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Fyksen TS, Seljeflot I, Vanberg P, Atar D, Halvorsen S. Platelet activity, coagulation, and fibrinolysis in long-term users of anabolic-androgenic steroids compared to strength-trained athletes. Thromb Res 2024; 238:60-66. [PMID: 38676967 DOI: 10.1016/j.thromres.2024.04.027] [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: 11/17/2023] [Revised: 04/18/2024] [Accepted: 04/23/2024] [Indexed: 04/29/2024]
Abstract
INTRODUCTION Use of anabolic-androgenic steroids (AAS) is associated with adverse cardiovascular (CV) effects, including potential prothrombotic effects. This study aimed to assess platelet activation and aggregation, coagulation, and fibrinolysis, in long-term AAS users compared to non-using strength-trained athletes. MATERIALS AND METHODS Thirty-seven strength-trained men using AAS were compared to seventeen non-using professional strength-trained athletes at similar age (median 33 years). AAS use was verified by blood and urine analyses. Platelet Function Analyzer 100 (PFA-100) and whole blood impedance aggregometry with thrombin, arachidonic acid, and ADP as agonists, were performed to evaluate platelet aggregation. ELISA methods were used for markers of platelet activation. Fibrinogen, D-dimer, the coagulation inhibitors protein S and C activity, and antithrombin were measured by routine. Fibrinolysis was evaluated by Plasminogen Activator Inhibitor-1 (PAI-1) activity. RESULTS There were no significant differences in platelet aggregation between the two groups. Von Willebrand factor was lower among the AAS users (p < 0.01), and P-Selectin was slightly higher (p = 0.05), whereas CD40 Ligand, β-thromboglobulin, and thrombospondin did not differ significantly. No differences were found in the assessed coagulation inhibitors. Higher D-dimer levels (p < 0.01) and lower PAI-1 activity (p < 0.01) were found among the AAS users. CONCLUSIONS The investigated long-term users of AAS did not exhibit elevated platelet activity compared to strength-trained non-using athletes. However, AAS use was associated with higher D-dimer levels and lower PAI-1 activity. These findings suggest that any prothrombotic effect of long-term AAS use may predominantly involve other aspects of the hemostatic system than blood platelets.
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Affiliation(s)
- Tea Sætereng Fyksen
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Cardiology, Oslo University Hospital Ullevål, Oslo, Norway.
| | - Ingebjørg Seljeflot
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Center for Clinical Heart Research, Department of Cardiology, Oslo University Hospital Ullevål, Oslo, Norway
| | - Paul Vanberg
- Department of Cardiology, Oslo University Hospital Ullevål, Oslo, Norway
| | - Dan Atar
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Cardiology, Oslo University Hospital Ullevål, Oslo, Norway
| | - Sigrun Halvorsen
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Cardiology, Oslo University Hospital Ullevål, Oslo, Norway
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Nkambule BB, Chan MV, Lachapelle AR, Grech J, Thibord F, Chen MH, Johnson AD. The association between platelet reactivity and lipoprotein levels in Framingham Heart Study participants. Thromb Res 2023; 225:103-109. [PMID: 37062119 DOI: 10.1016/j.thromres.2023.03.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/21/2023] [Accepted: 03/22/2023] [Indexed: 04/03/2023]
Abstract
BACKGROUND Hypertriglyceridemia is an independent risk factor for major adverse cardiovascular events, though the mechanisms linking triglycerides and platelet function with thrombosis, remain elusive. The aim of this study was to assess the association between platelet function and triglyceride levels. METHODS We included participants from the Framingham Heart Study Third Generation cohort, OMNI, and New Offspring Spouse cohort who attended the third examination cycle (2016-2019). Eligible participants were categorized into four triglyceride subgroups. RESULTS The study comprised a total of 1897 (55.53 %) participants with normal TG levels; 883 (25.85 %) participants with high-normal TGs; 378 (11.07 %) with borderline high TGs; and 258 (7.55 %) participants with hypertriglyceridemia. After adjusting for age, sex, alcohol consumption, aspirin, statin and P2Y12 inhibitors, the levels of ADP-induced platelet aggregation were inversely associated with total cholesterol levels (P < 0.0001). Platelet disaggregation was associated with low-density lipoprotein and high-density lipoprotein cholesterol levels (P < 0.0001). Lastly, in a shear-stress chamber assay mimicking arterial flow velocities, TG levels in the normal-high group were associated with increased levels of collagen-dependent thrombogenicity (β = 24.16, SE = 6.65, P < 0.0001). CONCLUSION Triglyceride levels are associated with altered platelet activation and aggregation. Furthermore, increased platelet-driven thrombogenicity is directly associated with triglyceride levels after adjusting for medications and other covariates.
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Affiliation(s)
- Bongani Brian Nkambule
- National Heart, Lung and Blood Institute, Population Sciences Branch, Framingham, MA, United States of America; University of Kwazulu-Natal (UKZN), College of Health Sciences, Durban, South Africa
| | - Melissa Victoria Chan
- National Heart, Lung and Blood Institute, Population Sciences Branch, Framingham, MA, United States of America
| | - Amber Rose Lachapelle
- National Heart, Lung and Blood Institute, Population Sciences Branch, Framingham, MA, United States of America
| | - Joseph Grech
- National Heart, Lung and Blood Institute, Population Sciences Branch, Framingham, MA, United States of America
| | - Florian Thibord
- National Heart, Lung and Blood Institute, Population Sciences Branch, Framingham, MA, United States of America
| | - Ming-Huei Chen
- National Heart, Lung and Blood Institute, Population Sciences Branch, Framingham, MA, United States of America
| | - Andrew Danner Johnson
- National Heart, Lung and Blood Institute, Population Sciences Branch, Framingham, MA, United States of America.
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Jones WL, Ramos CR, Banerjee A, Moore EE, Hansen KC, Coleman JR, Kelher M, Neeves KB, Silliman CC, Di Paola J, Branchford BR. Apolipoprotein A-I, elevated in trauma patients, inhibits platelet activation and decreases clot strength. Platelets 2022; 33:1119-1131. [PMID: 35659185 PMCID: PMC9547822 DOI: 10.1080/09537104.2022.2078488] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 04/19/2022] [Accepted: 04/29/2022] [Indexed: 10/18/2022]
Abstract
Apolipoprotein A-I (ApoA-I) is elevated in the plasma of a subgroup of trauma patients with systemic hyperfibrinolysis. We hypothesize that apoA-I inhibits platelet activation and clot formation. The effects of apoA-I on human platelet activation and clot formation were assessed by whole blood thrombelastography (TEG), platelet aggregometry, P-selectin surface expression, microfluidic adhesion, and Akt phosphorylation. Mouse models of carotid artery thrombosis and pulmonary embolism were used to assess the effects of apoA-I in vivo. The ApoA-1 receptor was investigated with transgenic mice knockouts (KO) for the scavenger receptor class B member 1 (SR-BI). Compared to controls, exogenous human apoA-I inhibited arachidonic acid and collagen-mediated human and mouse platelet aggregation, decreased P-selectin surface expression and Akt activation, resulting in diminished clot strength and increased clot lysis by TEG. ApoA-I also decreased platelet aggregate size formed on a collagen surface under flow. In vivo, apoA-I delayed vessel occlusion in an arterial thrombosis model and conferred a survival advantage in a pulmonary embolism model. SR-BI KO mice significantly reduced apoA-I inhibition of platelet aggregation versus wild-type platelets. Exogenous human apoA-I inhibits platelet activation, decreases clot strength and stability, and protects mice from arterial and venous thrombosis via the SR-BI receptor.
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Affiliation(s)
- Wilbert L Jones
- Department of Surgery, School of Medicine University of Colorado Denver, Anschutz Medical Campus, Aurora, CO
| | - Christopher R. Ramos
- Department of Surgery, School of Medicine University of Colorado Denver, Anschutz Medical Campus, Aurora, CO
| | - Anirban Banerjee
- Department of Surgery, School of Medicine University of Colorado Denver, Anschutz Medical Campus, Aurora, CO
| | - Ernest E. Moore
- Department of Surgery, School of Medicine University of Colorado Denver, Anschutz Medical Campus, Aurora, CO
- Dept. of Surgery, Denver Health Medical Center, Denver CO
| | - Kirk C. Hansen
- Department of Biochemistry/Molecular Genetics, School of Medicine University of Colorado Denver, Anschutz Medical Campus, Aurora, CO
| | - Julia R. Coleman
- Department of Surgery, School of Medicine University of Colorado Denver, Anschutz Medical Campus, Aurora, CO
| | - Marguerite Kelher
- Department of Surgery, School of Medicine University of Colorado Denver, Anschutz Medical Campus, Aurora, CO
- Vitalant Research Institute, Denver, CO
| | - Keith B. Neeves
- Department of Pediatrics, School of Medicine University of Colorado Denver, Anschutz Medical Campus, Aurora, CO
- Department of Bioengineering, School of Medicine University of Colorado Denver, Anschutz Medical Campus, Aurora, CO
| | - Christopher C. Silliman
- Department of Surgery, School of Medicine University of Colorado Denver, Anschutz Medical Campus, Aurora, CO
- Department of Pediatrics, School of Medicine University of Colorado Denver, Anschutz Medical Campus, Aurora, CO
- Vitalant Research Institute, Denver, CO
| | - Jorge Di Paola
- Dept. of Pediatrics, Division of Hematology/Oncology, Washington University School of Medicine, St. Louis, MO
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Liu JD, Gong R, Zhang SY, Zhou ZP, Wu YQ. Beneficial effects of high-density lipoprotein (HDL) on stent biocompatibility and the potential value of HDL infusion therapy following percutaneous coronary intervention. Medicine (Baltimore) 2022; 101:e31724. [PMID: 36397406 PMCID: PMC9666103 DOI: 10.1097/md.0000000000031724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Several epidemiological studies have shown a clear inverse relationship between serum levels of high-density lipoprotein cholesterol (HDL-C) and the risk of atherosclerotic cardiovascular disease (ASCVD), even at low-density lipoprotein cholesterol levels below 70 mg/dL. There is much evidence from basic and clinical studies that higher HDL-C levels are beneficial, whereas lower HDL-C levels are detrimental. Thus, HDL is widely recognized as an essential anti-atherogenic factor that plays a protective role against the development of ASCVD. Percutaneous coronary intervention is an increasingly common treatment choice to improve myocardial perfusion in patients with ASCVD. Although drug-eluting stents have substantially overcome the limitations of conventional bare-metal stents, there are still problems with stent biocompatibility, including delayed re-endothelialization and neoatherosclerosis, which cause stent thrombosis and in-stent restenosis. According to numerous studies, HDL not only protects against the development of atherosclerosis, but also has many anti-inflammatory and vasoprotective properties. Therefore, the use of HDL as a therapeutic target has been met with great interest. Although oral medications have not shown promise, the developed HDL infusions have been tested in clinical trials and have demonstrated viability and reproducibility in increasing the cholesterol efflux capacity and decreasing plasma markers of inflammation. The aim of the present study was to review the effect of HDL on stent biocompatibility in ASCVD patients following implantation and discuss a novel therapeutic direction of HDL infusion therapy that may be a promising candidate as an adjunctive therapy to improve stent biocompatibility following percutaneous coronary intervention.
