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Pasqualetti F, Gabelloni M, Faggioni L, Aquaro GD, De Vietro F, Mendola V, Spina N, Frey J, Montemurro N, Cantarella M, Caccese M, Gadducci G, Giannini N, Valenti S, Morganti R, Ius T, Caffo M, Vergaro G, Cosottini M, Naccarato AG, Lombardi G, Bocci G, Neri E, Paiar F. Glioblastoma and Internal Carotid Artery Calcium Score: A Possible Novel Prognostic Partnership? J Clin Med 2024; 13:1512. [PMID: 38592330 PMCID: PMC10933913 DOI: 10.3390/jcm13051512] [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: 01/23/2024] [Revised: 02/24/2024] [Accepted: 02/29/2024] [Indexed: 04/10/2024] Open
Abstract
Purpose: Clinical evidence suggests an association between comorbidities and outcome in patients with glioblastoma (GBM). We hypothesised that the internal carotid artery (ICA) calcium score could represent a promising prognostic biomarker in a competing risk analysis in patients diagnosed with GBM. Methods: We validated the use of the ICA calcium score as a surrogate marker of the coronary calcium score in 32 patients with lung cancer. Subsequently, we assessed the impact of the ICA calcium score on overall survival in GBM patients treated with radio-chemotherapy. Results: We analysed 50 GBM patients. At the univariate analysis, methyl-guanine-methyltransferase gene (MGMT) promoter methylation (p = 0.048), gross total tumour resection (p = 0.017), and calcium score (p = 0.011) were significant prognostic predictors in patients with GBM. These three variables also maintained statistical significance in the multivariate analysis. Conclusions: the ICA calcium score could be a promising prognostic biomarker in GBM patients.
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Affiliation(s)
- Francesco Pasqualetti
- Radiation Oncology Unit, Azienda Ospedaliero Universitaria Pisana, 56123 Pisa, Italy; (M.C.); (G.G.); (N.G.); (S.V.); (F.P.)
| | - Michela Gabelloni
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy;
| | - Lorenzo Faggioni
- Academic Radiology, Department of Translational Research, University of Pisa, 56126 Pisa, Italy; (L.F.); (G.D.A.); (F.D.V.); (V.M.); (N.S.); (J.F.); (E.N.)
| | - Giovanni Donato Aquaro
- Academic Radiology, Department of Translational Research, University of Pisa, 56126 Pisa, Italy; (L.F.); (G.D.A.); (F.D.V.); (V.M.); (N.S.); (J.F.); (E.N.)
| | - Fabrizio De Vietro
- Academic Radiology, Department of Translational Research, University of Pisa, 56126 Pisa, Italy; (L.F.); (G.D.A.); (F.D.V.); (V.M.); (N.S.); (J.F.); (E.N.)
| | - Vincenzo Mendola
- Academic Radiology, Department of Translational Research, University of Pisa, 56126 Pisa, Italy; (L.F.); (G.D.A.); (F.D.V.); (V.M.); (N.S.); (J.F.); (E.N.)
| | - Nicola Spina
- Academic Radiology, Department of Translational Research, University of Pisa, 56126 Pisa, Italy; (L.F.); (G.D.A.); (F.D.V.); (V.M.); (N.S.); (J.F.); (E.N.)
| | - Jessica Frey
- Academic Radiology, Department of Translational Research, University of Pisa, 56126 Pisa, Italy; (L.F.); (G.D.A.); (F.D.V.); (V.M.); (N.S.); (J.F.); (E.N.)
| | - Nicola Montemurro
- Department of Neurosurgery, Azienda Ospedaliero Universitaria Pisana, 56123 Pisa, Italy;
| | - Martina Cantarella
- Radiation Oncology Unit, Azienda Ospedaliero Universitaria Pisana, 56123 Pisa, Italy; (M.C.); (G.G.); (N.G.); (S.V.); (F.P.)
| | - Mario Caccese
- Oncology Unit 1, Department of Oncology, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy; (M.C.); (G.L.)
| | - Giovanni Gadducci
- Radiation Oncology Unit, Azienda Ospedaliero Universitaria Pisana, 56123 Pisa, Italy; (M.C.); (G.G.); (N.G.); (S.V.); (F.P.)
| | - Noemi Giannini
- Radiation Oncology Unit, Azienda Ospedaliero Universitaria Pisana, 56123 Pisa, Italy; (M.C.); (G.G.); (N.G.); (S.V.); (F.P.)
| | - Silvia Valenti
- Radiation Oncology Unit, Azienda Ospedaliero Universitaria Pisana, 56123 Pisa, Italy; (M.C.); (G.G.); (N.G.); (S.V.); (F.P.)
| | - Riccardo Morganti
- Section of Statistics, University Hospital of Pisa, 56124 Pisa, Italy;
| | - Tamara Ius
- Neurosurgery Unit, Head-Neck and NeuroScience Department, University Hospital of Udine, 33100 Udine, Italy;
| | - Maria Caffo
- Department of Neurosurgery, University of Messina, 98122 Messina, Italy;
| | - Giuseppe Vergaro
- Interdisciplinary Center for Health Sciences, Scuola Superiore Sant’Anna, 56127 Pisa, Italy;
- Cardiology Division, Fondazione Toscana Gabriele Monasterio, 56127 Pisa, Italy
| | - Mirco Cosottini
- Department of Neuroradiology, University of Pisa, 56126 Pisa, Italy;
| | - Antonio Giuseppe Naccarato
- Division of Pathology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy;
| | - Giuseppe Lombardi
- Oncology Unit 1, Department of Oncology, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy; (M.C.); (G.L.)
| | - Guido Bocci
- Department of Clinical and Experimental Medicine, Clinical Pharmacology, University of Pisa, 56126 Pisa, Italy
| | - Emanuele Neri
- Academic Radiology, Department of Translational Research, University of Pisa, 56126 Pisa, Italy; (L.F.); (G.D.A.); (F.D.V.); (V.M.); (N.S.); (J.F.); (E.N.)
| | - Fabiola Paiar
- Radiation Oncology Unit, Azienda Ospedaliero Universitaria Pisana, 56123 Pisa, Italy; (M.C.); (G.G.); (N.G.); (S.V.); (F.P.)
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Shakya S, Cary MP. Hospital Utilization for Coronary Artery Disease, 1997-2014. J Cardiovasc Nurs 2024; 39:153-159. [PMID: 36594990 DOI: 10.1097/jcn.0000000000000965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Coronary artery disease (CAD) is the leading cause of cardiovascular morbidity, mortality, and healthcare costs in the United States. There are few reports on how public health and payment reforms might have influenced inpatient hospital use among patients with CAD. OBJECTIVE This study describes trends in hospital discharges, hospital charges, and discharge destinations in a national sample of patients with CAD between 1997 and 2014. METHODS This was a longitudinal study with descriptive analysis of the Healthcare Cost and Utilization Project of National Inpatient Sample data. FINDINGS During this study period, the total number of discharges was 1 333 996. Patients with CAD between 65 and 84 years old were among the highest users of inpatient hospital services, followed by those in the 45- to 64-year age group. The death rate increased from 5961 to 7217 per 10 000 patients during this time. The mean charge increased more than 5 times, from $9100 to $49 643. There was a large difference in mean hospital charges in urban ($51 666) and rural ($25 548) locations in 2014. Coronary artery disease patients with private insurance paid more than those with Medicaid and Medicare plans. The discharge to home and healthcare costs increased by 4.1% and 4.8%, respectively. CONCLUSION AND IMPLICATIONS Future researchers should use data sets, such as Medicare claims/Medical Expenditure Panel Study, that can provide comprehensive insights into patient-level factors influencing the use of inpatient care services among patients with CAD. Healthcare providers in posthospital settings should be well skilled in providing advanced cardiac rehabilitation and education to patients with CAD.
