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Meulendijks ER, Krul SPJ, Baalman SW, de Vries TAC, Wesselink R, Ernault AC, Kawasaki M, Al-Shama R, Neefs J, Limpens J, de Groot JR. Circulating adipose tissue proteins involved in atrial fibrillation: An explorative scoping review. Trends Cardiovasc Med 2024; 34:148-158. [PMID: 36538994 DOI: 10.1016/j.tcm.2022.12.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 12/12/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022]
Abstract
Obesity increases the risk of atrial fibrillation (AF), potentially through proteins secreted by adipose tissue (AT) that affect atrial electrical and structural remodeling. We aim to give a comprehensive overview of circulating AT proteins involved in inflammation and fibrosis, that are associated with prevalent AF (paroxysmal or persistent) and the risk on developing new-onset AF. These include adipokines, defined as proteins enriched in AT as adiponectin, but also proteins less specific to AT. We systematically performed an explorative search for studies reporting associations between proteins secreted from cells residing in the AT and AF, and additionally assessed the effect of obesity on these proteins by a secondary search. The AT proteins involved in inflammation were mostly increased in patients with prevalent and new-onset AF, and with obesity, while the AT enriched adipokines were mostly not associated with AF. This review provides insight into circulating adipose tissue proteins involved in AF substrate formation.
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Affiliation(s)
- Eva R Meulendijks
- Amsterdam UMC, University of Amsterdam, Heart Center, department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Meibergdreef 9, Amsterdam 1105, the Netherlands; Amsterdam Cardiovascular Sciences, Heart Failure and Arrhythmias, Amsterdam, the Netherlands.
| | - Sébastien P J Krul
- Amsterdam UMC, University of Amsterdam, Heart Center, department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Meibergdreef 9, Amsterdam 1105, the Netherlands
| | - Sarah W Baalman
- Amsterdam UMC, University of Amsterdam, Heart Center, department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Meibergdreef 9, Amsterdam 1105, the Netherlands
| | - Tim A C de Vries
- Amsterdam UMC, University of Amsterdam, Heart Center, department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Meibergdreef 9, Amsterdam 1105, the Netherlands; Amsterdam Cardiovascular Sciences, Heart Failure and Arrhythmias, Amsterdam, the Netherlands
| | - Robin Wesselink
- Amsterdam UMC, University of Amsterdam, Heart Center, department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Meibergdreef 9, Amsterdam 1105, the Netherlands; Amsterdam Cardiovascular Sciences, Heart Failure and Arrhythmias, Amsterdam, the Netherlands
| | - Auriane C Ernault
- Amsterdam UMC, University of Amsterdam, Heart Center, department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Meibergdreef 9, Amsterdam 1105, the Netherlands; Amsterdam Cardiovascular Sciences, Heart Failure and Arrhythmias, Amsterdam, the Netherlands
| | - Makiri Kawasaki
- Amsterdam UMC, University of Amsterdam, Heart Center, department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Meibergdreef 9, Amsterdam 1105, the Netherlands
| | - Rushd Al-Shama
- Amsterdam UMC, University of Amsterdam, Heart Center, department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Meibergdreef 9, Amsterdam 1105, the Netherlands; Amsterdam Cardiovascular Sciences, Heart Failure and Arrhythmias, Amsterdam, the Netherlands
| | - Jolien Neefs
- Amsterdam UMC, University of Amsterdam, Heart Center, department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Meibergdreef 9, Amsterdam 1105, the Netherlands
| | - Jacqueline Limpens
- Amsterdam UMC, University of Amsterdam, Heart Center, department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Meibergdreef 9, Amsterdam 1105, the Netherlands
| | - Joris R de Groot
- Amsterdam UMC, University of Amsterdam, Heart Center, department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Meibergdreef 9, Amsterdam 1105, the Netherlands; Amsterdam Cardiovascular Sciences, Heart Failure and Arrhythmias, Amsterdam, the Netherlands
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Feng R, Zhang Z, Fan Q. Carbohydrate antigen 125 in congestive heart failure: ready for clinical application? Front Oncol 2023; 13:1161723. [PMID: 38023127 PMCID: PMC10644389 DOI: 10.3389/fonc.2023.1161723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
Congestion is the permanent mechanism driving disease progression in patients with acute heart failure (AHF) and also is an important treatment target. However, distinguishing between the two different phenotypes (intravascular congestion and tissue congestion) for personalized treatment remains challenging. Historically, carbohydrate antigen 125 (CA125) has been a frequently used biomarker for the screening, diagnosis, and prognosis of ovarian cancer. Interestingly, CA125 is highly sensitive to tissue congestion and shows potential for clinical monitoring and optimal treatment of congestive heart failure (HF). Furthermore, in terms of right heart function parameters, CA125 levels are more advantageous than other biomarkers of HF. CA125 is expected to become a new biological alternative marker for congestive HF and thereby is expected be widely used in clinical practice.
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Affiliation(s)
- Rui Feng
- Department of Laboratory Medicine, Wuhan Asian Heart Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
- School of Medicine, Wuhan University of Science and Technology, Wuhan, China
| | - Zhenlu Zhang
- Department of Laboratory Medicine, Wuhan Asian Heart Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
| | - Qingkun Fan
- Department of Laboratory Medicine, Wuhan Asian Heart Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
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Papathanasiou KA, Giotaki SG, Vrachatis DA, Siasos G, Lambadiari V, Iliodromitis KE, Kossyvakis C, Kaoukis A, Raisakis K, Deftereos G, Papaioannou TG, Giannopoulos G, Avramides D, Deftereos SG. Molecular Insights in Atrial Fibrillation Pathogenesis and Therapeutics: A Narrative Review. Diagnostics (Basel) 2021; 11:diagnostics11091584. [PMID: 34573926 PMCID: PMC8470040 DOI: 10.3390/diagnostics11091584] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 08/29/2021] [Accepted: 08/30/2021] [Indexed: 12/15/2022] Open
Abstract
The prevalence of atrial fibrillation (AF) is bound to increase globally in the following years, affecting the quality of life of millions of people, increasing mortality and morbidity, and beleaguering health care systems. Increasingly effective therapeutic options against AF are the constantly evolving electroanatomic substrate mapping systems of the left atrium (LA) and ablation catheter technologies. Yet, a prerequisite for better long-term success rates is the understanding of AF pathogenesis and maintenance. LA electrical and anatomical remodeling remains in the epicenter of current research for novel diagnostic and treatment modalities. On a molecular level, electrical remodeling lies on impaired calcium handling, enhanced inwardly rectifying potassium currents, and gap junction perturbations. In addition, a wide array of profibrotic stimuli activates fibroblast to an increased extracellular matrix turnover via various intermediaries. Concomitant dysregulation of the autonomic nervous system and the humoral function of increased epicardial adipose tissue (EAT) are established mediators in the pathophysiology of AF. Local atrial lymphomononuclear cells infiltrate and increased inflammasome activity accelerate and perpetuate arrhythmia substrate. Finally, impaired intracellular protein metabolism, excessive oxidative stress, and mitochondrial dysfunction deplete atrial cardiomyocyte ATP and promote arrhythmogenesis. These overlapping cellular and molecular alterations hinder us from distinguishing the cause from the effect in AF pathogenesis. Yet, a plethora of therapeutic modalities target these molecular perturbations and hold promise in combating the AF burden. Namely, atrial selective ion channel inhibitors, AF gene therapy, anti-fibrotic agents, AF drug repurposing, immunomodulators, and indirect cardiac neuromodulation are discussed here.
