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Fu M, Mei A, Min X, Yang H, Wu W, Zhong J, Li C, Chen J. Advancements in Cardiovascular Disease Research Affected by Smoking. Rev Cardiovasc Med 2024; 25:298. [PMID: 39228476 PMCID: PMC11367002 DOI: 10.31083/j.rcm2508298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 04/09/2024] [Accepted: 04/18/2024] [Indexed: 09/05/2024] Open
Abstract
The harmful substances in tobacco are widely recognized to exert a significant detrimental impact on human health, constituting one of the most substantial global public health threats to date. Tobacco usage also ranks among the principal contributors to cardiovascular ailments, with tobacco being attributed to up to 30% of cardiovascular disease-related deaths in various countries. Cardiovascular disease is influenced by many kinds of pathogenic factors, among them, tobacco usage has led to an increased year by year incidence of cardiovascular disease. Exploring the influencing factors of harmful substances in tobacco and achieving early prevention are important means to reduce the incidence of cardiovascular diseases and maintain health. This article provides a comprehensive review of the effects of smoking on health and cardiovascular diseases.
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Affiliation(s)
- Miaoxin Fu
- Sinopharm Dongfeng General Hospital (Hubei Clinical Research Center of Hypertension), Hubei Key Laboratory of Wudang Local Chinese Medicine Research, Hubei University of Medicine, 442000 Shiyan, Hubei, China
| | - Aihua Mei
- Sinopharm Dongfeng General Hospital (Hubei Clinical Research Center of Hypertension), Hubei Key Laboratory of Wudang Local Chinese Medicine Research, Hubei University of Medicine, 442000 Shiyan, Hubei, China
| | - Xinwen Min
- Sinopharm Dongfeng General Hospital (Hubei Clinical Research Center of Hypertension), Hubei Key Laboratory of Wudang Local Chinese Medicine Research, Hubei University of Medicine, 442000 Shiyan, Hubei, China
| | - Handong Yang
- Sinopharm Dongfeng General Hospital (Hubei Clinical Research Center of Hypertension), Hubei Key Laboratory of Wudang Local Chinese Medicine Research, Hubei University of Medicine, 442000 Shiyan, Hubei, China
| | - Wenwen Wu
- School of Public Health, Hubei University of Medicine, 442000 Shiyan, Hubei, China
| | - Jixin Zhong
- Department of Rheumatology and Immunology, Tongji Hospital, Huazhong University of Science and Technology, 430074 Wuhan, Hubei, China
| | - Chunlei Li
- Sinopharm Dongfeng General Hospital (Hubei Clinical Research Center of Hypertension), Hubei Key Laboratory of Wudang Local Chinese Medicine Research, Hubei University of Medicine, 442000 Shiyan, Hubei, China
| | - Jun Chen
- Sinopharm Dongfeng General Hospital (Hubei Clinical Research Center of Hypertension), Hubei Key Laboratory of Wudang Local Chinese Medicine Research, Hubei University of Medicine, 442000 Shiyan, Hubei, China
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Lin S, Zhu P, Jiang L, Hu Y, Huang L, He Y, Zhang H. Neutrophil extracellular traps induced by IL-1β promote endothelial dysfunction and aggravate limb ischemia. Hypertens Res 2024; 47:1654-1667. [PMID: 38605142 DOI: 10.1038/s41440-024-01661-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 02/22/2024] [Accepted: 03/13/2024] [Indexed: 04/13/2024]
Abstract
Vascular inflammation and endothelial dysfunction contribute to vascular diseases. While neutrophil extracellular traps (NETs) participate in some vascular pathologies, their roles in lower limb ischemia remain poorly defined. This study investigated the functional significance of NETs in vascular inflammation and remodeling associated with limb ischemia. Single-cell RNA sequencing (scRNA-seq) and flow cytometry revealed neutrophil activation and upregulated NETs formation in human limb ischemia, with immunofluorescence confirming IL-1β-induced release of NETs for vascular inflammation. Endothelial cell activation was examined via scRNA-seq and western blotting, indicating enhanced proliferation, expression of adhesion molecules (VCAM-1, ICAM-1), inflammatory cytokines (IL-1β, IL-6) and decreased expression of VE-cadherin, that could be mediated by NETs to exacerbate endothelial inflammation. Mechanistically, NETs altered endothelial cell function via increased pSTAT1/STAT1 signaling. Vascular inflammation and subsequent ischemia were alleviated in vivo by NETosis or IL-1β inhibition in ischemic mice. IL-1β-NETs induce endothelial activation and inflammation in limb ischemia by stimulating STAT1 signaling. Targeting NETs may thus represent a novel therapeutic strategy for inflammatory vascular diseases associated with limb ischemia. Graphical abstract of NETs regulation of the development of vascular inflammation in lower limb ischemia via pSTAT1/STAT1 signaling pathway.
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Affiliation(s)
- Shigang Lin
- Department of Vascular Surgery, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Pengwei Zhu
- Department of Cardiology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Liujun Jiang
- Department of Cardiology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yujian Hu
- Department of Vascular Surgery, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Lirui Huang
- Department of Vascular Surgery, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yangyan He
- Department of Vascular Surgery, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
| | - Hongkun Zhang
- Department of Vascular Surgery, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
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Abellán Alemán J, Sabaris RC, Pardo DE, García Donaire JA, Romanos FG, Iriso JI, Penagos LM, Iglesias LJN, de Salinas APM, Pérez-Monteoliva NRR, Lezcano PSR, Saborido MT, Roca FV. Documento de consenso sobre tabaquismo y riesgo vascular. HIPERTENSION Y RIESGO VASCULAR 2024; 41 Suppl 1:S1-S85. [PMID: 38729667 DOI: 10.1016/s1889-1837(24)00075-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2024]
Abstract
Consensus statement on smoking and vascular risk About 22% of the Spanish population are daily smokers. Men are more likely to smoke than women. In Spain, women between 15-25 years of age smoke as much or more than men. Every smoker should be assessed for: physical dependence on nicotine (Fagerström test), social and psychological dependence (Glover Nilsson test), level of motivation to quit (Richmond test), probability of therapy success (Henri-Mondor and Michael-Fiore tests), and stage of behavioral change development (Prochaska and DiClementi). Advice on smoking cessation is highly cost-effective and should always be provided. Smoking is an enhancer of cardiovascular risk because it acts as a pathogen agent in the development of arteriosclerosis and is associated with ischemic heart disease, stroke, and peripheral artery disease. Smoking increases the risk of chronic lung diseases (COPD) and is related to cancers of the lung, female genitalia, larynx, oropharynx, bladder, mouth, esophagus, liver and biliary tract, and stomach, among others. Combined oral contraceptives should be avoided in women smokers older than 35 years of age due to the risk of thromboembolism. In smoking cessation, the involvement of physicians, nurses, psychologists, etc. is important, and their multidisciplinary collaboration is needed. Effective pharmacological treatments for smoking cessation are available. Combined treatments are recommended when smoker's dependence is high. For individuals who are unable to quit smoking, a strategy based on tobacco damage management with a total switch to smokeless products could be a less dangerous alternative for their health than continuing to smoke.
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Affiliation(s)
- José Abellán Alemán
- Sociedad Murciana de Hipertensión Arterial y Riesgo Cardiovascular, Cátedra de Riesgo Cardiovascular, Universidad Católica de Murcia, Murcia, España.
| | - Rafael Crespo Sabaris
- Sociedad Riojana de Hipertensión y Riesgo Vascular, Centro de Salud de Entrena, La Rioja, España
| | - Daniel Escribano Pardo
- Sociedad Aragonesa de Hipertensión y Riesgo Vascular, Centro de Salud Oliver, Zaragoza, España
| | - José Antonio García Donaire
- Sociedad Española de Hipertensión, Unidad de Hipertensión, Servicio de Medicina Interna, Hospital Clínico Universitario San Carlos, Madrid, España
| | - Fernando García Romanos
- Sociedad de Hipertensión y Riesgo Vascular de las Illes Balears, Centro de Salud Santa Catalina, Palma de Mallorca, España
| | - Jesús Iturralde Iriso
- Sociedad Vasca de Hipertensión y Riesgo Vascular, Centro de Salud la Habana-Cuba, Vitoria-Gasteiz, España
| | - Luis Martín Penagos
- Sociedad Cántabra de Hipertensión y Riesgo Vascular, Servicio de Nefrología, Hospital Universitario Marqués de Valdecilla, Santander, España
| | - L Javier Nieto Iglesias
- Sociedad Castilla-La Mancha de Hipertensión y Riesgo Vascular, Unidad de Hipertensión y Riesgo Vascular, Servicio de Nefrología, Hospital General Universitario de Ciudad Real, Ciudad Real, España
| | - Alfonso Pobes Martínez de Salinas
- Sociedad Asturiana de Hipertensión y Riesgo Vascular, Área de Gestión Clínica, Interáreas de Nefrología VII y VIII del SESPA, Asturias, España
| | | | - Pablo Sánchez-Rubio Lezcano
- Sociedad Aragonesa de Hipertensión y Riesgo Vascular, Servicio de Medicina Interna, Hospital General Universitario San Jorge, Huesca, España
| | - Maribel Troya Saborido
- Sociedad Catalana de Hipertensión y Riesgo Vascular, Servicio de Nefrología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España
| | - Francisco Valls Roca
- Sociedad Valenciana de Hipertensión y Riesgo Vascular, Centro de Salud de Beniganim, Valencia, España
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Caimi G, Urso C, Brucculeri S, Lo Presti R, Carlisi M. Calculated whole blood viscosity in non-diabetic subjects with asymptomatic carotid atherosclerosis: How insulin resistance may affect blood viscosity. Clin Hemorheol Microcirc 2024; 88:199-209. [PMID: 38905035 DOI: 10.3233/ch-221422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/23/2024]
Abstract
BACKGROUND AND OBJECTIVE Asymptomatic atherosclerosis is an important early marker of vascular damage and, among its risk factors, hemorheological alterations play an important role. PATIENTS AND METHODS In a cohort of 85 non-diabetic subjects with asymptomatic carotid atherosclerosis (ACA), we have measured whole blood viscosity (cWBV) according to the haematocrit and plasma fibrinogen level. The cWBV distinguish the subgroup of ACA subjects with 3-5 cardiovascular risk factors (CRFs) from that with 1-2 CRFs and the same behavior is present for haematocrit and plasma fibrinogen level. Therefore, we divided the whole group of ACA subjects according to the medians of the four surrogate indexes with an insulin resistance degree of TG/HDL-C, TyG, VAI and LAP. RESULTS The analysis of the correlation between cWBV and each index of insulin resistance has shown that no correlation is present in the whole group and in the group of ACA subjects with 1-2 CRFs, while in the subgroup with 3-5 CRFs there is a positive correlation between cWBV with TG/HDL-C and TyG at a low degree of statistical significance. CONCLUSIONS The date underline that subjects with this clinical condition have an unaltered evaluation of the cWBV compared to the other indices.
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Affiliation(s)
- G Caimi
- Department of Health Promotion and Child Care, Internal Medicine and Medical Specialties, Università degli Studi di Palermo, Palermo, Italy
| | - C Urso
- Fondazione Istituto "G. Giglio" Cefalù, Palermo, Italy
| | - S Brucculeri
- Fondazione Istituto "G. Giglio" Cefalù, Palermo, Italy
| | - R Lo Presti
- Department of Psychology, Educational Science and Human Movement, Università degli Studi di Palermo, Palermo, Italy
| | - M Carlisi
- Department of Health Promotion and Child Care, Internal Medicine and Medical Specialties, Università degli Studi di Palermo, Palermo, Italy
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Tverdal A, Selmer R, Thelle DS. Smoking history and all-cause, ischaemic heart disease and lung cancer mortality: follow-up study of 358 551 men and women aged 40-43 years. Tob Control 2023:tc-2023-057977. [PMID: 37963773 DOI: 10.1136/tc-2023-057977] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 11/01/2023] [Indexed: 11/16/2023]
Abstract
AIMS We studied the health consequences of quitting smoking before age 43 by time since quitting, number of years smoked and cigarettes smoked per day. The outcomes were all-cause, ischaemic heart disease and lung cancer mortality. DESIGN Prospective study. SETTING Norwegian counties. PARTICIPANTS Men and women aged 40-43 years who participated in a national cardiovascular screening programme and who were followed from 1985 to 2018. MEASUREMENTS Self-reports from questionnaire on time since quitting smoking, years smoked and number of cigarettes per day, and measurements of height, weight and blood pressure, and a blood sample where serum was analysed for total serum cholesterol and triglycerides. FINDINGS The all-cause mortality rate was 30% higher among quitters less than 1 year ago compared with never smokers (adjusted HR=1.30, 95% CI 1.18-1.43 in men and HR=1.31, 95% CI 1.16 to 1.50 in women). Quitters who had smoked longer than 20 years had 23% higher mortality in men (HR=1.23, 95% CI 1.14 to 1.34) and 32% higher mortality in women (HR=1.32, 95% CI 1.18 to 1.49). Past smoking of more than 20 cigarettes/day was associated with HR=1.14 (1.05-1.23) in men and HR=1.16 (1.01-1.32) in women. The HR for lung cancer was 6.77 (95% CI 4.86 to 9.45) for quitting men who had smoked for more than 20 years compared with never smokers. The corresponding figure for women was 5.75 (95% CI 4.08 to 8.09). CONCLUSIONS The mortality among quitters was close to that of never smokers, except for a higher mortality for lung cancer, which on the other hand was much lower than the lung cancer mortality in current smokers.
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Affiliation(s)
- Aage Tverdal
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Randi Selmer
- Department of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Dag S Thelle
- Department of Biostatistics, University of Oslo, Oslo, Norway
- Institute of Medicine,School of Public Health and Community Medicien, University of Gothenburg, Goteborg, Sweden
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Garcia-Sayan E, Lee M, Stone JR, Stone DM, Smulevitz B, McPherson DD, Fisher-Hoch SP, McCormick JB, Laing ST. Endothelial Dysfunction and Cardiometabolic Risk Factors in Mexican American Adults: The Cameron County Hispanic Cohort. Am J Cardiol 2023; 205:75-83. [PMID: 37595411 DOI: 10.1016/j.amjcard.2023.07.165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 07/17/2023] [Accepted: 07/26/2023] [Indexed: 08/20/2023]
Abstract
Endothelial dysfunction assessed by impaired brachial flow-mediated dilation (FMD) predicts incident cardiovascular disease (CVD). We have previously shown that clustering of diabetes mellitus, obesity, and metabolic syndrome in young Hispanic patients was associated with subclinical atherosclerosis. This study aimed to assess determinants of impaired FMD response (%FMD), an earlier marker of atherosclerosis, in a population-based sample of asymptomatic Mexican Americans. Cardiometabolic biomarkers and FMD were obtained from 960 Cameron County Hispanic Cohort participants. Gender-specific median values of %FMD were used to categorize participants into those with %FMD below or above the median. The sample was further stratified into those younger and older than 55 years. Survey-weighted logistic regression analyses were conducted to evaluate the effects of cardiometabolic biomarkers on the %FMD groups. The low %FMD group was significantly older, had higher visceral adipose tissue, systolic blood pressure, or plasma glucose, and had metabolic syndrome compared with those in the high %FMD group. Multivariable-adjusted age-stratified logistic regression analyses showed that in older participants, male gender (odds ratio [OR] = 2.4 [1.4 to 4.2]) and having hypertension (OR = 2.3 [1.3 to 4.3]) or prediabetes mellitus (OR = 3.4 [1.5 to 7.5]) remained significantly associated with odds of low %FMD. In younger participants, high low-density lipoprotein (OR = 2.8 [1.6 to 4.9]) or having the metabolic syndrome (OR = 1.9 [1.1 to 3.6]) were significantly associated with odds of low %FMD. In conclusion, we found age-dependent associations between cardiometabolic biomarkers and an FMD response below the gender-specific median in a sample composed of Mexican Americans without previous CVD. Targeting specific risk factors by age may mitigate progression to incident CVD in this high-risk racial disparity group.
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Affiliation(s)
- Enrique Garcia-Sayan
- Department of Medicine, Section of Cardiology, Baylor College of Medicine, Houston, Texas
| | - Miryoung Lee
- Department of Epidemiology, Human Genetics and Environmental Sciences, the University of Texas Health Science Center-Houston, School of Public Health, Brownsville Campus, Brownsville, Texas
| | - James R Stone
- Division of Cardiology, Department of Internal Medicine, the University of Texas Health Science Center-Houston, Houston, Texas
| | - Danielle M Stone
- Division of Cardiology, Department of Internal Medicine, the University of Texas Health Science Center-Houston, Houston, Texas
| | - Beverly Smulevitz
- Division of Cardiology, Department of Internal Medicine, the University of Texas Health Science Center-Houston, Houston, Texas
| | - David D McPherson
- Division of Cardiology, Department of Internal Medicine, the University of Texas Health Science Center-Houston, Houston, Texas
| | - Susan P Fisher-Hoch
- Department of Epidemiology, Human Genetics and Environmental Sciences, the University of Texas Health Science Center-Houston, School of Public Health, Brownsville Campus, Brownsville, Texas
| | - Joseph B McCormick
- Department of Epidemiology, Human Genetics and Environmental Sciences, the University of Texas Health Science Center-Houston, School of Public Health, Brownsville Campus, Brownsville, Texas
| | - Susan T Laing
- Division of Cardiology, Department of Internal Medicine, the University of Texas Health Science Center-Houston, Houston, Texas.
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Zuo X, Liu L, Liu K, Zhang X, Ye R, Yang C, Ma J, Jia S, Yang X, Liu X, Sun L, Huo X, Chen X. Proximal aorta dilatation in hypertension. J Hypertens 2023; 41:1511-1520. [PMID: 37642588 DOI: 10.1097/hjh.0000000000003518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
Dilation of the proximal aorta is a common clinical manifestation in hypertensive patients. Although it is straightforward to link hypertension with proximal aortic dilation, previous studies on their interrelation have yielded controversial results. Cross-sectional design, methodology of blood pressure assessment, confounding factors like medications, and inconsistent reference values may lead to the paradoxical conclusions. Recently, advances have been made in the exploration of determinants and clinical value of proximal aortic dilatation. Thus, we reviewed these findings and summarized that aortic dilatation may be the consequence of hemodynamic and nonhemodynamic co-factors' combined action. Moreover, proximal aortic dilatation tends to be a predictor for aortic aneurysm dissection or rupture, hypertensive target organ damage as well as cardiovascular events. The present review contributes to a comprehensive understanding of the pathological process of proximal aortic dilatation in hypertension.
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Affiliation(s)
- Xianghao Zuo
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
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Tasdighi E, Jha KK, Dardari ZA, Osuji N, Rajan T, Boakye E, Hall ME, Rodriguez CJ, Stokes AC, El Shahawy O, Benjamin EJ, Bhatnagar A, DeFilippis AP, Blaha MJ. Investigating the association of traditional and non-traditional tobacco product use with subclinical and clinical cardiovascular disease: The Cross-Cohort Collaboration-Tobacco working group rationale, design, and methodology. Tob Induc Dis 2023; 21:89. [PMID: 37427074 PMCID: PMC10326890 DOI: 10.18332/tid/166517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 05/25/2023] [Accepted: 05/28/2023] [Indexed: 07/11/2023] Open
Abstract
While the impact of combustible cigarette smoking on cardiovascular disease (CVD) is well-established, the longitudinal association of non-traditional tobacco products with subclinical and clinical CVD has not been fully explored due to: 1) limited data availability; and 2) the lack of well-phenotyped prospective cohorts. Therefore, there is the need for sufficiently powered well-phenotyped datasets to fully elucidate the CVD risks associated with non-cigarette tobacco products. The Cross-Cohort Collaboration (CCC)-Tobacco is a harmonized dataset of 23 prospective cohort studies predominantly in the US. A priori defined variables collected from each cohort included baseline characteristics, details of traditional and non-traditional tobacco product use, inflammatory markers, and outcomes including subclinical and clinical CVD. The definitions of the variables in each cohort were systematically evaluated by a team of two physician-scientists and a biostatistician. Herein, we describe the method of data acquisition and harmonization and the baseline sociodemographic and risk profile of participants in the combined CCC-Tobacco dataset. The total number of participants in the pooled cohort is 322782 (mean age: 59.7 ± 11.8 years) of which 76% are women. White individuals make up the majority (73.1%), although there is good representation of other race and ethnicity groups including African American (15.6%) and Hispanic/Latino individuals (6.4%). The prevalence of participants who never smoked, formerly smoked, and currently smoke combustible cigarettes is 50%, 36%, and 14%, respectively. The prevalence of current and former cigar, pipe, and smokeless tobacco is 7.3%, 6.4%, and 8.6%, respectively. E-cigarette use was measured only in follow-up visits of select studies, totaling 1704 former and current users. CCC-Tobacco is a large, pooled cohort dataset that is uniquely designed with increased power to expand knowledge regarding the association of traditional and non-traditional tobacco use with subclinical and clinical CVD, with extension to understudied groups including women and individuals from underrepresented racial-ethnic groups.
