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Suthahar N, Wang D, Aboumsallem JP, Shi C, de Wit S, Liu EE, Lau ES, Bakker SJL, Gansevoort RT, van der Vegt B, Jovani M, Kreger BE, Lee Splansky G, Benjamin EJ, Vasan RS, Larson MG, Levy D, Ho JE, de Boer RA. Association of Initial and Longitudinal Changes in C-reactive Protein With the Risk of Cardiovascular Disease, Cancer, and Mortality. Mayo Clin Proc 2023; 98:549-558. [PMID: 37019514 PMCID: PMC10698556 DOI: 10.1016/j.mayocp.2022.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 10/05/2022] [Accepted: 10/07/2022] [Indexed: 04/07/2023]
Abstract
OBJECTIVE To evaluate the value of serial C-reactive protein (CRP) measurements in predicting the risk of cardiovascular disease (CVD), cancer, and mortality. METHODS The analysis was performed using data from two prospective, population-based observational cohorts: the Prevention of Renal and Vascular End-Stage Disease (PREVEND) study and the Framingham Heart Study (FHS). A total of 9253 participants had CRP measurements available at two examinations (PREVEND: 1997-1998 and 2001-2002; FHS Offspring cohort: 1995-1998 and 1998-2001). All CRP measurements were natural log-transformed before analyses. Cardiovascular disease included fatal and nonfatal cardiovascular, cerebrovascular and peripheral vascular events, and heart failure. Cancer included all malignancies except nonmelanoma skin cancers. RESULTS The mean age of the study population at baseline was 52.4±12.1 years and 51.2% (n=4733) were women. Advanced age, female sex, smoking, body mass index, and total cholesterol were associated with greater increases in CRP levels over time (Pall<.001 in the multivariable model). Baseline CRP, as well as increase in CRP over time (ΔCRP), were associated with incident CVD (hazard ratio [HR]: 1.29 per 1-SD increase; 95% confidence interval [CI]: 1.29 to 1.47, and HR per 1-SD increase: 1.19; 95% CI: 1.09 to 1.29 respectively). Similar findings were observed for incident cancer (baseline CRP, HR: 1.17; 95% CI: 1.09 to 1.26; ΔCRP, HR: 1.08; 95% CI: 1.01 to 1.15) and mortality (baseline CRP, HR: 1.29; 95% CI: 1.21 to 1.37; ΔCRP, HR: 1.10; 95% CI: 1.05 to 1.16). CONCLUSION Initial as well as subsequent increases in CRP levels predict future CVD, cancer, and mortality in the general population.
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Affiliation(s)
- Navin Suthahar
- Department of Cardiology, University of Groningen, Groningen, the Netherlands; Department of Cardiology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
| | - Dongyu Wang
- Cardiovascular Institute and Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA; Department of Biostatistics, Boston University, Boston, MA, USA
| | | | - Canxia Shi
- Department of Cardiology, University of Groningen, Groningen, the Netherlands
| | - Sanne de Wit
- Department of Cardiology, University of Groningen, Groningen, the Netherlands
| | - Elizabeth E Liu
- Cardiovascular Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Emily S Lau
- Cardiovascular Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Stephan J L Bakker
- Division of Nephrology, Department of Internal Medicine, University of Groningen, Groningen, the Netherlands
| | - Ron T Gansevoort
- Division of Nephrology, Department of Internal Medicine, University of Groningen, Groningen, the Netherlands
| | - Bert van der Vegt
- Department of Pathology, University of Groningen, Groningen, the Netherlands
| | - Manol Jovani
- Digestive Diseases and Nutrition, University of Kentucky Albert B. Chandler Hospital, Lexington, KY, USA
| | - Bernard E Kreger
- Department of Medicine, School of Medicine, Boston University, Boston, MA, USA; The Framingham Heart Study, Framingham, MA, USA
| | | | - Emelia J Benjamin
- Department of Biostatistics, Boston University, Boston, MA, USA; Department of Epidemiology, School of Public Health, Boston University, Boston, MA, USA; Department of Medicine, School of Medicine, Boston University, Boston, MA, USA; The Framingham Heart Study, Framingham, MA, USA
| | - Ramachandran S Vasan
- Department of Epidemiology, School of Public Health, Boston University, Boston, MA, USA; Department of Medicine, School of Medicine, Boston University, Boston, MA, USA; The Framingham Heart Study, Framingham, MA, USA
| | - Martin G Larson
- Department of Biostatistics, Boston University, Boston, MA, USA; The Framingham Heart Study, Framingham, MA, USA
| | - Daniel Levy
- The Framingham Heart Study, Framingham, MA, USA; Population Sciences Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Jennifer E Ho
- Cardiovascular Institute and Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Rudolf A de Boer
- Department of Cardiology, University of Groningen, Groningen, the Netherlands; Department of Cardiology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
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Liu G, Zhang Y, Zhang W, Wu X, Jiang H, Huang H, Zhang X. Novel predictive risk factor for erectile dysfunction: Serum high-sensitivity C-reactive protein. Andrology 2022; 10:1096-1106. [PMID: 35713296 DOI: 10.1111/andr.13206] [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: 03/23/2022] [Revised: 05/23/2022] [Accepted: 06/07/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND C-reactive protein (CRP), as a marker of inflammation, may be closely related to erectile dysfunction (ED), however, there is no meta-analysis exists for it. OBJECTIVES We aimed to verify the relationship between CRP and erectile dysfunction and to explore the changes of CRP levels in ED patients after first-line treatment. MATERIALS AND METHODS We searched databases including the Cochrane Library, PubMed, and MEDLINE to identify studies up to January 1, 2022. We performed a comprehensive analysis of the included studies by STATA software and calculated standardized mean differences (SMDs) and their corresponding 95% confidence intervals. RESULTS A total of 12 studies were included and the analysis showed that CRP levels were higher significantly in patients with erectile dysfunction than the healthy controls (P < 0.001) and decreased by a mean of 0.38 mg/L after first-line PDE5i drug treatment (P = 0.001). DISCUSSION AND CONCLUSION This novel meta-analysis suggests that CRP is statistically significantly associated with erectile dysfunction and may be a predictor or risk factor for the assessment of ED. However, further original studies with large sample sizes are needed to validate this. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Guodong Liu
- Department of Urology, the First Affiliated Hospital of Anhui Medical University, Anhui province, China.,Institute of Urology, the First Affiliated Hospital of Anhui Medical University, Anhui province, China.,Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Anhui province, China
| | - Yuyang Zhang
- Department of Urology, the First Affiliated Hospital of Anhui Medical University, Anhui province, China.,Institute of Urology, the First Affiliated Hospital of Anhui Medical University, Anhui province, China.,Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Anhui province, China
| | - Wei Zhang
- Department of Urology, the First Affiliated Hospital of Anhui Medical University, Anhui province, China.,Institute of Urology, the First Affiliated Hospital of Anhui Medical University, Anhui province, China.,Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Anhui province, China
| | - Xu Wu
- Department of Urology, the First Affiliated Hospital of Anhui Medical University, Anhui province, China.,Institute of Urology, the First Affiliated Hospital of Anhui Medical University, Anhui province, China.,Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Anhui province, China
| | - Hui Jiang
- The department of Urology, Peking University Third Hospital, Beijing, China
| | - Houbao Huang
- Department of Urology, The First Affiliated Hospital of Wannan Medical College, Anhui province, China
| | - Xiansheng Zhang
- Department of Urology, the First Affiliated Hospital of Anhui Medical University, Anhui province, China.,Institute of Urology, the First Affiliated Hospital of Anhui Medical University, Anhui province, China.,Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Anhui province, China
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Inflammatory cardiovascular risk markers and silent myocardial ischemia in type 2 diabetic patients. VOJNOSANIT PREGL 2022. [DOI: 10.2298/vsp201012010m] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background/Aim. A special feature of coronary heart disease (CHD) in patients with type 2 diabetes mellitus (T2DM) is that it is often a symptomatic and occurs as a consequence of cardiovascular autonomic neuropathy. Dysregulation of the autonomic nervous system is associated with elevated values of inflammatory markers such as high-sensitivity C-reactive protein (hs-CRP) and interleukin- 6 (IL-6), which accelerate atherosclerosis and the occurrence of cardiovascular complications in patients with T2DM. The aim of the study was to evaluate the importance of determining inflammatory cardiovascular risk markers IL-6 and hs-CRP in screening for the presence of CHD in asymptomatic patients with T2DM. Methods. The study included 169 patients with T2DM without any symptoms and signs of CHD. Ergometric testing proved or ruled out the presence of silent CHD. The levels of hs- CRP and IL-6 were determined by ELISA. Results. IL-6 values were significantly higher in patients with a positive ergometric test (6.83 ? 1.99 pg/mL) compared to patients with a negative ergometric test (3.04 ? 1.39 pg/mL) (p < 0.001). We also found that hs-CRP values in patients with a positive ergometric test were significantly higher compared to patients with a negative ergometric test (6.37 ? 2.25 vs 1.67 ? 1.41 mg/L; p < 0.001). Combinations of IL-6 and hs-CRP with age, HbA1c values, and duration of diabetes, presented through three binary logistic regression models, are significant predictors of silent CHD proven by ergometric testing, ie, with their increase, the probability of a positive ergometric test also increases (p < 0.01). The sensitivity of the associated finding of elevated IL-6 and hs-CRP values in the detection of silent CHD by ergometric testing was 90%, and the specificity was 86%. Conclusion. Hs-CRP and IL-6 are significant predictors of silent CHD, and their determination could be recommended for improving cardiovascular risk stratification in asymptomatic patients with T2DM.
