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Utility of urinary liver-type fatty acid-binding protein as a prognostic marker in adult congenital heart patients hospitalized for acute heart failure. Heart Vessels 2023; 38:371-380. [PMID: 36169710 DOI: 10.1007/s00380-022-02174-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 09/14/2022] [Indexed: 02/07/2023]
Abstract
Progression to acute kidney injury (AKI) under treatment in adult congenital heart disease (ACHD) patients with heart failure is associated with poor prognosis, early detection and interventions are necessary. We aimed to explore the utility of urinary liver-type fatty acid binding protein (L-FABP) in ACHD patients hospitalized for acute decompensated heart failure (ADHF). We prospectively evaluated hemodynamic, biochemical data, and urinary biomarkers including urinary L-FABP in ACHD patients hospitalized in our institution from June 2019 to March 2022. The primary outcomes were the development of AKI and death. AKI was defined as serum creatinine level increased by 0.3 mg/dl or more within 5 days after hospitalization. A total of 104 ADHF patients aged 31 (36-51) years were enrolled. 26 cases (25% of ADHF patients) developed AKI during hospitalization and 4 died after hospital discharge. Serum creatinine (sCr), serum total bilirubin, brain natriuretic peptide (BNP), and urinary L-FABP in AKI patients were significantly higher than in non-AKI patients, whereas systemic oxygen saturation of the peripheral artery (SpO2) and estimated glomerular filtration ratio in AKI patients were lower than non-AKI patients. There was no difference in the intravenous diuretic dose on admission and during hospitalization between the two groups. In the receiver operating characteristic (ROC) analysis, the maximum area under the curve (AUC) of urinary biomarkers in AKI patients was urinary L-FABP (AUC = 0.769, p < 0.001) with a cutoff value of 4.86 µg/gCr. Urinary L-FABP level on admission was associated with a predictor for AKI development during hospitalization after adjusting for sCr, BNP and SpO2. Urinary L-FABP was a useful predictor for the development of AKI in ACHD patients hospitalized for ADHF. Monitoring of urinary L-FABP allows us to detect a high-risk patient earlier than the conventional biomarkers.
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Tognocchi M, Conte G, Rossi E, Perioli R, Mantino A, Serra A, Mele M. Characterization of polar and non-polar lipids of Hermetia illucens and Tenebrio molitor meals as animal feed ingredients. Anim Feed Sci Technol 2022. [DOI: 10.1016/j.anifeedsci.2022.115524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Altulayhi RI, Alqahtani RM, Alakeel RA, Khorshid FA, Alshammari RH, Alattas SG, Alshammari FAM, Bin-Jumah M, Abdel-Daim MM, Almohideb M. Correlation between measles immunization coverage and overall morbidity and mortality for COVID-19: an epidemiological study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:62266-62273. [PMID: 34184228 PMCID: PMC8238512 DOI: 10.1007/s11356-021-14980-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 06/14/2021] [Indexed: 06/13/2023]
Abstract
We conducted the current analysis to determine the potential role of measles vaccination in the context of the spread of COVID-19. Data were extracted from the World Health Organization's (WHO) Global Health Observatory data repository about the measles immunization coverage estimates and correlated to overall morbidity and mortality for COVID-19 among different countries. Data were statistically analyzed to calculate the Spearman rank correlation coefficient (rho). There was a significant positive correlation between the vaccine coverage (%) and new cases per one million populations (rho = 0.24; p-value = 0.025); however, this correlation was absent in deaths per one million populations (rho = 0.17; p-value = 0.124). On further analysis of the effect of first reported year of vaccination policy, there was no significant correlation with both of total cases per one million populations (rho = 0.11; p-value = 0.327) and deaths per one million populations (rho = -0.02; p-value = 0.829). Claims regarding the possible protective effect of measles vaccination seem to be doubtful.