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Affiliation(s)
- Jian-Di Liu
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Ren Gong
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Shi-Yuan Zhang
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Zhi-Peng Zhou
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Yan-Qing Wu
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- * Correspondence: Yan-Qing Wu, Department of Cardiology, The Second Affiliated Hospital of Nanchang University, Minde Road No. 1, Nanchang, Jiangxi 330006, China (e-mail: )
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HDL and Endothelial Function. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1377:27-47. [DOI: 10.1007/978-981-19-1592-5_3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Trandafir C, Sandiramourty S, Laurent-Chabalier S, Ter Schiphorst A, Nguyen H, Wacongne A, Ricci JE, Pereira F, Thouvenot E, Renard D. Brain Infarction MRI Pattern in Stroke Patients with Intracardiac Thrombus. Cerebrovasc Dis 2021; 50:581-587. [PMID: 34139688 DOI: 10.1159/000515707] [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: 12/14/2020] [Accepted: 02/25/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Acute infarction patterns have been described in cardioembolic stroke, mainly with atrial fibrillation (AF) or patent foramen ovale. We aimed to analyse acute infarction magnetic resonance imaging (MRI) characteristics in stroke patients with intracardiac thrombus (ICT) compared with stroke patients with AF. METHODS We performed a retrospective study analysing brain MRI scans of consecutive acute symptomatic cardioembolic infarction patients associated with ICT or AF who were recruited and registered in the stroke database between June 2018 and November 2019. Diffusion-weighted imaging performed within 1 week after symptom onset, intra-/extracranial vessel imaging, echocardiography, and ≥24-h ECG monitoring were required for inclusion. Baseline, biological, and echocardiography characteristics were assessed. Analysed MRI characteristics were infarction location (anterior/middle/posterior cerebral artery territory; anterior/posterior/mixed anterior-posterior circulation; multiterritorial infarction; brainstem; cerebellum; small cortical cerebellar infarctions [SCCIs] or non-SCCI; cortical/subcortical/cortico-subcortical), lesion number, subcortical lesion size (> or <15 mm), and total infarction volume. RESULTS We included 28 ICT and 94 AF patients presenting with acute stroke. ICT patients were younger (median age 66 vs. 81 years, p < 0.001), more frequently male (79 vs. 47%, p = 0.003), and smokers (39 vs. 17%, p = 0.013), had more frequent history of diabetes (36 vs. 18%, p = 0.049) and ischaemic heart disease (57 vs. 21%, p < 0.001), and had lower HDL cholesterol levels (0.39 vs. 0.53 g/L, p < 0.001). On MRI, SCCI was more frequent in the ICT group (25 vs. 5%, p = 0.006) in the absence of other differences in infarction localisation, number, size, or volume on MRI. On multivariate analysis, younger age (p < 0.001), history of ischaemic heart disease (p < 0.001), and low HDL cholesterol levels (p = 0.01) were significantly associated with ICT. Results approaching statistical significance were observed for SCCI (more frequent in the ICT group, p = 0.053) and non-SCCI (more frequent in the AF group, p = 0.053) on MRI. CONCLUSIONS ICT-related stroke is associated with acute SCCI presence on MRI. Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique identifier: NCT04456309.
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Affiliation(s)
- Cassiana Trandafir
- Department of Neurology, CHU Nîmes, University of Montpellier, Nîmes, France
| | - Shridevi Sandiramourty
- Department of Radiology, Research Team EA 2992, CHU Nîmes, University of Montpellier, Nîmes, France
| | - Sabine Laurent-Chabalier
- Department of Biostatistics, Clinical Epidemiology, Public Health, and Innovation in Methodology, CHU Nîmes, University of Montpellier, Nîmes, France
| | | | - Hai Nguyen
- Department of Radiology, Research Team EA 2992, CHU Nîmes, University of Montpellier, Nîmes, France
| | - Anne Wacongne
- Department of Neurology, CHU Nîmes, University of Montpellier, Nîmes, France
| | - Jean-Etienne Ricci
- Department of Cardiology, CHU Nîmes, University of Montpellier, Nîmes, France
| | - Fabricio Pereira
- Department of Radiology, Research Team EA 2992, CHU Nîmes, University of Montpellier, Nîmes, France
| | - Eric Thouvenot
- Department of Neurology, CHU Nîmes, University of Montpellier, Nîmes, France.,Institut de Génomique Fonctionnelle, CNRS UMR5203, INSERM 1191, University of Montpellier, Montpellier, France
| | - Dimitri Renard
- Department of Neurology, CHU Nîmes, University of Montpellier, Nîmes, France
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Đukanović N, Obradović S, Zdravković M, Đurašević S, Stojković M, Tosti T, Jasnić N, Đorđević J, Todorović Z. Lipids and Antiplatelet Therapy: Important Considerations and Future Perspectives. Int J Mol Sci 2021; 22:3180. [PMID: 33804754 PMCID: PMC8003871 DOI: 10.3390/ijms22063180] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 03/17/2021] [Accepted: 03/18/2021] [Indexed: 01/15/2023] Open
Abstract
Lipids play an essential role in platelet functions. It is known that polyunsaturated fatty acids play a role in increasing platelet reactivity and that the prothrombotic phenotype plays a crucial role in the occurrence of major adverse cardiovascular events. The ongoing increase in cardiovascular diseases' incidence emphasizes the importance of research linking lipids and platelet function. In particular, the rebound phenomenon that accompanies discontinuation of clopidogrel in patients receiving dual antiplatelet therapy has been associated with changes in the lipid profile. Our many years of research underline the importance of reduced HDL values for the risk of such a rebound effect and the occurrence of thromboembolic events. Lipids are otherwise a heterogeneous group of molecules, and their signaling molecules are not deposited but formed "on-demand" in the cell. On the other hand, exosomes transmit lipid signals between cells, and the profile of such changes can be monitored by lipidomics. Changes in the lipid profile are organ-specific and may indicate new drug action targets.
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Affiliation(s)
- Nina Đukanović
- High Medical School Milutin Milanković, Crnotravska 27, 11000 Belgrade, Serbia;
| | - Slobodan Obradović
- Clinic of Emergency Medicine, Military Medical Academy, University of Defence, Crnotravska 27, 11000 Belgrade, Serbia;
- Medical Faculty of the Military Medical Academy, University of Defence, Crnotravska 27, 11000 Belgrade, Serbia
| | - Marija Zdravković
- Dr Subotića 8, School of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (M.Z.); (M.S.)
- Dr Žorža Matea bb, University Medical Centre “Bežanijska kosa”, 11070 Belgrade, Serbia
| | - Siniša Đurašević
- Faculty of Biology, University of Belgrade, Studentski trg 3, 11000 Belgrade, Serbia; (S.Ð.); (N.J.); (J.Ð.)
| | - Maja Stojković
- Dr Subotića 8, School of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (M.Z.); (M.S.)
| | - Tomislav Tosti
- Faculty of Chemistry, University of Belgrade, Studentski trg 12-16, 11000 Belgrade, Serbia;
| | - Nebojša Jasnić
- Faculty of Biology, University of Belgrade, Studentski trg 3, 11000 Belgrade, Serbia; (S.Ð.); (N.J.); (J.Ð.)
| | - Jelena Đorđević
- Faculty of Biology, University of Belgrade, Studentski trg 3, 11000 Belgrade, Serbia; (S.Ð.); (N.J.); (J.Ð.)
| | - Zoran Todorović
- Dr Subotića 8, School of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (M.Z.); (M.S.)
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Al Awaida W, Ahmed AA, Hamza AA, Amber KI, Al-Ameer HJ, Jarrar Y, Fatima G, Maslat AO, Gushchina Y, Al Bawareed O, Hadi NR. Association of KDR rs1870377 genotype with clopidogrel resistance in patients with post percutaneous coronary intervention. Heliyon 2021; 7:e06251. [PMID: 33665428 PMCID: PMC7900686 DOI: 10.1016/j.heliyon.2021.e06251] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 01/08/2021] [Accepted: 02/07/2021] [Indexed: 11/30/2022] Open
Abstract
Background Clopidogrel is an antiplatelet therapy that is widely used in pre and post percutaneous (PCI) coronary intervention procedures to prevent platelet aggregation and stent restenosis. However, there is a wide inter-individual variation in clopidogrel response and some patients showed resistance against the activity of Clopidogrel. Kinase insert domain receptor (KDR) gene is responsible for the transcription of vascular endothelial growth factor receptor 2 (VEGFR2) that plays a major role in the cardiovascular diseases (CVDs) and platelet aggregation. The aim of this study was to find out the association of KDR rs1870377 genotype with clopidogrel resistance (CR) in CVD patients, of Iraqi Arabic origin, hospitalized for elective PCI. Materials and methods This study was a case-control study with a total of 324 PCI patients. Those patients were classified into 213 patients with non-clopidogrel resistant and 111 patients with CR, depending on the analysis of platelet activity phenotype after clopidogrel administration. KDR rs1870377 was genotyped for all patients using polymerase chain reaction-restriction fragment length polymorphism technique and confirmed by DNA Sänger sequencing through applying Biosystems Model (ABI3730x1). Results KDR rs1870377 SNP is strongly associated (Chi-sqaure, p vale <0.05) with CR under dominant, co-dominant and recessive models. Additionally, A allele in the rs1870377 SNP may have an impact on the serum levels of VEGFR2 and low density lipoprotein. Conclusions KDR rs1870377 SNP is a potential genetic biomarker of CR among CVD patients of Iraqi Arabic origin. Further clinical studies, with larger sample, are required to confirm the findings of this study.
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Affiliation(s)
- Wajdy Al Awaida
- Department of Biology and Biotechnology, American University of Madaba, Madaba 11821, Jordan
| | - Ali A Ahmed
- Department of Pharmacology and Therapeutics, College of Medicine, University of Kufa, Iraq
| | - Asia Ali Hamza
- Department of Biochemistry, College of Medicine, University of Kufa, Iraq
| | - Khalid I Amber
- Al Najaf Center for Cardiovascular Surgery and Cardiac Catheterization in AL-Sadder Teaching Hospital in Al Najaf Al-Ashraf Governorate, Iraq
| | - Hamzeh J Al-Ameer
- Department of Biology and Biotechnology, American University of Madaba, Madaba 11821, Jordan
| | - Yazun Jarrar
- Department of Pharmacy, College of Pharmacy, Alzaytoonah University of Jordan, 11734 Amman, Jordan
| | - Ghizal Fatima
- Era's Medical College, Era University, Lucknow, India
| | - Ahmed O Maslat
- Department of Biological Sciences, Yarmouk University, Irbid, Jordan
| | - Yulia Gushchina
- Department of General and Clinical Pharmacology, Рeoples' Friendship University of Russia (RUDN University), 6 Miklukho-Maklaya Street, Moscow, 117198, Russian Federation
| | - Omar Al Bawareed
- Department of Normal Physiology, Рeoples' Friendship University of Russia (RUDN University), 6 Miklukho-Maklaya Street, Moscow, 117198, Russian Federation
| | - Najah R Hadi
- Department of Pharmacology and Therapeutics, College of Medicine, University of Kufa, Iraq
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Cammisotto V, Nocella C, Bartimoccia S, Sanguigni V, Francomano D, Sciarretta S, Pastori D, Peruzzi M, Cavarretta E, D’Amico A, Castellani V, Frati G, Carnevale R, Group SM. The Role of Antioxidants Supplementation in Clinical Practice: Focus on Cardiovascular Risk Factors. Antioxidants (Basel) 2021; 10:146. [PMID: 33498338 PMCID: PMC7909411 DOI: 10.3390/antiox10020146] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 01/08/2021] [Accepted: 01/18/2021] [Indexed: 12/15/2022] Open
Abstract
Oxidative stress may be defined as an imbalance between reactive oxygen species (ROS) and the antioxidant system to counteract or detoxify these potentially damaging molecules. This phenomenon is a common feature of many human disorders, such as cardiovascular disease. Many of the risk factors, including smoking, hypertension, hypercholesterolemia, diabetes, and obesity, are associated with an increased risk of developing cardiovascular disease, involving an elevated oxidative stress burden (either due to enhanced ROS production or decreased antioxidant protection). There are many therapeutic options to treat oxidative stress-associated cardiovascular diseases. Numerous studies have focused on the utility of antioxidant supplementation. However, whether antioxidant supplementation has any preventive and/or therapeutic value in cardiovascular pathology is still a matter of debate. In this review, we provide a detailed description of oxidative stress biomarkers in several cardiovascular risk factors. We also discuss the clinical implications of the supplementation with several classes of antioxidants, and their potential role for protecting against cardiovascular risk factors.
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Affiliation(s)
- Vittoria Cammisotto
- Department of General Surgery and Surgical Specialty Paride Stefanini, Sapienza University of Rome, 00185 Rome, Italy
| | - Cristina Nocella
- Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, 00185 Rome, Italy; (S.B.); (D.P.); (V.C.)
| | - Simona Bartimoccia
- Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, 00185 Rome, Italy; (S.B.); (D.P.); (V.C.)
| | - Valerio Sanguigni
- Unit of Internal Medicine and Endocrinology, Madonna delle Grazie Hospital, Velletri, 00049 Rome, Italy; (V.S.); (D.F.)
