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Yu XR, Du JL, Jiang M, Ren Y, Zhang FL, Kong FL, Li FE. Correlation of TyG-BMI and TyG-WC with severity and short-term outcome in new-onset acute ischemic stroke. Front Endocrinol (Lausanne) 2024; 15:1327903. [PMID: 38846495 PMCID: PMC11153697 DOI: 10.3389/fendo.2024.1327903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 05/09/2024] [Indexed: 06/09/2024] Open
Abstract
Objectives To research the connection between the indexes of the indexes of triglyceride-glucose (TyG) combined with obesity indices and the initial neurological severity and short-term outcome of new-onset acute ischemic stroke. Methods Data of patients with acute ischemic stroke admitted to the Stroke Ward of the Affiliated Hospital of Beihua University from November 2021 to October 2023, were collected. The two indexes were calculated by combining TyG and obesity indices: TyG-body mass index (TyG-BMI) and TyG-waist circumference (TyG-WC). The National Institute of Health Stroke Scale (NIHSS) was used to assess and group patients with neurological deficits within 24 hours of admission: mild stroke (NIHSS ≤5) and moderate-severe stroke (NIHSS >5). Short-term prognosis was evaluated using the modified Rankin Scale (mRS) at discharge or 14 days after onset of the disease and grouped: good outcome (mRS ≤2) and poor outcome (mRS >2). According to the quartiles of TyG-BMI and TyG-WC, the patients were placed into four groups: Q1, Q2, Q3 and Q4. Multi-factor logistic regression analysis was utilized to evaluate the correlation of TyG-BMI and TyG-WC with the severity and short-term outcome. Results The study included 456 patients. After adjusting for multiple variables, the results showed that compared with the quartile 1, patients in quartile 4 of TyG-BMI had a reduced risk of moderate-severe stroke [Q4: OR: 0.407, 95%CI (0.185-0.894), P = 0.025]; Patients in quartiles 2, 3 and 4 of TyG-BMI had sequentially lower risk of short-term adverse outcomes [Q2: OR: 0.394, 95%CI (0.215-0.722), P = 0.003; Q3: OR: 0.324, 95%CI (0.163-0.642), P = 0.001; Q4: OR: 0.158, 95%CI (0.027-0.349), P <0.001]; Patients in quartiles 3 and 4 of TyG-WC had sequentially lower risk of moderate-severe stroke [Q3: OR: 0.355, 95%CI (0.173-0.728), P = 0.005; Q4: OR: 0.140, 95%CI (0.056-0.351), P <0.001]; Patients in quartiles 3 and 4 of TyG-WC had sequentially lower risk of short-term adverse outcomes [Q3: OR: 0.350, 95%CI (0.175-0.700), P = 0.003; Q4: OR: 0.178, 95%CI (0.071-0.451), P <0.001]. Conclusions TyG-WC and TyG-BMI were correlated with the severity and short-term outcome of new-onset acute ischemic stroke. As TyG-WC and TyG-BMI increased, stroke severity decreased and short-term outcome was better.