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Affiliation(s)
- Erfan Tasdighi
- Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Baltimore, United States
| | - Kunal K. Jha
- Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Baltimore, United States
| | - Zeina A. Dardari
- Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Baltimore, United States
| | - Ngozi Osuji
- Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Baltimore, United States
| | - Tanuja Rajan
- Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Baltimore, United States
| | - Ellen Boakye
- Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Baltimore, United States
- American Heart Association Tobacco Regulation and Addiction Center, Dallas, United States
| | - Michael E. Hall
- American Heart Association Tobacco Regulation and Addiction Center, Dallas, United States
- Department of Medicine, University of Mississippi Medical Center, Jackson, United States
| | - Carlos J. Rodriguez
- American Heart Association Tobacco Regulation and Addiction Center, Dallas, United States
- Division of Cardiology, Department of Medicine, Albert Einstein College of Medicine, New York, United States
| | - Andrew C. Stokes
- American Heart Association Tobacco Regulation and Addiction Center, Dallas, United States
- Department of Global Health, School of Public Health, Boston University, Boston, United States
| | - Omar El Shahawy
- American Heart Association Tobacco Regulation and Addiction Center, Dallas, United States
- Department of Population Health, New York University Grossman School of Medicine, New York, United States
| | - Emelia J. Benjamin
- American Heart Association Tobacco Regulation and Addiction Center, Dallas, United States
- Cardiovascular Medicine, Boston Medical Center, Boston University School of Medicine, Boston, United States
- Department of Epidemiology, School of Public Health, Boston University, Boston, United States
| | - Aruni Bhatnagar
- American Heart Association Tobacco Regulation and Addiction Center, Dallas, United States
- School of Medicine, University of Louisville, Louisville, United States
| | - Andrew P. DeFilippis
- American Heart Association Tobacco Regulation and Addiction Center, Dallas, United States
- Department of Medicine, Vanderbilt University Medical Center, Nashville, United States
| | - Michael J. Blaha
- Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Baltimore, United States
- American Heart Association Tobacco Regulation and Addiction Center, Dallas, United States
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Allalou A, Peng J, Robinson GA, Marruganti C, D’Aiuto F, Butler G, Jury EC, Ciurtin C. Impact of puberty, sex determinants and chronic inflammation on cardiovascular risk in young people. Front Cardiovasc Med 2023; 10:1191119. [PMID: 37441710 PMCID: PMC10333528 DOI: 10.3389/fcvm.2023.1191119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 06/14/2023] [Indexed: 07/15/2023] Open
Abstract
Worrying trends of increased cardiovascular disease (CVD) risk in children, adolescents and young people in the Modern Era have channelled research and public health strategies to tackle this growing epidemic. However, there are still controversies related to the dynamic of the impact of sex, age and puberty on this risk and on cardiovascular health outcomes later in life. In this comprehensive review of current literature, we examine the relationship between puberty, sex determinants and various traditional CVD-risk factors, as well as subclinical atherosclerosis in young people in general population. In addition, we evaluate the role of chronic inflammation, sex hormone therapy and health-risk behaviours on augmenting traditional CVD-risk factors and health outcomes, ultimately aiming to determine whether tailored management strategies for this age group are justified.
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Affiliation(s)
- Amal Allalou
- University College London Medical School, University College London, London, United Kingdom
| | - Junjie Peng
- Centre for Adolescent Rheumatology Versus Arthritis, University College London, London, United Kingdom
- Centre for Rheumatology Research, Division of Medicine, University College London, London, United Kingdom
| | - George A. Robinson
- Centre for Adolescent Rheumatology Versus Arthritis, University College London, London, United Kingdom
- Centre for Rheumatology Research, Division of Medicine, University College London, London, United Kingdom
| | - Crystal Marruganti
- Eastman Dental Hospital, University College London Hospital, London, United Kingdom
| | - Francesco D’Aiuto
- Eastman Dental Hospital, University College London Hospital, London, United Kingdom
| | - Gary Butler
- Department of Paediatric Endocrinology, University College London Hospital, London, United Kingdom
- Institute of Child Health, University College London, London, United Kingdom
| | - Elizabeth C. Jury
- Centre for Rheumatology Research, Division of Medicine, University College London, London, United Kingdom
| | - Coziana Ciurtin
- Centre for Adolescent Rheumatology Versus Arthritis, University College London, London, United Kingdom
- Centre for Rheumatology Research, Division of Medicine, University College London, London, United Kingdom
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Mokwena K, Modjadji P. Pre-morbid cardiometabolic risks among South Africans living in informal settlements. Cardiovasc J Afr 2023; 34:23-29. [PMID: 35687088 PMCID: PMC10392806 DOI: 10.5830/cvja-2022-021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 04/08/2022] [Indexed: 06/07/2023] Open
Abstract
AIM Numerous studies have been conducted on cardiometabolic risk factors in South Africa. However, not much has been done in informal settlement populations faced with their own set of health risks. This study screened for pre-morbid cardiometabolic risks and associated factors among adults living in informal settlements in South Africa. METHODS A cross-sectional study used the WHO STEPwise questionnaire to collect data on demography, anthropometry, blood pressure, and glucose and cholesterol levels (n = 329). Cardiometabolic risks were based on the criteria considered by the International Diabetes Federation and the National Cholesterol Education Program Adult Treatment Panel III. Data were analysed using STATA 14. RESULTS The median age of the participants was 35 (25-42) years. Cardiometabolic risk factors among the participants were hypertension (66%), overweight/obesity (45%), abdominal obesity (46%), and elevated cholesterol (15%) and glucose levels (7%). The metabolic syndrome was found in 17% of the participants, with a high prevalence observed among participants aged 35-59 years (28%) and ≥ 60 years (40%). The metabolic syndrome was significantly associated with gender [males, adjusted odds ratio (AOR) = 0.4, 95% CI: 0.20-0.90] and age, 35-59 years (AOR = 5.07, 95% CI: 2.24-11.23) and ≥ 60 years (AOR = 6.57, 95% CI; 1.57-27.54). CONCLUSIONS Prevalent cardiometabolic risk factors in informal settlements indicate the need for routine screening for all the components of the metabolic syndrome at the primary healthcare level.
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Affiliation(s)
- Kebogile Mokwena
- Department of Public Health, School of Health Care Sciences, Sefako Makgatho Health Sciences University, Ga-Rankuwa, South Africa
| | - Perpetua Modjadji
- Department of Public Health, School of Health Care Sciences, Sefako Makgatho Health Sciences University, Ga-Rankuwa, South Africa.
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Meng L, Yu X, Han H, Jia X, Hu B, Zhang L, Wang Z, Zhang W, Zhong M, Zhu H. Circulating miR-143 and miR-145 as promising biomarkers for evaluating severity of coronary artery stenosis in patients with acute coronary syndrome. Clin Biochem 2023; 111:32-40. [PMID: 36241060 DOI: 10.1016/j.clinbiochem.2022.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 08/17/2022] [Accepted: 10/07/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND Multiple studies have provided evidence that miR-143 and miR-145 play a crucial role in the pathogenesis and progression of atherosclerosis. In the present study, we aim to investigate the expression of plasma miR-143 and miR-145 in patients with acute coronary syndrome (ACS) and their association with the severity of coronary artery stenosis. METHODS The study enrolled 279 patients with ACS, including 201 patients with unstable angina (UA) and 78 patients with acute myocardial infarction (AMI), and 65 matched subjects as the control group. The plasma levels of miR-143 and miR-145 were detected by quantitative real-time PCR (qRT-PCR). Gensini score was applied to evaluate the severity of coronary artery stenosis. RESULTS Plasma levels of miR-143 and miR-145 in patients with ACS were both decreased compared with the control group (p < 0.001). Plasma levels of miR-143 and miR-145 were negatively correlated with Gensini score (miR-143: r = -0.246, p < 0.001; miR-145: r = -0.222, p < 0.001). Logistic regression analysis showed that miR-143 and miR-145 were protective factors for the onset of ACS, UA, or AMI separately. MiR-143 (AUC: 0.786, p < 0.001) and miR-145 (AUC: 0.793, p < 0.001) were able to predict the degree of coronary artery stenosis greater than 50 %. CONCLUSION The plasma levels of miR-143 and miR-145 were significantly decreased in ACS patients and were negatively correlated with coronary stenosis. In conclusion, plasma miR-143 and miR-145 levels can be used as noninvasive biomarkers for evaluating coronary artery stenosis.
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Affiliation(s)
- Linlin Meng
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China
| | - Xin Yu
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China; Department of Cardiology, The People's Hospital of Pingyi County, Shandong, China
| | - Haitao Han
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China
| | - Xu Jia
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China
| | - Boang Hu
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China
| | - Lei Zhang
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China
| | - Zhihao Wang
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China; Department of Geriatric Medicine, Qilu Hospital, Cheeloo College of Medicine, Shandong University; Shandong key Laboratory of Cardiovascular Proteomics, Jinan, Shandong, 250012, China
| | - Wei Zhang
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China
| | - Ming Zhong
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China
| | - Hui Zhu
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China.
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12
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Dahdah A, Jaggers RM, Sreejit G, Johnson J, Kanuri B, Murphy AJ, Nagareddy PR. Immunological Insights into Cigarette Smoking-Induced Cardiovascular Disease Risk. Cells 2022; 11:3190. [PMID: 36291057 PMCID: PMC9600209 DOI: 10.3390/cells11203190] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/28/2022] [Accepted: 10/07/2022] [Indexed: 01/19/2023] Open
Abstract
Smoking is one of the most prominent addictions of the modern world, and one of the leading preventable causes of death worldwide. Although the number of tobacco smokers is believed to be at a historic low, electronic cigarette use has been on a dramatic rise over the past decades. Used as a replacement for cigarette smoking, electronic cigarettes were thought to reduce the negative effects of burning tobacco. Nonetheless, the delivery of nicotine by electronic cigarettes, the most prominent component of cigarette smoke (CS) is still delivering the same negative outcomes, albeit to a lesser extent than CS. Smoking has been shown to affect both the structural and functional aspects of major organs, including the lungs and vasculature. Although the deleterious effects of smoking on these organs individually is well-known, it is likely that the adverse effects of smoking on these organs will have long-lasting effects on the cardiovascular system. In addition, smoking has been shown to play an independent role in the homeostasis of the immune system, leading to major sequela. Both the adaptive and the innate immune system have been explored regarding CS and have been demonstrated to be altered in a way that promotes inflammatory signals, leading to an increase in autoimmune diseases, inflammatory diseases, and cancer. Although the mechanism of action of CS has not been fully understood, disease pathways have been explored in both branches of the immune system. The pathophysiologically altered immune system during smoking and its correlation with cardiovascular diseases is not fully understood. Here we highlight some of the important pathological mechanisms that involve cigarette smoking and its many components on cardiovascular disease and the immune systems in order to have a better understanding of the mechanisms at play.
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Affiliation(s)
- Albert Dahdah
- Division of Cardiac Surgery, Department of Surgery, Ohio State University Wexner Medical Center, Columbus, OH 43210, USA
| | - Robert M. Jaggers
- Division of Cardiac Surgery, Department of Surgery, Ohio State University Wexner Medical Center, Columbus, OH 43210, USA
| | - Gopalkrishna Sreejit
- Division of Cardiac Surgery, Department of Surgery, Ohio State University Wexner Medical Center, Columbus, OH 43210, USA
| | - Jillian Johnson
- Division of Cardiac Surgery, Department of Surgery, Ohio State University Wexner Medical Center, Columbus, OH 43210, USA
| | - Babunageswararao Kanuri
- Division of Cardiac Surgery, Department of Surgery, Ohio State University Wexner Medical Center, Columbus, OH 43210, USA
| | - Andrew J. Murphy
- Division of Immunometabolism, Baker Heart and Diabetes Institute, Melbourne, VIC 3010, Australia
| | - Prabhakara R. Nagareddy
- Division of Cardiac Surgery, Department of Surgery, Ohio State University Wexner Medical Center, Columbus, OH 43210, USA
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13
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Ahmed AM, Ibrahim AM. Effect of heavy cigarette and water pipe smoking on antioxidants and lipids in Sudanese male smokers: a case-control study. Afr Health Sci 2022; 22:125-132. [PMID: 36910389 PMCID: PMC9993274 DOI: 10.4314/ahs.v22i3.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Tobacco smoking is a source of many toxins such as free radicals, mutagenic substances as well as cause for developing cardiovascular diseases (CVD), particularly atherosclerosis. This study aims to assess the impact of smoking on antioxidants in Sudanese male smokers. Methods Cases were 85 and 48 men who smoke cigarettes (CS) and water pipe (WPS) respectively and they were compared with matching 50 non-smoking controls. Blood samples were collected and following parameters: Glutathione peroxidase, Superoxide dismutase, Total cholesterol, Triglyceride, LDL, HDL, Paraoxinase, and Malondialdehyde were measured. Results There were no significant differences in biochemical parameters between light CS and WPS compared to controls. In heavy smokers of both WPS and CS, the TC, TG, LDL, and MDA were higher than controls (p>0.05), GPx, SOD, HDL, and PON were lower in smokers than controls (p>0.05). In both groups of smokers; HDL, GPx, SOD, and PON were inversely correlated with duration of smoking (p>0.05), also, HDL was positively correlated with SOD and GPx (p>0.05). Moreover, GPx and SOD were correlated with each other in both groups of smokers (p>0.05). Conclusion In Sudanese male smokers' biochemical profile disturbances suggest that heavy smoking was leading to developing CVD, particularly WPS.
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Affiliation(s)
- Ahmed M Ahmed
- Department of Clinical Laboratory Sciences, Faculty of Applied Medical Sciences, Taibah University, AL Madinah, Saudi Arabia
| | - Amna M Ibrahim
- Faculty of Medicine, Omdurman Islamic University, Khartoum, Sudan
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14
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Monasso GS, Felix JF, Gaillard R, Jaddoe VWV. Fetal and Childhood Exposure to Parental Tobacco Smoking and Arterial Health at Age 10 Years. Am J Hypertens 2022; 35:867-874. [PMID: 35882377 PMCID: PMC9527773 DOI: 10.1093/ajh/hpac084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 06/14/2022] [Accepted: 07/25/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Exposure to parental tobacco smoking during fetal life and childhood is associated with adverse cardiovascular health outcomes. It is not known whether these adverse parental lifestyle exposures are also associated with changes in the structure and function of the carotid arteries in children aged 10 years. METHODS In a population-based prospective cohort study among 4,639 healthy children, we examined the associations of fetal exposure to maternal (no, first trimester only, continued), paternal (no, yes), and combined parental tobacco smoking (nonsmoking parents, mother only, father only, both parents smoked) with carotid intima-media thickness and distensibility at 10 years. We also assessed the associations of exposure to any parental tobacco smoking at ages 6 and 10 years with these outcomes. RESULTS Compared with no exposure, fetal exposure to continued maternal smoking was not associated with carotid intima-media thickness (-0.04 standard deviation score (SDS); 95% confidence interval (CI): -0.13, 0.05); and distensibility (0 SDS, 95% CI: -0.09, 0.09) at age 10 years. Fetal exposure to two smoking parents was also not associated with carotid intima-media thickness (-0.07 SDS, 95% CI: -0.16, 0.02) and distensibility (0 SDS, 95% CI: -0.09, 0.10) at this age. Exposure to any parental smoking during childhood also was not associated with these outcomes at age 10 years. CONCLUSIONS Exposure to parental tobacco smoking during fetal life and childhood was not associated with markers of arterial health in children aged 10 years. Prevention strategies aiming at minimizing smoke exposure later in life are still relevant regarding arterial health.
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Affiliation(s)
- Giulietta S Monasso
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands,Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Janine F Felix
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands,Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Romy Gaillard
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands,Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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15
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Gottdiener JS, Buzkova P, Kahn PA, DeFilippi C, Shah S, Barasch E, Kizer JR, Psaty B, Gardin JM. Relation of Cigarette Smoking and Heart Failure in Adults ≥65 Years of Age (From the Cardiovascular Health Study). Am J Cardiol 2022; 168:90-98. [PMID: 35045935 PMCID: PMC8930705 DOI: 10.1016/j.amjcard.2021.12.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/14/2021] [Accepted: 12/20/2021] [Indexed: 11/25/2022]
Abstract
Cigarette smoking is associated with adverse cardiac outcomes, including incident heart failure (HF). However, key components of potential pathways from smoking to HF have not been evaluated in older adults. In a community-based study, we studied cross-sectional associations of smoking with blood and imaging biomarkers reflecting mechanisms of cardiac disease. Serial nested, multivariable Cox models were used to determine associations of smoking with HF, and to assess the influence of biochemical and functional (cardiac strain) phenotypes on these associations. Compared with never smokers, smokers had higher levels of inflammation (C-reactive protein and interleukin-6), cardiomyocyte injury (cardiac troponin T [hscTnT]), myocardial "stress"/fibrosis (soluble suppression of tumorigenicity 2 [sST2], galectin 3), and worse left ventricle systolic and diastolic function. In models adjusting for age, gender, and race (DEMO) and for clinical factors potentially in the causal pathway (CLIN), smoking exposures were associated with C-reactive protein and interleukin-6, sST2, hscTnT, and with N-terminal pro-brain natriuretic protein (in Whites). In DEMO adjusted models, the cumulative burden of smoking was associated with worse left ventricle systolic strain. Current smoking and former smoking were associated with HF in DEMO models (hazard ratio 1.41, 95% confidence interval 1.22 to 1.64 and hazard ratio 1.14, 95% confidence interval 1.03 to 1.25, respectively), and with current smoking after CLIN adjustment. Adjustment for time-varying myocardial infarction, inflammation, cardiac strain, hscTnT, sST2, and galectin 3 did not materially alter the associations. Smoking was associated with HF with preserved and decreased ejection fraction. In conclusion, in older adults, smoking is associated with multiple blood and imaging biomarker measures of pathophysiology previously linked to HF, and to incident HF even after adjustment for clinical intermediates.