- Department of Internal Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy
| | - Davide Francomano
- Unit of Internal Medicine and Endocrinology, Madonna delle Grazie Hospital, Velletri, 00049 Rome, Italy; (V.S.); (D.F.)
| | - Sebastiano Sciarretta
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 04100 Latina, Italy; (S.S.); (M.P.); (E.C.); (G.F.)
- Department of AngioCardioNeurology, IRCCS Neuromed, 86077 Pozzilli, Italy
| | - Daniele Pastori
- Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, 00185 Rome, Italy; (S.B.); (D.P.); (V.C.)
| | - Mariangela Peruzzi
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 04100 Latina, Italy; (S.S.); (M.P.); (E.C.); (G.F.)
- Mediterranea, Cardiocentro, 80122 Napoli, Italy
| | - Elena Cavarretta
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 04100 Latina, Italy; (S.S.); (M.P.); (E.C.); (G.F.)
- Mediterranea, Cardiocentro, 80122 Napoli, Italy
| | - Alessandra D’Amico
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy;
| | - Valentina Castellani
- Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, 00185 Rome, Italy; (S.B.); (D.P.); (V.C.)
| | - Giacomo Frati
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 04100 Latina, Italy; (S.S.); (M.P.); (E.C.); (G.F.)
- Department of AngioCardioNeurology, IRCCS Neuromed, 86077 Pozzilli, Italy
| | - Roberto Carnevale
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 04100 Latina, Italy; (S.S.); (M.P.); (E.C.); (G.F.)
- Mediterranea, Cardiocentro, 80122 Napoli, Italy
| | - SMiLe Group
- Faculty of Medicine and Surgery, Sapienza University of Rome, 04100 Latina, Italy;
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Harima K, Honda S, Mikami K, Kitajima M, Urushizaka M, Tomisawa T, Hagii J, Metoki H, Yasujima M, Osanai T. Collagen-Induced Platelet Aggregates, Diabetes, and Aspirin Therapy Predict Clinical Outcomes in Acute Ischemic Stroke. J Stroke Cerebrovasc Dis 2019; 28:2302-2310. [PMID: 31174954 DOI: 10.1016/j.jstrokecerebrovasdis.2019.05.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 05/15/2019] [Accepted: 05/19/2019] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND Aggregation of platelets is a trigger for additional development of larger thrombi. This study aimed to identify factors that may affect platelet aggregability and their role in clinical outcomes in acute ischemic stroke. METHODS Consecutive acute ischemic stroke patients (n = 352) who were transferred within 24 hours after its onset were enrolled. Peripheral venous blood was sampled to measure platelet aggregability and other parameters. RESULTS Mean values of spontaneous small-sized platelet aggregates and collagen- or adenosine diphosphate (ADP)-induced large-sized aggregates were elevated in acute ischemic stroke. In atherothrombotic stroke (n = 178), collagen and ADP-induced large-sized aggregates were positively correlated with HbA1c, respectively. High incidence of the modified Rankin Scales (mRS) 5-6 at discharge was associated with diabetes complication (odds ratio [OR] 8.77, 95% confidence interval [CI] 1.32-57.56). The proportion of patients who were functionally independent (the mRS 0-2) at discharge was lower in the middle tertile of collagen and ADP-induced large-sized aggregates than their low tertile (OR 2.46, 95% CI 1.09-5.58; OR 2.43, 95% CI 1.05-5.59, respectively). Prestroke administration of aspirin recovered the proportion of independence at discharge (OR 0.25, 95% CI 0.06-0.99), and ameliorated incidence of the mRS 5-6. On logistic regression analysis, diabetes, HbA1c, collagen-induced large-sized aggregates, and prestroke administration of aspirin remained independent predictors of clinical outcomes in atherothrombotic stroke. In cardioembolic and lacunar stroke, no relations with clinical outcomes were found. CONCLUSIONS High plasma level of HbA1c is involved in enhanced platelet aggregability in acute atherothrombotic stroke patients, and prestroke administration of aspirin may be beneficial to clinical outcomes.
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Affiliation(s)
- Kaho Harima
- Department of Nursing Science, Hirosaki University Graduate School of Health Science, Hirosaki, Japan
| | - Sumika Honda
- Department of Nursing Science, Hirosaki University Graduate School of Health Science, Hirosaki, Japan
| | - Kasumi Mikami
- Department of Nursing Science, Hirosaki University Graduate School of Health Science, Hirosaki, Japan
| | - Maiko Kitajima
- Department of Nursing Science, Hirosaki University Graduate School of Health Science, Hirosaki, Japan
| | - Mayumi Urushizaka
- Department of Nursing Science, Hirosaki University Graduate School of Health Science, Hirosaki, Japan
| | - Toshiko Tomisawa
- Department of Nursing Science, Hirosaki University Graduate School of Health Science, Hirosaki, Japan
| | - Joji Hagii
- Hirosaki Stroke and Rehabilitation Center, Hirosaki, Japan
| | | | | | - Tomohiro Osanai
- Department of Nursing Science, Hirosaki University Graduate School of Health Science, Hirosaki, Japan.
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Non-linear association of plasma level of high-density lipoprotein cholesterol with endobronchial biopsy bleeding in patients with lung cancer. Lipids Health Dis 2019; 18:17. [PMID: 30658636 PMCID: PMC6339312 DOI: 10.1186/s12944-019-0966-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 01/06/2019] [Indexed: 01/08/2023] Open
Abstract
Background Despite a large body of studies have demonstrated the multifaceted behavior of high-density lipoproteins (HDLs) in several physiological and pathological processes, the levels of plasma HDL-cholesterol (HDL-C) that may be associated with endobronchial biopsy (EBB)-related bleeding have never been examined. Methods We conducted a single-center retrospective cohort study of 628 consecutive patients with primary lung cancer who had undergone EBB at a large tertiary hospital between January 2014 and February 2018. Patients were divided into the bleeding group and the non-bleeding group according to the bronchoscopy report. The association between HDL-C levels and EBB-induced bleeding was evaluated using the LASSO regression analysis, multiple regression analysis and smooth curve fitting adjusted for potential confounders. Results There was an inverse association of plasma HDL-C concentration with the incidence of EBB-induced bleeding as assessed by univariate analysis (P < 0.05). However, in piecewise linear regression analysis, a non-linear relationship with threshold saturation effects was observed between plasma HDL-C concentrations and EBB-induced bleeding. The incidence of EBB-induced bleeding decreased with HDL-C concentrations from 1.5 mmol/L up to 2.0 mmol/L (adjusted OR, 0.39; 95% CI, 0.20–0.74), but increased with HDL-C levels above the inflection point (HDL-C = 2.0 mmol/L). Conclusions There was a non-linear association between plasma HDL-C concentrations and the risk of EBB-induced bleeding in patients with lung cancer. The plasma level of HDL-C above 2.0 mmol/L or below 1.5 mmol/L may increase the risk of EBB-induced bleeding.
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12
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Laboratory Monitoring of Antiplatelet Therapy. Platelets 2019. [DOI: 10.1016/b978-0-12-813456-6.00036-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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13
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Jäger B, Piackova E, Haller PM, Andric T, Kahl B, Christ G, Geppert A, Wojta J, Huber K. Increased platelet reactivity in dyslipidemic patients with coronary artery disease on dual anti-platelet therapy. Arch Med Sci 2019; 15:65-71. [PMID: 30697254 PMCID: PMC6348363 DOI: 10.5114/aoms.2018.81035] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 09/09/2017] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION The optimal duration of dual anti-platelet therapy (DAPT) following percutaneous coronary intervention (PCI) is still a matter of debate. Biomarkers may help to identify patients who will benefit from extended DAPT. The aim of the study was to test the interaction between lipid parameters and platelet function in patients with coronary artery disease (CAD) on DAPT. MATERIAL AND METHODS Overall, 58 patients on DAPT were prospectively included following PCI in stable CAD. Platelet markers, i.e. mean platelet volume (MPV), platelet distribution width (PDW), fraction of reticulated thrombocytes (RT) and ADP-induced multiple electrode aggregometry (MEA), as well as serum lipids, i.e. high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), triglycerides (TG) and remnant cholesterol (RC), were assessed after intake of a maintenance dose of ASA and P2Y12 inhibitor. RESULTS A significant inverse correlation was found for HDL-C levels and markers of platelet activation: MPV (r = -0.351, p = 0.009), PDW (r = -0.391, p = 0.003), fraction of RT (r = -0.402, p = 0.003) and ADP-induced MEA (r = -0.345, p = 0.011). Only a weak or no association was found between other lipid parameters and platelet markers. After multivariable adjustment, HDL-C levels served as a strong and significant predictor of MPV (95% CI: -0.039 to -0.009; p = 0.002), PDW (95% CI: -0.094 to -0.034; p < 0.0001), RT (95% CI: -0.107 to -0.031; p = 0.001) and MEA (95% CI: -0.540 to -0.170; p < 0.0001), while TG, LDL-C, RC and TC were not significantly associated with platelet function. CONCLUSIONS Within lipid parameters, only HDL-C levels are strongly associated with markers of platelet activation in CAD patients on DAPT. Accordingly, detection of dyslipidemia might indicate the need for prolongation of DAPT.
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Affiliation(s)
- Bernhard Jäger
- 3 Medical Department, Cardiology and Intensive Care Medicine, Wilhelminenhospital, Vienna, Austria
| | - Editha Piackova
- 3 Medical Department, Cardiology and Intensive Care Medicine, Wilhelminenhospital, Vienna, Austria
| | - Paul Michael Haller
- 3 Medical Department, Cardiology and Intensive Care Medicine, Wilhelminenhospital, Vienna, Austria
| | - Tijana Andric
- 3 Medical Department, Cardiology and Intensive Care Medicine, Wilhelminenhospital, Vienna, Austria
| | - Beatrice Kahl
- 3 Medical Department, Cardiology and Intensive Care Medicine, Wilhelminenhospital, Vienna, Austria
| | - Günther Christ
- 5 Medical Department with Cardiology, Kaiser Franz Josef Hospital, Vienna, Austria
| | - Alexander Geppert
- 3 Medical Department, Cardiology and Intensive Care Medicine, Wilhelminenhospital, Vienna, Austria
| | - Johann Wojta
- Department of Cardiology, Medical University Vienna, Vienna, Austria
- Cardiovascular Research, Ludwig Boltzmann Cluster, Vienna, Austria
| | - Kurt Huber
- 3 Medical Department, Cardiology and Intensive Care Medicine, Wilhelminenhospital, Vienna, Austria
- Medical Faculty, Sigmund Freud University, Vienna, Austria
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Garcia C, Montée N, Faccini J, Series J, Meilhac O, Cantero AV, Le Faouder P, Elbaz M, Payrastre B, Vindis C. Acute coronary syndrome remodels the antiplatelet aggregation properties of HDL particle subclasses. J Thromb Haemost 2018; 16:933-945. [PMID: 29543379 DOI: 10.1111/jth.14003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Indexed: 01/29/2023]
Abstract
Essentials HDL subclasses were studied in acute coronary syndrome (ACS). HDL2 from ACS patients have better antiplatelet potency than HDL from non ACS subjects. ACS remodels the antiplatelet properties of HDL subclasses. Oxidized polyunsaturated fatty acids content of HDL is modified by ACS. SUMMARY Background Although HDLs have antithrombotic effects by reducing platelet activation, the relationship between HDL levels and the risk of acute coronary syndrome (ACS) is unclear, as HDL particles are heterogeneous in composition and biological properties. Objective To characterize the effects of HDL2 and HDL3 subclasses from ACS patients and non-coronary artery disease (CAD) subjects on platelet activation. Methods We measured platelet aggregation and ex vivo thrombus formation, analyzed signaling pathways by flow cytometry, and performed a targeted lipidomics analysis on HDL subclasses. Results Analysis of human platelet aggregation in suspension, adhesion on von Willebrand factor and thrombus formation on collagen under arterial shear demonstrated that HDL2 from ACS patients had higher antiplatelet potency than HDL3 from ACS patients and HDL from non-CAD subjects. HDL binding to scavenger receptor class B type I was essential for this effect. A lipidomics analysis revealed that HDL2 from ACS patients had more oxidized polyunsaturated fatty acids (PUFAs). An inverse correlation between the concentrations of 9-hydroxyoctadecadienoic acid (9-HODE), 13-hydroxyoctadecadienoic acid (13-HODE), the eicosapentaenoic acid metabolite 18-hydroxyeicosapentaenoic acid (18-HEPE) and hydroxyeicosatetraenoic acid isomers in HDL2 and platelet aggregation was observed. This relationship was further demonstrated by the direct inhibitory effects of 18-HEPE, 9-HODE, 13-HODE, 17-hydroxydocosahexaenoic acid and 14-hydroxydocosahexaenoic acid on collagen-related peptide-induced platelet aggregation, indicating that oxidized PUFAs contribute to the antithrombotic effect of ACS HDL2. Conclusions Our data shed new light on the antiplatelet effects of HDL subclasses, and suggest physiological adaptation through the modulation of HDL properties in ACS patients that may limit their platelet-dependent thrombotic risk.