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Liao M, Tang M, Cao X, Liang G, Xie M, Zhou P. Coronary CT angiography for preoperative evaluation of non-cardiac surgery in patients with thoracic tumors: preliminary exploratory analysis in a retrospective cohort. J Cardiothorac Surg 2023; 18:87. [PMID: 36941619 PMCID: PMC10026420 DOI: 10.1186/s13019-022-02096-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 12/11/2022] [Indexed: 03/23/2023] Open
Abstract
PURPOSE Noninvasive coronary CT angiography (CCTA) was used to retrospectively analyze the characteristics of coronary artery disease (CAD) in patients with thoracic tumors and the impact of the results on clinical surgery decision-making, thus increasing the understanding of perioperative cardiac risk evaluation. METHOD A total of 779 patients (age 68.6 ± 6.6 years) with thoracic tumor (lung, esophageal, and mediastinal tumor) scheduled for non-cardiac surgery were retrospectively enrolled. Patients were divided into two groups: accepted or canceled surgery. Clinical data and CCTA results were compared between the two groups, and multivariate logistic regression analysis was performed to determine predictors of the events of cancellations of scheduled surgeries. RESULTS 634 patients (81.4%) had non-significant CAD and 145 patients (18.6%) had significant CAD. Single‑, 2‑, and 3‑ vessel disease was found in 173 (22.2%), 93 (11.9%) and 50 (6.4%) patients, respectively. 500 (64.2%), 96 (12.3%), 96 (12.3%), 56 (7.2%) and 31 (4.0%) patients were rated as CACS 0, 1-99, 100-399, 400-999 and > 1000, respectively. Cancellations of scheduled procedures continue to increase based on the severity of the stenosis and the number of major coronary artery stenosis. The degree of stenosis and the number of vascular stenosis were independent predictors of cancelling scheduled surgery. CONCLUSIONS For patients with thoracic tumors scheduled for non-cardiac surgery, the results suggested by CCTA significantly influenced surgery planning and facilitated to reduce perioperative cardiovascular events.
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Affiliation(s)
- Meng Liao
- School of Medical and Life Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China
- Department of Radiology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China
| | - Mingyue Tang
- School of Medical and Life Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China
- Department of Radiology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China
| | - Xu Cao
- School of Medical and Life Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China
- Department of Radiology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China
| | - Gao Liang
- Department of Radiology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China
| | - Mingguo Xie
- Department of Radiology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China.
| | - Peng Zhou
- Department of Radiology, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610041, China.
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Tsao CW, Aday AW, Almarzooq ZI, Anderson CAM, Arora P, Avery CL, Baker-Smith CM, Beaton AZ, Boehme AK, Buxton AE, Commodore-Mensah Y, Elkind MSV, Evenson KR, Eze-Nliam C, Fugar S, Generoso G, Heard DG, Hiremath S, Ho JE, Kalani R, Kazi DS, Ko D, Levine DA, Liu J, Ma J, Magnani JW, Michos ED, Mussolino ME, Navaneethan SD, Parikh NI, Poudel R, Rezk-Hanna M, Roth GA, Shah NS, St-Onge MP, Thacker EL, Virani SS, Voeks JH, Wang NY, Wong ND, Wong SS, Yaffe K, Martin SS. Heart Disease and Stroke Statistics-2023 Update: A Report From the American Heart Association. Circulation 2023; 147:e93-e621. [PMID: 36695182 DOI: 10.1161/cir.0000000000001123] [Citation(s) in RCA: 1278] [Impact Index Per Article: 1278.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS The American Heart Association, through its Epidemiology and Prevention Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update with review of published literature through the year before writing. The 2023 Statistical Update is the product of a full year's worth of effort in 2022 by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. The American Heart Association strives to further understand and help heal health problems inflicted by structural racism, a public health crisis that can significantly damage physical and mental health and perpetuate disparities in access to health care, education, income, housing, and several other factors vital to healthy lives. This year's edition includes additional COVID-19 (coronavirus disease 2019) publications, as well as data on the monitoring and benefits of cardiovascular health in the population, with an enhanced focus on health equity across several key domains. RESULTS Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.
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Kwok CS, Bennett S, Lip GYH. Coronary artery calcium score and its association with stroke: A systematic review and meta-analysis. Eur J Clin Invest 2023; 53:e13892. [PMID: 36251530 DOI: 10.1111/eci.13892] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/13/2022] [Accepted: 10/13/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND The relationship between coronary artery calcium (CAC) score and incident stroke is controversial. METHODS We conducted a systematic review of the literature evaluating CAC score and incident stroke. A search of MEDLINE and EMBASE was performed, and data were extracted from relevant studies. Statistical pooling with random-effects meta-analysis was undertaken to evaluate the risk of incident stroke with any CAC vs. no CAC, 1-100 CAC vs. no CAC, and >100 CAC vs. no CAC. RESULTS Data from nine different cohort studies from the United States and Europe with a total of 61,096 patients were included in this review. The mean age of patients in the studies ranged from 44 to 69 years, and follow-up duration ranged from a median of 5.5 years to 12.3 years. The crude stroke event varied from 1.6% to 9.5%. Meta-analysis of risk of incident stroke with any vs. no CAC (RR 1.70 95% CI 0.87-3.31, I2 = 95%) and for CAC 1-100 vs. no CAC (RR 1.54 95% CI 0.75-3.17, I2 = 93%) was not statistically significant. For CAC >100, the risk of incident stroke was significantly higher compared with no CAC (RR 2.61 95% CI 1.51-4.52, I2 = 89%). When one study which included only young adults was excluded, there was significant increase in risk of incident stroke with all categories of CAC. CONCLUSIONS There is an association between high CAC score and incident stroke, but more studies are needed to determine how patients with incidental CAC should be managed from the perspective of stroke prevention.
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Affiliation(s)
- Chun Shing Kwok
- Faculty of Health, Education and Life Sciences, Birmingham City University, Birmingham, UK.,Department of Cardiology, University Hospital of North Midlands NHS trust, Stoke-on-Trent, UK
| | - Sadie Bennett
- Department of Cardiology, University Hospital of North Midlands NHS trust, Stoke-on-Trent, UK
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool, UK.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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The Correlation between the Vascular Calcification Score of the Coronary Artery and the Abdominal Aorta in Patients with Psoriasis. Diagnostics (Basel) 2023; 13:diagnostics13020274. [PMID: 36673084 PMCID: PMC9858225 DOI: 10.3390/diagnostics13020274] [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: 12/01/2022] [Revised: 12/22/2022] [Accepted: 01/09/2023] [Indexed: 01/15/2023] Open
Abstract
Psoriasis is known as an independent risk factor for cardiovascular disease due to its chronic inflammation. Studies have been conducted to evaluate the progress of atherosclerotic plaques in psoriasis. However, inadequate efforts have been made to clarify the relationship between atherosclerosis progress in coronary arteries and other important blood vessels. For that reason, we investigated the correlation and development of the coronary artery calcification score (CACS) and the abdominal aortic calcification score (AACS) during a follow-up examination. Eighty-three patients with psoriasis underwent coronary computed tomography angiography (CCTA) for total CACS and abdominal computed tomography (AbCT) for total AACS. PASI score, other clinical features, and blood samples were collected at the same time. The patients' medical histories were also retrieved for further analysis. Linear regression was used to analyze the CACS and AACS associations. There was a moderate correlation between CACS and AACS, while both calcification scores relatively reflected the coronary plaque number, coronary stenosis number, and stenosis severity observed with CCTA. Both calcification scores were independent of the PASI score. However, a significantly higher CACS was found in psoriatic arthritis, whereas no similar phenomenon was recorded for AACS. To conclude, both CACS and AACS might be potential alternative tests to predict the presence of coronary lesions as confirmed by CCTA.
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Parkkila K, Kiviniemi A, Tulppo M, Perkiömäki J, Kesäniemi YA, Ukkola O. Carotid and femoral bruits as cardiovascular risk indicators in a middle-aged Finnish population: A 20-year prospective study. PLoS One 2022; 17:e0278901. [PMID: 36490299 PMCID: PMC9733881 DOI: 10.1371/journal.pone.0278901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 11/27/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Effective treatment and prevention of cardiovascular (CV) diseases requires reliable methods of assessing individual CV event risk. Although standardized risk calculators like Systematic Coronary Risk Evaluation (SCORE) are sufficient in most instances, sometimes more specific clinical examination is needed to determine the most optimal intervention and its intensity. AIM To study whether carotid and femoral bruits provide prognostic information on CV events, CV mortality and all-cause mortality beyond traditional CV risk factors. METHODS 1045 subjects (49.8% men), aged 51.3 ± 5.97 years were clinically examined in the beginning of 1990's. The subjects were followed for over 20 years and data on CV events and causes of deaths was collected. RESULTS During the follow-up period, 241 (23.1%) of the subjects died and 82 (34.6%) of the deaths were of CV origin. Carotid bruits were a significant risk factor for CV deaths only if subjects with previous CV events were included. After adjusting for age, sex, systolic blood pressure, smoking, diabetes, LDL cholesterol, coronary artery disease and stroke, carotid bruits posed a hazard ratio (HR) (95% confidence interval) of 4.15 (2.39-8.52) p<0.001 for CV deaths. After excluding subjects with previous CV events (after which n = 941) neither carotid nor femoral bruits were statistically associated with CV events or all-cause mortality. Adding carotid or femoral bruits in the baseline risk model with traditional CV risk factors did not improve C-statistic, reclassification, or discrimination of the subjects. CONCLUSIONS Carotid and femoral bruits do not provide clinically useful information in a pure primary prevention setting. Carotid bruits might be useful in evaluating the overall CV risk in a population where recurrent CV events may occur.