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Affiliation(s)
- John S Gottdiener
- Department of Medicine (Cardiology), University of Maryland School of Medicine, Baltimore, Maryland; Departments of.
| | | | - Peter A Kahn
- Section of Pulmonary, Critical Care, and Sleep Medicine, Yale University School of Medicine, New Haven, Connecticut
| | | | - Sanjiv Shah
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Eddy Barasch
- Division of Cardiology, St. Francis Hospital, Roslyn, New York
| | - Jorge R Kizer
- Cardiology Section, San Francisco Veterans Affairs Health Care System, San Francisco, California; Departments of; Medicine and of; Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California
| | - Bruce Psaty
- Medicine; Epidemiology, and; Health Services, University of Washington, Seattle, Washington; Kaiser Permanente Washington Health Research Institute, Seattle, Washington; and
| | - Julius M Gardin
- Division of Cardiology, Department of Medicine, Rutgers New Jersey Medical School, Newark, New Jersey
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16
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Li B, Liu S, Wang Y, Zhao J, Song Y, Xu W, Zhang C, Gao C, Zhao Q, Wu D. The influence of carotid atherosclerosis on surgical outcomes of patients with cervical spondylotic myelopathy: A retrospective study. Medicine (Baltimore) 2022; 101:e28743. [PMID: 35119027 PMCID: PMC8812591 DOI: 10.1097/md.0000000000028743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 01/12/2022] [Indexed: 01/04/2023] Open
Abstract
The appearance of atherosclerosis in the carotid artery may be suggest the possibility of atherosclerosis in the spinal cord artery, which can cause spinal cord ischemia and further lead to neural element damage.According to the inclusion and exclude standard, there are 137 patients with cervical spondylotic myelopathy (CSM) incorporating retrospective analysis. These patients were consecutively admitted into The Second Hospital- Cheeloo College of Medicine-Shandong University from January 2016 to December 2018 and have accepted surgical treatment. All patients were examined by color Doppler ultrasound to detect carotid atherosclerosis before surgery. All patients were divided into 2 groups according to the presence or absence of carotid atherosclerosis: carotid atherosclerosis group (n = 88) and noncarotid atherosclerosis group (n = 49). All patients were followed up for at least 12 months after surgery. Demographic and surgery-related data were collected and analyzed to identify potential factors that affect the surgical outcomes in CSM.The average age of carotid atherosclerosis group (51 males and 37 females), and noncarotid atherosclerosis group (24 males and 25 females) were 62.02 ± 10.34 years (range, 38-85 years) and 49.61 ± 10.28 years (range, 26-67 years), respectively.In carotid atherosclerosis group: pre and postoperative modify Japanese Orthopedic Association Scores (mJOA score) were 11.58 ± 1.82 and 14.36 ± 1.64; the recovery rate of mJOA score was 45.57% ± 13.28%. In noncarotid atherosclerosis group: pre and postoperative mJOA score were 12.00 ± 2.11 and 15.04 ± 1.70; the recovery rate of mJOA score was 53.90% ± 13.22%. Univariate logistic regression analysis demonstrated that gender (P = .004), age ≥65 years (P = .001), duration of symptoms ≥12 months (P = .040), smoking history (P < .001), preoperative mJOA score ≤11 (P = .007) and carotid atherosclerosis (P = .004) were related to poor surgical outcomes. Multivariate logistic regression analysis showed significant correlations between poor surgical outcomes and age ≥65 years (P = .047), smoking history (P = .010), preoperative mJOA score ≤11 (P = .008) or carotid atherosclerosis (P = .047).Carotid atherosclerosis may be a risk factor for poor surgical outcomes in CSM.
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Affiliation(s)
- Bohan Li
- Health Management Center, The Second Hospital, Cheeloo College of Medicine, Shandong University, Shandong, PR China
| | - Shuling Liu
- Department of Radiology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Shandong, PR China
| | - Yongmei Wang
- Department of Cardiology, The Second Hospital, Cheeloo College of Medicine, Shandong University,Shandong, PR China
| | - Jie Zhao
- Department of Spine Surgery, The Second Hospital, Cheeloo College of Medicine, Shandong University, Shandong, PR China
| | - Yang Song
- Department of Spine Surgery, The Second Hospital, Cheeloo College of Medicine, Shandong University, Shandong, PR China
| | - Wen Xu
- Department of Spine Surgery, The Second Hospital, Cheeloo College of Medicine, Shandong University, Shandong, PR China
| | - Cheng Zhang
- Department of Spine Surgery, The Second Hospital, Cheeloo College of Medicine, Shandong University, Shandong, PR China
| | - Chunzheng Gao
- Department of Spine Surgery, The Second Hospital, Cheeloo College of Medicine, Shandong University, Shandong, PR China
| | - Qian Zhao
- Department of cardiovascular, Jinan Central Hospital, Cheeloo College of Medicine, Shandong University, Shandong, PR China
| | - Dongjin Wu
- Department of Spine Surgery, The Second Hospital, Cheeloo College of Medicine, Shandong University, Shandong, PR China
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Santos FSD, Oliveira IOD, Mintem GC, Horta BL, Gigante DP. Epidemiology of interleukin-6: the 30-year follow-up of the 1982 Pelotas (Brazil) birth cohort study. Ann Hum Biol 2022; 48:525-533. [PMID: 35105198 DOI: 10.1080/03014460.2021.1998619] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Cardiovascular diseases are the main cause of death globally. Interleukin-6 (IL-6) is a biomarker of cardiovascular risk. AIM To investigate factors associated with IL-6 concentration in serum, from early life up to 30 years of age. SUBJECTS AND METHODS In the 2012-2013 follow-up, IL-6 was measured in 2809 participants of the 1982 Pelotas Birth Cohort (1369 males). Multivariable linear regressions, stratified by sex, were performed to evaluate the associations of African ancestry, family income and maternal education at birth, monthly income and education at 30 years, smoking status, harmful alcohol intake, physical activity, and body composition with IL-6, considering a conceptual hierarchical framework. RESULTS Males with low educational levels and current smokers had the highest mean IL-6. Among females, African ancestry and low monthly income were associated with the highest mean values for the outcome. Physical activity had an inverse association with IL-6 concentration among females. A direct relationship was observed between the measures of adiposity on IL-6, in both sexes. CONCLUSION Body composition was the main predictor for the outcome evaluated in males and females. Thus, the avoidance of overweight remains an important strategy for the prevention and control of cardiovascular risk and biomarkers associated with these diseases.
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Affiliation(s)
| | | | - Gicele Costa Mintem
- Post-graduate Program in Nutrition and Food, Federal University of Pelotas, Pelotas, Brazil
| | - Bernardo Lessa Horta
- Post-graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Denise Petrucci Gigante
- Post-graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.,Post-graduate Program in Nutrition and Food, Federal University of Pelotas, Pelotas, Brazil
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18
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Wang Z, Liu Y, Xie J, Liu NF. Association between hemoglobin glycation index and subclinical myocardial injury in the general population free from cardiovascular disease. Nutr Metab Cardiovasc Dis 2022; 32:469-478. [PMID: 34895803 DOI: 10.1016/j.numecd.2021.10.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 10/09/2021] [Accepted: 10/21/2021] [Indexed: 01/20/2023]
Abstract
BACKGROUND AND AIMS The relationship between hemoglobin glycation index (HGI) and the diagnosis and prognosis of cardiovascular disease (CVD) has been verified by previous studies. However, it remains unknown whether HGI has a predictive effect on subclinical myocardial injury (SC-MI). The purpose of the present study was to explore the relationship between HGI and SC-MI in the general population free from CVD. METHODS AND RESULTS The present study included 6009 participants free of CVD from the third National Health and Nutrition Examination Survey. Binary Logistic regression analysis was used to tested the association between HGI and SC-MI. As results, the HGI was significantly higher in participants with SC-MI compared with those without, and the HGI was positively correlated with SC-MI and other metabolic disorder parameters. Each 1-unit increase of HGI and glycated hemoglobin A1c (HbA1c) was independently associated with higher risk of SC-MI (P < 0.05), while fasting plasma glucose (FPG) was no longer a predictive indicator of SC-MI with the increase of confounding factors [OR (95% CI): 1.001 (0.999-1.003), P = 0.305]. And in the subgroup analysis, HGI, only in participants without diabetes, was independently associated with higher risk of SC-MI, while HbA1c and FPG had no independent predictive role in both diabetic and non-diabetic participants. CONCLUSIONS HGI was a significant predictor of SC-MI in the general population free from CVD.
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Affiliation(s)
- Zhenwei Wang
- Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China
| | - Yihai Liu
- Department of Cardiology, Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, China
| | - Jing Xie
- College of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing 210000, China
| | - Nai-Feng Liu
- Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China.
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Skranes JB, Lyngbakken MN, Hveem K, Røsjø H, Omland T. Tobacco Consumption and High-Sensitivity Cardiac Troponin I in the General Population: The HUNT Study. J Am Heart Assoc 2022; 11:e021776. [PMID: 35001649 PMCID: PMC9238518 DOI: 10.1161/jaha.121.021776] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Background Cardiac troponins represent a sensitive index of subclinical myocardial injury and are associated with increased risk of cardiovascular events in the general population. Despite positive associations with cardiovascular risk of both cardiac troponins and cigarette smoking, concentrations of cardiac troponin I measured by high‐sensitivity assays (hs‐cTnI) are paradoxically lower in current smokers than in never‐smokers. The impact of smoking intensity and time from smoking cessation on hs‐cTnI remains unknown. Methods and Results hs‐cTnI concentrations were measured in 32028 subjects free from cardiovascular disease enrolled in the prospective, population‐based HUNT (Trøndelag Health Study). Tobacco habits were self‐reported and classified as never (n=14 559), former (n=14 248), and current (n=3221) smokers. Current smokers exhibited significantly lower concentrations of hs‐cTnI than never‐smokers (P<0.001). In adjusted models, both current smoking (−17.3%; 95% CI, −20.6 to −13.9%) and former smoking (−6.6%; 95% CI, −8.7 to −4.5%) were associated with significantly lower hs‐cTnI concentrations. Among former smokers, higher smoking burden (>10 pack‐years) were associated with lower concentrations of hs‐cTnI. Time since smoking cessation was associated with increasing concentrations of hs‐cTnI in a dose‐dependent manner (P for trend<0.001), and subjects who quit smoking >30 years ago had concentrations of hs‐cTnI comparable with those of never‐smokers. Conclusions In the general population, both current and former cigarette smoking is associated with lower concentrations of hs‐cTnI. In former smokers, there was a dose‐response relationship between pack‐years of smoking, and hs‐cTnI. Time since smoking cessation was associated with increasing concentrations of hs‐cTnI, indicating a continuum of hs‐cTnI from current smoker to never‐smokers.
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Affiliation(s)
- Julia Brox Skranes
- Department of Cardiology Division of Medicine Akershus University Hospital Lørenskog Norway.,Division of Research and Innovation Akershus University Hospital Lørenskog Norway
| | - Magnus Nakrem Lyngbakken
- Department of Cardiology Division of Medicine Akershus University Hospital Lørenskog Norway.,Division of Research and Innovation Akershus University Hospital Lørenskog Norway
| | - Kristian Hveem
- Institute of Clinical MedicineUniversity of Oslo Oslo Norway.,K.G. Jebsen Center for Genetic Epidemiology Department of Public Health and Nursing Norwegian University of Science and Technology Trondheim Norway.,Department of Medicine Levanger HospitalNord-Trøndelag Hospital Trust Levanger Norway
| | - Helge Røsjø
- Division of Research and Innovation Akershus University Hospital Lørenskog Norway.,HUNT Research Centre Department of Public Health and General Practice Norwegian University of Science and Technology Levanger Norway
| | - Torbjørn Omland
- Department of Cardiology Division of Medicine Akershus University Hospital Lørenskog Norway.,Division of Research and Innovation Akershus University Hospital Lørenskog Norway
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20
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Kazemitabar M, Garcia D. Translation and psychometric validation of the Persian version of the Questionnaire on Smoking Urges for assessment of craving to smoke among university students. PeerJ 2021; 9:e12531. [PMID: 34900437 PMCID: PMC8627126 DOI: 10.7717/peerj.12531] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 11/02/2021] [Indexed: 11/20/2022] Open
Abstract
Background Even though tobacco is one of the most preventable causes of death worldwide, it endangers more than 8 million people yearly. In this context, meta-analyses suggest that a significant part of the general Iranian population over 15 years of age smoke and that there is a need for good screening tools for smoking cravings and urges in Iran. The present study reported the translation and investigated the psychometric properties (i.e., factor structure, validity, and reliability) of the Persian version of the Questionnaire on Smoking Urges (QSU) with 12 items in the Iranian context. Method The translation process and content validity of the items were examined entirely in an expert panel using the Content Validity Index. The total sample of participants in which the translated version was tested consisted of 392 (172 female, 220 male, Mage = 22.31 years, SD = 2.90) university students who answered the QSU 12-item at the start of their participation in smoking cessation interventions. The QSU 12-item was firstly translated, then piloted using a subsample of 150 university students and finally validity and reliability of the instrument were investigated using a subsample of 242 participants. We tested the proposed models in the literature, that is, a 1-factor solution and a 2-factor solution with six items on each factor (Factor 1: desire/intention to smoke; Factor 2: relief of negative affect or withdrawal symptoms and anticipation of positive outcome). At last, we tested differences across differences in QSU-scores across different subgroups of individuals based on their demographics. Results The results suggested that, in contrast to past studies, a modified 2-factor model, using five items for Factor 1 and 7 items for Factor 2, was the best fitting model (CFI = .95, RMSEA = .09, CI = 90%). Additionally, the QSU 12-item Persian version showed good convergent and divergent validity, internal consistency (Factor 1 = .94, Factor 2 = .97), ICC (average measure ICC = .95, CI = 95%, F(391, 4301) = 20.54, p < .001), concurrent validity (r = .71, p < .01), and discriminant validity (r = −.04, p > .05). Finally, subgroups based on gender, marital status, (un)employment, and educational level did not differed in their responses to the QSU 12-item. Conclusion The Persian version of the QSU 12-item has satisfactory psychometric properties and, with a slight modification, it can be considered as a reliable and valid method to estimate smoking urges in the Iranian population. Moreover, the QSU 12-item seems appropriate to measure urge for smoking among groups of individuals with different sociodemographic backgrounds. Importantly, the QSU 12-item differentiates individuals’ desire and intention to smoke from their anticipated relief of negative affect or withdrawal symptoms, which can be important for personalizing interventions targeting individuals who want to quit smoking.
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Affiliation(s)
- Maryam Kazemitabar
- Department of Psychology, University of Tehran, Tehran, Iran.,Promotion of Health and Innovation (PHI) Lab, International Network for Well-Being, Iran
| | - Danilo Garcia
- Department of Behavioral Sciences and Learning, Linköping University, Linköping, Sweden.,Centre for Law and Mental Health (CELAM), University of Gothenburg, Gothenburg, Sweden.,Promotion of Health and Innovation (PHI) Lab, International Network for Well-Being, Sweden.,Department of Psychology, University of Gothenburg, Gothenburg, Sweden.,Department of Psychology, Lund University, Lund, Sweden
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21
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He C, Wang W, Chen Q, Shen Z, Pan E, Sun Z, Lou P, Zhang X. Factors associated with stroke among patients with type 2 diabetes mellitus in China: a propensity score matched study. Acta Diabetol 2021; 58:1513-1523. [PMID: 34125293 DOI: 10.1007/s00592-021-01758-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 06/05/2021] [Indexed: 12/25/2022]
Abstract
OBJECTIVE This study aimed to examine the prevalence of stroke and associated factors of stroke in patients with type 2 diabetes(T2DM) in China. METHODS Participants were 18,013 T2DM patients recruited with stratified random cluster sampling method from December 2013 to January 2014 in China. Propensity score matching was used to eliminate confounding effects between groups and logistic regression analysis was used to examine factors associated with stroke among T2DM patients. RESULTS Overall, the prevalence of stroke in the subjects with T2DM was 9.5%. After nearest neighbor matching, smoking (OR = 1.60, 95%CI: 1.26-2.03), hypertension (OR = 2.96, 95%CI: 2.55-3.43), dyslipidemia (OR = 2.00, 95%CI: 1.71-2.33), family history of stroke (OR = 2.02, 95%CI: 1.61-2.54), obesity (OR = 1.21, 95%CI: 1.01-1.45) and sleep duration < 6 h/day (OR = 1.44, 95%CI: 1.20-1.73) or > 8 h/day (OR = 1.22, 95%CI: 1.05-1.42) were positively associated with stroke, whereas drinking 1-3 days/week (OR = 0.64, 95%CI: 0.45-0.90) or daily (OR = 0.45, 95%CI: 0.33-0.60), effective exercise (OR = 0.65, 95%CI: 0.57-0.73) and underweight (OR = 0.30, 95%CI: 0.13-0.71) were negatively related to stroke. Besides, the risk of stroke increased substantially with accumulation of above seven modified risk factors. The odds ratio values of stroke in patients having ≥ 5 of the above seven risk factors was 14.39 (95% CI: 8.87-23.26). CONCLUSIONS The prevalence of stroke was high among T2DM in China. It is of great significance to strengthen comprehensive management of health-related behaviors including smoking cessation, moderate alcohol consumption, effective exercise, 6-8 h of sleep duration, keeping normal weight and the prevention of hypertension and dyslipidemia to have sustained beneficial effects on improvements of stroke risk factors.
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Affiliation(s)
- Chenlu He
- School of Public Health, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China
| | - Wei Wang
- School of Public Health, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China.
| | - Qian Chen
- School of Public Health, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China
| | - Ziyuan Shen
- School of Public Health, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China
| | - Enchun Pan
- Huai´an Center for Disease Control and Prevention, Huai´an, 223001, Jiangsu, China
| | - Zhongming Sun
- Huai´an Center for Disease Control and Prevention, Huai´an, 223001, Jiangsu, China
| | - Peian Lou
- Xuzhou Center for Disease Control and Prevention, Xuzhou, 221000, Jiangsu, China
| | - Xunbao Zhang
- School of Public Health, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China.
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22
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Duan F, Zeng C, Liu S, Gong J, Hu J, Li H, Tan H. α1-nAchR-Mediated Signaling Through Lipid Raft Is Required for Nicotine-Induced NLRP3 Inflammasome Activation and Nicotine-Accelerated Atherosclerosis. Front Cell Dev Biol 2021; 9:724699. [PMID: 34490270 PMCID: PMC8416509 DOI: 10.3389/fcell.2021.724699] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 07/16/2021] [Indexed: 01/13/2023] Open
Abstract
Background Nicotine exerts direct effects on multiple cell types in the cardiovascular system by associating with its high-affinity nicotinic acetylcholine receptors (nAchRs). Lipid raft is a membrane microdomain that recruits various receptors and signaling molecules for coordinating cellular immune response and many others signaling processes. Here, we aim to identify the essential role of lipid raft in mediating nicotine-triggered inflammatory and nicotine-accelerated atherosclerosis, and to figure out the specific receptor of nicotine-induced Nod-like receptor protein 3 (NLRP3) inflammasome activation in macrophage. Methods and Results ApoE–/– mice were fed with a high-fat diet to build atherosclerosis model. Methyl-β-cyclodextrin was used to interrupt intact lipid raft. We confirmed that nicotine triggered NLRP3 inflammasome activation and induced macrophage migration into atherosclerotic plaque, thus accelerated atherosclerosis in apoE–/– mice fed with a high-fat diet. Mechanically, nicotine increased the expression of α1-nAChR and stimulated the accumulation of α1-nAChR in lipid raft, leading to NLRP3 inflammasome activation in macrophage. Conversely, silencing of α1-nAChR in macrophage sufficiently blocked the pro-inflammasome activation effect of nicotine, indicating that α1-nAChR was the specific receptor for nicotine in triggering NLRP3 inflammasome in macrophage. Furthermore, both the destruction of lipid raft by methyl-β-cyclodextrin and the interference of lipid raft clustering by silencing acid sphingomyelinase reversed nicotine-induced NLRP3 inflammasome activation by reducing the accumulation of α1-nAChR in lipid raft in macrophage, suggesting lipid raft–mediated accumulation of α1-nAChR was the key event in regulating the pro-inflammatory effects of nicotine in macrophage. Importantly, nicotine-induced NLRP3 inflammasome activation and macrophage migration into atherosclerotic plaque were reversed by methyl-β-cyclodextrin, making a significant improvement for atherosclerosis in apoE–/– mice fed with a high-fat diet. Conclusion α1-nAChR-mediated signaling through lipid raft is required for NLRP3 inflammasome activation and pro-atherosclerotic property of nicotine.
