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Akkaya S, Cakmak U. Association between C-Reactive Protein to Albumin Ratio and Multi-Vessel Coronary Artery Disease in Patients with Stable Coronary Artery Disease. J Pers Med 2024; 14:378. [PMID: 38673005 PMCID: PMC11050953 DOI: 10.3390/jpm14040378] [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: 03/02/2024] [Revised: 03/27/2024] [Accepted: 03/30/2024] [Indexed: 04/28/2024] Open
Abstract
Multivessel coronary artery disease (MV-CAD) remains a prevalent and serious health concern despite advances in treatment. Early identification and risk stratification are crucial for optimizing treatment. The CRP-to-albumin ratio (CAR) has emerged as a promising biomarker in various inflammatory diseases. This study investigated the potential of CAR as a marker for MV-CAD. We retrospectively analyzed 1360 patients with suspected CAD. Patients were divided into three groups based on CAR tertiles. Logistic regression analyses were carried out to estimate the association between MHR and MV-CAD. Elevated CAR levels were significantly associated with an increased prevalence of CAD (p < 0.001), severe CAD (p < 0.001), and MV-CAD (p < 0.001). Patients with the highest CAR tertile had five times higher odds of MV-CAD compared to the lowest tertile (p < 0.001). CAR demonstrated moderate accuracy in predicting MV-CAD (AUC: 0.644, 95% CI: 0.615-0.674, p < 0.001). CAR holds promise as a tool for the early identification and risk stratification of multivessel CAD. Further research is warranted to validate its clinical utility and explore its potential to guide treatment decisions and improve outcomes in patients with this high-risk condition.
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Affiliation(s)
- Suleyman Akkaya
- Department of Cardiology, Health Sciences University, Gazi Yasargil Research and Training Hospital, 21070 Diyarbakir, Turkey
| | - Umit Cakmak
- Department of Nephrology, Health Sciences University, Gazi Yasargil Research and Training Hospital, 21070 Diyarbakir, Turkey;
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Moriya S, Wada H, Iwata H, Endo H, Doi S, Ogita M, Dohi T, Okazaki S, Suwa S, Miyauchi K, Daida H, Minamino T. Red Cell Distribution Width Predicts Long-Term Cardiovascular Outcomes in Patients with Chronic Coronary Syndrome. Int Heart J 2022; 63:1041-1047. [DOI: 10.1536/ihj.22-304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Affiliation(s)
- Soshi Moriya
- Department of Cardiovascular Medicine, Juntendo University Shizuoka Hospital
| | - Hideki Wada
- Department of Cardiovascular Medicine, Juntendo University Shizuoka Hospital
| | - Hiroshi Iwata
- Department of Cardiovascular Medicine and Biology, Juntendo University Graduate School of Medicine
| | - Hirohisa Endo
- Department of Cardiovascular Medicine and Biology, Juntendo University Graduate School of Medicine
| | - Shinichiro Doi
- Department of Cardiovascular Medicine and Biology, Juntendo University Graduate School of Medicine
| | - Manabu Ogita
- Department of Cardiovascular Medicine, Juntendo University Shizuoka Hospital
| | - Tomotaka Dohi
- Department of Cardiovascular Medicine and Biology, Juntendo University Graduate School of Medicine
| | - Shinya Okazaki
- Department of Cardiovascular Medicine and Biology, Juntendo University Graduate School of Medicine
| | - Satoru Suwa
- Department of Cardiovascular Medicine, Juntendo University Shizuoka Hospital
| | - Katsumi Miyauchi
- Department of Cardiovascular Medicine and Biology, Juntendo University Graduate School of Medicine
| | - Hiroyuki Daida
- Department of Cardiovascular Medicine and Biology, Juntendo University Graduate School of Medicine
| | - Tohru Minamino
- Department of Cardiovascular Medicine and Biology, Juntendo University Graduate School of Medicine
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Nakajima A, Libby P, Mitomo S, Yuki H, Araki M, Seegers LM, McNulty I, Lee H, Ishibashi M, Kobayashi K, Dijkstra J, Ouchi T, Onishi H, Yabushita H, Matsuoka S, Kawamoto H, Watanabe Y, Tanaka K, Chou S, Sato T, Naganuma T, Okutsu M, Tahara S, Kurita N, Nakamura S, Kuter DJ, Nakamura S, Jang IK. Biomarkers associated with coronary high-risk plaques. J Thromb Thrombolysis 2022; 54:647-659. [PMID: 36205839 DOI: 10.1007/s11239-022-02709-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/11/2022] [Indexed: 11/28/2022]
Abstract
Vascular inflammation, lipid metabolism, and thrombogenicity play a key role not only in atherogenesis but also in the development of acute coronary syndromes. Biomarkers associated with coronary high-risk plaques defined according to intravascular imaging have not been systematically studied. A total of 69 patients with coronary artery disease who underwent both optical coherence tomography and intravascular ultrasound imaging, and who provided blood specimens were included. Comprehensive biomarkers for inflammation, lipid, and coagulation were analyzed. Composite models sought biomarker patterns associated with thin-cap fibroatheroma (TCFA) and "high-risk plaques" (TCFA and large plaque burden). Two different composite models were developed for TCFA, based on the finding that high sensitivity C-reactive protein (hsCRP), plasminogen activator inhibitor-1, fibrinogen, IL-6, homocysteine and amyloid A levels were elevated, and high-density lipoprotein cholesterol (HDL) and bile acid levels were decreased in these patients. Both composite models were highly accurate for detecting patients with TCFA (area under curve [AUC]: 0.883 in model-A and 0.875 in model-B, both p < 0.001). In addition, creatinine, hsCRP, fibrinogen, tumor necrosis factor-α, IL-6, homocysteine, amyloid A, HDL, prothrombin, and bile acid were useful for detecting patients with "high-risk plaques". Two composite models were highly accurate for detection of patients with "high-risk plaques" (AUC: 0.925 in model-A and 0.947 in model-B, both p < 0.001). Biomarkers useful for detection of patients with high-risk coronary plaques defined according to intravascular imaging have been identified. These biomarkers may be useful to risk stratify patients and to develop targeted therapy.Clinical Trial Registration https://www.umin.ac.jp/ctr/ , UMIN000041692. Biomarkers and high-risk plaques hsCRP, PAI-1, fibrinogen, IL-6, homocysteine, amyloid A, HDL, and bile acid were useful for detecting patients with TCFA. hsCRP, fibrinogen, IL-6, homocysteine, amyloid A, creatinine, TNFα, HDL, prothrombin, and bile acid were useful for detecting patients with "high-risk plaques" (plaque which has both TCFA and large plaque burden). White arrowhead denotes TCFA. Red and green dashed lines denote lumen area and external elastic membrane area, respectively.
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Affiliation(s)
- Akihiro Nakajima
- Cardiology Division, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, GRB 800, Boston, MA, 02114, USA.,Interventional Cardiology Unit, New Tokyo Hospital, 1271 Wanagaya, Matsudo, Chiba, 270-2232, Japan
| | - Peter Libby
- Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Satoru Mitomo
- Interventional Cardiology Unit, New Tokyo Hospital, 1271 Wanagaya, Matsudo, Chiba, 270-2232, Japan
| | - Haruhito Yuki
- Interventional Cardiology Unit, New Tokyo Hospital, 1271 Wanagaya, Matsudo, Chiba, 270-2232, Japan
| | - Makoto Araki
- Cardiology Division, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, GRB 800, Boston, MA, 02114, USA
| | - Lena Marie Seegers
- Cardiology Division, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, GRB 800, Boston, MA, 02114, USA
| | - Iris McNulty
- Cardiology Division, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, GRB 800, Boston, MA, 02114, USA
| | - Hang Lee
- Biostatistics Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Midori Ishibashi
- Department of Clinical Laboratory Medicine, New Tokyo Hospital, Matsudo, Chiba, Japan
| | - Kazuna Kobayashi
- Clinical Research Center, New Tokyo Hospital, Matsudo, Chiba, Japan
| | - Jouke Dijkstra
- Division of Image Processing, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Toru Ouchi
- Interventional Cardiology Unit, New Tokyo Hospital, 1271 Wanagaya, Matsudo, Chiba, 270-2232, Japan
| | - Hirokazu Onishi
- Interventional Cardiology Unit, New Tokyo Hospital, 1271 Wanagaya, Matsudo, Chiba, 270-2232, Japan
| | - Hiroto Yabushita
- Interventional Cardiology Unit, New Tokyo Hospital, 1271 Wanagaya, Matsudo, Chiba, 270-2232, Japan
| | - Satoshi Matsuoka
- Interventional Cardiology Unit, New Tokyo Hospital, 1271 Wanagaya, Matsudo, Chiba, 270-2232, Japan
| | - Hiroyoshi Kawamoto
- Interventional Cardiology Unit, New Tokyo Hospital, 1271 Wanagaya, Matsudo, Chiba, 270-2232, Japan
| | - Yusuke Watanabe
- Interventional Cardiology Unit, New Tokyo Hospital, 1271 Wanagaya, Matsudo, Chiba, 270-2232, Japan
| | - Kentaro Tanaka
- Interventional Cardiology Unit, New Tokyo Hospital, 1271 Wanagaya, Matsudo, Chiba, 270-2232, Japan
| | - Shengpu Chou
- Department of Diabetes Internal Medicine, New Tokyo Hospital, Matsudo, Chiba, Japan
| | - Tomohiko Sato
- Interventional Cardiology Unit, New Tokyo Hospital, 1271 Wanagaya, Matsudo, Chiba, 270-2232, Japan
| | - Toru Naganuma
- Interventional Cardiology Unit, New Tokyo Hospital, 1271 Wanagaya, Matsudo, Chiba, 270-2232, Japan
| | - Masaaki Okutsu
- Interventional Cardiology Unit, New Tokyo Hospital, 1271 Wanagaya, Matsudo, Chiba, 270-2232, Japan
| | - Satoko Tahara
- Interventional Cardiology Unit, New Tokyo Hospital, 1271 Wanagaya, Matsudo, Chiba, 270-2232, Japan
| | - Naoyuki Kurita
- Interventional Cardiology Unit, New Tokyo Hospital, 1271 Wanagaya, Matsudo, Chiba, 270-2232, Japan
| | - Shotaro Nakamura
- Interventional Cardiology Unit, New Tokyo Hospital, 1271 Wanagaya, Matsudo, Chiba, 270-2232, Japan
| | - David J Kuter
- Hematology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Sunao Nakamura
- Interventional Cardiology Unit, New Tokyo Hospital, 1271 Wanagaya, Matsudo, Chiba, 270-2232, Japan.
| | - Ik-Kyung Jang
- Cardiology Division, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, GRB 800, Boston, MA, 02114, USA. .,Division of Cardiology, Kyung Hee University Hospital, Seoul, Korea.
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Li D, Li S, Xia Z, Cao J, Zhang J, Chen B, Zhang X, Zhu W, Fang J, Liu Q, Hua W. Prognostic significance of pretreatment red blood cell distribution width in primary diffuse large B-cell lymphoma of the central nervous system for 3P medical approaches in multiple cohorts. EPMA J 2022; 13:499-517. [PMID: 36061828 PMCID: PMC9437163 DOI: 10.1007/s13167-022-00290-5] [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: 04/28/2022] [Accepted: 07/04/2022] [Indexed: 12/08/2022]
Abstract
Background/aims Predicting the clinical outcomes of primary diffuse large B-cell lymphoma of the central nervous system (PCNS-DLBCL) to methotrexate-based combination immunochemotherapy treatment in advance and therefore administering the tailored treatment to the individual is consistent with the principle of predictive, preventive, and personalized medicine (PPPM/3PM). The red blood cell distribution width (RDW) has been reported to be associated with the clinical outcomes of multiple cancer. However, its prognostic role in PCNS-DLBCL is yet to be evaluated. Therefore, we aimed to effectively stratify PCNS-DLBCL patients with different prognosis in advance and early identify the patients who were appropriate to methotrexate-based combination immunochemotherapy based on the pretreatment level of RDW and a clinical prognostic model. Methods A prospective-retrospective, multi-cohort study was conducted from 2010 to 2020. We evaluated RDW in 179 patients (retrospective discovery cohorts of Huashan Center and Renji Center and prospective validation cohort of Cancer Center) with PCNS-DLBCL treated with methotrexate-based combination immunochemotherapy. A generalized additive model with locally estimated scatterplot smoothing was used to identify the relationship between pretreatment RDW levels and clinical outcomes. The high vs low risk of RDW combined with MSKCC score was determined by a minimal P-value approach. The clinical outcomes in different groups were then investigated. Results The pretreatment RDW showed a U-shaped relationship with the risk of overall survival (OS, P = 0.047). The low RDW (< 12.6) and high RDW (> 13.4) groups showed significantly worse OS (P < 0.05) and progression-free survival (PFS; P < 0.05) than the median group (13.4 > RDW > 12.6) in the discovery and validation cohort, respectively. RDW could predict the clinical outcomes successfully. In the discovery cohort, RDW achieved the area under the receiver operating characteristic curve (AUC) of 0.9206 in predicting the clinical outcomes, and the predictive value (AUC = 0.7177) of RDW was verified in the validation cohort. In addition, RDW combined with MSKCC predictive model can distinguish clinical outcomes with the AUC of 0.8348 for OS and 0.8125 for PFS. Compared with the RDW and MSKCC prognosis variables, the RDW combined with MSKCC scores better identified a subgroup of patients with favorable long-term survival in the validation cohort (P < 0.001). RDW combined MSKCC score remained to be independently associated with clinical outcomes by multivariable analysis. Conclusions Based on the pretreatment RDW and MSKCC scores, a novel predictive tool was established to stratify PCNS-DLBCL patients with different prognosis effectively. The predictive model developed accordingly is promising to judge the response of PCNS-DLBCL to methotrexate-based combination immunochemotherapy treatment. Thus, hematologists and oncologists could tailor and adjust therapeutic modalities by monitoring RDW in a prospective rather than the reactive manner, which could save medical expenditures and is a key concept in 3PM. In brief, RDW combined with MSKCC model could serve as an important tool for predicting the response to different treatment and the clinical outcomes for PCNS-DLBCL, which could conform with the principles of predictive, preventive, and personalized medicine. Supplementary Information The online version contains supplementary material available at 10.1007/s13167-022-00290-5.