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Affiliation(s)
- C Garcia
- Laboratory of Hematology, CHU Toulouse, Toulouse, France
| | - N Montée
- Institute of Metabolic and Cardiovascular Diseases/I2MC, INSERM, UMR-1048 and University Toulouse 3, Toulouse, France
- INSERM, UMR-1188, Diabète Athérothrombose Thérapies Réunion Océan Indien, Université de la Réunion, Saint Denis, France
| | - J Faccini
- Institute of Metabolic and Cardiovascular Diseases/I2MC, INSERM, UMR-1048 and University Toulouse 3, Toulouse, France
| | - J Series
- Laboratory of Hematology, CHU Toulouse, Toulouse, France
| | - O Meilhac
- INSERM, UMR-1188, Diabète Athérothrombose Thérapies Réunion Océan Indien, Université de la Réunion, Saint Denis, France
| | - A-V Cantero
- Institute of Metabolic and Cardiovascular Diseases/I2MC, INSERM, UMR-1048 and University Toulouse 3, Toulouse, France
- Laboratory of Biochemistry, CHU Toulouse, Toulouse, France
| | - P Le Faouder
- MetaToul-Lipidomic Core Facility, MetaboHUB, INSERM, UMR-1048, Toulouse, France
| | - M Elbaz
- Institute of Metabolic and Cardiovascular Diseases/I2MC, INSERM, UMR-1048 and University Toulouse 3, Toulouse, France
- Department of Cardiology, CHU Toulouse, Toulouse, France
| | - B Payrastre
- Laboratory of Hematology, CHU Toulouse, Toulouse, France
- Institute of Metabolic and Cardiovascular Diseases/I2MC, INSERM, UMR-1048 and University Toulouse 3, Toulouse, France
| | - C Vindis
- Laboratory of Hematology, CHU Toulouse, Toulouse, France
- Institute of Metabolic and Cardiovascular Diseases/I2MC, INSERM, UMR-1048 and University Toulouse 3, Toulouse, France
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15
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Wadowski PP, Lee S, Kopp CW, Koppensteiner R, Panzer S, Gremmel T. Low Levels of High-Density Lipoprotein Cholesterol Are Linked to Impaired Clopidogrel-Mediated Platelet Inhibition. Angiology 2018; 69:786-794. [PMID: 29482349 DOI: 10.1177/0003319718760074] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Low high-density lipoprotein cholesterol (HDL-C) levels are an independent predictor of ischemic events in patients with atherosclerotic cardiovascular disease. This may in part be due to decreased clopidogrel-mediated platelet inhibition in patients with low HDL-C. We investigated the association of HDL-C with on-treatment platelet reactivity to adenosine diphosphate (ADP) in 314 patients on dual antiplatelet therapy with clopidogrel and aspirin undergoing angioplasty and stenting. Platelet P-selectin expression was assessed by flow cytometry, and platelet aggregation was determined by the VerifyNow P2Y12 assay and the Impact-R. High-density lipoprotein cholesterol levels were inversely associated with P-selectin expression and the VerifyNow P2Y12 assay (both P ≤ .01). Moreover, we found a positive correlation of HDL-C with surface coverage by the Impact-R ( P = .003). Patients with low HDL-C (≤35 mg/dL) exhibited a significantly higher P-selectin expression in response to ADP and higher platelet aggregation by the VerifyNow P2Y12 assay and the Impact-R than patients with normal HDL-C (>35 mg/dL; all P < .05). High on-treatment residual platelet reactivity by the VerifyNow P2Y12 assay occurred significantly more frequently in patients with low HDL-C levels than in those with normal HDL-C (47.4% vs 30.1%, P = .01). In conclusion, low HDL-C is linked to impaired clopidogrel-mediated platelet inhibition after angioplasty and stenting.
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Affiliation(s)
- Patricia P Wadowski
- 1 Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Silvia Lee
- 1 Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Christoph W Kopp
- 1 Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Renate Koppensteiner
- 1 Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Simon Panzer
- 2 Department of Blood Group Serology and Transfusion Medicine, Medical University of Vienna, Vienna, Austria
| | - Thomas Gremmel
- 1 Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
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Diagnostic Value of Mean Platelet Volume Combined With Troponin I for Acute Coronary Syndrome. Am J Med Sci 2016; 352:159-65. [PMID: 27524214 DOI: 10.1016/j.amjms.2016.04.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 04/19/2016] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To explore diagnostic performance of mean platelet volume (MPV) for acute myocardial infarction (AMI) of patients with acute coronary syndrome (ACS). METHODS We compared MPV and other indicators of 1,524 patients with ACS. Among them, 880 patients were diagnosed with AMI, 344 were diagnosed with unstable angina pectoris and 350 were the control group. RESULTS The level of MPV in ACS group was significantly higher than the control group (9.5 ± 1.34fL versus 7.9 ± 1.03fL, P < 0.001). Additionally, MPV of AMI group was higher than unstable angina pectoris (9.4 ± 1.30fL versus 9.2 ± 1.42fL, P < 0.001). Increased MPV could be identified as an early independent predictor of AMI (odds ratio = 1.957, 95% CI: 1.389-2.758, P < 0.001). The area under the receiver operating characteristic curves curve for MPV combined with troponin I (TnI) was 0.816, the sensitivity (68.81%) and the specificity (97.98%) at the best cut-off value were higher than using MPV or TnI alone respectively. CONCLUSIONS MPV has been shown as an independent risk factor for early onset of AMI and can be applied to assist AMI diagnosis of ACS patients. Additionally, measuring MPV in conjunction with TnI levels can improve the diagnostic performance of TnI with higher sensitivity and specificity.
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17
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Lipoproteins as modulators of atherothrombosis: From endothelial function to primary and secondary coagulation. Vascul Pharmacol 2016; 82:1-10. [DOI: 10.1016/j.vph.2015.10.009] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Revised: 10/23/2015] [Accepted: 10/26/2015] [Indexed: 12/20/2022]
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18
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McMahon KM, Foit L, Angeloni NL, Giles FJ, Gordon LI, Thaxton CS. Synthetic high-density lipoprotein-like nanoparticles as cancer therapy. Cancer Treat Res 2015; 166:129-50. [PMID: 25895867 PMCID: PMC4418545 DOI: 10.1007/978-3-319-16555-4_6] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
High-density lipoproteins (HDL) are diverse natural nanoparticles that carry cholesterol and are best known for the role that they play in cardiovascular disease. However, due to their unique targeting capabilities, diverse molecular cargo, and natural functions beyond cholesterol transport, it is becoming increasingly appreciated that HDLs are critical to cancer development and progression. Accordingly, this chapter highlights ongoing research focused on the connections between HDL and cancer in order to design new drugs and targeted drug delivery vehicles. Research is focused on synthesizing biomimetic HDL-like nanoparticles (NP) that can be loaded with diverse therapeutic cargo (e.g., chemotherapies, nucleic acids, proteins) and specifically targeted to cancer cells. Beyond drug delivery, new data is emerging that HDL-like NPs may be therapeutically active in certain tumor types, for example, B cell lymphoma. Overall, HDL-like NPs are becoming increasingly appreciated as targeted, biocompatible, and efficient therapies for cancer, and may soon become indispensable agents in the cancer therapeutic armamentarium.
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Affiliation(s)
- Kaylin M. McMahon
- Northwestern University, Feinberg School of Medicine, Department of Urology, Tarry 16-703, 303 E. Chicago Ave. Chicago, IL 60611 United States
- Simpson Querrey Institute (SQI), 303 E. Superior St, Chicago, IL 60611 United States
| | - Linda Foit
- Northwestern University, Feinberg School of Medicine, Department of Urology, Tarry 16-703, 303 E. Chicago Ave. Chicago, IL 60611 United States
- Simpson Querrey Institute (SQI), 303 E. Superior St, Chicago, IL 60611 United States
| | - Nicholas L. Angeloni
- Northwestern University, Feinberg School of Medicine, Department of Urology, Tarry 16-703, 303 E. Chicago Ave. Chicago, IL 60611 United States
- Simpson Querrey Institute (SQI), 303 E. Superior St, Chicago, IL 60611 United States
| | - Francis J. Giles
- Northwestern Medicine Developmental Therapeutics Institute, Northwestern University, 645 N. Michigan Ave, Chicago, IL 60611, USA
| | - Leo I. Gordon
- Department of Medicine, Division of Hematology/Oncology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL 60611
| | - C. Shad Thaxton
- Northwestern University, Feinberg School of Medicine, Department of Urology, Tarry 16-703, 303 E. Chicago Ave. Chicago, IL 60611 United States
- Simpson Querrey Institute (SQI), 303 E. Superior St, Chicago, IL 60611 United States
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL 60611
- International Institute for Nanotechnology (IIN), Northwestern University, 2145 Sheridan Rd. Evanston IL. 60208, United States
- Corresponding Author:
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Abstract
High-density lipoproteins (HDLs) exert many beneficial effects which may help to protect against the development or progression of atherosclerosis or even facilitate lesion regression. These activities include promoting cellular cholesterol efflux, protecting low-density lipoproteins (LDLs) from modification, preserving endothelial function, as well as anti-inflammatory and antithrombotic effects. However, questions remain about the relative importance of these activities for atheroprotection. Furthermore, the many molecules (both lipids and proteins) associated with HDLs exert both distinct and overlapping activities, which may be compromised by inflammatory conditions, resulting in either loss of function or even gain of dysfunction. This complexity of HDL functionality has so far precluded elucidation of distinct structure-function relationships for HDL or its components. A better understanding of HDL metabolism and structure-function relationships is therefore crucial to exploit HDLs and its associated components and cellular pathways as potential targets for anti-atherosclerotic therapies and diagnostic markers.
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Affiliation(s)
- Wijtske Annema
- Institute of Clinical Chemistry, University Hospital Zurich, Zurich, Switzerland,
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20
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Rosenson RS, Brewer HB, Rader DJ. Lipoproteins as biomarkers and therapeutic targets in the setting of acute coronary syndrome. Circ Res 2014; 114:1880-9. [PMID: 24902972 DOI: 10.1161/circresaha.114.302805] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The period following an acute coronary syndrome (ACS) represents a critical time frame with a high risk for recurrent events and death. The pathogenesis of this increase in clinical cardiovascular disease events after ACS is complex, with molecular mechanisms including increased thrombosis and inflammation. Dyslipoproteinemia is common in patients with ACS and predictive of recurrent cardiovascular disease events after presentation with an ACS event. Although randomized clinical trials have provided fairly convincing evidence that high-dose statins reduce the risk of recurrent cardiovascular events after ACS, there remain questions about how aggressively to reduce low-density lipoprotein cholesterol levels in ACS. Furthermore, no other lipid-related interventions have yet been proven to be effective in reducing major cardiovascular events after ACS. Here, we review the relationship of lipoproteins as biomarkers to cardiovascular risk after ACS, the evidence for lipid-targeted interventions, and the potential for novel therapeutic approaches in this arena.