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Affiliation(s)
- Karri Parkkila
- Medical Research Center Oulu, Research Unit of Internal Medicine, Oulu University Hospital, University of Oulu, Oulu, Finland
- * E-mail:
| | - Antti Kiviniemi
- Medical Research Center Oulu, Research Unit of Internal Medicine, Oulu University Hospital, University of Oulu, Oulu, Finland
| | - Mikko Tulppo
- Department of Physiology, Research Unit of Biomedicine, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Juha Perkiömäki
- Medical Research Center Oulu, Research Unit of Internal Medicine, Oulu University Hospital, University of Oulu, Oulu, Finland
| | - Y. Antero Kesäniemi
- Medical Research Center Oulu, Research Unit of Internal Medicine, Oulu University Hospital, University of Oulu, Oulu, Finland
| | - Olavi Ukkola
- Medical Research Center Oulu, Research Unit of Internal Medicine, Oulu University Hospital, University of Oulu, Oulu, Finland
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Wei Y, Ma H, Xu B, Wang Z, He Q, Liu L, Zhou Z, Song Y, Chen P, Li J, Zhang Y, Mao G, Wang B, Tang G, Qin X, Zhang H, Xu X, Huo Y, Guo H. Joint Association of Low Vitamin K1 and D Status With First Stroke in General Hypertensive Adults: Results From the China Stroke Primary Prevention Trial (CSPPT). Front Neurol 2022; 13:881994. [PMID: 35645985 PMCID: PMC9135055 DOI: 10.3389/fneur.2022.881994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 04/11/2022] [Indexed: 11/28/2022] Open
Abstract
Background Vitamin K plays a role in preventing vascular calcification and may have a synergetic influence with vitamin D on cardiovascular health. However, whether this relationship applies to stroke, especially in a high-risk population of hypertensive individuals, remains unclear. The present study aims to study the joint association of low vitamin K1 and D status with first stroke in general hypertensive adults. Methods This study used a nested, case–control design with data from the China Stroke Primary Prevention Trial. The analysis included 604 first total stroke patients and 604 matched controls from a Chinese population with hypertension. Odds ratios (ORs) and 95% confidence intervals were calculated using conditional logistic regression. Results There was a non-linear negative association between plasma vitamin K1 and the risk of first total stroke or ischemic stroke in the enalapril-only group. Compared to participants in vitamin K1 quartile 1, a significantly lower risk of total stroke (OR = 0.58, 95% CI: 0.36, 0.91, P = 0.020) or ischemic stroke (OR = 0.34, 95% CI: 0.17, 0.63, P < 0.001) was found in participants in vitamin K1 quartile 2-4 in the enalapril-only group. When further divided into four subgroups by 25(OH)D and vitamin K1, a significantly higher risk of total stroke or ischemic stroke was observed in participants with both low vitamin K1 and 25(OH)D compared to those with both high vitamin K1 and 25(OH)D in the enalapril-only group. No increased risk was observed in the groups low in one vitamin only. Conclusion Low concentrations of both vitamin K1 and 25(OH)D were associated with increased risk of stroke.
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Affiliation(s)
- Yaping Wei
- Key Laboratory of Precision Nutrition and Food Quality, Department of Nutrition and Health, College of Food Sciences and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Hai Ma
- Rongcheng Center for Disease Control and Prevention, Rongcheng, China
| | - Benjamin Xu
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Zhuo Wang
- Key Laboratory of Precision Nutrition and Food Quality, Department of Nutrition and Health, College of Food Sciences and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Qiangqiang He
- Graduate School at Shenzhen, Tsinghua University, Shenzhen, China
- Shenzhen Evergreen Medical Institute, Shenzhen, China
| | - Lishun Liu
- Graduate School at Shenzhen, Tsinghua University, Shenzhen, China
- Shenzhen Evergreen Medical Institute, Shenzhen, China
| | - Ziyi Zhou
- Graduate School at Shenzhen, Tsinghua University, Shenzhen, China
- Shenzhen Evergreen Medical Institute, Shenzhen, China
| | - Yun Song
- Shenzhen Evergreen Medical Institute, Shenzhen, China
- Institute for Biomedicine, Anhui Medical University, Hefei, China
| | - Ping Chen
- College of Pharmacy, Jinan University, Guangzhou, China
| | - Jianping Li
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Yan Zhang
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Guangyun Mao
- Department of Preventive Medicine, School of Public Health & Management, Wenzhou Medical University, Wenzhou, China
| | - Binyan Wang
- Institute for Biomedicine, Anhui Medical University, Hefei, China
| | - Genfu Tang
- Institute for Biomedicine, Anhui Medical University, Hefei, China
| | - Xianhui Qin
- National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Hao Zhang
- Key Laboratory of Precision Nutrition and Food Quality, Department of Nutrition and Health, College of Food Sciences and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Xiping Xu
- Key Laboratory of Precision Nutrition and Food Quality, Department of Nutrition and Health, College of Food Sciences and Nutritional Engineering, China Agricultural University, Beijing, China
- National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yong Huo
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Huiyuan Guo
- Key Laboratory of Precision Nutrition and Food Quality, Department of Nutrition and Health, College of Food Sciences and Nutritional Engineering, China Agricultural University, Beijing, China
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Tsao CW, Aday AW, Almarzooq ZI, Alonso A, Beaton AZ, Bittencourt MS, Boehme AK, Buxton AE, Carson AP, Commodore-Mensah Y, Elkind MSV, Evenson KR, Eze-Nliam C, Ferguson JF, Generoso G, Ho JE, Kalani R, Khan SS, Kissela BM, Knutson KL, Levine DA, Lewis TT, Liu J, Loop MS, Ma J, Mussolino ME, Navaneethan SD, Perak AM, Poudel R, Rezk-Hanna M, Roth GA, Schroeder EB, Shah SH, Thacker EL, VanWagner LB, Virani SS, Voecks JH, Wang NY, Yaffe K, Martin SS. Heart Disease and Stroke Statistics-2022 Update: A Report From the American Heart Association. Circulation 2022; 145:e153-e639. [PMID: 35078371 DOI: 10.1161/cir.0000000000001052] [Citation(s) in RCA: 2480] [Impact Index Per Article: 1240.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS The American Heart Association, through its Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update. The 2022 Statistical Update is the product of a full year's worth of effort by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. This year's edition includes data on the monitoring and benefits of cardiovascular health in the population and an enhanced focus on social determinants of health, adverse pregnancy outcomes, vascular contributions to brain health, and the global burden of cardiovascular disease and healthy life expectancy. RESULTS Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.
