1
|
Hoang Ngo T, Tran Khuong Nguyen N, Thi Ngoc Pham N, Tran BLT, Tuan Huynh A, Duy Nguyen K, Duy Nguyen K, Tran AV. The combination of CYP2C19 polymorphism and inflammatory cell ratios in prognosis cardiac adverse events after acute coronary syndrome. INTERNATIONAL JOURNAL OF CARDIOLOGY. CARDIOVASCULAR RISK AND PREVENTION 2023; 19:200222. [PMID: 37920809 PMCID: PMC10618803 DOI: 10.1016/j.ijcrp.2023.200222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 10/16/2023] [Accepted: 10/18/2023] [Indexed: 11/04/2023]
Abstract
Background CYP2C19 gene polymorphism combination with inflammatory cell ratios was significant in the prognosis of coronary heart disease. Materials and methods A cross-sectional analysis study, with 6 months follow-up on 142 patients with acute coronary syndrome. Patients were analyzed for CYP2C19 gene polymorphisms by real-time polymerase chain reaction (PCR) and complete blood count to determine inflammatory cell ratios and recorded cardiovascular events (CEs) after following up to 6 months. Results For 90-day CEs, CYP2C19 gene polymorphism (Hazard Ratio (HR): 1.965, 95 % Confidence Interval (CI): 1.012-3.814), the combination of a neutrophil and lymphocyte ratio (NLR) ≥ 2.982 (HR: 13.001, 95 % CI: 1.37-97.304) or a platelet to lymphocyte ratio (PLR) ≥ 162.42 (HR: 2.878, 95 % CI: 1.212-6.835) was independent predictors of CEs. For 180-day CEs, CYP2C19 gene polymorphism combination with NLR ≥3.02 (HR: 13.946, 95 % CI: 1.833-106.121) or PLR ≥160.38 (HR: 5.349, 95 % CI: 1.379-20.745) or monocyte to lymphocyte ratio (MLR) ≥ 0.3 (HR: 4.699, 95 % CI: 1.032-31.393) were independent predictors of CEs. Conclusion NLR, PLR or MLR combined with CYP2C19 gene polymorphism were stronger independent predictors of cardiovascular events in patients with acute coronary syndromes compared to CYP2C19 gene polymorphism and inflammatory cell ratios separately. CYP2C19 polymorphism and high NLR was the strongest predictor of both CEs at 90 days and 180 days.
Collapse
Affiliation(s)
- Toan Hoang Ngo
- Department of Internal Medicine, Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho City, 90000, Viet Nam
| | - Nha Tran Khuong Nguyen
- Department of Internal Medicine, Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho City, 90000, Viet Nam
| | - Nga Thi Ngoc Pham
- Department of Internal Medicine, Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho City, 90000, Viet Nam
| | - Bao Lam Thai Tran
- Department of Internal Medicine, Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho City, 90000, Viet Nam
| | - An Tuan Huynh
- Department of Internal Medicine, Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho City, 90000, Viet Nam
| | - Khue Duy Nguyen
- Department of Interventional Cardiovascular and Neurology, Can Tho University of Medicine and Pharmacy Hospital, Can Tho City, 90000, Viet Nam
| | - Khuong Duy Nguyen
- Department of Internal Medicine, Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho City, 90000, Viet Nam
| | - An Viet Tran
- Department of Internal Medicine, Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho City, 90000, Viet Nam
| |
Collapse
|
2
|
Vu HTT, Norman R, Pham NM, Nguyen HTT, Pham HM, Nguyen QN, Do LD, Tran HB, Huxley RR, Lee CMY, Hoang TM, Reid CM. Outcomes following the percutaneous coronary intervention in contemporary Vietnamese practice: Insight from a single centre prospective cohort. Heart Lung 2021; 50:634-639. [PMID: 34091109 DOI: 10.1016/j.hrtlng.2021.04.017] [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: 08/14/2020] [Revised: 03/31/2021] [Accepted: 04/01/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Evidence regarding the outcomes of percutaneous coronary intervention (PCI) in low-and-middle incomes countries remains limited. OBJECTIVES To report the outcomes post PCI at discharge, 30 days and 12 months in Vietnam and identify the key factors associated with adverse outcomes at 12 months. METHODS We used data from a single centre prospective cohort in Vietnam. Data regarding demographics, clinical presentation, procedural information, and outcomes of patients were collected and analysed. Primary outcomes were mortality and major adverse cardiac and cerebrovascular events. RESULTS In total, 926 patients were included. Poor outcomes were relatively low in those undergoing PCI. Predictors of mortality and major adverse cardiac and cerebrovascular events at 12 months post-PCI included being older than 75, being male, having acute myocardial infarction, left ventricular ejection fraction ≤ 40%, prior cerebral vascular disease and having an unsuccessful PCI. CONCLUSIONS Adverse outcomes of patients undergoing PCI in Vietnam are relatively low in comparison with those reported in other countries across the Asia Pacific region. Identification of factors associated with poor outcomes is beneficial for improving the quality of cardiac care and developing the prediction model of outcomes post-PCI in Vietnam.