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Affiliation(s)
- Konstantinos A. Papathanasiou
- Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (K.A.P.); (S.G.G.); (D.A.V.); (G.S.); (V.L.); (T.G.P.)
| | - Sotiria G. Giotaki
- Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (K.A.P.); (S.G.G.); (D.A.V.); (G.S.); (V.L.); (T.G.P.)
| | - Dimitrios A. Vrachatis
- Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (K.A.P.); (S.G.G.); (D.A.V.); (G.S.); (V.L.); (T.G.P.)
| | - Gerasimos Siasos
- Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (K.A.P.); (S.G.G.); (D.A.V.); (G.S.); (V.L.); (T.G.P.)
| | - Vaia Lambadiari
- Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (K.A.P.); (S.G.G.); (D.A.V.); (G.S.); (V.L.); (T.G.P.)
| | | | - Charalampos Kossyvakis
- Department of Cardiology, “G. Gennimatas” General Hospital of Athens, 11527 Athens, Greece; (C.K.); (A.K.); (K.R.); (G.D.); (D.A.)
| | - Andreas Kaoukis
- Department of Cardiology, “G. Gennimatas” General Hospital of Athens, 11527 Athens, Greece; (C.K.); (A.K.); (K.R.); (G.D.); (D.A.)
| | - Konstantinos Raisakis
- Department of Cardiology, “G. Gennimatas” General Hospital of Athens, 11527 Athens, Greece; (C.K.); (A.K.); (K.R.); (G.D.); (D.A.)
| | - Gerasimos Deftereos
- Department of Cardiology, “G. Gennimatas” General Hospital of Athens, 11527 Athens, Greece; (C.K.); (A.K.); (K.R.); (G.D.); (D.A.)
| | - Theodore G. Papaioannou
- Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (K.A.P.); (S.G.G.); (D.A.V.); (G.S.); (V.L.); (T.G.P.)
| | | | - Dimitrios Avramides
- Department of Cardiology, “G. Gennimatas” General Hospital of Athens, 11527 Athens, Greece; (C.K.); (A.K.); (K.R.); (G.D.); (D.A.)
| | - Spyridon G. Deftereos
- Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (K.A.P.); (S.G.G.); (D.A.V.); (G.S.); (V.L.); (T.G.P.)
- Correspondence: ; Tel.: +30-21-0583-2355
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Wang Q, Dang C, Liu H, Hui J. Plasma carbohydrate antigen-125 for prediction of atrial fibrillation recurrence after radiofrequency catheter ablation. BMC Cardiovasc Disord 2021; 21:400. [PMID: 34412586 PMCID: PMC8375058 DOI: 10.1186/s12872-021-02207-y] [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] [Received: 04/08/2021] [Accepted: 08/12/2021] [Indexed: 12/20/2022] Open
Abstract
Background Elevated plasma carbohydrate antigen-125 (CA-125) levels are strongly associated with new-onset atrial fibrillation (AF) and heart failure, but the relationship between plasma CA-125 level and AF recurrence following radiofrequency catheter ablation (RFCA) remains poorly investigated. We aimed to assess whether elevated CA-125 levels are related to long-term AF recurrence following RFCA. Methods Preoperative CA-125 levels were determined in AF patients undergoing initial RFCA. Multivariate-adjusted Cox models were constructed to determine the relationship between CA-125 levels and AF recurrence. Multivariate logistic regression analyses were performed to determine predictors of AF recurrence. Results Of the 353 enrolled patients, 85 patients (24.1%) had AF recurrence at the 12-month follow-up. These patients had significantly higher baseline CA-125 levels than those without AF recurrence [(18.71 ± 12.63) vs. (11.27 ± 5.40) U/mL, P < 0.001]. The incidence of AF recurrence across quartiles 1–4 of CA-125 was 11.5%, 13.3%, 21.6% and 50.0%, respectively (P-trend < 0.001). The adjusted hazard ratios (aHRs) for AF recurrence across quartiles 1–4 of CA-125 were 1.00 (reference), 1.085 (95% CI, 0.468–2.520), 1.866 (95% CI, 0.867–4.019), and 4.246 (95% CI, 2.113–8.533), respectively (P-trend < 0.001). A similar effect was obtained when CA-125 was studied as continuous data (aHR per unit increase in LnCA-125, 3.225, 95% CI, 2.258–4.606; P < 0.001). When a predefined CA-125 cut-off of 13.75 U/mL was established, patients with CA-125 ≥ 13.75 U/mL had a higher risk of recurrent AF than those with CA-125 < 13.75 U/mL (aHR, 3.540, 95% CI, 2.268–5.525, P < 0.001). Multivariate analysis revealed CA-125, high-sensitivity C-reactive protein, and left atrium anteroposterior diameter as independent risk factors for AF recurrence. Conclusions Elevated preoperative CA-125 levels are related to a higher risk of AF recurrence and can independently predict AF recurrence following RFCA.
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Affiliation(s)
- Qingya Wang
- Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, 215006, China
| | - Chengjing Dang
- Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, 215006, China
| | - Haoyu Liu
- Department of Physical Medicine and Rehabilitation, The First Affiliated Hospital of Soochow University, Suzhou, 215006, China
| | - Jie Hui
- Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, 215006, China.
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Potential Biomarkers in Atrial Fibrillation: Insight into their Clinical Significance. J Cardiovasc Pharmacol 2021; 78:184-191. [PMID: 34173807 DOI: 10.1097/fjc.0000000000001042] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 03/24/2021] [Indexed: 11/26/2022]
Abstract
ABSTRACT In risk-stratifying patients with atrial fibrillation (AF), physicians rely heavily on clinical parameters that provide risk scores and determine treatment strategies. There has been increasing research on potential biomarkers in the blood that could more accurately determine both risk of complications in AF and risk of incidence of AF. This review highlights the clinical significance of five novel biomarkers that have been shown to be linked to AF. These biomarkers are carbohydrate antigen 125 (CA-125), galectin-3 (gal-3), growth differentiating factor-15 (GDF-15), a member of the interleukin 1 receptor family, IL1RL1 (ST2) and N-terminal pro B-type natriuretic peptide (NT-proBNP).
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Kohli U, Meinert E, Chong G, Tesher M, Jani P. Fulminant myocarditis and atrial fibrillation in child with acute COVID-19. J Electrocardiol 2020; 73:150-152. [PMID: 33268052 PMCID: PMC7568943 DOI: 10.1016/j.jelectrocard.2020.10.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 10/02/2020] [Accepted: 10/08/2020] [Indexed: 12/14/2022]
Abstract
COVID-19 has manifested with ventricular dysfunction and cardiac arrhythmias, most commonly atrial fibrillation (AFib), in adults. However, very few pediatric patients with acute COVID-19 have had cardiac involvement. AFib, an exceedingly rare arrhythmia in otherwise healthy children, has not been reported in children with COVID-19. We report a 15 year-old girl with acute COVID-19, fulminant myocarditis and AFib.
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Affiliation(s)
- Utkarsh Kohli
- Section of Pediatric Cardiology, Department of Pediatrics, Comer Children's Hospital and the Pritzker School of Medicine of the University of Chicago, Chicago, IL, United States of America.