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Affiliation(s)
- Danhui Li
- Department of Pathology, Renji Hospital, School of Medicine, Shanghai JiaoTong University, No. 160 PuJian Road, Shanghai, 200127 China
| | - Shengjie Li
- Department of Neurosurgery, Huashan Hospital, Fudan University, No. 12 Wulumuqi Road, Shanghai, 200040 China
- Institute of Neurosurgery, Fudan University, Shanghai, 200040 China
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, 200040 China
- Department of Clinical Laboratory, EENT Hospital, Shanghai Medical College, Fudan University, Shanghai, 200032 China
| | - Zuguang Xia
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Fudan University, Shanghai, 200032 China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032 China
| | - Jiazhen Cao
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032 China
- Department of Clinical Laboratory, Fudan University Shanghai Cancer Center, Shanghai, 200032 China
| | - Jinsen Zhang
- Department of Neurosurgery, Huashan Hospital, Fudan University, No. 12 Wulumuqi Road, Shanghai, 200040 China
- Institute of Neurosurgery, Fudan University, Shanghai, 200040 China
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, 200040 China
| | - Bobin Chen
- Department of Hematology, Huashan Hospital, Fudan University, Shanghai, 200040 China
| | - Xin Zhang
- Department of Neurosurgery, Huashan Hospital, Fudan University, No. 12 Wulumuqi Road, Shanghai, 200040 China
- Institute of Neurosurgery, Fudan University, Shanghai, 200040 China
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, 200040 China
| | - Wei Zhu
- Department of Neurosurgery, Huashan Hospital, Fudan University, No. 12 Wulumuqi Road, Shanghai, 200040 China
- Institute of Neurosurgery, Fudan University, Shanghai, 200040 China
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, 200040 China
| | - Jianchen Fang
- Department of Pathology, Renji Hospital, School of Medicine, Shanghai JiaoTong University, No. 160 PuJian Road, Shanghai, 200127 China
| | - Qiang Liu
- Department of Pathology, Renji Hospital, School of Medicine, Shanghai JiaoTong University, No. 160 PuJian Road, Shanghai, 200127 China
| | - Wei Hua
- Department of Neurosurgery, Huashan Hospital, Fudan University, No. 12 Wulumuqi Road, Shanghai, 200040 China
- Institute of Neurosurgery, Fudan University, Shanghai, 200040 China
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, 200040 China
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Coronary Atherosclerosis, Cardiac Troponin, and Interleukin-6 in Patients With Chest Pain. JACC: CARDIOVASCULAR IMAGING 2022; 15:1427-1438. [PMID: 35926901 PMCID: PMC9353061 DOI: 10.1016/j.jcmg.2022.03.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 01/26/2022] [Accepted: 03/04/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Increased inflammation and myocardial injury can be observed in the absence of myocardial infarction or obstructive coronary artery disease (CAD). OBJECTIVES The authors determined whether biomarkers of inflammation and myocardial injury-interleukin (IL)-6 and high-sensitivity cardiac troponin (hs-cTn)-were associated with the presence and extent of CAD and were independent predictors of major adverse cardiovascular events (MACEs) in stable chest pain. METHODS Using participants from the PROMISE trial, the authors measured hs-cTn I and IL-6 concentrations and analyzed computed tomography angiography (CTA) images in the core laboratory for CAD characteristics: significant stenosis (≥70%), high-risk plaque (HRP), Coronary Artery Disease Reporting and Data System (CAD-RADS) categories, segment involvement score (SIS), and coronary artery calcium (CAC) score. The primary endpoint was a composite MACE (death, myocardial infarction, or unstable angina). RESULTS The authors included 1,796 participants (age 60.2 ± 8.0 years; 47.5% men, median follow-up 25 months). In multivariable linear regression adjusted for atherosclerotic cardiovascular disease (ASCVD) risk, hs-cTn was associated with HRP, stenosis, CAD-RADS, and SIS. IL-6 was only associated with stenosis and CAD-RADS. hs-cTn above median (1.5 ng/L) was associated with MACEs in univariable analysis (HR: 2.1 [95% CI: 1.3-3.6]; P = 0.006), but not in multivariable analysis adjusted for ASCVD and CAD. IL-6 above median (1.8 ng/L) was associated with MACEs in multivariable analysis adjusted for ASCVD and HRP (HR: 1.9 [95% CI: 1.1-3.3]; P = 0.03), CAC (HR: 1.9 [95% CI: 1.0-3.4]; P = 0.04), and SIS (HR: 1.8 [95% CI: 1.0-3.2]; P = 0.04), but not for stenosis or CAD-RADS. In participants with nonobstructive CAD (stenosis 1%-69%), the presence of both hs-cTn and IL-6 above median was strongly associated with MACEs (HR: 2.5-2.7 after adjustment for CAD characteristics). CONCLUSIONS Concentrations of hs-cTn and IL-6 were associated with CAD characteristics and MACEs, indicating that myocardial injury and inflammation may each contribute to pathways in CAD pathophysiology. This association was most pronounced among participants with nonobstructive CAD representing an opportunity to tailor treatment in this at-risk group. (PROspective Multicenter Imaging Study for Evaluation of Chest Pain [PROMISE]; NCT01174550).
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Liao MT, Lai CL, Wang TC, Lin JW, Ho YL, Chan KA. Red Cell Distribution Width and Mortality in Patients Undergoing Percutaneous Coronary Intervention. Biomedicines 2021; 10:biomedicines10010045. [PMID: 35052725 PMCID: PMC8772904 DOI: 10.3390/biomedicines10010045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 12/17/2021] [Accepted: 12/22/2021] [Indexed: 12/23/2022] Open
Abstract
Red cell distribution width (RDW) can effectively predict prognosis in coronary artery disease (CAD) patients following percutaneous coronary intervention (PCI). There is currently no relevant research to demonstrate a linear or non-linear association between RDW and mortality. This is a multi-center, retrospective cohort study, with data collected from 2006 to 2017. Source data included electronic medical records of the Integrated Medical Database of National Taiwan University Hospital, and health insurance claims from the National Health Insurance Administration. Patients were stratified into five groups according to RDW values (13.4%, 14.1%, 14.8%, and 15.9%). Multivariable logistic and Cox regression analyses were used to determine 1-year all-cause and cardiovascular (CV) mortalities. Data of 10,669 patients were analyzed and those with the lowest RDW (≤13.3%) served as the reference group. The adjusted odds ratios (ORs) of 1-year all-cause mortality from the second to fifth RDW group were 1.386, 1.589, 2.090, and 3.192, respectively (p for trend < 0.001). The adjusted ORs of 1-year CV mortality were 1.555, 1.585, 1.623, and 2.850, respectively (p for trend = 0.015). The adjusted hazard ratios (HRs) of 1-year all-cause mortality were 1.394, 1.592, 2.003, and 2.689, respectively (p for trend = 0.006). The adjusted HRs of 1-year CV mortality were 1.533, 1.568, 1.609, and 2.710, respectively (p for trend = 0.015). RDW was an independent predicting factor and had a linear relationship with the 1-year all-cause and CV mortalities in patients undergoing PCI. Thus, RDW may be a clinically useful parameter to predict the mortality in those patients.
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Affiliation(s)
- Min-Tsun Liao
- Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu 300, Taiwan;
- Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei 100, Taiwan; (J.-W.L.); (Y.-L.H.)
| | - Chao-Lun Lai
- Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu 300, Taiwan;
- Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei 100, Taiwan; (J.-W.L.); (Y.-L.H.)
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei 100, Taiwan
- Correspondence: ; Tel.: +886-3-5326151
| | - Ting-Chuan Wang
- Health Data Research Center, National Taiwan University, Taipei 100, Taiwan; (T.-C.W.); (K.A.C.)
| | - Jou-Wei Lin
- Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei 100, Taiwan; (J.-W.L.); (Y.-L.H.)
- Cardiovascular Center, National Taiwan University Hospital Yunlin Branch, Douliu City 640, Taiwan
| | - Yi-Lwun Ho
- Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei 100, Taiwan; (J.-W.L.); (Y.-L.H.)
- Department of Internal Medicine, National Taiwan University Hospital, Taipei 100, Taiwan
| | - K. Arnold Chan
- Health Data Research Center, National Taiwan University, Taipei 100, Taiwan; (T.-C.W.); (K.A.C.)
- Graduate Institute of Oncology, College of Medicine, National Taiwan University, Taipei 100, Taiwan
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Ling Y, Wang W, Fu C, Fan Q, Liu J, Tang S. The Relationship between Red Cell Distribution Width and Residual SYNTAX Scores in ST-Segment Elevation Myocardial Infarction Patients after Percutaneous Coronary Intervention. DISEASE MARKERS 2021; 2021:3281837. [PMID: 34956418 PMCID: PMC8695033 DOI: 10.1155/2021/3281837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 11/05/2021] [Accepted: 11/25/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Residual SYNTAX score (rSS) values have been suggested to serve as an independent predictor of mortality in ST-segment elevation myocardial infarction (STEMI) patients following percutaneous coronary intervention (PCI). Prior work has also indicated that red cell distribution width (RDW) can predict the incidence of major adverse cardiac events (MACEs) in STEMI patients. As such, we sought to explore the relationship between RDW and rSS in STEMI patients that have undergone PCI. METHODS In total, 456 eligible patients were recruited for this study. Youden's index was used to calculate the optimal RDW cut-off value, after which the relationship between RDW and rSS values was assessed through Spearman's correlation analyses. Independent predictors of high rSS levels were then identified via multivariate logistic regression analysis. RESULTS Patients were separated into two groups based upon whether they exhibited high RDW levels (>13.9, Group 1) or low RDW levels (<13.9, Group 2). The average rSS value of patients in Group 2 was found to be significantly decreased compared to patients in Group 1 (P < 0.001). RDW values were found to be positively correlated with rSS (r = 0.604, P < 0.001), and multivariate logistic regression analysis determined that high RDW levels were independently predictive of higher rSS (OR = 27.1 [14.8-51.7]; P < 0.001). Additionally, a nomogram incorporating RDW exhibited good calibration, discriminative capacity, and clinical utility. CONCLUSIONS In summary, RDW is strongly correlated with rSS in STEMI patients following PCI, with high RDW levels serving as an independent predictor of high rSS in this patient population.
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Affiliation(s)
- Yang Ling
- Department of Cardiology, Yijishan Hospital Affiliated to Wannan Medical College, Wuhu 241000, China
| | - Wei Wang
- Department of Gastroenterology, Yijishan Hospital Affiliated to Wannan Medical College, Wuhu 241000, China
| | - Cong Fu
- Department of Cardiology, Yijishan Hospital Affiliated to Wannan Medical College, Wuhu 241000, China
| | - Qun Fan
- Department of Cardiology, Yijishan Hospital Affiliated to Wannan Medical College, Wuhu 241000, China
| | - Jichun Liu
- Department of Cardiology, Yijishan Hospital Affiliated to Wannan Medical College, Wuhu 241000, China
| | - Shengxing Tang
- Department of Cardiology, Yijishan Hospital Affiliated to Wannan Medical College, Wuhu 241000, China
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Role of IL-37- and IL-37-Treated Dendritic Cells in Acute Coronary Syndrome. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2021; 2021:6454177. [PMID: 34471467 PMCID: PMC8405329 DOI: 10.1155/2021/6454177] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 07/27/2021] [Accepted: 08/10/2021] [Indexed: 12/14/2022]
Abstract
As a chronic inflammatory disease, atherosclerosis is a leading cause of morbidity and mortality in most countries. Inflammation is responsible for plaque instability and the subsequent onset of acute coronary syndrome (ACS), which is one of the leading causes of hospitalization. Therefore, exploring the potential mechanism underlying ACS is of considerable concern, and searching for alternative therapeutic targets is very urgent. Interleukin-37 (IL-37) inhibits the production of proinflammatory chemokines and cytokines and acts as a natural inhibitor of innate and adaptive immunity. Interestingly, our previous study with murine models showed that IL-37 alleviated cardiac remodeling and myocardial ischemia/reperfusion injury. Of note, our clinical study revealed that IL-37 is elevated and plays a beneficial role in patients with ACS. Moreover, dendritic cells (DCs) orchestrate both immunity and tolerance, and tolerogenic DCs (tDCs) are characterized by more secretion of immunosuppressive cytokines. As expected, IL-37-treated DCs are tolerogenic. Hence, we speculate that IL-37- or IL-37-treated DCs is a novel therapeutic possibility for ACS, and the precise mechanism of IL-37 requires further study.
