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Aydin E, Aydin S, Gül M, Yetim M, Demir M, Özkan C, Karakurt M, Burak C, Bayraktar MF, Temizer O, Erbay İ, Muştu M, Karagöz A, Üzoğullari İR, Şen T, Özeke Ö, Topaloğlu S, Aras D, Tanboğa Hİ. Influence of Intermittent Fasting During Ramadan on Circadian Variation of Symptom-Onset and Prehospital Time Delay in Acute ST-Segment Elevation Myocardial Infarction. Angiology 2022; 74:569-578. [PMID: 35975875 DOI: 10.1177/00033197221114087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Ramadan interferes with circadian rhythms mainly by disturbing the routine patterns of feeding and smoking. The objective of this study was to investigate the circadian pattern of ST elevation acute myocardial infarction (STEMI) during the month of Ramadan. We studied consecutive STEMI patients 1 month before and after Ramadan (non-Ramadan group-NRG) and during Ramadan (Ramadan group-RG). The RG group was also divided into two groups, based on whether they chose to fast: fasting (FG) and non-fasting group (NFG). The time of STEMI onset was compared. A total of 742 consecutive STEMI patients were classified into 4 groups by 6 h intervals according to time-of-day at symptom onset. No consistent circadian variation in the onset of STEMI was observed both between the RG (P = .938) and NRG (P = .766) or between the FG (P = .232) and NFG (P = .523). When analyzed for subgroups of the study sample, neither smoking nor diabetes showed circadian rhythm. There was a trend towards a delay from symptom onset to hospital presentation, particularly at evening hours in the RG compared with the control group. In conclusion, there was no significant difference in STEMI onset time, but the time from symptom onset to hospital admission was significantly delayed during Ramadan.
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Affiliation(s)
- Ertan Aydin
- Cardiology, Prof. Dr A. İlhan Özdemir Training and Research Hospital, Giresun University, Giresun, Turkey
| | | | - Murat Gül
- Cardiology, Faculty of Medicine, Aksaray University, Aksaray, Turkey
| | - Mucahit Yetim
- Cardiology, Erol Olçok Training and Research Hospital, Hitit University, Çorum, Turkey
| | - Mevlüt Demir
- Cardiology, Evliya Celebi Training and Research Hospital, Kütahya Health Sciences University, Kutahya, Turkey
| | - Can Özkan
- Cardiology, Muş State Hospital, Muş, Turkey
| | - Mustafa Karakurt
- Cardiology, Kırıkkale Yuksek Ihtisas Hospital, Kırıkkale, Turkey
| | - Cengiz Burak
- Cardiology, Faculty of Medicine, 485644Kafkas University, Kars, Turkey
| | | | | | - İlke Erbay
- Cardiology, Muş State Hospital, Muş, Turkey
| | - Mehmet Muştu
- Cardiology, Faculty of Medicine, Karamanoğlu Mehmetbey University, Karaman, Turkey
| | - Ahmet Karagöz
- Cardiology, Prof. Dr A. İlhan Özdemir Training and Research Hospital, Giresun University, Giresun, Turkey
| | | | - Taner Şen
- Cardiology, Evliya Celebi Training and Research Hospital, Kütahya Health Sciences University, Kutahya, Turkey
| | - Özcan Özeke
- Cardiology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Serkan Topaloğlu
- Cardiology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Dursun Aras
- Cardiology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
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Sen A, Gémes K, Stålhammar G, Svensen C, Tornvall P, Jonsson M, Varmdal T, Endreseth BH, Janszky I, Möller J. Risk for Acute Myocardial Infarction After Ophthalmologic Procedures. Ann Intern Med 2022; 175:628-633. [PMID: 35313112 DOI: 10.7326/m20-6618] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Preoperative cardiovascular evaluations are frequently done before ambulatory ophthalmologic procedures. However, whether these procedures can trigger an acute myocardial infarction (AMI) is unknown. OBJECTIVE To assess the short-term risk for AMI associated with ophthalmologic procedures. DESIGN Case-crossover design. SETTING Population-based nationwide study from Norway and Sweden. PARTICIPANTS First-time patients with AMI, aged 40 years and older, identified via inpatient registries and linked to outpatient surgical procedures in Norway (2008 to 2014) and Sweden (2001 to 2014), respectively. MEASUREMENTS Using self-matching, for each participant, exposure to ophthalmologic procedures in the 0 to 7 days before AMI diagnosis (hazard period) was compared with an 8-day period 30 days earlier, that is, days 29 to 36 before AMI (control period) to estimate the relative risk for an AMI the week after an ophthalmologic procedure. The odds ratios (ORs) with 95% CIs were calculated, using conditional logistic regression. Only patients who had a procedure of interest during either the hazard or control period were included. RESULTS For the 806 patients with AMI included in this study, there was a lower likelihood of AMI in the week after an ophthalmologic procedure than during the control week (OR, 0.83; 95% CI, 0.75 to 0.91). Furthermore, there was no evidence of increased risk for AMI when analyses were stratified by surgery subtype, anesthesia (local or general), duration, invasiveness (low, intermediate, or high), patient's age (<65 years or ≥65 years), or comorbidity (none vs. any). LIMITATION Potential bias from time-varying confounders between the hazard and the control periods. CONCLUSION Ophthalmologic procedures done in an outpatient setting did not seem to be associated with an increased risk for AMI. PRIMARY FUNDING SOURCE Central Norway Regional Health Authority and the Swedish Research Council.
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Affiliation(s)
- Abhijit Sen
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Center for Oral Health Services and Research (TkMidt), Trondheim, and Clinic of Surgery, St. Olav's University Hospital, Trondheim, Norway (A.S.)
| | - Katalin Gémes
- Department of Global Public Health, Institute of Environmental Medicine, and Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden (K.G.)
| | - Gustav Stålhammar
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, and St. Erik Eye Hospital, Stockholm, Sweden (G.S.)
| | - Christer Svensen
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden (C.S., P.T.)
| | - Per Tornvall
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden (C.S., P.T.)
| | - Magnus Jonsson
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, and Department of Vascular Surgery, Karolinska University Hospital, Stockholm, Sweden (M.J.)
| | - Torunn Varmdal
- Department of Research and Development, St. Olav's University Hospital, Trondheim, and Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway (T.V.)
| | | | - Imre Janszky
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, and Clinic of Surgery and Regional Center for Health Care Improvement, St. Olav's University Hospital, Trondheim, Norway (I.J.)
| | - Jette Möller
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden (J.M.)
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Chronic Stress, Exercise and Cardiovascular Disease: Placing the Benefits and Risks of Physical Activity into Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189922. [PMID: 34574843 PMCID: PMC8471640 DOI: 10.3390/ijerph18189922] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/09/2021] [Accepted: 09/10/2021] [Indexed: 12/18/2022]
Abstract
Chronic stress, which has been exacerbated worldwide by the lingering COVID pandemic, has been strongly linked to cardiovascular disease (CVD). In addition, autonomic dysregulation via sustained sympathetic activity has been shown to increase the risk of arrhythmias, platelet aggregation, acute coronary syndromes and heart failure. Fortunately, effective coping strategies have been shown to attenuate the magnitude of hyperarousal associated with the stress response, including moderate-to-vigorous lifestyle activity and/or structured exercise. A good-to-excellent level of cardiorespiratory fitness also appears to be highly cardioprotective. These beneficial effects have been substantiated by numerous studies that have evaluated the levels of stress reactivity and stress recovery in physically active individuals versus matched sedentary controls, as well as before and after exercise interventions. On the other hand, unaccustomed strenuous exercise in habitually sedentary persons with underlying CVD is associated with a disproportionate incidence of acute cardiac events. Moreover, extreme exercise regimens appear to increase coronary calcification and the likelihood of developing atrial fibrillation. This review summarizes these relations and more, with specific reference to placing the benefits and risks of physical activity into perspective.