| | - Elizabeth Meinert
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Comer Children's Hospital and the Pritzker School of Medicine of the University of Chicago, Chicago, IL, United States of America
| | - Grace Chong
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Comer Children's Hospital and the Pritzker School of Medicine of the University of Chicago, Chicago, IL, United States of America
| | - Melissa Tesher
- Division of Rheumatology, Department of Pediatrics, Comer Children's Hospital and the Pritzker School of Medicine of the University of Chicago, Chicago, IL, United States of America
| | - Priti Jani
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Comer Children's Hospital and the Pritzker School of Medicine of the University of Chicago, Chicago, IL, United States of America
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7
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Yao L, Zhong Y, He L, Wang Y, Wu J, Geng J, Zhou Y, Zhang J, Chen J, Shan Z, Teng W, Xu Y, Chen L, Liu L. Serum CA125 Level Is Associated with Diabetic Retinopathy in Chinese Patients with Type 2 Diabetes. Diabetes Metab Syndr Obes 2020; 13:1803-1812. [PMID: 32547142 PMCID: PMC7250309 DOI: 10.2147/dmso.s250928] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Accepted: 05/07/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND To investigate the association between serum carbohydrate antigen 125 (CA125) and the presence as well as severity of diabetes retinopathy (DR) in Chinese adult patients with type 2 diabetes. METHODS A hospital-based cross-sectional study was conducted from February 2012 to November 2018. DR was assessed using Early Treatment Diabetic Retinopathy Study criteria. Vision-threatening DR (VTDR) was diagnosed if subjects had severe non-proliferative DR (NPDR), proliferative DR (PDR), or clinically significant macular edema (CSME). Multivariate logistic regression models were applied to explore the associations. RESULTS Among the 2696 participants, the overall prevalence of DR was 25.1%, of which the prevalence of mild NPDR, moderate NPDR, and VTDR was 10.8%, 4.5%, and 9.9%, respectively. Serum CA125 level was significantly higher in participants with DR and increased with the severity of DR (P = 0.013). After accounting for age, gender, smoking, drinking, duration of diabetes, anti-diabetic agents use, systolic blood pressure, pulse pressure, weight, hemoglobin A1c and fasting plasma glucose levels, CA125 level was significantly associated with subjects in any-severity DR (odds ratio [OR] 1.006 [95% confidence interval CI: 1.002-1.010], P = 0.006) and VTDR (1.008 [1.003-1.013], P = 0.001). When CA125 was treated as categorized variables, the prevalence of VTDR might increase as improving CA125 quartiles (P value for trend = 0.017). CONCLUSION In this study, serum CA125 level was associated with the presence and severity of DR in Chinese patients with type 2 diabetes. Further prospective studies should be warranted to validate the feasible role of CA125 as well as other biomarkers.
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Affiliation(s)
- Litong Yao
- China Medical University, Shenyang110001, People’s Republic of China
- Department of Breast Surgery, The First Hospital of China Medical University, Shenyang110001, People’s Republic of China
| | - Yifan Zhong
- Department of Ophthalmology, The First Hospital of China Medical University, Shenyang110001, People’s Republic of China
| | - Lingzi He
- China Medical University, Shenyang110001, People’s Republic of China
| | - Yan Wang
- Department of Radiology, General Hospital of Liaohe Oil Field, Panjin124010, People’s Republic of China
| | - Jingyang Wu
- Department of Ophthalmology, The First Hospital of China Medical University, Shenyang110001, People’s Republic of China
| | - Jin Geng
- Department of Ophthalmology, The First Hospital of China Medical University, Shenyang110001, People’s Republic of China
| | - Yun Zhou
- Department of Ophthalmology, The First Hospital of China Medical University, Shenyang110001, People’s Republic of China
| | - Jiahua Zhang
- Department of Ophthalmology, The First Hospital of China Medical University, Shenyang110001, People’s Republic of China
| | - Jun Chen
- Department of Ophthalmology, The First Hospital of China Medical University, Shenyang110001, People’s Republic of China
| | - Zhongyan Shan
- Department of Endocrinology and Metabolism, Institute of Endocrinology, Liaoning Provincial Key Laboratory of Endocrine Diseases, The First Affiliated Hospital of China Medical University, Shenyang110001, People’s Republic of China
| | - Weiping Teng
- Department of Endocrinology and Metabolism, Institute of Endocrinology, Liaoning Provincial Key Laboratory of Endocrine Diseases, The First Affiliated Hospital of China Medical University, Shenyang110001, People’s Republic of China
| | - Yingying Xu
- Department of Breast Surgery, The First Hospital of China Medical University, Shenyang110001, People’s Republic of China
| | - Lei Chen
- Department of Ophthalmology, The First Hospital of China Medical University, Shenyang110001, People’s Republic of China
- Correspondence: Lei Chen; Lei Liu Email ;
| | - Lei Liu
- Department of Ophthalmology, The First Hospital of China Medical University, Shenyang110001, People’s Republic of China
- Correspondence: Lei Chen; Lei Liu Email ;
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Yoon JY, Yang DH, Cho HJ, Kim NK, Kim CY, Son J, Roh JH, Jang SY, Bae MH, Lee JH, Park HS, Cho Y, Chae SC. Serum levels of carbohydrate antigen 125 in combination with N-terminal pro-brain natriuretic peptide in patients with acute decompensated heart failure. Korean J Intern Med 2019; 34:811-818. [PMID: 30616330 PMCID: PMC6610187 DOI: 10.3904/kjim.2017.313] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 01/26/2018] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND/AIMS Carbohydrate antigen 125 (CA-125) is an emerging prognostic biomarker for heart failure. We aimed to test the long-term prognostic value of CA-125 in combination with N-terminal pro-brain natriuretic peptide (NT-proBNP) in patients with acute decompensated heart failure (ADHF). METHODS This observational study included a total of 413 patients (64.1 ± 15.6 yearold, 214 men) with ADHF. All-cause mortality during the 2-year follow-up was investigated for the prognosis. RESULTS During the follow-up (mean follow-up, 591 ± 233 days), 109 deaths (26.0%) were recorded. In the multivariable analysis model, CA-125 was an independent factor associated with all-cause mortality (log CA-125: hazard ratio, 1.23; 95% confidence interval, 1.02 to 1.48; p = 0.030) together with age, sex, New York Heart Association class, β-blocker, and NT-proBNP. The Kaplan-Meier survival analysis demonstrated that the group with both low marker levels showed the best 2-year survival (87.9%) followed by the group with low NT-proBNP and high CA-125 (76.1%), high NT-proBNP and low CA-125 (64.7%) and high NT-proBNP and high CA-125 levels (54.3%) (p < 0.001). Addition of CA-125 in combination with NT-proBNP and established risk factors further increased the predictive power for mortality in patients with ADHF. CONCLUSION CA-125 was an independent factor associated with all-cause mortality in patients with ADHF. Combination of CA-125 with NT-proBNP significantly improved the prediction of mortality in patients with ADHF.
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Affiliation(s)
- Jae Yong Yoon
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Dong Heon Yang
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
- Cardiology Center, Kyungpook National University Medical Center, Daegu, Korea
- Correspondence to Dong Heon Yang, M.D. Department of Internal Medicine, Kyungpook National University Hospital, 130 Dongdeok-ro,
Jung-gu, Daegu 41944, Korea Tel: +82-53-420-6587 Fax: +82-53-426-2046 E-mail:
| | - Hyun Jun Cho
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Nam Kyun Kim
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Chang-Yeon Kim
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Jihyun Son
- Cardiology Center, Kyungpook National University Medical Center, Daegu, Korea
| | - Jae-Hyung Roh
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Se Yong Jang
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
- Cardiology Center, Kyungpook National University Medical Center, Daegu, Korea
| | - Myung Hwan Bae
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Jang Hoon Lee
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Hun Sik Park
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Yongkeun Cho
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Shung Chull Chae
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
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Bulska-Będkowska W, Chełmecka E, Owczarek AJ, Mizia-Stec K, Witek A, Szybalska A, Grodzicki T, Olszanecka-Glinianowicz M, Chudek J. CA125 as a Marker of Heart Failure in the Older Women: Population-Based Analysis. J Clin Med 2019; 8:jcm8050607. [PMID: 31058877 PMCID: PMC6572540 DOI: 10.3390/jcm8050607] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 04/25/2019] [Accepted: 04/30/2019] [Indexed: 12/11/2022] Open
Abstract
(1) Background: Cancer antigen 125 (CA125) is a glycoprotein that is expressed by tissue derived from coelomic epithelium in the pleura, peritoneum, pericardium. It has been shown that CA125 concentrations are correlated with NT-proBNP in older people with congestive heart failure (HF). We conducted a study on the association between concentrations of CA125 and NT-proBNP in a population-based cohort of older Polish women. (2) Methods: The current research is sub-study of a large, cross-sectional research project (PolSenior). The study group consisted of 1565 Caucasian women aged 65–102 years. To assess the relationship between CA125 and other variables a stepwise backward multivariate normal and skew-t regression analyses were performed. (3) Results: The median of CA125 concentration was 13.0 U/mL and values over the upper normal range limit (35 U/mL) were observed in 5.1% (n = 79) of the study cohort. The concentration of CA125 was positively related to age, hospitalization for HF and history of atrial fibrillation and chronic obstructive pulmonary disease, levels of NT-proBNP, IL-6, hs-CRP and triglycerides. We found in the multivariate analyses, that increased CA125 levels were independently associated with log10 (IL-6) (β = 11.022), history of hospitalization for HF (β = 4.619), log10 (NT-proBNP) (β = 4.416) and age (β = 3.93 for 10 years). (4) Conclusions: Despite the association between CA125 and NT-proBNP, the usefulness of CA125 for the detection of HF in older women is limited by factors such as inflammatory status and age.
