B., L.P., P.T., C.T., A.B., A.R., S.V., C.W.H., H.M.); DZHK (German Centre for Cardiovascular Research), partner site Rheine-Main, Bad Nauheim, Germany (C.L., J.H., L.G., J.B., H.B., L.P., P.T., C.T., A.B., A.R., S.V., C.W.H., H.M.); and Department of Internal Medicine I, Division of Cardiology, University of Giessen, Giessen, Germany (C.L., O.D., C.W.H., H.N.)
| | - Peter Thiele
- From the Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany (C.L., J.H., L.G., J.B., H.B., L.P., P.T., C.T., A.B., A.R., S.V., C.W.H., H.M.); DZHK (German Centre for Cardiovascular Research), partner site Rheine-Main, Bad Nauheim, Germany (C.L., J.H., L.G., J.B., H.B., L.P., P.T., C.T., A.B., A.R., S.V., C.W.H., H.M.); and Department of Internal Medicine I, Division of Cardiology, University of Giessen, Giessen, Germany (C.L., O.D., C.W.H., H.N.)
| | - Christian Troidl
- From the Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany (C.L., J.H., L.G., J.B., H.B., L.P., P.T., C.T., A.B., A.R., S.V., C.W.H., H.M.); DZHK (German Centre for Cardiovascular Research), partner site Rheine-Main, Bad Nauheim, Germany (C.L., J.H., L.G., J.B., H.B., L.P., P.T., C.T., A.B., A.R., S.V., C.W.H., H.M.); and Department of Internal Medicine I, Division of Cardiology, University of Giessen, Giessen, Germany (C.L., O.D., C.W.H., H.N.)
| | - Alexander Berkowitsch
- From the Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany (C.L., J.H., L.G., J.B., H.B., L.P., P.T., C.T., A.B., A.R., S.V., C.W.H., H.M.); DZHK (German Centre for Cardiovascular Research), partner site Rheine-Main, Bad Nauheim, Germany (C.L., J.H., L.G., J.B., H.B., L.P., P.T., C.T., A.B., A.R., S.V., C.W.H., H.M.); and Department of Internal Medicine I, Division of Cardiology, University of Giessen, Giessen, Germany (C.L., O.D., C.W.H., H.N.)
| | - Andreas Rolf
- From the Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany (C.L., J.H., L.G., J.B., H.B., L.P., P.T., C.T., A.B., A.R., S.V., C.W.H., H.M.); DZHK (German Centre for Cardiovascular Research), partner site Rheine-Main, Bad Nauheim, Germany (C.L., J.H., L.G., J.B., H.B., L.P., P.T., C.T., A.B., A.R., S.V., C.W.H., H.M.); and Department of Internal Medicine I, Division of Cardiology, University of Giessen, Giessen, Germany (C.L., O.D., C.W.H., H.N.)
| | - Sandra Voss
- From the Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany (C.L., J.H., L.G., J.B., H.B., L.P., P.T., C.T., A.B., A.R., S.V., C.W.H., H.M.); DZHK (German Centre for Cardiovascular Research), partner site Rheine-Main, Bad Nauheim, Germany (C.L., J.H., L.G., J.B., H.B., L.P., P.T., C.T., A.B., A.R., S.V., C.W.H., H.M.); and Department of Internal Medicine I, Division of Cardiology, University of Giessen, Giessen, Germany (C.L., O.D., C.W.H., H.N.)
| | - Christian W. Hamm
- From the Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany (C.L., J.H., L.G., J.B., H.B., L.P., P.T., C.T., A.B., A.R., S.V., C.W.H., H.M.); DZHK (German Centre for Cardiovascular Research), partner site Rheine-Main, Bad Nauheim, Germany (C.L., J.H., L.G., J.B., H.B., L.P., P.T., C.T., A.B., A.R., S.V., C.W.H., H.M.); and Department of Internal Medicine I, Division of Cardiology, University of Giessen, Giessen, Germany (C.L., O.D., C.W.H., H.N.)
| | - Holger Nef
- From the Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany (C.L., J.H., L.G., J.B., H.B., L.P., P.T., C.T., A.B., A.R., S.V., C.W.H., H.M.); DZHK (German Centre for Cardiovascular Research), partner site Rheine-Main, Bad Nauheim, Germany (C.L., J.H., L.G., J.B., H.B., L.P., P.T., C.T., A.B., A.R., S.V., C.W.H., H.M.); and Department of Internal Medicine I, Division of Cardiology, University of Giessen, Giessen, Germany (C.L., O.D., C.W.H., H.N.)