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Rouzbahani M, Azimivghar J, Moghadam RH, Montazeri N, Janjani P, Rai A, Rad EJ, Naderipour A, Salehi N. Acute myocardial infarction: Circadian, daily, monthly and seasonal patterns of occurrence in diabetics. J Diabetes Metab Disord 2021; 20:765-770. [PMID: 34222090 PMCID: PMC8212248 DOI: 10.1007/s40200-021-00813-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 04/28/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND Illustrating the temporal pattern of acute myocardial infarction (AMI), as a major cause of mortality, may help with disease prevention and better treatment. Therefore, the aim of our study was to investigate the circadian, daily, monthly and seasonal patterns of AMI occurrence in patients with diabetes mellitus, and other likely associated factors. METHODS This cross-sectional study was performed on 142 diabetic patients admitted to the Imam Ali cardiovascular hospital, Kermanshah, Iran with a diagnosis of ST-segment elevation myocardial infarction (STEMI) from March 2018 to February 2019. Data were collected using a checklist developed based on the study goals. One-way Analysis of Variance (ANOVA) and Chi-Square test (or Fishers҆ Exact test) were used to assess the differences between subgroups. Multiple logistic regression model was constructed to evaluate independent predictors of the AMI occurrence. RESULT Out of the 142 diabetic patients, 90 (63.4%) were male. The mean age of the patients was (mean ± SD) 62.81 ± 10.21 years. Occurrence of STEMI was the most common during winter (p = 0.001). Prior angina, prior congestive heart failure (CHF), prior stroke, High-density lipoprotein (HDL), and Creatine Phosphokinase (CPK) were significantly associated with seasonal pattern of STEMI (p-value < 0.05). Angiotensin receptor blockers (ARBs) use was associated with an increased odds of the AMI occurrence in winter (OR = 8.32; P = 0.027). CONCLUSION The present study of Iranian patients with diabetes revealed that AMI occurred more frequently during the winter compared to the other seasons. ARBs use was associated with an increased odd of the AMI occurrence in winter. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s40200-021-00813-3.
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Affiliation(s)
- Mohammad Rouzbahani
- Cardiovascular Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Javad Azimivghar
- Cardiovascular Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Reza Heidari Moghadam
- Cardiovascular Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nafiseh Montazeri
- Cardiovascular Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Parisa Janjani
- Cardiovascular Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Alireza Rai
- Cardiovascular Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Etrat Javadi Rad
- Cardiovascular Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Arsalan Naderipour
- Department of Emergency Medicine, School of Paramedics, Kermanshah University of Medical Sciences (KUMS), Kermanshah, Iran
| | - Nahid Salehi
- Cardiovascular Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Arastoo S, Haptonstall KP, Choroomi Y, Moheimani R, Nguyen K, Tran E, Gornbein J, Middlekauff HR. Acute and chronic sympathomimetic effects of e-cigarette and tobacco cigarette smoking: role of nicotine and non-nicotine constituents. Am J Physiol Heart Circ Physiol 2020; 319:H262-H270. [PMID: 32559135 DOI: 10.1152/ajpheart.00192.2020] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Electronic cigarettes (ECs) and tobacco cigarettes (TCs) both release nicotine, a sympathomimetic drug. We hypothesized that baseline heart rate variability (HRV) and hemodynamics would be similar in chronic EC and TC smokers and that after acute EC use, changes in HRV and hemodynamics would be attributable to nicotine, not non-nicotine, constituents in EC aerosol. In 100 smokers, including 58 chronic EC users and 42 TC smokers, baseline HRV and hemodynamics [blood pressure (BP) and heart rate (HR)] were compared. To isolate the acute effects of nicotine vs. non-nicotine constituents in EC aerosol, we compared changes in HRV, BP, and HR in EC users after using an EC with nicotine (ECN), EC without nicotine (EC0), nicotine inhaler (NI), or sham vaping (control). Outcomes were also compared with TC smokers after smoking one TC. Baseline HRV and hemodynamics were not different in chronic EC users and TC smokers. In EC users, BP and HR, but not HRV outcomes, increased only after using the ECN, consistent with a nicotine effect on BP and HR. Similarly, in TC smokers, BP and HR but not HRV outcomes increased after smoking one TC. Despite a similar increase in nicotine, the hemodynamic increases were significantly greater after TC smokers smoked one TC compared with the increases after EC users used the ECN. In conclusion, chronic EC and TC smokers exhibit a similar pattern of baseline HRV. Acute increases in BP and HR in EC users are attributable to nicotine, not non-nicotine, constituents in EC aerosol. The greater acute pressor effects after TC compared with ECN may be attributable to non-nicotine, combusted constituents in TC smoke.NEW & NOTEWORTHY Chronic electronic cigarette (EC) users and tobacco cigarette (TC) smokers exhibit a similar level of sympathetic nerve activity as estimated by heart rate variability. Acute increases in blood pressure (BP) and heart rate in EC users are attribute to nicotine, not non-nicotine, constituents in EC aerosol. Acute TC smoking increased BP significantly more than acute EC use, despite similar increases in plasma nicotine, suggestive of additional adverse vascular effects attributable to combusted, non-nicotine constituents in TC smoke.