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Rasmussen SR, Nielsen RV, Eriksson F, Dons M, Vedel AG, Buggeskov KB, Møgelvang R, Ostrowski SR, Ravn HB. Prognostic Value of Soluble Urokinase-Type Plasminogen Activator Receptor and High-Sensitivity C-Reactive Protein on Postoperative Mortality in Patients Undergoing Elective On-Pump Cardiac Surgery. J Cardiothorac Vasc Anesth 2020; 35:2415-2423. [PMID: 33243671 DOI: 10.1053/j.jvca.2020.10.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 10/21/2020] [Accepted: 10/23/2020] [Indexed: 11/11/2022]
Abstract
OBJECTIVES Elevated soluble urokinase-type plasminogen activator receptor (suPAR) and high-sensitivity C-reactive protein (hsCRP) have been associated with increased mortality in patients with cardiovascular disease. The aim of the present study was to explore the relationship between suPAR and hsCRP values and associated mortality after elective cardiac surgery. A secondary aim was to assess whether a combined risk model of European System for Cardiac Operative Risk Evaluation (EuroSCORE II), suPAR, and/or hsCRP would improve the prognostic accuracy compared with EuroSCORE II alone. DESIGN Retrospective observational study. SETTING Single-center, university hospital. PARTICIPANTS Adult patients admitted for elective on-pump cardiac surgery were included. Biobank blood samples were obtained from previous research projects at a tertiary heart center from 2012 to 2018. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS A total of 931 patients were included. Kaplan-Meier and Cox proportional hazard analyses were used to explore a potential association between preoperative suPAR and hsCRP values and all-cause mortality up to one year after surgery. Thirty-day mortality was predicted from suPAR, hsCRP, and EuroSCORE II by logistic regression and compared using area under the receiver operating characteristics curve and Brier scores. After adjustment for known confounders, a doubling of suPAR and hsCRP corresponded to a hazard ratio for all-cause mortality of 2.27 (95% confidence interval 1.65-3.11; p < 0.001) and 1.26 (95% confidence interval 1.07-1.49; p = 0.005), respectively. However, adding the biomarkers to EuroSCORE II did not improve prediction/discrimination with respect to 30-day mortality. CONCLUSIONS Elevated preoperative levels of suPAR and hsCRP were associated with all-cause mortality in elective cardiac surgery patients. However, inclusion of biomarkers did not improve the prognostic accuracy of EuroSCORE II.
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Affiliation(s)
- Sebastian Roed Rasmussen
- Department of Cardiothoracic Anesthesiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
| | - Rikke Vibeke Nielsen
- Department of Cardiothoracic Anesthesiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Frank Eriksson
- Section of Biostatistics, University of Copenhagen, Copenhagen, Denmark
| | - Maria Dons
- Department of Cardiothoracic Anesthesiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Anne Grønborg Vedel
- Department of Cardiothoracic Anesthesiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Katrine Bredahl Buggeskov
- Department of Cardiothoracic Anesthesiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Rasmus Møgelvang
- Department of Cardiothoracic Anesthesiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Clinical Cardiovascular Research Unit, Svendborg, University of Southern Denmark, Svendborg, Denmark
| | - Sisse Rye Ostrowski
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Clinical Immunology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Hanne Berg Ravn
- Department of Cardiothoracic Anesthesiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Bao D, Luo G, Kan F, Wang X, Luo J, Jiang C. Prognostic value of red cell distribution width in patients undergoing percutaneous coronary intervention: a meta-analysis. BMJ Open 2020; 10:e033378. [PMID: 32912972 PMCID: PMC7485231 DOI: 10.1136/bmjopen-2019-033378] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVE To evaluate the prognostic value of baseline red cell distribution width (RDW) in patients with coronary artery diseases (CADs) undergoing percutaneous coronary intervention (PCI) by conducting a meta-analysis. DESIGN Systematic review and meta-analysis. DATA SOURCE PubMed, Embase, Wanfang, CNKI and VIP databases were searched from their inceptions to 19 June 2019. ELIGIBLE CRITERIA Studies investigating the value of baseline RDW for predicting all-cause mortality, cardiovascular mortality and major adverse cardiac events (MACEs) in patients with CAD undergoing PCI were included. DATA EXTRACTION AND SYNTHESIS Two authors independently extracted the data and evaluated the methodological quality using the Newcastle-Ottawa Scale. STATA V.12.0 software was applied to produce the forest plots using a random-effect model. RESULTS Twelve studies (13 articles) involving 17 113 patients were included and analysed. Comparison between the highest and lowest RDW category indicated that the pooled risk ratio (RR) was 1.77 (95% CI 1.32 to 2.37) for all-cause mortality, 1.70 (95% CI 1.25 to 2.32) for cardiovascular mortality and 1.62 (95% CI 1.21 to 2.18) for MACEs. The predictive effect of elevated RDW for all-cause mortality was stronger in the subgroup of patients without anaemia (RR 4.59; 95% CI 3.07 to 6.86) than with anaemia. CONCLUSIONS This meta-analysis indicated that elevated RDW was associated with higher risk of mortality and adverse cardiac events in patients with CAD undergoing PCI. The value of elevated RDW for predicting all-cause mortality appears to be stronger in patients without anaemia. RDW may be served as a promising prognostic biomarker in patients undergoing PCI.
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Affiliation(s)
- Donglai Bao
- Department of Cardiovascular disease, Yiwu Central Hospital, Yiwu, China
| | - Gaojiang Luo
- Department of Cardiovascular disease, Yiwu Central Hospital, Yiwu, China
| | - Fuqiang Kan
- Department of Cardiovascular disease, Yiwu Central Hospital, Yiwu, China
| | - Xiaoyan Wang
- Department of Cardiovascular disease, Yiwu Central Hospital, Yiwu, China
| | - Jinwei Luo
- Department of Cardiovascular disease, Yiwu Central Hospital, Yiwu, China
| | - Changhao Jiang
- Department of Cardiovascular disease, Yiwu Central Hospital, Yiwu, China
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11
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Cerşit S, Öcal L, Keskin M, Gürsoy MO, Kalçik M, Bayam E, Karaduman A, Uysal S, Uslu A, Küp A, Dereli S, Arslantaş U, Türkmen MM. Association of C-Reactive Protein-to-Albumin Ratio With the Presence and Progression of Abdominal Aortic Aneurysm. Angiology 2020; 72:153-158. [PMID: 32911951 DOI: 10.1177/0003319720954084] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Aortic dilatation due to inflammation may lead to an increase in C-reactive protein (CRP) levels. We investigated the possible relationship between CRP-to-albumin ratio (CAR) and presence and progression of abdominal aortic aneurysms (AAAs). The study included 150 patients previously diagnosed with AAA (diameter 40-54 mm) and 100 normal controls. Clinical and laboratory parameters and maximal cross-sectional AAA diameters (measured by computed tomography angiography) were obtained from all participants at baseline assessment as well as after 1 year for those with an AAA. The patients with AAA had significantly higher serum CAR compared with controls at baseline (P < .001). Increased serum CAR was found to be an independent predictor of the presence of AAA (odds ratio: 3.162, 95% CI: 1.690-5.126, P = .001) after multivariate logistic regression analysis. There was a significant increase in aortic diameter and CAR after 1 year in the patients with AAA (P < .001; P = .003); a significant correlation was found between changes in the diameter of AAAs and CAR (r = 0.414; P = .005). Serum CAR may be useful as an inflammatory biomarker for the presence and progression of AAA.
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Affiliation(s)
- Sinan Cerşit
- Department of Cardiology, Health Sciences University, 111350Koşuyolu Kartal Heart Training and Research Hospital, Istanbul, Turkey
| | - Lutfi Öcal
- Department of Cardiology, Health Sciences University, 111350Koşuyolu Kartal Heart Training and Research Hospital, Istanbul, Turkey
| | - Muhammed Keskin
- Department of Cardiology, Health Sciences University, Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
| | - Mustafa Ozan Gürsoy
- Department of Cardiology, Katip Çelebi University, Atatürk Training and Research Hospital, Izmir, Turkey
| | - Macit Kalçik
- Department of Cardiology, Health Sciences University, 111350Koşuyolu Kartal Heart Training and Research Hospital, Istanbul, Turkey
| | - Emrah Bayam
- Department of Cardiology, Health Sciences University, 111350Koşuyolu Kartal Heart Training and Research Hospital, Istanbul, Turkey
| | - Ahmet Karaduman
- Department of Cardiology, Health Sciences University, 111350Koşuyolu Kartal Heart Training and Research Hospital, Istanbul, Turkey
| | - Samet Uysal
- Department of Cardiology, Health Sciences University, 111350Koşuyolu Kartal Heart Training and Research Hospital, Istanbul, Turkey
| | - Abdulkadir Uslu
- Department of Cardiology, Health Sciences University, 111350Koşuyolu Kartal Heart Training and Research Hospital, Istanbul, Turkey
| | - Ayhan Küp
- Department of Cardiology, Health Sciences University, 111350Koşuyolu Kartal Heart Training and Research Hospital, Istanbul, Turkey
| | - Seçkin Dereli
- Department of Cardiology, Ordu University School of Medicine, Ordu, Turkey
| | - Uğur Arslantaş
- Department of Cardiology, Health Sciences University, 111350Koşuyolu Kartal Heart Training and Research Hospital, Istanbul, Turkey
| | - Mehmet Muhsin Türkmen
- Department of Cardiology, Health Sciences University, 111350Koşuyolu Kartal Heart Training and Research Hospital, Istanbul, Turkey
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12
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Xie JH, Zhu RR, Zhao L, Zhong YC, Zeng QT. Down-regulation and Clinical Implication of Galectin-9 Levels in Patients with Acute Coronary Syndrome and Chronic Kidney Disease. Curr Med Sci 2020; 40:662-670. [PMID: 32862376 DOI: 10.1007/s11596-020-2238-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 06/15/2020] [Indexed: 10/23/2022]
Abstract
In various autoimmune diseases, Galecin-9 (Gal-9) has been shown to regulate the T-cell balance by decreasing Th1 and Th17, while increasing the number of regulatory T cells (Tregs). However, the role of Gal-9 in the patients with acute coronary syndrome (ACS) and chronic kidney disease (CKD) remains unclear. This study aims to measure the Gal-9 levels in serum and peripheral blood mononuclear cells (PBMCs) in patients with ACS plus CKD and examine their clinical implication. The serum levels of Gal-9 were determined by enzyme-linked immunosorbent assay (ELISA), the expression levels of Gal-9, Tim-3, and Foxp3 mRNA in PBMCs were detected by real-time reverse transcription-polymerase chain reaction (RT-PCR), and the expression of Gal-9 on the surface of PBMCs and in PBMCs was analyzed by flow cytometry. Furthermore, the correlation of serum Gal-9 levels with anthropometric and biochemical variables in patients with ACS plus CKD was analyzed. The lowest levels of Gal-9 in serum and PBMCs were found in the only ACS group, followed by the ACS+CKD group, and the normal coronary artery (NCA) group, respectively. Serum Gal-9 levels were increased along with the progression of glomerular filtration rate (GFR) categories of G1 to G4. Additionally, serum Gal-9 levels were negatively correlated with high-sensitivity C-reactive protein (hs-CRP), estimated GFR (eGFR), and lipoprotein(a), but positively with creatinine, age, osmotic pressure, and blood urea nitrogen (BUN). Notably, serum Gal-9 was independently associated with hs-CRP, osmotic pressure, and lipoprotein(a). Furthermore, serum Gal-9 levels were elevated in patients with type 2 diabetes (T2DM) and impaired glucose tolerance (IGT) in ACS group. It was suggested that the levels of Gal-9 in serum and PBMCs were decreased in patients with simple ACS and those with ACS plus CKD, and hs-CRP, eGFR, osmotic pressure and T2DM may have an influence on serum Gal-9 levels.
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Affiliation(s)
- Jian-Hua Xie
- Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Rui-Rui Zhu
- Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Li Zhao
- Department of Gastroenterology, Hubei Provincial Hospital of Integrated Traditional Chinese and Western Medicine, Wuhan, 430022, China
| | - Yu-Cheng Zhong
- Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
| | - Qiu-Tang Zeng
- Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
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13
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Yildirim T, Kiris T, Avci E, Yildirim SE, Argan O, Safak Ö, Aktas Z, Toklu O, Esin FK. Increased Serum CRP-Albumin Ratio Is Independently Associated With Severity of Carotid Artery Stenosis. Angiology 2020; 71:740-746. [PMID: 32527139 DOI: 10.1177/0003319720926761] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Carotid artery stenosis (CAS), mainly caused by carotid atherosclerosis, is related to ischemic stroke. We investigated whether C-reactive protein (CRP) to albumin ratio (CAR) was associated with increased severity of carotid stenosis in patients undergoing carotid angiography. A total of 269 patients who were undergoing carotid angiography were included in this study. The patients were divided into 2 groups with respect to the severe CAS: group 1 (stenosis < 70%, n = 189) or group II (stenosis ≥ 70%, n = 80). C-reactive protein to albumin ratio was higher in group II compared to group I (0.56 ± 0.25 vs 0.14 ± 0.01, P < .001). The CAR (odds ratio [OR]: 1.051, 95%CI: 1.027-1.076, P < .001), neutrophil to lymphocyte ratio (NLR), and total cholesterol levels were independent predictors of severe CAS. The area under the receiver operating characteristic curve (area under the curve) for the CAR to predict severe CAS was 0.798 (95% CI: 0.741-0.854, P < .001). C-reactive to protein albumin ratio was an independent risk factor of severe CAS. Therefore, CAR might be considered a potential index in the severity of carotid artery disease.