| | - Helge Möllmann
- From the Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany (C.L., J.H., L.G., J.B., H.B., L.P., P.T., C.T., A.B., A.R., S.V., C.W.H., H.M.); DZHK (German Centre for Cardiovascular Research), partner site Rheine-Main, Bad Nauheim, Germany (C.L., J.H., L.G., J.B., H.B., L.P., P.T., C.T., A.B., A.R., S.V., C.W.H., H.M.); and Department of Internal Medicine I, Division of Cardiology, University of Giessen, Giessen, Germany (C.L., O.D., C.W.H., H.N.)
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Lopez EF, Kabarowski JH, Ingle KA, Kain V, Barnes S, Crossman DK, Lindsey ML, Halade GV. Obesity superimposed on aging magnifies inflammation and delays the resolving response after myocardial infarction. Am J Physiol Heart Circ Physiol 2014; 308:H269-80. [PMID: 25485899 DOI: 10.1152/ajpheart.00604.2014] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Polyunsaturated fatty acid (PUFA) intake has increased over the last 100 yr, contributing to the current obesogenic environment. Obesity and aging are prominent risk factors for myocardial infarction (MI). How obesity interacts with aging to alter the post-MI response, however, is unclear. We tested the hypothesis that obesity in aging mice would impair the resolution of post-MI inflammation. PUFA diet (PUFA aging group) feeding to 12-mo-old C57BL/6J mice for 5 mo showed higher fat mass compared with standard lab chow (LC)-fed young (LC young group; 3-5 mo old) or aging alone control mice (LC aging group). LC young, LC aging, and PUFA aging mice were subjected to coronary artery ligation to induce MI. Despite similar infarct areas post-MI, plasma proteomic profiling revealed higher VCAM-1 in the PUFA aging group compared with LC young and LC aging groups, leading to increased neutrophil infiltration in the PUFA aging group (P<0.05). Macrophage inflammatory protein-1γ and CD40 were also increased at day 1, and myeloperoxidase remained elevated at day 5, an observation consistent with delayed wound healing in the PUFA aging group. Lipidomic analysis showed higher levels of arachidonic acid and 12(S)-hydroxyeicosatetraenoic acid at day 1 post-MI in the PUFA aging group compared with the LC aging group (all P<0.05), thereby mediating neutrophil extravasation in the PUFA aging group. The inflammation-resolving enzymes 5-lipoxygenase, cyclooxygenase-2, and heme oxyegnase-1 were altered to delay wound healing post-MI in the PUFA aging group compared with LC young and LC aging groups. PUFA aging magnifies the post-MI inflammatory response and impairs the healing response by stimulating prolonged neutrophil trafficking and proinflammatory lipid mediators.
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Affiliation(s)
| | - Janusz H Kabarowski
- Department of Microbiology, The University of Alabama at Birmingham, Birmingham, Alabama
| | - Kevin A Ingle
- Department of Medicine, The University of Alabama at Birmingham, Birmingham, Alabama
| | - Vasundhara Kain
- Department of Medicine, The University of Alabama at Birmingham, Birmingham, Alabama
| | - Stephen Barnes
- Targeted Metabolomics and Proteomics Laboratory, The University of Alabama at Birmingham, Birmingham, Alabama; Department of Pharmacology and Toxicology, The University of Alabama at Birmingham, Birmingham, Alabama
| | - David K Crossman
- Department of Genetics, The University of Alabama at Birmingham, Birmingham, Alabama; and
| | - Merry L Lindsey
- Mississippi Center for Heart Research, Department of Physiology and Biophysics, University of Mississippi Medical Center, and Research Service, G.V. (Sonny) Montgomery Veterans Affairs Medical Center, Jackson, Mississippi
| | - Ganesh V Halade
- Department of Medicine, The University of Alabama at Birmingham, Birmingham, Alabama;
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24
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Latet SC, Hoymans VY, Van Herck PL, Vrints CJ. The cellular immune system in the post-myocardial infarction repair process. Int J Cardiol 2014; 179:240-7. [PMID: 25464457 DOI: 10.1016/j.ijcard.2014.11.006] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2014] [Revised: 10/02/2014] [Accepted: 11/03/2014] [Indexed: 12/20/2022]
Abstract
Growing evidence indicates that overactivation and prolongation of the inflammatory response after acute myocardial infarction (AMI) result in worse left ventricular remodelling, dysfunction and progression to heart failure. This post-AMI inflammatory response is characterised by the critical involvement of cells from both the innate and adaptive immune systems. In this review paper, we aim to summarise and discuss the emergence of immune cells in the bloodstream and myocardium after AMI in men and mice. Subset composition, phenotypes, and kinetics of immune cells are considered. In addition, the relation with post-MI cardiac remodelling, function and outcome is reported. Increased knowledge of immune components, the mechanisms and interactions by which these cells contribute to myocardial damage and repair following AMI may help to close the gaps that limit improvement of treatments of those who survive the acute infarction.
