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Jiang Y, Yang ZG, Wang J, Jiang L, Han PL, Shi R, Li Y. Type 2 diabetes mellitus aggravates coronary atherosclerosis in hypertensive individuals based on coronary CT angiography: a retrospective propensity score-based study. Front Cardiovasc Med 2024; 11:1372519. [PMID: 38836061 PMCID: PMC11149417 DOI: 10.3389/fcvm.2024.1372519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 05/06/2024] [Indexed: 06/06/2024] Open
Abstract
Background The effect of type 2 diabetes mellitus (T2DM) on coronary atherosclerosis detected on coronary computed tomography angiography (CCTA) in hypertensive patients has attracted increasing attention. This study investigated the relationships of T2DM with coronary artery plaque characteristics and semiquantitative CCTA scores in hypertensive patients. Materials and methods In this single-center study, 1,700 hypertensive patients, including 850 T2DM [HT(T2DM+)] and 850 non-T2DM [HT(T2DM-)] individuals, were retrospectively analyzed after propensity matching. Plaque type, extent, coronary stenosis, segment involvement score (SIS), segment stenosis score (SSS), and CT-based Leaman score (CT-LeSc) based on CCTA were assessed and compared between the two groups. Results HT(T2DM+) patients had more coronary segments with calcified plaque (2.08 ± 2.20 vs. 1.40 ± 1.91), mixed plaque (2.90 ± 2.87 vs. 2.50 ± 2.66), nonobstructive stenosis (4.23 ± 2.44 vs. 3.62 ± 2.42), and obstructive stenosis (1.22 ± 2.18 vs. 0.78 ± 1.51), a lower proportion of 1-vessel disease (15.3% vs. 25.5%), a higher proportion of 3-vessel disease (59.6% vs. 46.7%), and higher SIS (5.5 ± 3.1 vs. 4.4 ± 3.0), SSS (10.3 ± 8.5 vs. 7.7 ± 7.1), and CT-LeSc (9.4 ± 5.6 vs. 7.9 ± 5.2) than HT(T2DM-) patients (all P-values <0.05). Multivariable analysis revealed that T2DM was an independent risk factor for calcified plaque [odds ratio (OR) = 2.213], obstructive coronary artery disease (CAD) (OR = 1.271), multivessel disease (OR = 1.838), SIS > 4 (OR = 1.910), SSS > 6 (OR = 1.718), and CT-LeSc > 5 (OR = 1.584) in hypertension population (all P-values <0.05). Conclusion T2DM was independently associated with the presence of calcified coronary artery plaque and increased the risk of obstructive CAD, multivessel disease, and CT-LeSc > 5 in hypertensive patients. More attention should be given to the assessment and management for coronary atherosclerosis in hypertensive patients with T2DM, as this population may have a higher risk of cardiovascular events.
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Affiliation(s)
- Yu Jiang
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zhi-Gang Yang
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jin Wang
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Li Jiang
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Pei-Lun Han
- West China Biomedical Big Data Centre, West China Hospital, Sichuan University, Chengdu, China
| | - Rui Shi
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yuan Li
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Kelly C, Gurung R, Kamng'ona R, Sheha I, Chammudzi M, Jambo K, Mallewa J, Rapala A, Heyderman R, Mallon P, Mwandumba H, Khoo S, Klein N. Circulating microparticles are increased amongst people presenting with HIV and advanced immune suppression in Malawi and correlate closely with arterial stiffness: a nested case control study. Wellcome Open Res 2022; 6:264. [PMID: 36300175 PMCID: PMC9577278 DOI: 10.12688/wellcomeopenres.17044.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2022] [Indexed: 11/20/2022] Open
Abstract
Background: We aim to investigate whether circulating microparticle (CMPs) subsets were raised amongst people presenting with a new diagnosis of HIV and advanced immune suppression in Malawi, and whether they associated with arterial stiffness. Methods: Microparticle characterisation and carotid femoral Pulse Wave Velocity (cfPWV) were carried out in a cohort of adults with a new HIV diagnosis and CD4 <100 cells/µL at 2 weeks post ART initiation. HIV uninfected controls were matched on age, systolic BP and diastolic BP in a 1:1 ratio. Circulating microparticles were identified from platelet poor plasma and stained for endothelial, leucocyte, monocyte and platelet markers. Results: The median (IQ) total CMP count for 71 participants was 1 log higher in HIV compared to those without (p<0.0001) and was associated with arterial stiffness (spearman rho 0.47, p<0.001). In adjusted analysis, every log increase in circulating particles showed a 20% increase in cfPWV (95% CI 4 - 40%, p=0.02). In terms of subsets, endothelial and platelet derived microparticles were most strongly associated with HIV. Endothelial derived E-selectin+ CMPs were 1.3log-fold higher and platelet derived CD42a+ CMPs were 1.4log-fold higher (both p<0.0001). Endothelial and platelet derived CMPs also correlated most closely with arterial stiffness [spearman rho: E-selectin+ 0.57 and CD42a 0.56, both p<0.0001). Conclusions: Circulating microparticles associate strongly with arterial stiffness among PLWH in Malawi. Endothelial and platelet microparticles are the predominant cell origin types, indicating that platelet driven endothelial dysfunction pathways warrant further investigation in HIV associated arterial stiffness.
