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Poupore N, Edrissi C, Sowah M, Stanley M, Joffe J, Lewis D, Cunningham T, Sanders CB, Knisely K, Rathfoot C, Nathaniel TI. Analysis of severity in ischemic stroke patients with coronary artery disease in the telestroke network. Future Cardiol 2022; 18:797-807. [PMID: 36052858 DOI: 10.2217/fca-2022-0059] [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: 01/05/2023] Open
Abstract
Aim: This study investigated demographic and clinical risk factors associated with severity in acute ischemic stroke (AIS) patients with a history of coronary artery disease (CAD). Materials & methods: Multivariate logistic regression models were used to determine specific factors associated with worsening or improving neurologic functions among AIS patients with CAD treated in the telestroke. Results: AIS patients with CAD, peripheral vascular disease (OR: 3.995; 95% CI: 1.035-15.413; p = 0.044) and hypertension (OR: 6.056; 95% CI: 1.207-30.374; p = 0.029) were associated with worsening neurologic functions. Conclusion: Our findings suggest the need to develop strategic management to improve the care of AIS patients with a history of CAD that present with hypertension and peripheral vascular disease in the telestroke network.
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Affiliation(s)
- Nicolas Poupore
- University of South Carolina School of Medicine-Greenville, Greenville, SC 29605, USA
| | - Camron Edrissi
- University of South Carolina School of Medicine-Greenville, Greenville, SC 29605, USA
| | - Mareshah Sowah
- University of South Carolina School of Medicine-Greenville, Greenville, SC 29605, USA
| | - Madison Stanley
- University of South Carolina School of Medicine-Greenville, Greenville, SC 29605, USA
| | - Jonah Joffe
- University of South Carolina School of Medicine-Greenville, Greenville, SC 29605, USA
| | - Donovan Lewis
- University of South Carolina School of Medicine-Greenville, Greenville, SC 29605, USA
| | - Teanda Cunningham
- University of South Carolina School of Medicine-Greenville, Greenville, SC 29605, USA
| | | | - Krista Knisely
- University of South Carolina School of Medicine-Greenville, Greenville, SC 29605, USA
| | - Chase Rathfoot
- University of South Carolina School of Medicine-Greenville, Greenville, SC 29605, USA
| | - Thomas I Nathaniel
- University of South Carolina School of Medicine-Greenville, Greenville, SC 29605, USA
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Sae-Jie W, Tangcharoen T, Vathesatogkit P, Aekplakorn W, Charoen P. Mendelian randomization study of the effect of coronary artery calcification on atherosclerotic cardiovascular diseases. Sci Rep 2022; 12:14829. [PMID: 36050433 PMCID: PMC9437097 DOI: 10.1038/s41598-022-19180-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 08/25/2022] [Indexed: 11/21/2022] Open
Abstract
Calcium calcification in the wall of arteries (CAC) leads to a higher risk of atherosclerosis related outcomes, especially myocardial infarction (MI). Nevertheless, the causal role of CAC on other related outcomes is unclear. In this study, we used Mendelian randomization (MR) to systematically investigate the causal role of CAC across a broad range of atherosclerotic cardiovascular diseases including coronary heart disease, angina, MI, ischemic heart disease, stroke, and peripheral vascular disease. Publicly available data from the UK biobank and other data sources were used. Using the two-sample Mendelian randomization (MR) approach, we applied 3 MR models including the inverse variance weighted, the weighted-median, and the weighted-mode methods. Eight SNPs associated with CAC were selected as instrumental variables. We observed causal evidence of CAC on MI consistently across all MR models (PIVW = 1.0 × 10-4, PW-Median = 1.1 × 10-4, PW-Mode = 3.8 × 10-2) and this causation is shown in an acute transmural MI of inferior wall (PIVW = 1.5 × 10-4, PW-Median = 4.8 × 10-5, PW-Mode = 3.2 × 10-2) but not consistently observed in an anterior wall. As each site of acute MI was suggested to have relatively specific mechanisms, our finding suggested that the causal role of CAC on MI is in an inferior wall possibly as a consequence of large calcification from a prolonged process, whereas non-calcified artery plaque or other underlying mechanisms may predominantly play role in an anterior infarction during an advanced atherosclerotic process.
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Affiliation(s)
- Wichanon Sae-Jie
- Department of Mathematics, Faculty of Science, Mahidol University, Bangkok, Thailand
| | - Tarinee Tangcharoen
- Department of Internal Medicine, Faculty of Medicine, Ramathibodi Hospital of Mahidol University, Bangkok, Thailand
| | - Prin Vathesatogkit
- Department of Internal Medicine, Faculty of Medicine, Ramathibodi Hospital of Mahidol University, Bangkok, Thailand
| | - Wichai Aekplakorn
- Department of Community Medicine, Faculty of Medicine, Ramathibodi Hospital of Mahidol University, Bangkok, Thailand
| | - Pimphen Charoen
- Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand. .,Integrative Computational Bioscience (ICBS) Center, Mahidol University, Bangkok, Thailand.
