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Gager GM, Eyileten C, Postuła M, Nowak A, Gąsecka A, Jilma B, Siller-Matula JM. Expression Patterns of MiR-125a and MiR-223 and Their Association with Diabetes Mellitus and Survival in Patients with Non-ST-Segment Elevation Acute Coronary Syndrome. Biomedicines 2023; 11:biomedicines11041118. [PMID: 37189736 DOI: 10.3390/biomedicines11041118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 03/27/2023] [Accepted: 04/03/2023] [Indexed: 05/17/2023] Open
Abstract
Background: MicroRNAs (miRNA, miR) are small, non-coding RNAs which have become increasingly relevant as diagnostic and prognostic biomarkers. The objective of this study was the investigation of blood-derived miRNAs and their link to long-term all-cause mortality in patients who suffered from non-ST-segment elevation acute coronary syndrome (NSTE-ACS). Methods: This study was an observational prospective study, which included 109 patients with NSTE-ACS. Analysis of the expression of miR-125a and miR-223 was conducted by polymerase chain reaction (PCR). The follow-up period comprised a median of 7.5 years. Long-term all-cause mortality was considered as the primary endpoint. Adjusted Cox-regression analysis was performed for prediction of events. Results: Increased expression of miR-223 (>7.1) at the time point of the event was related to improved long-term all-cause survival (adjusted (adj.) hazard ratio (HR) = 0.09, 95% confidence interval (95%CI): 0.01-0.75; p = 0.026). The receiver operating characteristic (ROC) analysis provided sufficient c-statistics (area under the curve (AUC) = 0.73, 95%CI: 0.58-0.86; p = 0.034; negative predictive value of 98%) for miR-223 to predict long-term all-cause survival. The Kaplan-Meier time to event analysis showed a separation of the survival curves between the groups at an early stage (log rank p = 0.015). Higher plasma miR-125a levels were found in patients with diabetes mellitus vs. in those without (p = 0.010). Furthermore, increased miR-125a expression was associated with an elevated HbA1c concentration. Conclusions: In this hypothesis-generating study, higher values of miR-223 were related to improved long-term survival in patients after NSTE-ACS. Larger studies are required in order to evaluate whether miR-223 can be used as a suitable predictor for long-term all-cause mortality.
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Affiliation(s)
- Gloria M Gager
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, 1090 Vienna, Austria
- Department of Clinical Pharmacology, Medical University of Vienna, 1090 Vienna, Austria
| | - Ceren Eyileten
- Centre for Preclinical Research and Technology (CEPT), Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, 02-091 Warsaw, Poland
- Genomics Core Facility, Center of New Technologies (CeNT), University of Warsaw, 00-927 Warsaw, Poland
| | - Marek Postuła
- Centre for Preclinical Research and Technology (CEPT), Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Anna Nowak
- Centre for Preclinical Research and Technology (CEPT), Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, 02-091 Warsaw, Poland
- Doctoral School, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Aleksandra Gąsecka
- Department of Cardiology, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Bernd Jilma
- Department of Clinical Pharmacology, Medical University of Vienna, 1090 Vienna, Austria
| | - Jolanta M Siller-Matula
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, 1090 Vienna, Austria