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Affiliation(s)
- Sam C Latet
- Cardiovascular Diseases, Department of Translational Pathophysiological Research, University of Antwerp, Campus Drie Eiken, Universiteitsplein 1, 2610 Wilrijk, Belgium; Laboratory of Cellular and Molecular Cardiology, Department of Cardiology, Antwerp University Hospital, Wilrijkstraat 10, 2650 Edegem, Belgium.
| | - Vicky Y Hoymans
- Cardiovascular Diseases, Department of Translational Pathophysiological Research, University of Antwerp, Campus Drie Eiken, Universiteitsplein 1, 2610 Wilrijk, Belgium; Laboratory of Cellular and Molecular Cardiology, Department of Cardiology, Antwerp University Hospital, Wilrijkstraat 10, 2650 Edegem, Belgium.
| | - Paul L Van Herck
- Cardiovascular Diseases, Department of Translational Pathophysiological Research, University of Antwerp, Campus Drie Eiken, Universiteitsplein 1, 2610 Wilrijk, Belgium; Laboratory of Cellular and Molecular Cardiology, Department of Cardiology, Antwerp University Hospital, Wilrijkstraat 10, 2650 Edegem, Belgium.
| | - Christiaan J Vrints
- Cardiovascular Diseases, Department of Translational Pathophysiological Research, University of Antwerp, Campus Drie Eiken, Universiteitsplein 1, 2610 Wilrijk, Belgium; Laboratory of Cellular and Molecular Cardiology, Department of Cardiology, Antwerp University Hospital, Wilrijkstraat 10, 2650 Edegem, Belgium.
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25
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Association of admission serum calcium levels and in-hospital mortality in patients with acute ST-elevated myocardial infarction: an eight-year, single-center study in China. PLoS One 2014; 9:e99895. [PMID: 24926660 PMCID: PMC4057419 DOI: 10.1371/journal.pone.0099895] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Accepted: 05/19/2014] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVE The relationship between admission serum calcium levels and in-hospital mortality in patients with acute ST-segment elevation myocardial infarction (STEMI) has not been well definitively explored. The objective was to assess the predictive value of serum calcium levels on in-hospital mortality in STEMI patients. METHODS From 2003 to 2010, 1431 consecutive STEMI patients admitted to the First Affiliated Hospital of Nanjing Medical University were enrolled in the present study. Patients were stratified according to quartiles of serum calcium from the blood samples collected in the emergency room after admission. Between the aforementioned groups,the baseline characteristics, in-hospital management, and in-hospital mortality were analyzed. The association of serum calcium level with in-hospital mortality was calculated by a multivariable Cox regression analysis. RESULTS Among 1431 included patients, 79% were male and the median age was 65 years (range, 55-74). Patients in the lower quartiles of serum calcium, as compared to the upper quartiles of serum calcium, were older, had more cardiovascular risk factors, lower rate of emergency revascularization,and higher in-hospital mortality. According to univariate Cox proportional analysis, patients with lower serum calcium level (hazard ratio 0.267, 95% confidence interval 0.164-0.433, p<0.001) was associated with higher in-hospital mortality. The result of multivariable Cox proportional hazard regression analyses showed that the Killip's class≥3 (HR = 2.192, p = 0.026), aspartate aminotransferase (HR = 1.001, p<0.001), neutrophil count (HR = 1.123, p<0.001), serum calcium level (HR = 0.255, p = 0.001), and emergency revascularization (HR = 0.122, p<0.001) were significantly and independently associated with in-hospital mortality in STEMI patients. CONCLUSIONS Serum calcium was an independent predictor for in-hospital mortality in patients with STEMI. This widely available serum biochemical index may be incorporated into the current established risk stratification model of STEMI patients. Further studies are required to determine the actual mechanism and whether patients with hypocalcaemia could benefit from calcium supplement.