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Affiliation(s)
- Robert S Rosenson
- From the Department of Medicine (Cardiology), Icahn School of Medicine at Mount Sinai, New York, NY (R.S.R.); Cardiovascular Research Institute, Medstar Research Institute, Washington Hospital Center, DC (H.B.B.); and Departments of Medicine and Genetics and Cardiovascular Institute, Perelman School of Medicine of the University of Pennsylvania, Philadelphia (D.J.R.)
| | - H Bryan Brewer
- From the Department of Medicine (Cardiology), Icahn School of Medicine at Mount Sinai, New York, NY (R.S.R.); Cardiovascular Research Institute, Medstar Research Institute, Washington Hospital Center, DC (H.B.B.); and Departments of Medicine and Genetics and Cardiovascular Institute, Perelman School of Medicine of the University of Pennsylvania, Philadelphia (D.J.R.)
| | - Daniel J Rader
- From the Department of Medicine (Cardiology), Icahn School of Medicine at Mount Sinai, New York, NY (R.S.R.); Cardiovascular Research Institute, Medstar Research Institute, Washington Hospital Center, DC (H.B.B.); and Departments of Medicine and Genetics and Cardiovascular Institute, Perelman School of Medicine of the University of Pennsylvania, Philadelphia (D.J.R.).
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van der Stoep M, Korporaal SJA, Van Eck M. High-density lipoprotein as a modulator of platelet and coagulation responses. Cardiovasc Res 2014; 103:362-71. [DOI: 10.1093/cvr/cvu137] [Citation(s) in RCA: 90] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
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Chromium picolinate inhibits cholesterol-induced stimulation of platelet aggregation in hypercholesterolemic rats. Ir J Med Sci 2014; 184:291-6. [DOI: 10.1007/s11845-014-1102-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2013] [Accepted: 02/26/2014] [Indexed: 01/18/2023]
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Abstract
INTRODUCTION RNA interference (RNAi) is a powerful mechanism for gene silencing with the potential to greatly impact the development of new therapies for many human diseases. Short interfering RNAs (siRNAs) may be the ideal molecules for therapeutic RNAi. However, therapeutic siRNAs face significant challenges that must be overcome prior to widespread clinical use. Many efforts have been made to overcome the hurdles associated with systemic administration of siRNA; however, current approaches are still limited. As such, there is an urgent need to develop new strategies for siRNA delivery that have the potential to impact a broad spectrum of systemic diseases. AREAS COVERED This review focuses on the promise of siRNA therapies and highlights current siRNA delivery methods. With an eye toward new strategies, this review first introduces high-density lipoprotein (HDL) and describes its natural biological functions, and then transitions into how HDLs may provide significant opportunities as next-generation siRNA delivery vehicles. Importantly, this review describes how synthetic HDLs leverage the natural ability of HDL to stabilize and deliver siRNAs. EXPERT OPINION HDLs are natural nanoparticles that are critical to understanding the systemic delivery of therapeutic nucleic acids, like siRNA. Methods to synthesize biomimetic HDLs are being explored, and data demonstrate that this type of delivery vehicle may be highly beneficial for targeted and efficacious systemic delivery of siRNAs.
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Affiliation(s)
- Kaylin Marie McMahon
- Northwestern University, Feinberg School of Medicine, Department of Urology , 303 E. Chicago Avenue, Tarry 16-703, Chicago, IL 60611 , USA +1 312 503 9354 ; +1 312 503 1867 ;
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Varol E, Aksoy F, Bas HA, Ari H, Ozaydin M. Mean platelet volume is elevated in patients with low high-density lipoprotein cholesterol. Angiology 2013; 65:733-6. [PMID: 24065627 DOI: 10.1177/0003319713504024] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A low high-density lipoprotein cholesterol (HDL-C) level is a predictor of increased cardiovascular risk. We assessed the mean platelet volume (MPV) in patients with low HDL-C. We studied 59 patients with low HDL-C (HDL-C ≤35 mg/dL) and 56 control participants (HDL-C levels >35 mg/dL) with similar cardiovascular risk factors. As expected, HDL-C was significantly lower among the patients with low HDL-C than that of the control group (32 ± 3 vs 51 ± 5 mg/dL, respectively; P < .001). Platelet count was significantly lower among the patients with low HDL-C than that of the control group (213 ± 60 vs 285 ± 75 × 10(9)/L, respectively; P < .001). The MPV was significantly higher among the patients with low HDL-C than that of the control group (8.7 ± 0.6 vs 7.1 ± 0.5 fL, respectively; P < .001). We have shown that MPV was significantly elevated in patients with low HDL-C compared with control participants.
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Affiliation(s)
- Ercan Varol
- Department of Cardiology, Suleyman Demirel University, Isparta, Turkey
| | - Fatih Aksoy
- Department of Cardiology, Suleyman Demirel University, Isparta, Turkey
| | - Hasan Aydin Bas
- Department of Cardiology, Suleyman Demirel University, Isparta, Turkey
| | - Hatem Ari
- Department of Cardiology, Suleyman Demirel University, Isparta, Turkey
| | - Mehmet Ozaydin
- Department of Cardiology, Suleyman Demirel University, Isparta, Turkey
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High-density cholesterol and apolipoprotein AI as modifiers of plasma fibrin clot properties in apparently healthy individuals. Blood Coagul Fibrinolysis 2013; 24:50-4. [PMID: 23037322 DOI: 10.1097/mbc.0b013e32835a083c] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Low high-density lipoprotein cholesterol (HDL-C) increases cardiovascular risk, whereas its high levels protect against atherosclerosis via multiple beneficial effects. Dense and poorly lysable fibrin clot formation is observed in cardiovascular disease. We sought to investigate whether HDL-C and its major component apolipoprotein A (Apo A)-I affect fibrin clot properties. In 136 apparently healthy individuals (99 men, 37 women, aged 49-69 years) we determined plasma fibrin clot permeability (Ks coefficient) and lysis time (t50%) together with Apo A-I and lipoprotein (a) [Lp(a)] levels. The median HDL-C level was 1.33 mmol/l (range from 0.77 to 2.19 mmol/l). HDL-C was positively associated with Apo A-I (r = 0.62, P < 0.00001). HDL-C and Apo A-I were positively correlated with Ks (r = 0.52, P < 0.00001 and r = 0.44, P < 0.00001, respectively) and inversely with t50% (r = -0.44, P < 0.00001 and r = -0.35, P = 0.00003, respectively). No such associations were seen for other lipid variables. Ks and t50% were associated with Lp(a) (r = -0.42, P < 0.00001 and r = 0.42, P < 0.00001, respectively) and fibrinogen (r = -0.31, P = 0.00024 and r = 0.39, P < 0.00001, respectively). Individuals with HDL-C at least 1.4 mmol/l (n = 54) had 19% higher Ks (P = 0.00016) and 17% shorter t50% (P = 0.0012) than the remainder. After adjustment for age, fibrinogen, and Lp(a), HDL-C was the independent predictor of Ks (β = 0.7, P < 0.00001) and t50% (β = -0.62, P < 0.00001). This study shows that elevated HDL-C levels are associated with improved fibrin clot permeability and lysis, indicating a novel antithrombotic mechanism underlying the postulated beneficial effects of therapy targeted at HDL-C.
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Abstract
In addition to its role in reverse cholesterol transport, high-density lipoprotein (HDL) cholesterol has direct action on numerous cell types that influence cardiovascular and metabolic health. Cellular responses to HDL entail its capacity to invoke cholesterol efflux that causes signal initiation via scavenger receptor class B, type I, and plasma membrane receptor activation by HDL cargo molecules. In endothelial cells and their progenitors, HDL attenuates apoptosis and stimulates proliferation and migration. HDL also has diverse anti-inflammatory actions in both endothelial cells and leukocytes. In vascular smooth muscles, HDL tempers proinflammatory, promigratory, and degradative processes, and through actions on endothelium and platelets HDL is antithrombotic. There are additional actions of HDL of potential cardiovascular consequence that are indirect, including the capacities to promote pancreatic β-cell insulin secretion, to protect pancreatic β cells from apoptosis, and to enhance glucose uptake by skeletal muscle myocytes. Furthermore, HDL decreases white adipose tissue mass, increases energy expenditure, and promotes the production of adipose-derived cytokine adiponectin that has its own vascular-protective properties. Many of these numerous actions of HDL have been observed not only in cell culture and animal models but also in human studies, and assessments of these functions are now being applied to patient populations to better-elucidate which actions of HDL may contribute to its cardioprotective potential and how they can be quantified and targeted. Further work on the many mechanisms of HDL action promises to reveal new prophylactic and therapeutic strategies to optimize both cardiovascular and metabolic health.
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Affiliation(s)
- Chieko Mineo
- Division of Pulmonary and Vascular Biology, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA
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Abstract
In addition to its role in reverse cholesterol transport, high-density lipoprotein (HDL) cholesterol has direct action on numerous cell types that influence cardiovascular and metabolic health. Cellular responses to HDL entail its capacity to invoke cholesterol efflux that causes signal initiation via scavenger receptor class B, type I, and plasma membrane receptor activation by HDL cargo molecules. In endothelial cells and their progenitors, HDL attenuates apoptosis and stimulates proliferation and migration. HDL also has diverse anti-inflammatory actions in both endothelial cells and leukocytes. In vascular smooth muscles, HDL tempers proinflammatory, promigratory, and degradative processes, and through actions on endothelium and platelets HDL is antithrombotic. There are additional actions of HDL of potential cardiovascular consequence that are indirect, including the capacities to promote pancreatic β-cell insulin secretion, to protect pancreatic β cells from apoptosis, and to enhance glucose uptake by skeletal muscle myocytes. Furthermore, HDL decreases white adipose tissue mass, increases energy expenditure, and promotes the production of adipose-derived cytokine adiponectin that has its own vascular-protective properties. Many of these numerous actions of HDL have been observed not only in cell culture and animal models but also in human studies, and assessments of these functions are now being applied to patient populations to better-elucidate which actions of HDL may contribute to its cardioprotective potential and how they can be quantified and targeted. Further work on the many mechanisms of HDL action promises to reveal new prophylactic and therapeutic strategies to optimize both cardiovascular and metabolic health.
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Affiliation(s)
- Chieko Mineo
- Division of Pulmonary and Vascular Biology, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA
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28
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Abstract
PURPOSE OF REVIEW HDL and their main apolipoprotein (apo) constituent apoA-I are antiatherogenic. This has been predominantly attributed to the ability of apoA-I/HDL to efflux cholesterol from macrophages within atherosclerotic plaques. It is now emerging that a number of the protective properties of HDL may be due to their effects on the endothelium. RECENT FINDINGS In addition to their well characterized anti-inflammatory and antioxidant effects, apoA-I and HDL regulate several other key biological pathways known to preserve endothelial function and promote vascular repair. The ATP-binding cassette (ABC) transporters ABCA1 and ABCG1, and the scavenger receptor B type 1 mediate multiple intracellular signaling pathways as well as the efflux of cholesterol and/or oxysterols in response to apoA-I/HDL. Although cholesterol efflux triggers a host of signaling events in endothelial cells, there is evidence that some of the beneficial actions of HDL may occur independently of efflux. SUMMARY Current data suggest that in endothelial cells ABCA1 and ABCG1 mediate the activation of intracellular signaling pathways primarily through the efflux of cholesterol and oxysterols to apoA-I/HDL. Interaction between HDL and scavenger receptor B type 1 initiates the greatest number of known signaling pathways and there is evidence that some of these are activated independent of efflux.