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Farah Yusuf Mohamud M. Epidemiological Characteristics and Risk Factors Associated with Acute Myocardial Infarction in Somalia: A Single-Center Experience. Int J Gen Med 2022; 15:7605-7617. [PMID: 36213302 PMCID: PMC9532582 DOI: 10.2147/ijgm.s383690] [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] [Received: 07/29/2022] [Accepted: 09/23/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction Acute myocardial infarction (AMI) is a clinical emergency condition that encompasses STEMI and NSTEMI that leads to significant morbidity and mortality rate. Methods This prospectively cohort study was obtained from adult (≥18 years) patients with definitive diagnosis of AMI based on the International Classification of Diseases (ICD; codes I21, I22) those visiting to our hospital from December 2020 to November 2021. Patients with no definite diagnosis of MI and those having with stable or unstable angina were excluded from the study. Descriptive methods including frequency of tables and bar charts for different categories were used for data analysis. Results Of 23,147 patients, 3526 were presented with chest pain in our emergency unit over the study period. A total of 97 patients met the inclusion criteria of AMI for this analysis. Of them, 73 (75.3%) had STEMI, and 24 (24.7%) had NSTEMI. Those with STEMI, anterior MI was common occlusion site (n=24, 32.9%) followed by inferior MI (n=15, 20.5%). The mean age of patients was 54.2±12.1 years. Of the total study subjects, 67 (69.1%) were males with no significant difference in subgroups. Most of the participants were married (n=41, 42.3%). More than half of the patients were employed (n=51, 52.6%), while most of the participants were no formal education (n-39, 44.2%). Regarding the ASCVD risk factors, history of hypertension, diabetes mellitus, previous history of coronary artery disease (CAD), and dyslipidemia were the most common comorbidities in STEMI and NSTEMI cases, 31 (41.2%), 36 (49.3%), 24 (32.9%) and 15 (20.5%) vs 14 (66.7%), 11 (45.8%), 11 (45.8%), and 6 (25%), respectively. On the initial clinical presentations, typical chest pain and palpitation were the most frequent clinical presenting symptoms in both STEMI and NSTEMI patients of our study (STEMI=80.4% vs NSTEMI=68% in each), followed by dyspnea (STEMI=72.6% vs NSTEMI=41.7%) and epigastric pain (STEMI=32.9% vs NSTEMI=29.2%). The use of aspirin, clopidogrel, and LMWH therapy within the first hours after the emergency were high and comparable in both subgroups (91.8%, vs 89.7% vs 89.7%). The majority of the patients developed heart failure (36.1%), arrhythmia (23.7%), and cardiogenic shock (18%). Conclusion As registered, the present study has a higher proportion of STEMI cases among the AMI participants when compared to the NSTEMI. Hypertension, diabetes, hyperlipidemia, and family history of CAD respectively were the highest prevalence risk factors of AMI.
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Affiliation(s)
- Mohamed Farah Yusuf Mohamud
- Mogadishu Somali Turkish Training and Research Hospital, Mogadishu, Somalia
- Correspondence: Mohamed Farah Yusuf Mohamud, Mogadishu Somali-Turkish Training and Research Hospital, 30 Street, Alikamin, Wartanabada District, Mogadishu, Somalia, Tel +252615591689, Email
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Carmona-Puerta R, Lorenzo-Martínez E. Nonspecific ventricular repolarization abnormalities: A wolf in sheep's clothing. Rev Clin Esp 2022; 222:S2254-8874(22)00054-6. [PMID: 35842412 DOI: 10.1016/j.rceng.2022.03.008] [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: 02/21/2022] [Accepted: 03/16/2022] [Indexed: 10/17/2022]
Abstract
The term nonspecific ventricular repolarization abnormalities refers to a set of minor alterations of the ST segment and/or the T wave. For a long time, they have been of little clinical interest as they do not translate into specific diagnoses. It has even been asserted that they constitute benign electrocardiographic findings. Their presence has been reported in various cardiovascular and non-cardiovascular diseases. However, it is frequently identified in apparently healthy asymptomatic people. A growing number of studies demonstrate their importance as predictors of cardiovascular morbidity and mortality, expanding their spectrum towards cardiovascular prevention. In light of the body of scientific evidence, it is imperative that the traditional view of nonspecific ventricular repolarization abnormalities changes.
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Affiliation(s)
- R Carmona-Puerta
- Servicio de Electrofisiología y Arritmología, Hospital Universitario Cardiocentro Ernesto Guevara, Santa Clara, Cuba.