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Affiliation(s)
- Tarik Yildirim
- Department of Cardiology, Balikesir University Medical School, Balikesir, Turkey
| | - Tuncay Kiris
- Department of Cardiology, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey
| | - Eyüp Avci
- Department of Cardiology, Balikesir University Medical School, Balikesir, Turkey
| | | | - Onur Argan
- Department of Cardiology, Balikesir University Medical School, Balikesir, Turkey
| | - Özgen Safak
- Department of Cardiology, Balikesir University Medical School, Balikesir, Turkey
| | - Zihni Aktas
- Department of Cardiology, Balikesir Atatürk City Hospital, Balikesir, Turkey
| | - Oguzhan Toklu
- Department of Cardiology, Private Lokman Hekim Esnaf Hospital, Fethiye, Muğla, Turkey
| | - Fatma Kayaalı Esin
- Department of Cardiology, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey
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14
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Süleymanoğlu M, Burak C, Gümüşdağ A, Yesin M, Rencüzoğulları İ, Karabağ Y, Çağdaş M, Çap M. Assessment of the relation between C-reactive protein to albumin ratio and the severity and complexity of peripheral arterial disease. Vascular 2020; 28:731-738. [DOI: 10.1177/1708538120925952] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Background Peripheral arterial disease is associated with increased cardiovascular mortality and morbidity. C-reactive protein and albumin are biomarkers of inflammation and malnutrition that play key roles in the pathophysiological pathways involved in the progression of atherosclerosis and peripheral arterial disease. In this study, we aimed to assess the relationship between C-reactive protein to albumin ratio and the suprapopliteal peripheral arterial disease severity and complexity as assessed by TransAtlantic Inter-Society Consensus-II (TASC-II) classification. Method Our study enrolled 224 consecutive patients referred for peripheral angiography with the clinical features of possible peripheral arterial disease at a tertiary care center between January 2016 and September 2019. Level of disease and lesion characteristics were defined with reference to angiographic findings according to the TASC-II classification. Results C-reactive protein/albumin ratio levels were significantly higher in TASC-II class C and D than in TASC-II class B patients with a median level of 1.8 to 2.1 vs 1.4, respectively ( p = 0.018). In multivariate regression analysis, C-reactive protein to albumin ratio remained an independent predictor of severe peripheral arterial disease. The predictive performance of C-reactive protein to albumin ratio, C-reactive protein, and albumin were compared by Receiver Operating Characteristic curve analysis. C-reactive protein to albumin ratio surpassed C-reactive protein and albumin in predicting peripheral arterial disease severity and complexity. A level of C-reactive protein to albumin ratio > 0.14 predicted a higher grade of suprapopliteal TASC-II class with sensitivity and specificity of 68.2% and 56.0%, respectively. Conclusion C-reactive protein to albumin ratio was strongly associated with peripheral arterial disease severity and complexity, as assessed by TASC-II classification. Also, C-reactive protein to albumin ratio was found to be a more accurate marker than C-reactive protein and albumin alone in predicting more severe and complex lesions in patients with peripheral arterial disease.
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Affiliation(s)
| | - Cengiz Burak
- Department of Cardiology, M.D. Kafkas University Medical Faculty, Kars, Turkey
| | - Ayça Gümüşdağ
- Department of Cardiology, M.D. Kafkas University Medical Faculty, Kars, Turkey
| | - Mahmut Yesin
- Department of Cardiology, M.D. Kafkas University Medical Faculty, Kars, Turkey
| | | | - Yavuz Karabağ
- Department of Cardiology, M.D. Kafkas University Medical Faculty, Kars, Turkey
| | - Metin Çağdaş
- Department of Cardiology, M.D. Kafkas University Medical Faculty, Kars, Turkey
| | - Murat Çap
- Department of Cardiology, M.D. University of Health Sciences, Diyarbakir Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey
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15
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Kul S, Konus AH, Dursun I, Turan T, Cirakoglu OF, Sahin S, Karal H, Akyuz AR. Anterior Tragal Crease Is Associated With SYNTAX Score in Non-ST-Segment Elevation Myocardial Infarction. Angiology 2020; 71:793-798. [PMID: 32347104 DOI: 10.1177/0003319720920143] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The main aim of this study was to investigate the relation between anterior tragal crease (ATC) and coronary artery lesion complexity and severity assessed using the SYNTAX score (SXscore) in patients with non-ST-segment elevation myocardial infarction (NSTEMI). A total of 121 patients with a first-time diagnosis of NSTEMI were consecutively enrolled. ATC was defined as ≥1 crease that was close to the tragus and descended anteriorly. SXscore was calculated using the SXscore algorithm. The SXscore was higher in the ATC-positive group than in the ATC-negative group (11.85 ± 8.20 vs 7.52 ± 6.38, P = .003). In the univariate analysis, hemoglobin (male: 11.7-17.4 g/dL, female: 11.7-16.1 g/dL; P = .006), diabetes mellitus (P = .031), current smoking (P = .022), and presence of ATC (P = .022) were significantly associated with increased SXscore. Multivariate analysis revealed ATC (95% confidence interval [CI]: 1.313-7.800, P = .011), current smoking (95% CI: 2.034-13.893, P = .001), and hemoglobin (95% CI: 0.433-0.822, P = .002) as independent determinants of increased SXscore. Anterior tragal crease is easily detected by physical examination. Presence of ATC in patients with NSTEMI may be a warning signal of complexity and severity of coronary artery disease (CAD).
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Affiliation(s)
- Selim Kul
- Department of Cardiology, Saglik Bilimleri Universitesi, University of Health Sciences, 420101Trabzon Ahi Evren Cardiovascular and Thoracic Surgery Research and Application Center, Trabzon, Turkey
| | - Ali Hakan Konus
- Department of Cardiology, Saglik Bilimleri Universitesi, University of Health Sciences, 420101Trabzon Ahi Evren Cardiovascular and Thoracic Surgery Research and Application Center, Trabzon, Turkey
| | - Ihsan Dursun
- Department of Cardiology, Saglik Bilimleri Universitesi, University of Health Sciences, 420101Trabzon Ahi Evren Cardiovascular and Thoracic Surgery Research and Application Center, Trabzon, Turkey
| | - Turhan Turan
- Department of Cardiology, Saglik Bilimleri Universitesi, University of Health Sciences, 420101Trabzon Ahi Evren Cardiovascular and Thoracic Surgery Research and Application Center, Trabzon, Turkey
| | - Omer Faruk Cirakoglu
- Department of Cardiology, Saglik Bilimleri Universitesi, University of Health Sciences, 420101Trabzon Ahi Evren Cardiovascular and Thoracic Surgery Research and Application Center, Trabzon, Turkey
| | - Sinan Sahin
- Department of Cardiology, Saglik Bilimleri Universitesi, University of Health Sciences, 420101Trabzon Ahi Evren Cardiovascular and Thoracic Surgery Research and Application Center, Trabzon, Turkey
| | - Huseyin Karal
- Department of Cardiology, Saglik Bilimleri Universitesi, University of Health Sciences, 420101Trabzon Ahi Evren Cardiovascular and Thoracic Surgery Research and Application Center, Trabzon, Turkey
| | - Ali Riza Akyuz
- Department of Cardiology, Saglik Bilimleri Universitesi, University of Health Sciences, 420101Trabzon Ahi Evren Cardiovascular and Thoracic Surgery Research and Application Center, Trabzon, Turkey
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16
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Altın C, Yılmaz M, Gezmiş E, Müderrisoğlu H. Koroner arter kalsiyum skoru kırmızı kan hücresi dağılım genişliği ve ortalama trombosit hacmi ile ilişkilidir. EGE TIP DERGISI 2019. [DOI: 10.19161/etd.465086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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17
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IL-37 Plays a Beneficial Role in Patients with Acute Coronary Syndrome. Mediators Inflamm 2019; 2019:9515346. [PMID: 31686988 PMCID: PMC6803729 DOI: 10.1155/2019/9515346] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Revised: 08/10/2019] [Accepted: 08/22/2019] [Indexed: 12/13/2022] Open
Abstract
Background Interleukin-37 (IL-37) acts as an inhibitor of innate and adaptive immunity. However, the exact role of IL-37 in the patients with acute coronary syndrome (ACS) remains to be elucidated. Methods Patients were classified into 4 groups: normal coronary artery (NCA), stable angina (SA), unstable angina (UA), and acute myocardial infarction (AMI). The circulating Treg, Th1, and Th17 frequencies were measured. The effect of IL-37 on stimulated peripheral blood mononuclear cells (PBMCs) and the influence of IL-37 on DCs were explored. In addition, the role of IL-37-treated tDCs on Treg cell expansion and the stability of these tDCs were also tested. Results Our results showed that the circulating Treg frequencies were decreased, while Th1 and Th17 frequencies were increased in ACS patients, and that IL-37 expanded Tregs but suppressed Th1 and Th17 cells in activated PBMCs derived from ACS patients. Of note, IL-37-treated human DCs obtained a tolerogenic phenotype, and such tDCs promoted expansion of Tregs and decreased the Th1 and Th17 populations when cocultured with CD4+ T cells. Interestingly, IL-37-treated DCs from patients with ACS are phenotypically and functionally comparable to IL-37-treated DCs from NCA patients, and tolerogenic properties of IL-37-treated DCs were highly stable. Conclusion In conclusion, our results reveal a beneficial role of IL-37 in the patients with ACS and suggest that autologous IL-37-treated tDCs may be a novel therapeutic strategy for the patients with ACS.
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18
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Demir V, Yılmaz S, Ede H, Turan Y. Correlation of Resting Heart Rate with the Severity and Complexity of Coronary Artery Disease: A Single-Center Retrospective Study. Int J Prev Med 2019; 10:104. [PMID: 31360351 PMCID: PMC6592136 DOI: 10.4103/ijpvm.ijpvm_347_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 01/21/2019] [Indexed: 11/04/2022] Open
Abstract
Background We aimed to explore the association between resting heart rate (RHR) and the severity and complexity of atherosclerosis in coronary artery disease (CAD). Methods Clinical and laboratory data of 388 patients who underwent coronary angiography were evaluated retrospectively. SYNTAX and Gensini scores were calculated based on angiographic findings. These scores which indicate the severity of atherosclerosis was calculated for all the patients. Patients were divided into three main groups according to RHR. Group 1 composed of patients with RHR ≤70 (n = 217), group 2 composed of patients with RHR between 70 and 89 (n = 133), and group 3 composed of patients with RHR ≥90 beats per min (bpm) (n = 38). Gensini and SYNTAX score values of the three study groups were compared. Also, Gensini score was tested for whether it showed a positive correlation with RHR and SYNTAX scores. Results All patients had an average age of 61.3 years, and the mean for RHR was 72 bpm. Mean Gensini score in the general CAD population was 24.4 ± 22.5, and mean SYNTAX score was 13.6 ± 8.1 points. The Gensini and Syntax score values of the group 3 were significantly higher than that of the other two groups (59.8 ± 31.2, P < 0.001 and 26.0 ± 6.5, P < 0.001, respectively). There was a significant correlation with Gensini score and RHR, SYNTAX score, C-reactive protein (CRP), and left ventricular ejection fraction [(r = 0.725, P < 0.001), (r = 0.680, P < 0.001), (r = 0.543, P < 0.001), (r = -0.224, P < 0.001), respectively]. Conclusions RHR is an effective easily available marker for the assessment of severity and complexity of CAD.
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Affiliation(s)
- Vahit Demir
- Department of Cardiology, Yozgat Bozok University, Yozgat, Turkey
| | - Samet Yılmaz
- Department of Cardiology, Yozgat State Hospital, Yozgat, Turkey
| | - Huseyin Ede
- Department of Cardiology, Yozgat Bozok University, Yozgat, Turkey
| | - Yasar Turan
- Department of Cardiology, Yozgat Bozok University, Yozgat, Turkey
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19
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Nejati P, Naeimipour S, Salehi A, Shahbazi M. Association of tumor necrosis factor-alpha gene promoter polymorphism and its mRNA expression level in coronary artery disease. Meta Gene 2018. [DOI: 10.1016/j.mgene.2018.08.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
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20
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Correlation of changes in the red blood cell distribution width with the response to continuous positive airway pressure in patients with obstructive sleep apnea. Sleep Biol Rhythms 2018. [DOI: 10.1007/s41105-018-0191-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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21
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Clinical utility of circulating interleukin-6 concentrations in the detection of functionally relevant coronary artery disease. Int J Cardiol 2018; 275:20-25. [PMID: 30340850 DOI: 10.1016/j.ijcard.2018.10.029] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 09/06/2018] [Accepted: 10/08/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND Inflammation plays a major role in the pathogenesis of coronary artery disease (CAD). METHODS We hypothesized, that quantifying inflammation by measuring circulating interleukin-6 concentrations help in the diagnosis and/or prediction of functionally relevant CAD. Among consecutive patients with symptoms suggestive of CAD, functionally relevant CAD was adjudicated in two domains: first, diagnosis according to myocardial perfusion single photon emission tomography (MPI-SPECT) and coronary angiography; second, cardiovascular death and all-cause death during 2-years follow-up. Adjudication was done blinded to the interleukin-6 concentrations. RESULTS Among 1553 patients, symptoms were adjudicated to be causally related to CAD in 43% (665/1553). Interleukin-6 concentrations were higher in patients with functionally relevant CAD as compared to those without (1.56 pg/mL versus 1.30 pg/mL, p < 0.001), but overall had only low-to-modest diagnostic accuracy (area under the curve [AUC]: 0.57, 95%CI 0.55-0.61) and were no independent predictor of functionally relevant CAD after multivariable adjustment (p = 0.068). Interleukin-6 concentrations had moderate-to-high accuracy in the prediction of cardiovascular death (AUC 0.75, 95%CI 0.69-0.82) and all-cause death (AUC 0.72, 95%CI 0.66-0.78) at 2-years, and remained a significant predictor after multivariable adjustment (p < 0.001). Compared to patients with interleukin-6 concentrations below the median (1.41 pg/mL), patients with concentrations above the median had a significantly higher cumulative incidence of cardiovascular death (1% vs. 4%, log-rank p < 0.001) and all-cause death (2% vs. 8%, log-rank p < 0.001) at 2 years. CONCLUSION Interleukin-6 concentrations are strong and independent predictors of cardiovascular death and all-cause death.