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Affiliation(s)
| | - Rakan M. Alqahtani
- Department of Critical Care Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Reem Abdullah Alakeel
- Family Medicine Department, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Faten Abdulrahman Khorshid
- Department of Biological Sciences, Faculty of Science, King Abdulaziz University, Jeddah, 21589 Saudi Arabia
| | | | - Sana Ghazi Alattas
- Biological Sciences Department, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Fahad Abdullah M. Alshammari
- Department of Adult Emergency Medicine, Department of Emergency Medical Services, King Khalid Hospital, Hail, Saudi Arabia
| | - May Bin-Jumah
- Biology Department, College of Science, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Mohamed M. Abdel-Daim
- Department of Zoology, Science College, King Saud University, Riyadh, 11451 Saudi Arabia
- Pharmacology Department, Faculty of Veterinary Medicine, Suez Canal University, Ismailia, 41522 Egypt
| | - Mohammad Almohideb
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
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Rueda F, Borràs E, García-García C, Iborra-Egea O, Revuelta-López E, Harjola VP, Cediel G, Lassus J, Tarvasmäki T, Mebazaa A, Sabidó E, Bayés-Genís A. Protein-based cardiogenic shock patient classifier. Eur Heart J 2019; 40:2684-2694. [DOI: 10.1093/eurheartj/ehz294] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Revised: 01/04/2019] [Accepted: 04/19/2019] [Indexed: 11/15/2022] Open
Abstract
Abstract
Aims
Cardiogenic shock (CS) is associated with high short-term mortality and a precise CS risk stratification could guide interventions to improve patient outcome. Here, we developed a circulating protein-based score to predict short-term mortality risk among patients with CS.
Methods and results
Mass spectrometry analysis of 2654 proteins was used for screening in the Barcelona discovery cohort (n = 48). Targeted quantitative proteomics analyses (n = 51 proteins) were used in the independent CardShock cohort (n = 97) to derive and cross-validate the protein classifier. The combination of four circulating proteins (Cardiogenic Shock 4 proteins—CS4P), discriminated patients with low and high 90-day risk of mortality. CS4P comprises the abundances of liver-type fatty acid-binding protein, beta-2-microglobulin, fructose-bisphosphate aldolase B, and SerpinG1. Within the CardShock cohort used for internal validation, the C-statistic was 0.78 for the CardShock risk score, 0.83 for the CS4P model, and 0.84 (P = 0.033 vs. CardShock risk score) for the combination of CardShock risk score with the CS4P model. The CardShock risk score with the CS4P model showed a marked benefit in patient reclassification, with a net reclassification improvement (NRI) of 0.49 (P = 0.020) compared with CardShock risk score. Similar reclassification metrics were observed in the IABP-SHOCK II risk score combined with CS4P (NRI =0.57; P = 0.032). The CS4P patient classification power was confirmed by enzyme-linked immunosorbent assay (ELISA).
Conclusion
A new protein-based CS patient classifier, the CS4P, was developed for short-term mortality risk stratification. CS4P improved predictive metrics in combination with contemporary risk scores, which may guide clinicians in selecting patients for advanced therapies.
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Affiliation(s)
- Ferran Rueda
- Heart Institute, Hospital Universitari Germans Trias i Pujol, c/ Canyet SN, 08916 Badalona, Spain
- Department of Medicine, CIBERCV, Autonomous University of Barcelona, Barcelona, Spain
| | - Eva Borràs
- Proteomics Unit, Centre de Regulació Genòmica (CRG), Barcelona Institute of Science and Technology (BIST), Dr Aiguader 88, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Dr Aiguader 88, Barcelona, Spain
| | - Cosme García-García
- Heart Institute, Hospital Universitari Germans Trias i Pujol, c/ Canyet SN, 08916 Badalona, Spain
- Department of Medicine, CIBERCV, Autonomous University of Barcelona, Barcelona, Spain
| | - Oriol Iborra-Egea
- Heart Institute, Hospital Universitari Germans Trias i Pujol, c/ Canyet SN, 08916 Badalona, Spain
- Department of Medicine, CIBERCV, Autonomous University of Barcelona, Barcelona, Spain
| | - Elena Revuelta-López
