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Asakura K, Minami Y, Nagata T, Katamine M, Muramatsu Y, Kinoshita D, Ako J. Higher triglyceride levels are associated with the higher prevalence of layered plaques in non-culprit coronary plaques. J Thromb Thrombolysis 2024; 57:58-66. [PMID: 37702855 DOI: 10.1007/s11239-023-02888-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/21/2023] [Indexed: 09/14/2023]
Abstract
High triglyceride (TG) levels have been recognized as a risk factor for cardiovascular events in patients with coronary artery disease (CAD). This study aimed to clarify the association between TG levels and characteristics of non-culprit coronary plaques in patients with CAD. A total of 531 consecutive patients with stable CAD who underwent percutaneous coronary intervention for culprit lesions and optical coherence tomography (OCT) assessment of non-culprit plaques in the culprit vessel were included in this study. The morphology of the non-culprit plaques assessed by OCT imaging were compared between the higher TG (TG ≥ 150 mg/dL, n = 197) and lower TG (TG < 150 mg/dL, n = 334) groups. The prevalence of layered plaques (40.1 vs. 27.5%, p = 0.004) was significantly higher in the higher TG group than in the lower TG group, although the prevalence of other plaque components was comparable between the two groups. High TG levels were an independent factor for the presence of layered plaques (odds ratio 1.761, 95% confidence interval 1.213-2.558, p = 0.003) whereas high low-density lipoprotein cholesterol levels (≥ 140 mg/dL) and low eicosapentaenoic acid/arachidonic acid ratios (< 0.4) were independently associated with a higher prevalence of thin-cap fibroatheroma and macrophages. Higher TG levels were associated with a higher prevalence of layered plaques in non-culprit plaques among patients with stable CAD. These results may partly explain the effect of TG on the progression of coronary plaques and the increased incidence of recurrent events in patients with CAD.
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Affiliation(s)
- Kiyoshi Asakura
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0329, Japan
| | - Yoshiyasu Minami
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0329, Japan.
| | - Takako Nagata
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0329, Japan
| | - Masahiro Katamine
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0329, Japan
| | - Yusuke Muramatsu
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0329, Japan
| | - Daisuke Kinoshita
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0329, Japan
| | - Junya Ako
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0329, Japan
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Scheer AS, I R de Oliveira B, Shah A, Jacques A, Chasland LC, Green DJ, Maiorana AJ. The effects of water-based circuit exercise training on vascular function in people with coronary heart disease. Am J Physiol Heart Circ Physiol 2023; 325:H1386-H1393. [PMID: 37830985 DOI: 10.1152/ajpheart.00468.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 10/04/2023] [Accepted: 10/09/2023] [Indexed: 10/14/2023]
Abstract
Impaired endothelial function in people with coronary heart disease (CHD) is associated with increased mortality. Water immersion can increase peripheral artery shear stress which may provide an additional stimulus to the endothelium during exercise. This study compared the effects of water-based circuit exercise training (WEX) and gym-based circuit exercise training (GEX) on vascular function in people with stable CHD. Participants were randomized to 12 wk of WEX (n = 20), GEX (n = 20), or a control group (usual activities; n = 12). Endothelium-dependent flow-mediated dilation (FMD) and glyceryl trinitrate-mediated dilation (GTN) of the brachial artery were assessed pre- and postintervention. FMD increased following WEX [4.0% (3.0%-5.1%) to 5.3% (4.1%-6.5%); P = 0.016], but was unchanged following GEX [4.9% (3.8%-5.9%) to 5.0% (3.8%-6.1%); P = 0.822]. There were no between-group differences in the change in FMD and no significant changes in GTN-mediated dilation percentage. Triglycerides decreased following GEX [1.2 mmol·L-1 (1.0-1.4 mmol·L-1) to 1.0 mmol·L-1 (0.8-1.3 mmol·L-1); P = 0.022], but there were no further differences in lipid profiles. WEX improved endothelial function of the brachial artery in people with stable CHD, suggesting that WEX is an effective alternative to gym-based exercise in people living with CHD, which may specifically address vascular health.NEW & NOTEWORTHY This study found that 12 wk of water-based circuit exercise training was well tolerated and improved vascular endothelial function in people with stable coronary heart disease. However, there was no effect on endothelium-independent function. Water-based exercise appears to be an effective alternative to gym-based exercise for people with coronary heart disease, which has specific benefits to vascular health and function.