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Affiliation(s)
- Sara Arastoo
- Department of Medicine, Division of Cardiology, David Geffen School of Medicine at University of California, Los Angeles, California
| | - Kacey P Haptonstall
- Department of Medicine, Division of Cardiology, David Geffen School of Medicine at University of California, Los Angeles, California
| | - Yasmine Choroomi
- Department of Medicine, Division of Cardiology, David Geffen School of Medicine at University of California, Los Angeles, California
| | - Roya Moheimani
- Department of Medicine, Division of Cardiology, David Geffen School of Medicine at University of California, Los Angeles, California
| | - Kevin Nguyen
- Department of Medicine, Division of Cardiology, David Geffen School of Medicine at University of California, Los Angeles, California
| | - Elizabeth Tran
- Department of Medicine, Division of Cardiology, David Geffen School of Medicine at University of California, Los Angeles, California
| | - Jeffrey Gornbein
- Departments of Medicine and Computational Medicine, David Geffen School of Medicine at University of California, Los Angeles, California
| | - Holly R Middlekauff
- Department of Medicine, Division of Cardiology, David Geffen School of Medicine at University of California, Los Angeles, California
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Kojima S, Nishihira K, Takegami M, Nakao YM, Honda S, Takahashi J, Takayama M, Shimokawa H, Sumiyoshi T, Ogawa H, Kimura K, Yasuda S. Nationwide real-world database of 20,462 patients enrolled in the Japanese Acute Myocardial Infarction Registry (JAMIR): Impact of emergency coronary intervention in a super-aging population. IJC HEART & VASCULATURE 2018; 20:1-6. [PMID: 29928687 PMCID: PMC6008289 DOI: 10.1016/j.ijcha.2018.06.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 05/28/2018] [Accepted: 06/07/2018] [Indexed: 12/02/2022]
Abstract
BACKGROUND Cardiovascular diseases, including acute myocardial infarction (AMI), are leading causes of death among the Japanese, who have the longest life expectancy in the world. Over the past 50 years in Japan, the percentage of elderly individuals has increased 4-fold, from 5.7% in 1960 to 23.1% in 2010. To explore medical practices and emergency care for AMI in this aging society, the Japan Acute Myocardial Infarction Registry (JAMIR) was established as a nationwide real-world database. METHODS JAMIR conducted retrospective analysis of 20,462 AMI patients (mean age, 68.8 ± 13.3 years; 15,281 men [74.7%]) hospitalized between January 2011 and December 2013. RESULTS The rates of ambulance use and emergency PCI were 78.9% and 87.9%, respectively. The median door-to-balloon time was 80 min (interquartile range, 53-143 min). Overall in-hospital mortality was 8.3%, including 6.6% due to cardiac death. JAMIR included 4837 patients aged ≥80 years (23.6%). In this age group, patients who underwent PCI (79.9%) had significantly lower in-hospital mortality than those who did not (11.1% vs. 36.9%, P < 0.001). CONCLUSIONS The large JAMIR database, with 24% of AMI patients aged ≥80 years, could provide useful information about medical care in an aging society. The reasonable in-hospital outcomes observed may justify consideration of PCI for patients with AMI aged ≥80 years.