| | - E Lorenzo-Martínez
- Departamento de Fisiología, Universidad de Ciencias Médicas de Villa Clara, Santa Clara, Cuba
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Gager GM, Eyileten C, Postula M, Gasecka A, Jarosz-Popek J, Gelbenegger G, Jilma B, Lang I, Siller-Matula J. Association Between the Expression of MicroRNA-125b and Survival in Patients With Acute Coronary Syndrome and Coronary Multivessel Disease. Front Cardiovasc Med 2022; 9:948006. [PMID: 35872885 PMCID: PMC9304571 DOI: 10.3389/fcvm.2022.948006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 06/22/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundMicroRNAs (miRNA, miR) have an undeniable physiological and pathophysiological significance and act as promising novel biomarkers. The aim of the study was to investigate blood-derived miRNAs and their association with long-term all-cause mortality in patients with multivessel disease (MVD) suffering from acute coronary syndrome (ACS).Materials and MethodsThis study was an observational prospective study, which included 90 patients with MVD and ACS. Expression of miR-125a, miR-125b, and miR-223 was analysed by polymerase chain reaction (PCR). Patients were followed-up for a median of 7.5 years. All-cause mortality was considered as the primary endpoint. Adjusted Cox-regression analysis was performed for prediction of events.ResultsElevated expression of miR-125b (>4.6) at the time-point of ACS was associated with increased long-term all-cause mortality (adjusted [adj.] hazard ratio [HR] = 11.26, 95% confidence interval [95% CI]: 1.15–110.38; p = 0.038). The receiver operating characteristic (ROC) analysis showed a satisfactory c-statistics for miR-125b for the prediction of long-term all-cause mortality (area under the curve [AUC] = 0.76, 95% CI: 0.61–0.91; p = 0.034; the negative predictive value of 98%). Kaplan–Meier time to event analysis confirmed an early separation of the survival curves between patients with high vs low expression of miR-125b (p = 0.003). An increased expression of miR-125a and miR-223 was found in patients with non-ST-segment elevation ACS (NSTE-ACS) as compared to those with ST-segment elevation myocardial infarction (STEMI) (p = 0.043 and p = 0.049, respectively) with no difference in the expression of miR-125b between the type of ACS.ConclusionIn this hypothesis generating study, lower values of miR-125b were related to improved long-term survival in patients with ACS and MVD. Larger studies are needed to investigate whether miR-125b can be used as a suitable predictor for long-term all-cause mortality.
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Affiliation(s)
- Gloria M. Gager
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - Ceren Eyileten
- Department of Experimental and Clinical Pharmacology, Centre for Preclinical Research and Technology (CEPT), Medical University of Warsaw, Warsaw, Poland
- Genomics Core Facility, Center of New Technologies (CeNT), University of Warsaw, Warsaw, Poland
| | - Marek Postula
- Department of Experimental and Clinical Pharmacology, Centre for Preclinical Research and Technology (CEPT), Medical University of Warsaw, Warsaw, Poland
| | - Aleksandra Gasecka
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Joanna Jarosz-Popek
- Department of Experimental and Clinical Pharmacology, Centre for Preclinical Research and Technology (CEPT), Medical University of Warsaw, Warsaw, Poland
- Doctoral School, Medical University of Warsaw, Warsaw, Poland
| | - Georg Gelbenegger
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - Bernd Jilma
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - Irene Lang
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Jolanta Siller-Matula
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
- Department of Experimental and Clinical Pharmacology, Centre for Preclinical Research and Technology (CEPT), Medical University of Warsaw, Warsaw, Poland
- *Correspondence: Jolanta Siller-Matula,
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Carmona-Puerta R, Lorenzo-Martínez E. Trastornos inespecíficos de la repolarización ventricular: un lobo con piel de oveja. Rev Clin Esp 2022. [DOI: 10.1016/j.rce.2022.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Ren YG, Liu MC, Ji MZ, Chen C, Hu HZ, Wang ZX, Yu PQ, Shang JM, Zhou QW, Tao NY, Guo YF, Lu YJ, Wang ZZ. Rapid detection of human heart-type fatty acid-binding protein in human plasma and blood using a colloidal gold-based lateral flow immunoassay. Exp Ther Med 2021; 22:1238. [PMID: 34539834 PMCID: PMC8438696 DOI: 10.3892/etm.2021.10673] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 02/15/2021] [Indexed: 12/22/2022] Open
Abstract
The incidence of acute myocardial infarction (AMI) is currently increasing. Early detection is important for the treatment and prognosis of patients with AMI. Heart-type fatty acid-binding protein (H-FABP) may be used as an early marker of AMI due to its high sensitivity, specificity and prognostic value. Therefore, in the present study, H-FABP was used as a biomarker in a double-antibody sandwich method and colloidal gold-based lateral flow immunoassay to develop a rapid detection kit for H-FABP with a processing time of only 5 min. The sensitivity of the kit in plasma and whole blood was 1 ng/ml and this method had good specificity, exhibiting no cross-reaction with cardiac troponin I, myoglobin or creatine kinase-Mb. The kits had good shelf life and stability, as they were able to be stored at 40˚C for 30 days. A total of 12 clinical samples were collected for detection and the coincidence rate with the ELISA method was up to 91.67%. Therefore, the present study provided a simple, rapid and economical early-detection in-home testing kit.