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An J, Kim HD, Kim SO, Kim HI, Song GW, Lee HC, Shim JH. Cervicocerebral atherosclerosis and its hepatic and coronary risk factors in patients with liver cirrhosis. Clin Mol Hepatol 2021; 28:67-76. [PMID: 34637612 PMCID: PMC8755468 DOI: 10.3350/cmh.2021.0202] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 10/11/2021] [Indexed: 11/16/2022] Open
Abstract
Background/Aims We aimed to investigate the silent atherosclerotic burden of cervicocephalic vessels in cirrhotic patients compared with the general population, as well as the relevant risk factors including coronary parameters. Methods This study included 993 stroke-free patients with liver cirrhosis (LC) who underwent magnetic resonance angiography (MRA) of the head and neck as a pre-liver transplant assessment and 6,099 health checkup participants who underwent MRA examination. The two cohorts were matched for cerebrovascular risk factors, and the prevalence of atherosclerosis in major intracranial and extracranial arteries was compared in 755 matched pairs. Moreover, traditional, hepatic, and coronary variables related to cerebral atherosclerosis were assessed in cirrhotic patients. Results Overall, intracranial atherosclerosis was significantly less prevalent in the LC group than in the matched control group (2.3% vs. 5.4%, P=0.002), whereas the prevalence of extracranial atherosclerosis was similar (4.4% vs. 5.8%, P=0.242). These results were maintained in multivariate analyses of the pooled samples, with corresponding adjusted odds ratios [ORs] of LC of 0.56 and 0.77 (95% confidence intervals [CIs], 0.36–0.88 and 0.55–1.09). In the LC group, lower platelet count was inversely correlated with intracranial atherosclerosis (adjusted OR, 0.31; 95% CI, 0.13–0.76). Coronary artery calcium (CAC) score ≥100 was the only predictive factor for both intracranial and extracranial atherosclerosis (adjusted ORs, 4.06 and 5.43, respectively). Conclusions LC confers protection against intracranial atherosclerosis, and thrombocytopenia may be involved in this protective effect. High CAC score could serve as a potential surrogate for cervicocerebral vascular screening in asymptomatic cirrhotic patients.
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Affiliation(s)
- Jihyun An
- Gastroenterology and Hepatology, Hanyang University College of Medicine, Guri, Gyeonggi, Republic of Korea
| | - Hyung-Don Kim
- Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Seon-Ok Kim
- Biostatistics and Clinical Epidemiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Ha Il Kim
- Gastroenterology, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea
| | - Gi-Won Song
- Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.,Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Han Chu Lee
- Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.,Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Ju Hyun Shim
- Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.,Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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11
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Gorgulho B, Alves MA, Teixeira JA, Santos RO, de Matos SA, Bittencourt MS, Benseñor I, Lotufo P, Marchioni DM. Dietary patterns associated with subclinical atherosclerosis: a cross-sectional analysis of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) study. Public Health Nutr 2021; 24:5006-5014. [PMID: 33413712 PMCID: PMC11082815 DOI: 10.1017/s1368980020005340] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 12/11/2020] [Accepted: 12/21/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To identify dietary patterns associated with subclinical atherosclerosis measured as coronary artery calcification (CAC). DESIGN Cross-sectional analysis of data from the Brazilian Longitudinal Study of Adult Health. Dietary data were assessed using a FFQ, and a principal component factor analysis was used to derive the dietary patterns. Scree plot, eigenvalues > 1 and interpretability were considered to retain the factors. CAC was measured using a computed tomography scanner and an electrocardiography-gated prospective Ca score examination and was categorised into three groups based on the CAC score: 0, 1-100 and >100 Agatston units. Multinomial regression models were conducted for dietary patterns and CAC severity categories. SETTING Brazil, São Paulo, 2008-2010. PARTICIPANTS Active and retired civil servants who lived in São Paulo and underwent a CAC exam were included (n 4025). RESULTS Around 10 % of participants (294 men, 97 women) had a detectable CAC (>0), 6·5 % (182 men, 73 women) had a CAC of 1-100 and 3·5 % (110 men, 23 women) had a CAC > 100. Three dietary patterns were identified: convenience food, which was positively associated with atherosclerotic calcification; plant-based and dairy food, which showed no association with CAC; and the traditional Brazilian food pattern (rice, legumes and meats), which was inversely associated with atherosclerotic calcification. CONCLUSIONS Our results showed that a dietary pattern consisting of traditional Brazilian foods could be important to reducing the risk of atherosclerotic calcification and prevent future cardiovascular events, whereas a convenience dietary pattern was positively associated with this outcome.
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Affiliation(s)
- Bartira Gorgulho
- Department of Food and Nutrition, School of Nutrition, Federal University of Mato Grosso, Cuiabá, MT, Brazil
| | - Mariane A Alves
- Department of Nutrition, School of Public Health, University of São Paulo, Av. Dr. Arnaldo, 715 – Cerqueira César, São Paulo – SP, CEP 01246-904, Brazil
| | - Juliana A Teixeira
- Department of Nutrition, School of Public Health, University of São Paulo, Av. Dr. Arnaldo, 715 – Cerqueira César, São Paulo – SP, CEP 01246-904, Brazil
| | - Roberta O Santos
- Department of Nutrition, School of Public Health, University of São Paulo, Av. Dr. Arnaldo, 715 – Cerqueira César, São Paulo – SP, CEP 01246-904, Brazil
| | | | - Marcio Sommer Bittencourt
- Center for Clinical and Epidemiological Research, University Hospital, University of São Paulo, São Paulo, Brazil
| | - Isabela Benseñor
- Center for Clinical and Epidemiological Research, University Hospital, University of São Paulo, São Paulo, Brazil
| | - Paulo Lotufo
- Center for Clinical and Epidemiological Research, University Hospital, University of São Paulo, São Paulo, Brazil
| | - Dirce Maria Marchioni
- Department of Nutrition, School of Public Health, University of São Paulo, Av. Dr. Arnaldo, 715 – Cerqueira César, São Paulo – SP, CEP 01246-904, Brazil
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12
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The Added Value of Coronary Calcium Score in Predicting Cardiovascular Events in Familial Hypercholesterolemia. JACC Cardiovasc Imaging 2021; 14:2414-2424. [PMID: 34274263 DOI: 10.1016/j.jcmg.2021.06.011] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 06/01/2021] [Accepted: 06/11/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVES This study aimed at investigating the additional contribution of coronary artery calcium (CAC) score to SAFEHEART (Spanish Familial Hypercholesterolemia Cohort Study) risk equation (SAFEHEART-RE) for cardiovascular risk prediction in heterozygous familial hypercholesterolemia (HeFH). BACKGROUND Common cardiovascular risk equations are imprecise for HeFH. Because of the high phenotype variability of HeFH, CAC score could help to better stratify the risk of atherosclerotic cardiovascular disease (ASCVD). METHODS REFERCHOL (French Registry of Familial Hypercholesterolemia) and SAFEHEART are 2 ongoing national registries on HeFH. We analyzed data from primary prevention HeFH patients undergoing CAC quantification. We used probability-weighted Cox proportional hazards models to estimate HRs. Area under the receiver-operating characteristic curve (AUC) and net reclassification improvement (NRI) were used to compare the incremental contribution of CAC score when added to the SAFEHEART-RE for ASCVD prediction. ASCVD was defined as coronary heart disease, stroke or transient ischemic attack, peripheral artery disease, resuscitated sudden death, and cardiovascular death. RESULTS We included 1,624 patients (mean age: 48.5 ± 12.8 years; men: 45.7%) from both registries. After a median follow-up of 2.7 years (interquartile range: 0.4-5.0), ASCVD occurred in 81 subjects. The presence of a CAC score of >100 was associated with an HR of 32.05 (95% CI: 10.08-101.94) of developing ASCVD as compared to a CAC score of 0. Receiving-operating curve analysis showed a good performance of CAC score alone in ASCVD prediction (AUC: 0.860 [95% CI: 0.853-0.869]). The addition of log(CAC + 1) to SAFEHEART-RE resulted in a significantly improved prediction of ASCVD (AUC: 0.884 [95% CI: 0.871-0.894] for SAFEHEART-RE + log(CAC + 1) vs AUC: 0.793 [95% CI: 0.779-0.818] for SAFEHEART-RE; P < 0.001). These results were confirmed also when considering only hard cardiovascular endpoints. The addition of CAC score was associated with an estimated overall net reclassification improvement of 45.4%. CONCLUSIONS CAC score proved its use in improving cardiovascular risk stratification and ASCVD prediction in statin-treated HeFH.