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Affiliation(s)
- Sunao Kojima
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Kensaku Nishihira
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Misa Takegami
- Department of Department of Preventive Medicine and Epidemiologic Informatics, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Yoko M. Nakao
- Department of Department of Preventive Medicine and Epidemiologic Informatics, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Satoshi Honda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Jun Takahashi
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Morimasa Takayama
- Department of Cardiovascular Medicine, Sakakibara Heart Institute, Fuchu, Tokyo, Japan
| | - Hiroaki Shimokawa
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Tetsuya Sumiyoshi
- Department of Cardiovascular Medicine, Sakakibara Heart Institute, Fuchu, Tokyo, Japan
| | - Hisao Ogawa
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Kazuo Kimura
- Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Satoshi Yasuda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
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Li J, Peng C, Guo Z, Shi C, Zhuang R, Hong X, Wang X, Xu D, Zhang P, Zhang D, Liu T, Su X, Zhang X. Radioiodinated Pentixather for SPECT Imaging of Expression of the Chemokine Receptor CXCR4 in Rat Myocardial-Infarction-Reperfusion Models. Anal Chem 2018; 90:9614-9620. [PMID: 29996650 DOI: 10.1021/acs.analchem.8b02553] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The purpose of this study is to develop a specific CXCR4-targeting radioiodinated agent (125I- or 131I-pentixather) for single-photon-emission-computed-tomography (SPECT) imaging of CXCR4 expression in myocardial-infarction-reperfusion (MI/R) rat models. After SPECT-CT imaging with 125I-pentixather at 4, 12, and 36 h and 3 and 7 days after MI/R, the models were validated by ex vivo autoradiography, TTC staining, and immunohistochemistry and in vivo echocardiography and classical 99mTc-MIBI perfusion imaging. The SPECT-CT images showed that the infarcted myocardium (IM) could be visualized with high quality as early as 4 h and reached the maximum at 3 days after MI/R and that CXCR4 upregulation was still visible at 7 days after MI/R. In the biodistribution study, high uptakes in the IM (0.99 ± 0.13, 1.52 ± 0.29, 1.75 ± 0.22, 1.94 ± 0.27, and 0.61 ± 0.14% ID/g at 4, 12, and 36 h and 3 and 7 days after MI/R, respectively) were observed that were much higher than that of normal myocardium. The highest uptake was reached at 3 days after MI/R, which agreed well with the SPECT results. In addition, the radioactivity uptakes of the IM in both the biodistribution and SPECT imaging could be blocked effectively by excess amounts of AMD3465, indicating the high specificity of radioiodinated pentixather to CXCR4. On the basis of its promising properties, 125I-pentixather may serve as a powerful CXCR4-expression diagnostic probe for evaluating lesions and monitoring therapy responses in patients with cardiovascular diseases.
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Affiliation(s)
- Jindian Li
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Center for Molecular Imaging and Translational Medicine, School of Public Health , Xiamen University , Xiamen 361102 , China
| | - Chenyu Peng
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Center for Molecular Imaging and Translational Medicine, School of Public Health , Xiamen University , Xiamen 361102 , China
| | - Zhide Guo
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Center for Molecular Imaging and Translational Medicine, School of Public Health , Xiamen University , Xiamen 361102 , China
| | - Changrong Shi
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Center for Molecular Imaging and Translational Medicine, School of Public Health , Xiamen University , Xiamen 361102 , China
| | - Rongqiang Zhuang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Center for Molecular Imaging and Translational Medicine, School of Public Health , Xiamen University , Xiamen 361102 , China
| | - Xingfang Hong