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Affiliation(s)
- Yang-Guang Ren
- Department of Breast and Thyroid Surgery, Huaihe Hospital of Henan University, Kaifeng, Henan 475004, P.R. China
| | - Mei-Chen Liu
- Joint National Laboratory for Antibody Drug Engineering, Key Laboratory of Cellular and Molecular Immunology of Henan Province, School of Basic Medical Sciences, Henan University, Kaifeng, Henan 475004, P.R. China
| | - Meng-Zhen Ji
- Joint National Laboratory for Antibody Drug Engineering, Key Laboratory of Cellular and Molecular Immunology of Henan Province, School of Basic Medical Sciences, Henan University, Kaifeng, Henan 475004, P.R. China
| | - Chen Chen
- Joint National Laboratory for Antibody Drug Engineering, Key Laboratory of Cellular and Molecular Immunology of Henan Province, School of Basic Medical Sciences, Henan University, Kaifeng, Henan 475004, P.R. China
| | - Hang-Zhan Hu
- Joint National Laboratory for Antibody Drug Engineering, Key Laboratory of Cellular and Molecular Immunology of Henan Province, School of Basic Medical Sciences, Henan University, Kaifeng, Henan 475004, P.R. China
| | - Zi-Xuan Wang
- Department of Breast and Thyroid Surgery, Huaihe Hospital of Henan University, Kaifeng, Henan 475004, P.R. China
| | - Pin-Qian Yu
- Joint National Laboratory for Antibody Drug Engineering, Key Laboratory of Cellular and Molecular Immunology of Henan Province, School of Basic Medical Sciences, Henan University, Kaifeng, Henan 475004, P.R. China
| | - Jia-Ming Shang
- Joint National Laboratory for Antibody Drug Engineering, Key Laboratory of Cellular and Molecular Immunology of Henan Province, School of Basic Medical Sciences, Henan University, Kaifeng, Henan 475004, P.R. China
| | - Qian-Wen Zhou
- Joint National Laboratory for Antibody Drug Engineering, Key Laboratory of Cellular and Molecular Immunology of Henan Province, School of Basic Medical Sciences, Henan University, Kaifeng, Henan 475004, P.R. China
| | - Ning-Ya Tao
- Joint National Laboratory for Antibody Drug Engineering, Key Laboratory of Cellular and Molecular Immunology of Henan Province, School of Basic Medical Sciences, Henan University, Kaifeng, Henan 475004, P.R. China
| | - Ya-Fei Guo
- Joint National Laboratory for Antibody Drug Engineering, Key Laboratory of Cellular and Molecular Immunology of Henan Province, School of Basic Medical Sciences, Henan University, Kaifeng, Henan 475004, P.R. China.,School of Medical Laboratory, Sanquan College of Xinxiang Medical University, Xinxiang, Henan 453003, P.R. China
| | - Yan-Jiao Lu
- Department of Breast and Thyroid Surgery, Huaihe Hospital of Henan University, Kaifeng, Henan 475004, P.R. China
| | - Zhi-Zeng Wang
- Joint National Laboratory for Antibody Drug Engineering, Key Laboratory of Cellular and Molecular Immunology of Henan Province, School of Basic Medical Sciences, Henan University, Kaifeng, Henan 475004, P.R. China
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Jönelid B, Christersson C, Hedberg P, Leppert J, Lindahl B, Lindhagen L, Oldgren J, Siegbahn A. Screening of biomarkers for prediction of multisite artery disease in patients with recent myocardial infarction. Scandinavian Journal of Clinical and Laboratory Investigation 2021; 81:353-360. [PMID: 34346268 DOI: 10.1080/00365513.2021.1921839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
A few studies have examined biomarkers in patients with myocardial infarction (MI) and peripheral artery disease (PAD), i.e. multisite artery disease (MSAD). The aim of the study was firstly, to associate biomarkers with the occurrence of PAD/MSAD and secondly, if those can, in addition to clinical characteristics, identify MI patients with MSAD.In two prospectively observational studies including unselected patients with recent MI, PAD was defined as an abnormal ankle-brachial index (ABI) score (<0.9 or >1.4). The proximity extension assay (PEA) technique was used, simultaneously analyzing 92 biomarkers with association to cardiovascular disease. Biomarkers were tested for univariate associations with PAD. Random forest was used to identify biomarkers with a higher association to PAD. The additional discriminatory accuracy of adding biomarkers