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Affiliation(s)
- Christine Kelly
- Centre for Experimental Pathogen Host Research, UCD, Dublin, Ireland
- Malawi-Liverpool-Wellcome Clinical Research Programme, Blantyre, Malawi, Malawi
- Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - Rijan Gurung
- Institute of Infection, immunity and Inflammation, UCL, London, UK
| | - Raphael Kamng'ona
- Malawi-Liverpool-Wellcome Clinical Research Programme, Blantyre, Malawi, Malawi
| | - Irene Sheha
- Malawi-Liverpool-Wellcome Clinical Research Programme, Blantyre, Malawi, Malawi
| | - Mishek Chammudzi
- Malawi-Liverpool-Wellcome Clinical Research Programme, Blantyre, Malawi, Malawi
| | - Kondwani Jambo
- Malawi-Liverpool-Wellcome Clinical Research Programme, Blantyre, Malawi, Malawi
- Liverpool School of Tropical Medicine, LSTM, Liverpool, UK
| | - Jane Mallewa
- College of Medicine, University of Malawi, Blantyre, Malawi
| | - Alicja Rapala
- Institute of Cardiovascular Science, UCL, London, UK
| | - Rob Heyderman
- Malawi-Liverpool-Wellcome Clinical Research Programme, Blantyre, Malawi, Malawi
- Institute of Infection, immunity and Inflammation, UCL, London, UK
| | - Patrick Mallon
- Centre for Experimental Pathogen Host Research, UCD, Dublin, Ireland
| | - Henry Mwandumba
- Malawi-Liverpool-Wellcome Clinical Research Programme, Blantyre, Malawi, Malawi
- Liverpool School of Tropical Medicine, LSTM, Liverpool, UK
| | - Saye Khoo
- Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - Nigel Klein
- Institute of Infection, immunity and Inflammation, UCL, London, UK
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Serum CTRP9 Reflects Coronary Collateralization in Nondiabetic Patients with Obstructive Coronary Artery Disease. BIOMED RESEARCH INTERNATIONAL 2022; 2022:8537686. [PMID: 35309173 PMCID: PMC8930261 DOI: 10.1155/2022/8537686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 02/14/2022] [Accepted: 02/15/2022] [Indexed: 11/17/2022]
Abstract
Aim. To explore the association between the serum C1q/tumor necrosis factor-related protein 9 (CTRP9) and the formation of coronary collateral circulation in obstructive coronary artery disease (CAD). Methods. A total of 206 patients who underwent coronary angiography at Beijing Anzhen Hospital and had epicardial arteries with at least 95% stenotic lesion were enrolled. Blood samples were taken after an overnight fasting before the coronary angiography. Serum CTRP9 level was measured using commercial enzyme linked immunosorbent assay (ELISA) kit. The development of coronary collateralization was determined according to the Rentrop classification system. Rentrop score 0-1 was graded as impaired or less-developed coronary collateralization (
) while the Rentrop score 2-3 was defined as well-developed collateralization (
). Results. Serum CTRP9 level was significantly higher in well-developed collateralization and diabetes groups (
). To further explore the association between the CTRP9 level and coronary collateralization, the enrolled participants were divided into 3 tertiles according to the serum CTRP9 level. The prevalence of impaired coronary collateralization decreased stepwise with the increasing CTRP9 tertiles (
for trend <0.001). Multivariate regression analysis showed that the serum CTRP9 is independently associated with well-developed collateralization, with an OR (95% CI) of 4.49 (1.75-11.55) and 8.98 (2.75-29.35) in the tertiles 2 and 3, respectively. The following subgroup and receiver-operating characteristic (ROC) analysis also indicated that the diagnostic value of serum CTRP9 level for detecting the formation of collateralization persisted only in nondiabetic participants. Lastly, adding the serum CTRP9 into the baseline model could increase the diagnostic value of established model consisting of relevant factor for the discrimination of well-developed collateralization only in the nondiabetic group (
). Conclusions. Serum CTRP9 reflects well-developed coronary collateralization in nondiabetic patients with obstructive CAD, and
indicated a greater chance to forming well-developed coronary collaterals.