- Heart Institute, Hospital Universitari Germans Trias i Pujol, c/ Canyet SN, 08916 Badalona, Spain
- Department of Medicine, CIBERCV, Autonomous University of Barcelona, Barcelona, Spain
| | - Veli-Pekka Harjola
- Emergency Medicine, Department of Emergency Medicine and Services, University of Helsinki, Helsinki University Hospital, Finland
| | - Germán Cediel
- Heart Institute, Hospital Universitari Germans Trias i Pujol, c/ Canyet SN, 08916 Badalona, Spain
- Department of Medicine, CIBERCV, Autonomous University of Barcelona, Barcelona, Spain
| | - Johan Lassus
- Cardiology, University of Helsinki, Heart and Lung Center, Helsinki University Hospital, Finland
| | - Tuukka Tarvasmäki
- Cardiology, University of Helsinki, Heart and Lung Center, Helsinki University Hospital, Finland
| | - Alexandre Mebazaa
- U942 Inserm, University Paris Diderot, APHP Hôpitaux Universitaires Saint-Louis-Lariboisière, INI-CRCT, Paris, France
| | - Eduard Sabidó
- Proteomics Unit, Centre de Regulació Genòmica (CRG), Barcelona Institute of Science and Technology (BIST), Dr Aiguader 88, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Dr Aiguader 88, Barcelona, Spain
| | - Antoni Bayés-Genís
- Heart Institute, Hospital Universitari Germans Trias i Pujol, c/ Canyet SN, 08916 Badalona, Spain
- Department of Medicine, CIBERCV, Autonomous University of Barcelona, Barcelona, Spain
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Röthlisberger S, Pedroza-Diaz J. Urine protein biomarkers for detection of cardiovascular disease and their use for the clinic. Expert Rev Proteomics 2017; 14:1091-1103. [DOI: 10.1080/14789450.2017.1394188] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Sarah Röthlisberger
- Grupo de Investigación e Innovación Biomédica, Instituto Tecnológico Metropolitano, Medellín, Colombia
| | - Johanna Pedroza-Diaz
- Grupo de Investigación e Innovación Biomédica, Instituto Tecnológico Metropolitano, Medellín, Colombia
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Panduru NM, Forsblom C, Saraheimo M, Thorn LM, Gordin D, Elonen N, Harjusalo V, Bierhaus A, Humpert PM, Groop PH. Urinary liver-type fatty acid binding protein is an independent predictor of stroke and mortality in individuals with type 1 diabetes. Diabetologia 2017; 60:1782-1790. [PMID: 28601908 DOI: 10.1007/s00125-017-4328-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 05/09/2017] [Indexed: 12/11/2022]
Abstract
AIMS/HYPOTHESIS In type 1 diabetes, cardiovascular disease (CVD) and diabetic nephropathy progress in parallel, thereby potentiating the risk of premature death during their development. Since urinary liver-type fatty acid binding protein (L-FABP) predicts the progression of diabetic nephropathy, the aim of this study was to investigate whether urinary L-FABP also predicts cardiovascular outcomes and mortality. METHODS We tested our hypothesis in a Finnish cohort of 2329 individuals with type 1 diabetes and a median follow-up of 14.1 years. The L-FABP to creatinine ratio was determined from baseline urine samples. The predictive value of urinary L-FABP was evaluated using Cox regression models, while its added predictive benefit for cardiovascular outcomes and mortality was evaluated using a panel of statistical indexes. RESULTS Urinary L-FABP predicted incident stroke independently of traditional risk factors (HR 1.33 [95% CI 1.20, 1.49]) and after further adjustment for eGFR (HR 1.28 [95% CI 1.14, 1.44]) or AER (HR 1.24 [95% CI 1.06, 1.44]). In addition, it predicted mortality independently of traditional risk factors (HR 1.34 [95% CI 1.24, 1.45]), and after adjustment for eGFR (HR 1.29 [95% CI 1.18, 1.39]) or AER (HR 1.22 [95% CI 1.09, 1.36]). Urinary L-FABP was as good a predictor as eGFR or AER, and improved the AUC for both outcomes on top of traditional risk factors, with no reclassification benefit (integrated discrimination improvement/net reclassification improvement) for stroke or mortality when AER or eGFR were added to traditional risk factors. However, urinary L-FABP was not a predictor of other cardiovascular endpoints (coronary artery disease, peripheral vascular disease and overall CVD events) when adjusted for the AER. CONCLUSIONS/INTERPRETATION Urinary L-FABP is an independent predictor of stroke and mortality in individuals with type 1 diabetes.