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Affiliation(s)
- Weronika Bulska-Będkowska
- Department of Internal Diseases and Oncological Chemotherapy, School of Medicine in Katowice, Medical University of Silesia, 40-027 Katowice, Poland.
| | - Elżbieta Chełmecka
- Department of Statistics, Department of Instrumental Analysis, School of Pharmacy and Laboratory Medicine in Sosnowiec, Medical University of Silesia, 41-200 Sosnowiec, Poland.
| | - Aleksander J Owczarek
- Department of Statistics, Department of Instrumental Analysis, School of Pharmacy and Laboratory Medicine in Sosnowiec, Medical University of Silesia, 41-200 Sosnowiec, Poland.
| | - Katarzyna Mizia-Stec
- First Department of Cardiology, School of Medicine in Katowice, Medical University of Silesia, 40-635 Katowice, Poland.
| | - Andrzej Witek
- Department of Gynecology and Obstetrics, School of Medicine in Katowice, Medical University of Silesia, 40-752 Katowice, Poland.
| | | | - Tomasz Grodzicki
- Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, 31-531 Cracow, Poland.
| | - Magdalena Olszanecka-Glinianowicz
- Health Promotion and Obesity Management Unit, Department of Pathophysiology, School of Medicine in Katowice, Medical University of Silesia, 40-752 Katowice, Poland.
| | - Jerzy Chudek
- Department of Internal Diseases and Oncological Chemotherapy, School of Medicine in Katowice, Medical University of Silesia, 40-027 Katowice, Poland.
- Pathophysiology Unit, Department of Pathophysiology, School of Medicine in Katowice, Medical University of Silesia, 40-752 Katowice, Poland.
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10
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Zacharia E, Papageorgiou N, Ioannou A, Siasos G, Papaioannou S, Vavuranakis M, Latsios G, Vlachopoulos C, Toutouzas K, Deftereos S, Providência R, Tousoulis D. Inflammatory Biomarkers in Atrial Fibrillation. Curr Med Chem 2019; 26:837-854. [DOI: 10.2174/0929867324666170727103357] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 11/20/2016] [Accepted: 12/02/2016] [Indexed: 11/22/2022]
Abstract
During the last few years, a significant number of studies have attempted to clarify
the underlying mechanisms that lead to the presentation of atrial fibrillation (AF). Inflammation
is a key component of the pathophysiological processes that lead to the development
of AF; the amplification of inflammatory pathways triggers AF, and, in tandem, AF
increases the inflammatory state. Indeed, the plasma levels of several inflammatory biomarkers
are elevated in patients with AF. In addition, the levels of specific inflammatory
biomarkers may provide information regarding to the AF duration. Several small studies
have assessed the role of anti-inflammatory treatment in atrial fibrillation but the results
have been contradictory. Large-scale studies are needed to evaluate the role of inflammation
in AF and whether anti-inflammatory medications should be routinely administered to
patients with AF.
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Affiliation(s)
- Effimia Zacharia
- 1st Department of Cardiology, Hippokration Hospital, University of Athens, Athens, Greece
| | | | | | - Gerasimos Siasos
- 1st Department of Cardiology, Hippokration Hospital, University of Athens, Athens, Greece
| | - Spyridon Papaioannou
- 1st Department of Cardiology, Hippokration Hospital, University of Athens, Athens, Greece
| | - Manolis Vavuranakis
- 1st Department of Cardiology, Hippokration Hospital, University of Athens, Athens, Greece
| | - George Latsios
- 1st Department of Cardiology, Hippokration Hospital, University of Athens, Athens, Greece
| | | | - Konstantinos Toutouzas
- 1st Department of Cardiology, Hippokration Hospital, University of Athens, Athens, Greece
| | | | - Rui Providência
- Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom
| | - Dimitris Tousoulis
- 1st Department of Cardiology, Hippokration Hospital, University of Athens, Athens, Greece
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11
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Akinwunmi BO, Babic A, Vitonis AF, Cramer DW, Titus L, Tworoger SS, Terry KL. Chronic Medical Conditions and CA125 Levels among Women without Ovarian Cancer. Cancer Epidemiol Biomarkers Prev 2018; 27:1483-1490. [PMID: 30237250 DOI: 10.1158/1055-9965.epi-18-0203] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 05/22/2018] [Accepted: 09/13/2018] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Randomized trials using the biomarker cancer antigen (CA) 125, with or without pelvic ultrasound, have failed to show a clear benefit of general population screening for ovarian cancer. In part, this may be due to a lack of information about conditions, besides ovarian cancer, that can alter CA125 levels and affect specificity or sensitivity. We evaluated the association between common medical conditions and CA125 levels among women without ovarian cancer. METHODS We used data and specimens from 2,004 women without ovarian cancer who participated in the New England Case Control study between 1992 and 2008. Participants completed in-person interviews and donated blood samples at enrollment. We measured CA125 using the CA125II assay and calculated the association between medical conditions and log-transformed CA125 using linear regression. RESULTS The median age of participants was 53 years and 1,119 (56%) were postmenopausal. The average CA125 level was 14.5 units/mL for premenopausal and 11.7 for postmenopausal women. Among premenopausal women, CA125 was significantly lower for women with colon polyps (P = 0.06) and hysterectomy (P = 0.01) and significantly higher with endometriosis (P = 0.05). CA125 was also significantly higher in premenopausal women with coronary artery disease (CVD) (P < 0.01, n = 2 cases) but not among postmenopausal with CVD (n = 79). Furthermore, among postmenopausal women, CA125 was significantly lower for women with osteoporosis, hypercholesterolemia, and osteoarthritis (P = 0.03, 0.02, and 0.01 respectively) and higher for women with a history of inflammatory bowel disease (P = 0.04). CONCLUSIONS Several chronic diseases are associated with CA125, which could influence the interpretation of CA125 in the context of ovarian cancer screening. IMPACT Consideration of chronic medical conditions may be necessary to interpret CA125 values.