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Affiliation(s)
- Xin-Rui Yu
- Postgraduate Department, School of Clinical Medicine, Beihua University, Jilin, China
| | - Jing-Lu Du
- Postgraduate Department, School of Clinical Medicine, Beihua University, Jilin, China
| | - Mei Jiang
- Postgraduate Department, School of Clinical Medicine, Beihua University, Jilin, China
| | - Yuan Ren
- Postgraduate Department, School of Clinical Medicine, Beihua University, Jilin, China
- Department of Neurology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Fu-Liang Zhang
- Department of Neurology, The First Hospital of Jilin University, Changchun, China
| | - Fan-Li Kong
- Department of Pathophysiology, School of Basic Medicine, Beihua University, Jilin, China
| | - Feng-E. Li
- Neurology Department, the Affiliated Hospital of Beihua University, Jilin, China
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Tavolinejad H, Rashedi S, Mojtaba Ghorashi S, Tajdini M, Sadeghian S, Pashang M, Jalali A, Salehi Omran A, Bagheri J, Karimi A, Shirzad M, Mehrani M, Hosseini K. Prognostic significance of positive family history in outcomes after coronary artery bypass grafting: Do we need to update our assumptions? J Cardiothorac Surg 2022; 17:84. [PMID: 35477472 PMCID: PMC9044642 DOI: 10.1186/s13019-022-01836-4] [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: 09/18/2021] [Accepted: 04/17/2022] [Indexed: 12/02/2022] Open
Abstract
Background Recent research suggests a protective role for positive family history of premature cardiovascular disease (FHpCVD) in patients undergoing coronary artery bypass grafting. We aimed to further investigate this unlikely association. Methods In this registry-based cohort study, patients who underwent first-time non-emergent coronary bypass surgery at Tehran Heart Center between 2007 and 2016 were included. Patients with and without FHpCVD were compared in terms of all-cause mortality and first non-fatal cardiovascular events (CVEs) comprising non-fatal acute coronary syndrome, non-fatal stroke or transient ischemic attack, and repeat coronary revascularization. Results A total of 13,156 patients were included (mean age 60.83 ± 9.57, 74.5% male), among which 2684 (20.4%) patients had FHpCVD. Median follow-up was 77.7 months. FHpCVD was weakly associated with reduced all-cause mortality using inverse probability weight (IPW) method (hazard ratio [HR] = 0.853; 95% confidence interval [CI] 0.730–0.997; P = 0.046), and not associated with non-fatal CVEs considering death as the competing event (sub-distribution HR [SHR] = 1.124; 95% CI 0.999–1.265; P = 0.053). Within a subgroup of patients without previous myocardial infarction or revascularization (7403 cases; 56.3%), FHpCVD was associated with lower mortality (HR = 0.700; 95% CI 0.548–0.894; P = 0.004) and higher non-fatal CVEs (SHR = 1.197; 95% CI 1.019–1.405; P = 0.028), whereas among patients with previous coronary events, there was no association between FHpCVD and outcomes. Conclusions FHpCVD was associated with lower all-cause mortality but higher non-fatal CVEs, especially in those without prior coronary events. Such discordance calls for caution in assuming a protective role for FHpCVD. The prognostic significance of FHpCVD needs further evaluation among surgical patients.
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Affiliation(s)
- Hamed Tavolinejad
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.,Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sina Rashedi
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.,Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyyed Mojtaba Ghorashi
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Masih Tajdini
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeed Sadeghian
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mina Pashang
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Arash Jalali
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Salehi Omran
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Jamshid Bagheri
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbasali Karimi
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahmoud Shirzad
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Mehrani
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Kaveh Hosseini
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran. .,Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
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3
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Zhang Y, Wang J, Zhai G, Zhou Y. Development and Validation of a Predictive Model for Chronic Kidney Disease After Percutaneous Coronary Intervention in Chinese. Clin Appl Thromb Hemost 2022; 28:10760296211069998. [PMID: 35073208 PMCID: PMC8793426 DOI: 10.1177/10760296211069998] [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] [Indexed: 11/15/2022] Open
Abstract
AIM There is no model for predicting the outcomes for coronary heart disease (CHD) patients with chronic kidney disease (CKD) after percutaneous coronary intervention (PCI). To develop and validate a model to predict major adverse cardiovascular events (MACEs) in patients with comorbid CKD and CHD undergoing PCI. METHODS We enrolled 1714 consecutive CKD patients who underwent PCI from January 1, 2008 to December 31, 2017. In the development cohort, we used least absolute shrinkage and selection operator regression for data dimension reduction and feature selection. We used multivariable logistic regression analysis to develop the prediction model. Finally, we used an independent cohort to validate the model. The performance of the prediction model was evaluated with respect to discrimination, calibration, and clinical usefulness. RESULTS The predictors included a positive family history of CHD, history of revascularization, ST segment changes, anemia, hyponatremia, transradial intervention, the number of diseased vessels, dose of contrast media >200 ml, and coronary collateral circulation. In the validation cohort, the model showed good discrimination (area under the receiver operating characteristic curve, 0.612; 95% confidence interval: 0.560, 0.664) and good calibration (Hosmer-Lemeshow test, P = 0.444). Decision curve analysis demonstrated that the model was clinically useful. CONCLUSIONS We created a nomogram that predicts MACEs after PCI in CHD patients with CKD and may help improve the screening and treatment outcomes.