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Affiliation(s)
- Nicolae M Panduru
- Second Clinical Department - Diabetes, Nutrition and Metabolic Disorders Unit, 'Carol Davila' University of Medicine and Pharmacy, Bucharest, Romania
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Biomedicum 1 Helsinki, Haartmaninkatu 8, P.O. Box 63, University of Helsinki, FI-00014, Helsinki, Finland
- Research Programmes Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland
- Abdominal Center Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Carol Forsblom
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Biomedicum 1 Helsinki, Haartmaninkatu 8, P.O. Box 63, University of Helsinki, FI-00014, Helsinki, Finland
- Research Programmes Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland
- Abdominal Center Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Markku Saraheimo
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Biomedicum 1 Helsinki, Haartmaninkatu 8, P.O. Box 63, University of Helsinki, FI-00014, Helsinki, Finland
- Research Programmes Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland
- Abdominal Center Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Lena M Thorn
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Biomedicum 1 Helsinki, Haartmaninkatu 8, P.O. Box 63, University of Helsinki, FI-00014, Helsinki, Finland
- Research Programmes Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland
- Abdominal Center Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Daniel Gordin
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Biomedicum 1 Helsinki, Haartmaninkatu 8, P.O. Box 63, University of Helsinki, FI-00014, Helsinki, Finland
- Research Programmes Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland
- Abdominal Center Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Nina Elonen
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Biomedicum 1 Helsinki, Haartmaninkatu 8, P.O. Box 63, University of Helsinki, FI-00014, Helsinki, Finland
- Research Programmes Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland
- Abdominal Center Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Valma Harjusalo
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Biomedicum 1 Helsinki, Haartmaninkatu 8, P.O. Box 63, University of Helsinki, FI-00014, Helsinki, Finland
- Research Programmes Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland
- Abdominal Center Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Angelika Bierhaus
- Department of Medicine I and Clinical Chemistry, University of Heidelberg, Heidelberg, Germany
| | - Per M Humpert
- Department of Medicine I and Clinical Chemistry, University of Heidelberg, Heidelberg, Germany
- Stoffwechselzentrum Rhein Pfalz, Mannheim, Germany
| | - Per-Henrik Groop
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Biomedicum 1 Helsinki, Haartmaninkatu 8, P.O. Box 63, University of Helsinki, FI-00014, Helsinki, Finland.
- Research Programmes Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland.
- Abdominal Center Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
- Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia.
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Yoshimatsu S, Sugaya T, Hossain MI, Islam MM, Chisti MJ, Kamoda T, Fukushima T, Wagatsuma Y, Sumazaki R, Ahmed T. Urinary L-FABP as a mortality predictor in <5-year-old children with sepsis in Bangladesh. Pediatr Int 2016. [PMID: 26214495 DOI: 10.1111/ped.12765] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Although sepsis is often associated with high mortality in severely malnourished children, data are very limited on appropriate diagnostic tools to predict mortality. We examined the role of urinary liver-type fatty acid-binding protein (L-FABP) in children <5 years old with sepsis who died. METHODS This prospective observational study was conducted at the Dhaka Hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh. Children aged 6-59 months admitted with sepsis from April 2010 to December 2011 were enrolled. Comparison of clinical and laboratory characteristics was made between children who survived (n = 83) and those who did not survive (n = 22). RESULTS On multiple Poisson regression analysis, after adjusting for potential confounders such as mid-upper arm circumference < 115 mm, plasma albumin < 2.5 g/dL, potassium > 5.0 mmol/L, and blood urea nitrogen > 20 mg/dL on admission, first urine L-FABP ≥ 370 ng/mL (relative risk [RR], 2.76; 95%CI: 1.22-6.25), weight-for-length/height z score < -3 (RR, 2.54; 95%CI: 1.26-5.09), capillary refilling time > 2.0 s (RR, 5.16; 95%CI: 1.46-18.3), and sodium > 160 mmol/L (RR, 2.72; 95%CI: 1.07-6.90) were identified as significant risk factors of mortality in children with sepsis. Diagnostic performance of first urine L-FABP was analyzed using receiver operating characteristic curve, and the area under the curve was 0.647 (95%CI: 0.500-0.795). CONCLUSION Urinary L-FABP may be a useful predictor of mortality in septic children. Urinary examination is non-invasive and easy to apply at the bedside.