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Deljanin-Ilić M, Kocić G, Lazarević G, Simonović D, Stojanović M, Ilić S, Đorđević B, Petrović D, Stojanović S. Exercise training and inflammatory markers in coronary artery disease patients. ACTA FACULTATIS MEDICAE NAISSENSIS 2022. [DOI: 10.5937/afmnai39-36545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Aim. To evaluate the influence of exercise training on inflammatory markers and exercise tolerance in coronary artery disease (CAD) patients. Patients and methods. A total of 54 subjects were enrolled in the present study, including 34 CAD patients (CAD group: 59.2 ± 8.2 years) and 20 healthy controls (C group: 54.2 ± 8.0 years). C reactive protein (CRP), erythrocyte sedimentation rate (ESR), white blood cell (WBC), and placental growth factor (PIGF) were determined, and an exercise test was performed in both groups at baseline and once again in CAD group after the supervised 3 weeks of aerobic exercise training. Results. At baseline, CRP, ESR and PIGF were significantly higher in the CAD group compared to the C group (p = 0.038, p = 0.019 and p = 0.002), while exercise capacity was significantly higher in the C group (p ˂ 0.01). After 3 weeks of exercise training, CRP, ESR, WBC count and PIGF significantly decreased (p = 0.048, p ˂ 0.001, p = 0.002 and p ˂ 0.001 respectively), while exercise capacity significantly increased (p ˂ 0.001) in the CAD group. In the CAD group, CRP decrease significantly correlated with WBC and PIGF decrease (r = 0.816, p = 0.002 and r = 0.988, p ˂ 0.001), as well as with exercise capacity increase (r = 0.834, p ˂ 0.001). Also, WBC decrease significantly correlated both with PIGF decrease (r = 0.768, p ˂ 0.001) and exercise capacity increase (r = 0.548, p = 0.012), while PIGF decrease significantly correlated with exercise capacity increase (r = 0.548, p = 0.013). Conclusion. Residential exercise training in CAD patients reduces inflammation, expressed through a significant decrease in CRP, ESR, WBC count and PIGF levels. Those positive changes in inflammatory markers are associated with significant improvement in exercise capacity.
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Liu Y, Lai S, Liang L, Zhang D. Study on the interaction mechanism between C-reactive protein and platelets in the development of acute myocardial infarction. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:1012. [PMID: 34277812 PMCID: PMC8267311 DOI: 10.21037/atm-21-2733] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 06/16/2021] [Indexed: 01/08/2023]
Abstract
Background Myocardial infarction (MI) is the single most critical event in coronary disease. Platelets are involved in the processes of acute MI (AMI). They lack nuclear DNA but retain megakaryocyte mRNAs, hence, their transcriptome could provide information preceding coronary events. However, their mechanisms are not clear. In this study, we obtained a gene expression atlas of platelets from patients after their very first AMI, and our purpose was to clarify the mechanisms of platelet involvement in the occurrence of AMI through bioinformatics analyses and animal models of AMI in vivo. Methods We obtained a gene expression atlas of platelets from patients after their very first AMI from the Gene Expression Omnibus (GEO). Differentially expressed genes (DEGs) were retrieved using R language. Weighted gene co-expression network analysis (WGCNA) was implemented in order to construct a gene co-expression correlation network among DEGs. Animal models of AMI in vivo were constructed to confirm the results of the bioinformatics analysis. Results Gene integration analysis yielded 2,852 DEGs (P<0.05, |log2FC| >1). Bioinformatics analysis demonstrated a significant association between C-reactive protein (CRP) and Staphylococcus aureus infection (SAI) (P=0.015). Data from in vivo experiments showed that CRP increased significantly in AMI rats (P<0.001), and the expression of FCGR2B mRNA and HLA-DRB4 mRNA was elevated in response to the increase of CRP (P<0.001). Conclusions From the results of this study, we speculate that in the development of AMI, the increase in CRP activates platelets and induces platelets to play an anti-inflammatory role.
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Affiliation(s)
- Yubao Liu
- Department of Intensive Care Medicine, The Second Affiliated Hospital of Qiqihar Medical College, Qiqihar, China
| | - Shuhui Lai
- The First Clinical Medical College of Nanchang University, Nanchang, China
| | - Lijie Liang
- Ultrasound Department, The Second Affiliated Hospital of Qiqihar Medical College, Qiqihar, China
| | - Donghai Zhang
- Department of Intensive Care Medicine, The Second Affiliated Hospital of Qiqihar Medical College, Qiqihar, China
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Yu C, Wan Y, Xu W, Jin X, Zhang S, Xin M, Jiang H, Cheng X. Increased Circulating Cathepsin L in Patients with Coronary Artery Disease. Int Heart J 2020; 62:9-15. [PMID: 33390563 DOI: 10.1536/ihj.20-182] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Cathepsin L (CatL) is a potent collagenase involved in atherosclerotic vascular remodeling and dysfunction in animals and humans. This study investigated the hypothesis that plasma CatL is associated with the prevalence of coronary artery disease (CAD). Between February May 2011 and January 2013, 206 consecutive subjects were enrolled from among patients who underwent coronary angiography and percutaneous coronary intervention treatment. Age-matched subjects (n = 215) served as controls. Plasma CatL and high-sensitive C-reactive protein (hs-CRP) and high-density lipoprotein cholesterol were measured. The patients with CAD had significantly higher plasma CatL levels compared to the controls (1.4 ± 0.4 versus 0.4 ± 0.2 ng/mL, P < 0.001), and the patients with acute coronary syndrome had significantly higher plasma CatL levels compared to those with stable angina pectoris (1.7 ± 0.7 versus 0.8 ± 0.4 ng/mL, P < 0.01). Linear regression analysis showed that overall, the plasma CatL levels were inversely correlated with the high-density lipoprotein levels (r = -0.32, P < 0.01) and positively with hs-CRP levels (r = 0.35, P < 0.01). Multiple logistic regression analyses shows that cathepsin L levels were independent predictors of CAD (add ratio, 1.8; 95% CI, 1.2 to 2.1; P < 0.01). These data demonstrated that increased levels of plasma CatL are closely associated with the presence of CAD and that circulating CatL serves as a useful biomarker for CAD.