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Kelly C, Gurung R, Kamng'ona R, Sheha I, Chammudzi M, Jambo K, Mallewa J, Rapala A, Heyderman R, Mallon P, Mwandumba H, Khoo S, Klein N. Circulating microparticles are increased amongst people presenting with HIV and advanced immune suppression in Malawi and correlate closely with arterial stiffness: a nested case control study. Wellcome Open Res 2021; 6:264. [PMID: 36300175 PMCID: PMC9577278 DOI: 10.12688/wellcomeopenres.17044.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2021] [Indexed: 03/21/2024] Open
Abstract
Background: We aimed to investigate whether circulating microparticle (CMPs) subsets were raised amongst people presenting with human immunodeficiency virus (HIV) and advanced immune suppression in Malawi, and whether they associated with arterial stiffness. Methods: Antiretroviral therapy (ART)-naïve adults with a new HIV diagnosis and CD4 <100 cells/µL had microparticle characterisation and carotid femoral Pulse Wave Velocity (cfPWV) at 2 weeks post ART initiation. HIV uninfected controls were matched on age, systolic blood pressure (BP) and diastolic BP in a 1:1 ratio. Circulating microparticles were identified from platelet poor plasma and stained for endothelial, leucocyte, monocyte and platelet markers. Results: The median (IQ) total CMP count for 71 participants was 1 log higher in HIV compared to those without (p<0.0001) and was associated with arterial stiffness (spearman rho 0.47, p<0.001). In adjusted analysis, every log increase in circulating particles showed a 20% increase in cfPWV (95% confidence interval [CI] 4 - 40%, p=0.02). In terms of subsets, endothelial and platelet derived microparticles were most strongly associated with HIV. Endothelial derived E-selectin+ CMPs were 1.3log-fold higher and platelet derived CD42a+ CMPs were 1.4log-fold higher (both p<0.0001). Endothelial and platelet derived CMPs also correlated most closely with arterial stiffness (spearman rho: E-selectin+ 0.57 and CD42a 0.56, both p<0.0001). Conclusions: Circulating microparticles associate strongly with arterial stiffness among people living with HIV in Malawi. Endothelial damage and platelet microparticles are the predominant cell origin types and future translational studies could consider prioritising these pathways.
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Affiliation(s)
- Christine Kelly
- Centre for Experimental Pathogen Host Research, UCD, Dublin, Ireland
- Malawi-Liverpool-Wellcome Clinical Research Programme, Blantyre, Malawi, Malawi
- Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - Rijan Gurung
- Institute of Infection, immunity and Inflammation, UCL, London, UK
| | - Raphael Kamng'ona
- Malawi-Liverpool-Wellcome Clinical Research Programme, Blantyre, Malawi, Malawi
| | - Irene Sheha
- Malawi-Liverpool-Wellcome Clinical Research Programme, Blantyre, Malawi, Malawi
| | - Mishek Chammudzi
- Malawi-Liverpool-Wellcome Clinical Research Programme, Blantyre, Malawi, Malawi
| | - Kondwani Jambo
- Malawi-Liverpool-Wellcome Clinical Research Programme, Blantyre, Malawi, Malawi
- Liverpool School of Tropical Medicine, LSTM, Liverpool, UK
| | - Jane Mallewa
- College of Medicine, University of Malawi, Blantyre, Malawi
| | - Alicja Rapala
- Institute of Cardiovascular Science, UCL, London, UK
| | - Rob Heyderman
- Malawi-Liverpool-Wellcome Clinical Research Programme, Blantyre, Malawi, Malawi
- Institute of Infection, immunity and Inflammation, UCL, London, UK
| | - Patrick Mallon
- Centre for Experimental Pathogen Host Research, UCD, Dublin, Ireland
| | - Henry Mwandumba
- Malawi-Liverpool-Wellcome Clinical Research Programme, Blantyre, Malawi, Malawi
- Liverpool School of Tropical Medicine, LSTM, Liverpool, UK
| | - Saye Khoo
- Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - Nigel Klein
- Institute of Infection, immunity and Inflammation, UCL, London, UK
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Kurbanov SK, Vlasova ÉE, Maĭorov GB, Latypov RS, Vasil'ev VP, Galiautdinov DM, Shiriaev AA, Akchurin RS. [In-hospital outcomes of endarterectomy and coronary artery bypass grafting in multiple diffuse lesions of coronary arteries]. ANGIOLOGII︠A︡ I SOSUDISTAI︠A︡ KHIRURGII︠A︡ = ANGIOLOGY AND VASCULAR SURGERY 2021; 27:143-150. [PMID: 33825741 DOI: 10.33529/angid2021123] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND According to a series of studies, performing coronary endarterectomy in direct myocardial revascularization increases the risk of myocardial infarction and in-hospital mortality. There are no commonly accepted indications for carrying out endarterectomy, and in clinical practice this technique is used in severe diffuse lesions of coronary arteries. AIM The study was aimed at assessing in-hospital clinical outcomes of coronary artery bypass grafting (CABG) with the use of endarterectomy in patients with severe multiple diffuse lesions of coronary arteries. PATIENTS AND METHODS This was a single-centre retrospective study enrolling a total of 205 patients presenting with multiple diffuse lesions and subjected to CABG procedures. Of these, after excluding those with severe concomitant pathology (n=28), 177 were enrolled and divided into 2 groups: 76 patients during formation of a coronary anastomosis were subjected to forced endarterectomy from the native channel (Group 1, n=76) and the remaining patients to prolonged anastomosis and/or bypass grafting of distal branches of the diffusely damaged artery (Group 2, n=101). In-hospital outcomes were analysed in both groups. RESULTS The demographic and clinical characteristics were comparable by all parameters except for age: Group 1 patients were older (66.3±8.4 vs 63.0±8.5, p<0.05). The groups were comparable by severity of coronary lesions by both the SYNTAX Score and diffuse lesion index. The incidence of perioperative myocardial infarction during coronary endarterectomy (Group 1) amounted to 9.2% (7/71) and in the group without endarterectomy (Group 2) to 0. There were no cases of in-hospital mortality in either group. CONCLUSION In severe diffuse coronary lesions, endarterectomy combined with CABG makes it possible to perform adequate myocardial revascularization. Performing endarterectomy from coronary arteries is associated with an increased risk for the development of myocardial infarction, but its use is justified if it is impossible to create an anastomosis by means of other techniques.