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Karabağ Y, Çağdaş M, Rencuzogullari I, Karakoyun S, Artaç İ, İliş D, Atalay E, Yesin M, Gürsoy MO, Halil Tanboğa I. Relationship between C-reactive protein/albumin ratio and coronary artery disease severity in patients with stable angina pectoris. J Clin Lab Anal 2018; 32:e22457. [PMID: 29667724 PMCID: PMC6816976 DOI: 10.1002/jcla.22457] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 03/27/2018] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Syntax score (SS), which is an angiographic tool used in grading the complexity of coronary artery disease (CAD), has prognostic importance in coronary artery disease (CAD) and provides important information regarding selection of revascularization strategy. C-reactive protein (CRP) and albumin are indicators of inflammation, and high levels of them are associated with high SS. We aimed to investigate whether baseline CRP to albumin ratio C-Reactive Protein/Albumin Ratio (CAR), an easily available and novel inflammatory marker, is associated with SS. METHOD A total 403 consecutive patients with stabile angina pectoris, who underwent coronary angiography for suspected CAD from January 2015 to June 2016, were classified into two groups, low SS (≤22) and intermediate-high SS (>22). RESULTS C-Reactive Protein/Albumin Ratio was significantly higher in patients with intermediate-high SS group (P < .001). In multivariate regression analysis, CAR remained an independent predictor of intermediate-high SS group together with hypertension and LDL. The predictive performance of CAR, CRP, and albumin was compared by ROC curve analysis. CAR surpassed CRP and albumin in predicting intermediate-high SS group. CAR >6.3 predicted an intermediate-high SS with sensitivity and specificity of 86.8% and 43.4%, respectively. CONCLUSION C-Reactive Protein/Albumin Ratio was more tightly associated with the complexity and severity of CAD than CRP and albumin alone and was found to be an independent predictor for intermediate-high SS group.
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Affiliation(s)
- Yavuz Karabağ
- Department of CardiologyKafkas University Medical FacultyKarsTurkey
| | - Metin Çağdaş
- Department of CardiologyKafkas University Medical FacultyKarsTurkey
| | | | | | - İnanç Artaç
- Department of CardiologyKafkas University Medical FacultyKarsTurkey
| | - Doğan İliş
- Department of CardiologyKafkas University Medical FacultyKarsTurkey
| | - Eray Atalay
- Department of Internal MedicineKafkas University Medical FacultyKarsTurkey
| | - Mahmut Yesin
- Department of CardiologyKars Harakani State HospitalKarsTurkey
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Guaricci AI, Pontone G, Fusini L, De Luca M, Cafarelli FP, Guglielmo M, Baggiano A, Beltrama V, Muscogiuri G, Mushtaq S, Conte E, Guglielmi G, Andreini D, Brunetti ND, Di Biase M, Bartorelli AL, Pepi M. Additional value of inflammatory biomarkers and carotid artery disease in prediction of significant coronary artery disease as assessed by coronary computed tomography angiography. Eur Heart J Cardiovasc Imaging 2018; 18:1049-1056. [PMID: 27742738 DOI: 10.1093/ehjci/jew173] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Accepted: 07/22/2016] [Indexed: 12/13/2022] Open
Abstract
Aims To evaluate the relationship between an incremental model including cardiovascular risk factors, carotid disease, and inflammatory biomarkers to predict the presence of obstructive coronary artery disease (CAD). Methods and results A total of 134 consecutive and asymptomatic intermediate-risk patients (mean age 61 ± 9 years, 52% men) were enrolled. Each subject underwent circulating levels assessment of interleukin (IL)-2r, IL-6, IL-8, IL-10, high-sensitivity C-reactive protein (hs-CRP) and carotid and coronary artery evaluation using carotid ultrasound and coronary computed tomography angiography (CCTA), respectively. Carotid disease was diagnosed in 71 (53%) patients. Obstructive and multi-vessel CAD were found in 50 (37%) and 18 (14%) patients, respectively. Patients in whom CCTA showed multi-vessel CAD had a higher rate of carotid disease (89 vs. 46%, P = 0.001) and increased values of all interleukins when compared with patients without multi-vessel obstructive CAD. The univariate and multivariate analysis showed that male gender, diabetes, carotid disease, and IL-6 were independently associated with obstructive CAD. At receiver operating characteristic curve analysis, the multivariate model (including male gender, carotid disease, IL-6 > 5.9 pg/mL, and diabetes) showed the highest area under the curve for prediction of obstructive CAD, multi-vessel CAD, and high-risk plaque defined as mixed and/or remodelled plaque when compared with all other models (P < 0.001). Conclusion Among asymptomatic intermediate-risk patients, the presence of increased IL6 levels in addition to traditional risk factors (male gender with diabetes) and carotid artery disease predicts higher rates of obstructive CAD and it could be of help to identify which subset of asymptomatic patients could be referred to CCTA for screening.
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Affiliation(s)
- Andrea Igoren Guaricci
- Cardiology Unit, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy.,Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | | | - Laura Fusini
- Centro Cardiologico Monzino, IRCCS, Milan, Italy
| | - Maria De Luca
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Francesco Pio Cafarelli
- Department of Radiology, Scientific Institute 'Casa Sollievo della Sofferenza' Hospital, Foggia, Italy
| | | | | | | | | | | | | | - Giuseppe Guglielmi
- Department of Radiology, Scientific Institute 'Casa Sollievo della Sofferenza' Hospital, Foggia, Italy
| | - Daniele Andreini
- Centro Cardiologico Monzino, IRCCS, Milan, Italy.,Department of Cardiovascular Sciences and Community Health, University of Milan, Milan, Italy
| | | | - Matteo Di Biase
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Antonio L Bartorelli
- Centro Cardiologico Monzino, IRCCS, Milan, Italy.,Department of Biomedical and Clinical Sciences 'Luigi SACCO', University of Milan, Milan, Italy
| | - Mauro Pepi
- Centro Cardiologico Monzino, IRCCS, Milan, Italy
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Baldassarre MPA, Andersen A, Consoli A, Knop FK, Vilsbøll T. Cardiovascular biomarkers in clinical studies of type 2 diabetes. Diabetes Obes Metab 2018; 20:1350-1360. [PMID: 29419909 DOI: 10.1111/dom.13247] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Revised: 02/01/2018] [Accepted: 02/04/2018] [Indexed: 01/08/2023]
Abstract
When planning cardiovascular (CV) studies in type 2 diabetes (T2D), selection of CV biomarkers is a complex issue. Because the pathophysiology of CV disease (CVD) in T2D is multifactorial, ideally, the selected CV biomarkers should cover all aspects of the known pathophysiology of the disease. This will allow the researcher to distinguish between effects on different aspects of the pathophysiology. To this end, we discuss a host of biomarkers grouped according to their role in the pathogenesis of CVD, namely: (1) cardiac damage biomarkers; (2) inflammatory biomarkers; and (3) novel biomarkers (oxidative stress and endothelial dysfunction biomarkers). Within each category we present the best currently validated biomarkers, with special focus on the population of interest (people with T2D). For each individual biomarker, we discuss the physiological role, validation in the general population and in people with T2D, analytical methodology, modifying factors, effects of glucose-lowering drugs, and interpretation. This approach will provide clinical researchers with the information necessary for planning, conducting and interpreting results from clinical trials. Furthermore, a systematic approach to selection of CV biomarkers in T2D research will improve the quality of future research.
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Affiliation(s)
- Maria P A Baldassarre
- Department of Medicine and Aging Sciences, G. d'Annunzio University, Chieti, Italy
- Aging and Translational Medicine Research Center, CeSI-Met, G. d'Annunzio' University, Chieti, Italy
- Clinical Metabolic Physiology, Steno Diabetes Center Copenhagen, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - Andreas Andersen
- Clinical Metabolic Physiology, Steno Diabetes Center Copenhagen, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - Agostino Consoli
- Department of Medicine and Aging Sciences, G. d'Annunzio University, Chieti, Italy
- Aging and Translational Medicine Research Center, CeSI-Met, G. d'Annunzio' University, Chieti, Italy
| | - Filip K Knop
- Clinical Metabolic Physiology, Steno Diabetes Center Copenhagen, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Tina Vilsbøll
- Clinical Metabolic Physiology, Steno Diabetes Center Copenhagen, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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25
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Pickering RJ, Rosado CJ, Sharma A, Buksh S, Tate M, de Haan JB. Recent novel approaches to limit oxidative stress and inflammation in diabetic complications. Clin Transl Immunology 2018; 7:e1016. [PMID: 29713471 PMCID: PMC5905388 DOI: 10.1002/cti2.1016] [Citation(s) in RCA: 103] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 03/16/2018] [Accepted: 03/20/2018] [Indexed: 12/25/2022] Open
Abstract
Diabetes is considered a major burden on the healthcare system of Western and non‐Western societies with the disease reaching epidemic proportions globally. Diabetic patients are highly susceptible to developing micro‐ and macrovascular complications, which contribute significantly to morbidity and mortality rates. Over the past decade, a plethora of research has demonstrated that oxidative stress and inflammation are intricately linked and significant drivers of these diabetic complications. Thus, the focus now has been towards specific mechanism‐based strategies that can target both oxidative stress and inflammatory pathways to improve the outcome of disease burden. This review will focus on the mechanisms that drive these diabetic complications and the feasibility of emerging new therapies to combat oxidative stress and inflammation in the diabetic milieu.
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Affiliation(s)
- Raelene J Pickering
- Department of Diabetes Central Clinical School Monash University Melbourne VIC Australia
| | - Carlos J Rosado
- Department of Diabetes Central Clinical School Monash University Melbourne VIC Australia
| | - Arpeeta Sharma
- Oxidative Stress Laboratory Basic Science Domain Baker Heart and Diabetes Institute Melbourne VIC Australia
| | - Shareefa Buksh
- Oxidative Stress Laboratory Basic Science Domain Baker Heart and Diabetes Institute Melbourne VIC Australia
| | - Mitchel Tate
- Heart Failure Pharmacology Basic Science Domain Baker Heart and Diabetes Institute Melbourne VIC Australia
| | - Judy B de Haan
- Oxidative Stress Laboratory Basic Science Domain Baker Heart and Diabetes Institute Melbourne VIC Australia
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Medical significance of simultaneous application of red blood cell distribution width (RDW) and neopterin as diagnostic/prognostic biomarkers in clinical practice. Pteridines 2017. [DOI: 10.1515/pterid-2017-0021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Abstract
In our individual and collaborative studies, we have played a part in pioneering investigations on the usefulness of biomarkers – red blood cell distribution width (RDW) and neopterin. This mini review includes historical data on the topic and is related to the first contributions in this field, as well as to the possibilities for further improvement and simultaneous application of RDW and neopterin measurements in the prevention, prognosis and treatment of a great number of socially important disease conditions (arterial, cardiovascular, brain vascular, peripheral artery diseases, inflammations, autoimmune states, cancers and leukemias, addictions, etc.). When comparing the results obtained with the immunobiochemical biomarker neopterin with RDW, they are reported to be very similar as independent predictors of the same pathological states in the human body although their biomedical origins are very different. Both the parameters were until now successfully, but only separately used in medical practice. The combined use of these two biomarkers can shed some more light on their interrelationships and provide some clues as to how the interaction between immune system activation and red blood cells biology are intertwined.
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27
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Relation of presystolic wave on doppler examination to syntax score in patients with acute myocardial infarction. Int J Cardiovasc Imaging 2017; 34:569-576. [DOI: 10.1007/s10554-017-1270-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Accepted: 11/04/2017] [Indexed: 12/14/2022]
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Karabakan M, Bozkurt A, Akdemir S, Gunay M, Keskin E. Significance of serum endothelial cell specific molecule-1 (Endocan) level in patients with erectile dysfunction: a pilot study. Int J Impot Res 2017; 29:175-178. [PMID: 28424502 DOI: 10.1038/ijir.2017.19] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2016] [Revised: 02/25/2017] [Accepted: 03/29/2017] [Indexed: 12/13/2022]
Abstract
This study aimed to measure the serum endocan level of patients with erectile dysfunction (ED) and to investigate the possible association between the Endothelial-specific molecule-1 (Endocan) level and ED. Twenty healthy and sixty-four male patients included in the study were divided into four groups: severe ED (19 patients), moderate ED (24 patients), mild ED (21 patients) and control group (20 healthy men). The erectile function of all the patients was evaluated using the International Index of Erectile Function-5 (IIEF-5) questionnaire. The body mass index (BMI) of each participant was determined, together with levels of fasting blood glucose, total testosterone, low- and high-density lipoprotein cholesterol, triglyceride and endocan in serum samples. No significant difference was found between the three ED groups and the control group in terms of the mean age, BMI and the levels of cholesterol and fasting blood glucose (P>0.05). The mean serum endocan level was found to 1.076±0.5, 0.674±0.40 and 0.671±0.3 ng ml-1 in the severe, moderate and mild ED groups, respectively. This indicated that the highest value was obtained from the severe ED group, and the difference between the severe ED group and the other groups was statistically significant. In the control group, the serum endocan level was 0.73±0.46 ng ml-1, which was significantly higher compared to the moderate and mild ED groups (P<0.05). The significant difference between the control and ED groups in terms of the serum endocan level can assist in the evaluation of endothelial pathologies in the etiology ED.