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Affiliation(s)
- Shoji Yoshimatsu
- Department of Child Health, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.,Department of Clinical Trial and Clinical Epidemiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.,Department of Epidemiology and Clinical Research, Research Institute of Tuberculosis, Tokyo, Japan
| | | | - Md Iqbal Hossain
- Centre for Nutrition and Food Security, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - M Munirul Islam
- Centre for Nutrition and Food Security, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Mohammod Jobayer Chisti
- Centre for Nutrition and Food Security, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Tomohiro Kamoda
- Department of Child Health, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Takashi Fukushima
- Department of Child Health, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Yukiko Wagatsuma
- Department of Clinical Trial and Clinical Epidemiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Ryo Sumazaki
- Department of Child Health, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Tahmeed Ahmed
- Centre for Nutrition and Food Security, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
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Kamijo-Ikemori A, Hashimoto N, Sugaya T, Matsui K, Hisamichi M, Shibagaki Y, Miyake F, Kimura K. Elevation of urinary liver-type fatty acid binding protein after cardiac catheterization related to cardiovascular events. Int J Nephrol Renovasc Dis 2015; 8:91-9. [PMID: 26316797 PMCID: PMC4547648 DOI: 10.2147/ijnrd.s88467] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Purpose Contrast medium (CM) induces tubular hypoxia via endothelial damage due to direct cytotoxicity or viscosity. Urinary liver-type fatty acid binding protein (L-FABP) increases along with tubular hypoxia and may be a detector of systemic circulation injury. The aim of this study was to evaluate the clinical usefulness of detecting increases in urinary L-FABP levels due to administration of CM, as a prognostic biomarker for cardiovascular disease in patients without occurrence of CM-induced nephropathy undergoing cardiac catheterization procedure (CCP). Methods Retrospective longitudinal analyses of the relationship between urinary L-FABP levels and occurrence of cardiovascular events were performed (n=29). Urinary L-FABP was measured by ELISA before CCP, and at 6, 12, 24, and 48 hours after CCP. Results Urinary L-FABP levels were significantly higher at 12 hours (P<0.05) and 24 hours (P<0.005) after CCP compared with before CCP, only in the patients with occurrence of cardiovascular events (n=17), but not in those without cardiovascular events (n=12). The parameter with the largest area under the curve (0.816) for predicting the occurrence of cardiovascular events was the change in urinary L-FABP at 24 hours after CCP. The difference in urinary L-FABP levels (ΔL-FABP ≥11.0 μg/g creatinine) between before CCP and at 24 hours after CCP was a risk factor for the occurrence of cardiovascular events (hazard ratio, 4.93; 95% confidence interval, 1.27–19.13; P=0.021). Conclusion Measurement of urinary L-FABP before CCP and at 24 hours after CCP in patients with mild to moderate renal dysfunction may be an important indicator for risk stratification of onset of cardiovascular events.
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Affiliation(s)
- Atsuko Kamijo-Ikemori
- Department of Nephrology and Hypertension, St Marianna University School of Medicine, Kawasaki, Kanagawa, Japan ; Department of Anatomy, St Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Nobuyuki Hashimoto
- Department of Cardiology, St Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Takeshi Sugaya
- Department of Nephrology and Hypertension, St Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Katsuomi Matsui
- Department of Nephrology and Hypertension, St Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Mikako Hisamichi
- Department of Nephrology and Hypertension, St Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Yugo Shibagaki
- Department of Nephrology and Hypertension, St Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Fumihiko Miyake
- Department of Cardiology, St Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Kenjiro Kimura
- Department of Nephrology and Hypertension, St Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
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Masuda H, Miyazaki T, Shimada K, Tamura N, Matsudaira R, Yoshihara T, Ohsaka H, Sai E, Matsumori R, Fukao K, Hiki M, Kume A, Kiyanagi T, Takasaki Y, Daida H. Disease duration and severity impacts on long-term cardiovascular events in Japanese patients with rheumatoid arthritis. J Cardiol 2014; 64:366-70. [PMID: 24685688 DOI: 10.1016/j.jjcc.2014.02.018] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Revised: 01/19/2014] [Accepted: 02/19/2014] [Indexed: 11/25/2022]
Abstract
BACKGROUND Rheumatoid arthritis (RA) increases the mortality and morbidity of cardiovascular disease (CVD). However, the relationship between RA and the risk of CVD in the Japanese population remains unclear. METHODS AND RESULTS This study comprised 571 RA patients who were admitted to Juntendo University Hospital from January 1990 to December 2000. Cardiovascular events (CVEs) were defined as cardiac death, acute coronary syndrome (ACS), symptomatic stroke, and congestive heart failure. During follow-up (mean 11.7 ± 5.8 years), 7.5% of the patients died from all causes and 11.0% experienced CVEs. The morbidity of stroke and ACS was 3.6 and 2.5 per 1000 person-years, respectively. The mean RA disease duration at enrolment was significantly longer in patients who experienced CVEs than in those who did not experience CVEs (15.0 ± 12.7 years vs. 10. 8 ± 9.7 years; p = 0.01). Physical disabilities due to RA were more severe in patients who experienced CVEs than in those who did not experience CVEs. Patients with a long RA disease duration showed significantly higher event rates (p = 0.033). Cox proportional hazards analysis identified a longer RA duration as an independent risk factor for CVD (hazard ratio 1.57, 95% CI 1.09-2.30, p = 0.02). CONCLUSION Japanese RA patients showed a relatively high incidence of CVD, despite the fact that they had few coronary risk factors. The RA disease duration was an independent risk factor for CVEs.