Collapse
Affiliation(s)
- Hoa T T Vu
- School of Public Health, Curtin University, Perth, Australia; Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen, Vietnam
| | - Richard Norman
- School of Public Health, Curtin University, Perth, Australia
| | - Ngoc M Pham
- School of Public Health, Curtin University, Perth, Australia; Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen, Vietnam; Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | | | - Hung M Pham
- Vietnam National Heart Institute, Hanoi, Vietnam
| | | | - Loi D Do
- Vietnam National Heart Institute, Hanoi, Vietnam
| | - Hieu B Tran
- Vietnam National Heart Institute, Hanoi, Vietnam
| | - Rachel R Huxley
- School of Public Health, Curtin University, Perth, Australia; Faculty of Health, Deakin University, Melbourne, Australia; The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Crystal M Y Lee
- School of Public Health, Curtin University, Perth, Australia; School of Psychology and Public Health, La Trobe University, Melbourne, Australia; Boden Collaboration for Obesity, Nutrition, Exercise & Eating Disorders, University of Sydney, Sydney, Australia
| | - Tu M Hoang
- Thai Nguyen National Hospital, Thai Nguyen, Vietnam
| | | |
Collapse
|
3
|
The Role of Colchicine in Acute Coronary Syndromes. Clin Ther 2019; 41:11-20. [DOI: 10.1016/j.clinthera.2018.07.023] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 07/29/2018] [Indexed: 12/23/2022]
|
4
|
AlKhalfan F, Kerneis M, Nafee T, Yee MK, Chi G, Plotnikov A, Braunwald E, Gibson CM. D-Dimer Levels and Effect of Rivaroxaban on Those Levels and Outcomes in Patients With Acute Coronary Syndrome (An ATLAS ACS-TIMI 46 Trial Substudy). Am J Cardiol 2018; 122:1459-1464. [PMID: 30217378 DOI: 10.1016/j.amjcard.2018.07.032] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 07/17/2018] [Accepted: 07/19/2018] [Indexed: 11/19/2022]
Abstract
D-dimer has been used as both a diagnostic and prognostic biomarker in the assessment of patients with venous thromboembolism, but its prognostic value in the setting of arterial acute coronary syndromes (ACS) and the ability of pharmacotherapy to reduce D-dimer in ACS is less well characterized. It was hypothesized that elevated baseline D-dimer would be associated with poor clinical outcomes in ACS, and that Factor Xa inhibition with Rivaroxaban would reduce D-dimer acutely and chronically. The ATLAS ACS TIMI-46 trial assessed the safety and efficacy of rivaroxaban compared with placebo in ACS patients. A subset of subjects had a D-dimer measured at baseline (n = 1,834, 52.5%). A univariate and multivariable logistic regression assessed the relation between baseline D-dimer and a composite end point of cardiovascular death, myocardial infarction, or stroke through 6 months. The Wilcoxon rank sum test was used to compare change in D-dimer level between the treatment groups from baseline. Baseline D-dimer was associated with the composite efficacy outcome in a univariate logistic regression (odds ratio 1.15, 95% confidence interval 1.03 to 1.29, p = 0.015) and a multivariable logistic regression (odds ratio 1.13, 95% confidence interval 1.00 to 1.28, p = 0.048). Rivaroxaban administration lowered D-dimer levels compared wth placebo after administration of the first dose of study drug (p = 0.026), at day 30 (p < 0.001) and day 180 (p < 0.001). In conclusion, elevated baseline D-dimer was associated with an increased risk of the composite outcome within 6 months of the ACS event and administration of the Factor Xa inhibitor rivaroxaban was associated with lower D-dimer levels compared with placebo after the first dose, at day 30 and day 180.