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Affiliation(s)
- S K Kurbanov
- Department of Cardiovascular Surgery, Research Institute of Clinical Cardiology named after A.L. Myasnikov, National Medical Research Centre of Cardiology of the RF Ministry of Public Health, Moscow, Russia
| | - É E Vlasova
- Department of Cardiovascular Surgery, Research Institute of Clinical Cardiology named after A.L. Myasnikov, National Medical Research Centre of Cardiology of the RF Ministry of Public Health, Moscow, Russia
| | - G B Maĭorov
- Department of Cardiovascular Surgery, Research Institute of Clinical Cardiology named after A.L. Myasnikov, National Medical Research Centre of Cardiology of the RF Ministry of Public Health, Moscow, Russia
| | - R S Latypov
- Department of Cardiovascular Surgery, Research Institute of Clinical Cardiology named after A.L. Myasnikov, National Medical Research Centre of Cardiology of the RF Ministry of Public Health, Moscow, Russia
| | - V P Vasil'ev
- Department of Cardiovascular Surgery, Research Institute of Clinical Cardiology named after A.L. Myasnikov, National Medical Research Centre of Cardiology of the RF Ministry of Public Health, Moscow, Russia
| | - D M Galiautdinov
- Department of Cardiovascular Surgery, Research Institute of Clinical Cardiology named after A.L. Myasnikov, National Medical Research Centre of Cardiology of the RF Ministry of Public Health, Moscow, Russia
| | - A A Shiriaev
- Department of Cardiovascular Surgery, Research Institute of Clinical Cardiology named after A.L. Myasnikov, National Medical Research Centre of Cardiology of the RF Ministry of Public Health, Moscow, Russia
| | - R S Akchurin
- Department of Cardiovascular Surgery, Research Institute of Clinical Cardiology named after A.L. Myasnikov, National Medical Research Centre of Cardiology of the RF Ministry of Public Health, Moscow, Russia
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6
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Torales JM, Centurión OA, Aquino NJ, Chávez CO, Alderete JF, Scavenius KE, Sequeira OR, Miño LM, Candia JC, Cáceres C, Lovera OA, Martínez JE. The relation between QRS complex fragmentation and segmental abnormalities of the myocardial contractility in patients with coronary artery disease. Indian Heart J 2021; 73:325-330. [PMID: 34154750 PMCID: PMC8322790 DOI: 10.1016/j.ihj.2021.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 02/15/2021] [Accepted: 03/23/2021] [Indexed: 11/12/2022] Open
Abstract
Background Fragmented QRS (fQRS) is defined as any QRS complex with duration of less than 120 ms (ms) and at least one notch in the R or S wave in two or more leads belonging to the same coronary territory. The fQRS represents a delay in ventricular conduction caused by a myocardial scar associated to arrhythmic events. Methods This is a descriptive, retrospective, cross-sectional study of a total of 123 patientsadmitted with ischemic heart disease. The aim was to correlate the presence of fQRS in a conventional 12-leads electrocardiogram (ECG) with myocardial regional motility disorders. Results A total of 62% of the patients were male, the mean age was 63 ± 12 SD. fQRS was observed in 44% (64% men and 36% women), the most frequent location being the inferior wall (61%), followed by the anteroseptal and lateral walls (14% for both). Of the 36 patients with fQRS, 30 had segmental disorders, while 6 did not. Of the 45 patients without fQRS, 28 had segmental disorders, but 17 did not, which gives us a sensitivity of 52% (moderate SnNout) and specificity of 74% (high SpPin), with a positive predictive value of 83%, a negative predictive value of 38% and a prevalence of 72%. Conclusion The presence of fQRS in the ECG has high specificity and a high positive predictive value of the existence of segmental myocardial motility disorders in patients with documented coronary artery disease.