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Affiliation(s)
- Ying Zhang
- Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, 12667Capital Medical University,Beijing, China.,117914Affiliated Hospital of Chengde Medical College, Chengde, China
| | - Jianlong Wang
- Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, 12667Capital Medical University,Beijing, China
| | - Guangyao Zhai
- Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, 12667Capital Medical University,Beijing, China
| | - Yujie Zhou
- Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, 12667Capital Medical University,Beijing, China
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Hosseini K, Yavari N, Pashang M, Jalali A, Nalini M, Majdi Nassab F, Sadeghian S, Salehi Omran A, Bagheri J, Poorhosseini H, Salarifar M, Ahmadi Tafti SH, Tajdini M. Sex difference in the risk factor distributions and outcomes after coronary artery bypass graft surgery in the young population. Eur J Cardiothorac Surg 2021; 62:6423098. [PMID: 34747461 DOI: 10.1093/ejcts/ezab475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 09/24/2021] [Accepted: 10/07/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Coronary artery disease is becoming a major health concern in the young population. Male and female patients may experience different journeys after coronary artery disease events. We aimed to evaluate risk factors and compare outcomes between young male and female patients undergoing coronary artery bypass graft surgery (CABG). METHODS In this registry-based large sample size study, patients undergoing isolated CABG at a young age (premature isolated CABG) between 2007 and 2016 were included and followed up until 2020. Premature was defined as women and men younger than 55 years old. The main end points of the study were 7-year all-cause mortality and 7-year major adverse cardiovascular and cerebrovascular events (MACCEs). RESULTS Of a total of 24 428 patients who underwent CABG, 7217 patients (men-to-women ratio ≈4:1) with premature isolated CABG were included. The median follow-up duration was 78.5 months (75.2-81.6 months). The prevalence rates of diabetes mellitus, hypertension, dyslipidaemia and obesity were significantly higher in women than in men (58.3% vs 28.6%, 64.2% vs 38.5%, 69.7% vs 55.3% and 44.7 vs 23.9, respectively; all Ps < 0.05). The risk factor burden (mean of the risk factor count per year) was also higher among the female population. Diabetes mellitus was the common mortality predictor between men and women. In the subgroup analysis (interaction analysis in the adjusted model), hypertensive females had a higher rate of MACCE and a higher rate of mortality than hypertensive males; however, this difference was not significant in the non-hypertensive population. Opium addiction was a strong predictor of MACCE and all-cause mortality among men. Female patients had a higher rate of 7-year MACCE (hazard ratio, 1.33; 95% confidence interval, 1.16-1.51) and a higher rate of 7-year all-cause mortality (hazard ratio, 1.23; 95% confidence interval, 0.98-1.53). CONCLUSIONS The risk factor profile and predictors of outcomes were different between our female and male patients. Women carried a higher risk of events and mortality after CABG at a young age.