Collapse
Affiliation(s)
- Fahad AlKhalfan
- Division of Cardiovascular Medicine, The PERFUSE Study Group, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Mathieu Kerneis
- Division of Cardiovascular Medicine, The PERFUSE Study Group, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Tarek Nafee
- Division of Cardiovascular Medicine, The PERFUSE Study Group, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Megan K Yee
- Division of Cardiovascular Medicine, The PERFUSE Study Group, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Gerald Chi
- Division of Cardiovascular Medicine, The PERFUSE Study Group, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Alexei Plotnikov
- Johnson & Johnson Pharmaceutical Research and Development, Raritan, New Jersey
| | - Eugene Braunwald
- Division of Cardiovascular Medicine, TIMI Study Group, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - C Michael Gibson
- Division of Cardiovascular Medicine, The PERFUSE Study Group, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
| |
Collapse
|
5
|
Montenegro Sá F, Ruivo C, Graça Santos L, Antunes A, Campos Soares F, Baptista J, Morais J. Progressão ultrarrápida de doença coronária ou placa instável não detetada? Rev Port Cardiol 2018; 37:259-264. [DOI: 10.1016/j.repc.2017.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2017] [Revised: 04/05/2017] [Accepted: 04/15/2017] [Indexed: 11/28/2022] Open
|
6
|
Montenegro Sá F, Ruivo C, Graça Santos L, Antunes A, Soares FC, Baptista J, Morais J. Ultra-rapid progression of coronary artery disease or undiagnosed unstable plaque? A brief review from a case report. REVISTA PORTUGUESA DE CARDIOLOGIA (ENGLISH EDITION) 2018. [DOI: 10.1016/j.repce.2018.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
7
|
Gao X, Mu J, Guan S, Li Q, Du Y, Zhang H, Bi K. Simultaneous determination of phenolic acids and diterpenoids and their comparative pharmacokinetic study in normal and acute blood stasis rats by UFLC–MS/MS after oral administration of Guan-Xin-Shu-Tong capsules. J Chromatogr B Analyt Technol Biomed Life Sci 2018; 1072:221-228. [DOI: 10.1016/j.jchromb.2017.11.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 11/03/2017] [Accepted: 11/13/2017] [Indexed: 12/31/2022]
|
8
|
Capodanno D, Angiolillo DJ. Canakinumab for secondary prevention of atherosclerotic disease. Expert Opin Biol Ther 2017; 18:215-220. [DOI: 10.1080/14712598.2018.1420776] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Davide Capodanno
- Division of Cardiology, Cardio-Thoracic-Vascular Department, Azienda Ospedaliero Universitaria “Policlinico-Vittorio Emanuele” and Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Dominick J. Angiolillo
- Division of Cardiology, Department of Medicine, University of Florida College of Medicine – Jacksonville, Jacksonville, FL, USA
| |
Collapse
|
9
|
Vaidya K, Arnott C, Martínez GJ, Ng B, McCormack S, Sullivan DR, Celermajer DS, Patel S. Colchicine Therapy and Plaque Stabilization in Patients With Acute Coronary Syndrome: A CT Coronary Angiography Study. JACC Cardiovasc Imaging 2017; 11:305-316. [PMID: 29055633 DOI: 10.1016/j.jcmg.2017.08.013] [Citation(s) in RCA: 172] [Impact Index Per Article: 24.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 08/03/2017] [Accepted: 08/04/2017] [Indexed: 01/10/2023]
Abstract
OBJECTIVES The authors sought to evaluate the plaque-modifying effects of low-dose colchicine therapy plus optimal medical therapy (OMT) in patients post-acute coronary syndrome (ACS), as assessed by coronary computed tomography angiography (coronary CTA). BACKGROUND Colchicine therapy has been postulated to have beneficial anti-inflammatory effects in patients with ACS, translating into reduction in future adverse cardiovascular events. However, whether favorable plaque modification underpins this is yet unproven. METHODS In this prospective nonrandomized observational study of 80 patients with recent ACS (<1 month), patients received either 0.5 mg/day colchicine plus OMT or OMT alone and were followed for 1 year. Our primary outcome was change in low attenuation plaque volume (LAPV), a marker of plaque instability on coronary CTA and robust predictor