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Affiliation(s)
- Judith María Torales
- Department of Cardiology, Hospital de Clínicas, Asunción National University (UNA), San Lorenzo, Paraguay; Department of Health Sciences Investigation, Sanatorio Metropolitano, Fernando de La Mora, Paraguay
| | - Osmar Antonio Centurión
- Department of Cardiology, Hospital de Clínicas, Asunción National University (UNA), San Lorenzo, Paraguay; Department of Health Sciences Investigation, Sanatorio Metropolitano, Fernando de La Mora, Paraguay.
| | - Nelson J Aquino
- Department of Cardiology, Hospital de Clínicas, Asunción National University (UNA), San Lorenzo, Paraguay
| | - Christian O Chávez
- Department of Cardiology, Hospital de Clínicas, Asunción National University (UNA), San Lorenzo, Paraguay
| | - José F Alderete
- Department of Cardiology, Hospital de Clínicas, Asunción National University (UNA), San Lorenzo, Paraguay; Department of Health Sciences Investigation, Sanatorio Metropolitano, Fernando de La Mora, Paraguay
| | - Karina E Scavenius
- Department of Cardiology, Hospital de Clínicas, Asunción National University (UNA), San Lorenzo, Paraguay; Department of Health Sciences Investigation, Sanatorio Metropolitano, Fernando de La Mora, Paraguay
| | - Orlando R Sequeira
- Department of Cardiology, Hospital de Clínicas, Asunción National University (UNA), San Lorenzo, Paraguay
| | - Luis M Miño
- Department of Cardiology, Hospital de Clínicas, Asunción National University (UNA), San Lorenzo, Paraguay; Department of Health Sciences Investigation, Sanatorio Metropolitano, Fernando de La Mora, Paraguay
| | - José C Candia
- Department of Cardiology, Hospital de Clínicas, Asunción National University (UNA), San Lorenzo, Paraguay
| | - Cristina Cáceres
- Department of Cardiology, Hospital de Clínicas, Asunción National University (UNA), San Lorenzo, Paraguay
| | - Oscar A Lovera
- Department of Cardiology, Hospital de Clínicas, Asunción National University (UNA), San Lorenzo, Paraguay
| | - Jorge E Martínez
- Department of Cardiology, Hospital de Clínicas, Asunción National University (UNA), San Lorenzo, Paraguay
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7
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Sun Y, Lu Q, Tao X, Cheng B, Yang G. Cyp2C19*2 Polymorphism Related to Clopidogrel Resistance in Patients With Coronary Heart Disease, Especially in the Asian Population: A Systematic Review and Meta-Analysis. Front Genet 2020; 11:576046. [PMID: 33414804 PMCID: PMC7783419 DOI: 10.3389/fgene.2020.576046] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 11/30/2020] [Indexed: 01/11/2023] Open
Abstract
In recent years, the relationship between Cyp2C19*2 gene polymorphism and clopidogrel resistance reflected by platelet function assay has been studied extensively, but there is no clear conclusion yet. In order to evaluate the relationship between Cyp2C19*2 gene polymorphism and clopidogrel resistance more accurately, meta-analysis was conducted in this study. The I2 value taking 50% as the limit, the heterogeneity is judged as high or low, and then a random effect model or a fixed effect model is selected for statistical analysis. PubMed, EMBASE, Web of Science, CNKI, and China Wanfang database were searched, and the related literatures from the establishment of the database to May 2020 were collected and analyzed by STATA 15.0 software. A total of 3,073 patients were involved in 12 studies, including 1,174 patients with clopidogrel resistance and 1,899 patients with non-clopidogrel resistance. The results of this study showed that allele model (A vs. G): OR = 2.42 (95%CI: 1.97-2.98); dominant model (AA+GA vs. GG): OR = 2.74 (95%CI: 2.09-3.59); recessive model (AA vs. GA+GG): OR = 4.07 (95%CI: 3.06-5.41); homozygous model (AA vs. GG): OR = 5.70 (95%CI: 4.22-7.71); heterozygote model (GA vs. GG): OR = 2.32 (95%CI: 1.76-3.07), the differences were statistically significant. Also, the analysis of the Ethnicity subgroup indicated that the Asian allele model and the other four gene models were statistically significant. In conclusion, Cyp2C19*2 gene polymorphism is strongly associated with clopidogrel resistance. Allele A, genotype GA, AA, and GG + GA can increase clopidogrel resistance, especially in the Asian population.