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Affiliation(s)
- Hiroshi Masuda
- Department of Cardiovascular Medicine, Juntendo University, School of Medicine, Tokyo, Japan
| | - Tetsuro Miyazaki
- Department of Cardiovascular Medicine, Juntendo University, School of Medicine, Tokyo, Japan.
| | - Kazunori Shimada
- Department of Cardiovascular Medicine, Juntendo University, School of Medicine, Tokyo, Japan
| | - Naoto Tamura
- Department of Internal Medicine and Rheumatology, Juntendo University, School of Medicine, Tokyo, Japan
| | - Ran Matsudaira
- Department of Internal Medicine and Rheumatology, Juntendo University, School of Medicine, Tokyo, Japan
| | - Takuma Yoshihara
- Department of Cardiovascular Medicine, Juntendo University, School of Medicine, Tokyo, Japan
| | - Hiromichi Ohsaka
- Department of Cardiovascular Medicine, Juntendo University, School of Medicine, Tokyo, Japan
| | - Eiryu Sai
- Department of Cardiovascular Medicine, Juntendo University, School of Medicine, Tokyo, Japan
| | - Rie Matsumori
- Department of Cardiovascular Medicine, Juntendo University, School of Medicine, Tokyo, Japan
| | - Kosuke Fukao
- Department of Cardiovascular Medicine, Juntendo University, School of Medicine, Tokyo, Japan
| | - Makoto Hiki
- Department of Cardiovascular Medicine, Juntendo University, School of Medicine, Tokyo, Japan
| | - Atsumi Kume
- Department of Cardiovascular Medicine, Juntendo University, School of Medicine, Tokyo, Japan
| | - Takashi Kiyanagi
- Department of Cardiovascular Medicine, Juntendo University, School of Medicine, Tokyo, Japan
| | - Yoshinari Takasaki
- Department of Internal Medicine and Rheumatology, Juntendo University, School of Medicine, Tokyo, Japan
| | - Hiroyuki Daida
- Department of Cardiovascular Medicine, Juntendo University, School of Medicine, Tokyo, Japan
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10
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Level of urinary liver-type fatty acid-binding protein is associated with cardiac markers and electrocardiographic abnormalities in type-2 diabetes with chronic kidney disease stage G1 and G2. Heart Vessels 2014; 30:362-8. [PMID: 24626813 DOI: 10.1007/s00380-014-0489-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Accepted: 02/21/2014] [Indexed: 12/24/2022]
Abstract
Urinary liver-type fatty acid-binding protein (L-FABP) reflects the degree of stress in proximal tubules of the kidney. We examined the level of L-FABP in type-2 diabetes mellitus (T2DM) patients with chronic kidney disease (CKD) stage G1 and G2, and its relationship with cardiac markers and electrocardiographic (ECG) abnormalities. T2DM patients whose estimated glomerular filtration rate (eGFR) was ≥60 mL/min/1.73 m(2) were recruited [n = 276 (165 males), mean age 64 years]. The median level of urinary L-FABP was 6.6 μg/gCr. Urinary L-FABP showed significant correlation with urinary albumin-to-creatinine ratio (ACR) (r = 0.51, p < 0.0001). Median (25th-75th percentile) eGFR was 82 (72-95) mL/min/1.73 m2. We divided patients into four subgroups (group 1, L-FABP ≤8.4 μg/gCr and ACR ≤30 mg/gCr; group 2, L-FABP ≤8.4 μg/gCr and ACR >30 mg/gCr; group 3, L-FABP >8.4 μg/gCr and ACR ≤30 mg/gCr; group 4, L-FABP >8.4 μg/gCr and ACR >30 mg/gCr). Compared with group 1, group 4 was significantly higher in systolic blood pressure, and eGFR using standardized serum cystatin C, high-sensitivity troponin T, and N-terminal pro-brain natriuretic peptide (NT-proBNP). Group 4 had significantly higher level of NT-proBNP than group 3. Groups 2, 3 and 4 showed more ECG abnormalities than group 1. These findings suggest that simultaneous measurement of urinary L-FABP and ACR should be useful to assess cardiovascular damage reflecting on the elevation of cardiac markers and ECG abnormalities in T2DM with CKD G1 and G2.