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Affiliation(s)
- Kaveh Hosseini
- Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.,Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.,Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Negin Yavari
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mina Pashang
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Arash Jalali
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahdi Nalini
- Cardiovascular Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Saeed Sadeghian
- Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.,Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Salehi Omran
- Department of Cardiac Surgery, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Jamshid Bagheri
- Department of Cardiac Surgery, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamidreza Poorhosseini
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mojtaba Salarifar
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Masih Tajdini
- Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.,Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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Sattartabar B, Ajam A, Pashang M, Jalali A, Sadeghian S, Mortazavi H, Mansourian S, Bagheri J, Karimi AA, Hosseini K. Sex and age difference in risk factor distribution, trend, and long-term outcome of patients undergoing isolated coronary artery bypass graft surgery. BMC Cardiovasc Disord 2021; 21:460. [PMID: 34556032 PMCID: PMC8461921 DOI: 10.1186/s12872-021-02273-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Accepted: 09/20/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Preoperative coronary artery disease risk factors (CADRFs) distribution and pattern may also have an important role in determining major adverse cardiovascular events (MACEs). In this study, we aimed to evaluate the CADRFs distribution and trend over 10 years and also the long-term outcome of CABG in different age-sex categories. METHOD In this registry-based serial cross-sectional study, we enrolled 24,328 patients who underwent isolated CABG and evaluated the prevalence of CADRFs according to sex and age. We used inverse probability weighting (IPW) to compare survival and MACE between the sexes. We also used Cox regression to determine each CADRFs effect on survival and MACEs. RESULTS In general, DLP (56.00%), HTN (53.10%), DM (38.40%), and positive family history (38.30%) were the most frequent risk factors in all patients. Prevalence of HTN, DLP, DM, obesity, and positive family history were all higher in women, all statistically significant. The median follow-up duration was 78.1 months (76.31-79.87 months). After inverse probability weighting (to balance risk factors and comorbidities), men had lower MACEs during follow-up (HR 0.72; 95% CI 0.57-0.91; P value 0.006) and there was no significant difference in survival between sexes. DM and HTN were associated with higher mortality and MACEs in both sexes. CONCLUSION Although DLP is still the most frequent CADRF among the CABG population, the level of LDL and TG is decreasing. Women experience higher MACE post CABG. Therefore, health care providers and legislators must pay greater attention to female population CADRFs and ways to prevent them at different levels.
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Affiliation(s)
- Babak Sattartabar
- Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, North Kargar Ave., 1411713138, Tehran, Iran.,Research Department, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Ajam
- Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
| | - Mina Pashang
- Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, North Kargar Ave., 1411713138, Tehran, Iran.,Research Department, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Arash Jalali
- Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, North Kargar Ave., 1411713138, Tehran, Iran.,Research Department, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeed Sadeghian
- Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, North Kargar Ave., 1411713138, Tehran, Iran.,Research Department, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamideh Mortazavi
- Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, North Kargar Ave., 1411713138, Tehran, Iran.,Research Department, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Soheil Mansourian
- Department of Cardiac Surgery, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Jamshid Bagheri
- Department of Cardiac Surgery, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas-Ali Karimi
- Department of Cardiac Surgery, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Kaveh Hosseini
- Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, North Kargar Ave., 1411713138, Tehran, Iran. .,Research Department, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
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Wang H, Liu Z, Shao J, Jiang M, Lu X, Lin L, Wang L, Xu Q, Zhang H, Li X, Zhou J, Chen Y, Zhang R. Pathogenesis of premature coronary artery disease: Focus on risk factors and genetic variants. Genes Dis 2020; 9:370-380. [PMID: 35224153 PMCID: PMC8843894 DOI: 10.1016/j.gendis.2020.11.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 10/17/2020] [Accepted: 11/04/2020] [Indexed: 11/24/2022] Open
Abstract
The development of premature coronary artery disease (PCAD) is dependent on both genetic predisposition and traditional risk factors. Strategies for unraveling the genetic basis of PCAD have evolved with the advent of modern technologies. Genome-wide association studies (GWASs) have identified a considerable number of common genetic variants that are associated with PCAD. Most of these genetic variants are attributable to lipid and blood pressure-related single-nucleotide polymorphisms (SNPs). The genetic variants that predispose individuals to developing PCAD may depend on race and ethnicity. Some characteristic genetic variants have been identified in Chinese populations. Although translating this genetic knowledge into clinical applications is still challenging, these genetic variants can be used for CAD phenotype identification, genetic prediction and therapy. In this article we will provide a comprehensive review of genetic variants detected by GWASs that are predicted to contribute to the development of PCAD. We will highlight recent findings regarding CAD-related genetic variants in Chinese populations and discuss the potential clinical utility of genetic variants for preventing and managing PCAD.
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