of adverse cardiovascular events. Secondary outcomes were changes in other coronary CTA measures and in high-sensitivity C-reactive protein (hsCRP). RESULTS Mean duration of follow-up was 12.6 months; mean age was 57.4 years. Colchicine therapy significantly reduced LAPV (mean 15.9 mm3 [-40.9%] vs. 6.6 mm3 [-17.0%]; p = 0.008) and hsCRP (mean 1.10 mg/l [-37.3%] vs. 0.38 mg/l [-14.6%]; p < 0.001) versus controls. Reductions in total atheroma volume (mean 42.3 mm3 vs. 26.4 mm3; p = 0.28) and low-density lipoprotein levels (mean 0.44 mmol/l vs. 0.49 mmol/l; p = 0.21) were comparable in both groups. With multivariate linear regression, colchicine therapy remained significantly associated with greater reduction in LAPV (p = 0.039) and hsCRP (p = 0.004). There was also a significant linear association (p < 0.001) and strong positive correlation (r = 0.578) between change in LAPV and hsCRP. CONCLUSIONS Our findings suggest, for the first time, that low-dose colchicine therapy favorably modifies coronary plaque, independent of high-dose statin intensification therapy and substantial low-density lipoprotein reduction. The improvements in plaque morphology are likely driven by the anti-inflammatory properties of colchicine, as demonstrated by reductions in hsCRP, rather than changes in lipoproteins. Colchicine may be beneficial as an additional secondary prevention agent in patients post-ACS if validated in future studies.
Collapse
Affiliation(s)
- Kaivan Vaidya
- Department of Cardiology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Clare Arnott
- Department of Cardiology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia; Sydney Medical School, The University of Sydney, New South Wales, Australia
| | - Gonzalo J Martínez
- The Heart Research Institute, Sydney, New South Wales, Australia; Division of Cardiovascular Diseases, Pontificia Universidad Católica Hospital, Santiago, Chile
| | - Bernard Ng
- Department of Radiology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Samuel McCormack
- Department of Radiology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - David R Sullivan
- Sydney Medical School, The University of Sydney, New South Wales, Australia; Charles Perkins Centre, The University of Sydney, New South Wales, Australia; Department of Biochemistry, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - David S Celermajer
- Department of Cardiology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia; Sydney Medical School, The University of Sydney, New South Wales, Australia; The Heart Research Institute, Sydney, New South Wales, Australia
| | - Sanjay Patel
- Department of Cardiology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia; Sydney Medical School, The University of Sydney, New South Wales, Australia; The Heart Research Institute, Sydney, New South Wales, Australia; Charles Perkins Centre, The University of Sydney, New South Wales, Australia.
| |
Collapse
|
10
|
Amorim FG, Campagnaro BP, Tonini CL, Norbim APC, Louro ID, Vasquez EC, Arruda JA, Meyrelles SS. Association of interleukin-6 gene polymorphism with angina pectoris. Angiology 2011; 62:549-53. [PMID: 21421628 DOI: 10.1177/0003319711398862] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
In this study, we investigated the role of the -174G>C polymorphism of interleukin-6 (IL-6) as a predisposing factor to angina pectoris. Patients were separated into 2 groups: angina (N = 72) and nonangina (N = 71). There were no statistical differences between groups for all cardiovascular risk factors evaluated. The GG genotype frequency was 18% lower in the angina than in the non-angina group, whereas GC + CC was 18% higher in the angina group (P = .036). The frequency of G allele was 11% lower in the angina than in the nonangina group and C allele was 11% higher in the angina group (P = .043). Patients carrying the C allele showed a 2-fold increased risk for angina pectoris (P = .036). Our study demonstrates a high incidence of the -174G>C polymorphism of the IL-6 gene in patients with angina pectoris compared with those carrying the G allele, reinforcing the contribution of genetic factors to the symptoms of angina pectoris.