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Affiliation(s)
- Chenglin Yu
- Department of Cardiology and Hypertension, Yanbian University Hospital
| | - Ying Wan
- Department of Cardiology and Hypertension, Yanbian University Hospital
| | - Wenhu Xu
- Department of Cardiology and Hypertension, Yanbian University Hospital
| | - Xiongjie Jin
- Department of Cardiology and Hypertension, Yanbian University Hospital
| | - Shengming Zhang
- Department of Cardiology and Hypertension, Yanbian University Hospital
| | - Minglong Xin
- Department of Cardiology and Hypertension, Yanbian University Hospital
| | - Haiying Jiang
- Department of Physiology and Pathophysiology, Jiaxing University Medical College
| | - Xianwu Cheng
- Department of Cardiology and Hypertension, Yanbian University Hospital.,Department of Physiology and Pathophysiology, Jiaxing University Medical College
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Lakunchykova O, Averina M, Wilsgaard T, Watkins H, Malyutina S, Ragino Y, Keogh RH, Kudryavtsev AV, Govorun V, Cook S, Schirmer H, Eggen AE, Hopstock LA, Leon DA. Why does Russia have such high cardiovascular mortality rates? Comparisons of blood-based biomarkers with Norway implicate non-ischaemic cardiac damage. J Epidemiol Community Health 2020; 74:698-704. [PMID: 32414935 PMCID: PMC7577103 DOI: 10.1136/jech-2020-213885] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 04/13/2020] [Indexed: 02/06/2023]
Abstract
Background Russia has one of the highest rates of mortality from cardiovascular disease (CVD). At age 35–69 years, they are eight times higher than in neighbouring Norway. Comparing profiles of blood-based CVD biomarkers between these two populations can help identify reasons for this substantial difference in risk. Methods We compared age-standardised mean levels of CVD biomarkers for men and women aged 40–69 years measured in two cross-sectional population-based studies: Know Your Heart (KYH) (Russia, 2015–2018; n=4046) and the seventh wave of the Tromsø Study (Tromsø 7) (Norway, 2015–2018; n=17 646). A laboratory calibration study was performed to account for inter-laboratory differences. Results Levels of total, low-density lipoprotein-, high-density lipoprotein-cholesterol and triglycerides were comparable in KYH and Tromsø 7 studies. N-terminal pro-b-type natriuretic peptide (NT-proBNP), high-sensitivity cardiac troponin T (hs-cTnT) and high-sensitivity C-reactive protein (hsCRP) were higher in KYH compared with Tromsø 7 (NT-proBNP was higher by 54.1% (95% CI 41.5% to 67.8%) in men and by 30.8% (95% CI 22.9% to 39.2%) in women; hs-cTnT—by 42.4% (95% CI 36.1% to 49.0%) in men and by 68.1% (95% CI 62.4% to 73.9%) in women; hsCRP—by 33.3% (95% CI 26.1% to 40.8%) in men and by 35.6% (95% CI 29.0% to 42.6%) in women). Exclusion of participants with pre-existing coronary heart disease (279 men and 282 women) had no substantive effect. Conclusions Differences in cholesterol fractions cannot explain the difference in CVD mortality rate between Russia and Norway. A non-ischemic pathway to the cardiac damage reflected by raised NT-proBNP and hs-cTnT is likely to contribute to high CVD mortality in Russia.
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Affiliation(s)
- Olena Lakunchykova
- Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway
| | - Maria Averina
- Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway.,Department of Laboratory Medicine, University Hospital of North Norway, Tromsø, Norway
| | - Tom Wilsgaard
- Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway
| | - Hugh Watkins
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK.,Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK
| | - Sofia Malyutina
- Novosibirsk State Medical University, Russian Ministry of Health, Novosibirsk, Russian Federation.,Research Institute of Internal and Preventive Medicine, Branch of Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russian Federation
| | - Yulia Ragino
- Research Institute of Internal and Preventive Medicine, Branch of Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russian Federation
| | - Ruth H Keogh
- Department of Medical Statistics, London School of Hygiene & Tropical Medicine, London, UK
| | - Alexander V Kudryavtsev
- Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway.,Department of Innovative Programs, Northern State Medical University, Arkhangelsk, Russian Federation
| | - Vadim Govorun
- Federal Research and Clinical Center of Physical-Chemical Medicine of the Federal Medical Biological Agency of Russia, Moskva, Russian Federation
| | - Sarah Cook
- Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway
| | - Henrik Schirmer
- Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway.,Department of Cardiology, Akershus University Hospital, Lorenskog, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Anne Elise Eggen
- Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway
| | | | - David A Leon
- Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway.,Department of Non-communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
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Patil V, Avhad A, Kulkarni A, Pandere K. High-sensitive C-reactive protein in patients with coronary artery disease. J Nat Sci Biol Med 2020. [DOI: 10.4103/jnsbm.jnsbm_159_19] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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9
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Iakunchykova O, Averina M, Kudryavtsev AV, Wilsgaard T, Soloviev A, Schirmer H, Cook S, Leon DA. Evidence for a Direct Harmful Effect of Alcohol on Myocardial Health: A Large Cross-Sectional Study of Consumption Patterns and Cardiovascular Disease Risk Biomarkers From Northwest Russia, 2015 to 2017. J Am Heart Assoc 2019; 9:e014491. [PMID: 31847661 PMCID: PMC6988140 DOI: 10.1161/jaha.119.014491] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Background Alcohol drinking is an increasingly recognized risk factor for cardiovascular disease. However, there are few studies of the impact of harmful and hazardous drinking on biomarkers of myocardial health. We conducted a study in Russia to investigate the impact of heavy drinking on biomarkers of cardiac damage and inflammation. Methods and Results The Know Your Heart study recruited a random sample of 2479 participants from the population of northwest Russia (general population) plus 278 patients (narcology clinic subsample) with alcohol problems. The general population sample was categorized into harmful drinkers, hazardous drinkers, nonproblem drinkers, and nondrinkers, according to self-reported level of alcohol consumption, whereas the narcology clinic sample was treated as the separate group in the analysis. Measurements were made of the following: (1) high-sensitivity cardiac troponin T, (2) NT-proBNP (N-terminal pro-B-type natriuretic peptide), and (3) hsCRP (high-sensitivity C-reactive protein). The narcology clinic subsample had the most extreme drinking pattern and the highest levels of all 3 biomarkers relative to nonproblem drinkers in the general population: high-sensitivity cardiac troponin T was elevated by 10.3% (95% CI, 3.7%-17.4%), NT-proBNP by 46.7% (95% CI, 26.8%-69.8%), and hsCRP by 69.2% (95% CI, 43%-100%). In the general population sample, NT-proBNP was 31.5% (95% CI, 3.4%-67.2%) higher among harmful drinkers compared with nonproblem drinkers. Overall, NT-proBNP and hsCRP increased with increasing intensity of alcohol exposure (test of trend P<0.001). Conclusions These results support the hypothesis that heavy alcohol drinking has an adverse effect on cardiac structure and function that may not be driven by atherosclerosis.