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Miyase Y, Miura SI, Shiga Y, Nakamura A, Norimatsu K, Nishikawa H, Saku K. The ratio of low-frequency to high-frequency in ambulatory electrocardiographic monitoring immediately before coronary angiography as a predictor of the presence of coronary artery disease. J Clin Med Res 2014; 6:36-43. [PMID: 24400030 PMCID: PMC3881988 DOI: 10.4021/jocmr1661w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2013] [Indexed: 12/19/2022] Open
Abstract
Background There is considerable evidence that impaired autonomic control may be associated with the etiology of coronary artery disease (CAD). We hypothesized that the autonomic imbalance as assessed by measuring heart rate variability (HRV) and biological parameters before and after coronary angiography (CAG) may predict the presence of CAD. Methods Ambulatory electrocardiographic (ECG) examination using eHEART® (Parama-Tec) is a novel, rapid, and simple method with which we can measure HRV within 5 min. We selected patients (n = 78, 68 ± 10 y) who underwent CAG and analyzed their ambulatory ECGs and blood levels of neuropeptides at both 1 day and immediately before and after CAG. The patients were divided into the presence (n = 64, CAD group) and absence of CAD (n = 14, non-CAD group). Results Although the CAD group showed an increase in blood pressure immediately before CAG, the ratio of low-frequency to high-frequency (LF/HF) was significantly decreased in the CAD group, but not in the non-CAD group. On the other hand, there was no difference in a coefficient of variation of the R-R interval or pulse rate between the two groups. CAD was independently associated with hypertension (P = 0.011), dyslipidemia (P = 0.009), and LF/HF immediately before CAG (P = 0.046) by a logistic regression analysis. Conclusions These findings suggest that LF/HF immediately before CAG in addition to hypertension and dyslipidemia might predict the presence of CAD.
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Affiliation(s)
- Yuiko Miyase
- Department of Cardiology, Fukuoka University School of Medicine, Fukuoka 814-0180, Japan
| | - Shin-Ichiro Miura
- Department of Cardiology, Fukuoka University School of Medicine, Fukuoka 814-0180, Japan ; Department of Molecular Cardiovascular Therapeutics, Fukuoka University School of Medicine, Fukuoka 814-0180, Japan
| | - Yuhei Shiga
- Department of Cardiology, Fukuoka University School of Medicine, Fukuoka 814-0180, Japan
| | - Ayumi Nakamura
- Department of Cardiology, Fukuoka University School of Medicine, Fukuoka 814-0180, Japan
| | - Kenji Norimatsu
- Department of Cardiology, Fukuoka University School of Medicine, Fukuoka 814-0180, Japan
| | - Hiroaki Nishikawa
- Department of Cardiology, Fukuoka University School of Medicine, Fukuoka 814-0180, Japan
| | - Keijiro Saku
- Department of Cardiology, Fukuoka University School of Medicine, Fukuoka 814-0180, Japan ; Department of Molecular Cardiovascular Therapeutics, Fukuoka University School of Medicine, Fukuoka 814-0180, Japan
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Dipstick proteinuria as a surrogate marker of long-term mortality after acute myocardial infarction. J Cardiol 2013; 62:277-82. [DOI: 10.1016/j.jjcc.2013.05.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Revised: 05/02/2013] [Accepted: 05/08/2013] [Indexed: 11/21/2022]
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Cakar MA, Sahinkus S, Aydin E, Vatan MB, Keser N, Akdemir R, Gunduz H. Relation between the GRACE score and severity of atherosclerosis in acute coronary syndrome. J Cardiol 2013; 63:24-8. [PMID: 24012333 DOI: 10.1016/j.jjcc.2013.06.017] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Revised: 05/13/2013] [Accepted: 06/27/2013] [Indexed: 12/22/2022]
Abstract