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Affiliation(s)
- Babatunde O Akinwunmi
- Obstetrics and Gynecology Epidemiology Center, Brigham and Women's Hospital, Boston, Massachusetts. .,Department of Global and Continuing Education, Harvard Medical School, Boston, Massachusetts
| | - Ana Babic
- Dana Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts
| | - Allison F Vitonis
- Obstetrics and Gynecology Epidemiology Center, Brigham and Women's Hospital, Boston, Massachusetts
| | - Daniel W Cramer
- Obstetrics and Gynecology Epidemiology Center, Brigham and Women's Hospital, Boston, Massachusetts.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.,Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, Boston, Massachusetts
| | - Linda Titus
- Departments of Epidemiology and Pediatrics, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
| | - Shelley S Tworoger
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.,Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida
| | - Kathryn L Terry
- Obstetrics and Gynecology Epidemiology Center, Brigham and Women's Hospital, Boston, Massachusetts.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.,Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, Boston, Massachusetts
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12
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NT-proBNP and CA 125 levels are associated with increased pro-inflammatory cytokines in coronary sinus serum of patients with chronic heart failure. Cytokine 2018; 111:13-19. [PMID: 30098475 DOI: 10.1016/j.cyto.2018.07.037] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 07/04/2018] [Accepted: 07/31/2018] [Indexed: 02/08/2023]
Abstract
PURPOSE Heart failure (HF) is considered to be a complex syndrome associated with neurohormonal and cytokine activation, that contribute to its progression. There are evidences which showed that, carbohydrate antigen 125 (CA 125), a tumor marker widely used for ovarian cancer therapy monitoring, was significantly elevated in HF patients. We hypothesized that inflammatory stimuli may be responsible for amino-terminal fragment of the prohormone B-type natriuretic peptide (NT-proBNP) and CA-125 production and release in chronic HF (CHF). We aimed to measure the levels of NT-proBNP, CA 125, pro-anti-inflammatory cytokines (IL-6, IL-1β, IL-8, TNF-α and IL-4), from peripheral venous (PV) and coronary sinus (CS) blood samples, in patients with CHF and to assess their correlation with echocardiographic indices. METHODS We enrolled 32 subjects (20M/12F) with CHF (III-IV NYHA functional class) who were to undergo cardiac resynchronization therapy (CRT) device implantation and 30 healthy controls (18M/12F). Two blood samples, from PV and CS, were collected at the time of CRT for each CHF patient. Serum levels of biomarkers were measured by ELISA. Cardiac function was assessed echocardiographically. RESULTS All investigated biomarkers were significantly higher in CHF patients than in non-CHF controls (P < 0.001). There were positive correlations between biomarkers concentrations in PV and CS (r between 0.54 and 0.98, all P < 0.003). NT-proBNP, IL-6 and IL-1β levels were 17%, 86% and 36% higher in CS than in PV, these increases being very well correlated each other, while CA 125 levels were 86% higher in PV than in CS. Moreover, CS NT-proBNP, CS IL-6 and CS IL-1β serum concentrations were inversely related to the echocardiographically determined left ventricular ejection fraction (LVEF) (r = -0.61, P < 0.001; r = -0.71, P < 0.001 and r = -0.48, P = 0.005, respectively). A positive relationship was found between CA 125 and IL-1β (r = 0.51, P = 0.003) in CS serum and between CA 125 and IL-6 (r = 0.43, P = 0.015), TNF-α (r = 0.46, P = 0.008) in PV serum. CA 125 concentrations were closely related to NT-proBNP both in CS (r = 0.46, P = 0.008) and PV (r = 0.52, P = 0.002). CONCLUSIONS CS sampling of NT-proBNP, CA 125 and pro-anti-inflammatory cytokines provides an additional insight into the possible mechanisms by which these biomarkers lead to left ventricular remodeling. Our results clearly suggest that serum NT-proBNP and CA 125 levels not only in PV, but also in CS of patients with CHF, may be dependent on inflammation as a consequence of cytokine network activation.
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13
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Cheung A, Gong M, Bellanti R, Ali-Hasan-Al-Saegh S, Li G, Roig E, Núñez J, Stamos TD, Yilmaz MB, Hakki K, Wu WKK, Wong SH, Wong WT, Bazoukis G, Lampropoulos K, Tse LA, Zhao J, Lip GYH, Baranchuk A, Wong MCS, Liu T, Tse G. Cancer antigen-125 and risk of atrial fibrillation: a systematic review and meta-analysis. HEART ASIA 2018; 10:e010970. [PMID: 29387174 DOI: 10.1136/heartasia-2017-010970] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 11/10/2017] [Accepted: 11/12/2017] [Indexed: 01/08/2023]
Abstract
Background Cancer antigen-125 (Ca-125) is traditionally recognised as a tumour marker and its role in cardiovascular diseases has been studied only in recent years. Whether Ca-125 is elevated in patients with atrial fibrillation (AF) and its levels predict the risk of AF remains controversial. Therefore, we conducted a systematic review and meta-analysis of the association between Ca-125 levels and AF. Methods PubMed and EMBASE databases were searched until 1 June 2017 for studies that evaluated the association between Ca-125 and AF. Inclusion criteria included studies that compare Ca-125 in patients with and without AF, or those reporting HRs/ORs for risk of AF stratified by Ca-125 levels. Results A total of 39 entries were retrieved from the databases, of which 10 studies were included in the final meta-analysis. Ca-125 was significantly higher in patients with AF compared with those in sinus rhythm (mean difference=16 U/mL, 95% CI 2 to 30 U/mL, P<0.05; I2: 98%). Ca-125 significantly increased the risk of AF (HR: 1.39, 95% CI 1.06 to 1.82, P<0.05; I2: 84%). Conclusion Ca-125 was significantly higher in patients with AF than in those in sinus rhythm, and high Ca-125 is predictive of AF occurrence. However, the high heterogeneity observed means there is an uncertainty in the relationship between Ca-125 and AF, which needs to be confirmed by larger prospective studies.
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Affiliation(s)
- Angel Cheung
- Department of Biomedical Engineering, Brown University, Providence, Rhode Island, USA
| | - Mengqi Gong
- Department of Cardiology, Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China
| | - Roberto Bellanti
- Department of Medicine, Cambridge University Hospital NHS Trust, Cambridge, UK
| | | | - Guangping Li
- Department of Cardiology, Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China
| | - Eulàlia Roig
- Cardiology Department, Hospital de la Santa Creu i Sant Pau, Institut de Recerca Biomèdica Sant Pau and Universitat Autònoma, Barcelona, Spain
| | - Julio Núñez
- Cardiology Department, Departamento de Medicina, Hospital Clínico Universitario, Universitat de València, Valencia, Spain.,CIBER in Cardiovascular Diseases (CIBERCV), Madrid, Spain
| | - Thomas D Stamos
- Department of Cardiology, University of Illinois at Chicago, Chicago, Illinois, USA
| | | | - Kaya Hakki
- Department of Cardiology, Cumhuriyet University Medical School, Sivas, Turkey
| | - William K K Wu
- Department of Anaesthesia and Intensive Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China.,Faculty of Medicine, Li Ka Shing Institute of Health Sciences, Chinese University of Hong Kong, Hong Kong, China
| | - Sunny Hei Wong
- Faculty of Medicine, Li Ka Shing Institute of Health Sciences, Chinese University of Hong Kong, Hong Kong, China.,Department of Medicine and Therapeutics, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China
| | - Wing Tak Wong
- School of Life Sciences, Chinese University of Hong Kong, Hong Kong, China
| | - George Bazoukis
- Second Department of Cardiology, Laboratory of Cardiac Electrophysiology, Evangelismos General Hospital of Athens, Athens, Greece
| | - Konstantinos Lampropoulos
- Second Department of Cardiology, Laboratory of Cardiac Electrophysiology, Evangelismos General Hospital of Athens, Athens, Greece
| | - Lah Ah Tse
- Division of Occupational and Environmental Health, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Jichao Zhao
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
| | - Gregory Y H Lip
- Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK.,Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Adrian Baranchuk
- Division of Cardiology, Kingston General Hospital, Queen's University, Kingston, Ontario, Canada
| | - Martin C S Wong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Tong Liu
- Department of Cardiology, Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China
| | - Gary Tse
- Faculty of Medicine, Li Ka Shing Institute of Health Sciences, Chinese University of Hong Kong, Hong Kong, China.,Department of Medicine and Therapeutics, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China
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14
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Sekiguchi H, Shimamoto K, Takano M, Kimura M, Takahashi Y, Tatsumi F, Watanabe E, Jujo K, Ishizuka N, Kawana M, Hagiwara N. Cancer antigen-125 plasma level as a biomarker of new-onset atrial fibrillation in postmenopausal women. Heart 2017; 103:1368-1373. [PMID: 28285269 PMCID: PMC5561355 DOI: 10.1136/heartjnl-2016-310272] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 02/10/2017] [Accepted: 02/22/2017] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE Plasma cancer antigen (CA)-125 is a tumour marker recently shown to be associated with systolic heart failure and new-onset atrial fibrillation (AF) after myocardial infarction. However, no reports have described the relationship between CA-125 and new-onset AF in healthy postmenopausal women. The aim of the present study was to evaluate the relationship between CA-125 and new-onset AF in postmenopausal women. METHODS Between 2005 and 2015, 2086 women, including 1012 postmenopausal women, visited our hospital for annual health check-ups. We excluded patients with systolic dysfunction, chronic inflammatory disease, chronic obstructive pulmonary disease, histories of AF or neoplastic diseases. A total of 746 postmenopausal women underwent thorough physical examinations, including those for biomarkers such as brain natriuretic peptide, high-sensitivity C-reactive protein (hs-CRP) and CA-125. RESULTS During the 10-year observation period, AF was documented in 31 participants (4.2%). The mean age of participants developing AF (75±6 years) was higher than that of those without AF (68±8 years). Participants developing AF showed significantly higher CA-125 (11.4±6.3 U/mL) and hs-CRP (0.10±0.11 mg/dL) levels than did those without AF (7.7±3.2 U/mL, p<0.01; 0.07±0.08 mg/dL, p<0.05). Cox regression analyses revealed ageing (HR 1.3; 95% CI 1.08 to 1.57; p<0.01) and plasma CA-125 levels (HR 1.29; 95% CI 1.10 to 1.51; p=0.02) as independent predictors of AF. CONCLUSIONS High CA-125 levels might be associated with new-onset AF in healthy postmenopausal women.