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Affiliation(s)
- Olena Iakunchykova
- Department of Community Medicine UIT The Arctic University of Norway Tromsø Norway
| | - Maria Averina
- Department of Community Medicine UIT The Arctic University of Norway Tromsø Norway.,Department of Laboratory Medicine University Hospital of North Norway Tromsø Norway
| | - Alexander V Kudryavtsev
- Department of Community Medicine UIT The Arctic University of Norway Tromsø Norway.,Department of Innovative Programs Northern State Medical University Arkhangelsk Russia
| | - Tom Wilsgaard
- Department of Community Medicine UIT The Arctic University of Norway Tromsø Norway
| | - Andrey Soloviev
- Department of Psychiatry and Clinical Psychology Northern State Medical University Arkhangelsk Russia
| | - Henrik Schirmer
- Department of Cardiology Akershus University Hospital Lørenskog Norway.,Institute of Clinical Medicine Campus Ahus University of Oslo Norway.,Department of Clinical Medicine UIT The University of Norway Tromsø Norway
| | - Sarah Cook
- Department of Noncommunicable Disease Epidemiology London School of Hygiene and Tropical Medicine London United Kingdom
| | - David A Leon
- Department of Community Medicine UIT The Arctic University of Norway Tromsø Norway.,Department of Noncommunicable Disease Epidemiology London School of Hygiene and Tropical Medicine London United Kingdom
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10
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Marini A, Naka KK, Vakalis K, Bechlioulis A, Bougiakli M, Giannitsi S, Nikolaou K, Antoniadou EI, Gartzonika C, Chasiotis G, Bairaktari E, Katsouras CS, Triantis G, Sionis D, Michalis LK. Extent of coronary artery disease in patients undergoing angiography for stable or acute coronary syndromes. Hellenic J Cardiol 2017; 58:115-121. [PMID: 28495650 DOI: 10.1016/j.hjc.2016.08.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 08/31/2016] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND We aimed to investigate whether the angiographic extent of coronary artery disease (CAD) differs in patients undergoing coronary angiography for stable CAD or acute coronary syndrome (ACS) and identify predictors of CAD extent in these patients. METHODS We enrolled 584 consecutive patients (463 with stable CAD, 121 with ACS) with angiographically established CAD (≥1 stenosis >25%). The Gensini score was used to assess the extent of coronary atherosclerosis. RESULTS Stable CAD patients had greater Framingham risk score and greater prevalence of hypertension, hypercholesterolemia, and diabetes (p<0.05 for all). Fasting glucose and systolic and diastolic blood pressure were higher, while high-sensitivity C-reactive protein (hsCRP) levels were lower in patients with stable CAD than in those with ACS (p<0.05 for all). No difference in Gensini score was observed between the two groups (p=0.118), but patients with ACS were more likely to have at least one significant epicardial angiographic lesion (>50% stenosis) (OR 2.0, p=0.022). Higher Gensini score was independently associated with (i) higher hsCRP and glucose levels, hypercholesterolemia, and increased age in stable CAD patients (R2 0.15, p<0001) and (ii) increased age and higher glucose and hsCRP levels in patients with ACS (R2 0.17, p<0001). CONCLUSIONS Patients undergoing coronary angiography for ACS or stable CAD presented with a similar extent of angiographic CAD, although patients with ACS had a higher prevalence of significant lesions in the presence of a better cardiovascular risk profile and higher inflammation levels. The extent of angiographic CAD in both the groups shared common determinants such as hsCRP, age, and hyperglycemia, but these appeared to explain only a small part of the variation of coronary atherosclerosis.
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Affiliation(s)
- Aikaterini Marini
- Michaelidion Cardiac Center, University of Ioannina, Ioannina, Greece
| | - Katerina K Naka
- Michaelidion Cardiac Center, University of Ioannina, Ioannina, Greece; 2(nd) Department of Cardiology, University of Ioannina, Ioannina, Greece
| | | | - Aris Bechlioulis
- Michaelidion Cardiac Center, University of Ioannina, Ioannina, Greece; 2(nd) Department of Cardiology, University of Ioannina, Ioannina, Greece
| | - Mara Bougiakli
- Michaelidion Cardiac Center, University of Ioannina, Ioannina, Greece
| | - Sophia Giannitsi
- Michaelidion Cardiac Center, University of Ioannina, Ioannina, Greece
| | | | | | | | - Georgios Chasiotis
- Laboratory of Biochemistry, University Hospital of Ioannina, Ioannina, Greece
| | - Eleni Bairaktari
- Laboratory of Biochemistry, University Hospital of Ioannina, Ioannina, Greece
| | - Christos S Katsouras
- Michaelidion Cardiac Center, University of Ioannina, Ioannina, Greece; 2(nd) Department of Cardiology, University of Ioannina, Ioannina, Greece
| | | | | | - Lampros K Michalis
- Michaelidion Cardiac Center, University of Ioannina, Ioannina, Greece; 2(nd) Department of Cardiology, University of Ioannina, Ioannina, Greece.
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Yang G, Li Y, Cui L, Jiang H, Li X, Jin C, Jin D, Zhao G, Jin J, Sun R, Piao L, Xu W, Fang C, Lei Y, Yuan K, Xuan C, Ding D, Cheng X. Increased Plasma Dipeptidyl Peptidase-4 Activities in Patients with Coronary Artery Disease. PLoS One 2016; 11:e0163027. [PMID: 27654253 PMCID: PMC5031423 DOI: 10.1371/journal.pone.0163027] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2016] [Accepted: 09/01/2016] [Indexed: 01/21/2023] Open
Abstract
Dipeptidyl peptidase-4 (DPP4) is one of the most potent mammalian serine proteases participated in the pathogenesis of subclinical atherosclerosis. Here we investigated whether the plasma soluble form of DPP4 is associated with the prevalence of coronary artery disease (CAD) with and without diabetes mellitus (DM). A cross-sectional study was conducted of 496 aged 26–81 years with (n = 362) and without (n = 134) CAD. Plasma DPP4 activity, high sensitive C-reactive protein (hs-CRP), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein levels were measured. The coronary atherosclerotic plaques were evaluated by coronary angiography. The CAD patients with (n = 84) and without (n = 278) DM had significantly higher DPP4 levels (11.8 ± 3.1 vs. 6.9 ± 3.5 ng/mL, P<0.01) than the nonCAD subjects. The acute coronary syndrome patients (n = 299) had elevated DPP4 levels than those with stable angina patients (n = 83). CAD patients even without DM had increased plasma DPP4 activities as compared with nonCAD subjects (10.9 ± 4.9 vs. 6.4 ± 3.1, ng/L, P< 0.01). A linear regression analysis revealed that overall, the DPP4 levels were positively associated with LCL-C and hs-CRP levels as well as syntax scores. A multiple logistic regression analysis demonstrated that plasma DPP4 activity was independent predictor of CAD (odds ratio, 1.56; 95% CI, 1.19–1.73; P<0.01). Our study shows that increased DPP4 activity levels are associated with the presence of CAD and that the plasma DPP4 level serves as a novel biomarker for CAD even without DM.
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Affiliation(s)
- Guang Yang
- Department of Cardiology, Yanbian University Hospital, Yanji, Jilin P.R., China
| | - Yuzi Li
- Department of Cardiology, Yanbian University Hospital, Yanji, Jilin P.R., China
| | - Lan Cui
- Department of Cardiology, Yanbian University Hospital, Yanji, Jilin P.R., China
- * E-mail: (XC); (LC)
| | - Haiying Jiang
- Department of Physiology, Yanbian University Medical College, Yanji, China
| | - Xiang Li
- Department of Cardiology, Yanbian University Hospital, Yanji, Jilin P.R., China
| | - Chunzi Jin
- Department of Central Laboratory, Yanbian University Hospital, Yanji, China
| | - Dehao Jin
- Department of Angiography Center, Yanbian University Hospital, Yanji, China
| | - Guangxian Zhao
- Department of Cardiology, Yanbian University Hospital, Yanji, Jilin P.R., China
| | - Jiyong Jin
- Department of Cardiology, Yanbian University Hospital, Yanji, Jilin P.R., China
| | - Rui Sun
- Department of Cardiology, Yanbian University Hospital, Yanji, Jilin P.R., China
| | - Limei Piao
- Department of Cardiology, Yanbian University Hospital, Yanji, Jilin P.R., China
| | - Wenhu Xu
- Department of Cardiology, Yanbian University Hospital, Yanji, Jilin P.R., China
| | - Chenghu Fang
- Department of Cardiology, Yanbian University Hospital, Yanji, Jilin P.R., China
| | - Yanna Lei
- Department of Cardiology, Yanbian University Hospital, Yanji, Jilin P.R., China
| | - Kuichang Yuan
- Department of Cardiology, Yanbian University Hospital, Yanji, Jilin P.R., China
| | - Chunhua Xuan
- Department of Cardiology, Yanbian University Hospital, Yanji, Jilin P.R., China
| | - Dazi Ding
- Department of Cardiology, Yanbian University Hospital, Yanji, Jilin P.R., China
| | - Xianwu Cheng
- Department of Cardiology, Yanbian University Hospital, Yanji, Jilin P.R., China
- Department of Internal Medicine, Kyung Hee University, Seoul, South Korea
- * E-mail: (XC); (LC)
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Teeuw WJ, Laine ML, Bizzarro S, Loos BG. A Lead ANRIL Polymorphism Is Associated with Elevated CRP Levels in Periodontitis: A Pilot Case-Control Study. PLoS One 2015; 10:e0137335. [PMID: 26348353 PMCID: PMC4562619 DOI: 10.1371/journal.pone.0137335] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Accepted: 08/15/2015] [Indexed: 12/29/2022] Open
Abstract
Elevated high sensitive C-reactive protein (hsCRP) is a marker for systemic inflammation and a risk marker for atherosclerotic cardiovascular disease (ACVD), and has also been associated with periodontitis. Inter-individual variation for hsCRP in periodontitis has been shown. ANRIL is the strongest genetic susceptibility locus for both periodontitis and ACVD, and it is speculated that genetic variation in ANRIL may modulate inflammatory processes. Therefore, we explored the possible association between hsCRP plasma levels and a leading ANRIL single nucleotide polymorphism (SNP) in periodontitis patients and controls. 171 healthy subjects with North European descent (115 periodontitis and 56 controls) were included in this case-control study. hsCRP levels were determined and subjects were genotyped for the leading ANRIL SNP rs1333048. In a multivariate analysis, periodontitis, female gender, increasing BMI and homozygosity for the major allele (AA-genotype) of rs1333048 were significantly associated with elevated hsCRP plasma levels (p = 0.012, p = 0.004, p = 0.007 and p = 0.003, respectively). Periodontitis patients with rs1333048 AA-genotype showed higher levels of hsCRP than those carrying the minor C allele (median: 4.5 mg/L vs. 1.6 mg/L, padjusted = 0.007). This study is the first to show that, in addition to gender and BMI, also a leading SNP in ANRIL is explanatory for inter-individual variation in hsCRP levels in periodontitis patients of North European descent.