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26
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Zhang S, Dehn S, DeBerge M, Rhee KJ, Hudson B, Thorp EB. Phagocyte-myocyte interactions and consequences during hypoxic wound healing. Cell Immunol 2014; 291:65-73. [PMID: 24862542 DOI: 10.1016/j.cellimm.2014.04.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2014] [Accepted: 04/14/2014] [Indexed: 12/24/2022]
Abstract
Myocardial infarction (MI), secondary to atherosclerotic plaque rupture and occlusive thrombi, triggers acute margination of inflammatory neutrophils and monocyte phagocyte subsets to the damaged heart, the latter of which may give rise briefly to differentiated macrophage-like or dendritic-like cells. Within the injured myocardium, a primary function of these phagocytic cells is to remove damaged extracellular matrix, necrotic and apoptotic cardiac cells, as well as immune cells that turn over. Recognition of dying cellular targets by phagocytes triggers intracellular signaling, particularly in macrophages, wherein cytokines and lipid mediators are generated to promote inflammation resolution, fibrotic scarring, angiogenesis, and compensatory organ remodeling. These actions cooperate in an effort to preserve myocardial contractility and prevent heart failure. Immune cell function is modulated by local tissue factors that include secreted protease activity, oxidative stress during clinical reperfusion, and hypoxia. Importantly, experimental evidence suggests that monocyte function and phagocytosis efficiency is compromised in the setting of MI risk factors, including hyperlipidemia and ageing, however underlying mechanisms remain unclear. Herein we review seminal phagocyte and cardiac molecular factors that lead to, and culminate in, the recognition and removal of dying injured myocardium, the effects of hypoxia, and their relationship to cardiac infarct size and heart healing.
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Affiliation(s)
- Shuang Zhang
- Department of Pathology and Feinberg Cardiovascular Research Institute, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Shirley Dehn
- Department of Pathology and Feinberg Cardiovascular Research Institute, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Matthew DeBerge
- Department of Pathology and Feinberg Cardiovascular Research Institute, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Ki-Jong Rhee
- Department of Pathology and Feinberg Cardiovascular Research Institute, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Barry Hudson
- Department of Pathology and Feinberg Cardiovascular Research Institute, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Edward B Thorp
- Department of Pathology and Feinberg Cardiovascular Research Institute, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
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27
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Van Linthout S, Miteva K, Tschöpe C. Crosstalk between fibroblasts and inflammatory cells. Cardiovasc Res 2014; 102:258-69. [PMID: 24728497 DOI: 10.1093/cvr/cvu062] [Citation(s) in RCA: 397] [Impact Index Per Article: 39.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Fibroblasts, which are traditionally recognized as a quiescent cell responsible for extracellular matrix production, are more and more appreciated as an active key player of the immune system. This review describes how fibroblasts and immune cells reciprocally influence the pathogenesis of fibrosis. An overview is given how fibroblasts are triggered by components of the innate and adaptive immunity on the one hand and how fibroblasts modulate immune cell behaviour via conditioning the cellular and cytokine microenvironment on the other hand. Finally, latest insights into the role of cardiac fibroblasts in the orchestration of inflammatory cell infiltration in the heart, and their impact on heart failure, are outlined.
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Affiliation(s)
- Sophie Van Linthout
- Berlin-Brandenburg Center for Regenerative Therapies, Charité, University Medicine Berlin, Campus Virchow Clinic, Berlin, Germany
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28
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Meune C, Balmelli C, Vogler E, Twerenbold R, Reiter M, Reichlin T, Haaf P, Drexler B, Wildi K, Hoeller R, Rubini Gimenez M, Moehring B, Zellweger C, Potocki M, Mueller C. Consideration of high-sensitivity troponin values below the 99th percentile at presentation: Does it improve diagnostic accuracy? Int J Cardiol 2013; 168:3752-7. [DOI: 10.1016/j.ijcard.2013.06.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2012] [Revised: 04/25/2013] [Accepted: 06/15/2013] [Indexed: 11/15/2022]
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29
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Williams BA, Merhige ME. Association between neutrophil-lymphocyte ratio and impaired myocardial perfusion in patients with known or suspected coronary disease. Heart Lung 2013; 42:436-41. [PMID: 23981470 DOI: 10.1016/j.hrtlng.2013.07.013] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Revised: 07/10/2013] [Accepted: 07/11/2013] [Indexed: 01/04/2023]
Abstract
OBJECTIVE To determine whether an elevated neutrophil-lymphocyte ratio (NLR) is associated with chronically impaired myocardial perfusion in patients with known or suspected coronary disease. BACKGROUND Elevated NLRs are positively associated with cardiac events, anatomic coronary disease, and myocardial infarct size. However, no study has evaluated the association between NLR and chronically impaired myocardial perfusion. METHODS This study included 683 patients undergoing cardiac positron emission tomography (PET) with a calculable NLR within 90 days of PET. The primary outcome was myocardial perfusion defect size measured in percent of left ventricular mass (%LV60). RESULTS NLR was independently associated with %LV60 when analyzed as both a continuous and binary outcome (p < 0.001). Individuals with NLR above the 90th percentile had a 5-fold increased likelihood of significant perfusion defects compared to individuals with NLR between the 10th and 25th percentiles (Odds ratio = 4.7, p < 0.001). CONCLUSION An elevated NLR demonstrated strong associations with myocardial perfusion.