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Affiliation(s)
- Haruki Sekiguchi
- Cardiology, Aoyama Hospital, Tokyo Women's Medical University, Tokyo, Japan.,Cardiology, National Hospital Organization Yokohama Medical Center, Kanagawa, Japan.,Cardiology, Tokyo Women's Medical University, Tokyo, Japan.,Cardiology, Institute of Geriatrics Tokyo Women's Medical University, Tokyo, Japan
| | - Ken Shimamoto
- Cardiology, Aoyama Hospital, Tokyo Women's Medical University, Tokyo, Japan.,Cardiology, Tokyo Women's Medical University, Tokyo, Japan.,General Medicine, Tokyo Women's Medical University, Tokyo, Japan
| | - Mayu Takano
- Cardiology, Aoyama Hospital, Tokyo Women's Medical University, Tokyo, Japan.,Cardiology, Tokyo Women's Medical University, Tokyo, Japan
| | - Makiko Kimura
- Cardiology, Aoyama Hospital, Tokyo Women's Medical University, Tokyo, Japan.,Cardiology, Tokyo Women's Medical University, Tokyo, Japan
| | - Yufuko Takahashi
- Cardiology, Aoyama Hospital, Tokyo Women's Medical University, Tokyo, Japan.,Cardiology, Tokyo Women's Medical University, Tokyo, Japan
| | - Fujio Tatsumi
- Cardiology, Aoyama Hospital, Tokyo Women's Medical University, Tokyo, Japan.,Cardiology, Tokyo Women's Medical University, Tokyo, Japan
| | - Eri Watanabe
- Cardiology, Aoyama Hospital, Tokyo Women's Medical University, Tokyo, Japan.,Cardiology, Tokyo Women's Medical University, Tokyo, Japan
| | - Kentaro Jujo
- Cardiology, Tokyo Women's Medical University, Tokyo, Japan
| | - Naoko Ishizuka
- Cardiology, Tokyo Women's Medical University, Tokyo, Japan.,Cardiology, Institute of Geriatrics Tokyo Women's Medical University, Tokyo, Japan
| | - Masatoshi Kawana
- Cardiology, Aoyama Hospital, Tokyo Women's Medical University, Tokyo, Japan.,Cardiology, Tokyo Women's Medical University, Tokyo, Japan.,General Medicine, Tokyo Women's Medical University, Tokyo, Japan
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15
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Kaya H, Kurt R, Beton O, Zorlu A, Yucel H, Gunes H, Oguz D, Yilmaz MB. Cancer Antigen 125 is Associated with Length of Stay in Patients with Acute Heart Failure. Tex Heart Inst J 2017; 44:22-28. [PMID: 28265209 DOI: 10.14503/thij-15-5626] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Length of stay is the primary driver of heart-failure hospitalization costs. Because cancer antigen 125 has been associated with poor morbidity and mortality rates in heart failure, we investigated the relationship between admission cancer antigen 125 levels and lengths of stay in heart-failure patients. A total of 267 consecutive patients (184 men, 83 women) with acute decompensated heart failure were evaluated prospectively. The median length of stay was 4 days, and the patients were classified into 2 groups: those with lengths of stay ≤4 days and those with lengths of stay >4 days. Patients with longer lengths of stay had a significantly higher cancer antigen 125 level of 114 U/mL (range, 9-298 U/mL) than did those with a shorter length of stay (19 U/mL; range; 3-68) (P <0.001). The optimal cutoff level of cancer antigen 125 in the prediction of length of stay was >48 U/mL, with a specificity of 95.8% and a sensitivity of 96% (area under the curve, 0.979; 95% confidence interval [CI], 0.953-0.992). In the multivariate logistic regression model, cancer antigen 125 >48 U/mL on admission (odds ratio=4.562; 95% CI, 1.826-11.398; P=0.001), sodium level (P<0.001), creatinine level (P=0.009), and atrial fibrillation (P=0.015) were also associated with a longer length of stay after adjustment for variables found to be statistically significant in univariate analysis and correlated with cancer antigen 125 level. In addition, it appears that in a cohort of patients with acute decompensated heart failure, cancer antigen 125 is independently associated with prolonged length of stay.
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16
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Santoro F, Ferraretti A, Musaico F, Di Martino L, Tarantino N, Ieva R, Di Biase M, Brunetti ND. Carbohydrate-antigen-125 levels predict hospital stay duration and adverse events at long-term follow-up in Takotsubo cardiomyopathy. Intern Emerg Med 2016; 11:687-94. [PMID: 26832351 DOI: 10.1007/s11739-016-1393-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 01/07/2016] [Indexed: 12/12/2022]
Abstract
The aim of this study is to evaluate the possible role of carbohydrate-antigen(CA)-125 as prognostic marker at short- and long-term follow-up, in subjects with Takotsubo cardiomyopathy (TTC). Sixty-three consecutive subjects with TTC were enrolled in the study and followed for a median 139 days. Circulating levels of CA-125, NT-proBNP, and left ventricular ejection fraction (LVEF) were evaluated at admission. Duration of hospital stay, incidence of death, re-hospitalization and recurrence of TTC during follow-up were recorded. The mean hospital stay was 8.3 days, adverse events occurred during follow up in 17 % of cases. CA-125 levels at admission are inversely related to LVEF (r -0.30, p < 0.05) and directly related to hospital stay (r 0.29, p < 0.05). CA-125 levels at admission are higher in subjects with adverse events at follow-up (88.9 ± 200.0 vs 20.9 ± 30.0 U/mL, p < 0.05). Rates of incidence of adverse events are proportionally increased with CA-125 tertiles (0, 6, 11 % respectively, p for trend <0.01), at survival analysis (Log Rank p < 0.05) and after correction for age, gender, LVEF and NT-proBNP levels in multivariable Cox analysis (p < 0.05). CA-125 levels <10 U/ml are predictors of adverse events at follow up with 91 % sensitivity, 52 % specificity, 29 % positive predictive power, and 96 % negative predictive power. Increased CA-125 admission levels are associated with a longer hospital stay, a lower LVEF, and a higher risk of adverse events during follow up. CA-125 might be useful for early risk stratification of subjects with TTC.