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Affiliation(s)
- Fengqi Duan
- Department of Pathophysiology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Cheng Zeng
- Department of Pathophysiology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Sijun Liu
- Department of Pathophysiology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Jianfeng Gong
- Department of Pathophysiology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Jia Hu
- Department of Pathophysiology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Hongyu Li
- Laboratory Animal Center, Sun Yat-sen University, Guangzhou, China
| | - Hongmei Tan
- Department of Pathophysiology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China.,Laboratory Animal Center, Sun Yat-sen University, Guangzhou, China.,The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
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23
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Wang Y, Armijos RX, Xun P, Weigel MM. Dietary Inflammatory Index and Cardiometabolic Risk in Ecuadorian Women. Nutrients 2021; 13:nu13082640. [PMID: 34444800 PMCID: PMC8400965 DOI: 10.3390/nu13082640] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 07/27/2021] [Accepted: 07/27/2021] [Indexed: 12/15/2022] Open
Abstract
Low-grade systemic inflammation is implicated in metabolic syndrome (MetS) and cardiometabolic diseases. Diet is hypothesized to be an important low-grade inflammation modifier. However, few studies have examined the association of dietary inflammation with MetS and cardiometabolic risk in Latin American populations and their findings are inconsistent. Our cross-sectional study examined the association of dietary inflammatory potential with MetS and cardiometabolic risk components in 276 urban Ecuadorian women. Dietary inflammation was evaluated using an energy-adjusted Dietary Inflammatory Index (E-DII), divided into quartiles (Q). E-DII scores ranged from −4.89 (most anti-inflammatory) to 4.45 (most pro-inflammatory). Participants in the most pro-inflammatory (Q4) compared to the least inflammatory E-DII quartile (Q1) had a 4.4 increased adjusted odds for MetS (95% C.I. = 2.0, 9.63; p < 0.001). Every one-unit increase in E-DII was associated with a 1.4 increase in MetS (95% CI = 1.22, 1.52; p < 0.001). In other adjusted models, the most pro-inflammatory E-DII quartile (Q4) was positively associated with total blood cholesterol and triglycerides (p < 0.001), LDL-c (p = 0.007), diastolic blood pressure (p< 0.002), mean arterial pressure (p < 0.006), waist circumference (p < 0.008), and Framingham risk score (p < 0.001). However, the previously identified associations with pulse wave velocity and BMI were no longer evident in the models. These findings suggest that more pro-inflammatory diets may contribute to poorer cardiometabolic health. Promoting healthier diets with a lower inflammatory potential may help to prevent or slow development of cardiometabolic disorders.
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Affiliation(s)
- Yankun Wang
- Department of Environmental & Occupational Health, Indiana University-Bloomington School of Public Health, Bloomington, IN 47405, USA; (Y.W.); (R.X.A.)
- Global Environmental Health Research Laboratory, Indiana University-Bloomington School of Public Health, Bloomington, IN 47405, USA
| | - Rodrigo X. Armijos
- Department of Environmental & Occupational Health, Indiana University-Bloomington School of Public Health, Bloomington, IN 47405, USA; (Y.W.); (R.X.A.)
- Global Environmental Health Research Laboratory, Indiana University-Bloomington School of Public Health, Bloomington, IN 47405, USA
- Center for Latin American & Caribbean Studies, Indiana University-Bloomington, Bloomington, IN 47405, USA
| | - Pengcheng Xun
- Department of Epidemiology and Biostatistics, Indiana University-Bloomington School of Public Health, Bloomington, IN 47405, USA;
- Atara Biotherapeutics, Thousand Oaks, CA 91320, USA
| | - Mary Margaret Weigel
- Department of Environmental & Occupational Health, Indiana University-Bloomington School of Public Health, Bloomington, IN 47405, USA; (Y.W.); (R.X.A.)
- Global Environmental Health Research Laboratory, Indiana University-Bloomington School of Public Health, Bloomington, IN 47405, USA
- Center for Latin American & Caribbean Studies, Indiana University-Bloomington, Bloomington, IN 47405, USA
- Correspondence: ; Tel.: +812-856-4930
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24
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Ibanez B, Fernández-Ortiz A, Fernández-Friera L, García-Lunar I, Andrés V, Fuster V. Progression of Early Subclinical Atherosclerosis (PESA) Study: JACC Focus Seminar 7/8. J Am Coll Cardiol 2021; 78:156-179. [PMID: 34238438 DOI: 10.1016/j.jacc.2021.05.011] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 03/24/2021] [Accepted: 05/14/2021] [Indexed: 12/23/2022]
Abstract
Atherosclerosis starts early in life and progresses silently for decades. Considering atherosclerosis as a "systemic disease" invites the use of noninvasive methodologies to detect disease in various regions before symptoms appear. The PESA-(Progression of Early Subclinical Atherosclerosis) CNIC-SANTANDER study is an ongoing prospective cohort study examining imaging, biological, and behavioral parameters associated with the presence and progression of early subclinical atherosclerosis. Between 2010 and 2014, PESA enrolled 4,184 asymptomatic middle-aged participants who undergo serial 3-yearly follow-up examinations including clinical interviews, lifestyle questionnaires, sampling, and noninvasive imaging assessment of multiterritorial subclinical atherosclerosis (carotids, iliofemorals, aorta, and coronaries). PESA tracks the trajectories of atherosclerosis and associated disorders from early stages to the transition to symptomatic phases. A joint venture between the CNIC and the Santander Bank, PESA is expected to run until at least 2029, and its significant contributions to date are presented in this review paper.
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Affiliation(s)
- Borja Ibanez
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Cardiology Department, IIS-Fundación Jiménez Díaz University Hospital, Madrid, Spain; CIBER de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
| | - Antonio Fernández-Ortiz
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; CIBER de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain; Hospital Clínico San Carlos, IdISSC, Universidad Complutense, Madrid, Spain
| | - Leticia Fernández-Friera
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; CIBER de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain; Hospital Universitario HM Montepríncipe-CIEC, Universidad San Pablo CEU, Madrid, Spain
| | - Inés García-Lunar
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; CIBER de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain; Cardiology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Vicente Andrés
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; CIBER de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
| | - Valentín Fuster
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Icahn School of Medicine at Mount Sinai, New York, New York, USA.
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25
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Xu S, Ilyas I, Little PJ, Li H, Kamato D, Zheng X, Luo S, Li Z, Liu P, Han J, Harding IC, Ebong EE, Cameron SJ, Stewart AG, Weng J. Endothelial Dysfunction in Atherosclerotic Cardiovascular Diseases and Beyond: From Mechanism to Pharmacotherapies. Pharmacol Rev 2021; 73:924-967. [PMID: 34088867 DOI: 10.1124/pharmrev.120.000096] [Citation(s) in RCA: 393] [Impact Index Per Article: 131.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The endothelium, a cellular monolayer lining the blood vessel wall, plays a critical role in maintaining multiorgan health and homeostasis. Endothelial functions in health include dynamic maintenance of vascular tone, angiogenesis, hemostasis, and the provision of an antioxidant, anti-inflammatory, and antithrombotic interface. Dysfunction of the vascular endothelium presents with impaired endothelium-dependent vasodilation, heightened oxidative stress, chronic inflammation, leukocyte adhesion and hyperpermeability, and endothelial cell senescence. Recent studies have implicated altered endothelial cell metabolism and endothelial-to-mesenchymal transition as new features of endothelial dysfunction. Endothelial dysfunction is regarded as a hallmark of many diverse human panvascular diseases, including atherosclerosis, hypertension, and diabetes. Endothelial dysfunction has also been implicated in severe coronavirus disease 2019. Many clinically used pharmacotherapies, ranging from traditional lipid-lowering drugs, antihypertensive drugs, and antidiabetic drugs to proprotein convertase subtilisin/kexin type 9 inhibitors and interleukin 1β monoclonal antibodies, counter endothelial dysfunction as part of their clinical benefits. The regulation of endothelial dysfunction by noncoding RNAs has provided novel insights into these newly described regulators of endothelial dysfunction, thus yielding potential new therapeutic approaches. Altogether, a better understanding of the versatile (dys)functions of endothelial cells will not only deepen our comprehension of human diseases but also accelerate effective therapeutic drug discovery. In this review, we provide a timely overview of the multiple layers of endothelial function, describe the consequences and mechanisms of endothelial dysfunction, and identify pathways to effective targeted therapies. SIGNIFICANCE STATEMENT: The endothelium was initially considered to be a semipermeable biomechanical barrier and gatekeeper of vascular health. In recent decades, a deepened understanding of the biological functions of the endothelium has led to its recognition as a ubiquitous tissue regulating vascular tone, cell behavior, innate immunity, cell-cell interactions, and cell metabolism in the vessel wall. Endothelial dysfunction is the hallmark of cardiovascular, metabolic, and emerging infectious diseases. Pharmacotherapies targeting endothelial dysfunction have potential for treatment of cardiovascular and many other diseases.
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Affiliation(s)
- Suowen Xu
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China (S.X., I.I., X.Z., S.L., J.W.); Sunshine Coast Health Institute, University of the Sunshine Coast, Birtinya, Australia (P.J.L.); School of Pharmacy, Pharmacy Australia Centre of Excellence, The University of Queensland, Woolloongabba, Queensland, Australia (P.J.L., D.K.); Department of Medical Biotechnology, School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, China (H.L.); The Research Center of Basic Integrative Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China (H.L.); Department of Pharmacology and Toxicology, School of Pharmaceutical Sciences, National and Local United Engineering Laboratory of Druggability and New Drugs Evaluation, Guangzhou, China (Z.L., P.L.); College of Life Sciences, Key Laboratory of Bioactive Materials of Ministry of Education, State Key Laboratory of Medicinal Chemical Biology, Nankai University, Tianjin, China (J.H.); Department of Bioengineering, Northeastern University, Boston, Massachusetts (I.C.H., E.E.E.); Department of Chemical Engineering, Northeastern University, Boston, Massachusetts (E.E.E.); Department of Neuroscience, Albert Einstein College of Medicine, New York, New York (E.E.E.); Department of Cardiovascular and Metabolic Sciences, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio (S.J.C.); and ARC Centre for Personalised Therapeutics Technologies, Department of Biochemistry and Pharmacology, School of Biomedical Science, University of Melbourne, Parkville, Victoria, Australia (A.G.S.)
| | - Iqra Ilyas
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China (S.X., I.I., X.Z., S.L., J.W.); Sunshine Coast Health Institute, University of the Sunshine Coast, Birtinya, Australia (P.J.L.); School of Pharmacy, Pharmacy Australia Centre of Excellence, The University of Queensland, Woolloongabba, Queensland, Australia (P.J.L., D.K.); Department of Medical Biotechnology, School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, China (H.L.); The Research Center of Basic Integrative Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China (H.L.); Department of Pharmacology and Toxicology, School of Pharmaceutical Sciences, National and Local United Engineering Laboratory of Druggability and New Drugs Evaluation, Guangzhou, China (Z.L., P.L.); College of Life Sciences, Key Laboratory of Bioactive Materials of Ministry of Education, State Key Laboratory of Medicinal Chemical Biology, Nankai University, Tianjin, China (J.H.); Department of Bioengineering, Northeastern University, Boston, Massachusetts (I.C.H., E.E.E.); Department of Chemical Engineering, Northeastern University, Boston, Massachusetts (E.E.E.); Department of Neuroscience, Albert Einstein College of Medicine, New York, New York (E.E.E.); Department of Cardiovascular and Metabolic Sciences, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio (S.J.C.); and ARC Centre for Personalised Therapeutics Technologies, Department of Biochemistry and Pharmacology, School of Biomedical Science, University of Melbourne, Parkville, Victoria, Australia (A.G.S.)
| | - Peter J Little
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China (S.X., I.I., X.Z., S.L., J.W.); Sunshine Coast Health Institute, University of the Sunshine Coast, Birtinya, Australia (P.J.L.); School of Pharmacy, Pharmacy Australia Centre of Excellence, The University of Queensland, Woolloongabba, Queensland, Australia (P.J.L., D.K.); Department of Medical Biotechnology, School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, China (H.L.); The Research Center of Basic Integrative Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China (H.L.); Department of Pharmacology and Toxicology, School of Pharmaceutical Sciences, National and Local United Engineering Laboratory of Druggability and New Drugs Evaluation, Guangzhou, China (Z.L., P.L.); College of Life Sciences, Key Laboratory of Bioactive Materials of Ministry of Education, State Key Laboratory of Medicinal Chemical Biology, Nankai University, Tianjin, China (J.H.); Department of Bioengineering, Northeastern University, Boston, Massachusetts (I.C.H., E.E.E.); Department of Chemical Engineering, Northeastern University, Boston, Massachusetts (E.E.E.); Department of Neuroscience, Albert Einstein College of Medicine, New York, New York (E.E.E.); Department of Cardiovascular and Metabolic Sciences, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio (S.J.C.); and ARC Centre for Personalised Therapeutics Technologies, Department of Biochemistry and Pharmacology, School of Biomedical Science, University of Melbourne, Parkville, Victoria, Australia (A.G.S.)
| | - Hong Li
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China (S.X., I.I., X.Z., S.L., J.W.); Sunshine Coast Health Institute, University of the Sunshine Coast, Birtinya, Australia (P.J.L.); School of Pharmacy, Pharmacy Australia Centre of Excellence, The University of Queensland, Woolloongabba, Queensland, Australia (P.J.L., D.K.); Department of Medical Biotechnology, School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, China (H.L.); The Research Center of Basic Integrative Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China (H.L.); Department of Pharmacology and Toxicology, School of Pharmaceutical Sciences, National and Local United Engineering Laboratory of Druggability and New Drugs Evaluation, Guangzhou, China (Z.L., P.L.); College of Life Sciences, Key Laboratory of Bioactive Materials of Ministry of Education, State Key Laboratory of Medicinal Chemical Biology, Nankai University, Tianjin, China (J.H.); Department of Bioengineering, Northeastern University, Boston, Massachusetts (I.C.H., E.E.E.); Department of Chemical Engineering, Northeastern University, Boston, Massachusetts (E.E.E.); Department of Neuroscience, Albert Einstein College of Medicine, New York, New York (E.E.E.); Department of Cardiovascular and Metabolic Sciences, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio (S.J.C.); and ARC Centre for Personalised Therapeutics Technologies, Department of Biochemistry and Pharmacology, School of Biomedical Science, University of Melbourne, Parkville, Victoria, Australia (A.G.S.)
| | - Danielle Kamato
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China (S.X., I.I., X.Z., S.L., J.W.); Sunshine Coast Health Institute, University of the Sunshine Coast, Birtinya, Australia (P.J.L.); School of Pharmacy, Pharmacy Australia Centre of Excellence, The University of Queensland, Woolloongabba, Queensland, Australia (P.J.L., D.K.); Department of Medical Biotechnology, School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, China (H.L.); The Research Center of Basic Integrative Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China (H.L.); Department of Pharmacology and Toxicology, School of Pharmaceutical Sciences, National and Local United Engineering Laboratory of Druggability and New Drugs Evaluation, Guangzhou, China (Z.L., P.L.); College of Life Sciences, Key Laboratory of Bioactive Materials of Ministry of Education, State Key Laboratory of Medicinal Chemical Biology, Nankai University, Tianjin, China (J.H.); Department of Bioengineering, Northeastern University, Boston, Massachusetts (I.C.H., E.E.E.); Department of Chemical Engineering, Northeastern University, Boston, Massachusetts (E.E.E.); Department of Neuroscience, Albert Einstein College of Medicine, New York, New York (E.E.E.); Department of Cardiovascular and Metabolic Sciences, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio (S.J.C.); and ARC Centre for Personalised Therapeutics Technologies, Department of Biochemistry and Pharmacology, School of Biomedical Science, University of Melbourne, Parkville, Victoria, Australia (A.G.S.)
| | - Xueying Zheng
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China (S.X., I.I., X.Z., S.L., J.W.); Sunshine Coast Health Institute, University of the Sunshine Coast, Birtinya, Australia (P.J.L.); School of Pharmacy, Pharmacy Australia Centre of Excellence, The University of Queensland, Woolloongabba, Queensland, Australia (P.J.L., D.K.); Department of Medical Biotechnology, School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, China (H.L.); The Research Center of Basic Integrative Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China (H.L.); Department of Pharmacology and Toxicology, School of Pharmaceutical Sciences, National and Local United Engineering Laboratory of Druggability and New Drugs Evaluation, Guangzhou, China (Z.L., P.L.); College of Life Sciences, Key Laboratory of Bioactive Materials of Ministry of Education, State Key Laboratory of Medicinal Chemical Biology, Nankai University, Tianjin, China (J.H.); Department of Bioengineering, Northeastern University, Boston, Massachusetts (I.C.H., E.E.E.); Department of Chemical Engineering, Northeastern University, Boston, Massachusetts (E.E.E.); Department of Neuroscience, Albert Einstein College of Medicine, New York, New York (E.E.E.); Department of Cardiovascular and Metabolic Sciences, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio (S.J.C.); and ARC Centre for Personalised Therapeutics Technologies, Department of Biochemistry and Pharmacology, School of Biomedical Science, University of Melbourne, Parkville, Victoria, Australia (A.G.S.)
| | - Sihui Luo
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China (S.X., I.I., X.Z., S.L., J.W.); Sunshine Coast Health Institute, University of the Sunshine Coast, Birtinya, Australia (P.J.L.); School of Pharmacy, Pharmacy Australia Centre of Excellence, The University of Queensland, Woolloongabba, Queensland, Australia (P.J.L., D.K.); Department of Medical Biotechnology, School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, China (H.L.); The Research Center of Basic Integrative Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China (H.L.); Department of Pharmacology and Toxicology, School of Pharmaceutical Sciences, National and Local United Engineering Laboratory of Druggability and New Drugs Evaluation, Guangzhou, China (Z.L., P.L.); College of Life Sciences, Key Laboratory of Bioactive Materials of Ministry of Education, State Key Laboratory of Medicinal Chemical Biology, Nankai University, Tianjin, China (J.H.); Department of Bioengineering, Northeastern University, Boston, Massachusetts (I.C.H., E.E.E.); Department of Chemical Engineering, Northeastern University, Boston, Massachusetts (E.E.E.); Department of Neuroscience, Albert Einstein College of Medicine, New York, New York (E.E.E.); Department of Cardiovascular and Metabolic Sciences, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio (S.J.C.); and ARC Centre for Personalised Therapeutics Technologies, Department of Biochemistry and Pharmacology, School of Biomedical Science, University of Melbourne, Parkville, Victoria, Australia (A.G.S.)
| | - Zhuoming Li
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China (S.X., I.I., X.Z., S.L., J.W.); Sunshine Coast Health Institute, University of the Sunshine Coast, Birtinya, Australia (P.J.L.); School of Pharmacy, Pharmacy Australia Centre of Excellence, The University of Queensland, Woolloongabba, Queensland, Australia (P.J.L., D.K.); Department of Medical Biotechnology, School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, China (H.L.); The Research Center of Basic Integrative Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China (H.L.); Department of Pharmacology and Toxicology, School of Pharmaceutical Sciences, National and Local United Engineering Laboratory of Druggability and New Drugs Evaluation, Guangzhou, China (Z.L., P.L.); College of Life Sciences, Key Laboratory of Bioactive Materials of Ministry of Education, State Key Laboratory of Medicinal Chemical Biology, Nankai University, Tianjin, China (J.H.); Department of Bioengineering, Northeastern University, Boston, Massachusetts (I.C.H., E.E.E.); Department of Chemical Engineering, Northeastern University, Boston, Massachusetts (E.E.E.); Department of Neuroscience, Albert Einstein College of Medicine, New York, New York (E.E.E.); Department of Cardiovascular and Metabolic Sciences, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio (S.J.C.); and ARC Centre for Personalised Therapeutics Technologies, Department of Biochemistry and Pharmacology, School of Biomedical Science, University of Melbourne, Parkville, Victoria, Australia (A.G.S.)