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Affiliation(s)
- Ying Sun
- Department of Geriatric Cardiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Qing Lu
- Department of Geriatric Cardiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Xuefei Tao
- Department of Geriatric Cardiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Biao Cheng
- Department of Geriatric Cardiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Guoxing Yang
- Department of Operations Management, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
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8
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Li D, Guo P, Chen L, Wu Y, Wang G, Xiao C. Outcomes of Surgical Patch Angioplasty of The Coronary Artery for Diffuse Coronary Artery Disease. Braz J Cardiovasc Surg 2020; 35:706-712. [PMID: 33118736 PMCID: PMC7598967 DOI: 10.21470/1678-9741-2019-0390] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Introduction Diffuse coronary artery disease (CAD) has a poor prognosis and many patients are ineligible for conventional coronary artery bypass grafting (CABG). This study evaluated the 12-month outcomes of coronary artery reconstruction and surgical patch angioplasty of the coronary artery for diffuse CAD. Methods A retrospective cohort study of patients who underwent CABG with surgical patch angioplasty of the coronary artery (reconstruction group) or standard CABG alone (standard group) at the Cardiovascular Surgery Department of the local Hospital between January 2014 and January 2016. Follow-up was censored at 12 months after surgery. Results Cardiopulmonary bypass and aortic cross-clamping durations were longer in the reconstruction group (n=32) than in the standard group (n=125) (P<0.05). There were no differences in graft blood flow and postoperative levels of cardiac markers between the two groups (P>0.05). In the reconstruction group, one patient died; a vein graft showed occlusion. In the standard group, two patients died; one left internal mammary artery graft and three vein grafts showed occlusion. There were no significant differences in mortality, major adverse cardiovascular and cerebrovascular events, and patency between the two groups (P>0.05). Conclusion Coronary artery reconstruction and surgical patch angioplasty of the coronary artery can be performed for diffuse CAD. Patient outcomes were not significantly different from those of patients who underwent standard CABG.
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Affiliation(s)
- Dong Li
- Medical School of Chinese PLA Department of Cardiovascular Surgery Beijing China Department of Cardiovascular Surgery, Medical School of Chinese PLA, Beijing, China
| | - Pengfei Guo
- Medical School of Chinese PLA Department of Cardiovascular Surgery Beijing China Department of Cardiovascular Surgery, Medical School of Chinese PLA, Beijing, China
| | - Lei Chen
- Medical School of Chinese PLA Department of Cardiovascular Surgery Beijing China Department of Cardiovascular Surgery, Medical School of Chinese PLA, Beijing, China
| | - Yang Wu
- Medical School of Chinese PLA Department of Cardiovascular Surgery Beijing China Department of Cardiovascular Surgery, Medical School of Chinese PLA, Beijing, China
| | - Gang Wang
- Medical School of Chinese PLA Department of Cardiovascular Surgery Beijing China Department of Cardiovascular Surgery, Medical School of Chinese PLA, Beijing, China
| | - Cangsong Xiao
- Medical School of Chinese PLA Department of Cardiovascular Surgery Beijing China Department of Cardiovascular Surgery, Medical School of Chinese PLA, Beijing, China
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9
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Cooper DM, Radom-Aizik S. Exercise-associated prevention of adult cardiovascular disease in children and adolescents: monocytes, molecular mechanisms, and a call for discovery. Pediatr Res 2020; 87:309-318. [PMID: 31649340 PMCID: PMC11177628 DOI: 10.1038/s41390-019-0581-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 08/07/2019] [Accepted: 08/15/2019] [Indexed: 12/28/2022]
Abstract
Atherosclerosis originates in childhood and adolescence. The goal of this review is to highlight how exercise and physical activity during childhood and adolescence, critical periods of growth and development, can prevent adult cardiovascular disease (CVD), particularly through molecular mechanisms of monocytes, a key cell of the innate immune system. Monocytes are heterogeneous and pluripotential cells that can, paradoxically, play a role in both the instigation and prevention of atherosclerosis. Recent discoveries in young adults reveal that brief exercise affects monocyte gene pathways promoting a cell phenotype that patrols the vascular system and repairs injuries. Concurrently, exercise inhibits pro-inflammatory monocytes, cells that contribute to vascular damage and plaque formation. Because CVD is typically asymptomatic in youth, minimally invasive techniques must be honed to study the subtle anatomic and physiologic evidence of vascular dysfunction. Exercise gas exchange and heart rate measures can be combined with ultrasound assessments of vascular anatomy and reactivity, and near-infrared spectroscopy to quantify impaired O2 transport that is often hidden at rest. Combined with functional, transcriptomic, and epigenetic monocyte expression and measures of monocyte-endothelium interaction, molecular mechanisms of early CVD can be formulated, and then translated into effective physical activity-based strategies in youth to prevent adult-onset CVD.