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Affiliation(s)
- Wijnand J. Teeuw
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, the Netherlands
- * E-mail:
| | - Marja L. Laine
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, the Netherlands
| | - Sergio Bizzarro
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, the Netherlands
| | - Bruno G. Loos
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, the Netherlands
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Acute effect of sildenafil on inflammatory markers/mediators in patients with vasculogenic erectile dysfunction. Int J Cardiol 2014; 182:98-101. [PMID: 25577741 DOI: 10.1016/j.ijcard.2014.12.072] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2014] [Accepted: 12/21/2014] [Indexed: 11/21/2022]
Abstract
BACKGROUND Erectile dysfunction (ED) is associated with an incremental inflammatory activation. Evidence suggests that chronic phosphodiesterase 5 (PDE-5) inhibition may have a favorable effect on inflammatory activation and surrogate markers of ED. The aim of this study is to investigate the acute effect of sildenafil on circulating pro-inflammatory markers/mediators in ED patients. METHODS The study comprised a randomized, double-blind, crossover trial carried out on two separate arms: one with sildenafil 100mg, and one with placebo. Twenty-seven subjects participated in the study (seven in the pilot and 20 in the main phase). In the main phase, blood samples were collected at baseline and at 2 and 4h after sildenafil or placebo administration to determine fibrinogen, high sensitivity C-reactive protein (hsCRP), high sensitivity interleukin-6 (hsIL-6) and tumor necrosis factor α (TNF-α). RESULTS Administration of sildenafil produced a significant sustained reduction of fibrinogen, hsCRP and hsIL-6 (maximal absolute response of -44mg/dl, 0.42mg/l and 0.68pg/ml at 4h). Likewise, TNF-α was acutely decreased after sildenafil (maximal response of -13pg/ml, 2h). The effect of sildenafil on fibrinogen, hsCRP and hsIL-6 and TNF-α was independent of the baseline values of these markers/mediators or the baseline testosterone level (all P<0.05). Soluble vascular cell adhesion molecule 1 (sVCAM-1) levels remained unchanged. CONCLUSIONS The present study shows for the first time the acute effect of sildenafil administration on pro-inflammatory markers/mediators in men with vasculogenic ED. This finding may have important implications in ED patients who are considered to be at increased cardiovascular risk.
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Cai A, Li G, Chen J, Li X, Wei X, Li L, Zhou Y. Glycated hemoglobin level is significantly associated with the severity of coronary artery disease in non-diabetic adults. Lipids Health Dis 2014; 13:181. [PMID: 25477191 PMCID: PMC4271481 DOI: 10.1186/1476-511x-13-181] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Accepted: 11/30/2014] [Indexed: 02/07/2023] Open
Abstract
Background To investigate relationship between glycated hemoglobin (HbA1c) level and coronary artery disease (CAD) severity. Methods Observational study was conducted and 573 participants were enrolled and baseline characteristics were collected. Clinical presentations in terms of stable angina, unstable angina or acute myocardial infarction were diagnosed. All participants were performed coronary angiography to figure out the numbers of coronary artery stenosis in terms of none-stenosis (< 50% stenosis), single or multiple vessels stenoses (≥ 50% stenosis). All participants were divided into subgroups according to two categories in terms of severity of clinical presentation (stable angina, unstable angina, or acute myocardial infarction) and the number of coronary artery stenosis (none, single, and multiple vessels). Primary endpoint was to evaluate relationship between baseline HbA1c value and CAD severity. Results Consistent to previous studies, participants with CAD had more risk factors such as elderly, smoking, low HDL-C and high CRP levels. Notably, HbA1c level was more prominent in CAD group than that without CAD. As compared to stable angina subgroup, HbA1c levels were gradually increased in unstable angina and acute myocardial infarction groups. Similar trend was identified in another category in terms of higher HbA1c level corresponding to more vessels stenoses. Multivariate regression analyses showed that after adjusted for traditional risk factors as well as fasting blood glucose, HbA1c remained strongly associated with the severity of CAD. Nonetheless, there was no significant association when CRP was accounted for. Conclusion HbA1c may be a useful indicator for CAD risk evaluation in non-diabetic adults.
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Affiliation(s)
| | | | | | | | | | - Liwen Li
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Road 2, Guangzhou 510080, China.
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Li X, Li Y, Jin J, Jin D, Cui L, Li X, Rei Y, Jiang H, Zhao G, Yang G, Zhu E, Nan Y, Cheng X. Increased serum cathepsin K in patients with coronary artery disease. Yonsei Med J 2014; 55:912-9. [PMID: 24954318 PMCID: PMC4075394 DOI: 10.3349/ymj.2014.55.4.912] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
PURPOSE Cathepsin K is a potent collagenase implicated in human and animal atherosclerosis-based vascular remodeling. This study examined the hypothesis that serum CatK is associated with the prevalence of coronary artery disease (CAD). MATERIALS AND METHODS Between January 2011 and December 2012, 256 consecutive subjects were enrolled from among patients who underwent coronary angiography and percutaneous coronary intervention treatment. A total of 129 age-matched subjects served as controls. RESULTS The subjects' serum cathepsin K and high sensitive C-reactive protein (hs-CRP) and high-density lipoprotein cholesterol were measured. The patients with CAD had significantly higher serum cathepsin K levels compared to the controls (130.8±25.5 ng/mL vs. 86.9±25.5 ng/mL, p<0.001), and the patients with acute coronary syndrome had significantly higher serum cathepsin K levels compared to those with stable angina pectoris (137.1±26.9 ng/mL vs. 102.6±12.9 ng/mL, p<0.001). A linear regression analysis showed that overall, the cathepsin K levels were inversely correlated with the high-density lipoprotein levels (r=-0.29, p<0.01) and positively with hs-CRP levels (r=0.32, p<0.01). Multiple logistic regression analyses shows that cathepsin K levels were independent predictors of CAD (odds ratio, 1.76; 95% confidence interval, 1.12 to 1.56; p<0.01). CONCLUSION These data indicated that elevated levels of cathepsin K are closely associated with the presence of CAD and that circulating cathepsin K serves a useful biomarker for CAD.