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13
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Abdominal aorta plaques are better in predicting future cardiovascular events compared to carotid intima-media thickness: A 20-year prospective study. Atherosclerosis 2021; 330:36-42. [PMID: 34229196 DOI: 10.1016/j.atherosclerosis.2021.06.925] [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: 02/27/2021] [Revised: 06/04/2021] [Accepted: 06/30/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND AIMS Both carotid intima-media thickness (IMT) and arterial plaques have been shown to predict future CV events. Since there are no previous studies on the subject, our objective was to compare carotid IMT and the length of plaques in abdominal-pelvic main arteries in CV risk assessment in a prospective study setting with a follow-up of over 20 years. METHODS A total of 1007 patients (50% men), aged 51 ± 6.0 years, participated in the current study. Carotid IMT and the summarized plaque length (SUM) from abdominal aorta to common femoral arteries were ultrasonographically assessed. Patients were followed-up a median (1st-3rd quartile) of 22.5 (17.5-23.2) years for CV events. RESULTS SUM significantly predicted CV events (HR per every 10 mm increase: 1.035, 95% CI: 1.027-1.044, p < 0.001). Those in the highest SUM tertile had over 3-fold risk for CV event (HR: 3.392, 95% CI: 2.427-4.741, p < 0.001) when compared to those in the lowest tertile. SUM significantly predicted CV events even after adjusting for age, sex, hypertension, diabetes, smoking (pack-years), LDL cholesterol and IMT. Adding SUM to the established model improved C-index (95% CI) from 0.706 (0.674-0.738) to 0.718 (0.688-0.747) as well as both discrimination (p < 0.001) and reclassification (p < 0.001) of the patients. In contrast, IMT predicted cardiovascular events only in univariate analysis and it did not improve discrimination or reclassification of the patients. CONCLUSIONS In light of our findings, SUM is a superior indicator and clinical tool for evaluating the overall CV risk compared to carotid IMT.
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14
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Targher G, Tilg H, Byrne CD. Non-alcoholic fatty liver disease: a multisystem disease requiring a multidisciplinary and holistic approach. Lancet Gastroenterol Hepatol 2021; 6:578-588. [PMID: 33961787 DOI: 10.1016/s2468-1253(21)00020-0] [Citation(s) in RCA: 215] [Impact Index Per Article: 71.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 01/11/2021] [Accepted: 01/11/2021] [Indexed: 12/13/2022]
Abstract
Non-alcoholic fatty liver disease (NAFLD) is a public health problem worldwide. This narrative Review provides an overview of the current literature to support the notion that NAFLD is a multisystem disease. Convincing evidence shows a strong association between NAFLD and the risk of developing multiple extrahepatic complications such as type 2 diabetes, cardiovascular disease (ie, the predominant cause of mortality in people with NAFLD), chronic kidney disease, and some types of extrahepatic malignancies. The magnitude of this risk parallels the severity of NAFLD (especially the stage of liver fibrosis). There are probably multiple underlying mechanisms by which NAFLD might increase the risk of cardiovascular disease, type 2 diabetes, and extrahepatic complications. Addressing the growing burden of NAFLD will require setting up a multidisciplinary working group and framework to progress and embrace novel collaborative ways of working to deliver holistic, person-centred care and management of people with NAFLD.
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Affiliation(s)
- Giovanni Targher
- Department of Medicine, Section of Endocrinology, Diabetes, and Metabolism, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy.
| | - Herbert Tilg
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, and Metabolism, Innsbruck Medical University, Innsbruck, Austria
| | - Christopher D Byrne
- Department of Nutrition and Metabolism, Faculty of Medicine, University of Southampton, Southampton, UK; NIHR Southampton Biomedical Research Centre, University Hospital Southampton, Southampton, UK
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15
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Obisesan OH, Osei AD, Berman D, Dardari ZA, Uddin SMI, Dzaye O, Orimoloye OA, Budoff MJ, Miedema MD, Rumberger J, Mirbolouk M, Boakye E, Johansen MC, Rozanski A, Shaw LJ, Han D, Nasir K, Blaha MJ. Thoracic Aortic Calcium for the Prediction of Stroke Mortality (from the Coronary Artery Calcium Consortium). Am J Cardiol 2021; 148:16-21. [PMID: 33667445 PMCID: PMC8113160 DOI: 10.1016/j.amjcard.2021.02.038] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 02/15/2021] [Accepted: 02/23/2021] [Indexed: 12/12/2022]
Abstract
Thoracic aortic calcium(TAC) is an important marker of extracoronary atherosclerosis with established predictive value for all-cause mortality. We sought to explore the predictive value of TAC for stroke mortality, independent of the more established coronary artery calcium (CAC) score. The CAC Consortium is a retrospectively assembled database of 66,636 patients aged ≥18 years with no previous history of cardiovascular disease, baseline CAC scans for risk stratification, and follow-up for 12 ± 4 years. CAC scans capture the adjacent thoracic aorta, enabling assessment of TAC from the same images. TAC was available in 41,066 (62%), and was primarily analyzed as present or not present. To account for competing risks for nonstroke death, we utilized multivariable-adjusted Fine and Gray competing risk regression models adjusted for traditional cardiovascular risk factors and CAC score. The mean age of participants was 53.8 ± 10.3 years, with 34.4% female. There were 110 stroke deaths during follow-up. The unadjusted subdistribution hazard ratio (SHR) for stroke mortality in those who had TAC present compared with those who did not was 8.80 (95% confidence interval [CI]: 5.97, 12.98). After adjusting for traditional risk factors and CAC score, the SHR was 2.21 (95% CI:1.39,3.49). In sex-stratified analyses, the fully adjusted SHR for females was 3.42 (95% CI: 1.74, 6.73) while for males it was 1.55 (95% CI: 0.83, 2.90). TAC was associated with stroke mortality independent of CAC and traditional risk factors, more so in women. The presence of TAC appears to be an independent risk marker for stroke mortality.
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Affiliation(s)
| | - Albert D Osei
- Medstar Union Memorial Hospital, Baltimore, Maryland
| | | | - Zeina A Dardari
- Johns Hopkins University School of Medicine, Baltimore, Maryland
| | | | - Omar Dzaye
- Johns Hopkins University School of Medicine, Baltimore, Maryland
| | | | - Matthew J Budoff
- Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Los Angeles, California
| | | | | | | | - Ellen Boakye
- Johns Hopkins University School of Medicine, Baltimore, Maryland
| | | | - Alan Rozanski
- Division of Cardiology, Mount Sinai St. Luke's Hospital, New York
| | | | - Donghee Han
- Department of Imaging, Cedars-Sinai Medical Center, Los Angeles, California
| | | | - Michael J Blaha
- Johns Hopkins University School of Medicine, Baltimore, Maryland.
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16
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Gong J, Asher SB, Cucchiara B, Cuchel M, Soffer D. Case report: 68 yo Chinese-American woman with high HDL-C and ischemic stroke attributed to intracranial atherosclerotic stenosis. J Clin Lipidol 2021; 15:248-254. [PMID: 33573892 DOI: 10.1016/j.jacl.2021.01.006] [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: 07/03/2020] [Revised: 01/05/2021] [Accepted: 01/19/2021] [Indexed: 11/30/2022]
Abstract
Atherosclerotic cardiovascular disease (ASCVD) events are the most common cause of death in the United States and for most individuals who experience these events, may be predicted by risk identification tools. ASCVD risk calculators enable a clinician-patient discussion and the presence of risk-enhancing factors may further inform decision-making with respect to preventive pharmacotherapy, especially statin prescription. In cases where the decision of whether to treat with medicine is unclear, coronary artery calcium scoring by computed tomography offers enhanced risk stratification and may allow both clinicians and patients to feel more at ease with the decision to withhold statin therapy. Despite this thoughtful approach, individual risk may still be underestimated. We present a case of a woman whose family history suggested increased short- and long-term ASCVD risk due to intracranial atherosclerosis, but whose tests suggested a more equivocal indication for treatment. Neither she nor her clinician appreciated the presence of significant enough risk to persevere through minor statin side effects for primary prevention, but she was lucky to have survived without appreciable harm from an acute cerebrovascular event and is now able to pursue an appropriate secondary preventive strategy. We discuss how exceptional characteristics may mislead clinicians, including misperception about lower risk due to gender, East Asian predisposition to intracranial more than coronary atherosclerosis, high levels of high density lipoprotein cholesterol (HDL-C), and CACS = 0.
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Affiliation(s)
- Jan Gong
- Perelman School of Medicine at the University of Pennsylvania
| | | | - Brett Cucchiara
- Perelman School of Medicine at the University of Pennsylvania
| | - Marina Cuchel
- Perelman School of Medicine at the University of Pennsylvania
| | - Daniel Soffer
- Perelman School of Medicine at the University of Pennsylvania.