| | - Peiqing Liu
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China (S.X., I.I., X.Z., S.L., J.W.); Sunshine Coast Health Institute, University of the Sunshine Coast, Birtinya, Australia (P.J.L.); School of Pharmacy, Pharmacy Australia Centre of Excellence, The University of Queensland, Woolloongabba, Queensland, Australia (P.J.L., D.K.); Department of Medical Biotechnology, School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, China (H.L.); The Research Center of Basic Integrative Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China (H.L.); Department of Pharmacology and Toxicology, School of Pharmaceutical Sciences, National and Local United Engineering Laboratory of Druggability and New Drugs Evaluation, Guangzhou, China (Z.L., P.L.); College of Life Sciences, Key Laboratory of Bioactive Materials of Ministry of Education, State Key Laboratory of Medicinal Chemical Biology, Nankai University, Tianjin, China (J.H.); Department of Bioengineering, Northeastern University, Boston, Massachusetts (I.C.H., E.E.E.); Department of Chemical Engineering, Northeastern University, Boston, Massachusetts (E.E.E.); Department of Neuroscience, Albert Einstein College of Medicine, New York, New York (E.E.E.); Department of Cardiovascular and Metabolic Sciences, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio (S.J.C.); and ARC Centre for Personalised Therapeutics Technologies, Department of Biochemistry and Pharmacology, School of Biomedical Science, University of Melbourne, Parkville, Victoria, Australia (A.G.S.)
| | - Jihong Han
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China (S.X., I.I., X.Z., S.L., J.W.); Sunshine Coast Health Institute, University of the Sunshine Coast, Birtinya, Australia (P.J.L.); School of Pharmacy, Pharmacy Australia Centre of Excellence, The University of Queensland, Woolloongabba, Queensland, Australia (P.J.L., D.K.); Department of Medical Biotechnology, School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, China (H.L.); The Research Center of Basic Integrative Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China (H.L.); Department of Pharmacology and Toxicology, School of Pharmaceutical Sciences, National and Local United Engineering Laboratory of Druggability and New Drugs Evaluation, Guangzhou, China (Z.L., P.L.); College of Life Sciences, Key Laboratory of Bioactive Materials of Ministry of Education, State Key Laboratory of Medicinal Chemical Biology, Nankai University, Tianjin, China (J.H.); Department of Bioengineering, Northeastern University, Boston, Massachusetts (I.C.H., E.E.E.); Department of Chemical Engineering, Northeastern University, Boston, Massachusetts (E.E.E.); Department of Neuroscience, Albert Einstein College of Medicine, New York, New York (E.E.E.); Department of Cardiovascular and Metabolic Sciences, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio (S.J.C.); and ARC Centre for Personalised Therapeutics Technologies, Department of Biochemistry and Pharmacology, School of Biomedical Science, University of Melbourne, Parkville, Victoria, Australia (A.G.S.)
| | - Ian C Harding
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China (S.X., I.I., X.Z., S.L., J.W.); Sunshine Coast Health Institute, University of the Sunshine Coast, Birtinya, Australia (P.J.L.); School of Pharmacy, Pharmacy Australia Centre of Excellence, The University of Queensland, Woolloongabba, Queensland, Australia (P.J.L., D.K.); Department of Medical Biotechnology, School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, China (H.L.); The Research Center of Basic Integrative Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China (H.L.); Department of Pharmacology and Toxicology, School of Pharmaceutical Sciences, National and Local United Engineering Laboratory of Druggability and New Drugs Evaluation, Guangzhou, China (Z.L., P.L.); College of Life Sciences, Key Laboratory of Bioactive Materials of Ministry of Education, State Key Laboratory of Medicinal Chemical Biology, Nankai University, Tianjin, China (J.H.); Department of Bioengineering, Northeastern University, Boston, Massachusetts (I.C.H., E.E.E.); Department of Chemical Engineering, Northeastern University, Boston, Massachusetts (E.E.E.); Department of Neuroscience, Albert Einstein College of Medicine, New York, New York (E.E.E.); Department of Cardiovascular and Metabolic Sciences, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio (S.J.C.); and ARC Centre for Personalised Therapeutics Technologies, Department of Biochemistry and Pharmacology, School of Biomedical Science, University of Melbourne, Parkville, Victoria, Australia (A.G.S.)
| | - Eno E Ebong
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China (S.X., I.I., X.Z., S.L., J.W.); Sunshine Coast Health Institute, University of the Sunshine Coast, Birtinya, Australia (P.J.L.); School of Pharmacy, Pharmacy Australia Centre of Excellence, The University of Queensland, Woolloongabba, Queensland, Australia (P.J.L., D.K.); Department of Medical Biotechnology, School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, China (H.L.); The Research Center of Basic Integrative Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China (H.L.); Department of Pharmacology and Toxicology, School of Pharmaceutical Sciences, National and Local United Engineering Laboratory of Druggability and New Drugs Evaluation, Guangzhou, China (Z.L., P.L.); College of Life Sciences, Key Laboratory of Bioactive Materials of Ministry of Education, State Key Laboratory of Medicinal Chemical Biology, Nankai University, Tianjin, China (J.H.); Department of Bioengineering, Northeastern University, Boston, Massachusetts (I.C.H., E.E.E.); Department of Chemical Engineering, Northeastern University, Boston, Massachusetts (E.E.E.); Department of Neuroscience, Albert Einstein College of Medicine, New York, New York (E.E.E.); Department of Cardiovascular and Metabolic Sciences, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio (S.J.C.); and ARC Centre for Personalised Therapeutics Technologies, Department of Biochemistry and Pharmacology, School of Biomedical Science, University of Melbourne, Parkville, Victoria, Australia (A.G.S.)
| | - Scott J Cameron
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China (S.X., I.I., X.Z., S.L., J.W.); Sunshine Coast Health Institute, University of the Sunshine Coast, Birtinya, Australia (P.J.L.); School of Pharmacy, Pharmacy Australia Centre of Excellence, The University of Queensland, Woolloongabba, Queensland, Australia (P.J.L., D.K.); Department of Medical Biotechnology, School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, China (H.L.); The Research Center of Basic Integrative Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China (H.L.); Department of Pharmacology and Toxicology, School of Pharmaceutical Sciences, National and Local United Engineering Laboratory of Druggability and New Drugs Evaluation, Guangzhou, China (Z.L., P.L.); College of Life Sciences, Key Laboratory of Bioactive Materials of Ministry of Education, State Key Laboratory of Medicinal Chemical Biology, Nankai University, Tianjin, China (J.H.); Department of Bioengineering, Northeastern University, Boston, Massachusetts (I.C.H., E.E.E.); Department of Chemical Engineering, Northeastern University, Boston, Massachusetts (E.E.E.); Department of Neuroscience, Albert Einstein College of Medicine, New York, New York (E.E.E.); Department of Cardiovascular and Metabolic Sciences, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio (S.J.C.); and ARC Centre for Personalised Therapeutics Technologies, Department of Biochemistry and Pharmacology, School of Biomedical Science, University of Melbourne, Parkville, Victoria, Australia (A.G.S.)
| | - Alastair G Stewart
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China (S.X., I.I., X.Z., S.L., J.W.); Sunshine Coast Health Institute, University of the Sunshine Coast, Birtinya, Australia (P.J.L.); School of Pharmacy, Pharmacy Australia Centre of Excellence, The University of Queensland, Woolloongabba, Queensland, Australia (P.J.L., D.K.); Department of Medical Biotechnology, School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, China (H.L.); The Research Center of Basic Integrative Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China (H.L.); Department of Pharmacology and Toxicology, School of Pharmaceutical Sciences, National and Local United Engineering Laboratory of Druggability and New Drugs Evaluation, Guangzhou, China (Z.L., P.L.); College of Life Sciences, Key Laboratory of Bioactive Materials of Ministry of Education, State Key Laboratory of Medicinal Chemical Biology, Nankai University, Tianjin, China (J.H.); Department of Bioengineering, Northeastern University, Boston, Massachusetts (I.C.H., E.E.E.); Department of Chemical Engineering, Northeastern University, Boston, Massachusetts (E.E.E.); Department of Neuroscience, Albert Einstein College of Medicine, New York, New York (E.E.E.); Department of Cardiovascular and Metabolic Sciences, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio (S.J.C.); and ARC Centre for Personalised Therapeutics Technologies, Department of Biochemistry and Pharmacology, School of Biomedical Science, University of Melbourne, Parkville, Victoria, Australia (A.G.S.)
| | - Jianping Weng
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China (S.X., I.I., X.Z., S.L., J.W.); Sunshine Coast Health Institute, University of the Sunshine Coast, Birtinya, Australia (P.J.L.); School of Pharmacy, Pharmacy Australia Centre of Excellence, The University of Queensland, Woolloongabba, Queensland, Australia (P.J.L., D.K.); Department of Medical Biotechnology, School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, China (H.L.); The Research Center of Basic Integrative Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China (H.L.); Department of Pharmacology and Toxicology, School of Pharmaceutical Sciences, National and Local United Engineering Laboratory of Druggability and New Drugs Evaluation, Guangzhou, China (Z.L., P.L.); College of Life Sciences, Key Laboratory of Bioactive Materials of Ministry of Education, State Key Laboratory of Medicinal Chemical Biology, Nankai University, Tianjin, China (J.H.); Department of Bioengineering, Northeastern University, Boston, Massachusetts (I.C.H., E.E.E.); Department of Chemical Engineering, Northeastern University, Boston, Massachusetts (E.E.E.); Department of Neuroscience, Albert Einstein College of Medicine, New York, New York (E.E.E.); Department of Cardiovascular and Metabolic Sciences, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio (S.J.C.); and ARC Centre for Personalised Therapeutics Technologies, Department of Biochemistry and Pharmacology, School of Biomedical Science, University of Melbourne, Parkville, Victoria, Australia (A.G.S.)
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Dzaye O, Berning P, Dardari ZA, Mortensen MB, Marshall CH, Nasir K, Budoff MJ, Blumenthal RS, Whelton SP, Blaha MJ. Coronary artery calcium is associated with increased risk for lung and colorectal cancer in men and women: the Multi-Ethnic Study of Atherosclerosis (MESA). Eur Heart J Cardiovasc Imaging 2021; 23:708-716. [PMID: 34086883 DOI: 10.1093/ehjci/jeab099] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 05/03/2021] [Indexed: 11/14/2022] Open
Abstract
AIMS This study explored the association of coronary artery calcium (CAC) with incident cancer subtypes in the Multi-Ethnic Study of Atherosclerosis (MESA). CAC is an established predictor of cardiovascular disease (CVD), with emerging data also supporting independent predictive value for cancer. The association of CAC with risk for individual cancer subtypes is unknown. METHODS AND RESULTS We included 6271 MESA participants, aged 45-84 and without known CVD or self-reported history of cancer. There were 777 incident cancer cases during mean follow-up of 12.9 ± 3.1 years. Lung and colorectal cancer (186 cases) were grouped based on their strong overlap with CVD risk profile; prostate (men) and ovarian, uterine, and breast cancer (women) were considered as sex-specific cancers (in total 250 cases). Incidence rates and Fine and Gray competing risks models were used to assess relative risk of cancer-specific outcomes stratified by CAC groups or Log(CAC+1). The mean age was 61.7 ± 10.2 years, 52.7% were women, and 36.5% were White. Overall, all-cause cancer incidence increased with CAC scores, with rates per 1000 person-years of 13.1 [95% confidence interval (CI): 11.7-14.7] for CAC = 0 and 35.8 (95% CI: 30.2-42.4) for CAC ≥400. Compared with CAC = 0, hazards for those with CAC ≥400 were increased for lung and colorectal cancer in men [subdistribution hazard ratio (SHR): 2.2 (95% CI: 1.1-4.7)] and women [SHR: 2.2 (95% CI: 1.0-4.6)], but not significantly for sex-specific cancers across sexes. CONCLUSION CAC scores were associated with cancer risk in both sexes; however, this was stronger for lung and colorectal when compared with sex-specific cancers. Our data support potential synergistic use of CAC scores in the identification of both CVD and lung and colorectal cancer risk.
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Affiliation(s)
- Omar Dzaye
- Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Blalock 524D1, 600 N Wolfe St, Baltimore, MD 21287, USA.,Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Philipp Berning
- Department of Hematology and Oncology, University Hospital Muenster, Muenster, Germany
| | - Zeina A Dardari
- Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Blalock 524D1, 600 N Wolfe St, Baltimore, MD 21287, USA
| | - Martin Bødtker Mortensen
- Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Blalock 524D1, 600 N Wolfe St, Baltimore, MD 21287, USA.,Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
| | - Catherine Handy Marshall
- Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Blalock 524D1, 600 N Wolfe St, Baltimore, MD 21287, USA
| | - Khurram Nasir
- Division of Cardiovascular Prevention and Wellness, Houston Methodist DeBakey Heart & Vascular Center, Houston, TX, USA
| | - Matthew J Budoff
- Department of Medicine, Lundquist Institute, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Roger S Blumenthal
- Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Blalock 524D1, 600 N Wolfe St, Baltimore, MD 21287, USA
| | - Seamus P Whelton
- Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Blalock 524D1, 600 N Wolfe St, Baltimore, MD 21287, USA
| | - Michael J Blaha
- Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Blalock 524D1, 600 N Wolfe St, Baltimore, MD 21287, USA
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Timmons JG, Greenlaw N, Boyle JG, Chaturvedi N, Ford I, Brouwers MCGJ, Tillin T, Hramiak I, Hughes AD, Jenkins AJ, Klein BEK, Klein R, Ooi TC, Rossing P, Stehouwer CDA, Sattar N, Colhoun HM, Petrie JR. Metformin and carotid intima-media thickness in never-smokers with type 1 diabetes: The REMOVAL trial. Diabetes Obes Metab 2021; 23:1371-1378. [PMID: 33591613 DOI: 10.1111/dom.14350] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 01/29/2021] [Accepted: 02/09/2021] [Indexed: 02/05/2023]
Abstract
AIM To determine whether metformin's effects on carotid artery intima-media thickness (cIMT) in type 1 diabetes differ according to smoking status. METHODS Regression model effect estimates for the effect of metformin versus placebo (double-blind) on carotid IMT were calculated as a subgroup analysis of the REMOVAL trial. RESULTS In 428 randomized participants (227 never-smokers, 201 ever-smokers), averaged mean carotid IMT progression (per year) was reduced by metformin versus placebo in never-smokers (-0.012 mm, 95% CI -0.021 to -0.002; p = .0137) but not in ever-smokers (0.003 mm, 95% CI -0.008 to 0.014; p = .5767); and similarly in non-current smokers (-0.008 mm, 95% CI -0.015 to -0.00001; p = .0497) but not in current smokers (0.013 mm, 95% CI -0.007 to 0.032; p = .1887). Three-way interaction terms (treatment*time*smoking status) were significant for never versus ever smoking (p = .0373, prespecified) and non-current versus current smoking (p = .0496, exploratory). Averaged maximal carotid IMT progression (per year) was reduced by metformin versus placebo in never-smokers (-0.020 mm, 95% CI -0.034 to -0.006; p = .0067) but not in ever-smokers (-0.006 mm, 95% CI -0.020 to 0.008; p = .4067), although this analysis was not supported by a significant three-way interaction term. CONCLUSIONS This subgroup analysis of the REMOVAL trial provides additional support for a potentially wider role of adjunct metformin therapy in cardiovascular risk management in type 1 diabetes, particularly for individuals who have never smoked cigarettes.
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Affiliation(s)
- Joseph G Timmons
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Nicola Greenlaw
- Robertson Centre for Biostatistics, University of Glasgow, Glasgow, UK
| | - James G Boyle
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Nish Chaturvedi
- Institute of Cardiovascular Science, University College London, London, UK
| | - Ian Ford
- Robertson Centre for Biostatistics, University of Glasgow, Glasgow, UK
| | - Martijn C G J Brouwers
- Department of Internal Medicine and Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Therese Tillin
- Institute of Cardiovascular Science, University College London, London, UK
| | | | - Alun D Hughes
- Institute of Cardiovascular Science, University College London, London, UK
| | - Alicia J Jenkins
- NHMRC Clinical Trials Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Barbara E K Klein
- University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Ron Klein
- University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Teik C Ooi
- Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Peter Rossing
- Steno Diabetes Center Copenhagen and the University of Copenhagen, Copenhagen, Denmark
| | - Coen D A Stehouwer
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands; and, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Naveed Sattar
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Helen M Colhoun
- Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - John R Petrie
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
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Nieto Iglesias J, Abellán-Huerta J, García López JC, Tárraga López PJ, Divisón-Garrote JA. Update on smoking. Alternatives for the management of patients with cardiovascular risk. HIPERTENSION Y RIESGO VASCULAR 2021; 38:178-185. [PMID: 33926853 DOI: 10.1016/j.hipert.2021.04.001] [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: 03/30/2021] [Accepted: 04/04/2021] [Indexed: 10/21/2022]
Abstract
Smoking is the leading cause of morbidity and mortality worldwide and is clearly involved as a cardiovascular risk factor. Smoking has different effects on the cardiovascular system, such as a decrease in nitric oxide, increased inflammatory response, increased adhesion of pro-atherogenic molecules, lipid disturbances, generation of oxidative stress and endothelial dysfunction as can be shown in different biomarkers modifications. Despite the aids currently available for smoking cessation, many smokers are unwilling or unable to achieve this. So alternative tools with potential harm reduction, such as non-combustion tobacco products, could be an option due to the better results they had shown on cardiovascular risk factors. This has led these devices to be taken into account as a risk-modifying tobacco product according to the FDA.
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Affiliation(s)
- J Nieto Iglesias
- Unidad de Hipertensión y Riesgo Vascular, Servicio de Nefrología, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain.
| | - J Abellán-Huerta
- Servicio de Cardiología, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
| | - J C García López
- Servicio de Cardiología, Hospital General Universitario de Albacete, Albacete, Spain
| | - P J Tárraga López
- Centro de Salud Zona 5, Complejo Hospitalario Universitario de Albacete, Universidad de Castilla-La Mancha, Albacete, Spain
| | - J A Divisón-Garrote
- Centro de Salud de Casas Ibáñez (Albacete), Universidad Católica San Antonio de Murcia (UCAM), Spain
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Abstract
The assumption that light cigarette smoking, meaning smoking one to five cigarettes per day, is not so harmful has been dissipated by several studies. Regardless of the quantity of tobacco cigarettes, smoking remains a leading risk factor for the development and progression of cardiovascular diseases. Smoke is a mixture of several toxic chemicals, such as nicotine, carbon monoxide, and oxidants, implicated in the pathogenesis of cardiovascular and pulmonary diseases. Despite anti-smoking campaigns, a misconception concerning “safe smoking” still exists. The purpose of this literature review is to highlight the deleterious effect of light cigarette smoking and claim the consensus that there is no safe smoking.
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30
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Systemic circulating inflammatory burden and periodontitis in adolescents. Clin Oral Investig 2021; 25:5855-5865. [PMID: 33759000 DOI: 10.1007/s00784-021-03891-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 03/12/2021] [Indexed: 01/19/2023]
Abstract
OBJECTIVES To analyze the association between systemic inflammatory burden of cardiovascular disease (CVD) risk and periodontitis in adolescents, including mediating pathways triggered by their common risk factors. MATERIALS AND METHODS Using a population-based sample study (n = 405) of Brazilian adolescents (17-18 years old), direct and mediation pathways triggered by "Socioeconomic Status," "Adiposity," Smoking, and "Blood Pressure" were modelled for the association between the "Systemic Circulating Inflammatory Burden of CVD Risk" (IL-1β, IL-6, IL-8, TNF-α) and the "Initial Periodontitis" (bleeding on probing (BoP), probing depth (PD) ≥ 4 mm, clinical attachment loss (CAL) ≥ 4 mm), both as continuous latent variables, using structural equation modeling. Sensitivity analysis was performed for the outcomes "Gingivitis" (visible plaque; BoP); "Moderate Periodontitis" (PD ≥ 5 mm and CAL ≥ 5 mm) and periodontitis (CDC-AAP case definition). RESULTS Higher "Systemic Circulating Inflammatory Burden of CVD Risk" was directly associated with higher "Initial Periodontitis" (standardized coefficient [SC] = 0.178, P value < 0.001). Lower "Socioeconomic Status" (SC = - 0.022, P value = 0.015) and Smoking (SC = 0.030, P value = 0.021) triggered the "Initial Periodontitis", mediated by "Systemic Circulating Inflammatory Burden of CVD Risk". Sensitivity analysis showed a dose-response relationship between "Systemic Circulating Inflammatory Burden of CVD Risk" and "Moderate Periodontitis" (SC = 0.323, P value = 0.021). CONCLUSIONS "Systemic Circulating Inflammatory Burden of CVD Risk" appeared as an underlying mechanism of early periodontal breakdown in adolescents, also triggered by social vulnerability and smoking. CLINICAL RELEVANCE The association between periodontitis and CVD in adulthood seems to establish much earlier in life than had been previously studied, giving impetus to preventive approaches focused on their common risk factors.