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Affiliation(s)
- M Karabakan
- Department of Urology, Mersin Toros State Hospital, Mersin, Turkey
| | - A Bozkurt
- Department of Urology, Erzincan University, Mengucek Gazi Research and Training Hospital, Erzincan, Turkey
| | - S Akdemir
- Department of Urology, Faculty of Medicine, İzmir University, İzmir, Turkey
| | - M Gunay
- Department of Chemistry, Erzincan University Mengucek Gazi Research and Training Hospital, Erzincan, Turkey
| | - E Keskin
- Department of Urology, Erzincan University, Mengucek Gazi Research and Training Hospital, Erzincan, Turkey
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Yarlioglues M, Kurtul A. Association of red cell distribution width with noninfarct-related artery-chronic total occlusion in acute myocardial infarction patients. Biomark Med 2017; 11:255-263. [DOI: 10.2217/bmm-2016-0255] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Objective: The presence of chronic total occlusion (CTO) in noninfarct-related artery (non-IRA) is an independent predictor of mortality in acute myocardial infarction (AMI). We investigated whether red cell distribution width (RDW) levels are associated with presence of non-IRA-CTO in AMI (ST-elevation myocardial infarction [STEMI] and non-STEMI). Patients and methods: Patients (n = 858) were categorized into three groups: single vessel disease, multivessel disease (MVD) without CTO and MVD with CTO. Results: MVD with CTO group had higher RDW levels than single vessel disease and MVD without CTO groups (14.87 ± 1.09% vs 13.82 ± 1.01% and 13.87 ± 0.87%, respectively, p < 0.001). In-hospital mortality was also higher in patients with MVD with CTO (p < 0.001). On multivariate analysis, RDW (odds ratio [OR]: 1.761; p < 0.001), age (OR: 1.04; p < 0.001), creatinine (OR: 3.524; p = 0.027), current smoker (OR: 0.489; p = 0.022), hemoglobin (OR: 0.826; p = 0.044), and non-STEMI (OR: 3.065; p < 0.001) were predictors of occurrence of non-IRA-CTO. Conclusion: Increased RDW is independently associated with presence of non-IRA-CTO in AMI patients.
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Affiliation(s)
- Mikail Yarlioglues
- Department of Cardiology, Ankara Education & Research Hospital, Ankara, Turkey
| | - Alparslan Kurtul
- Department of Cardiology, Ankara Education & Research Hospital, Ankara, Turkey
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30
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An overall and dose-response meta-analysis of red blood cell distribution width and CVD outcomes. Sci Rep 2017; 7:43420. [PMID: 28233844 PMCID: PMC5324076 DOI: 10.1038/srep43420] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Accepted: 01/24/2017] [Indexed: 01/04/2023] Open
Abstract
Red blood cell distribution width (RDW) is the coefficient of variation of red blood cell size, considered to be associated with cardiovascular disease (CVD). This study aimed to comprehensively synthesize previous studies on RDW and CVD outcomes through an overall and dose-response meta-analysis. PubMed, Embase and Web of Science were searched systematically for English and Chinese language publications up to November 30, 2015. We extracted data from publications matching our inclusion criteria for calculating pooled hazard ratio (HR), which was used to assess prognostic impact of RDW on CVD. Twenty-seven articles, consisting of 28 studies and 102,689 participants (mean age 63.9 years, 63,703 males/36,846 females, 2,140 gender-unmentioned subjects) were included in the present meta-analysis. The pooled HRs are 1.12 (95% CI = 1.09-1.15) for the association of all-cause mortality (ACM) per 1% increase of RDW, 1.12(95% CI = 1.08-1.17) for major adverse cardiac events (MACEs) per 1% increase of RDW. A dose-response curve relating RDW increase to its effect on CVD outcomes was established (pcurve < 0.001). For every 1-unit increase of RDW, there is an increased risk of occurrence of ACM (pooled HR = 1.03, 95% CI = 1.02-1.04) and MACEs (pooled HR = 1.04, 95% CI = 1.01-1.06). This study indicates RDW may be a prognostic indicator for CVD outcomes.
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Uysal HB, Dağlı B, Akgüllü C, Avcil M, Zencir C, Ayhan M, Sönmez HM. Blood count parameters can predict the severity of coronary artery disease. Korean J Intern Med 2016; 31:1093-1100. [PMID: 27052265 PMCID: PMC5094927 DOI: 10.3904/kjim.2015.199] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 08/22/2015] [Accepted: 09/22/2015] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND/AIMS Because of the inflammatory nature of coronary artery disease (CAD), both platelets and white blood cells have been investigated for years. The aim of this study was to investigate the relationships between some prominently hematologic blood count parameters (mean platelet volume [MPV], neutrophil to lymphocyte ratio [NLR]) and the severity of CAD by using Gensini scores. METHODS A total of 194 patients, who had undergone coronary angiography, enrolled in this study. The control group consisted of 42 patients who had normal coronary arteries. Remaining CAD patients were divided into two groups according to their Gensini scores. RESULTS NLR and MPV were higher in the severe atherosclerosis group compared with the mild atherosclerosis group (p = 0.007, p = 0.005, respectively). The Gensini score showed significant correlations with NLR (r = 0.20, p = 0.011), MPV (r = 0.23, p = 0.004) and high density lipoprotein cholesterol (r = -0.161, p = 0.047). Using a cut-off level of 2.54, NLR predicted severe atherosclerosis with a sensitivity of 74% and specificity of 53% (area under curve [AUC], 0.627; 95% confidence interval [CI], 0.545 to 0.704; p = 0.004). MPV values above 10.4 predicted severe atherosclerosis with a sensitivity of 39% and specificity of 90% (AUC, 0.631; 95% CI, 0.549 to 0.708; p = 0.003). In the multiple logistic regression analysis, high levels of NLR (odds ratio [OR], 1.450; 95% CI, 1.080 to 1.945; p = 0.013) and MPV (OR, 1.622; 95% CI, 1.147 to 2.295; p = 0.006) were found to be independent predictors of severe atherosclerosis. CONCLUSIONS Our study suggests that both NLR and MPV are predictors of severe atherosclerosis and may be used for the prediction and identification of cardiac risks in CAD patients.
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Affiliation(s)
- Hilal Bektas Uysal
- Department of Internal Medicine, Adnan Menderes University School of Medicine, Aydin, Turkey
- Correspondence to Hilal Bektas Uysal, M.D. Department of Internal Medicine, Adnan Menderes University School of Medicine, 090100, Aytepe, Aydin, Turkey Tel: +90-256-444-1256 Fax: +90-256-213-6064 E-mail:
| | - Bekir Dağlı
- Department of Emergency, Adnan Menderes University School of Medicine, Aydin, Turkey
| | - Cağdaş Akgüllü
- Department of Cardiology, Adnan Menderes University School of Medicine, Aydin, Turkey
| | - Mücahit Avcil
- Department of Emergency, Adnan Menderes University School of Medicine, Aydin, Turkey
| | - Cemil Zencir
- Department of Cardiology, Adnan Menderes University School of Medicine, Aydin, Turkey
| | - Mediha Ayhan
- Department of Endocrinology, Adnan Menderes University School of Medicine, Aydin, Turkey
| | - Hulki Meltem Sönmez
- Department of Internal Medicine, Adnan Menderes University School of Medicine, Aydin, Turkey
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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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Serum Galectin-9 Levels Are Associated with Coronary Artery Disease in Chinese Individuals. Mediators Inflamm 2015; 2015:457167. [PMID: 26663989 PMCID: PMC4667018 DOI: 10.1155/2015/457167] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2015] [Revised: 09/10/2015] [Accepted: 09/13/2015] [Indexed: 01/12/2023] Open
Abstract
Background. Recently, several studies suggest that galectin-9 (Gal-9) might play a pivotal role in the pathogenesis of autoimmune diseases. However, the exact role of Gal-9 in atherosclerosis remains to be elucidated. Methods. Serum Gal-9, high-sensitivity C-reactive protein (hs-CRP), interferon- (IFN-) γ, interleukin- (IL-) 4, IL-17, and transforming growth factor- (TGF-) β1 were measured. The effect of Gal-9 on peripheral blood mononuclear cells (PBMC) was investigated in patients with normal coronary artery (NCA). Results. The lowest level of Gal-9 was found in the ST-segment elevation myocardial infarction (STEMI) group, followed by the non-ST-segment elevation ACS (NSTEACS), the NCA, and the stable angina pectoris (SAP) groups, respectively. Additionally, Gal-9 was found to be independently associated with hs-CRP, lipoprotein(a), and creatinine. Notably, Gal-9 was also noted to be an independent predictor of the Gensini score. Moreover, Gal-9 suppressed T-helper 17 (Th17) and expanded regulatory T cells (Tregs), resulting in decreased IL-17 production and increased secretion of TGF-β1. Conclusions. Serum Gal-9 is associated with not only coronary artery disease (CAD), but also the severity of coronary arteries stenosis. Gal-9 can expand Tregs and suppress Th17 development in activated PBMC, implying that Gal-9 has the potential to dampen the development of atherosclerosis and may be a new therapy for CAD.
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Zhao H, Liu H, Chai L, Xu P, Hua L, Guan XY, Duan B, Huang YL, Li YS. Plasma α1-antitrypsin: a neglected predictor of angiographic severity in patients with stable angina pectoris. Chin Med J (Engl) 2015; 128:755-61. [PMID: 25758268 PMCID: PMC4833978 DOI: 10.4103/0366-6999.152485] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Background: As an acute phase protein, α1-antitrypsin (AAT) has been extensively studied in acute coronary syndrome, but it is unclear whether a relationship exists between AAT and stable angina pectoris (SAP). The purpose of the present study was to investigate the association between AAT plasma levels and SAP. Methods: Overall, 103 SAP patients diagnosed by coronary angiography and clinical manifestations and 118 control subjects matched for age and gender were enrolled in this case-control study. Plasma levels of AAT, high-sensitivity C-reactive protein (hsCRP), lipid profiles and other clinical parameters were assayed for all participants. The severity of coronary lesions was evaluated based on the Gensini score (GS) assessed by coronary angiography. Results: Positively correlated with the GS (r = 0.564, P < 0.001), the plasma AAT level in the SAP group was significantly higher than that in the control group (142.08 ± 19.61 mg/dl vs. 125.50 ± 19.67 mg/dl, P < 0.001). The plasma AAT level was an independent predictor for both SAP (odds ratio [OR] = 1.037, 95% confidence interval [CI]: 1.020–1.054, P < 0.001) and a high GS (OR = 1.087, 95% CI: 1.051–1.124, P < 0.001) in a multivariate logistic regression model. In the receiver operating characteristic curve analysis, plasma AAT level was found to have a larger area under the curve (AUC) for predicting a high GS (AUC = 0.858, 95% CI: 0.788–0.929, P < 0.001) than that of hsCRP (AUC = 0.665, 95% CI: 0.557–0.773, P = 0.006; Z = 2.9363, P < 0.001), with an optimal cut-off value of 137.85 mg/dl (sensitivity: 94.3%, specificity: 68.2%). Conclusions: Plasma AAT levels correlate with both the presence and severity of coronary stenosis in patients with SAP, suggesting that it could be a potential predictive marker of severe stenosis in SAP patients.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Yi-Shi Li
- Key Laboratory of Clinical Trial Research in Cardiovascular Drugs, Ministry of Health, State Key Laboratory of Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
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Caselli C, De Graaf MA, Lorenzoni V, Rovai D, Marinelli M, Del Ry S, Giannessi D, Bax JJ, Neglia D, Scholte AJ. HDL cholesterol, leptin and interleukin-6 predict high risk coronary anatomy assessed by CT angiography in patients with stable chest pain. Atherosclerosis 2015; 241:55-61. [DOI: 10.1016/j.atherosclerosis.2015.04.811] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Revised: 04/21/2015] [Accepted: 04/29/2015] [Indexed: 12/18/2022]
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Baysal E, Burak C, Cay S, Aksu T, Altıntaş B, Yaylak B, Sevük U, Bilge Ö. The neutrophil to lymphocyte ratio is associated with severity of rheumatic mitral valve stenosis. J Blood Med 2015; 6:151-6. [PMID: 25999773 PMCID: PMC4435248 DOI: 10.2147/jbm.s82423] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Background Rheumatic heart disease (RHD) is a serious health concern in developing countries. Rheumatic mitral stenosis (RMS) is the most long-term sequel in RHD. The neutrophil to lymphocyte ratio (NLR) is a novel marker, and a higher NLR has been associated with poor clinical outcomes in various cardiovascular disorders. We evaluated the availability of NLR to predict severity of mitral stenosis (MS) in patients with RHD. Methods We analyzed 300 consecutive patients with RMS. The patients were divided into tertiles according to NLR: 0.85< NLR ≤1.85 (n=100, tertile 1), 1.86≤ NLR ≤2.46 (n=100, tertile 2), and 2.47≤ NLR ≤7.08 (n=100, tertile 3). Patients with RMS were divided into three groups based on the degree of MS as mild, moderate, and severe MS. After the initial evaluation, 187 patients with moderate-to-severe RMS (Group 1) and 113 patients with mild RMS (Group 2) were reassessed. Results The patients with severe RMS had significantly elevated NLR, mean platelet volume, and pulmonary artery systolic pressure values compared to patients with moderate and mild MS (P<0.001, P<0.001, P<0.001 respectively). Multivariate binary logistic regression analysis revealed that high levels of NLR was an independent predictor of severe RMS (odds ratio =0.68, P=0.008). Moderate-to-severe RMS incidence was significantly higher among patients in the tertile 3 (odds ratio =2.8, P=0.001). Conclusion NLR is a new inflammatory marker and a simple, rapid, and easily accessible prognostic parameter that can be associated with severity of RMS in patients with RHD.