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17
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Virani SS, Alonso A, Aparicio HJ, Benjamin EJ, Bittencourt MS, Callaway CW, Carson AP, Chamberlain AM, Cheng S, Delling FN, Elkind MSV, Evenson KR, Ferguson JF, Gupta DK, Khan SS, Kissela BM, Knutson KL, Lee CD, Lewis TT, Liu J, Loop MS, Lutsey PL, Ma J, Mackey J, Martin SS, Matchar DB, Mussolino ME, Navaneethan SD, Perak AM, Roth GA, Samad Z, Satou GM, Schroeder EB, Shah SH, Shay CM, Stokes A, VanWagner LB, Wang NY, Tsao CW. Heart Disease and Stroke Statistics-2021 Update: A Report From the American Heart Association. Circulation 2021; 143:e254-e743. [PMID: 33501848 DOI: 10.1161/cir.0000000000000950] [Citation(s) in RCA: 3098] [Impact Index Per Article: 1032.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS The American Heart Association, through its Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update. The 2021 Statistical Update is the product of a full year's worth of effort by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. This year's edition includes data on the monitoring and benefits of cardiovascular health in the population, an enhanced focus on social determinants of health, adverse pregnancy outcomes, vascular contributions to brain health, the global burden of cardiovascular disease, and further evidence-based approaches to changing behaviors related to cardiovascular disease. RESULTS Each of the 27 chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS The Statistical Update represents a critical resource for the lay public, policy makers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.
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18
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Tschiderer L, Seekircher L, Klingenschmid G, Izzo R, Baldassarre D, Iglseder B, Calabresi L, Liu J, Price JF, Bae JH, Brouwers FP, de Groot E, Schmidt C, Bergström G, Aşçi G, Gresele P, Okazaki S, Kapellas K, Landecho MF, Sattar N, Agewall S, Zou ZY, Byrne CD, Nanayakkara PWB, Papagianni A, Witham MD, Bernal E, Ekart R, van Agtmael MA, Neves MF, Sato E, Ezhov M, Walters M, Olsen MH, Stolić R, Zozulińska-Ziółkiewicz DA, Hanefeld M, Staub D, Nagai M, Nieuwkerk PT, Huisman MV, Kato A, Honda H, Parraga G, Magliano D, Gabriel R, Rundek T, Espeland MA, Kiechl S, Willeit J, Lind L, Empana JP, Lonn E, Tuomainen TP, Catapano A, Chien KL, Sander D, Kavousi M, Beulens JWJ, Bots ML, Sweeting MJ, Lorenz MW, Willeit P. The Prospective Studies of Atherosclerosis (Proof-ATHERO) Consortium: Design and Rationale. Gerontology 2020; 66:447-459. [PMID: 32610336 DOI: 10.1159/000508498] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 05/07/2020] [Indexed: 11/19/2022] Open
Abstract
Atherosclerosis - the pathophysiological mechanism shared by most cardiovascular diseases - can be directly or indirectly assessed by a variety of clinical tests including measurement of carotid intima-media thickness, carotid plaque, -ankle-brachial index, pulse wave velocity, and coronary -artery calcium. The Prospective Studies of Atherosclerosis -(Proof-ATHERO) consortium (https://clinicalepi.i-med.ac.at/research/proof-athero/) collates de-identified individual-participant data of studies with information on atherosclerosis measures, risk factors for cardiovascular disease, and incidence of cardiovascular diseases. It currently comprises 74 studies that involve 106,846 participants from 25 countries and over 40 cities. In summary, 21 studies recruited participants from the general population (n = 67,784), 16 from high-risk populations (n = 22,677), and 37 as part of clinical trials (n = 16,385). Baseline years of contributing studies range from April 1980 to July 2014; the latest follow-up was until June 2019. Mean age at baseline was 59 years (standard deviation: 10) and 50% were female. Over a total of 830,619 person-years of follow-up, 17,270 incident cardiovascular events (including coronary heart disease and stroke) and 13,270 deaths were recorded, corresponding to cumulative incidences of 2.1% and 1.6% per annum, respectively. The consortium is coordinated by the Clinical Epidemiology Team at the Medical University of Innsbruck, Austria. Contributing studies undergo a detailed data cleaning and harmonisation procedure before being incorporated in the Proof-ATHERO central database. Statistical analyses are being conducted according to pre-defined analysis plans and use established methods for individual-participant data meta-analysis. Capitalising on its large sample size, the multi-institutional collaborative Proof-ATHERO consortium aims to better characterise, understand, and predict the development of atherosclerosis and its clinical consequences.
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Affiliation(s)
- Lena Tschiderer
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Lisa Seekircher
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Raffaele Izzo
- Department of Advanced Biochemical Sciences, Federico II University, Naples, Italy
| | - Damiano Baldassarre
- Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy
- Centro Cardiologico Monzino IRCCS, Milan, Italy
| | - Bernhard Iglseder
- Department of Geriatric Medicine, Gemeinnützige Salzburger Landeskliniken Betriebsgesellschaft GmbH Christian-Doppler-Klinik, Salzburg, Austria
- Department of Geriatric Medicine, Paracelsus Medical University, Salzburg, Austria
| | - Laura Calabresi
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy
| | - Jing Liu
- Department of Epidemiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Jackie F Price
- Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Jang-Ho Bae
- Heart Center, Konyang University Hospital, Daejeon, Republic of Korea
- Department of Cardiology, Konyang University College of Medicine, Daejeon, Republic of Korea
| | - Frank P Brouwers
- Department of Cardiology, Haga Teaching Hospital, The Hague, The Netherlands
| | - Eric de Groot
- Imagelabonline and Cardiovascular, Eindhoven/Lunteren, The Netherlands
| | - Caroline Schmidt
- Wallenberg Laboratory for Cardiovascular Research, University of Gothenburg, Gothenburg, Sweden
| | - Göran Bergström
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Clinical Physiology, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Gülay Aşçi
- Nephrology Department, Ege University School of Medicine, Bornova-Izmir, Turkey
| | - Paolo Gresele
- Division of Internal and Cardiovascular Medicine, Department of Medicine, University of Perugia, Perugia, Italy
| | - Shuhei Okazaki
- Department of Neurology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Kostas Kapellas
- Australian Research Centre for Population Oral Health, University of Adelaide, Adelaide, South Australia, Australia
| | - Manuel F Landecho
- Department of Internal Medicine, University Clinic of Navarra, Navarra, Spain
| | - Naveed Sattar
- BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, United Kingdom
| | - Stefan Agewall
- Oslo University Hospital Ullevål and Institute of Clinical Sciences, University of Oslo, Oslo, Norway
| | - Zhi-Yong Zou
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Christopher D Byrne
- Human Development and Health Academic Unit, Faculty of Medicine, The Institute of Developmental Sciences, University of Southampton - Southampton General Hospital, Southampton, United Kingdom
| | | | - Aikaterini Papagianni
- University Department of Nephrology, Hippokration General Hospital, Thessaloniki, Greece
| | - Miles D Witham
- AGE Research Group, NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle-upon-Tyne Hospitals Trust, Newcastle, United Kingdom
| | - Enrique Bernal
- Infectious Diseases Unit, Reina Sofia Hospital, Murcia, Spain
| | - Robert Ekart
- Department of Dialysis, University Medical Centre Maribor, Maribor, Slovenia
| | - Michiel A van Agtmael
- Department of Internal Medicine Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - Mario F Neves
- Department of Clinical Medicine, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Eiichi Sato
- Division of Nephrology, Shinmatsudo Central General Hospital, Chiba, Japan
| | - Marat Ezhov
- Laboratory of Lipid Disorders, National Medical Research Center of Cardiology, Moscow, Russian Federation
| | - Matthew Walters
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, United Kingdom
| | - Michael H Olsen
- Department of Internal Medicine, Holbaek Hospital, University of Southern Denmark, Odense, Denmark
| | - Radojica Stolić
- Department of Internal Medicine, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | | | - Markolf Hanefeld
- Center for Clinical Studies, Technical University Dresden, Dresden, Germany
| | - Daniel Staub
- Department of Angiology, University Hospital Basel, Basel, Switzerland
| | - Michiaki Nagai
- Department of Internal Medicine, General Medicine and Cardiology, Hiroshima City Asa Hospital, Hiroshima, Japan
| | - Pythia T Nieuwkerk
- Department of Medical Psychology, Amsterdam UMC - Location AMC, Amsterdam, The Netherlands
| | - Menno V Huisman
- Department of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The Netherlands
| | - Akihiko Kato
- Blood Purification Unit, Hamamatsu University Hospital, Hamamatsu, Japan