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e-Cigarette and Conventional Tobacco Cigarette Use, Dual Use, and C-Reactive Protein. J Am Coll Cardiol 2020; 75:2271-2273. [PMID: 32354388 DOI: 10.1016/j.jacc.2020.02.061] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 02/15/2020] [Accepted: 02/24/2020] [Indexed: 10/24/2022]
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Chen P, Wan G, Zhu B. Incidence and risk factors of symptomatic thrombosis related to peripherally inserted central catheter in patients with lung cancer. J Adv Nurs 2020; 77:1284-1292. [PMID: 33249623 DOI: 10.1111/jan.14666] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 09/14/2020] [Accepted: 11/03/2020] [Indexed: 02/06/2023]
Abstract
AIMS To determine the incidence and risk factors associated with peripherally inserted central catheter-related thrombosis (PICC-RT) in patients with lung cancer. DESIGN A retrospective cross-sectional design. METHODS Patients with lung cancer receiving PICC insertion during 1 March 2014-31 May 2019 at a tertiary hospital in Shanghai, China were enrolled (N = 748). Symptomatic PICC-RT was confirmed by Doppler ultrasonography in the presence of clinical symptoms and signs. Univariate and multivariate logistic regression analyses were performed to identify risk factors of symptomatic PICC-RT. RESULTS Among the patients (mean age, 60.7 years; males, 67.1%), 55 (7.35%) had symptomatic PICC-RT. Based on the multivariate analysis, history of smoking [OR 2.49 (1.13-5.46), p < .05], use of Carboplatin [OR 2.23 (1.19-4.17), p < .05] or Docetaxel [OR 7.23 (1.65-31.56), p < .05], PICC size [OR 3.52 (1.78-6.99), p < .001], and level of D-dimer [OR 5.32 (2.39-11.83), p < .001] were significant risk factors of PICC-RT. CONCLUSION Several modifiable factors (e.g., PICC size and level of D-dimer) were related to PICC-RT. In the future, prospective studies are warranted to examine whether those factors could increase the risk of PICC-RT. Meanwhile, healthcare professionals are recommended to perform a comprehensive assessment of the patients receiving PICC insertion. Close attention should be paid to those at risk for PICC-RT. IMPACT Identification of risk factors associated with PICC-RT is an important step towards individualizing the care plan for patients receiving PICC. Our findings provided evidence for the management of PICC-RT in patients with lung cancer. In clinical practice, nurses could deliver appropriate interventions against modifiable risk factors to reduce the risk of PICC-RT.
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Affiliation(s)
- Pei Chen
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Guangming Wan
- Department of Emergency, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Bingqian Zhu
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
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Alfaddagh A, Martin SS, Leucker TM, Michos ED, Blaha MJ, Lowenstein CJ, Jones SR, Toth PP. Inflammation and cardiovascular disease: From mechanisms to therapeutics. Am J Prev Cardiol 2020; 4:100130. [PMID: 34327481 PMCID: PMC8315628 DOI: 10.1016/j.ajpc.2020.100130] [Citation(s) in RCA: 143] [Impact Index Per Article: 35.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 11/14/2020] [Accepted: 11/17/2020] [Indexed: 12/11/2022] Open
Abstract
Inflammation constitutes a complex, highly conserved cascade of molecular and cellular events. Inflammation has been labeled as “the fire within,” is highly regulated, and is critical to host defense and tissue repair. In general, inflammation is beneficial and has evolved to promote survival. However, inflammation can also be maladaptive when chronically activated and sustained, leading to progressive tissue injury and reduced survival. Examples of a maladaptive response include rheumatologic disease and atherosclerosis. Despite evidence gathered by Virchow over 100 years ago showing that inflammatory white cells play a role in atherogenesis, atherosclerosis was until recently viewed as a disease of passive cholesterol accumulation in the subendothelial space. This view has been supplanted by considerable basic scientific and clinical evidence demonstrating that every step of atherogenesis, from the development of endothelial cell dysfunction to foam cell formation, plaque formation and progression, and ultimately plaque rupture stemming from architectural instability, is driven by the cytokines, interleukins, and cellular constituents of the inflammatory response. Herein we provide an overview of the role of inflammation in atherosclerotic cardiovascular disease, discuss the predictive value of various biomarkers involved in inflammation, and summarize recent clinical trials that evaluated the capacity of various pharmacologic interventions to attenuate the intensity of inflammation and impact risk for acute cardiovascular events.
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Affiliation(s)
- Abdulhamied Alfaddagh
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Seth S Martin
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Thorsten M Leucker
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Erin D Michos
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Michael J Blaha
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Charles J Lowenstein
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Steven R Jones
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Peter P Toth
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Brandi G, Rizzo A, Deserti M, Relli V, Indio V, Bin S, Pariali M, Palloni A, De Lorenzo S, Tovoli F, Tavolari S. Wilson disease, ABCC2 c.3972C > T polymorphism and primary liver cancers: suggestions from a familial cluster. BMC MEDICAL GENETICS 2020; 21:225. [PMID: 33208122 PMCID: PMC7673086 DOI: 10.1186/s12881-020-01165-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 11/09/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Polymorphisms in genes modulating xenobiotics metabolism, in particular the ABCC2 c.3972C > T single nucleotide polymorphism (SNP) at exon 28, have been suggested to increase primary liver cancer (PLC) risk. Conversely, the occurrence of PLCs in Wilson disease patients is a rare event, in contrast with the occurrence observed in other chronic liver diseases. Here we report the clinical case of five siblings carrying the ABCC2 c.3972C > T SNP; three of them were affected by Wilson disease and two brothers with Wilson disease also developed PLCs. METHODS The presence of the ABCC2 c.3972C > T SNP was assessed by Sanger sequencing and the exposure of PLC risk factors by standardized questionnaires. RESULTS Notably, PLCs occurred only in the two brothers with the ABCC2 c.3972C > T SNP and Wilson disease who resulted exposed to asbestos and cigarette smoking, but not in the other siblings with the ABCC2 c.3972C > T SNP, alone or in association with Wilson disease, not exposed to these carcinogens and/or to other known risk factors for PLCs. CONCLUSIONS These findings suggest that ABCC2 c.3972C > T SNP and WD, also in association, may not represent a sufficient condition for PLC development, but that co-occurrence of further host/exogenous risk factors are needed to drive this process, reinforcing the notion that liver carcinogenesis is the result of a complex interplay between environmental and host genetic determinants. Due to the sporadic cases of this study and the paucity of data currently available in literature on this issue, future investigations in a larger population are needed to confirm our findings.
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Affiliation(s)
- Giovanni Brandi
- Division of Oncology, Azienda Ospedaliero-Universitaria of Bologna, Bologna, Italy.
- Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola-Malpighi University Hospital, via Massarenti 9, 40138, Bologna, Italy.
| | - Alessandro Rizzo
- Division of Oncology, Azienda Ospedaliero-Universitaria of Bologna, Bologna, Italy
| | - Marzia Deserti
- Division of Oncology, Azienda Ospedaliero-Universitaria of Bologna, Bologna, Italy
- Center for Applied Biomedical Research, S. Orsola-Malpighi University Hospital, Bologna, Italy
| | - Valeria Relli
- Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola-Malpighi University Hospital, via Massarenti 9, 40138, Bologna, Italy
- Center for Applied Biomedical Research, S. Orsola-Malpighi University Hospital, Bologna, Italy
| | - Valentina Indio
- "Giorgio Prodi" Cancer Research Center, University of Bologna, Bologna, Italy
| | - Sofia Bin
- Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola-Malpighi University Hospital, via Massarenti 9, 40138, Bologna, Italy
| | - Milena Pariali
- Center for Applied Biomedical Research, S. Orsola-Malpighi University Hospital, Bologna, Italy
| | - Andrea Palloni
- Division of Oncology, Azienda Ospedaliero-Universitaria of Bologna, Bologna, Italy
- Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola-Malpighi University Hospital, via Massarenti 9, 40138, Bologna, Italy
| | - Stefania De Lorenzo
- Division of Oncology, Azienda Ospedaliero-Universitaria of Bologna, Bologna, Italy
- Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola-Malpighi University Hospital, via Massarenti 9, 40138, Bologna, Italy
| | - Francesco Tovoli
- Department of Medical and Surgical Sciences, S. Orsola-Malpighi University Hospital, Bologna, Italy
| | - Simona Tavolari
- Division of Oncology, Azienda Ospedaliero-Universitaria of Bologna, Bologna, Italy
- Center for Applied Biomedical Research, S. Orsola-Malpighi University Hospital, Bologna, Italy
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Skranes JB, Kleiven Ø, Aakre KM, Skadberg Ø, Melberg TH, Omland T, Ørn S. High-Sensitivity Cardiac Troponin I and T Response Following Strenuous Activity is Attenuated by Smokeless Tobacco: NEEDED (North Sea Race Endurance Exercise Study) 2014. J Am Heart Assoc 2020; 9:e017363. [PMID: 32930023 PMCID: PMC7792397 DOI: 10.1161/jaha.120.017363] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Background Use of snus, a smokeless tobacco product, is increasing in Scandinavia. Strenuous physical activity is associated with an acute increase in high‐sensitivity cardiac troponin (swhs‐cTn) concentrations. Current smoking is associated with lower hs‐cTn, but whether this also holds true for smokeless tobacco and whether tobacco affects the hs‐cTn response to exercise remain unknown. Methods and Results We measured hs‐cTnI and hs‐cTnT concentrations in 914 recreational athletes before and 3 and 24 hours after a 91‐km bicycle race. Self‐reported snus tobacco habits were reported as noncurrent (n=796) and current (n=118). The association between snus use and change in log‐transformed hs‐cTnI and hs‐cTnT concentrations (ie, the differences between concentrations at baseline and 3 hours and 24 hours ) were assessed by multivariable linear regression analysis. Concentrations of hs‐cTn at baseline were lower in current than in noncurrent snus users (hs‐cTnI median, 1.7 ng/L; Q1 to Q3: 1.6–2.3 versus 2.0 ng/L; Q1 to Q3: 1.6–3.2 [P=0.020]; and hs‐cTnT: median, 2.9 ng/L, Q1 to Q3: 2.9–3.5 versus 2.9 ng/L, Q1 to Q3: 2.9–4.3 [P=0.021]). In fully adjusted multivariable models, use of snus was associated with lower change in hs‐cTn concentrations from baseline to 3 hours (hs‐cTnI: −29% [P=0.002], hs‐cTnT: −18% [P=0.010]) and 24 hours (hscTnI: −30% [P=0.010], hs‐cTnT −19%, [P=0.013]). Conclusions Resting hs‐cTn concentrations are lower and the exercise‐induced cardiac troponin response is attenuated in current users of smokeless tobacco compared with nonusers. Further insight into the pathophysiological processes underlying the attenuated cardiac troponin response to exercise in tobacco users is needed. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT02166216.
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Affiliation(s)
- Julia Brox Skranes
- Department of Cardiology Akershus University Hospital Lørenskog Norway.,Institute of Clinical Medicine University of Oslo Norway
| | - Øyunn Kleiven
- Cardiology Department Stavanger University Hospital Stavanger Norway
| | - Kristin Moberg Aakre
- Department of Medical Biochemistry and Pharmacology Haukeland University Hospital Bergen Norway.,Department of Clinical Science University of Bergen Norway
| | - Øyvind Skadberg
- Department of Biochemistry Stavanger University Hospital Stavanger Norway
| | - Tor H Melberg
- Cardiology Department Stavanger University Hospital Stavanger Norway
| | - Torbjørn Omland
- Department of Cardiology Akershus University Hospital Lørenskog Norway.,Institute of Clinical Medicine University of Oslo Norway
| | - Stein Ørn
- Cardiology Department Stavanger University Hospital Stavanger Norway.,Department of Electrical Engineering and Computer Science University of Stavanger Norway
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Luz TCD, Cattafesta M, Petarli GB, Meneghetti JP, Zandonade E, Bezerra OMDPA, Salaroli LB. Cardiovascular risk factors in a Brazilian rural population. CIENCIA & SAUDE COLETIVA 2020; 25:3921-3932. [PMID: 32997024 DOI: 10.1590/1413-812320202510.36022018] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 02/22/2019] [Indexed: 01/22/2023] Open
Abstract
Given the extensive costs due to cardiovascular diseases and the increased prevalence of these diseases in farmers, this study aims to estimate the prevalence of cardiovascular risk factors in this population and to evaluate their associated factors. A cross-sectional study was carried out involving 790 farmers from the municipality of Santa Maria de Jetibá-ES, Brazil. Six out of ten evaluated farmers had at least one cardiovascular risk factor (CRF). High blood pressure was the most prevalent risk factor in 35.8% (95%CI 32-39, n = 283) followed by dyslipidemia (34.4%, 95%CI 31-38, n = 272). Those aged more than 50 years were 5.6 times (95%CI 2.03-15.43) more likely to evidence two or more CRFs. High waist circumference or tricipital skinfold indicating overweight increased 2.35 times (95%CI 1.47-3.76) and 1.6 times (95%CI 1.05-2.44) this likelihood, respectively. These findings reveal the high prevalence of CRF in rural workers and the significant impact of age and the accumulation of body fat in the development of these factors, showing the need to intensify public health policies geared to this population.
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Affiliation(s)
- Tamires Conceição da Luz
- Universidade Federal do Espírito Santo. Av. Fernando Ferrari 514, Goiabeiras. 29075-910 Vitória ES Brasil.
| | - Monica Cattafesta
- Universidade Federal do Espírito Santo. Av. Fernando Ferrari 514, Goiabeiras. 29075-910 Vitória ES Brasil.
| | - Glenda Blaser Petarli
- Universidade Federal do Espírito Santo. Av. Fernando Ferrari 514, Goiabeiras. 29075-910 Vitória ES Brasil.
| | - João Paulo Meneghetti
- Universidade Federal do Espírito Santo. Av. Fernando Ferrari 514, Goiabeiras. 29075-910 Vitória ES Brasil.
| | - Eliana Zandonade
- Universidade Federal do Espírito Santo. Av. Fernando Ferrari 514, Goiabeiras. 29075-910 Vitória ES Brasil.
| | | | - Luciane Bresciani Salaroli
- Universidade Federal do Espírito Santo. Av. Fernando Ferrari 514, Goiabeiras. 29075-910 Vitória ES Brasil.
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Hay M, Barnes C, Huentelman M, Brinton R, Ryan L. Hypertension and Age-Related Cognitive Impairment: Common Risk Factors and a Role for Precision Aging. Curr Hypertens Rep 2020; 22:80. [PMID: 32880739 PMCID: PMC7467861 DOI: 10.1007/s11906-020-01090-w] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Purpose of Review Precision Aging® is a novel concept that we have recently employed to describe how the model of precision medicine can be used to understand and define the multivariate risks that drive age-related cognitive impairment (ARCI). Hypertension and cardiovascular disease are key risk factors for both brain function and cognitive aging. In this review, we will discuss the common mechanisms underlying the risk factors for both hypertension and ARCI and how the convergence of these mechanisms may be amplified in an individual to drive changes in brain health and accelerate cognitive decline. Recent Findings Currently, our cognitive health span does not match our life span. Age-related cognitive impairment and preventing and treating ARCI will require an in-depth understanding of the interrelated risk factors, including individual genetic profiles, that affect brain health and brain aging. Hypertension and cardiovascular disease are important risk factors for ARCI. And, many of the risk factors for developing hypertension, such as diabetes, smoking, stress, viral infection, and age, are shared with the development of ARCI. We must first understand the mechanisms common to the converging risk factors in hypertension and ARCI and then design person-specific therapies to optimize individual brain health. Summary The understanding of the convergence of shared risk factors between hypertension and ARCI is required to develop individualized interventions to optimize brain health across the life span. We will conclude with a discussion of possible steps that may be taken to decrease ARCI and optimize an individual’s cognitive life span.
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Affiliation(s)
- Meredith Hay
- Department of Physiology, University of Arizona, 1501 N Campbell Rd, Room 4103, Tucson, AZ, 85724, USA.
- Psychology Department, University of Arizona, Tucson, AZ, USA.
- Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA.
| | - Carol Barnes
- Psychology Department, University of Arizona, Tucson, AZ, USA
- Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
| | - Matt Huentelman
- Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
- Neurogenomics Division, TGen, Phoenix, AZ, USA
| | - Roberta Brinton
- Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
- Center for Innovative Brain Sciences, University of Arizona, Tucson, AZ, USA
| | - Lee Ryan
- Psychology Department, University of Arizona, Tucson, AZ, USA
- Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
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Ferri N, Ruscica M, Coggi D, Bonomi A, Amato M, Frigerio B, Sansaro D, Ravani A, Veglia F, Capra N, Lupo MG, Macchi C, Castelnuovo S, Savonen K, Silveira A, Kurl S, Giral P, Pirro M, Strawbridge RJ, Gigante B, Smit AJ, Tremoli E, Colombo GI, Baldassarre D. Sex-specific predictors of PCSK9 levels in a European population: The IMPROVE study. Atherosclerosis 2020; 309:39-46. [PMID: 32862087 DOI: 10.1016/j.atherosclerosis.2020.07.014] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 06/13/2020] [Accepted: 07/15/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND AIMS Proprotein convertase subtilisin/kexin type 9 (PCSK9) is one of the key regulators of low-density lipoprotein cholesterol plasma levels. Circulating PCSK9, which differs between genders, represents a valid pharmacological target for preventing cardiovascular (CV) events. We aimed to investigate sex-related associations between PCSK9 plasma levels and biochemical and anthropomorphic factors, and familial and personal morbidities, in a large European cohort (n = 3673) of men (47.9%) and women (52.1%). METHODS Individuals (aged 54-79 years) free of CV diseases were enrolled in seven centers of five European countries: Finland, France, Italy, the Netherlands, and Sweden. PCSK9 plasma levels were measured by ELISA. RESULTS PCSK9 was higher in women than in men. Multiple linear regression analysis showed that latitude, sex, and treatments with statins and fibrates were the strongest predictors of PCSK9 in the whole group. These variables, together with triglycerides and high-density lipoprotein cholesterol, were also associated with PCSK9 in men or women. Mean corpuscular hemoglobin concentration and pack-years were PCSK9 independent predictors in women, whereas hypercholesterolemia and physical activity were independent predictors in men. The associations between PCSK9 and latitude, uric acid, diabetes, hypercholesterolemia and physical activity were significantly different in men and women (pinteraction <0.05 for all). CONCLUSIONS Besides confirming the association with lipids in the whole group, our study revealed previously unknown differences in PCSK9 predictors in men and women. These might be taken into account when defining individual risk for CV events and/or for refining PCSK9 lowering treatments.