Collapse
Affiliation(s)
- Fernanda Gobbi Amorim
- Biotechnology Graduate Program, Health Sciences Center, Federal University of Espirito Santo, Av. Marechal Campos 1468, Vitoria, Espirito Santo, Brazil
| | | | | | | | | | | | | | | |
Collapse
|
11
|
Rizzello V, Liuzzo G, Trabetti E, Di Giannuario G, Brugaletta S, Santamaria M, Piro M, Boccanelli A, Pignatti PF, Biasucci LM, Crea F. Role of the CD14 C(−260)T promoter polymorphism in determining the first clinical manifestation of coronary artery disease. J Cardiovasc Med (Hagerstown) 2010; 11:20-5. [DOI: 10.2459/jcm.0b013e328330e9fb] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
12
|
Variaciones diurnas de los biomarcadores en la medicina cardiovascular: importancia clínica. Rev Esp Cardiol 2009; 62:1340-1. [DOI: 10.1016/s0300-8932(09)73092-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
|
13
|
Frazier L, Vaughn WK, Willerson JT, Ballantyne CM, Boerwinkle E. Inflammatory protein levels and depression screening after coronary stenting predict major adverse coronary events. Biol Res Nurs 2009; 11:163-73. [PMID: 19251718 DOI: 10.1177/1099800409332801] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Traditional risk factors cannot account for the majority of future major adverse coronary events (MACE) in patients diagnosed with heart disease. We examined levels of inflammatory proteins to be possible predictors of future MACE and physiological and psychological factors that initiate temporal increases in inflammatory protein levels. METHODS Peripheral blood samples and depression data were collected 4 to 12 hr after elective coronary stent insertion in 490 patients. Depression screening was assessed by a single-question screening tool. Predictive modeling for future MACE was performed by using survival analysis, with time from the index event (placement of the stent) to future MACE as the dependent variable. RESULTS Patients with high-sensitivity c-reactive protein (hsCRP) in the second and third quartiles were 3 and 2.5 times more likely to have a MACE than patients with hsCRP in the first quartile, respectively. As levels of vascular cell adhesion molecule and monocyte chemoattractant protein-1 increased, so did the risk of future MACE. Patients who screened positive for depression were approximately 2 times more likely to have a MACE within 24 months after stent placement than were patients who did not screen positive. CONCLUSIONS Our results suggest that hsCRP, vascular cell adhesion molecule, and monocyte chemoattractant protein-1 levels, measured after coronary stent insertion in patients with coronary heart disease, are prognostic of future MACE. Furthermore, positive depression screening is an independent predictor of future MACE.
Collapse
Affiliation(s)
- Lorraine Frazier
- School of Nursing, Texas Heart Institute at St. Luke's Episcopal Hospital, Houston, Texas 77030, USA.
| | | | | | | | | |
Collapse
|
14
|
Bernardo E, Angiolillo DJ, Ramírez C, Cavallari U, Trabetti E, Sabaté M, Hernández R, Moreno R, Escaned J, Alfonso F, Bañuelos C, Costa MA, Bass TA, Pignatti PF, Macaya C, Fernandez-Ortiz A. Influence of the CD14 C260T promoter polymorphism on C-reactive protein levels in patients with coronary artery disease. Am J Cardiol 2006; 98:1182-4. [PMID: 17056323 DOI: 10.1016/j.amjcard.2006.06.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2006] [Revised: 06/05/2006] [Accepted: 06/05/2006] [Indexed: 11/18/2022]
Abstract
The CD14 receptor is an important mediator of inflammatory reactions, and its expression is under genetic control. The allelic variant of the C260T polymorphism located in the promoter region of the CD14 gene is associated with receptor expression and ischemic risk. To date, most studies assessing the functional implications of the C260T polymorphism have been performed under proinflammatory conditions (e.g., acute coronary syndromes), and whether gene sequence variations of the CD14 receptor have any functional effect on systemic inflammation in patients in a stable phase of their atherosclerotic disease process is unknown. Eighty-two patients with stable coronary artery disease were studied. High-sensitivity C-reactive protein (hs-CRP) was used as a measurement of systemic inflammation. The genotype distribution of the C260T polymorphism of the CD14 gene was as follows: CC in 18 of 82 patients (22%), TC in 48 of 82 patients (58.5%), and TT in 16 of 82 patients (19.5%). TT subjects had increased hs-CRP levels compared with carriers of the C allele (p = 0.04). A higher percentage of T allele homozygotes had hs-CRP levels >0.3 mg/dl (p = 0.01). Homozygosis status of the T allele was independently associated with hs-CRP levels >0.3 mg/dl (p = 0.004). In conclusion, these observations may support the findings in large-scale studies that T homozygotes of this functional polymorphism are at increased ischemic risk.