| | - Hirokazu Honda
- Division of Nephrology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Grace Parraga
- Department of Medical Biophysics, Western University, London, Ontario, Canada
| | - Dianna Magliano
- Department of Epidemiology and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, Victoria, Australia
| | - Rafael Gabriel
- National School of Public Health, Instituto de Salud Carlos III, Madrid, Spain
| | - Tatjana Rundek
- Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Mark A Espeland
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Stefan Kiechl
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
- VASCage GmbH, Research Centre on Vascular Ageing and Stroke, Innsbruck, Austria
| | - Johann Willeit
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Lars Lind
- Department of Medicine, Uppsala University, Uppsala, Sweden
| | - Jean Philippe Empana
- Paris Cardiovascular Research Centre (PARCC), University Paris Descartes, Paris, France
| | - Eva Lonn
- Department of Medicine and Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
- Hamilton General Hospital, Hamilton, Ontario, Canada
| | - Tomi-Pekka Tuomainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio Campus, Kuopio, Finland
| | - Alberico Catapano
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy
- IRCCS Multimedica, Milan, Italy
| | - Kuo-Liong Chien
- Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan
| | - Dirk Sander
- Department of Neurology, Benedictus Hospital Tutzing and Feldafing, Feldafing, Germany
- Department of Neurology, Technische Universität München, Munich, Germany
| | - Maryam Kavousi
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Joline W J Beulens
- Department of Epidemiology and Biostatistics, Amsterdam UMC - Location Vumc, Amsterdam, The Netherlands
| | - Michiel L Bots
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Michael J Sweeting
- Department of Health Sciences, University of Leicester, Leicester, United Kingdom
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Matthias W Lorenz
- Department of Neurology, Goethe University, Frankfurt am Main, Germany
| | - Peter Willeit
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria,
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom,
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19
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Incidental Coronary Artery Calcification and Stroke Risk in Patients With Atrial Fibrillation. AJR Am J Roentgenol 2020; 215:344-350. [PMID: 32348185 DOI: 10.2214/ajr.19.22298] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE. Atrial fibrillation (AF) is a major risk factor for stroke. The CHA2DS2-VASc score is used to risk stratify patients, and the score includes known coronary artery disease (CAD) as a variable. The aim of this study was to assess if the presence of incidental coronary artery calcification (CAC), without known CAD, is associated with stroke independent of CHA2DS2-VASc variables. MATERIALS AND METHODS. A retrospective review of health records was performed for patients who had AF, a chest CT scan performed within 1 year, and a subsequent visit for stroke. Patients with CAD and other vascular disease, a mechanical valve, or who were older than 74 years old were excluded. Included patients were one-to-one matched by age and CHA2DS2-VASc risk factors to patients who had had similar follow-up but who did not have a stroke. Nongated CT images were reviewed for CAC. Univariate and Cox regression analyses were performed. RESULTS. A total of 203 patients met the study criteria, and 203 matched patients without stroke were identified. Median age was 61 years old with stroke and 62 years old without stroke (p = 0.99). In both groups, 82 (39.0%) were women and the median CHA2DS2-VASc was 2 (interquartile range, 1-2). Anticoagulation medication was prescribed to 46 (22.7%) patients in the group who had had a stroke and 52 (25.6%) in the group without stroke (p = 0.49). On Cox regression analysis, CAC was associated with stroke (hazard ratio [HR], 1.47; 95% CI, 1.10-1.97; p < 0.01) and mortality (adjusted HR, 1.41; 95% CI, 1.02-1.95; p = 0.04). CONCLUSION. Patients with AF and incidental CAC depicted on chest CT have an increased risk of stroke and mortality beyond established risk factors.
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20
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Keuth J, Nitschke Y, Mulac D, Riehemann K, Rutsch F, Langer K. Reversion of arterial calcification by elastin-targeted DTPA-HSA nanoparticles. Eur J Pharm Biopharm 2020; 150:108-119. [PMID: 32151731 DOI: 10.1016/j.ejpb.2020.03.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 02/17/2020] [Accepted: 03/04/2020] [Indexed: 12/17/2022]
Abstract
Generalized arterial calcification of infancy (GACI) and pseudoxanthoma elasticum (PXE) are characterized by pathologic calcifications in the media of large- and medium sized arteries. GACI is associated with biallelic mutations in ENPP1 in the majority of cases, whereas mutations in ABCC6 are known to cause PXE. Different treatment approaches including bisphosphonates and orally administered pyrophosphate (PPi) were investigated in recent years, but reversion of calcification could not be achieved. With this study, we pursued the idea of a combination of controlled drug delivery through nanoparticles and active targeting via antibody conjugation to develop a treatment for GACI and PXE. To establish a suitable drug delivery system, the chelating drug diethylenetriamine pentaacetic acid (DTPA) was conjugated to nanoparticles composed of human serum albumin (HSA) as biodegradable and non-toxic particle matrix. To accomplish an active targeting of the elastic fibers exposed through calcification of the affected areas, the nanoparticle surface was functionalized with an anti-elastin antibody. Cytotoxicity and cell interaction studies revealed favorable preconditions for the intended i.v. application. The chelating ability was evaluated in vitro and ex vivo on aortic ring culture isolated from two mouse models of GACI and PXE. The positive results led to the conclusion that the produced nanoparticles might be a promising therapy in the treatment of GACI and PXE.
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Affiliation(s)
- Jacqueline Keuth
- Institute of Pharmaceutical Technology and Biopharmacy, University of Muenster, Corrensstraße 48, 48149 Muenster, Germany.
| | - Yvonne Nitschke
- Department of General Pediatrics, Muenster University Children's Hospital, Albert-Schweitzer-Campus 1, Gbde. A1, 48149 Muenster, Germany.
| | - Dennis Mulac
- Institute of Pharmaceutical Technology and Biopharmacy, University of Muenster, Corrensstraße 48, 48149 Muenster, Germany.
| | - Kristina Riehemann
- Center for Nanotechnology (CeNTech) and Institute of Physics, University of Muenster, Heisenbergstraße 11, 48149 Muenster, Germany.
| | - Frank Rutsch
- Department of General Pediatrics, Muenster University Children's Hospital, Albert-Schweitzer-Campus 1, Gbde. A1, 48149 Muenster, Germany.
| | - Klaus Langer
- Institute of Pharmaceutical Technology and Biopharmacy, University of Muenster, Corrensstraße 48, 48149 Muenster, Germany.
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21
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Virani SS, Alonso A, Benjamin EJ, Bittencourt MS, Callaway CW, Carson AP, Chamberlain AM, Chang AR, Cheng S, Delling FN, Djousse L, Elkind MSV, Ferguson JF, Fornage M, Khan SS, Kissela BM, Knutson KL, Kwan TW, Lackland DT, Lewis TT, Lichtman JH, Longenecker CT, Loop MS, Lutsey PL, Martin SS, Matsushita K, Moran AE, Mussolino ME, Perak AM, Rosamond WD, Roth GA, Sampson UKA, Satou GM, Schroeder EB, Shah SH, Shay CM, Spartano NL, Stokes A, Tirschwell DL, VanWagner LB, Tsao CW. Heart Disease and Stroke Statistics-2020 Update: A Report From the American Heart Association. Circulation 2020; 141:e139-e596. [PMID: 31992061 DOI: 10.1161/cir.0000000000000757] [Citation(s) in RCA: 4842] [Impact Index Per Article: 1210.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND The American Heart Association, in conjunction with the National Institutes of Health, annually reports on the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS The American Heart Association, through its Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update. The 2020 Statistical Update is the product of a full year's worth of effort by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. This year's edition includes data on the monitoring and benefits of cardiovascular health in the population, metrics to assess and monitor healthy diets, an enhanced focus on social determinants of health, a focus on the global burden of cardiovascular disease, and further evidence-based approaches to changing behaviors, implementation strategies, and implications of the American Heart Association's 2020 Impact Goals. RESULTS Each of the 26 chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS The Statistical Update represents a critical resource for the lay public, policy makers, media professionals, clinicians, healthcare administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.