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Affiliation(s)
- Nicola Ferri
- Dipartimento di Scienze Del Farmaco, Università Degli Studi di Padova, Padova, Italy
| | - Massimiliano Ruscica
- Dipartimento di Scienze Farmacologiche e Biomolecolari, Università Degli Studi di Milano, Milan, Italy
| | - Daniela Coggi
- Dipartimento di Scienze Farmacologiche e Biomolecolari, Università Degli Studi di Milano, Milan, Italy
| | - Alice Bonomi
- Centro Cardiologico Monzino, IRCCS, Milan, Italy
| | - Mauro Amato
- Centro Cardiologico Monzino, IRCCS, Milan, Italy
| | | | | | | | | | - Nicolò Capra
- Centro Cardiologico Monzino, IRCCS, Milan, Italy
| | - Maria G Lupo
- Dipartimento di Scienze Del Farmaco, Università Degli Studi di Padova, Padova, Italy
| | - Chiara Macchi
- Dipartimento di Scienze Farmacologiche e Biomolecolari, Università Degli Studi di Milano, Milan, Italy
| | - Samuela Castelnuovo
- Centro Dislipidemie E. Grossi Paoletti, Ospedale Ca' Granda di Niguarda, Milan, Italy
| | - Kai Savonen
- Foundation for Research in Health Exercise and Nutrition, Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
| | - Angela Silveira
- Atherosclerosis Research Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Sudhir Kurl
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio Campus, Finland
| | - Philippe Giral
- Assistance Publique - Hopitaux de Paris, Service Endocrinologie-Metabolisme, Groupe Hôpitalier Pitie-Salpetriere, Unités de Prévention Cardiovasculaire, Paris, France
| | - Matteo Pirro
- Internal Medicine, Angiology and Arteriosclerosis Diseases, Department of Clinical and Experimental Medicine, University of Perugia, Perugia, Italy
| | - Rona J Strawbridge
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom; Cardiovascular Medicine Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Health Data Research, UK
| | - Bruna Gigante
- Cardiovascular Medicine Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Andries J Smit
- Department of Medicine, University Medical Center Groningen, Groningen & Isala Clinics Zwolle, Department of Medicine, the Netherlands
| | | | | | - Damiano Baldassarre
- Centro Cardiologico Monzino, IRCCS, Milan, Italy; Department of Medical Biotechnology and Translational Medicine, Università Degli Studi di Milano, Milan, Italy.
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Practices of Adults in a Periurban Community of the Ho Municipality on Prevention of Hypertension. Int J Hypertens 2020; 2020:2136213. [PMID: 32395336 PMCID: PMC7199569 DOI: 10.1155/2020/2136213] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Revised: 11/23/2019] [Accepted: 12/13/2019] [Indexed: 11/22/2022] Open
Abstract
Background Hypertension remains a rising health threat among developing countries and it is due to poor knowledge and lifestyles. Integrated knowledge and practices are central towards the control of hypertension, especially in the developing world. Objectives This study assessed the practices of adults in a periurban community in the Ho Municipality of the Volta region on the prevention of hypertension. Methodology. A cross-sectional descriptive research design was carried out in a periurban community in the Volta region. Adults were recruited using a systematic sampling technique in the Ahoe community. Pretested questionnaires were used to collect information on sociodemographic, knowledge, and lifestyle practices regarding hypertension prevention. The data were entered into Microsoft excel 2013 spreadsheet, cleaned, and transported to the Statistical Package for Social Sciences (SPSS) version 22 software for analyses. The data were analysed using simple descriptive statistics. Results In this study, 49.3% explained that hypertension means the increased force of blood through the blood vessels as 90.8% indicated that taking antihypertensive medications can control hypertension. In describing the associated effects of hypertension, adults in the Ahoe community described the effects of hypertension as stroke (89.8%), heart attack (84.0%), diabetes (56.5%), and heart failure (82.3%). Also, 54.1% described hypertension as a lifelong disease while 55.8% indicated hypertension can be cured. Also, 92.2% identified exercising as an important factor in controlling hypertension as 32.7% use herbal preparations to control hypertension. Only 3.7% of adults in the Ahoe community were smokers and 54.5% smoked less than a year. The majority (61.6%) of the respondents did not drink alcohol as 69.7% engage in active exercises. Conclusion Education on hypertension should be intensified, and emphasis should be laid on regular exercised and strict dietary restrictions that ensure reduction in hypertension risk. Healthcare authorities should engage hypertensive clients to desist from the intake of herbal medications whose actual composition has not been scientifically determined.
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Zhao X, Li J, Tang X, Jiang L, Chen J, Qiao S, Yang Y, Gao R, Xu B, Yuan J. D-dimer as a thrombus biomarker for predicting 2-year mortality after percutaneous coronary intervention. Ther Adv Chronic Dis 2020; 11:2040622320904302. [PMID: 32206246 PMCID: PMC7076575 DOI: 10.1177/2040622320904302] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Accepted: 01/09/2020] [Indexed: 01/13/2023] Open
Abstract
Background: D-dimer has predictive value for mortality in some diseases. This study aimed to evaluate the correlation between D-dimer and mortality in patients undergoing percutaneous coronary intervention (PCI). Methods: We examined 10,724 consecutive patients who underwent PCI between January 2013 and December 2013. The primary endpoint was all-cause mortality, and the secondary endpoint was cardiac mortality. Patients were divided according to the median D-dimer level of 0.28 μg/ml. Multivariable model were including age, sex, and risk factors after stepwise selection. Results: After a 2-year follow up, 8565 patients with D-dimer data were analyzed. There were 116 (1.35%) all-cause deaths and 64 (0.75%) cardiac deaths. D-dimer levels were significantly higher in the all-cause mortality group [0.42 (0.29, 0.68) μg/ml] and cardiac mortality group [0.48 (0.30, 0.81) μg/ml] than in the survival group [0.28 (0.20, 0.41) μg/ml] (both p < 0.001). Multivariate-adjusted Cox hazard analysis showed that high D-dimer levels (⩾0.28 μg/ml) were significantly associated with all-cause mortality in the total population [hazard ratio (HR): 2.35, 95% confidence interval (CI): 1.44–3.84, p = 0.001], acute coronary syndrome (ACS) subgroup (HR: 1.91, 95% CI: 1.08–3.38, p = 0.027), and stable coronary artery disease (SCAD) subgroup (HR: 3.82, 95% CI: 1.45–10.10, p = 0.007). High D-dimer levels were significantly associated with cardiac mortality in the total population (HR: 3.44, 95% CI: 1.61–7.36, p = 0.001) and the ACS subgroup (HR: 3.33, 95% CI: 1.38–8.03, p = 0.007), but not in the SCAD subgroup (HR: 3.68, 95% CI: 0.80–16.91, p = 0.094). Conclusions: D-dimer levels are independently associated with 2-year all-cause mortality and cardiac mortality in patients undergoing PCI.
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Affiliation(s)
- Xueyan Zhao
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jianxin Li
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaofang Tang
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lin Jiang
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jue Chen
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shubin Qiao
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yuejin Yang
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Runlin Gao
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Bo Xu
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Xicheng District, Beijing 100037, China
| | - Jinqing Yuan
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Xicheng District, Beijing 100037, China
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Bakhshi H, Varadarajan V, Ambale-Venkatesh B, Meyghani Z, Ostovaneh MR, Durda P, Wu CO, Tracy RP, Cushman M, Bluemke DA, Lima JAC. Association of soluble interleukin-2 receptor α and tumour necrosis factor receptor 1 with heart failure: The Multi-Ethnic Study of Atherosclerosis. ESC Heart Fail 2020; 7:639-644. [PMID: 32155316 PMCID: PMC7160474 DOI: 10.1002/ehf2.12623] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 12/19/2019] [Accepted: 01/03/2020] [Indexed: 11/24/2022] Open
Abstract
Aims Soluble tumour necrosis factor‐α receptor 1 (sTNF‐αR1) and interleukin‐2 receptor α (sIL‐2Rα) predict incident heart failure (HF) in the elderly population. However, the association of these biomarkers with HF in a multi‐ethnic asymptomatic population is unclear. We aimed to investigate the association of sTNF‐αR1 and sIL‐2Rα with incident HF in a multi‐ethnic population of middle age and older participants. Methods and results The multi‐ethnic study of atherosclerosis is a prospective population‐based study of 6814 participants aged 45–84 years who were free of clinical cardiovascular disease at enrolment. We included 2869 participants with available sTNF‐αR1 or sIL‐2Rα level measurement at baseline multi‐ethnic study of atherosclerosis exam (2000–2002). We used Cox proportional‐hazards model to investigate the association between sTNF‐αR1 and sIL‐2Rα with incident HF after adjusting for traditional cardiovascular risk factors and coronary artery calcium score measured by cardiac computed tomography. Among the included participants, the mean (standard deviation) age was 61.6 (10.2) years and 46.7% were men. The median (interquartile range) sTNF‐αR1 and sIL‐2Rα were 1293 (1107–1547) and 901 (727–1154) pg/mL. During a median follow‐up of 14.2 (interquartile range: 11.7–14.8) years, 130 participants developed HF. In multivariable analysis, the hazard ratio (95% confidence interval, P value) of incident HF for each standard deviation increment of log‐transformed sTNF‐αR1 and sIL‐2Rα was 1.43 (1.21–1.7, P ≤ 0.001) and 1.26 (1.04–1.53, P = 0.02), respectively. Excluding participants with interim coronary heart disease, we found a statistically significant association between sTNF‐αR1 and HF with hazard ratio of 1.39 (95% confidence interval: 1.11 to 1.74, P = 0.005) and sIL‐2Rα and HF showing a hazard ratio of 1.39 (95% confidence interval: 1.09 to 1.76, P = 0.007). Conclusions sTNF‐αR1 and sIL‐2Rα are associated with a higher risk of incident HF in a multi‐ethnic cohort without a previous history of cardiovascular disease.
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Affiliation(s)
- Hooman Bakhshi
- Department of Medicine, Division of Cardiology, Johns Hopkins University, Wolfe Street/Blalock 524, Baltimore, MD, 21287, USA.,Inova Heart and Vascular Institute, Falls Church, Virginia, USA
| | - Vinithra Varadarajan
- Department of Medicine, Division of Cardiology, Johns Hopkins University, Wolfe Street/Blalock 524, Baltimore, MD, 21287, USA
| | - Bharath Ambale-Venkatesh
- Department of Medicine, Division of Cardiology, Johns Hopkins University, Wolfe Street/Blalock 524, Baltimore, MD, 21287, USA
| | - Zahra Meyghani
- Department of Medicine, Division of Cardiology, Johns Hopkins University, Wolfe Street/Blalock 524, Baltimore, MD, 21287, USA
| | - Mohammad R Ostovaneh
- Department of Medicine, Division of Cardiology, Johns Hopkins University, Wolfe Street/Blalock 524, Baltimore, MD, 21287, USA
| | - Peter Durda
- Department of Pathology and Laboratory Medicine, Larner College of Medicine at the University of Vermont, Burlington, VT, 05405, USA
| | - Colin O Wu
- Office of Biostatistics Research, National Heart Lung and Blood Institute, Bethesda, MD, 20892, USA
| | - Russell P Tracy
- Department of Pathology and Laboratory Medicine, Larner College of Medicine at the University of Vermont, Burlington, VT, 05405, USA
| | - Mary Cushman
- Department of Pathology and Laboratory Medicine, Larner College of Medicine at the University of Vermont, Burlington, VT, 05405, USA.,Department of Medicine, Larner College of Medicine at the University of Vermont, Burlington, VT, 05405, USA
| | - David A Bluemke
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, 53726, USA
| | - João A C Lima
- Department of Medicine, Division of Cardiology, Johns Hopkins University, Wolfe Street/Blalock 524, Baltimore, MD, 21287, USA
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42
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Fernández-Friera L, Fuster V, López-Melgar B, Oliva B, Sánchez-González J, Macías A, Pérez-Asenjo B, Zamudio D, Alonso-Farto JC, España S, Mendiguren J, Bueno H, García-Ruiz JM, Ibañez B, Fernández-Ortiz A, Sanz J. Vascular Inflammation in Subclinical Atherosclerosis Detected by Hybrid PET/MRI. J Am Coll Cardiol 2020; 73:1371-1382. [PMID: 30922468 DOI: 10.1016/j.jacc.2018.12.075] [Citation(s) in RCA: 102] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 12/13/2018] [Accepted: 12/14/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Atherosclerosis is a chronic inflammatory disease, but data on arterial inflammation at early stages is limited. OBJECTIVES The purpose of this study was to characterize vascular inflammation by hybrid 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/magnetic resonance imaging (PET/MRI). METHODS Carotid, aortic, and ilio-femoral 18F-FDG PET/MRI was performed in 755 individuals (age 40 to 54 years; 83.7% men) with known plaques detected by 2-/3-dimensional vascular ultrasound and/or coronary calcification in the PESA (Progression of Early Subclinical Atherosclerosis) study. The authors evaluated the presence, distribution, and number of arterial inflammatory foci (increased 18F-FDG uptake) and plaques with or without inflammation (coincident 18F-FDG uptake). RESULTS Arterial inflammation was present in 48.2% of individuals (24.4% femorals, 19.3% aorta, 15.8% carotids, and 9.3% iliacs) and plaques in 90.1% (73.9% femorals, 55.8% iliacs, and 53.1% carotids). 18F-FDG arterial uptakes and plaques significantly increased with cardiovascular risk factors (p < 0.01). Coincident 18F-FDG uptakes were present in 287 of 2,605 (11%) plaques, and most uptakes were detected in plaque-free arterial segments (459 of 746; 61.5%). Plaque burden, defined by plaque presence, number, and volume, was significantly higher in individuals with arterial inflammation than in those without (p < 0.01). The number of plaques and 18F-FDG uptakes showed a positive albeit weak correlation (r = 0.25; p < 0.001). CONCLUSIONS Arterial inflammation is highly prevalent in middle-aged individuals with known subclinical atherosclerosis. Large-scale multiterritorial PET/MRI allows characterization of atherosclerosis-related arterial inflammation and demonstrates 18F-FDG uptake in plaque-free arterial segments and, less frequently, within plaques. These findings suggest an arterial inflammatory state at early stages of atherosclerosis. (Progression of Early Subclinical Atherosclerosis [PESA]; NCT01410318).
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Affiliation(s)
- Leticia Fernández-Friera
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Hospital Universitario HM Montepríncipe-CIEC, Madrid, Spain; CIBERV, Madrid, Spain; Universidad CEU San Pablo, Madrid, Spain
| | - Valentín Fuster
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Icahn School of Medicine at Mount Sinai, New York, New York.
| | - Beatriz López-Melgar
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Hospital Universitario HM Montepríncipe-CIEC, Madrid, Spain; Universidad CEU San Pablo, Madrid, Spain
| | - Belén Oliva
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain
| | - Javier Sánchez-González
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Philips Healthcare, Iberia, Spain
| | - Angel Macías
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain
| | | | - Daniel Zamudio
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain
| | - Juan C Alonso-Farto
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Samuel España
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain
| | | | - Héctor Bueno
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Hospital Universitario 12 de Octubre and Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain; Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Jose M García-Ruiz
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; CIBERV, Madrid, Spain; Hospital Universitario de Cabueñes Gijón, Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain
| | - Borja Ibañez
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; CIBERV, Madrid, Spain; IIS-Fundación Jiménez Díaz University Hospital, Madrid, Spain
| | - Antonio Fernández-Ortiz
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; CIBERV, Madrid, Spain; Hospital Clínico San Carlos, Universidad Complutense, IdISSC, Madrid, Spain
| | - Javier Sanz
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Icahn School of Medicine at Mount Sinai, New York, New York
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Iakunchykova O, Averina M, Kudryavtsev AV, Wilsgaard T, Soloviev A, Schirmer H, Cook S, Leon DA. Evidence for a Direct Harmful Effect of Alcohol on Myocardial Health: A Large Cross-Sectional Study of Consumption Patterns and Cardiovascular Disease Risk Biomarkers From Northwest Russia, 2015 to 2017. J Am Heart Assoc 2019; 9:e014491. [PMID: 31847661 PMCID: PMC6988140 DOI: 10.1161/jaha.119.014491] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Background Alcohol drinking is an increasingly recognized risk factor for cardiovascular disease. However, there are few studies of the impact of harmful and hazardous drinking on biomarkers of myocardial health. We conducted a study in Russia to investigate the impact of heavy drinking on biomarkers of cardiac damage and inflammation. Methods and Results The Know Your Heart study recruited a random sample of 2479 participants from the population of northwest Russia (general population) plus 278 patients (narcology clinic subsample) with alcohol problems. The general population sample was categorized into harmful drinkers, hazardous drinkers, nonproblem drinkers, and nondrinkers, according to self-reported level of alcohol consumption, whereas the narcology clinic sample was treated as the separate group in the analysis. Measurements were made of the following: (1) high-sensitivity cardiac troponin T, (2) NT-proBNP (N-terminal pro-B-type natriuretic peptide), and (3) hsCRP (high-sensitivity C-reactive protein). The narcology clinic subsample had the most extreme drinking pattern and the highest levels of all 3 biomarkers relative to nonproblem drinkers in the general population: high-sensitivity cardiac troponin T was elevated by 10.3% (95% CI, 3.7%-17.4%), NT-proBNP by 46.7% (95% CI, 26.8%-69.8%), and hsCRP by 69.2% (95% CI, 43%-100%). In the general population sample, NT-proBNP was 31.5% (95% CI, 3.4%-67.2%) higher among harmful drinkers compared with nonproblem drinkers. Overall, NT-proBNP and hsCRP increased with increasing intensity of alcohol exposure (test of trend P<0.001). Conclusions These results support the hypothesis that heavy alcohol drinking has an adverse effect on cardiac structure and function that may not be driven by atherosclerosis.
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Affiliation(s)
- Olena Iakunchykova
- Department of Community Medicine UIT The Arctic University of Norway Tromsø Norway
| | - Maria Averina
- Department of Community Medicine UIT The Arctic University of Norway Tromsø Norway.,Department of Laboratory Medicine University Hospital of North Norway Tromsø Norway
| | - Alexander V Kudryavtsev
- Department of Community Medicine UIT The Arctic University of Norway Tromsø Norway.,Department of Innovative Programs Northern State Medical University Arkhangelsk Russia
| | - Tom Wilsgaard
- Department of Community Medicine UIT The Arctic University of Norway Tromsø Norway
| | - Andrey Soloviev
- Department of Psychiatry and Clinical Psychology Northern State Medical University Arkhangelsk Russia
| | - Henrik Schirmer
- Department of Cardiology Akershus University Hospital Lørenskog Norway.,Institute of Clinical Medicine Campus Ahus University of Oslo Norway.,Department of Clinical Medicine UIT The University of Norway Tromsø Norway
| | - Sarah Cook
- Department of Noncommunicable Disease Epidemiology London School of Hygiene and Tropical Medicine London United Kingdom
| | - David A Leon
- Department of Community Medicine UIT The Arctic University of Norway Tromsø Norway.,Department of Noncommunicable Disease Epidemiology London School of Hygiene and Tropical Medicine London United Kingdom
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Trumble BC, Finch CE. THE EXPOSOME IN HUMAN EVOLUTION: FROM DUST TO DIESEL. THE QUARTERLY REVIEW OF BIOLOGY 2019; 94:333-394. [PMID: 32269391 PMCID: PMC7141577 DOI: 10.1086/706768] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Global exposures to air pollution and cigarette smoke are novel in human evolutionary history and are associated with about 16 million premature deaths per year. We investigate the history of the human exposome for relationships between novel environmental toxins and genetic changes during human evolution in six phases. Phase I: With increased walking on savannas, early human ancestors inhaled crustal dust, fecal aerosols, and spores; carrion scavenging introduced new infectious pathogens. Phase II: Domestic fire exposed early Homo to novel toxins from smoke and cooking. Phases III and IV: Neolithic to preindustrial Homo sapiens incurred infectious pathogens from domestic animals and dense communities with limited sanitation. Phase V: Industrialization introduced novel toxins from fossil fuels, industrial chemicals, and tobacco at the same time infectious pathogens were diminishing. Thereby, pathogen-driven causes of mortality were replaced by chronic diseases driven by sterile inflammogens, exogenous and endogenous. Phase VI: Considers future health during global warming with increased air pollution and infections. We hypothesize that adaptation to some ancient toxins persists in genetic variations associated with inflammation and longevity.