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Affiliation(s)
- Xiang Li
- Department of Cardiology, Yanbian University Hospital, Yanji, Jilin P.R., China
| | - Yuzi Li
- Department of Cardiology, Yanbian University Hospital, Yanji, Jilin P.R., China
| | - Jiyong Jin
- Department of Cardiology, Yanbian University Hospital, Yanji, Jilin P.R., China
| | - Dehao Jin
- Intervention Laboratory, Yanbian University Hospital, Yanji, Jilin P.R., China
| | - Lan Cui
- Department of Cardiology, Yanbian University Hospital, Yanji, Jilin P.R., China.
| | - Xiangshan Li
- Central Laboratory, Yanbian University Hospital, Yanji, Jilin P.R., China
| | - Yanna Rei
- Department of Cardiology, Yanbian University Hospital, Yanji, Jilin P.R., China. ; Department of Anesthesiology, Yanbian University Hospital, Yanji, Jilin P.R., China
| | - Haiying Jiang
- Department of Physiology and Pathophysiology, Yanbian University Medical College, Yanji, Jilin P.R., China
| | - Guangxian Zhao
- Department of Cardiology, Yanbian University Hospital, Yanji, Jilin P.R., China
| | - Guang Yang
- Department of Cardiology, Yanbian University Hospital, Yanji, Jilin P.R., China
| | - Enbo Zhu
- Department of Cardiology, Yanbian University Hospital, Yanji, Jilin P.R., China
| | - Yongshan Nan
- Department of Anesthesiology, Yanbian University Hospital, Yanji, Jilin P.R., China
| | - Xianwu Cheng
- Department of Cardiology, Yanbian University Hospital, Yanji, Jilin P.R., China. ; Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan. ; Department of Internal Medicine, Kyung Hee University Hospital, Seoul, Korea
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Mouridsen MR, Nielsen OW, Carlsen CM, Mattsson N, Ruwald MH, Binici Z, Sajadieh A. High-sensitivity C-reactive protein and exercise-induced changes in subjects suspected of coronary artery disease. J Inflamm Res 2014; 7:45-55. [PMID: 24715762 PMCID: PMC3977554 DOI: 10.2147/jir.s54360] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Inflammation plays a major role in the development of atherosclerosis. We wanted to investigate the effects of exercise on high-sensitivity (hs) C-reactive protein (CRP) in subjects who were suspected of having coronary artery disease (CAD). METHODS Blood samples were obtained before, 5 minutes after, and 20 hours after an exercise test in 155 subjects who were suspected of CAD. Coronary anatomy was evaluated by computed tomography coronary angiography and/or coronary angiography. RESULTS Median baseline hs-CRP was higher in subjects with ≥50% coronary artery lumen diameter stenosis (n=41), compared with non-CAD-subjects (n=114), 2.93 mg/L (interquartile range 1.03-5.06 mg/L) and 1.30 mg/L (interquartile range 0.76-2.74 mg/L), respectively, P=0.007. In multivariate analyses testing conventional risk factors, hs-CRP proved borderline significant, odds ratio =2.32, P=0.065. Adding baseline hs-CRP to the results of the exercise test did not improve the diagnostic evaluation. Baseline natural logarithm (Ln) hs-CRP was positively associated with body mass index and baseline Ln-transformed hs troponin T levels, and negatively associated with the daily life activity level. An increase in hs-CRP of 0.13 mg/L (interquartile range 0.05-0.24 mg/L) from baseline to 5 minutes after peak exercise was found (P<0.0001), but the increase was not associated with presence of CAD. From baseline to 20 hours after exercise, no increase in hs-CRP was found. CONCLUSION In conclusion, hs-CRP was not independently associated with CAD. Hs-CRP increased immediately as a response to the exercise, and the increase was modest and not associated with CAD. The results indicate that exercise has potential to cause unwanted variations in hs-CRP and that exercise prior to hs-CRP measurements in subjects included in epidemiological studies, therefore, should be avoided.
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Affiliation(s)
- Mette Rauhe Mouridsen
- Department of Cardiology, Copenhagen University Hospital of Bispebjerg, Copenhagen NV, Denmark
| | - Olav Wendelboe Nielsen
- Department of Cardiology, Copenhagen University Hospital of Bispebjerg, Copenhagen NV, Denmark
| | | | - Nick Mattsson
- Department of Cardiology, Copenhagen University Hospital of Bispebjerg, Copenhagen NV, Denmark
| | - Martin H Ruwald
- Department of Cardiology, Gentofte University Hospital, Hellerup, Denmark
| | - Zeynep Binici
- Department of Cardiology, Herlev Hospital, Herlev, Denmark
| | - Ahmad Sajadieh
- Department of Cardiology, Copenhagen University Hospital of Bispebjerg, Copenhagen NV, Denmark
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Ellims AH, Wong G, Weir JM, Lew P, Meikle PJ, Taylor AJ. Plasma lipidomic analysis predicts non-calcified coronary artery plaque in asymptomatic patients at intermediate risk of coronary artery disease. Eur Heart J Cardiovasc Imaging 2014; 15:908-16. [PMID: 24618657 DOI: 10.1093/ehjci/jeu033] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
AIMS The optimal management of asymptomatic subjects at intermediate risk of coronary artery disease (CAD) is often uncertain. Re-stratification to a high- or low-risk category may enable optimization of preventative strategies. Coronary computed tomographic angiography (CCTA) enables a minimally invasive assessment of coronary artery plaque quantity and composition. Non-calcified plaque by CCTA is lipid-rich and more vulnerable to rupture and resultant acute coronary syndromes. The purpose of this study was to determine whether novel approaches to CAD risk stratification, such as plasma lipid profiling, may predict non-calcified plaque burden in intermediate risk subjects. METHODS AND RESULTS CCTA and several markers of CAD (including plasma lipid profiling, carotid intima-media thickness, aortic pulse wave velocity, and high-sensitivity C-reactive protein) were prospectively performed in 100 asymptomatic patients at intermediate CAD risk according to the Framingham risk score. Segment stenosis scores (SSS) were calculated to evaluate the burden of total, calcified, and non-calcified coronary artery plaque. Non-calcified plaque was observed in 66 subjects and 158 (11%) of 1425 coronary artery segments. Eighteen lipid species demonstrated significant associations with non-calcified plaque burden, but not with total plaque or calcified plaque burden. No other marker of CAD was found to predict coronary artery plaque burden. CONCLUSIONS Plasma lipidomic analysis can predict the burden of non-calcified coronary plaque in asymptomatic subjects at intermediate risk of CAD. Re-stratification of these patients by plasma lipid profiling may enable more appropriate and effective primary prevention management strategies.