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22
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Prognostic value of coronary artery calcium score in symptomatic individuals: A meta-analysis of 34,000 subjects. Int J Cardiol 2020; 299:56-62. [DOI: 10.1016/j.ijcard.2019.06.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Revised: 04/18/2019] [Accepted: 06/01/2019] [Indexed: 12/22/2022]
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23
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Benjamin EJ, Muntner P, Alonso A, Bittencourt MS, Callaway CW, Carson AP, Chamberlain AM, Chang AR, Cheng S, Das SR, Delling FN, Djousse L, Elkind MSV, Ferguson JF, Fornage M, Jordan LC, Khan SS, Kissela BM, Knutson KL, Kwan TW, Lackland DT, Lewis TT, Lichtman JH, Longenecker CT, Loop MS, Lutsey PL, Martin SS, Matsushita K, Moran AE, Mussolino ME, O'Flaherty M, Pandey A, Perak AM, Rosamond WD, Roth GA, Sampson UKA, Satou GM, Schroeder EB, Shah SH, Spartano NL, Stokes A, Tirschwell DL, Tsao CW, Turakhia MP, VanWagner LB, Wilkins JT, Wong SS, Virani SS. Heart Disease and Stroke Statistics-2019 Update: A Report From the American Heart Association. Circulation 2019; 139:e56-e528. [PMID: 30700139 DOI: 10.1161/cir.0000000000000659] [Citation(s) in RCA: 5336] [Impact Index Per Article: 1067.2] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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24
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Women's Health Initiative clinical trials: potential interactive effect of calcium and vitamin D supplementation with hormonal therapy on cardiovascular disease. Menopause 2019; 26:841-849. [DOI: 10.1097/gme.0000000000001360] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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25
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Lee JH, Kang EJ, Bae WY, Kim JK, Choi JH, Kim CH, Kim SJ, Jo KS, Kim MS, Koh TK. Carotid Arterial Calcium Scoring Using Upper Airway Computed Tomography in Patients with Obstructive Sleep Apnea: Efficacy as a Clinical Predictor of Cerebrocardiovascular Disease. Korean J Radiol 2019; 20:631-640. [PMID: 30887745 PMCID: PMC6424829 DOI: 10.3348/kjr.2018.0550] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Accepted: 12/16/2018] [Indexed: 12/23/2022] Open
Affiliation(s)
- Jae Hoon Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Dong-A University College of Medicine, Busan, Korea
| | - Eun Ju Kang
- Department of Radiology, Dong-A University College of Medicine, Busan, Korea
| | - Woo Yong Bae
- Department of Otorhinolaryngology-Head and Neck Surgery, Dong-A University College of Medicine, Busan, Korea.
| | - Jong Kuk Kim
- Department of Neurology, Dong-A University College of Medicine, Busan, Korea
| | - Jae Hyung Choi
- Department of Neurosurgery, Dong-A University College of Medicine, Busan, Korea
| | - Chul Hoon Kim
- Department of Oral and Maxillofacial Surgery, Dong-A University College of Medicine, Busan, Korea
| | - Sang Joon Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Dong-A University College of Medicine, Busan, Korea
| | - Kyoo Sang Jo
- Department of Otorhinolaryngology-Head and Neck Surgery, Dong-A University College of Medicine, Busan, Korea
| | - Moon Sung Kim
- Department of Radiology, Dong-A University College of Medicine, Busan, Korea
| | - Tae Kyung Koh
- Department of Otorhinolaryngology-Head and Neck Surgery, St. Mary's Medical Center, Busan, Korea
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26
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Bone marrow mesenchymal stem cell-derived exosomes alleviate high phosphorus-induced vascular smooth muscle cells calcification by modifying microRNA profiles. Funct Integr Genomics 2019; 19:633-643. [PMID: 30850904 DOI: 10.1007/s10142-019-00669-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 02/04/2019] [Accepted: 02/15/2019] [Indexed: 12/19/2022]
Abstract
Vascular calcification is a common complication in patients with chronic kidney disease (CKD). It is an important predictor of cardiovascular disease and all-cause mortality. Previous studies have confirmed that bone marrow mesenchymal stem cell (BMSC) therapy can reduce vascular calcification, but the specific mechanism is still controversial. In this study, we aimed to investigate the mechanisms of BMSC-derived exosomes (EXO) in improving vascular calcification. BMSCs were cultured and EXO were isolated using the Total Exosome Isolation Reagent. Human aortic vascular smooth muscle cells (HA-VSMCs) were cultured into three groups: control group, high phosphorus group, and high phosphorus plus EXO group. Then, indicators related to smooth muscle cell calcification and microRNA profiles were analyzed. BMSC-derived exosomes inhibited high phosphorus-induced calcification in HA-VSMCs. Besides, EXO treatment reduced calcium content and decreased the alkaline phosphatase (AKP) activity in high phosphorus co-incubated HA-VSMCs. MicroRNA (miRNA) and mRNA expression profiles analyses revealed that 63 miRNAs were significantly upregulated and 1424 genes were significantly downregulated in HA-VSMCs after EXO treatment. Functional miRNA-gene regulatory network revealed that mTOR, MAPK, and Wnt signaling pathway were involved in vascular calcification. BMSC-derived exosomes alleviated high phosphorus-induced calcification in HA-VSMC through modifying miRNA profiles.
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27
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Lamperti M, Jain A, Dharmalingam S. Neuroanesthesia and Coexisting Cardiac Problems: Acquired. CO-EXISTING DISEASES AND NEUROANESTHESIA 2019:37-62. [DOI: 10.1007/978-981-13-2086-6_4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
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28
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Benjamin EJ, Virani SS, Callaway CW, Chamberlain AM, Chang AR, Cheng S, Chiuve SE, Cushman M, Delling FN, Deo R, de Ferranti SD, Ferguson JF, Fornage M, Gillespie C, Isasi CR, Jiménez MC, Jordan LC, Judd SE, Lackland D, Lichtman JH, Lisabeth L, Liu S, Longenecker CT, Lutsey PL, Mackey JS, Matchar DB, Matsushita K, Mussolino ME, Nasir K, O'Flaherty M, Palaniappan LP, Pandey A, Pandey DK, Reeves MJ, Ritchey MD, Rodriguez CJ, Roth GA, Rosamond WD, Sampson UKA, Satou GM, Shah SH, Spartano NL, Tirschwell DL, Tsao CW, Voeks JH, Willey JZ, Wilkins JT, Wu JH, Alger HM, Wong SS, Muntner P. Heart Disease and Stroke Statistics-2018 Update: A Report From the American Heart Association. Circulation 2018; 137:e67-e492. [PMID: 29386200 DOI: 10.1161/cir.0000000000000558] [Citation(s) in RCA: 4510] [Impact Index Per Article: 751.7] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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29
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Cellular Senescence: A Translational Perspective. EBioMedicine 2017; 21:21-28. [PMID: 28416161 PMCID: PMC5514381 DOI: 10.1016/j.ebiom.2017.04.013] [Citation(s) in RCA: 613] [Impact Index Per Article: 87.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 04/06/2017] [Accepted: 04/06/2017] [Indexed: 12/17/2022] Open
Abstract
Cellular senescence entails essentially irreversible replicative arrest, apoptosis resistance, and frequently acquisition of a pro-inflammatory, tissue-destructive senescence-associated secretory phenotype (SASP). Senescent cells accumulate in various tissues with aging and at sites of pathogenesis in many chronic diseases and conditions. The SASP can contribute to senescence-related inflammation, metabolic dysregulation, stem cell dysfunction, aging phenotypes, chronic diseases, geriatric syndromes, and loss of resilience. Delaying senescent cell accumulation or reducing senescent cell burden is associated with delay, prevention, or alleviation of multiple senescence-associated conditions. We used a hypothesis-driven approach to discover pro-survival Senescent Cell Anti-apoptotic Pathways (SCAPs) and, based on these SCAPs, the first senolytic agents, drugs that cause senescent cells to become susceptible to their own pro-apoptotic microenvironment. Several senolytic agents, which appear to alleviate multiple senescence-related phenotypes in pre-clinical models, are beginning the process of being translated into clinical interventions that could be transformative. Cellular senescence is among the aging processes underlying chronic diseases, loss of resilience, and geriatric syndromes. Senolytics selectively induce senescent cell apoptosis. They delay or alleviate multiple disorders in preclinical studies. If senolytics are demonstrated to be effective and safe in clinical trials, they could be transformative.
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