BACKGROUND Patients with non-ST-elevation acute coronary syndrome are heterogeneous in terms of clinical presentation and immediate- and long-term risk of death or non-fatal ischemic events. The aim of the present study was to evaluate the relationship between the Global Registry of Acute Coronary Events (GRACE) score and severity of coronary artery disease angiographically evaluated by Gensini score in patients with non-ST-elevation acute coronary syndrome. METHODS A total of 245 patients with non-ST-elevation acute coronary syndrome were enrolled to the study. Based on the GRACE risk score classification system, the patients were divided into low- (n=97, 39.6%), intermediate- (n=84, 34.3%), and high- (n=64, 26.1%) risk groups. All patients underwent coronary angiography within five days after admission. RESULTS The Gensini scores were 26±29 in the low-risk group, 29±19 in the intermediate-risk group, and 38±23 in the high-risk group (p=0.016). The low-risk group was significantly different from the high-risk group (p=0.013), and the difference from the intermediate-risk group almost reached significance. Normal, noncritical, one and two, or multivessel disease were identified in 15 (6.1%), 31 (12.7%), 75 (30.6%), and 124 (50.6%) patients, respectively. The prevalence of multivessel disease was 28% in the low-risk group, 30% in the intermediate-risk group, and 42% in the high-risk group. The high-risk group was significantly different from the low-risk group (p<0.01). CONCLUSION Our study demonstrates that the GRACE score has significant value for assessing the severity and extent of coronary artery stenosis in patients with non-ST-elevation acute coronary syndrome.
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Affiliation(s)
- Mehmet Akif Cakar
- Cardiology Department, Sakarya University Faculty of Medicine, 54100 Sakarya, Turkey.
| | - Salih Sahinkus
- Cardiology Department, Sakarya University Faculty of Medicine, 54100 Sakarya, Turkey
| | - Ercan Aydin
- Cardiology Department, Sakarya University Faculty of Medicine, 54100 Sakarya, Turkey
| | - Mehmet Bulent Vatan
- Cardiology Department, Sakarya University Faculty of Medicine, 54100 Sakarya, Turkey
| | - Nurgul Keser
- Cardiology Department, Sakarya University Faculty of Medicine, 54100 Sakarya, Turkey
| | - Ramazan Akdemir
- Cardiology Department, Sakarya University Faculty of Medicine, 54100 Sakarya, Turkey
| | - Huseyin Gunduz
- Cardiology Department, Sakarya University Faculty of Medicine, 54100 Sakarya, Turkey
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Coskun A, Serteser M, Duran S, Inal TC, Erdogan BE, Ozpinar A, Can O, Unsal I. Reference interval of pregnancy-associated plasma protein-a in healthy men and non-pregnant women. J Cardiol 2012; 61:128-31. [PMID: 23159209 DOI: 10.1016/j.jjcc.2012.09.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2012] [Revised: 08/31/2012] [Accepted: 09/10/2012] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The serum pregnancy-associated plasma protein-A (PAPP-A) concentration is a predictor of ischemic cardiac events and renal impairment. However, the reference interval of PAPP-A has not been determined. This study determined the reference interval of PAPP-A in men and non-pregnant women. METHODS The study enrolled 126 apparently healthy individuals (52 males and 74 females). The mean age of the men and women was 34.7 (range 20-66) years and 34.6 (range 18-65) years, respectively. Serum PAPP-A concentrations were determined using an ultrasensitive enzyme-linked immunoassay kit. Reference intervals were calculated using the bootstrap method. RESULTS The results for three subjects were outliers, so the reference interval of PAPP-A was calculated using the data for 123 subjects. PAPP-A was undetectable in 26 subjects. The reference interval of PAPP-A for men and women (with the 90% confidence interval) was <22.9 ng/mL (19.7-23.3) and <33.6 ng/mL (25.2-36.7), respectively. In male subjects, serum PAPP-A levels of smokers [3.10 (UD, 7.30)ng/mL] were significantly lower than that of non-smokers [11.00 (UD, 24.4)ng/mL] (p<0.001) and there was a positive correlation between serum PAPP-A levels and subjects' age (r=0.439; p<0.001). CONCLUSIONS The reference interval of PAPP-A differed for men and non-pregnant women. In clinical practice, <22.9 ng/mL for men and <33.6 ng/mL for non-pregnant women may be used as reference intervals for PAPP-A.
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Affiliation(s)
- Abdurrahman Coskun
- Acibadem University, School of Medicine, Department of Medical Biochemistry, Istanbul, Turkey.
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