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Affiliation(s)
- Andris H Ellims
- Heart Centre, Alfred Hospital, Commercial Road, Melbourne, VIC 3004, Australia Baker IDI Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC 3004, Australia
| | - Gerard Wong
- Baker IDI Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC 3004, Australia
| | - Jacquelyn M Weir
- Baker IDI Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC 3004, Australia
| | - Philip Lew
- Department of Radiology, Alfred Hospital, Melbourne, Australia
| | - Peter J Meikle
- Baker IDI Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC 3004, Australia
| | - Andrew J Taylor
- Heart Centre, Alfred Hospital, Commercial Road, Melbourne, VIC 3004, Australia Baker IDI Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC 3004, Australia
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18
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Tajfard M, Ghayour-Mobarhan M, Rahimi HR, Mouhebati M, Esmaeily H, Ferns GAA, Latiff LA, Tajfiroozeh F, Mokhber N, Nazeminezhad R, Falsoleyman H, Taghipour A, Aziz AFA, Manaf RA, Saghiri Z, Hanachi P. Anxiety, Depression and Coronary Artery Disease among Patients Undergoing Angiography in Ghaem Hospital, Mashhad, Iran. Health (London) 2014. [DOI: 10.4236/health.2014.611137] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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19
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Cheng XW, Kikuchi R, Ishii H, Yoshikawa D, Hu L, Takahashi R, Shibata R, Ikeda N, Kuzuya M, Okumura K, Murohara T. Circulating cathepsin K as a potential novel biomarker of coronary artery disease. Atherosclerosis 2013; 228:211-6. [PMID: 23369704 DOI: 10.1016/j.atherosclerosis.2013.01.004] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2012] [Revised: 12/28/2012] [Accepted: 01/02/2013] [Indexed: 12/15/2022]
Abstract
BACKGROUND Cathepsin K (CatK) is one of the most potent mammalian collagenases involved in atherosclerosis-based vascular disease. We investigated whether circulating CatK is associated with the prevalence of coronary artery disease (CAD). METHODS Two-hundred fifty-two consecutive subjects were enrolled from among patients who underwent coronary angiography and intravascular ultrasound analyses. One-hundred thirty-two age-matched subjects served as controls. Plasma CatK, intact procollagen type I N-terminal propeptide (I-PINP), and linked carboxy-terminal telopeptide of collagen type I (ICTP) were measured. RESULTS Patients with CAD had higher CatK levels (44.0 ± 31.2 versus 15.5 ± 8.3 ng/mL, P < 0.001) and ICTP/I-PINP ratios (0.2 ± 0.1 versus 0.04 ± 0.03, P < 0.001) than the controls. Patients with acute coronary syndrome had higher CatK levels than those with stable angina pectoris. Overall, linear regression analysis showed that the CatK levels correlated positively with ICTP/I-PINP ratios (r = 0.41, P < 0.001). Multiple logistic regression analysis showed that CatK levels were independent predictors of CAD (odds ratio, 1.15; 95% CI, 1.07 to 1.23; P < 0.01). Furthermore, CatK levels were also correlated positively with percent plaque volumes and inversely with percent fibrous volumes by intravascular ultrasound. CONCLUSIONS These data indicated that high levels of CatK are closely linked with the presence of CAD and that CatK serves as a novel biomarker for CAD.
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Affiliation(s)
- Xian Wu Cheng
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
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Silva D, Pais de Lacerda A. Proteína C reativa de alta sensibilidade como biomarcador de risco na doença coronária. Rev Port Cardiol 2012; 31:733-45. [DOI: 10.1016/j.repc.2012.02.018] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2011] [Revised: 02/20/2012] [Accepted: 02/21/2012] [Indexed: 01/31/2023] Open
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Silva D, Pais de Lacerda A. High-sensitivity C-reactive protein as a biomarker of risk in coronary artery disease. REVISTA PORTUGUESA DE CARDIOLOGIA (ENGLISH EDITION) 2012. [DOI: 10.1016/j.repce.2012.09.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
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Yeow TP, Khir AS, Ismail AAS, Ismail IS, Kamarul Imran M, Khalid BAK, Kamaruddin NA, Azwany YN, Mustafa N, Osman A, Md Isa SH, Bebakar WMW, Nazaimoon WMW. Predictors of ischaemic heart disease in a Malaysian population with the metabolic syndrome. Diabet Med 2012; 29:1378-84. [PMID: 22803824 DOI: 10.1111/j.1464-5491.2012.03741.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
AIMS Cardiovascular disease is the foremost cause of mortality in Malaysia but little is known about the prevalence of the metabolic syndrome and its associations with other known cardiovascular risk markers. We undertook a population-based study to examine these. METHODS For the study, 4341 subjects were selected using a multistage stratified sampling method. Subjects were interviewed for personal and past medical history. Biomedical markers and anthropometric indices were measured. The metabolic syndrome was defined using the harmonized criteria. The associations between the metabolic syndrome and cardiovascular risk markers, including high-sensitivity C-reactive protein, microalbuminuria and HbA(1c) were examined. RESULTS The prevalence of the metabolic syndrome was 42.5%. Subjects with the metabolic syndrome are significantly more likely to have higher BMI (> 25 kg/m(2)), HbA(1c) [≥ 42 mmol/mol (6.0%)], LDL (≥ 2.6 mmol/l), elevated albumin:creatinine ratio (> 2.5 μg/mmol creatinine for men, 3.5 μg/mmol creatinine for women) and high-sensitivity C-reactive protein (> 3 mg/l); odds ratio 5.48, 6.14, 1.44, 3.68 and 1.84, respectively, P < 0.001. The presence of an elevated albumin:creatinine ratio and high-sensitivity C-reactive protein are strong predictors for the presence of a higher number of positive criteria of the metabolic syndrome. HbA(1c) > 48 mmol/mol (6.5%) is associated with increased relative risk of elevated albumin:creatinine ratio, high-sensitivity C-reactive protein and LDL (relative risk 3.10, 2.46 and 1.65 respectively, P < 0.001). CONCLUSIONS We confirmed the high prevalence of the metabolic syndrome in Malaysia. Our study revealed a strong relationship between risk markers of elevated BMI, HbA(1c), LDL, albumin:creatinine ratio and high-sensitivity C-reactive protein with the presence of the metabolic syndrome, putting them at a statistically high risk for cardiovascular mortality.
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Affiliation(s)
- T P Yeow
- Penang Medical College, Penang, Malaysia.
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Kones R. Rosuvastatin, inflammation, C-reactive protein, JUPITER, and primary prevention of cardiovascular disease--a perspective. Drug Des Devel Ther 2010; 4:383-413. [PMID: 21267417 PMCID: PMC3023269 DOI: 10.2147/dddt.s10812] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
The major public health concern worldwide is coronary heart disease, with dyslipidemia as a major risk factor. Statin drugs are recommended by several guidelines for both primary and secondary prevention. Rosuvastatin has been widely accepted because of its efficacy, potency, and superior safety profile. Inflammation is involved in all phases of atherosclerosis, with the process beginning in early youth and advancing relentlessly for decades throughout life. C-reactive protein (CRP) is a well-studied, nonspecific marker of inflammation which may reflect general health risk. Considerable evidence suggests CRP is an independent predictor of future cardiovascular events, but direct involvement in atherosclerosis remains controversial. Rosuvastatin is a synthetic, hydrophilic statin with unique stereochemistry. A large proportion of patients achieve evidence-based lipid targets while using the drug, and it slows progression and induces regression of atherosclerotic coronary lesions. Rosuvastatin lowers CRP levels significantly. The Justification for Use of statins in Prevention: an Intervention Trial Evaluating Rosuvastatin (JUPITER) trial was designed after the observation that when both low density lipoprotein and CRP were reduced, patients fared better than when only LDL was lowered. Advocates and critics alike acknowledge that the benefits of rosuvastatin in JUPITER were real. After a review, the US Food and Drug Administration extended the indications for rosuvastatin to include asymptomatic JUPITER-eligible individuals with one additional risk factor. The American Heart Association and Centers of Disease Control and Prevention had previously recognized the use of CRP in persons with "intermediate risk" as defined by global risk scores. The Canadian Cardiovascular Society guidelines went further and recommended use of statins in persons with low LDL and high CRP levels at intermediate risk. The JUPITER study focused attention on ostensibly healthy individuals with "normal" lipid profiles and high CRP values who benefited from statin therapy. The backdrop to JUPITER during this period was an increasing awareness of a rising cardiovascular risk burden and imperfect methods of risk evaluation, so that a significant number of individuals were being denied beneficial therapies. Other concerns have been a high level of residual risk in those who are treated, poor patient adherence, a need to follow guidelines more closely, a dual global epidemic of obesity and diabetes, and a progressively deteriorating level of physical activity in the population. Calls for new and more effective means of reducing risk for coronary heart disease are intensifying. In view of compelling evidence supporting earlier and aggressive therapy in people with high risk burdens, JUPITER simply offers another choice for stratification and earlier risk reduction in primary prevention patients. When indicated, and in individuals unwilling or unable to change their diet and lifestyles sufficiently, the benefits of statins greatly exceed the risks. Two side effects of interest are myotoxicity and an increase in the incidence of diabetes.
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Affiliation(s)
- Richard Kones
- The Cardiometabolic Research, Institute, Houston, TX 77054, USA.