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Affiliation(s)
- Brent A Williams
- Geisinger Health System, Geisinger Center for Health Research, 100 North Academy Avenue, Danville, PA 17822, USA.
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30
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Yayan J. Emerging families of biomarkers for coronary artery disease: inflammatory mediators. Vasc Health Risk Manag 2013; 9:435-56. [PMID: 23983474 PMCID: PMC3751465 DOI: 10.2147/vhrm.s45704] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Introduction Inflammation has been implicated in the development of atherosclerosis in patients with acute coronary syndrome. C-reactive protein is an established nonspecific prognostic inflammatory biomarker for patients with acute coronary syndrome in the medical literature. This has led to a concerted effort to identify circulating inflammatory biomarkers to facilitate predicting the risk for and diagnosing coronary artery disease in at-risk subjects. The objective of this study was to search after novel inflammatory biomarkers reported as useful for diagnosing coronary artery disease. Methods The PubMed database was searched for reports published from January 1, 2000 to June 30, 2012 of novel circulating biomarkers for coronary artery disease in addition to the established biomarker, C-reactive protein. The search terms used were “infarction”, “biomarkers”, and “markers”, and only original articles describing clinical trials that were written in English were included. All published articles were separately examined carefully after novel inflammatory markers for acute coronary syndrome. All irrelevant publications without content pertaining to inflammatory biomarkers for acute coronary syndrome were excluded from this study. Our results reflect all articles concerning biomarkers in humans. Results The PubMed search yielded 4,415 research articles. After further analysis, all relevant published original articles examining 53 biomarkers were included in this review, which identified 46 inflammation biomarkers useful for detecting coronary artery disease. Conclusion The emergence of diverse novel biomarkers for coronary artery disease has provided insight into the varied pathophysiology of this disease. Inflammatory biomarkers have tremendous potential in aiding the prediction of acute coronary syndrome and recurrent ischemic episodes, and will eventually help improve patient care and management.
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Affiliation(s)
- Josef Yayan
- Department of internal Medicine, University Hospital of Saarland, Homburg/Saar, Germany.
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31
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Ma Y, Yabluchanskiy A, Lindsey ML. Neutrophil roles in left ventricular remodeling following myocardial infarction. FIBROGENESIS & TISSUE REPAIR 2013; 6:11. [PMID: 23731794 PMCID: PMC3681584 DOI: 10.1186/1755-1536-6-11] [Citation(s) in RCA: 129] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2012] [Accepted: 04/11/2013] [Indexed: 12/20/2022]
Abstract
Polymorphonuclear granulocytes (PMNs; neutrophils) serve as key effector cells in the innate immune system and provide the first line of defense against invading microorganisms. In addition to producing inflammatory cytokines and chemokines and undergoing a respiratory burst that stimulates the release of reactive oxygen species, PMNs also degranulate to release components that kill pathogens. Recently, neutrophil extracellular traps have been shown to be an alternative way to trap microorganisms and contain infection. PMN-derived granule components are also involved in multiple non-infectious inflammatory processes, including the response to myocardial infarction (MI). In this review, we will discuss the biological characteristics, recruitment, activation, and removal of PMNs, as well as the roles of PMN-derived granule proteins in inflammation and innate immunity, focusing on the MI setting when applicable. We also discuss future perspectives that will direct research in PMN biology.
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Affiliation(s)
- Yonggang Ma
- San Antonio Cardiovascular Proteomics Center, San Antonio, TX, USA.
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