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Affiliation(s)
- Dan M Cooper
- Pediatric Exercise and Genomics Research Center, University of California Irvine School of Medicine, Pediatrics, Irvine, CA, USA.
| | - Shlomit Radom-Aizik
- Pediatric Exercise and Genomics Research Center, University of California Irvine School of Medicine, Pediatrics, Irvine, CA, USA
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Mo X, Liu W, Yang Y, Imani S, Lu S, Dan G, Nie X, Yan J, Zhan R, Li X, Deng Y, Chen B, Cai Y. NCF2, MYO1F, S1PR4, and FCN1 as potential noninvasive diagnostic biomarkers in patients with obstructive coronary artery: A weighted gene co-expression network analysis. J Cell Biochem 2019; 120:18219-18235. [PMID: 31245869 PMCID: PMC6771964 DOI: 10.1002/jcb.29128] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 05/05/2019] [Accepted: 05/07/2019] [Indexed: 12/11/2022]
Abstract
This study aims to explore the predictive noninvasive biomarker for obstructive coronary artery disease (CAD). By using the data set GSE90074, weighted gene co-expression network analysis (WGCNA), and protein-protein interactive network, construction of differentially expressed genes in peripheral blood mononuclear cells was conducted to identify the most significant gene clusters associated with obstructive CAD. Univariate and multivariate stepwise logistic regression analyses and receiver operating characteristic analysis were used to predicate the diagnostic accuracy of biomarker candidates in the detection of obstructive CAD. Furthermore, functional prediction of candidate gene biomarkers was further confirmed in ST-segment elevation myocardial infarction (STEMI) patients or stable CAD patients by using the datasets of GSE62646 and GSE59867. We found that the blue module discriminated by WGCNA contained 13 hub-genes that could be independent risk factors for obstructive CAD (P < .05). Among these 13 hub-genes, a four-gene signature including neutrophil cytosol factor 2 (NCF2, P = .025), myosin-If (MYO1F, P = .001), sphingosine-1-phosphate receptor 4 (S1PR4, P = .015), and ficolin-1 (FCN1, P = .012) alone or combined with two risk factors (male sex and hyperlipidemia) may represent potential diagnostic biomarkers in obstructive CAD. Furthermore, the messenger RNA levels of NCF2, MYO1F, S1PR4, and FCN1 were higher in STEMI patients than that in stable CAD patients, although S1PR4 showed no statistical difference (P > .05). This four-gene signature could also act as a prognostic biomarker to discriminate STEMI patients from stable CAD patients. These findings suggest a four-gene signature (NCF2, MYO1F, S1PR4, and FCN1) alone or combined with two risk factors (male sex and hyperlipidemia) as a promising prognostic biomarker in the diagnosis of STEMI. Well-designed cohort studies should be implemented to warrant the diagnostic value of these genes in clinical purpose.
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Affiliation(s)
- Xian‐Gang Mo
- Department of GeriatricsThe Affiliated Hospital of Guizhou Medical UniversityGuiyangGuizhouChina
| | - Wei Liu
- Health Physical Examination CenterThe Affiliated Hospital of Qingdao UniversityQingdaoShandongChina
| | - Yao Yang
- Institute of Materia Medica, College of PharmacyArmy Medical University (Third Military Medical University)ChongqingChina
| | - Saber Imani
- Department of OncologyThe Affiliated Hospital of Southwest Medical UniversityLuzhouSichuanChina
| | - Shan Lu
- Institute of Materia Medica, College of PharmacyArmy Medical University (Third Military Medical University)ChongqingChina
| | - Guorong Dan
- Institute of Materia Medica, College of PharmacyArmy Medical University (Third Military Medical University)ChongqingChina
| | - Xuqiang Nie
- Institute of Materia Medica, College of PharmacyArmy Medical University (Third Military Medical University)ChongqingChina
| | - Jun Yan
- Center of Hepatobiliary Pancreatic DiseaseBeijing Tsinghua Changgung HospitalBeijingChina
| | - Rixing Zhan
- Institute of Burn Research, Southwest HospitalArmy Medical University (Third Military Medical University)ChongqingChina
| | - Xiaohui Li
- Institute of Materia Medica, College of PharmacyArmy Medical University (Third Military Medical University)ChongqingChina
| | - Youcai Deng
- Institute of Materia Medica, College of PharmacyArmy Medical University (Third Military Medical University)ChongqingChina
| | - Bingbo Chen
- Laboratory Animal CenterArmy Medical University (Third Military Medical University)ChongqingChina
| | - Yue Cai
- Department of Cardiology, Xijing HospitalFourth Military Medical UniversityXi'anShaanxiChina
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11
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Xiang Q, Pang J, Chen Y, Hong D, Zhang Z, Zhou S. Association of Green Tea Consumption and Coronary Arterial Disease Risk in a Chinese Population in Guangzhou. J Altern Complement Med 2019; 25:435-440. [PMID: 30431316 DOI: 10.1089/acm.2018.0226] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Qiuling Xiang