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Affiliation(s)
- Erkan Baysal
- Department of Cardiology, Diyarbakır Gazi Yaşargil Education and Research Hospital, Diyarbakır, Turkey
| | - Cengiz Burak
- Department of Cardiology, Ankara Yüksek İhtisas Education and Research Hospital, Ankara, Turkey
| | - Serkan Cay
- Department of Cardiology, Ankara Yüksek İhtisas Education and Research Hospital, Ankara, Turkey
| | - Tolga Aksu
- Department of Cardiology, Kocaeli Derince Education and Research Hospital, Kocaeli, Turkey
| | - Bernas Altıntaş
- Department of Cardiology, Diyarbakır Gazi Yaşargil Education and Research Hospital, Diyarbakır, Turkey
| | - Barış Yaylak
- Department of Cardiology, Diyarbakır Gazi Yaşargil Education and Research Hospital, Diyarbakır, Turkey
| | - Utkan Sevük
- Department of Cardiovascular Surgery, Diyarbakır Gazi Yaşargil Education and Research Hospital, Diyarbakır, Turkey
| | - Önder Bilge
- Department of Cardiology, Diyarbakır Gazi Yaşargil Education and Research Hospital, Diyarbakır, Turkey
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Akboga MK, Canpolat U, Yayla C, Ozcan F, Ozeke O, Topaloglu S, Aras D. Association of Platelet to Lymphocyte Ratio With Inflammation and Severity of Coronary Atherosclerosis in Patients With Stable Coronary Artery Disease. Angiology 2015; 67:89-95. [PMID: 25922197 DOI: 10.1177/0003319715583186] [Citation(s) in RCA: 90] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The platelet to lymphocyte ratio (PLR) has recently emerged as a potential inflammatory biomarker. Hence, we assessed the relationship between PLR and the extent/severity of coronary artery disease (CAD) using the Gensini score in association with the inflammatory marker C-reactive protein (CRP) in patients with stable CAD. Angiographic data of 1646 patients were analyzed in this cross-sectional study. Patients were categorized according to Gensini scores as no CAD (control), mild, and severe CAD groups. The PLR in the control group was significantly lower than those of mild and severe CAD groups. In multivariate logistic regression analysis, PLR was found to be an independent predictor of the presence of severe CAD (odds ratio: 1.043 [1.036-1.049], P < .001). Furthermore, there was a significant correlation between PLR and the severity of CAD (r = .370, P < .001) and CRP levels (r = .312, P < .001). In conclusion, PLR was independently and positively associated with the severity of coronary atherosclerosis. These results suggest that PLR is an easily available and cheap inflammatory indicator that can be used in predicting the severity of CAD.
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Affiliation(s)
- Mehmet Kadri Akboga
- Turkiye Yuksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Ugur Canpolat
- Turkiye Yuksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Cagri Yayla
- Turkiye Yuksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Firat Ozcan
- Turkiye Yuksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Ozcan Ozeke
- Turkiye Yuksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Serkan Topaloglu
- Turkiye Yuksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Dursun Aras
- Turkiye Yuksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
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Akboga MK, Canpolat U, Sahinarslan A, Alsancak Y, Nurkoc S, Aras D, Aydogdu S, Abaci A. Association of serum total bilirubin level with severity of coronary atherosclerosis is linked to systemic inflammation. Atherosclerosis 2015; 240:110-4. [PMID: 25770689 DOI: 10.1016/j.atherosclerosis.2015.02.051] [Citation(s) in RCA: 92] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Revised: 01/20/2015] [Accepted: 02/23/2015] [Indexed: 02/08/2023]
Abstract
OBJECTIVE Although cardiovascular protective action of bilirubin has been attributed to its antioxidant effect, there was scarce data regarding the anti-inflammatory properties. Herein, we aimed to assess the relationship between serum total bilirubin level and severity of coronary artery disease (CAD) in association with the direct inflammatory marker such as C-reactive protein (CRP), the other indirect markers included in inflammation process such as neutrophil to lymphocyte ratio (NLR) and red cell distribution width (RDW) in patients with stable CAD. METHODS Angiographic data of 1501 patients were analyzed in this retrospective cross-sectional study. Patients were categorized according to Gensini scores as control, mild CAD and severe CAD groups. The association of clinical and laboratory parameters with the severity of CAD were determined by multivariable linear regression analysis. RESULTS Total bilirubin level in the control group was significantly higher than those of the other groups. After multivariable linear regression analysis total bilirubin [β=-3.131 (-4.481, -1.782), p<0.001] was significantly associated with the severity of CAD. Futhermore, there was a moderate and significant inverse correlation between serum total bilirubin level and the severity of CAD (r=-0.173, p<0.001), CRP (r=-0.112, p<0.001), NLR (r=-0.070, p=0.026) and RDW (r=-0.074, p=0.027). CONCLUSION Serum total bilirubin level was independently and inversely associated with the severity of coronary atherosclerosis in patients with stable CAD. In addition, total bilirubin level was inversely correlated with CRP, NLR and RDW. These results suggest that besides its already known effect on the oxidative stress, higher serum total bilirubin level may exhibit an anti-inflammatory effect in the coronary atherosclerotic process.
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Affiliation(s)
- Mehmet Kadri Akboga
- Turkiye Yuksek Ihtisas Education and Research Hospital, Department of Cardiology, Ankara, Turkey.
| | - Ugur Canpolat
- Turkiye Yuksek Ihtisas Education and Research Hospital, Department of Cardiology, Ankara, Turkey
| | - Asife Sahinarslan
- Gazi University Medical Faculty, Department of Cardiology, Ankara, Turkey
| | - Yakup Alsancak
- Gazi University Medical Faculty, Department of Cardiology, Ankara, Turkey
| | - Serdar Nurkoc
- Gazi University Medical Faculty, Department of Cardiology, Ankara, Turkey
| | - Dursun Aras
- Turkiye Yuksek Ihtisas Education and Research Hospital, Department of Cardiology, Ankara, Turkey
| | - Sinan Aydogdu
- Turkiye Yuksek Ihtisas Education and Research Hospital, Department of Cardiology, Ankara, Turkey
| | - Adnan Abaci
- Gazi University Medical Faculty, Department of Cardiology, Ankara, Turkey
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Lacey RE, Kumari M, Bartley M. Social isolation in childhood and adult inflammation: evidence from the National Child Development Study. Psychoneuroendocrinology 2014; 50:85-94. [PMID: 25197797 DOI: 10.1016/j.psyneuen.2014.08.007] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Revised: 08/12/2014] [Accepted: 08/13/2014] [Indexed: 11/18/2022]
Abstract
BACKGROUND Social isolation is known to be associated with poorer health amongst adults, including coronary heart disease. It is hypothesized that this association may be mediated by inflammation. There has been little prospective research on the long-term impact of social isolation in childhood on adult health or the pathways which might be involved. The aim of this study was to investigate whether social isolation in childhood is associated with increased adult inflammation and the mechanisms involved across the life course. METHODS This study used multiply-imputed data on 7462 participants of the National Child Development Study in Great Britain. The association between child social isolation (7-11 yrs) and levels of C-reactive protein (CRP) in middle age (44 yrs) was examined. We additionally investigated the role of adult social isolation, psychological distress, health behaviors and socioeconomic factors as potential mediators using path analysis and concurrent measurements made across the life course. RESULTS Socially isolated children had higher levels of C-reactive protein in mid-life (standardized coefficient=0.05, p≤0.001). In addition, children who were socially isolated tended to have lower subsequent educational attainment, be in a less advantaged social class in adulthood, were more likely to be psychologically distressed across adulthood and were more likely to be obese and to smoke. All of these factors partially explained the association between childhood social isolation and CRP. However, this association remained statistically significant after considering all mediators simultaneously. CONCLUSIONS Social isolation in childhood is associated with higher levels of C-reactive protein in mid-life. This is explained in part through complex mechanisms acting across the life course. Identification and interventions targeted toward socially isolated children may help reduce long-term adult health risk.
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Affiliation(s)
- Rebecca E Lacey
- Department of Epidemiology and Public Health, University College London, London WC1E 6BT, United Kingdom.
| | - Meena Kumari
- Department of Epidemiology and Public Health, University College London, London WC1E 6BT, United Kingdom; Institute of Social & Economic Research, University of Essex, Colchester CO4 3SQ, United Kingdom
| | - Mel Bartley
- Department of Epidemiology and Public Health, University College London, London WC1E 6BT, United Kingdom
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Chung H, Kwon HM, Kim JY, Yoon YW, Rhee J, Choi EY, Min PK, Hong BK, Rim SJ, Yoon JH, Lee SJ, Park JK, Kim MH, Jo M, Yang JH, Lee BK. Lipoprotein-associated phospholipase A₂ is related to plaque stability and is a potential biomarker for acute coronary syndrome. Yonsei Med J 2014; 55:1507-15. [PMID: 25323886 PMCID: PMC4205689 DOI: 10.3349/ymj.2014.55.6.1507] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
PURPOSE Plasma lipoprotein-associated phospholipase A₂ (Lp-PLA₂) binds to low-density lipoprotein. The levels of Lp-PLA₂ reflect the plaque burden, and are upregulated in acute coronary syndrome (ACS). We investigated the diagnostic value of Lp-PLA2 levels and found that it might be a potential biomarker for ACS. MATERIALS AND METHODS We classified 226 study participants into three groups: patients without significant stenosis (control group), patients with significant stenosis with stable angina (SA group), and patients with ACS (ACS group). RESULTS Lp-PLA₂ and high-sensitivity C-reactive protein (hs-CRP) levels were significantly greater in the ACS group than in the SA group (p=0.044 and p=0.029, respectively). Multivariate logistic regression analysis revealed that Lp-PLA₂ levels are significantly associated with ACS (odds ratio=1.047, p=0.013). The addition of Lp-PLA₂ to the ACS model significantly increased the global χ² value over traditional risk factors (28.14 to 35.602, p=0.006). The area under the receiver operating characteristic curve for Lp-PLA₂ was 0.624 (p=0.004). The addition of Lp-PLA₂ level to serum hs-CRP concentration yielded an integrated discrimination improvement of 0.0368 (p=0.0093, standard error: 0.0142) and improved the ability to diagnose ACS. CONCLUSION Lp-PLA₂ levels are related to plaque stability and might be a diagnostic biomarker for ACS.
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Affiliation(s)
- Hyemoon Chung
- Cardiology Division, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hyuck Moon Kwon
- Cardiology Division, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jong-Youn Kim
- Cardiology Division, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Young-Won Yoon
- Cardiology Division, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jihyuk Rhee
- Cardiology Division, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Eui-Young Choi
- Cardiology Division, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Pil-Ki Min
- Cardiology Division, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Bum-Kee Hong
- Cardiology Division, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Se-Joong Rim
- Cardiology Division, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Ji Hyun Yoon
- Cardiology Division, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Sung-Joo Lee
- Cardiology Division, Department of Internal Medicine, Chungju Medical Center, Chungju, Korea
| | - Jong-Kwan Park
- Cardiology Division, Department of Internal Medicine, NHIC Ilsan Hospital, Goyang, Korea
| | - Myung-Hyun Kim
- Cardiology Division, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Minhee Jo
- Cardiology Division, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jeong-Hee Yang
- Department of Biochemistry, CHA University College of Medicine, Seongnam, Korea
| | - Byoung Kwon Lee
- Cardiology Division, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
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Demir K, Avci A, Altunkeser BB, Yilmaz A, Keles F, Ersecgin A. The relation between neutrophil-to-lymphocyte ratio and coronary chronic total occlusions. BMC Cardiovasc Disord 2014; 14:130. [PMID: 25260530 PMCID: PMC4195893 DOI: 10.1186/1471-2261-14-130] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Accepted: 09/23/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Neutrophil-to-lymphocyte ratio (NLR) is a marker of systemic inflammation that correlates with cardiac events. This study assessed the association between NLR and the presence of chronic coronary total occlusion (CTO). METHODS The study population included 225 patients, a control group (n = 75), a coronary artery disease group (n = 75), and a CTO group (n = 75). NLR was compared in the three groups. RESULTS NLR levels were significantly higher in the CTO than in the other two groups (p < 0.001). Bivariate correlation analysis showed a positive correlation between NLR and SYNTAX Score, and multivariate logistic regression analysis found that NLR was an independent predictor of CTO. ROC analysis showed that an NLR cut-off of 2.09 could distinguish between patients with and without CTO (AUC = 0.74; 95% CI, 0.68-0.81), with a specificity of 69.3% and a sensitivity of 61%. CONCLUSION NLR may be useful as a marker of CTO.
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Affiliation(s)
- Kenan Demir
- Faculty of Medicine Cardiology Department, Selcuk University, 42075 Konya, Turkey.
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Predictors of coronary artery aneurysm after stent implantation in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention. Int J Cardiovasc Imaging 2014; 30:1435-44. [PMID: 25053515 DOI: 10.1007/s10554-014-0503-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Accepted: 07/17/2014] [Indexed: 12/28/2022]
Abstract
The clinical and angiographic predictors of coronary artery aneurysm (CAA) formation in patients with ST-segment elevation acute myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) are not clear. This study aims to assess the predictors of CAA formation after primary PCI. 3,428 patients who underwent PCI for STEMI were enrolled. The average period of follow-up was mean 48 months (range 35-56 months) after PCI. During this time, 1,304 patients were underwent follow-up coronary angiography. CAA was detected in 21 patients (1.6 %). CAA occurred at the segment of stent implantation in all patients. The clinical and angiographic data were compared between patients with CAA group (n = 21) and without CAA group (n = 1,283). Patients who developed CAA had longer reperfusion time, higher high-sensitiviy C-reactive protein (hs-CRP) levels and neutrophil to lymphocyte ratio than those who had without CAA. Angiographically, CAA developed proximally located lesions and lesion length was significantly greater in patients with CAA than without CAA. Statin and beta-blocker discontinuation were found higher in stent-associated CAA. Every 1 mg/l increase in hs-CRP and implantation of drug eluting stent (DES) were independent predictor of CAA formation after STEMI. Baseline elevated inflammation status and DES implantation in the setting of STEMI may predict the CAA formation.
