Interaction between eNOS gene polymorphism and current smoking on susceptibility to coronary heart disease in Chinese people

Optimisation of individual cardiovascular risk assessment in a German coronary artery disease cohort using a commercial test for genetic polymorphisms - a pilot study

BACKGROUND AND AIMS

Assessment of cardiovascular risk using established risk scores such as ESC SCORE2 or PROCAM insufficiently emphasise the role of genetic factors. We hypothesise that commercially available genetic assays may provide additional information on hereditary cardiovascular risk in a timely and cost-efficient manner.

METHODS

In a cohort of 51 patients treated for coronary artery disease (CAD) at University Hospital Heidelberg, Germany, a subgroup of patients with "unstable" CAD (i.e. recurrent acute coronary syndrome) was identified and compared to patients with "stable" disease (i.e. chronic coronary syndrome). Gene array analysis using a commercial assay for 15 potentially pathogenic polymorphisms revealed our cohort's genetic risk profile regarding atherosclerotic/thromboembolic events. Improvement of cardiovascular risk assessment based on established risk scores was analysed using net reclassification, logistic regression and receiver operating characteristic (ROC) analysis.

RESULTS

Discriminatory capacity of traditional risk scores such as SCORE2 or PROCAM with regard to stable and unstable CAD groups was poor (ROC AUC <0.5). Patients with "unstable" CAD exhibited a significantly increased frequency of pathogenic eNOS 894 T and MTHFR 1298 C polymorphisms compared to "stable" CAD patients, and information on these polymorphisms individually as well as combinations with additional polymorphisms included in the assay such as ACE D/D or PAI-1 5 G variants markedly improved risk prediction compared to SCORE2/PROCAM alone (ROC AUC ≥0.75).

CONCLUSION

Commercially available assays for genetic polymorphisms may provide valuable information on individual genetic cardiovascular risk, potentially guiding future primary and/or secondary preventative therapies for coronary artery disease.

Coronary vasomotion and exercise-induced adaptations in coronary artery disease patients: A systematic review and meta-analysis

Background:

Exercise can improve coronary blood flow in a healthy heart, but the vascular response of patients with coronary artery disease (CAD) is different. The aim of this study was to systematically review the chronic effects of exercise on coronary arterial function in CAD patients.

Materials and Methods:

Six electronic databases (PubMed, ScienceDirect, “Scopus,” Web of Science, EMBASE, and Google Scholar) covering publications from 1986 to 2019 were systematically searched with related keywords. Studies were included if they investigated changes in blood flow and coronary artery diameter in response to chronic exercise training in patients with CAD. A total of 5421 studies were assessed for quality and outcomes, and finally five studies met criteria for inclusion. For metaanalysis, the results of the studies were pooled using the randomeffects model. The heterogeneity between the studies was checked using I² index.

Results:

The total sample population consisted of 108 CAD patients. According to the findings of this study, coronary artery function in adaptation with exercise showed that a period of exercise leads to statistically significant improvement in coronary flow velocity reserve (z = 3.15, P = 0.002; standardized mean difference [SMD] =2.33, 95% confidence interval [CI]: 0.88–3.78) (containing six trials). In addition, vasodilatory response of coronary arteries in response to endothelium-independent vasodilator nitroglycerin was investigated in three studies (containing four trials). A meta-analysis showed that performing chronic aerobic exercises did not make a significant change in the endothelium-independent vasodilator (z = 0.83, P = 0.40; SMD = −0.36, 95% CI: −1.21–0.49).

Conclusion:

Based on the results of the present study, aerobic exercises improve the endothelial function of coronary arteries and thereby the vascular vasomotion function, while the results of this meta-analysis showed no change in arterial smooth muscle's function by chronic aerobic exercises. This study reflects the lack of high- and medium-quality reports about the chronic effects of anaerobic and resistance exercises and the various methods of aerobic exercise on cardiovascular function.

Involvement of FGFR4 Gene Variants on the Clinicopathological Severity in Urothelial Cell Carcinoma

Fibroblast growth factor receptor 4 (FGFR4) plays a prominent role in cell proliferation and cancer progression. This study explored the effect of FGFR4 single-nucleotide polymorphisms (SNPs) on the clinicopathological characteristics of urothelial cell carcinoma (UCC). This study was conducted to survey the possible correlation of the polymorphism of FGFR4 to the risk and clinicopathologic characteristics of UCC. Four loci of FGFR4 (rs2011077 T > C, rs351855 G > A, rs7708357 G>A, and rs1966265 A > G) were genotyped via the TaqMan allelic discrimination approach in 428 UCC cases and 856 controls. The results indicated that UCC subjects who carried the SNP rs2011077 TC+CC genotypes were significantly related to a higher tumor stage (odds ratio (OR): 1.751, 95% confidence interval (CI): 1.078–2.846), primary tumor size (OR: 1.637, 95% CI: 1.006–2.662), and histopathologic grading (OR: 1.919, 95% CI: 1.049–3.511). Moreover, the SNP rs1966265 AG+GG genotypes were prominently related to a higher tumor stage (OR: 1.769, 95% CI: 1.082–2.891), primary tumor size (OR: 1.654, 95% CI: 1.011–2.706), and histopathologic grading (OR: 2.006, 95% CI: 1.096–3.674) compared to individuals with AA homozygotes. In conclusion, our data reveal association of FGFR4 polymorphisms with UCC clinicopathologic characteristics. FGFR4 polymorphisms may serve as a marker or therapeutic target in UCC development.