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Affiliation(s)
- Hamish C Prosser
- Translational Research Group, Heart Research Institute Department of Cardiology, Royal Prince Alfred Hospital Department of Medicine, University of Sydney, Sydney, New South Wales, Australia Immunobiology Unit, Heart Research Institute
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Badimon L, Vilahur G. LDL-cholesterol versus HDL-cholesterol in the atherosclerotic plaque: inflammatory resolution versus thrombotic chaos. Ann N Y Acad Sci 2012; 1254:18-32. [DOI: 10.1111/j.1749-6632.2012.06480.x] [Citation(s) in RCA: 118] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abdel-Maksoud MF, Eckel RH, Hamman RF, Hokanson JE. Risk of coronary heart disease is associated with triglycerides and high-density lipoprotein cholesterol in women and non-high-density lipoprotein cholesterol in men. J Clin Lipidol 2012; 6:374-81. [PMID: 22836075 DOI: 10.1016/j.jacl.2012.02.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2011] [Revised: 01/06/2012] [Accepted: 02/25/2012] [Indexed: 11/28/2022]
Abstract
BACKGROUND Although the physiologic interrelationships between triglycerides (TG) and high-density lipoprotein cholesterol (HDL-C) are not fully understood, studies typically are adjusted for one when one is examining the role of the other. If the mechanism of coronary heart disease (CHD) risk is mediated through the other, then controlling for the second factor may mask the true effect of the first. We investigated the relationship between the combined effect of increased (↑) TG and decreased (↓) HDL-C compared with isolated ↑TG or isolated ↓HDL-C on CHD risk in men and women and compared these TG/HDL-C categories to non-HDL cholesterol (non-HDL-C). METHODS Subjects (936 women and 746 men) from the San Luis Valley Study were grouped on the basis of 4 sex-specific NCEP-ATP III cutpoints (↑TG ≥150 mg/dL, and ↓HDL-C, <40 and <50 mg/dL for men and women, respectively). Descriptive statistics and survival analyses were used. The reference group was ↓TG/↑HDL-C (TG <150, and HDL-C >50 and >40 mg/dL for women and men, respectively). Non-HDL-C was analyzed as a continuous variable. RESULTS Among women, all groups had greater risk of CHD compared with the ↓TG/↑HDL-C reference in univariate analysis: ↓TG/↓HDL-C HR = 2.82 [95% confidence interval 1.12-7.1], ↑TG/↑HDL-C HR = 3.82 [1.50-9.74], ↑TG/↓HDL-C HR= 4.32 [1.91-9.80]. The risk remained significant in the ↓TG/↓HDL-C group (HR= 3.27 [1.26-8.50] and marginally significant in other groups in multivariable analysis. Neither ↑TG nor ↓HDL-C was related to CHD risk in men. Non-HDL cholesterol was significantly related to CHD in men but not in women. CONCLUSIONS The CHD risk associated with ↓HDL-C in women was >2- to 4-fold elevated depending on TG levels. Non-HDL cholesterol was a significant predictor of CHD in men. Examining the combined effects of risk factors that share physiologic pathways may reveal important associations that can be otherwise obscured. Further dissection of gender specific pathways that affect HDL-C and TG and non-HDL cholesterol are important in understanding CHD risk.
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Affiliation(s)
- Madiha F Abdel-Maksoud
- Department of Epidemiology, Colorado School of Public Health, Anschutz Medical Campus, Aurora, CO 80045, USA.
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Tselepis AD, Tsoumani ME, Kalantzi KI, Dimitriou AA, Tellis CC, Goudevenos IA. Influence of high-density lipoprotein and paraoxonase-1 on platelet reactivity in patients with acute coronary syndromes receiving clopidogrel therapy. J Thromb Haemost 2011; 9:2371-8. [PMID: 22008470 DOI: 10.1111/j.1538-7836.2011.04541.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND The paraoxonase activity of the enzyme paraoxonase-1 (PON-1) associated with high-density lipoprotein (HDL) may significantly influence clopidogrel's antiplatelet and clinical efficacy as a result of its involvement in the clopidogrel biotransformation to the pharmacologically active thiol metabolite. We evaluated the possible relationships of HDL levels as well as PON-1 activities and the Q192R genotype with clopidogrel's antiplatelet efficacy in acute coronary syndrome (ACS) patients. METHODS AND RESULTS The platelet aggregation, P-selectin expression and platelet/leukocyte conjugates as well as the clopidogrel response variability (evaluated by the VASP phosphorylation test and expressed as platelet reactivity index, PRI) were assessed in 74 ACS patients undergoing percutaneous coronary intervention (PCI) in relation to the PON-1 Q192R genotype and to serum HDL-cholesterol levels, and PON-1 (paraoxonase and arylesterase) activities. Patients were loaded with 600 mg of clopidogrel followed by 75 mg per day. HDL-cholesterol levels and PON-1 activities at baseline (before clopidogrel loading) were not altered at 5- and 30-day post-clopidogrel loading, whereas baseline platelet activation parameters were significantly attenuated. At 5 days, 17 patients were clopidogrel non-responders (PRI: 64.2 ± 11.1%). HDL-cholesterol was inversely associated with platelet activation parameters independently on platelet response variability to clopidogrel whereas a negative association between platelet activation parameters and paraoxonase activity was observed in patients adequately responding to clopidogrel but not in clopidogrel non-responders. Similarly, the platelet activation markers were significantly higher in PON-1 Q192Q genotype carriers compared with those having one or two R alleles only in patients adequately responding to clopidogrel. CONCLUSIONS PON-1 is an important determinant of clopidogrel antiplatelet efficacy only in patients adequately responding to clopidogrel. These findings may be clinically important in ACS patients receiving clopidogrel therapy, especially the first days after the episode.
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Affiliation(s)
- A D Tselepis
- Laboratory of Biochemistry, Department of Chemistry Department of Cardiology, University of Ioannina, Ioannina, Greece.
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Efficacy of Ezetimibe/Simvastatin 10/20 mg Versus Rosuvastatin 10 mg in High-Risk Patients With or Without Obesity. ACTA ACUST UNITED AC 2011. [DOI: 10.1007/s13556-011-0001-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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Farmer JA, Liao J. Evolving concepts of the role of high-density lipoprotein in protection from atherosclerosis. Curr Atheroscler Rep 2011; 13:107-14. [PMID: 21380938 DOI: 10.1007/s11883-011-0166-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
High-density lipoprotein (HDL) is classified as a negative risk factor due to the inverse relationship between elevated levels of HDL cholesterol and atherosclerosis. The mechanism by which HDL can mediate protection from atherosclerosis is complex and multifactorial. The primary role of reverse cholesterol transport in the reduction of risk for coronary artery disease is supported by a considerable amount of experimental data. HDL is able to interact with and remove cholesterol from the lipid-laden foam cells in the peripheral vasculature with subsequent transportation to the liver for excretion. However, HDL has multiple other physiologic effects that may play a significant role in protection from atherosclerosis. HDL has been demonstrated to exhibit multiple beneficial effects on the coagulation system. Platelet function is improved by both direct and indirect mechanisms. HDL has a complex interaction with the protein C and protein S system. Thrombolytic balance is also improved by HDL. HDL has been demonstrated to have a significant natural antioxidant effect that inhibits the oxidative step required for low-density lipoprotein uptake by the macrophage. Additionally, HDL has also been demonstrated to exert multiple beneficial effects on endothelial function, including decreased apoptosis and endothelial repair.
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Affiliation(s)
- John A Farmer
- Baylor College of Medicine, Baylor Clinic, Houston, TX, 77030, USA.
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Göçmen AY, Burgucu D, Gümüşlü S. Effect of resveratrol on platelet activation in hypercholesterolemic rats: CD40-CD40L system as a potential target. Appl Physiol Nutr Metab 2011; 36:323-30. [PMID: 21574786 DOI: 10.1139/h11-022] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Our aim was to investigate whether trans-resveratrol (t-resveratrol), a red wine constituent known for its cardioprotective effects, was able to influence CD40 ligand (CD40L) and its receptor CD40 in platelets of hypercholesterolemic rats. Sixty Wistar rats were divided into 5 groups: control (C), ethanol (E), t-resveratrol (R), hypercholesterolemia (HC), and hypercholesterolemia plus t-resveratrol (HCR). Rats in the C, E, and R groups were fed a normal diet for 80 days. For 20 days before sacrifice, we intraperitoneally (i.p.) administered 0.1 mL ethanol (50% v/v) to the E group, and 0.1 mL t-resveratrol (20 mg·kg(-1)·day(-1)) to the R group. Rats in the HC and HCR groups were fed a 5% cholesterol diet for 80 days. Rats in the HCR group were administered i.p. 0.1 mL t-resveratrol (20 mg·kg(-1)·day(-1)) for 20 days before sacrifice. Serum levels of total cholesterol (TC), low-density lipoprotein (LDL-C), high-density lipoprotein (HDL-C), very low-density lipoprotein (VLDL-C), and total triglycerides (TG) were assayed with a commercial colorimetric kit. Platelet P-selectin, CD40, and CD40L expression was determined by flow cytometry. sCD40L and IL6 levels were measured by ELISA. In the HC group, we observed a significant increase in serum TC, LDL-C, VLDL-C, TG, sCD40, and IL-6 levels and platelet activation markers compared with levels in the control group. However, t-resveratrol administration to the HC group (HCR group) attenuated the increase in lipids, sCD40, and IL-6 and down-regulated platelet P-selectin, CD40, and CD40L expressions. A positive correlation was found for serum lipids and all the platelet activation markers. Our study showed that the CD40-CD40L dyad is up-regulated in the presence of hypercholesterolemia and that t-resveratrol administration down-regulated the increase.
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Affiliation(s)
- Ayşe Yeşim Göçmen
- Department of Biochemistry, Faculty of Medicine, Bozok University, 66200 Yozgat, Turkey
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Brodde MF, Korporaal SJ, Herminghaus G, Fobker M, Van Berkel TJ, Tietge UJ, Robenek H, Van Eck M, Kehrel BE, Nofer JR. Native high-density lipoproteins inhibit platelet activation via scavenger receptor BI. Atherosclerosis 2011; 215:374-82. [DOI: 10.1016/j.atherosclerosis.2010.12.026] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2010] [Revised: 12/14/2010] [Accepted: 12/27/2010] [Indexed: 10/18/2022]
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Kameda S, Sakata T, Kokubo Y, Mitsuguro M, Okamoto A, Sano M, Miyata T. Association of platelet aggregation with lipid levels in the Japanese population: the Suita study. J Atheroscler Thromb 2011; 18:560-7. [PMID: 21427509 DOI: 10.5551/jat.6288] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIM Platelets play a pivotal role in atherothrombotic diseases. Platelet aggregability induced by agonists has great interindividual variability; however, the factors influencing platelet aggregability variation have not been characterized in Asia. METHODS To examine the confounding factors influencing platelet counts and responsiveness to agonists, we measured the platelet counts and platelet aggregability induced by 1.7 µM adenosine diphosphate (ADP) or 1.7 µg/mL collagen using a light transmittance aggregometer in the Japanese general population without medication or cardiovascular disease (387 men and 550 women) in the Suita Study. RESULTS Platelet counts were negatively correlated with age in both men and women (Spearman's rank correlation coefficient: r(s)=-0.230 and -0.227; p< 0.01, respectively). In women, platelet counts were correlated negatively with the high-density lipoprotein (HDL) cholesterol level and positively with the low-density lipoprotein (LDL) cholesterol/HDL cholesterol (L/H) ratio (r(s)=-0.135 and 0.119; p< 0.01, respectively). In women, platelet aggregabilities by ADP and collagen were correlated with age (r(s)=0.118 and 0.143; p< 0.01, respectively), and collagen-induced platelet aggregability was correlated with the LDL cholesterol level, the L/H ratio, and the non-HDL cholesterol level (r(s)=0.167, 0.172, and 0.185; p< 0.01, respectively). Even after adjustment for age, systolic blood pressure, body mass index, and current smoking and drinking, the association of platelet counts with the L/H ratio in women and associations of collagen-induced platelet aggregability with the L/H ratio and the non-HDL cholesterol level remained. CONCLUSION Examination of platelet counts and platelet aggregability induced by ADP and collagen revealed gender, age and lipid levels as factors influencing inter-individual variability.
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Affiliation(s)
- Sachika Kameda
- Laboratory of Clinical Chemistry, National Cerebral and Cardiovascular Center, Fujishiro-dai, Suita, Osaka, Japan.