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Affiliation(s)
- Francesco Santoro
- Cardiology Department, University of Foggia, Viale Pinto n.1, 71100, Foggia, Italy
| | - Armando Ferraretti
- Cardiology Department, University of Foggia, Viale Pinto n.1, 71100, Foggia, Italy
| | - Francesco Musaico
- Cardiology Department, University of Foggia, Viale Pinto n.1, 71100, Foggia, Italy
| | - Luigi Di Martino
- Cardiology Department, University of Foggia, Viale Pinto n.1, 71100, Foggia, Italy
| | - Nicola Tarantino
- Cardiology Department, University of Foggia, Viale Pinto n.1, 71100, Foggia, Italy
| | - Riccardo Ieva
- Cardiology Department, University of Foggia, Viale Pinto n.1, 71100, Foggia, Italy
| | - Matteo Di Biase
- Cardiology Department, University of Foggia, Viale Pinto n.1, 71100, Foggia, Italy
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17
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Abstract
OBJECTIVES The present study aimed to evaluate the prognostic value of preoperative carbohydrate antigen 125 (CA125) levels for clinical outcomes after off-pump coronary artery bypass grafting (OPCAB). METHODS A total of 314 consecutive patients who underwent OPCAB were enrolled in this study and divided into three groups corresponding to baseline CA125 level tertiles. Clinical outcomes of these patients were followed up after 1 year. The primary endpoint was the incidence of combined major adverse cardiac events (MACE). RESULTS Event-free survival was significantly associated with the CA125 tertile (log-rank P=0.021); specifically, hazard ratios (HRs) increased progressively from CA125 tertile 1 to tertile 3 [vs. tertile 1: tertile 2 h=1.8; 95% confidence interval (CI): 1.1-2.8, P=0.040; tertile 3 h=2.9; 95% CI: 1.1-8.1, P=0.018]. In the first multivariate Cox regression analytical model (all variables except EuroSCORE), CA125 was an independent predictor of MACE (HR=1.1, 95% CI: 1.0-2.4, P=0.016). In a second model (CA125 levels and EuroSCORE only), CA125 remained an independent predictor of MACE (HR=1.1, 95% CI: 1.0-1.3, P=0.036). CONCLUSION An increased preoperative CA125 level is an independent predictor of worse clinical outcomes after OPCAB during a 1-year follow-up.
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18
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Kaya H, Zorlu A, Yucel H, Dogan OT, Sarikaya S, Aydin G, Kivrak T, Yilmaz MB. Cancer antigen-125 levels predict long-term mortality in chronic obstructive pulmonary disease. Biomarkers 2015; 20:162-7. [DOI: 10.3109/1354750x.2015.1045033] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Affiliation(s)
| | | | | | - Omer Tamer Dogan
- Department of Chest Disease, Cumhuriyet University Medical School, Sivas, Turkey,
| | - Savas Sarikaya
- Department of Cardiology, Bozok University Medical School, Yozgat, Turkey,
| | - Gulay Aydin
- Department of Cardiology, Unye State Hospital, Ordu, Turkey, and
| | - Tarik Kivrak
- Department of Cardiology, Sivas State Hospital, Sivas, Turkey
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Abstract
Atrial fibrillation (AF) is the most common cardiac arrhythmia. However, the development of preventative therapies for AF has been disappointing. The infiltration of immune cells and proteins that mediate the inflammatory response in cardiac tissue and circulatory processes is associated with AF. Furthermore, the presence of inflammation in the heart or systemic circulation can predict the onset of AF and recurrence in the general population, as well as in patients after cardiac surgery, cardioversion, and catheter ablation. Mediators of the inflammatory response can alter atrial electrophysiology and structural substrates, thereby leading to increased vulnerability to AF. Inflammation also modulates calcium homeostasis and connexins, which are associated with triggers of AF and heterogeneous atrial conduction. Myolysis, cardiomyocyte apoptosis, and the activation of fibrotic pathways via fibroblasts, transforming growth factor-β and matrix metalloproteases are also mediated by inflammatory pathways, which can all contribute to structural remodelling of the atria. The development of thromboembolism, a detrimental complication of AF, is also associated with inflammatory activity. Understanding the complex pathophysiological processes and dynamic changes of AF-associated inflammation might help to identify specific anti-inflammatory strategies for the prevention of AF.
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20
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Yucel H, Kaya H, Zorlu A, Yıldırımlı K, Sancakdar E, Gunes H, Kurt R, Ozgul U, Turgut O, Yilmaz M. Cancer antigen 125 levels and increased risk of new-onset atrial fibrillation. Herz 2014; 40 Suppl 2:119-24. [DOI: 10.1007/s00059-014-4148-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2014] [Revised: 08/12/2014] [Accepted: 08/15/2014] [Indexed: 12/12/2022]
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21
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Dullaart RP, Al-Daghri NM, Ashina M, Bouzas-Mosquera A, Brunetti ND, Buechler C, Chen HS, Corrales JJ, D'Archivio M, Dei Cas A, Pino GG, Gómez-Abril SA, Győri D, Haslacher H, Herder C, Kerstens MN, Koutsilieris M, Lombardi C, Lupattelli G, Mócsai A, Msaouel P, Orfao A, Ormazabal P, Pacher R, Perkmann T, Peteiro J, Plischke M, Reynaert NL, Ricci MA, Robles NR, Rocha M, Rutten EP, Sabico S, Santamaria F, Santoro F, Schmid A, Schmidt M, Schytz HW, Shyu KG, Tada H, Thorand B, Valerio G, Vesely DL, Wu TE, Yamagishi M, Yeh YT. Research update for articles published in EJCI in 2012. Eur J Clin Invest 2014. [DOI: 10.1111/eci.12319] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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22
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Čulić V. Inflammation, coagulation, weather and arrhythmogenesis: Is there a linkage? Int J Cardiol 2014; 176:289-93. [DOI: 10.1016/j.ijcard.2014.06.078] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Accepted: 06/29/2014] [Indexed: 01/24/2023]
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Sorror ML, Martin PJ, Storb RF, Bhatia S, Maziarz RT, Pulsipher MA, Maris MB, Davis C, Deeg HJ, Lee SJ, Maloney DG, Sandmaier BM, Appelbaum FR, Gooley TA. Pretransplant comorbidities predict severity of acute graft-versus-host disease and subsequent mortality. Blood 2014; 124:287-95. [PMID: 24797298 PMCID: PMC4093684 DOI: 10.1182/blood-2014-01-550566] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Accepted: 04/21/2014] [Indexed: 12/19/2022] Open
Abstract
Whether the hematopoietic cell transplantation comorbidity index (HCT-CI) can provide prognostic information about development of acute graft-versus-host disease (GVHD) and subsequent mortality is unknown. Five institutions contributed information on 2985 patients given human leukocyte antigen-matched grafts to address this question. Proportional hazards models were used to estimate the hazards of acute GVHD and post-GVHD mortality after adjustment for known risk variables. Higher HCT-CI scores predicted increased risk of grades 3 to 4 acute GVHD (P < .0001 and c-statistic of 0.64), and tests of interaction suggested that this association was consistent among different conditioning intensities, donor types, and stem cell sources. Probabilities of grades 3 to 4 GVHD were 13%, 18%, and 24% for HCT-CI risk groups of 0, 1 to 4, and ≥5. The HCT-CI was statistically significantly associated with mortality rates following diagnosis of grade 2 (hazard ratio [HR] = 1.24; P < .0001) or grades 3 to 4 acute GVHD (HR = 1.19; P < .0001). Patients with HCT-CI scores of ≥3 who developed grades 3 to 4 acute GVHD had a 2.63-fold higher risk of mortality than those with scores of 0 to 2 and did not develop acute GVHD. Thus, pretransplant comorbidities are associated with the development and severity of acute GVHD and with post-GVHD mortality. The HCT-CI could be useful in designing trials for GVHD prevention and could inform expectations for GVHD treatment trials.