Collapse
Affiliation(s)
- Esther Bernardo
- Cardiovascular Institute, San Carlos University Hospital, Madrid, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
15
|
Jiménez-Quevedo P, Sabaté M, Angiolillo D, Alfonso F, Hernández-Antolín R, Bañuelos C, Bernardo E, Ramirez C, Moreno R, Fernández C, Escaned J, Macaya C. LDL-cholesterol predicts negative coronary artery remodelling in diabetic patients: an intravascular ultrasound study. Eur Heart J 2005; 26:2307-12. [PMID: 16037102 DOI: 10.1093/eurheartj/ehi420] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
AIMS To investigate the relationship between coronary artery remodelling and glycaemic and lipid profiles in diabetic patients. METHODS AND RESULTS Intravascular ultrasound analyses of 131 angiographically non-significant coronary stenoses in 80 diabetic patients were performed. The remodelling index (RI) was calculated as the ratio between total vessel area at target site and total vessel area at proximal reference, and was assessed in two ways: as a continuous variable, and as a binary categorical variable: RI<1 namely, negative remodelling (group I), or RI> or =1 (group II). Percentage cross-sectional narrowing was 57+/-13%. On average, RI was 0.93+/-0.13. Coronary shrinkage was found in 94 (71.7%) lesions. Significant inverse correlations were demonstrated between RI and total cholesterol (r=-0.26, P=0.003), apolipoprotein-B (r=-0.23, P=0.01) and LDL-cholesterol (r=-0.3, P=0.001) levels. Multivariable lineal regression analysis identified LDL-cholesterol as the only independent predictor of RI (P=0.001). CONCLUSION Negative remodelling is a frequent finding in diabetics and it is associated with LDL-cholesterol levels. This may contribute to the diffuse coronary artery disease observed in diabetic patients.
Collapse
Affiliation(s)
- Pilar Jiménez-Quevedo
- Interventional Cardiology Unit, Cardiovascular Institute, Hospital Clínico San Carlos, C/Prof. Martín Lagos s/n, 28040 Madrid, Spain
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Abstract
The behavior and composition of coronary atherosclerotic plaques are ultimately responsible for the threat of acute ischemic events in patients with coronary artery disease. Different imaging modalities have been developed over the last several years in order to better characterize the atherosclerotic plaque and attempt to predict those in peril of complication. Since its implementation into cardiovascular medicine, nearly 40 years ago, coronary angiography has been the mainstay of identifying hemodynamically stenotic lesions. Further investigation into imaging modalities have suggested, however, that the degree of stenosis is only one of several factors influencing a plaque's tendency to rupture. Recent advances in imaging modalities, including invasive and non-invasive studies, have allowed us to examine the histological components that comprise these plaques. Specific information such as variations in temperature, plaque stiffness and calcification level is currently being researched as well as biological and chemical markers. The ultimate goal is to visualize the plaque and its characteristics, stratify its risk for acute events, be able to apply this modality to the general population of cardiac patients, while exposing the patient to minimal risk and having adequate positive and negative predictive values. This manuscript will review the more recent data concerning these interventions and their individual characteristics.
Collapse
Affiliation(s)
- Mario A Pulido
- Division of Cardiology and Cardiovascular Imaging Core Laboratories, The Cardiovascular Center, University of Florida, Shands Jacksonville, FL 32209, USA
| | | | | |
Collapse
|