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Affiliation(s)
- Benjamin C Trumble
- School of Human Evolution & Social Change and Center for Evolution and Medicine, Arizona State University Tempe, Arizona 85287 USA
| | - Caleb E Finch
- Leonard Davis School of Gerontology and Dornsife College, University of Southern California Los Angeles, California 90089-0191 USA
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45
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Cuttica MJ, Colangelo LA, Dransfield MT, Bhatt SP, Rana JS, Jacobs DR, Thyagarajan B, Sidney S, Lewis CE, Liu K, Lloyd-Jones D, Washko G, Kalhan R. Lung Function in Young Adults and Risk of Cardiovascular Events Over 29 Years: The CARDIA Study. J Am Heart Assoc 2019; 7:e010672. [PMID: 30561252 PMCID: PMC6405620 DOI: 10.1161/jaha.118.010672] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Background Diminished peak lung function in young adulthood is a risk factor for future chronic obstructive pulmonary disease. The association between lung disease and cardiovascular disease later in life is well documented. Whether peak lung function measured in young adulthood is associated with risk of future cardiovascular events is unknown. Methods and Results CARDIA (The Coronary Artery Risk Development in Young Adults) study is a prospective, multicenter, community‐based, longitudinal cohort study including 4761 participants aged 18 to 30 years with lung function testing we investigated the association between lung health in young adulthood and risk of subsequent cardiovascular events. We performed Cox proportional hazards regression to test the association between baseline and years 10 and 20 pulmonary function with incident cardiovascular events. Linear and logistic regression was performed to explore the associations of lung function with development of risk factors for cardiovascular disease as well as carotid intima‐media thickness and coronary artery calcified plaque. At baseline, mean age (±SD) was 24.9±3.6 years. Baseline forced expiratory volume in 1 second (hazard ratio) per −10‐unit decrement in percent predicted forced expiratory volume in 1 second (hazard ratio, 1.18; 95% CI, 1.06–1.31 [P=0.002]) and FVC per −10‐unit decrement in percent predicted FVC (hazard ratio, 1.19; 95% CI, 1.06–1.33 [P=0.003]) were associated with future cardiovascular events independent of traditional cardiovascular risk factors. Baseline lung function was associated with heart failure and cerebrovascular events but not coronary artery disease events. Conclusions Lung function in young adulthood is independently associated with cardiovascular events into middle age. This association appears to be driven by heart failure and cerebrovascular events rather than coronary heart disease. Clinical Trial Registration URL: https://www.clinicaltrials.gov. Unique identifier: NCT00005130.
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Affiliation(s)
- Michael J Cuttica
- 1 Division of Pulmonary and Critical Care Medicine Feinberg School of Medicine Northwestern University Chicago IL
| | - Laura A Colangelo
- 2 Department of Preventive Medicine Feinberg School of Medicine Northwestern University Chicago IL
| | - Mark T Dransfield
- 3 Division of Pulmonary, Allergy and Critical Care Medicine University of Alabama School of Medicine Birmingham AL
| | - Surya P Bhatt
- 3 Division of Pulmonary, Allergy and Critical Care Medicine University of Alabama School of Medicine Birmingham AL
| | - Jamal S Rana
- 4 Division of Cardiology Kaiser Permanente Northern California Oakland CA.,6 Division of Research Kaiser Permanente Northern California Oakland CA
| | - David R Jacobs
- 5 Division of Epidemiology and Community Health School of Public Health University of Minnesota Minneapolis MN
| | - Bharat Thyagarajan
- 5 Division of Epidemiology and Community Health School of Public Health University of Minnesota Minneapolis MN
| | - Stephen Sidney
- 6 Division of Research Kaiser Permanente Northern California Oakland CA
| | - Cora E Lewis
- 7 Division of Preventive Medicine Department of Medicine University of Alabama at Birmingham AL
| | - Kiang Liu
- 2 Department of Preventive Medicine Feinberg School of Medicine Northwestern University Chicago IL
| | - Donald Lloyd-Jones
- 2 Department of Preventive Medicine Feinberg School of Medicine Northwestern University Chicago IL
| | - George Washko
- 8 Division of Pulmonary and Critical Care Medicine Brigham and Women's Hospital Boston MA
| | - Ravi Kalhan
- 1 Division of Pulmonary and Critical Care Medicine Feinberg School of Medicine Northwestern University Chicago IL.,2 Department of Preventive Medicine Feinberg School of Medicine Northwestern University Chicago IL
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46
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Blaum C, Brunner FJ, Kröger F, Braetz J, Lorenz T, Goßling A, Ojeda F, Koester L, Karakas M, Zeller T, Westermann D, Schnabel R, Blankenberg S, Seiffert M, Waldeyer C. Modifiable lifestyle risk factors and C-reactive protein in patients with coronary artery disease: Implications for an anti-inflammatory treatment target population. Eur J Prev Cardiol 2019; 28:152–158. [PMID: 33838040 DOI: 10.1177/2047487319885458] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 10/09/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Modifiable lifestyle risk factors (modRF) of coronary artery disease (CAD) are associated with increased inflammation represented by elevated C-reactive protein (CRP) levels. Lifestyle changes may influence the inflammatory burden in patients with CAD, relevantly modifying the target population for emerging anti-inflammatory compounds. AIMS The aims of this study were to analyse the association of modRF and CRP levels in CAD patients, and to define a potential target population for anti-inflammatory treatment with and without the optimisation of modRF. METHODS We included all patients with angiographically documented CAD from the observational cohort study INTERCATH. Patients with recent myocardial infarction, malignancy, infectious disease, and pre-existing immunosuppressive medication including a history of solid organ transplantation were excluded. Overweight (body mass index (BMI) ≥ 25 kg/m2), smoking, lack of physical activity (PA; <1.5 h/week), and poor diet (≤12 points of an established Mediterranean diet score (MDS), range 0-28 points) were considered as modRF. CRP was measured by a high-sensitivity assay (hsCRP) at baseline. We performed multivariable linear regressions with log-transformed hsCRP as the dependent variable. Based on these associations, we calculated potential hsCRP levels for each patient, assuming optimisation of the individual modRF. RESULTS Of 1014 patients, 737 (73%) were male, the mean age was 69 years, and 483 (48%) had an hsCRP ≥ 2 mg/l. ModRF were significantly overrepresented in patients with hsCRP ≥ 2 mg/l compared to patients with an hsCRP < 2 mg/l (BMI ≥ 25 kg/m2: 76% vs 61%; PA < 1.5 h/week: 69% vs 57%; MDS ≤ 12: 46% vs 37%; smoking: 61% vs 54%; p < 0.05 for all). hsCRP increased with the incremental number of modRF present (median hsCRP values for N = 0, 1, 2, 3, and 4 modRF: 1.1, 1.0, 1.6, 2.4, 2.8 mg/l, p < 0.001). Multivariable linear regression adjusting for age, sex, intake of lipid-lowering medication, and diabetes mellitus revealed independent associations between log-transformed hsCRP and all modRF (BMI ≥ 25 kg/m2: exp(ß) = 1.55, p < 0.001; PA < 1.5 h/week: exp(ß) = 1.33, p < 0.001; MDS ≤ 12: exp(ß) = 1.18, p = 0.018; smoking: exp(ß) = 1.18, p = 0.019). Individual recalculation of hsCRP levels assuming optimisation of modRF identified 183 out of 483 (38%) patients with hsCRP ≥ 2 mg/l who could achieve an hsCRP < 2 mg/l via lifestyle changes. CONCLUSION modRF are strongly and independently associated with CRP levels in patients with CAD. A relevant portion of CAD patients with high inflammatory burden could achieve an hsCRP < 2 mg/l by lifestyle changes alone. This should be considered both in view of the cost and side-effects of pharmacological anti-inflammatory treatment and for the design of future clinical trials in this field.
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Affiliation(s)
- Christopher Blaum
- Department of General and Interventional Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany
| | - Fabian J Brunner
- Department of General and Interventional Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany
| | - Friederike Kröger
- Department of General and Interventional Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany
| | - Julian Braetz
- Department of General and Interventional Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany
| | - Thiess Lorenz
- Department of General and Interventional Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany
| | - Alina Goßling
- Department of General and Interventional Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany
| | - Francisco Ojeda
- Department of General and Interventional Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany
| | - Lukas Koester
- Department of General and Interventional Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany
| | - Mahir Karakas
- Department of General and Interventional Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany.,German Center for Cardiovascular Research (DZHK e.V.), partner site Hamburg/Kiel/Lübeck, Germany
| | - Tanja Zeller
- Department of General and Interventional Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany.,German Center for Cardiovascular Research (DZHK e.V.), partner site Hamburg/Kiel/Lübeck, Germany
| | - Dirk Westermann
- Department of General and Interventional Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany.,German Center for Cardiovascular Research (DZHK e.V.), partner site Hamburg/Kiel/Lübeck, Germany
| | - Renate Schnabel
- Department of General and Interventional Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany.,German Center for Cardiovascular Research (DZHK e.V.), partner site Hamburg/Kiel/Lübeck, Germany
| | - Stefan Blankenberg
- Department of General and Interventional Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany.,German Center for Cardiovascular Research (DZHK e.V.), partner site Hamburg/Kiel/Lübeck, Germany
| | - Moritz Seiffert
- Department of General and Interventional Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany.,German Center for Cardiovascular Research (DZHK e.V.), partner site Hamburg/Kiel/Lübeck, Germany
| | - Christoph Waldeyer
- Department of General and Interventional Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany
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Cai Y, Xu W, Liu H, Wang F, Duan L, Li H, Li M, Li Y, Han L, Xiao H. Effects of cigarette smoking on older chinese men treated with clopidogrel monotherapy or aspirin monotherapy: a prospective study. Platelets 2019; 31:667-673. [PMID: 31556777 DOI: 10.1080/09537104.2019.1667494] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
We investigated the comparative effects of smoking status on outcomes in older Chinese men receiving aspirin or clopidogrel monotherapy. This was a prospective observational study of outcomes in 668 men aged ≥ 60 years undergoing annual health examination in the Chinese People's Liberation Army General Hospital from March-April 2017. All patients received regular treatment with aspirin or clopidogrel. Platelet aggregation and phenotyping for rs762551 were measured in all patients. We recorded all major adverse cardiovascular and cerebrovascular events; namely, all-cause death, myocardial infarction, stroke, transient ischemic attack, and unstable angina. In the clopidogrel subgroup, homozygous carriers (AA) of the CYP1A2*1F gene (rs762551, 163C>A) appeared more frequently in smokers than in nonsmokers (45.6% vs 32.7%, p = .035). Adenosine diphosphate-induced platelet aggregation using light transmittance aggregometry was lower in smokers compared with nonsmokers (44.97 ± 20.05% vs 51.98 ± 19.38%, respectively; p = .0018). Smokers (n = 103) had a decreased risk of major adverse cardiovascular and cerebrovascular events, compared with nonsmokers [n = 159; hazard ratio, 0.466; 95% confidence interval: 0.262-0.829, p = .008]. In the aspirin subgroup, AA-induced platelet aggregation showed no significant difference regarding smoking vs nonsmoking status (30.90 ± 32.21 vs 29.78 ± 31.47, respectively; p = .771). However, we saw a significant increase in adverse clinical events in the smoking group (n = 148) compared with the nonsmoking group (n = 258; hazard ratio = 1.907, 95% confidence interval: 1.128-3.225; p = .016). In older Chinese men, active smokers benefitted from clopidogrel therapy compared with aspirin. Long-term cigarette smoking may contribute to increased variations in CYP1A2*1F, but the variations do not fully explain the smoking paradox.
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Affiliation(s)
- Yulun Cai
- Geriatric Cardiology Department of The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital , Beijing, China
| | - Weihao Xu
- Geriatric Cardiology Department of The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital , Beijing, China
| | - Hongbin Liu
- Geriatric Cardiology Department of The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital , Beijing, China
| | - Fan Wang
- Geriatric Cardiology Department of The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital , Beijing, China
| | - Lei Duan
- Geriatric Cardiology Department of The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital , Beijing, China
| | - Huiying Li
- Geriatric Cardiology Department of The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital , Beijing, China
| | - Man Li
- Geriatric Cardiology Department of The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital , Beijing, China
| | - Yuerui Li
- Geriatric Cardiology Department of The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital , Beijing, China
| | - Lina Han
- Geriatric Cardiology Department of The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital , Beijing, China
| | - Hunan Xiao
- Geriatric Cardiology Department of The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital , Beijing, China
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Abstract
Current evidence on cigarette smoking associated with pancreatic cancer mortality is limited. We searched MEDLINE, Web of Science, and Embase databases to identify relevant studies published through January 31, 2018. A random-effects model was used to estimate summary hazard ratios (HRs) and 95% confidence intervals (CIs). A total of 20 studies were retrieved, involving 2,517,623 participants. Of these, more than 15,341 patients with pancreatic cancer died. Compared with never smokers, current (summary HR, 1.56; 95% CI, 1.34-1.83) and former (summary HR, 1.15; 95% CI, 1.06-1.26) smokers had elevated risk of total mortality in patients diagnosed with pancreatic cancer. This effect of cigarette smoking is observed both in the Western regions and the Asia-Pacific regions. This effect of smoking is independent of alcohol use, body mass index, and history of diabetes but is modified by tumor stage and study settings. Dose-response associations between smoking and pancreatic cancer mortality were revealed for smoking intensity, cumulative amount of cigarettes smoked, and duration of smoking. Cigarette smoking was associated with an increase in total mortality for patients with pancreatic cancer. Future studies should further clarify the role of smoking as an effect modifier in treatment trials of pancreatic cancer.
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Hou FJ, Zhou YJ, Ma XT, He T, Yan RQ, Geng Q, Wang HY, Ma Y, Ren YQ, Dong FZ. Culprit Lesion Characteristics in Young Patients with Hyperhomocysteinemia. Med Sci Monit 2019; 25:5306-5311. [PMID: 31313754 PMCID: PMC6659466 DOI: 10.12659/msm.914979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background The relationships between culprit coronary plaque characteristics and hyperhomocysteinemia (HHcy) are not fully understood in young patients. In this study we investigated the relationship between culprit atherosclerotic plaque phenotype assessed by optical coherence tomography (OCT) and hyperhomocysteinemia (HHcy) in young patients. Material/Methods We investigated the OCT imaging and HHcy of 123 lesions in 123 young patients (≤45 years of age). According to OCT images, culprit lesions were classified as thin-cap fiber atheroma (TCFA), thrombus, and other. The 123 patients were grouped as: HHcy group (53 cases, HHcy ≥15.5 μmol/l) and control group (70 cases, HHcy <15.5 μmol/l). Results Compared with the control group, the HHcy group had a higher proportion of OCT-TCFA (p=0.03), OCT-vasa vasorum (p=0.013), and OCT-thrombus (p=0.012), and a larger lipid arc (p=0.002). HHcy (P=0.037) and metabolic syndrome (MetS) (P=0.016) remained independent predictors of TCFAs. HHcy (P=0.026) and smoking (P=0.005) remained independent determinants of thrombus. Conclusions HHcy and MetS are associated with TCFAs, and HHcy and smoking are associated with thrombus in young patients with coronary artery disease.
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Affiliation(s)
- Fang-Jie Hou
- Department of Cardiology, 12th Ward, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Beijing, China (mainland).,Department of Cardiology, Qingdao Municipal Hospital, Qingdao, Shandong, China (mainland)
| | - Yu-Jie Zhou
- Department of Cardiology, 12th Ward, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Beijing, China (mainland)
| | - Xiao-Teng Ma
- Department of Cardiology, 12th Ward, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Beijing, China (mainland)
| | - Tao He
- Department of Cardiology, Qingdao Municipal Hospital, Qingdao, Shandong, China (mainland)
| | - Rong-Qiang Yan
- Department of Cardiology, Qingdao Municipal Hospital, Qingdao, Shandong, China (mainland)
| | - Qiang Geng
- Department of Cardiology, Qingdao Municipal Hospital, Qingdao, Shandong, China (mainland)
| | - Hai-Yang Wang
- Department of Cardiology, Qingdao Municipal Hospital, Qingdao, Shandong, China (mainland)
| | - Ying Ma
- Department of Cardiology, Qingdao Municipal Hospital, Qingdao, Shandong, China (mainland)
| | - Yong-Qiang Ren
- Department of Cardiology, Qingdao Municipal Hospital, Qingdao, Shandong, China (mainland)
| | - Fu-Zong Dong
- Department of Cardiology, Qingdao Municipal Hospital, Qingdao, Shandong, China (mainland)
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50
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Watson M, Dardari Z, Kianoush S, Hall ME, DeFilippis AP, Keith RJ, Benjamin EJ, Rodriguez CJ, Bhatnagar A, Lima JA, Butler J, Blaha MJ, Rifai MA. Relation Between Cigarette Smoking and Heart Failure (from the Multiethnic Study of Atherosclerosis). Am J Cardiol 2019; 123:1972-1977. [PMID: 30967285 PMCID: PMC6529241 DOI: 10.1016/j.amjcard.2019.03.015] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 03/04/2019] [Accepted: 03/07/2019] [Indexed: 12/18/2022]
Abstract
We studied the association between cigarette smoking and incident heart failure (HF) in a racially diverse US cohort. We included 6,792 participants from the Multi-Ethnic Study of Atherosclerosis with information on cigarette smoking at baseline, characterized by status, intensity, burden, and time since quitting. Adjudicated outcomes included total incident HF cases and HF stratified by ejection fraction (EF) into HF with reduced EF (HFrEF; EF ≤ 40%) and preserved EF (HFpEF; EF ≥ 50%). We used Cox proportional hazards models adjusted for traditional cardiovascular risk factors and accounted for competing risk of each HF type. Mean age was 62 ± 10 years; 53% were women, 61% were nonwhite, and 13% were current smokers. A total of 279 incident HF cases occurred over a median follow-up of 12.2 years. The incidence rates of HFrEF and HFpEF were 2.2 and 1.9 cases per 1000 person-years, respectively. Current smoking was associated with higher risk of HF compared with never smoking (hazard ratio [HR], 2.05; 95% confidence interval [CI], 1.36 to 3.09); this was similar for HFrEF (HR, 2.58; 95% CI, 1.27 to 5.25) and HFpEF (HR, 2.51; 95% CI, 1.15 to 5.49). Former smoking was not significantly associated with HF (HR, 1.17; 95% CI, 0.88 to 1.56). Smoking intensity, burden, and time since quitting did not provide additional information for HF risk after accounting for smoking status.
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Affiliation(s)
- Megan Watson
- Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
| | - Zeina Dardari
- The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, Maryland
| | - Sina Kianoush
- The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, Maryland; Department of Medicine, Yale-Waterbury, Waterbury, Connecticut
| | - Michael E Hall
- Division of Cardiology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Andrew P DeFilippis
- The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, Maryland; Diabetes and Obesity Center, University of Louisville School of Medicine, Louisville, Kentucky; Division of Cardiology, University of Louisville School of Medicine, Louisville, Kentucky
| | - Rachel J Keith
- Diabetes and Obesity Center, University of Louisville School of Medicine, Louisville, Kentucky; Division of Cardiology, University of Louisville School of Medicine, Louisville, Kentucky
| | - Emelia J Benjamin
- Department of Medicine, Division of Cardiology, Boston University School of Medicine, Boston, Massachusetts; Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
| | - Carlos J Rodriguez
- Maya Angelou Center for Health Equity, Wake Forest University, Winston-Salem, North Carolina
| | - Aruni Bhatnagar
- Diabetes and Obesity Center, University of Louisville School of Medicine, Louisville, Kentucky; Division of Cardiology, University of Louisville School of Medicine, Louisville, Kentucky
| | - Joao A Lima
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Javed Butler
- Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi
| | - Michael J Blaha
- The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, Maryland
| | - Mahmoud Al Rifai
- The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, Maryland; Department of Medicine, University of Kansas School of Medicine, Wichita, Kansas.
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