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From Diabetes to Atherosclerosis: Potential of Metformin for Management of Cardiovascular Disease. Int J Mol Sci 2022; 23:ijms23179738. [PMID: 36077136 PMCID: PMC9456496 DOI: 10.3390/ijms23179738] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 08/20/2022] [Accepted: 08/22/2022] [Indexed: 11/17/2022] Open
Abstract
Atherosclerosis is a common cause of cardiovascular disease, which, in turn, is often fatal. Today, we know a lot about the pathogenesis of atherosclerosis. However, the main knowledge is that the disease is extremely complicated. The development of atherosclerosis is associated with more than one molecular mechanism, each making a significant contribution. These mechanisms include endothelial dysfunction, inflammation, mitochondrial dysfunction, oxidative stress, and lipid metabolism disorders. This complexity inevitably leads to difficulties in treatment and prevention. One of the possible therapeutic options for atherosclerosis and its consequences may be metformin, which has already proven itself in the treatment of diabetes. Both diabetes and atherosclerosis are complex metabolic diseases, the pathogenesis of which involves many different mechanisms, including those common to both diseases. This makes metformin a suitable candidate for investigating its efficacy in cardiovascular disease. In this review, we highlight aspects such as the mechanisms of action and targets of metformin, in addition to summarizing the available data from clinical trials on the effective reduction of cardiovascular risks.
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Poznyak AV, Nikiforov NG, Starodubova AV, Popkova TV, Orekhov AN. Macrophages and Foam Cells: Brief Overview of Their Role, Linkage, and Targeting Potential in Atherosclerosis. Biomedicines 2021; 9:biomedicines9091221. [PMID: 34572406 PMCID: PMC8468383 DOI: 10.3390/biomedicines9091221] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 09/02/2021] [Accepted: 09/09/2021] [Indexed: 12/27/2022] Open
Abstract
Atherosclerosis is still one of the main causes of death around the globe. This condition leads to various life-threatening cardiovascular complications. However, no effective preventive measures are known apart from lifestyle corrections, and no cure has been developed. Despite numerous studies in the field of atherogenesis, there are still huge gaps in already poor understanding of mechanisms that underlie the disease. Inflammation and lipid metabolism violations are undoubtedly the key players, but many other factors, such as oxidative stress, endothelial dysfunction, contribute to the pathogenesis of atherosclerosis. This overview is focusing on the role of macrophages in atherogenesis, which are at the same time a part of the inflammatory response, and also tightly linked to the foam cell formation, thus taking part in both crucial for atherogenesis processes. Being essentially involved in atherosclerosis development, macrophages and foam cells have attracted attention as a promising target for therapeutic approaches.
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Affiliation(s)
- Anastasia V. Poznyak
- Skolkovo Innovative Center, Institute for Atherosclerosis Research, 121609 Moscow, Russia
- Correspondence: (A.V.P.); (A.N.O.)
| | - Nikita G. Nikiforov
- Laboratory of Angiopathology, Institute of General Pathology and Pathophysiology, 125315 Moscow, Russia;
- National Medical Research Center of Cardiology, Institute of Experimental Cardiology, 121552 Moscow, Russia
- Institute of Gene Biology, 119334 Moscow, Russia
| | - Antonina V. Starodubova
- Federal Research Centre for Nutrition, Biotechnology and Food Safety, 2/14 Ustinsky Passage, 109240 Moscow, Russia;
- Medical Faculty, Pirogov Russian National Research Medical University, 1 Ostrovitianov Street, 117997 Moscow, Russia
| | - Tatyana V. Popkova
- V.A. Nasonova Institute of Rheumatology, 34A Kashirskoye Shosse, 115522 Moscow, Russia;
| | - Alexander N. Orekhov
- Skolkovo Innovative Center, Institute for Atherosclerosis Research, 121609 Moscow, Russia
- Laboratory of Angiopathology, Institute of General Pathology and Pathophysiology, 125315 Moscow, Russia;
- Correspondence: (A.V.P.); (A.N.O.)