- Laboratory of Pathogen Biology, School of Basic Medical Sciences , Dali University , Dali 671000 , China
| | - Xiangyu Wang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Center for Molecular Imaging and Translational Medicine, School of Public Health , Xiamen University , Xiamen 361102 , China
| | - Duo Xu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Center for Molecular Imaging and Translational Medicine, School of Public Health , Xiamen University , Xiamen 361102 , China
| | - Pu Zhang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Center for Molecular Imaging and Translational Medicine, School of Public Health , Xiamen University , Xiamen 361102 , China
| | - Deliang Zhang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Center for Molecular Imaging and Translational Medicine, School of Public Health , Xiamen University , Xiamen 361102 , China
| | - Ting Liu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Center for Molecular Imaging and Translational Medicine, School of Public Health , Xiamen University , Xiamen 361102 , China
| | - Xinhui Su
- Zhongshan Hospital Affiliated to Xiamen University , Xiamen 361004 , China
| | - Xianzhong Zhang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Center for Molecular Imaging and Translational Medicine, School of Public Health , Xiamen University , Xiamen 361102 , China
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Stress-induced release of the S100A8/A9 alarmin is elevated in coronary artery disease patients with impaired cortisol response. Sci Rep 2017; 7:17545. [PMID: 29235502 PMCID: PMC5727540 DOI: 10.1038/s41598-017-17586-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 11/27/2017] [Indexed: 12/19/2022] Open
Abstract
Psychological stress is thought to be an important trigger of cardiovascular events, yet the involved pathways and mediators are largely unknown. Elevated systemic levels of the pro-inflammatory alarmin S100A8/A9 correlate with poor prognosis in coronary artery disease (CAD) patients. Here, we investigated the links between S100A8/A9 release and parameters of anti-inflammatory glucocorticoid secretion in two different cohorts subjected to a psychological stress test. In the first cohort of 60 CAD patients, psychological stress induced a rapid increase of circulating S100A8/A9. This rapid S100A8/A9 response strongly correlated with elevated evening saliva cortisol levels, suggesting an association with a dysregulated hypothalamic–pituitary–adrenal (HPA) axis. In the second cohort of 27 CAD patients and 28 controls, elevated S100A8/A9 levels were still detectable 24 h after stress in 40% of patients and 36% of controls, with a tendency for higher levels in patients. The sustained S100A8/A9 response was associated with a poor rapid cortisol release after stress in patients, but not in the control group. Our findings reveal for the first time that acute psychological stress induces elevated levels of S100A8/A9. We also provide hypothesis-generating evidence that dysregulated cortisol secretion in CAD patients might be associated with an exaggerated pro-inflammatory S100A8/A9 response.
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Fabbian F, Bhatia S, De Giorgi A, Maietti E, Bhatia S, Shanbhag A, Deshmukh A. Circadian Periodicity of Ischemic Heart Disease: A Systematic Review of the Literature. Heart Fail Clin 2017; 13:673-680. [PMID: 28865776 DOI: 10.1016/j.hfc.2017.05.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
The authors performed a MEDLINE search to identify reports, published during the last 20 years, focused on circadian variation of acute myocardial infarction (AMI), and prevalence and the ratios between the number of events per hour during the morning and the other hours of the day were calculated. Despite the optimization of interventional and medical therapy of AMI since the first reports of circadian patterns in AMI occurrence, it was found that such a pattern still exists and that AMI happens most frequently in the morning hours.
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Affiliation(s)
- Fabio Fabbian
- Department of Medical Sciences, University of Ferrara, University Hospital St. Anna, Via Aldo Moro 8, I-44124, Cona, Ferrara, Italy.