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Affiliation(s)
- Anna S Scheer
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | | | - Amit Shah
- Advanced Heart Failure and Cardiac Transplant Service, Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - Angela Jacques
- Institute for Health Research, University of Notre Dame, Fremantle, Western Australia, Australia
| | - Lauren C Chasland
- School of Human Sciences (Exercise and Sport Sciences), The University of Western Australia, Perth, Western Australia, Australia
- Allied Health Department, Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - Daniel J Green
- School of Human Sciences (Exercise and Sport Sciences), The University of Western Australia, Perth, Western Australia, Australia
| | - Andrew J Maiorana
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
- Advanced Heart Failure and Cardiac Transplant Service, Fiona Stanley Hospital, Perth, Western Australia, Australia
- Allied Health Department, Fiona Stanley Hospital, Perth, Western Australia, Australia
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Asakura K, Minami Y, Nagata T, Katamine M, Katsura A, Hashimoto T, Kinoshita D, Ako J. Impact of the eicosapentaenoic acid to arachidonic acid ratio on plaque characteristics in statin-treated patients with coronary artery disease. J Clin Lipidol 2023; 17:189-196. [PMID: 36517412 DOI: 10.1016/j.jacl.2022.11.011] [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: 07/06/2022] [Revised: 11/15/2022] [Accepted: 11/24/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND A low eicosapentaenoic acid (EPA)/arachidonic acid (AA) ratio is associated with an increased risk of cardiovascular events in patients with coronary artery disease (CAD). OBJECTIVE To clarify the impact of the EPA/AA ratio on the characteristics of non-culprit coronary plaques in statin-treated patients with CAD. METHODS A total of 370 consecutive stable coronary disease patients treated with statins, who underwent percutaneous coronary intervention for the culprit lesion and optical coherence tomography (OCT) imaging of the non-culprit plaque in a culprit vessel were included. The characteristics of non-culprit plaques assessed using OCT were compared between the lower EPA/AA group (EPA/AA <0.4, n = 255) and the higher EPA/AA group (EPA/AA ≥0.4, n = 115). RESULTS The prevalence of lipid-rich plaque (58.8 vs. 41.7%, p = 0.003) and plaque with macrophages (56.5 vs. 31.3%, p <0.001) was significantly higher in the lower EPA/AA group than in the higher EPA/AA group. This association was observed even if the LDL-C level was <100 mg/dL. The prevalence of thin-cap fibroatheroma was significantly higher in patients with lower EPA/AA and higher LDL-C (≥100 mg/dL) than in those with higher EPA/AA and lower LDL-C (<100 mg/dL) (odds ratio: 2.750, 95% confidence interval: 1.182-6.988, p = 0.024). An EPA/AA <0.4 was independently associated with a higher prevalence of lipid-rich plaque, plaque with macrophages, and cholesterol crystals. CONCLUSION Lower EPA/AA ratio was associated with higher prevalence of vulnerable characteristics in non-culprit plaques. The present results suggest the importance of EPA/AA ratio on the secondary prevention of CAD.
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Affiliation(s)
- Kiyoshi Asakura
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Yoshiyasu Minami
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan.
| | - Takako Nagata
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Masahiro Katamine
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Aritomo Katsura
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Takuya Hashimoto
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Daisuke Kinoshita
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Junya Ako
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan
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Kunihiro S, da Silva Vernasque JR, da Silva C, dos Santos MF, Cremasco CP, Gabriel Filho LRA. Intersectoral Actions for the Promotion and Prevention of Obesity, Diabetes and Hypertension in Brazilian Cities: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13059. [PMID: 36293640 PMCID: PMC9602621 DOI: 10.3390/ijerph192013059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 09/19/2022] [Accepted: 09/24/2022] [Indexed: 06/16/2023]
Abstract
This study showed the effectiveness of biomedical interventions in obesity, diabetes and hypertension (NCDs), but innovative and intersectoral elements in the fight against obesity, type 2 diabetes and hypertension were rare. BACKGROUND Is it possible to find effective and innovative actions to promote health and prevent NCDs in Brazilian municipalities? Can they be replicated? OBJECTIVE Our objectives were to identify innovative and effective intersectoral actions for promoting and preventing NCDs in Brazilian municipalities. METHODS This is a systematic review in an exploratory theoretical essay with a qualitative and quantitative approach. It is descriptive and analytical in terms of reporting findings and results. Inclusion and exclusion criteria favored health promotion work. Bias risk assessments was performed using the Cochrane GRADE and bias risk, with meta-analyses using RevMan and Iramuteq. RESULTS Meta-analysis of biometric markers resulted in -4.46 [95% IC; -5.42, -3.49], p = 0.00001, indicating a reduction in NCD risk rates. The textual meta-analysis revealed P(r) ≈ 83% (Reinert), meaning low connectivity between the 'halos'. CONCLUSIONS There is evidence of the effectiveness in interventions, but innovative and intersectoral elements to combat and prevent NCDs were barely seen. While evidence of intervention effectiveness was observed, innovative and intersectoral elements to combat and prevent NCDs were barely noticed.