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Zimman A, Podrez EA. Regulation of platelet function by class B scavenger receptors in hyperlipidemia. Arterioscler Thromb Vasc Biol 2010; 30:2350-6. [PMID: 21071700 DOI: 10.1161/atvbaha.110.207498] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Platelets constitutively express class B scavenger receptors CD36 and SR-BI, 2 closely related pattern recognition receptors best known for their roles in lipoprotein and lipid metabolism. The biological role of scavenger receptors in platelets is poorly understood. However, in vitro and in vivo data suggest that class B scavenger receptors modulate platelet function and contribute significantly to thrombosis by sensing pathological or physiological ligands, inducing prothrombotic signaling, and increasing platelet reactivity. Platelet CD36 recognizes a novel family of endogenous oxidized choline phospholipids that accumulate in plasma of hyperlipidemic mice and in plasma of subjects with low high-density lipoprotein levels. This interaction leads to the activation of specific signaling pathways and promotes platelet activation and thrombosis. Platelet SR-BI, on the other hand, plays a critical role in the induction of platelet hyperreactivity and accelerated thrombosis under conditions associated with increased platelet cholesterol content. Intriguingly, oxidized high-density lipoprotein, an SR-BI ligand, can suppress platelet function. These recent findings demonstrate that platelet class B scavenger receptors play roles in thrombosis in dyslipidemia and may contribute to acute cardiovascular events in vivo in hypercholesterolemia.
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Affiliation(s)
- Alejandro Zimman
- Department of Molecular Cardiology, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio 44195, USA
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Korporaal SJA, Meurs I, Hauer AD, Hildebrand RB, Hoekstra M, Cate HT, Praticò D, Akkerman JWN, Van Berkel TJC, Kuiper J, Van Eck M. Deletion of the high-density lipoprotein receptor scavenger receptor BI in mice modulates thrombosis susceptibility and indirectly affects platelet function by elevation of plasma free cholesterol. Arterioscler Thromb Vasc Biol 2010; 31:34-42. [PMID: 21051668 DOI: 10.1161/atvbaha.110.210252] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Scavenger receptor BI (SR-BI) is a cell surface receptor that promotes the selective uptake of cholesteryl esters from high-density lipoprotein (HDL) by the liver. In mice, SR-BI deficiency results in increased plasma HDL cholesterol levels and enhanced susceptibility to atherosclerosis. The aim of this study was to investigate the role of SR-BI deficiency on platelet function. METHODS AND RESULTS SR-BI-deficient mice were thrombocytopenic, and their platelets were abnormally large, probably because of an increased cholesterol content. The FeCl(3) acute injury model to study arterial thrombosis susceptibility showed that SR-BI wild-type mice developed total arterial occlusion after 24±2 minutes. In SR-BI-deficient mice, however, the time to occlusion was reduced to 13±1 minutes (P=0.02). Correspondingly, in SR-BI-deficient mice, platelets circulated in an activated state and showed increased adherence to immobilized fibrinogen. In contrast, platelet-specific disruption of SR-BI by bone marrow transplantation in wild-type mice did not alter plasma cholesterol levels or affect platelet count, size, cholesterol content, or reactivity, suggesting that changes in plasma cholesterol levels were responsible for the altered responsiveness of platelets in SR-BI-deficient mice. CONCLUSIONS The function of SR-BI in HDL cholesterol homeostasis and prevention of atherosclerosis is indirectly also essential for maintaining normal platelet function and prevention of thrombosis.
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Affiliation(s)
- Suzanne J A Korporaal
- Leiden/Amsterdam Center for Drug Research, Division of Biopharmaceutics, Gorlaeus Laboratories, Einsteinweg 55, 2333 CC, Leiden, the Netherlands.
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Tardif JC. Emerging high-density lipoprotein infusion therapies: fulfilling the promise of epidemiology? J Clin Lipidol 2010; 4:399-404. [PMID: 21122683 DOI: 10.1016/j.jacl.2010.08.018] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2010] [Accepted: 08/18/2010] [Indexed: 12/20/2022]
Abstract
High-density lipoprotein (HDL) plays a key role in reverse cholesterol transport but also activates nitric oxide synthase and stimulates prostacyclin release, enhances endothelial repair, inhibits cell adhesion molecule expression on vascular endothelium and monocyte recruitment into the arterial wall, and exerts antithrombotic effects. In experimental animals, infusions of HDL or apolipoprotein A-1 (apoA-1) halt the progression or induce regression of atherosclerosis, with favorable effects on plaque composition. Remarkably, a benefit is observed after a single infusion. In a pilot study, weekly infusions of ETC-216, a formulation of recombinant apoA-1 Milano, were administered at two doses for 5 weeks to patients beginning within 2 weeks of an acute coronary syndrome (ACS). Among the 47 patients completing the study, percent atheroma volume by intracoronary ultrasound was reduced in the combined active treatment groups but not in the placebo group. In a larger trial, the Effect of rHDL on Atherosclerosis-Safety and efficacy (ERASE), 183 post-ACS patients were randomized to 4 weekly infusions of placebo or one of two doses of CSL-111, which consists of apoA-1 derived from human plasma and combined with soybean phosphatidylcholine. The greater dose was discontinued because of a high incidence of hepatic enzyme elevation. Among the 136 patients with evaluable end point data, percent change in atheroma volume, the primary endpoint, improved significantly in the CSL-111 group but not in the placebo group. The secondary end points of plaque characterization indices and quantitative coronary angiographic changes both improved significantly in the CSL-111 group compared with the group receiving placebo. Taken together, this evidence suggests that infusions of HDL or apoA-1 may reduce events, particularly among patients with ACS.
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Affiliation(s)
- Jean-Claude Tardif
- Department of Medicine, Research Centre, Montreal Heart Institute, 5000 Belanger Street, Montreal, Quebec H1T1C8, Canada.
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40
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Wang Y, Wang P, Li H. Correlation study of pulmonary embolism and high-density lipoprotein cholesterol. Clin Cardiol 2010; 33:72-6. [PMID: 20186986 DOI: 10.1002/clc.20692] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND It is currently thought that pulmonary embolism and deep vein thrombosis are different manifestations of the same pathological process of venous thromboembolism. Venous thromboembolism has a negative correlation with high-density lipoprotein cholesterol. HYPOTHESIS Pulmonary embolism has a negative correlation with the level of high-density lipoprotein cholesterol. METHODS A total of 90 patients with pulmonary embolism, diagnosed and treated at a single center, were retrospectively analyzed for the present study. Among them were 57 cases of pulmonary arterial trunk embolism in group A and 33 cases of pulmonary arterial non-trunk embolism in group B. RESULTS The results showed that the level of high-density lipoprotein cholesterol decreased markedly in patients with pulmonary arterial trunk embolism as compared to those with pulmonary arterial non-trunk embolism. A stepwise logistic regression analysis was performed upon the relationship between pulmonary arterial trunk embolism and multiple factors. The results showed that a pulmonary arterial trunk embolism had a negative correlation with the level of high-density lipoprotein cholesterol and a positive correlation with triglyceride and high sensitivity C-reactive protein. CONCLUSIONS Pulmonary arterial trunk embolism is negatively correlated with the level of high-density lipoprotein cholesterol.
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Affiliation(s)
- YuPeng Wang
- Department of Heart Center, Capital Medical University Affiliated Beijing Friendship Hospital, Beijing, China
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Pérez-López FR, Larrad-Mur L, Kallen A, Chedraui P, Taylor HS. Gender differences in cardiovascular disease: hormonal and biochemical influences. Reprod Sci 2010; 17:511-31. [PMID: 20460551 PMCID: PMC3107852 DOI: 10.1177/1933719110367829] [Citation(s) in RCA: 128] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Atherosclerosis is a complex process characterized by an increase in vascular wall thickness owing to the accumulation of cells and extracellular matrix between the endothelium and the smooth muscle cell wall. There is evidence that females are at lower risk of developing cardiovascular disease (CVD) as compared to males. This has led to an interest in examining the contribution of genetic background and sex hormones to the development of CVD. The objective of this review is to provide an overview of factors, including those related to gender, that influence CVD. METHODS Evidence analysis from PubMed and individual searches concerning biochemical and endocrine influences and gender differences, which affect the origin and development of CVD. RESULTS Although still controversial, evidence suggests that hormones including estradiol and androgens are responsible for subtle cardiovascular changes long before the development of overt atherosclerosis. CONCLUSION Exposure to sex hormones throughout an individual's lifespan modulates many endocrine factors involved in atherosclerosis.
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Affiliation(s)
- Faustino R Pérez-López
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Zaragoza, Clínico de Zaragoza Hospital, Zaragoza, Spain
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Abstract
PURPOSE OF REVIEW High-density lipoprotein (HDL) protects against atherosclerosis, transporting cholesterol from peripheral cells to the liver, where it is excreted into the bile. However, HDL also has prominent vascular protective effects. RECENT FINDINGS Recent studies have uncovered mechanisms through which HDL decreases vascular inflammation, boosts nitric oxide production, and inhibits thrombosis. The discovery that dysfunctional HDL can also have proinflammatory effects has uncovered a new aspect of HDL biology. SUMMARY Low-density lipoprotein is the primary target for drug therapy of dyslipidemias. Drugs that increase HDL also affect additional metabolic pathways. Development of selective drugs targeting key aspects of HDL metabolism may enable us to alter the composition of HDL and inhibit atherogenesis.
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Affiliation(s)
- Charles J Lowenstein
- Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York 14642, USA.
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Nofer JR, Brodde MF, Kehrel BE. High-density lipoproteins, platelets and the pathogenesis of atherosclerosis. Clin Exp Pharmacol Physiol 2010; 37:726-35. [PMID: 20337657 DOI: 10.1111/j.1440-1681.2010.05377.x] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
1. Prospective and interventional studies demonstrate an inverse relationship between plasma high-density lipoprotein (HDL)-cholesterol and the incidence of coronary artery disease. Although the atheroprotective effects of HDL are usually attributed to the reverse cholesterol transport, in which HDL shuttles cholesterol from cells in the arterial wall to the liver, other mechanisms are also under investigation. 2. Platelets are involved in both the initiation and progression of atherosclerotic lesions. In addition, the formation of thrombi over ruptured atherosclerotic plaques results in the narrowing or complete occlusion of coronary arteries. Current experimental evidence suggests that HDL may exert antiplatelet effects and thereby counteract the development of atherothrombotic vascular disease. 3. In vitro studies show that HDL inhibits agonist-stimulated platelet aggregation, fibrinogen binding, granule secretion and liberation of thromboxane A(2). Inhibitory effects of HDL are mediated, in part, by scavenger receptor type B1 and/or the apolipoprotein E receptor apoER2/LRP8 and are linked to the induction of intracellular signalling cascades encompassing stimulation of protein kinase C, cytoplasmatic alkalization and generation of nitric oxide. 4. Populational studies demonstrate that there is an inverse association between plasma HDL levels and recurrent venous thromboembolism. In addition, HDL-cholesterol has been identified as an independent predictor of acute platelet thrombus formation. The administration of reconstituted HDL particles in humans attenuates ex vivo platelet activation. 5. The present review summarizes recent advances in understanding HDL-platelet interactions and discusses the potential use of HDL-like particles in the therapy of thrombosis.
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Affiliation(s)
- Jerzy-Roch Nofer
- Center for Laboratory Medicine, University Hospital Münster, Münster, Germany.
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Extracellular hydrophobic regions in scavenger receptor BI play a key role in mediating HDL-cholesterol transport. Arch Biochem Biophys 2010; 496:132-9. [PMID: 20219439 DOI: 10.1016/j.abb.2010.02.011] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2010] [Revised: 02/18/2010] [Accepted: 02/23/2010] [Indexed: 01/26/2023]
Abstract
The binding of high density lipoprotein (HDL) to scavenger receptor BI (SR-BI) is responsible for whole-body cholesterol disposal via reverse cholesterol transport. The extracellular domain of SR-BI is required for HDL binding and selective uptake of HDL-cholesterol. We identified six highly hydrophobic regions in this domain that may be important for receptor activity and performed site-directed mutagenesis to investigate the importance of these regions in SR-BI-mediated cholesterol transport. Non-conservative mutation of the regions encompassing V67, L140/L142, V164 or V221 reduced hydrophobicity and impaired the ability of SR-BI to bind HDL, mediate selective uptake of HDL-cholesterol, promote cholesterol efflux, and enlarge the cholesterol oxidase-sensitive pool of membrane free cholesterol. In contrast, conservative mutations at V67, V164 or V221 did not affect the hydrophobicity or these cholesterol transport activities. We conclude that the hydrophobicity of N-terminal extracellular regions of SR-BI is critical for cholesterol transport, possibly by mediating receptor-ligand and/or receptor-membrane interactions.