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Bentley JP, Asselbergs FW, Coffey CS, Hebert PR, Moore JH, Hillege HL, van Gilst WH. Cardiovascular risk associated with interactions among polymorphisms in genes from the renin-angiotensin, bradykinin, and fibrinolytic systems. PLoS One 2010; 5:e12757. [PMID: 20856803 PMCID: PMC2939877 DOI: 10.1371/journal.pone.0012757] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2010] [Accepted: 08/24/2010] [Indexed: 11/19/2022] Open
Abstract
Background Vascular fibrinolytic balance is maintained primarily by interplay of tissue plasminogen activator (t-PA) and plasminogen activator inhibitor type 1 (PAI-1). Previous research has shown that polymorphisms in genes from the renin-angiotensin (RA), bradykinin, and fibrinolytic systems affect plasma concentrations of both t-PA and PAI-1 through a set of gene-gene interactions. In the present study, we extend this finding by exploring the effects of polymorphisms in genes from these systems on incident cardiovascular disease, explicitly examining two-way interactions in a large population-based study. Methodology/Principal Findings Data from the population-based PREVEND study in Groningen, The Netherlands (n = 8,138) were analyzed. The effects of the polymorphisms and their interactions on cardiovascular events were analyzed via Cox proportional hazards models. There was no association between five of the six polymorphisms singly and risk of cardiovascular disease. There was a significant main effect for the ACE I/D polymorphism for both dominant and additive coding schemes. There were significant interactions between the following polymorphism pairs even after adjustment for known risk factors: ACE I/D & PAI-1 4G/5G (p = 0.012), BDKRB2 C181T & ACE I/D (p = 0.016), BDKRB2 C58T & ACE I/D (p = 0.025), BDKRB2 exon 1 I/D & AT1R A1166C (p = 0.017), and BDKRB2 C58T & AT1R A1166C (p = 0.015). Conclusions/Significance This study suggests possible interactions between genes from the RA, bradykinin, and fibrinolytic systems on the risk of cardiovascular disease, extending previous research that has demonstrated that interactions among genes from these systems influence plasma concentrations of both t-PA and PAI-1. Further explorations of these interactions are needed.
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Affiliation(s)
- John P. Bentley
- Department of Pharmacy Administration, School of Pharmacy, University of Mississippi, University, Mississippi, United States of America
| | - Folkert W. Asselbergs
- Department of Cardiology, Division Heart & Lungs, University Medical Center Utrecht, Utrecht, The Netherlands
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- * E-mail:
| | - Christopher S. Coffey
- Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, Iowa, United States of America
| | - Patricia R. Hebert
- Charles E. Schmidt College of Biomedical Science, Florida Atlantic University, Boca Raton, Florida, United States of America
| | - Jason H. Moore
- Departments of Genetics and Community and Family Medicine, Dartmouth Medical School, Lebanon, New Hampshire, United States of America
| | - Hans L. Hillege
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Wiek H. van Gilst
- Department of Experimental Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Niccoli G, Ferrante G, Cosentino N, Conte M, Belloni F, Marino M, Bacà M, Montone RA, Sabato V, Schiavino D, Patriarca G, Crea F. Eosinophil cationic protein: A new biomarker of coronary atherosclerosis. Atherosclerosis 2010; 211:606-11. [DOI: 10.1016/j.atherosclerosis.2010.02.038] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2010] [Revised: 02/15/2010] [Accepted: 02/24/2010] [Indexed: 01/03/2023]
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Zakynthinos E, Pappa N. Inflammatory biomarkers in coronary artery disease. J Cardiol 2009; 53:317-33. [DOI: 10.1016/j.jjcc.2008.12.007] [Citation(s) in RCA: 228] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2008] [Revised: 12/24/2008] [Accepted: 12/26/2008] [Indexed: 11/30/2022]
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Association of circulating matrix metalloproteinase-1, but not adiponectin, with advanced coronary artery disease. Atherosclerosis 2009; 204:293-7. [DOI: 10.1016/j.atherosclerosis.2008.08.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2007] [Revised: 07/03/2008] [Accepted: 08/21/2008] [Indexed: 11/22/2022]
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Liu Y, Li X, Peng D, Tan Z, Liu H, Qing Y, Xue Y, Shi GP. Usefulness of serum cathepsin L as an independent biomarker in patients with coronary heart disease. Am J Cardiol 2009; 103:476-81. [PMID: 19195505 DOI: 10.1016/j.amjcard.2008.10.011] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2008] [Revised: 10/02/2008] [Accepted: 10/02/2008] [Indexed: 11/25/2022]
Abstract
Higher levels of cysteinyl cathepsin L were detected in human atherosclerotic lesions than in healthy aortas. However, a link between human coronary heart disease (CHD) and systemic cathepsin L levels remains unknown. A total of 137 volunteers with diagnosed acute and previous myocardial infarction (MI) and stable and unstable angina pectoris in addition to 48 controls were asked to undergo coronary angiography. Serum cathepsin L, high-sensitivity C-reactive protein, fasting glucose, and lipid protein profiles were measured. Serum cathepsin L levels were significantly higher in patients with CHD than in those without CHD (p <0.001). The significance persisted after adjusting for most major confounders. Patients with unstable angina pectoris had higher serum cathepsin L levels than those with stable angina pectoris (p = 0.02). Of patients with acute coronary syndrome, those with acute MI had higher serum cathepsin L levels than those with unstable angina pectoris (p <0.05) and patients with previous MI had the highest levels. Importantly, serum cathepsin L associated positively with number of coronary branch luminal narrowings (R = 0.38, p <0.001), Gensini scores (R = 0.44, p <0.001), high-sensitivity C-reactive protein (R = 0.32, p <0.001), fasting glucose (R = 0.16, p <0.03), and cigarette smokers (R = 0.27, p <0.001), but inversely with high-density lipoprotein (R = -0.23, p = 0.002) and apolipoprotein A1 (R = -0.19, p = 0.01) in all subjects. In conclusion, after adjusting for these confounders, we found that serum cathepsin L correlated positively and independently with Gensini score, suggesting that serum cathepsin L serves as a novel and independent biomarker for CHD.
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Vlachopoulos C, Rokkas K, Ioakeimidis N, Stefanadis C. Inflammation, Metabolic Syndrome, Erectile Dysfunction, and Coronary Artery Disease: Common Links. Eur Urol 2007; 52:1590-600. [PMID: 17707576 DOI: 10.1016/j.eururo.2007.08.004] [Citation(s) in RCA: 163] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2007] [Accepted: 08/02/2007] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Erectile dysfunction (ED) may be the early clinical manifestation of a generalized vascular disease and carries an independent risk for cardiovascular events. Low-grade subclinical inflammation affects endothelial function and is involved in all stages of the atherosclerotic process. This review identifies potential pathophysiologic links among low-grade inflammation, ED, metabolic syndrome, and coronary artery disease (CAD) and presents the clinical implications in terms of ED diagnosis, assessment of patient risk, and therapy. METHODS A comprehensive evaluation was performed for available published data in full-length papers that were identified in MedLine up to July 2007. RESULTS Studies support an association between metabolic syndrome, ED, and increased inflammatory state. Increased circulating levels of inflammatory and endothelial-prothrombotic compounds are related to the presence and severity of ED. Specific inflammatory biomarkers and their combination appear to have the potential to aid ED diagnosis or exclusion. ED and CAD may confer a similar unfavorable impact on the inflammatory and prothrombotic state, whereas ED adds an incremental activation on top of CAD; these findings have important implications for cardiovascular risk. Lifestyle and risk factor modification, as well as pharmacologic therapy, are associated with anti-inflammatory effects. CONCLUSIONS Low-grade systemic inflammation could be an important element of the association between metabolic syndrome, ED, and CAD. Its individualized assessment may be a valuable tool for ED diagnosis, risk assessment, and rationalized therapeutic approach especially in patients with ED who have metabolic syndrome and carry an intermediate risk for future cardiovascular events.
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Affiliation(s)
- Charalambos Vlachopoulos
- Cardiovascular Diseases and Sexual Health Unit, 1st Department of Cardiology, Athens Medical School, Hippokration Hospital, Athens, Greece.
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