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Affiliation(s)
- Stephen Kunihiro
- School of Sciences and Engineering, São Paulo State University (UNESP), Tupã 17602-673, Brazil
| | - Juliana Ribeiro da Silva Vernasque
- Faculty of Medical and Biological Sciences, São Paulo State University (Unesp), Botucatu 18618-687, Brazil
- Marília Medical School, FAMEMA, Marília 17519-030, Brazil
| | - Celso da Silva
- School of Sciences and Engineering, São Paulo State University (UNESP), Tupã 17602-673, Brazil
- Maurício de Nassau College—Dean’s Office, Maurício de Nassau University Center (UNINASSAU), Recife 52011-220, Brazil
- The Regional Council of Administration—CRA/SP, São Paulo 01427-001, Brazil
| | | | - Camila Pires Cremasco
- School of Sciences and Engineering, São Paulo State University (UNESP), Tupã 17602-673, Brazil
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Abe S, Haruyama Y, Kobashi G, Toyoda S, Inoue T, Tomiyama H, Ishizu T, Kohro T, Higashi Y, Takase B, Suzuki T, Ueda S, Yamazaki T, Furumoto T, Kario K, Koba S, Takemoto Y, Hano T, Sata M, Ishibashi Y, Node K, Maemura K, Ohya Y, Furukawa T, Ito H, Yamashina A. Effect of Novel Stratified Lipid Risk by “LDL-Window” and Flow-Mediated Dilation on the Prognosis of Coronary Artery Disease Using the FMD-J Study A Data. Circ J 2022; 86:1444-1454. [DOI: 10.1253/circj.cj-21-1068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Shichiro Abe
- Department of Cardiovascular Medicine, Dokkyo Medical University School of Medicine
| | - Yasuo Haruyama
- Center for Research Collaboration and Support, Dokkyo Medical University School of Medicine
| | - Gen Kobashi
- Center for Research Collaboration and Support, Dokkyo Medical University School of Medicine
| | - Shigeru Toyoda
- Department of Cardiovascular Medicine, Dokkyo Medical University School of Medicine
| | - Teruo Inoue
- Department of Cardiovascular Medicine, Dokkyo Medical University School of Medicine
| | | | - Tomoko Ishizu
- Cardiovascular Division, Institute of Clinical Medicine, University of Tsukuba
| | - Takahide Kohro
- Department of Hospital Planning and Management, Medical Informatics, Jichi Medical University School of Medicine
| | - Yukihito Higashi
- Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine
| | - Bonpei Takase
- Division of Biomedical Engineering, National Defense Medical College Research Institute
| | - Toru Suzuki
- Cardiovascular Medicine, University of Leicester
| | - Shinichiro Ueda
- Department of Clinical Pharmacology and Therapeutics, University of the Ryukyus School of Medicine
| | - Tsutomu Yamazaki
- Department of Clinical Epidemiology and Systems, Faculty of Medicine, The University of Tokyo
| | | | - Kazuomi Kario
- Division of Cardiovascular Medicine, Jichi Medical University School of Medicine
| | - Shinji Koba
- Department of Medicine, Division of Cardiology, Showa University School of Medicine
| | - Yasuhiko Takemoto
- Department of Internal Medicine and Cardiology, Osaka City University Graduate School of Medicine
| | - Takuzo Hano
- Department of Medical Education and Population-based Medicine, Postgraduate School of Medicine, Wakayama Medical University
| | - Masataka Sata
- Department of Cardiovascular Medicine, Institute of Health Biosciences, The University of Tokushima Graduate School
| | - Yutaka Ishibashi
- Department of General Medicine, Shimane University Faculty of Medicine
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University
| | - Koji Maemura
- Department of Cardiovascular Medicine, Course of Medical and Dental Sciences, Graduate School of Biomedical Sciences, Nagasaki University
| | - Yusuke Ohya
- The Third Department of Internal Medicine, University of the Ryukyus
| | - Taiji Furukawa
- Department of Internal Medicine, Teikyo University School of Medicine
| | - Hiroshi Ito
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
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