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Sampietro T, Bigazzi F, Puntoni M, Minichilli F, Landi P, Dal Pino B, Carpeggiani C, L'Abbate A. Low high-density lipoprotein predicts death in patients with mild left ventricular dysfunction regardless of coronary atherosclerosis. J Cardiovasc Med (Hagerstown) 2009; 10:898-905. [DOI: 10.2459/jcm.0b013e32832e6682] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Calkin AC, Drew BG, Ono A, Duffy SJ, Gordon MV, Schoenwaelder SM, Sviridov D, Cooper ME, Kingwell BA, Jackson SP. Reconstituted High-Density Lipoprotein Attenuates Platelet Function in Individuals With Type 2 Diabetes Mellitus by Promoting Cholesterol Efflux. Circulation 2009; 120:2095-104. [PMID: 19901191 DOI: 10.1161/circulationaha.109.870709] [Citation(s) in RCA: 144] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Background—
Individuals with diabetes mellitus have an increased risk of cardiovascular disease and exhibit platelet hyperreactivity, increasing their resistance to antithrombotic therapies such as aspirin and clopidogrel. Reconstituted high-density lipoprotein (rHDL) has short-term beneficial effects on atherosclerotic plaques, but whether it can effectively reduce the reactivity of diabetic platelets is not known.
Methods and Results—
Individuals with type 2 diabetes mellitus were infused with placebo or rHDL (CSL-111; 20 mg · kg
−1
· h
−1
) for 4 hours, resulting in an ≈1.4-fold increase in plasma HDL cholesterol levels. rHDL infusion was associated with a >50% reduction in the ex vivo platelet aggregation response to multiple agonists, an effect that persisted in washed platelets. In vitro studies in platelets from healthy individuals revealed that the inhibitory effects of rHDL on platelet function were time and dose dependent and resulted in a widespread attenuation of platelet function and a 50% reduction in thrombus formation under flow. These effects could be recapitulated, in part, by the isolated phospholipid component of rHDL, which enhanced efflux of cholesterol from platelets and reduced lipid raft assembly. In contrast, the apolipoprotein AI component of rHDL had minimal effect on platelet function, cholesterol efflux, or lipid raft assembly.
Conclusion—
These findings suggest that rHDL therapy is highly effective at inhibiting the heightened reactivity of diabetic platelets, partly through reducing the cholesterol content of platelet membranes. These properties, combined with the known short-term beneficial effects of rHDL on atherosclerotic lesions, suggest that rHDL infusions may be an effective approach to reduce atherothrombotic complications in diabetic individuals.
Clinical Trial Registration Information—
URL: http://www.clinicaltrials.gov. Unique identifier: NCT00395148.
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Affiliation(s)
- Anna C. Calkin
- From the Diabetes Complications Laboratory (A.C.C., M.V.G., M.E.C.), Metabolic and Vascular Physiology Laboratory (B.G.D., S.J.D., B.A.K.), and Lipoproteins and Atherosclerosis Laboratory (D.S.), Baker IDI Heart and Diabetes Institute, and Australian Centre for Blood Diseases, Monash University (A.C.C., A.O., S.M.S., S.P.J.), Melbourne, Australia
| | - Brian G. Drew
- From the Diabetes Complications Laboratory (A.C.C., M.V.G., M.E.C.), Metabolic and Vascular Physiology Laboratory (B.G.D., S.J.D., B.A.K.), and Lipoproteins and Atherosclerosis Laboratory (D.S.), Baker IDI Heart and Diabetes Institute, and Australian Centre for Blood Diseases, Monash University (A.C.C., A.O., S.M.S., S.P.J.), Melbourne, Australia
| | - Akiko Ono
- From the Diabetes Complications Laboratory (A.C.C., M.V.G., M.E.C.), Metabolic and Vascular Physiology Laboratory (B.G.D., S.J.D., B.A.K.), and Lipoproteins and Atherosclerosis Laboratory (D.S.), Baker IDI Heart and Diabetes Institute, and Australian Centre for Blood Diseases, Monash University (A.C.C., A.O., S.M.S., S.P.J.), Melbourne, Australia
| | - Stephen J. Duffy
- From the Diabetes Complications Laboratory (A.C.C., M.V.G., M.E.C.), Metabolic and Vascular Physiology Laboratory (B.G.D., S.J.D., B.A.K.), and Lipoproteins and Atherosclerosis Laboratory (D.S.), Baker IDI Heart and Diabetes Institute, and Australian Centre for Blood Diseases, Monash University (A.C.C., A.O., S.M.S., S.P.J.), Melbourne, Australia
| | - Michelle V. Gordon
- From the Diabetes Complications Laboratory (A.C.C., M.V.G., M.E.C.), Metabolic and Vascular Physiology Laboratory (B.G.D., S.J.D., B.A.K.), and Lipoproteins and Atherosclerosis Laboratory (D.S.), Baker IDI Heart and Diabetes Institute, and Australian Centre for Blood Diseases, Monash University (A.C.C., A.O., S.M.S., S.P.J.), Melbourne, Australia
| | - Simone M. Schoenwaelder
- From the Diabetes Complications Laboratory (A.C.C., M.V.G., M.E.C.), Metabolic and Vascular Physiology Laboratory (B.G.D., S.J.D., B.A.K.), and Lipoproteins and Atherosclerosis Laboratory (D.S.), Baker IDI Heart and Diabetes Institute, and Australian Centre for Blood Diseases, Monash University (A.C.C., A.O., S.M.S., S.P.J.), Melbourne, Australia
| | - Dmitri Sviridov
- From the Diabetes Complications Laboratory (A.C.C., M.V.G., M.E.C.), Metabolic and Vascular Physiology Laboratory (B.G.D., S.J.D., B.A.K.), and Lipoproteins and Atherosclerosis Laboratory (D.S.), Baker IDI Heart and Diabetes Institute, and Australian Centre for Blood Diseases, Monash University (A.C.C., A.O., S.M.S., S.P.J.), Melbourne, Australia
| | - Mark E. Cooper
- From the Diabetes Complications Laboratory (A.C.C., M.V.G., M.E.C.), Metabolic and Vascular Physiology Laboratory (B.G.D., S.J.D., B.A.K.), and Lipoproteins and Atherosclerosis Laboratory (D.S.), Baker IDI Heart and Diabetes Institute, and Australian Centre for Blood Diseases, Monash University (A.C.C., A.O., S.M.S., S.P.J.), Melbourne, Australia
| | - Bronwyn A. Kingwell
- From the Diabetes Complications Laboratory (A.C.C., M.V.G., M.E.C.), Metabolic and Vascular Physiology Laboratory (B.G.D., S.J.D., B.A.K.), and Lipoproteins and Atherosclerosis Laboratory (D.S.), Baker IDI Heart and Diabetes Institute, and Australian Centre for Blood Diseases, Monash University (A.C.C., A.O., S.M.S., S.P.J.), Melbourne, Australia
| | - Shaun P. Jackson
- From the Diabetes Complications Laboratory (A.C.C., M.V.G., M.E.C.), Metabolic and Vascular Physiology Laboratory (B.G.D., S.J.D., B.A.K.), and Lipoproteins and Atherosclerosis Laboratory (D.S.), Baker IDI Heart and Diabetes Institute, and Australian Centre for Blood Diseases, Monash University (A.C.C., A.O., S.M.S., S.P.J.), Melbourne, Australia
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Hajer GR, van der Graaf Y, Bots ML, Algra A, Visseren FLJ. Low plasma HDL-c, a vascular risk factor in high risk patients independent of LDL-c. Eur J Clin Invest 2009; 39:680-8. [PMID: 19453647 DOI: 10.1111/j.1365-2362.2009.02155.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND High concentrations of high density lipoprotein-cholesterol (HDL-c) are associated with lower cardiovascular risk, but it is not known whether this is also the case in the presence of intensive low density lipoprotein-cholesterol (LDL-C) therapy. In this study, we determined the relationship between HDL-c and new non-fatal or fatal vascular events in patients with various manifestations of clinical evident vascular disease and evaluated whether this relationship is modified by LDL-c levels. MATERIALS AND METHODS Prospective single centre, cohort study of 3837 patients with a history or recent diagnosis of clinical manifest vascular disease (coronary, cerebrovascular, peripheral arterial disease or abdominal aortic aneurysm) The relationship between HDL-c quintiles and time to a new event (myocardial infarction, ischaemic stroke, vascular death) was quantified with Cox-regression models and adjusted for potential confounders (age, gender, body mass index, type 2 diabetes, triglycerides, smoking, use of alcohol and lipid-lowering therapy). Effect modification of LDL-c was assessed with interaction terms. RESULTS During a median follow up of 3.3 (range 0.1-9.5) years, a total of 465 first new events occurred. Compared with the lowest quintile, the upper quintile of HDL-c levels was associated with a lower risk for new events; Hazard Ratio 0.61 (95% CI 0.43-0.86) irrespective of the localisation of vascular disease and use of lipid-lowering medication. Higher HDL-c levels were associated with comparably lower risks for vascular events in patients with LDL-c levels above and below 2.5 mmol L(-1) (P-values for interaction > 0.05). CONCLUSIONS Patients with various clinical manifestations of vascular diseases in the highest HDL-c quintile have a lower risk for vascular events compared with patients in the lowest HDL-c quintile. Further, the current results expand the evidence by showing that also in a cohort of patients with various localisations of clinical evident vascular disease, in which statins were widely used, higher HDL-c levels confer a lower risk for developing new vascular events, irrespective of the localisation of vascular disease, use of lipid-lowering medication and plasma LDL-c concentration.
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Affiliation(s)
- G R Hajer
- Department of Vascular Medicine, University Medical Center Utrecht, Utrecht, the Netherlands
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Sala C, Rescaldani M, Santin E, Bolla G, Cuspidi C. Clinical and functional correlates of platelet cyclic GMP in essential hypertensives. Am J Hypertens 2009; 22:674-9. [PMID: 19325534 DOI: 10.1038/ajh.2009.60] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Platelets play a central role in atherothrombosis, which is responsible of major cardiovascular complications in human hypertension. Nitric oxide (NO) inhibits platelet aggregation via the second messenger cyclic guanosine monophosphate (cGMP). In essential hypertensives (EHs), we examined the relationship between platelet cGMP and clinical, hemodynamic, humoral variables as well as the responses to aggregating agents. METHODS In untreated EHs (male/female 106/43, age 44.4 +/- 1.1 years, smokers yes/no 38/111), blood pressure (BP), heart rate (HR), and stroke volume (SV) (impedance cardiography) were assessed after supine rest and venous blood was sampled for platelet cGMP (radioimmunoassay on acid extracts of washed platelets), plasma cGMP, atrial natriuretic peptide (ANP), renin activity, aldosterone and platelet aggregation to epinephrine (EPI, 5 micromol/l), and adenosine diphosphate (ADP) (4 micromol/l) (optical aggregometry on platelet-rich plasma (PRP)). RESULTS Platelet cGMP (7.0 +/- 0.3 pmol/10(9) cells, mean +/- s.e.m.) was lower in males and smokers than in their counterparts (P < 0.01 for both). Among the variables tested, platelet cGMP was related to number of cigarettes (-0.21), high-density lipoprotein cholesterol (HDLc) (r = 0.32), aldosterone (r = -0.21), and hemoglobin (-0.16); in a multivariate analysis that also included sex, HDLc was the best predictor of platelet cGMP. The aggregating response to EPI (r = -0.28), but not to ADP (r = -0.07, ns), was inversely related to platelet cGMP levels. CONCLUSIONS cGMP in resting platelets of EHs is positively predicted by HDLc and is inversely related to the aggregating response to EPI. It is suggested that a defect of the platelet NO/cGMP system could identify uncomplicated EHs at higher risk of thrombotic events during surges of sympathetic activity.
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van Wijk DF, Stroes ESG, Monajemi H. Changing paradigm in HDL metabolism and cellular effects. ACTA ACUST UNITED AC 2009. [DOI: 10.2217/17584299.4.1.17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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