to clinical characteristics was analyzed by the c-statistics. Nine biomarkers were identified as significantly associated with MSAD/PAD in the primary patient cohort, analyzed early after the MI. In the prediction analysis, six biomarkers were identified associated with PAD. Three of these; Tumor necrosis factor receptor (TNFR-1), Tumor necrosis factor receptor 2 (TNFR-2) and Growth Differentiation Factor 15 (GDF-15) improved c-statistics when added to clinical characteristics from 0.683 (95% CI 0.610-0.756) to 0.715 (95% CI 0.645-0.784) in the primary patient cohort with a similar result, 0.729 (95% CI 0.687-0.770) to 0.752 (95% CI 0.771-0.792) in the secondary patient cohort. Biomarkers associated with inflammatory pathways are associated with MSAD in MI patients. Three biomarkers of 92; TNFR-1, TNFR-2 and GDF-15, in this exploratory added information in the prediction of MSAD and emphasis the importance of further studies.
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Affiliation(s)
- Birgitta Jönelid
- Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden
| | | | - Pär Hedberg
- Department of Clinical Physiology, Uppsala University, Västmanland County Hospital, Västerås, Sweden
| | - Jerzy Leppert
- Centre for Clinical Research, Uppsala University, Västmanland County Hospital, Västerås, Sweden
| | - Bertil Lindahl
- Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden.,Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden
| | - Lars Lindhagen
- Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden
| | - Jonas Oldgren
- Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden.,Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden
| | - Agneta Siegbahn
- Department of Medical Sciences, Clinical Chemistry, Uppsala, Sweden
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Tsegaye T, Gishu T, Habte MH, Bitew ZW. Recovery Rate and Predictors Among Patients with Acute Coronary Syndrome in Addis Ababa, Ethiopia: A Retrospective Cohort Study. RESEARCH REPORTS IN CLINICAL CARDIOLOGY 2021. [DOI: 10.2147/rrcc.s307151] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
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Wu S, Sun H, Sun B. MicroRNA-145 is involved in endothelial cell dysfunction and acts as a promising biomarker of acute coronary syndrome. Eur J Med Res 2020; 25:2. [PMID: 32178736 PMCID: PMC7076941 DOI: 10.1186/s40001-020-00403-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 02/10/2020] [Indexed: 02/07/2023] Open
Abstract
Background Acute coronary syndrome (ACS) is a serious type of cardiovascular diseases. This study aimed to investigate the expression patterns and clinical value of microRNA-145 (miR-145) in ACS patients, and further uncover the function of miR-145 in ACS rats. Methods Quantitative real-time PCR was used to estimate the expression of miR-145. Diagnostic value of miR-145 was evaluated, and its correlation with endothelial injury marker (vWF and H-FABP) and pro-inflammatory cytokines (IL-6 and TNF-α) was analyzed. Coronary artery ligation was adopted to construct the ACS rat model, and the effects of miR-145 on endothelial injury, inflammation and vascular endothelial cells (VECs) biological function were examined. Results Downregulated expression of miR-145 was found in the ACS serum samples compared with the healthy controls. The expression of miR-145 was proved to be a diagnostic biomarker and negatively correlated with vWF, H-FABP, IL-6 and TNF-α. The similar serum expression trends of miR-145 in ACS patients were also observed in the ACS rats, and the overexpression of miR-145 could decrease the elevated vWF, H-FABP, IL-6 and TNF-α in the animal model. Moreover, the upregulation of miR-145 in VECs led to promoted proliferation and migration. The bioinformatics prediction data and luciferase report results indicated that FOXO1 was a direct target of miR-145. Conclusions In conclusion, it was hypothesized that serum decreased expression of miR-145 may serve as a potential diagnostic biomarker in ACS patients. Overexpression of miR-145 may improve the endothelial injury and abnormal inflammation through targeting FOXO1, indicating that miR-145 serves as a candidate therapeutic target of ACS.