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Kurtul A, Murat SN, Yarlioglues M, Duran M, Karadeniz M, Ergun G, Akyel A, Mendi MA, Oksuz F. The association of red cell distribution width with in-stent restenosis in patients with stable coronary artery disease. Platelets 2014; 26:48-52. [PMID: 24831828 DOI: 10.3109/09537104.2014.881990] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Increased red cell distribution width (RDW) is closely related to the poor prognosis and adverse events of cardiovascular diseases. We aimed to investigate the association of serum RDW levels and in-stent restenosis (ISR) after coronary stenting with bare-metal stent in patients with stable coronary artery disease. A total of 251 patients (age 62 ± 11 years, 69% male) with a history of coronary stenting who underwent control coronary angiography (128 with ISR and 123 without ISR) were enrolled into the study. Laboratory parameters were measured before angiography. ISR was defined as luminal stenosis ≥50% within the stent or within 5 mm of its edges by the quantitative coronary analysis. The patients were divided into the two groups: ISR group and no-ISR group. Baseline characteristics of the patients were similar. The ISR group had significantly higher RDW levels compared with patients in no-ISR group (14.47 ± 1.37 vs. 13.59 ± 0.88, p < 0.001). Furthermore, the ISR group had significantly longer stent length and lower stent diameter when compared to no-ISR group (p = 0.001 and p = 0.004, respectively). In a multivariate analysis, RDW levels >13.75%, high-sensitivity C-reactive protein levels, stent diameter and stent length were independently associated with ISR [odds ratio (OR) = 2.12, 95% confidence interval (CI) = 1.71-3.15, OR = 2.80, 95% CI = (1.34-4.61), OR = -2.60, 95% CI = -(1.19-4.51), OR = 2.02, 95% CI = 1.99-3.76, p = 0.001, respectively]. We concluded that increased serum RDW levels were independently associated with bare-metal ISR in patients with stable coronary artery disease.
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Affiliation(s)
- Alparslan Kurtul
- Department of Cardiology, Ankara Education and Research Hospital , Ankara , Turkey
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Su SA, Ma H, Shen L, Xiang MX, Wang JA. Interleukin-17 and acute coronary syndrome. J Zhejiang Univ Sci B 2014; 14:664-9. [PMID: 23897784 DOI: 10.1631/jzus.bqicc701] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Inflammation plays an important role in atherosclerosis, which is also crucial for acute coronary syndrome (ACS). Recent studies have revealed that interleukin (IL)-17, which was regarded as a pro-inflammatory cytokine, has a dual function in the progress of ACS. In this review, we sum up both experimental and clinical studies on the relevance of IL-17 to atherosclerosis and its complications, and summarize the research progress on the effect of IL-17 on the atherosclerotic plaque stability and ACS onset. Although the studies are controversial and the mechanism remains unclear, we highlight the knowledge of the role of IL-17 in ACS and elucidate its potential mechanism.
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Affiliation(s)
- Sheng-an Su
- Cardiovascular Key Lab of Zhejiang Province, Department of Cardiology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China
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The importance of laboratory parameters in patients with obstructive sleep apnea syndrome. Blood Coagul Fibrinolysis 2013; 24:371-4. [PMID: 23322273 DOI: 10.1097/mbc.0b013e32835d53d4] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Platelet activation and inflammation are the related mechanisms of pathogenesis in obstructive sleep apnea syndrome (OSAS). Mean platelet volume (MPV) and platelet distribution width (PDW) are the markers of platelet activation. C-reactive protein (CRP) and red cell distribution width (RDW) in relation to the inflammation in OSAS might be increased. We aimed to investigate the correlation of the MPV, PDW, and RDW levels with the severity of OSAS. We included 98 patients with suspected OSAS, evaluated by polysomnography. According to their apnea-hypopnea index (AHI), patients were divided into group A (n = 20; 20.4%) with AHI below 5/h; group B (n = 15; 15.3%) with AHI 5-14.9/h; group C (n = 26; 26.5%) with AHI 15-29.9/h; and group D (n = 37; 37.8%) with AHI ≥30/h. Hemoglobin, MPV, PDW, and RDW were measured using an automated blood cell counter. BMI and age showed a statistically significant and gradual increase in AHI groups. Hemoglobin, platelet, CRP, MPV, and RDW values did not differ between AHI groups. PDW was significantly higher in group D (mean value 14.4 ± 1.8) than in group A (13.2 ± 0.5) (P < 0.001). Epworth sleepiness scale was significantly higher in group D (9.9 ± 5.5) than in group A (5.6 ± 3.5), B (9.2 ± 3.6) and C (6.6 ± 3.8) (P = 0.005). When the four groups were compared, group D had the lowest minimum SpO2 value [group A (89.4 ± 3.0), B (86.7 ± 4.2), C (81.2 ± 6.4), and D (68.2 ± 13.0)]. There was a statistically significant correlation between AHI and age (r = 0.35, P < 0.001), BMI (r = 0.31, P = 0.003), PDW (r = 0.28, P = 0.006), and Epworth sleepiness scale (r = 0.29, P = 0.007). However, AHI was not correlated with CRP, MPV, and RDW. PDW is higher in severe OSAS and is correlated with different parameters of breathing function during sleep. The severity of OSAS was not correlated with CRP, MPV, and RDW. These findings show an evidence for platelet activation in OSAS and suggest that PDW might be related markers of OSAS severity.
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Plasma levels of soluble receptor for advanced glycation end products and coronary atherosclerosis: possible correlation with clinical presentation. DISEASE MARKERS 2013; 35:135-40. [PMID: 24167358 PMCID: PMC3774980 DOI: 10.1155/2013/129360] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Revised: 07/24/2013] [Accepted: 07/28/2013] [Indexed: 01/31/2023]
Abstract
Receptor for Advanced Glycation End-products (RAGE) is a multi-ligand receptor ubiquitous present on epithelial, neuronal, vascular and inflammatory cells, usually expressed at low levels in homeostasis and to increased degrees at sites of stress or injury. The aim of the present study was to evaluate sRAGE plasma levels in patients with Acute Coronary Syndrome (ACS) and to assess its diagnostic efficacy in identification of patients with acute events. Plasma levels of sRAGE were determined in 860 patients with Coronary Artery Disease (CAD): 530 patients presented stable angina and 330 were observed during acute ischemic event (147 with unstable angina and 183 with myocardial infarction). sRAGE plasma levels were significantly lower in patients with ACS than in patients with stable angina: [median 584 pg/mL (IQR: 266–851 pg/mL) in MI patients, median 769 pg/mL (IQR: 394–987 pg/mL) in patients with unstable angina, median 834 pg/mL (IQR 630–1005 pg/mL) in patients with stable angina; P < 0.001]. sRAGE levels did not differ among ACS patients stratified by the extent of coronary artery disease. In conclusion, this study confirm the role of sRAGE in activation and progression of inflammatory process and suggests the possibility that sRAGE can be considered an indicator of destabilization of vulnerable plaque.
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Eberhard J, Grote K, Luchtefeld M, Heuer W, Schuett H, Divchev D, Scherer R, Schmitz-Streit R, Langfeldt D, Stumpp N, Staufenbiel I, Schieffer B, Stiesch M. Experimental gingivitis induces systemic inflammatory markers in young healthy individuals: a single-subject interventional study. PLoS One 2013; 8:e55265. [PMID: 23408963 PMCID: PMC3567060 DOI: 10.1371/journal.pone.0055265] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2012] [Accepted: 12/20/2012] [Indexed: 01/08/2023] Open
Abstract
Objectives We here investigated whether experimental gingivitis enhances systemic markers of inflammation which are also known as surrogate markers of atherosclerotic plaque development. Background Gingivitis is a low-level oral infection induced by bacterial deposits with a high prevalence within Western populations. A potential link between the more severe oral disease periodontitis and cardiovascular disease has already been shown. Methods 37 non-smoking young volunteers with no inflammatory disease or any cardiovascular risk factors participated in this single-subject interventional study with an intra-individual control. Intentionally experimental oral inflammation was induced by the interruption of oral hygiene for 21 days, followed by a 21-days resolving phase after reinitiation of oral hygiene. Primary outcome measures at baseline, day 21 and 42 were concentrations of hsCRP, IL-6, and MCP-1, as well as adhesion capacity and oxLDL uptake of isolated blood monocytes. Results The partial cessation of oral hygiene procedures was followed by the significant increase of gingival bleeding (34.0%, P<0.0001). This local inflammation was associated with a systemic increase in hsCRP (0.24 mg/L, P = 0.038), IL-6 (12.52 ng/L, P = 0.0002) and MCP-1 (9.10 ng/l, P = 0.124) in peripheral blood samples between baseline and day 21, which decreased at day 42. Monocytes showed an enhanced adherence to endothelial cells and increased foam cell formation after oxLDL uptake (P<0.050) at day 21 of gingivitis. Conclusions Bacterial-induced gingival low-level inflammation induced a systemic increase in inflammatory markers. Dental hygiene almost completely reversed this experimental inflammatory process, suggesting that appropriate dental prophylaxis may also limit systemic markers of inflammation in subjects with natural gingivitis. International Clinical Trials Register Platform of the World Health Organization, registry number: DRKS00003366, URL: http://apps.who.int/trialsearch/Default.aspx
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Affiliation(s)
- Jörg Eberhard
- Department of Prosthetic Dentistry and Biomaterials Science, Hannover Medical School, Hannover, Germany.
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Association of inflammatory markers with the morphology and extent of coronary plaque as evaluated by 64-slice multidetector computed tomography in patients with stable coronary artery disease. Int J Cardiovasc Imaging 2013; 29:1149-58. [PMID: 23358918 DOI: 10.1007/s10554-013-0181-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2012] [Accepted: 01/04/2013] [Indexed: 01/06/2023]
Abstract
We evaluated the association between inflammatory markers and coronary artery plaque assessed by 64-slice multidetector computed tomography. Coronary computed tomography angiography was performed in patients with chest discomfort suggestive of coronary artery disease (CAD). Individuals with an acute coronary syndrome were excluded from the study. Coronary plaque morphology, the number of artery segments exhibiting plaque, and the number of vessels with >50% stenosis were evaluated. Plasma levels of high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), plasminogen activator inhibitor-1, and vascular endothelial growth factor were measured. Among the 178 patients studied (age 65 ± 10 years; 70% men), 125 were diagnosed with CAD. Hs-CRP and IL-6 concentrations were significantly higher in patients with CAD than in patients without (2.73 ± 4.7 vs. 1.32 ± 2.6 mg/L, P = 0.018, and 3.06 ± 3.3 vs. 2.19 ± 2.4 pg/mL, P = 0.036). The IL-6 level was high in patients with predominantly calcified plaque, and was significantly higher in patients with 4-9 plaque segments than in those with no or 1-3 plaque segments (4.07 ± 5.3 vs. 2.19 ± 2.4 pg/mL and 2.43 ± 2.0 pg/mL, respectively, P = 0.025). The number of stenotic vessels was not significantly related to inflammatory markers. Multivariate logistic analysis revealed that plasma levels of hs-CRP but not IL-6 were associated with the presence of coronary plaque with calcification (OR 3.37, P = 0.026). This study supports the usefulness of inflammatory markers for the evaluation of coronary plaque in patients with stable CAD.
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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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Harutyunyan M, Gøtze JP, Winkel P, Johansen JS, Hansen JF, Jensen GB, Hilden J, Kjøller E, Kolmos HJ, Gluud C, Kastrup J. Serum YKL-40 predicts long-term mortality in patients with stable coronary disease: a prognostic study within the CLARICOR trial. Immunobiology 2012; 218:945-51. [PMID: 23294528 DOI: 10.1016/j.imbio.2012.10.015] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2012] [Accepted: 10/30/2012] [Indexed: 11/24/2022]
Abstract
OBJECTIVE We investigated whether the inflammatory biomarker YKL-40 could improve the long-term prediction of death made by common risk factors plus high-sensitivity C-reactive protein (hs-CRP) and N-terminal-pro-B natriuretic peptide (NT-proBNP) in patients with stable coronary artery disease (CAD). BACKGROUND Non-hospitalized CAD patients are usually followed in general practice. There is a need for identify biomarkers which could help to foresee the prognoses of these patients. Elevated serum YKL-40 is a short-term predictor for myocardial infarction, cardiovascular mortality and all-cause mortality in patients with stable CAD. METHODS Serum YKL-40, hs-CRP, and NT-proBNP were measured in 4265 (97.6%) of the 4372 patients with stable CAD included in the CLARICOR trial, and death was registered in a 6-years follow-up period. RESULTS The median serum YKL-40 was 110 μg/L [IQR=93], hs-CRP 2.8 mg/L [IQR=4.74], and NT-proBNP 203 ng/L [IQR=407]. During 6 years follow-up period 923 (21.1%) patients died. After adjustment for type of intervention, risk factors (age, sex, hypertension, diabetes, smoking status, and previous myocardial infarction) and medical treatment (diuretics, digoxin, and statin) serum YKL-40 (transformed as ln(max(82, YKL-40/μg/L)) was significantly associated with all-cause mortality [hazard ratio (HR)=1.55, 95% CI=1.39-1.73, p<0.001]. After additional adjustment for ln(hs-CRP) and ln(NT-proBNP) this was still true [HR=1.38, 95% CI=1.21-1.53, p<0.001]. CONCLUSIONS Serum YKL-40 is a predictor of long-term mortality in patients with stable CAD independent of common risk factors and ln(hs-CRP) and ln(NT-proBNP). Serum YKL-40 can be used for prognostication in these patients.
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Affiliation(s)
- Marina Harutyunyan
- Department of Medicine B, The Heart Centre, Rigshospitalet, Copenhagen University Hospital and Faculty of Health Sciences, Copenhagen, Denmark.
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