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Li A, Huang W, Yang Q, Peng L, Liu Q. Expression of the C677T Polymorphism of the 5, 10-Methylenetetrahydrofolate Reductase (MTHFR) Gene in Patients with Carotid Artery Atherosclerosis. Med Sci Monit 2020; 26:e920320. [PMID: 32675800 PMCID: PMC7387044 DOI: 10.12659/msm.920320] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Background The C677T polymorphism of the 5,10-methylenetetrahydrofolate reductase (MTHFR) gene polymorphism has been associated with hypertension and coronary heart disease, but its relationship with carotid artery remains unknown. This study aimed to investigate the association between the C677T polymorphism of the MTHFR gene in patients with confirmed carotid artery atherosclerosis. Material/Methods This retrospective study included 210 patients with carotid artery atherosclerosis (the patient group) and 210 controls (the control group). Color Doppler ultrasound was used to identify carotid artery intimo-medial thickness and atherosclerotic plaques. Sanger sequencing using the polymerase chain reaction (PCR) was used to detect the MTHFR C677T gene polymorphism. Systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting plasma glucose (FPG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglyceride (TG), glycosylated hemoglobin (HbA1c), and other laboratory indicators were measured. Results SBP, DBP, FPG, TC, LDL-C, HbA1c, and intimo-medial thickness were significantly increased in the patient group compared with the control group, and HDL-C was significantly lower. The allele frequencies of the C667T locus of MTHFR gene were significantly different between the two groups (P<0.05), and the TT genotype and the T allele frequencies in the patient group were higher than in the control group. Logistic regression analysis showed that SBP, TC, LDL-C, and the C667T MTHFR gene polymorphism were risk factors for carotid artery atherosclerosis. Conclusions The C677T polymorphism of the MTHFR gene was expressed in patients with carotid artery atherosclerosis.
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Affiliation(s)
- Anying Li
- Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China (mainland)
| | - Wei Huang
- Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China (mainland)
| | - Qiong Yang
- Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China (mainland)
| | - Liping Peng
- Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China (mainland)
| | - Qiang Liu
- Department of Neurosurgery, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China (mainland)
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Prognostic Relationship Between Peripheral Red Cell Distribution Width and Acute Cerebral Infarction in Patients with rtPA Thrombolysis. Neurotox Res 2020; 38:211-218. [PMID: 32162280 DOI: 10.1007/s12640-020-00186-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Revised: 02/20/2020] [Accepted: 02/25/2020] [Indexed: 12/11/2022]
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7
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Truong QA, Villines TC. Risk Scores versus Atherosclerosis Imaging: Time to Embrace What Is in Plain Sight! Radiol Cardiothorac Imaging 2020; 2:e200019. [PMID: 33778541 DOI: 10.1148/ryct.2020200019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Accepted: 02/04/2020] [Indexed: 11/11/2022]
Affiliation(s)
- Quynh A Truong
- Department of Radiology, Weill Cornell Medicine, 525 E 68th St, L-024, New York, NY 10065 (Q.A.T.); and Cardiovascular Imaging Center, Department of Medicine, University of Virginia Health System and School of Medicine, Charlottesville, Va (T.C.V.)
| | - Todd C Villines
- Department of Radiology, Weill Cornell Medicine, 525 E 68th St, L-024, New York, NY 10065 (Q.A.T.); and Cardiovascular Imaging Center, Department of Medicine, University of Virginia Health System and School of Medicine, Charlottesville, Va (T.C.V.)
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Chu Z, Cheng L, Tong Q. Carotid artery calcification score and its association with cognitive impairment. Clin Interv Aging 2019; 14:167-177. [PMID: 30697041 PMCID: PMC6342141 DOI: 10.2147/cia.s192586] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Purpose To retrospectively investigate the possible association between carotid artery calcification score (CS) and cognitive impairment in carotid artery stenosis (CAS) patients. Patients and methods Carotid artery was measured in 102 patients with cervical carotid arteries using Color Doppler ultrasound, multi-detector row spiral CT angiography and MRI scanning. Correlation analysis between CSs obtained by MD CT and cognitive scores was performed, and the correlation between CSs and vascular stenosis degree and MRI-measured plaque histological (lipid-rich necrotic nucleus [LRNC], intraplaque hemorrhage and fibrous cap surface rupture) and morphological parameters (lumen area [LA], wall area [WA], total area of blood vessels [TVA], plaque burden [PB]) was analyzed. Follow-up review analysis was conducted on 38 postoperative patients. Results Significant negative correlation was discovered between CS value and cognitive scores in CAS patients (R=-0.359, P<0.001), which did not exist in postoperative patients (P=0.348); CS value also showed significant correlation with WA (R=0.521, P=0.042), TVA (R=0.215, P=0.017) and PB (R=0.237, P=0.003) and had a certain predictive value for the occurrence probability of carotid plaque LRNC (P=0.029, AUC =0.780) in preoperative patients. Conclusion Carotid artery CSs have significant correlation with cognitive scores, which could be used as risk factor for early screening of cognitive impairment in CAS patients. The possible mechanism may be related to the calcification impact on the plaque burden.
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Affiliation(s)
- Zhou Chu
- Department of Vascular Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, Jiangsu, China,
| | - Liu Cheng
- Department of Vascular Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, Jiangsu, China,
| | - Qiao Tong
- Department of Vascular Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, Jiangsu, China,
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