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Affiliation(s)
- Shanshan Wu
- Department of Emergency, Yidu Central Hospital of Weifang, No. 4138, South Linglongshan Road, Weifang, 262500, Shandong, China
| | - Huijuan Sun
- Department of Emergency, Yidu Central Hospital of Weifang, No. 4138, South Linglongshan Road, Weifang, 262500, Shandong, China
| | - Bin Sun
- Department of Emergency, Yidu Central Hospital of Weifang, No. 4138, South Linglongshan Road, Weifang, 262500, Shandong, China.
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Genetic polymorphism of angiotensin converting enzyme and angiotensin II type 1 receptors and their impact on the outcome of acute coronary syndrome. Genomics 2020; 112:867-872. [DOI: 10.1016/j.ygeno.2019.05.028] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 05/31/2019] [Indexed: 11/21/2022]
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Percutaneous Coronary Intervention in Pregnancy: Modeling of the Fetal Absorbed Dose. Case Rep Obstet Gynecol 2019; 2019:8410203. [PMID: 31360566 PMCID: PMC6642787 DOI: 10.1155/2019/8410203] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 06/04/2019] [Accepted: 06/10/2019] [Indexed: 11/29/2022] Open
Abstract
There is a gap in the literature regarding fetal radiation exposure from interventional cardiac procedures. With an increasingly large and complex cohort of pregnant cardiac patients, it is necessary to evaluate the safety of invasive cardiac procedures and interventions in this population. Here we present a case of a patient with multiple medical comorbidities and non-ST elevation myocardial infarction (NSTEMI) at 15 weeks' gestation, managed with percutaneous coronary intervention (PCI). We were able to minimize the maternal and estimated fetal absorbed radiation dose to <1 milliGray (mGy), significantly less than the threshold dose for fetal adverse effects at this gestational age.
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Larson EA, German DM, Shatzel J, DeLoughery TG. Anticoagulation in the cardiac patient: A concise review. Eur J Haematol 2018; 102:3-19. [PMID: 30203452 DOI: 10.1111/ejh.13171] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2018] [Revised: 08/28/2018] [Accepted: 08/30/2018] [Indexed: 01/12/2023]
Abstract
Anticoagulation has multiple roles in the treatment of cardiovascular disease, including in management of acute myocardial infarction, during percutaneous coronary intervention, as stroke prophylaxis in patients with atrial arrhythmias, and in patients with mechanical heart valves. Clinical anticoagulation choices in the aforementioned diseases vary widely, due to conflicting data to support established agents and the rapid evolution of evidence-based practice that parallels more widespread use of novel oral anticoagulants. This review concisely summarizes evidence-based guidelines for anticoagulant use in cardiovascular disease, and highlights new data specific to direct oral anticoagulants.
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Affiliation(s)
- Elise A Larson
- The Division of Hematology, Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon
| | - David M German
- The Division of Cardiology, Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon
| | - Joseph Shatzel
- The Division of Hematology, Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon
| | - Thomas G DeLoughery
- The Division of Hematology, Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon
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Frampton J, Devries JT, Welch TD, Gersh BJ. Modern Management of ST-Segment Elevation Myocardial Infarction. Curr Probl Cardiol 2018; 45:100393. [PMID: 30660333 DOI: 10.1016/j.cpcardiol.2018.08.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 08/31/2018] [Indexed: 12/31/2022]
Abstract
Disruption of intracoronary plaque with thrombus formation resulting in severe or total occlusion of the culprit coronary artery provides the pathophysiologic foundation for ST-segment elevation myocardial infarction (STEMI). Management of STEMI focuses on timely restoration of coronary blood flow along with antithrombotic therapies and secondary prevention strategies. The purpose of this review is to discuss the epidemiology, pathophysiology, and diagnosis of STEMI. In addition, the review will focus on guideline-directed therapy for these patients and review potential associated complications.
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