| | - Subir Bhatia
- Department of Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - Afredo De Giorgi
- Department of Medical Sciences, University of Ferrara, University Hospital St. Anna, Via Aldo Moro 8, I-44124, Cona, Ferrara, Italy
| | - Elisa Maietti
- Department of Medical Sciences, University of Ferrara, Center for Clinical Epidemiology, 44121 Ferrara, Italy
| | - Sravya Bhatia
- School of Medicine, Duke University, 8 Duke University Medical Center Greenspace, Durham, NC 27703, USA
| | - Anusha Shanbhag
- Department of Internal Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham Street, Little Rock, AR 72205, USA
| | - Abhishek Deshmukh
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, 200 First Street Southwest, Rochester, Minnesota 55905, USA
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Targeting blood thrombogenicity precipitates atherothrombotic events in a mouse model of plaque destabilization. Sci Rep 2015; 5:10225. [PMID: 25959659 PMCID: PMC4426696 DOI: 10.1038/srep10225] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Accepted: 04/07/2015] [Indexed: 11/09/2022] Open
Abstract
Although some features of plaque instability can be observed in genetically modified mouse models, atherothrombosis induction in mice has been attested to be difficult. We sought to test the hypothesis that alterations in blood thrombogenicity might have an essential role in the development of atherothrombosis in ApoE-/- mice. In a mouse model of plaque destabilization established in our laboratory, we targeted blood thrombogenicity by systemically overexpressing murine prothrombin via adenovirus-mediated gene transfer. Systemic overexpression of prothrombin increased blood thrombogenicity, and remarkably, precipitated atherothrombotic events in 70% of the animals. The affected plaques displayed features of culprit lesions as seen in human coronary arteries, including fibrous cap disruption, luminal thrombosis, and plaque hemorrhage. Treatment with aspirin and clopidogrel substantially reduced the incidence of atherothrombosis in this model. Mechanistically, increased inflammation, apoptosis and upregulation of metalloproteinases contributed to the development of plaque destabilization and atherothrombosis. As conclusions, targeting blood thrombogenicity in mice can faithfully reproduce the process of atherothrombosis as occurring in human coronary vessels. Our results suggest that blood-plaque interactions are critical in the development of atherothrombosis in mice, substantiating the argument that changes in blood coagulation status may have a determinant role in the onset of acute coronary syndrome.
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Karangelis D, Daskalopoulos M, Giamouzis G, Koufakis T, Fragoulis S, Papadakis E, Kalafati G, Tsilimingas N. Acute aortic dissection is independent of weather conditions but statistically correlates with day of the week. J Emerg Trauma Shock 2014; 7:244-6. [PMID: 25114440 PMCID: PMC4126130 DOI: 10.4103/0974-2700.136877] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- Dimos Karangelis
- Department of Cardiac Surgery, Onassis Cardiac Centre, Athens, Greece
| | - Marios Daskalopoulos
- Department of Cardiovascular and Thoracic Surgery, Larissa University Hospital, Larissa, Greece
| | - Gregory Giamouzis
- Department of Cardiology, Larissa University Hospital, Larissa, Greece
| | - Theocharis Koufakis
- Department of Biomathematics, School of Medicine, University of Thessaly, Larissa, Greece. E-mail:
| | | | | | - Georgia Kalafati
- Department of Cardiovascular and Thoracic Surgery, Larissa University Hospital, Larissa, Greece
| | - Nikolaos Tsilimingas
- Department of Cardiovascular and Thoracic Surgery, Larissa University Hospital, Larissa, Greece
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Ekelund U, Akbarzadeh M, Khoshnood A, Björk J, Ohlsson M. Likelihood of acute coronary syndrome in emergency department chest pain patients varies with time of presentation. BMC Res Notes 2012; 5:420. [PMID: 22871081 PMCID: PMC3514348 DOI: 10.1186/1756-0500-5-420] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2012] [Accepted: 04/30/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is a circadian and circaseptal (weekly) variation in the onset of acute coronary syndrome (ACS). The aim of this study was to elucidate whether the likelihood of ACS among emergency department (ED) chest pain patients varies with the time of presentation. METHODS All patients presenting to the Lund ED at Skåne University Hospital with chest pain or discomfort during 2006 and 2007 were retrospectively included. Age, sex, arrival time at the ED and discharge diagnose (ACS or not) were obtained from the electronic medical records. RESULTS There was a clear but moderate circadian variation in the likelihood of ACS among presenting chest pain patients, the likelihood between 8 and 10 am being almost twice as high as between 6 and 8 pm. This was mainly explained by a variation in the ACS likelihood in females and patients under 65 years, with no significant variation in males and patients over 65 years. There was no significant circaseptal variation in the ACS likelihood. CONCLUSIONS Our results indicate that there is a circadian variation in the likelihood of ACS among ED chest pain patients, and suggest that physicians should consider the time of presentation to the ED when determining the likelihood of ACS.
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Affiliation(s)
- Ulf Ekelund
- Department of Emergency Medicine, Skåne University Hospital, Lund, SE-221 85, Sweden.