- Center for Stem Cell Biology and Tissue Engineering, Key Laboratory for Stem Cells and Tissue Engineering, Ministry of Education, Sun Yat-sen University, Guangzhou, China
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Jun Pang
- Department of Cardiology, Guizhou Provincial People's Hospital, Guizhou, China
| | - Ying Chen
- Department of Cardiology, Sun Yat-sen Memorial Hospital, Guangzhou, China
| | - Dongxi Hong
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
- Department of Cardiology, Sun Yat-sen Memorial Hospital, Guangzhou, China
| | - Zhen Zhang
- Center for Stem Cell Biology and Tissue Engineering, Key Laboratory for Stem Cells and Tissue Engineering, Ministry of Education, Sun Yat-sen University, Guangzhou, China
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Shuxian Zhou
- Department of Cardiology, Sun Yat-sen Memorial Hospital, Guangzhou, China
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12
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Brown RA, Lip GYH. Monocyte-platelet cross-talk in peripheral artery disease-how much does the pathogenesis of atherosclerosis depend on anatomical location? ANNALS OF TRANSLATIONAL MEDICINE 2019; 7:S19. [PMID: 31032300 DOI: 10.21037/atm.2019.01.47] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Affiliation(s)
- Richard A Brown
- Barts Heart Centre, Barts Health NHS Trust, St Bartholomew's Hospital, London, UK
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.,Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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13
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Brown RA, Lip GYH, Varma C, Shantsila E. Impact of Mon2 monocyte-platelet aggregates on human coronary artery disease. Eur J Clin Invest 2018; 48:e12911. [PMID: 29423944 DOI: 10.1111/eci.12911] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Accepted: 02/04/2018] [Indexed: 12/28/2022]
Abstract
BACKGROUND Monocyte-platelet aggregates (MPAs) form when Mon1, Mon2 or Mon3 monocyte subsets adhere to platelets. They are pathophysiologically linked to coronary artery disease (CAD). However, their individual roles in the occurrence of diffuse CAD remain unknown. MATERIALS AND METHODS Peripheral blood from 50 patients with diffuse CAD, 40 patients with focal CAD and 50 age-matched patients with normal coronary arteries was analysed by flow cytometry to quantify MPAs associated with individual monocyte subsets. Cutaneous forearm microcirculation was assessed using laser Doppler flowmetry at rest and after iontophoresis of acetylcholine (endothelium-dependent vasodilation) and sodium nitroprusside (endothelium-independent vasodilation) at 100 μA for 60 seconds. Patients with CAD had repeat assessment at 6 and 12 months. RESULTS Baseline counts of MPAs with Mon2 subset (CD14++CD16+CC2+ monocytes) were significantly higher in patients with diffuse CAD compared to focal CAD (P = .001) and patients without CAD (P = .006). On multivariate regression, MPAs with Mon2 independently predicted diffuse CAD (odds ratio 1.10, 95% confidence interval 1.02-1.19, P = .01) and correlated negatively with endothelium-dependent microvascular vasodilation (r = -.37, P = .008), an association which persisted after adjustment for covariates. Longitudinal observation confirmed the persistence of an inverse relationship between MPAs with Mon2 and endothelium-dependent microvascular function. CONCLUSION Monocyte-platelet aggregates with Mon2 are increased in patients with diffuse CAD and therefore could represent an important contributor to accelerated coronary atherosclerotic progression by a mechanism involving microvascular endothelial dysfunction.
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Affiliation(s)
- Richard A Brown
- Institute of Cardiovascular Sciences, City Hospital, University of Birmingham, Birmingham, UK.,Hull and East Yorkshire Hospitals NHS Trust, Castle Hill Hospital, Cottingham, UK
| | - Gregory Y H Lip
- Institute of Cardiovascular Sciences, City Hospital, University of Birmingham, Birmingham, UK.,Sandwell and West Birmingham Hospitals NHS Trust, City Hospital, Birmingham, UK
| | - Chetan Varma
- Sandwell and West Birmingham Hospitals NHS Trust, City Hospital, Birmingham, UK
| | - Eduard Shantsila
- Institute of Cardiovascular Sciences, City Hospital, University of Birmingham, Birmingham, UK
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14
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Wang L, Wang H, Hou X. Short-term effects of preoperative beta-blocker use for isolated coronary artery bypass grafting: A systematic review and meta-analysis. J Thorac Cardiovasc Surg 2018; 155:620-629.e1. [DOI: 10.1016/j.jtcvs.2017.08.025] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 07/27/2017] [Accepted: 08/16/2017] [Indexed: 11/27/2022]
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