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Daylight saving time shifts and incidence of acute myocardial infarction – Swedish Register of Information and Knowledge About Swedish Heart Intensive Care Admissions (RIKS-HIA). Sleep Med 2012; 13:237-42. [DOI: 10.1016/j.sleep.2011.07.019] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2011] [Revised: 07/01/2011] [Accepted: 07/18/2011] [Indexed: 11/23/2022]
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Elsas SM, Gregory WL, White G, Navarro G, Salinsky MC, Andrews DJ. Aura interruption: the Andrews/Reiter behavioral intervention may reduce seizures and improve quality of life - a pilot trial. Epilepsy Behav 2011; 22:765-72. [PMID: 22056814 DOI: 10.1016/j.yebeh.2011.09.030] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2011] [Revised: 09/15/2011] [Accepted: 09/16/2011] [Indexed: 10/15/2022]
Abstract
Patients with epilepsy frequently experience depression and emotional stress and these may function as seizure triggers in epileptogenic frontotemporal cortex, which serves in emotional processing. Eight patients enrolled in a pilot trial of a 6-month epilepsy-specific behavioral approach comprising counseling and relaxation to recognize and eliminate emotional seizure triggers. Potential participants with psychogenic seizures were excluded by long-term EEG and/or the MMPI profile. One participant became seizure free, another had an approximately 90% reduction in seizures, and two additional participants achieved a greater than 50% reduction in seizure frequency (total responder rate=50%), stable during 6 months of observation after the intervention. All completers showed marked and stable improvement of quality of life (Quality of Life in Epilepsy-89 inventory) and temporary improvement in the Profile of Mood States. An adequately powered randomized controlled trial is needed to confirm our findings, which suggest that behavioral approaches may hold promise for motivated patients with epilepsy.
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Affiliation(s)
- S M Elsas
- Department of Neurology, Oregon Health and Science University, Portland, OR, USA.
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Janszky I, Ahnve S, Lundberg I, Hemmingsson T. Early-onset depression, anxiety, and risk of subsequent coronary heart disease: 37-year follow-up of 49,321 young Swedish men. J Am Coll Cardiol 2010; 56:31-7. [PMID: 20620714 DOI: 10.1016/j.jacc.2010.03.033] [Citation(s) in RCA: 159] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2009] [Revised: 02/16/2010] [Accepted: 03/02/2010] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The purpose of this study was to investigate the long-term cardiac effects of depression and anxiety assessed at a young age, when reverse causation is not feasible. BACKGROUND Most prospective studies found a relatively strong association between depression and subsequent coronary heart disease (CHD). However, almost exclusively, only middle-age or older participants were examined, and subclinical atherosclerosis might contribute to the observed association. The prospective association between anxiety and CHD was less evident in previous studies and has been subjected to similar methodological concerns on the possibility for a reverse causation. METHODS In a nationwide survey, 49,321 young Swedish men, 18 to 20 years of age, were medically examined for military service in 1969 and 1970. All the conscripts were seen by a psychologist for a structured interview. Conscripts reporting or presenting any psychiatric symptoms were seen by psychiatrists. Depression and anxiety was diagnosed according to International Classification of Diseases-8th Revision (ICD-8). Data on well-established CHD risk factors and potential confounders were also collected (i.e., anthropometrics, diabetes, blood pressure, smoking, alcohol consumption, physical activity, socioeconomic position, family history of CHD, and geographic area). Participants were followed for CHD and for acute myocardial infarction for 37 years. RESULTS Multiadjusted hazard ratios associated with depression were 1.04 (95% confidence interval [CI]: 0.70 to 1.54), 1.03 (95% CI: 0.65 to 1.65), for CHD and for acute myocardial infarction, respectively. The corresponding multiadjusted hazard ratios for anxiety were 2.17 (95% CI: 1.28 to 3.67) and 2.51 (95% CI: 1.38 to 4.55). CONCLUSIONS In men, aged 18 to 20 years, anxiety as diagnosed by experts according to ICD-8 criteria independently predicted subsequent CHD events. In contrast, we found no support for such an effect concerning early-onset depression in men.
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Affiliation(s)
- Imre Janszky
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
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