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Affiliation(s)
- Mohamed L Sorror
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA; Division of Medical Oncology, Department of Medicine, University of Washington School of Medicine, Seattle, WA
| | - Paul J Martin
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA; Division of Medical Oncology, Department of Medicine, University of Washington School of Medicine, Seattle, WA
| | - Rainer F Storb
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA; Division of Medical Oncology, Department of Medicine, University of Washington School of Medicine, Seattle, WA
| | | | - Richard T Maziarz
- Center for Hematologic Malignancies, Knight Cancer Institute, and Division of Hematology and Medical Oncology, Oregon Health and Science University Knight Cancer Institute, Portland, OR
| | - Michael A Pulsipher
- Division of Hematology, University of Utah School of Medicine, Salt Lake City, UT; Pediatric Blood and Marrow Transplant Program, Primary Children's Medical Center, Huntsman Cancer Institute, Salt Lake City, UT
| | - Michael B Maris
- Colorado Blood Cancer Institute at Presbyterian/St. Luke's Medical Center, Denver, CO
| | - Christopher Davis
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - H Joachim Deeg
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA; Division of Medical Oncology, Department of Medicine, University of Washington School of Medicine, Seattle, WA
| | - Stephanie J Lee
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA; Division of Medical Oncology, Department of Medicine, University of Washington School of Medicine, Seattle, WA
| | - David G Maloney
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA; Division of Medical Oncology, Department of Medicine, University of Washington School of Medicine, Seattle, WA
| | - Brenda M Sandmaier
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA; Division of Medical Oncology, Department of Medicine, University of Washington School of Medicine, Seattle, WA
| | - Frederick R Appelbaum
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA; Division of Medical Oncology, Department of Medicine, University of Washington School of Medicine, Seattle, WA
| | - Theodore A Gooley
- Clinical Statistics Program, Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA; and Department of Biostatistics, University of Washington School of Public Health, Seattle, WA
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Li X, He M, Zhu J, Yao P, Li X, Yuan J, Min X, Lang M, Yang H, Hu FB, Wu T, Wei S. Higher carbohydrate antigen 125 levels are associated with increased risk of coronary heart disease in elderly chinese: a population-based case-control study. PLoS One 2013; 8:e81328. [PMID: 24303042 PMCID: PMC3841119 DOI: 10.1371/journal.pone.0081328] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Accepted: 10/21/2013] [Indexed: 01/07/2023] Open
Abstract
Background High carbohydrate antigen 125 (CA-125) level was reported to be associated with some cardiac dysfunctions, such as chronic heart failure, but the relationship between CA-125 level and coronary heart disease (CHD) risk remains unclear. The aim of this study was to explore the potential association in a Chinese older population. Methods In a population-based case-control study conducted in a Chinese older population, serum CA-125 levels were measured in 1177 diagnosed CHD patients and 3531 age and sex matched control subjects without CHD. Results Serum CA-125 level was significantly higher in CHD patients than controls (P < 0.001) with adjustment for age, gender, smoking, drinking, BMI, physical activity, hypertension, dyslipidemia, diabetes mellitus, medication history and family history of CHD and myocardial infarction. CHD risk was doubled (OR: 2.10, 95%CI: 1.69-2.60) among subjects in the highest quartile compared to those in the lowest quartile of CA-125 level (Ptrend < 0.001). Furthermore, CA-125 levels were associated with CHD risks in subjects with age over 60 years (OR: 2.19, 95%CI: 1.75-2.73), current smokers (OR: 2.29, 95%CI: 1.50-3.49), current drinkers (OR: 2.35, 95%CI: 1.57-3.53) and subjects with hypertension (OR: 2.04, 95%CI: 1.71-2.43). Conclusions Elevated serum CA-125 level might be associated with increased risk of coronary heart disease in the Chinese older population. Further investigations are needed to identify the possible biological role of CA-125 in CHD development in the future.
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Affiliation(s)
- Xiaorong Li
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
- MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Meian He
- MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Jiang Zhu
- Dongfeng Central Hospital, Dongfeng Motor Corporation and Hubei University of Medicine, Shiyan, Hubei, China
| | - Ping Yao
- MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Xiulou Li
- Dongfeng Central Hospital, Dongfeng Motor Corporation and Hubei University of Medicine, Shiyan, Hubei, China
| | - Jing Yuan
- MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Xinwen Min
- Dongfeng Central Hospital, Dongfeng Motor Corporation and Hubei University of Medicine, Shiyan, Hubei, China
| | - Mingjian Lang
- Dongfeng Central Hospital, Dongfeng Motor Corporation and Hubei University of Medicine, Shiyan, Hubei, China
| | - Handong Yang
- Dongfeng Central Hospital, Dongfeng Motor Corporation and Hubei University of Medicine, Shiyan, Hubei, China
| | - Frank B. Hu
- Departments of Nutrition and Epidemiology, Harvard School of Public Health, Boston, Massachusetts, United States of America
| | - Tangchun Wu
- MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Sheng Wei
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
- MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
- * E-mail:
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25
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Association of inflammatory factors with occurrence and recurrence of atrial fibrillation: A meta-analysis. Int J Cardiol 2013; 169:62-72. [DOI: 10.1016/j.ijcard.2013.08.078] [Citation(s) in RCA: 136] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2013] [Revised: 07/21/2013] [Accepted: 08/28/2013] [Indexed: 11/20/2022]
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Lappegård KT, Hovland A, Pop GAM, Mollnes TE. Atrial fibrillation: inflammation in disguise? Scand J Immunol 2013; 78:112-9. [PMID: 23672430 DOI: 10.1111/sji.12061] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Accepted: 05/03/2013] [Indexed: 02/03/2023]
Abstract
Atrial fibrillation is highly prevalent, and affected patients are at an increased risk of a number of complications, including heart failure and thrombo-embolism. Over the past years, there has been increasing interest in the role of inflammatory processes in atrial fibrillation, from the first occurrence of the arrhythmia to dreaded complications such as strokes or peripheral emboli. As the standard drug combination which aims at rate control and anticoagulation only offers partial protection against complications, newer agents are needed to optimize treatment. In this paper, we review recent knowledge regarding the impact of inflammation on the occurrence, recurrence, perpetuation and complications of the arrhythmia, as well as the role of anti-inflammatory therapies in the treatment for the disease.
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Affiliation(s)
- K T Lappegård
- Coronary Care Unit, Division of Internal Medicine, Nordland Hospital, Bodø, Norway.
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Alegret JM, Aragonès G, Elosua R, Beltrán-Debón R, Hernández-Aguilera A, Romero-Menor C, Camps J, Joven J. The relevance of the association between inflammation and atrial fibrillation. Eur J Clin Invest 2013; 43:324-31. [PMID: 23397981 DOI: 10.1111/eci.12047] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2012] [Accepted: 12/20/2012] [Indexed: 01/17/2023]
Abstract
BACKGROUND The relevance of the association between inflammation and atrial fibrillation (AF) is not firmly established. The clinical importance is considerable because inflammation is usually not targeted as a treatment option, minimizing a probable benefit. MATERIALS AND METHODS We have used a case-control study with a Mendelian randomization rationale to assess whether proposed risk factors that have a genetic component and are readily detected in circulating blood are causally related to AF. The studied variables were C-reactive protein (CRP) and a representative of the chemokine system, the monocyte chemoattractant protein-1 (CCL2). RESULTS Plasma CRP and CCL2 concentrations were significantly higher in AF patients than in the unaffected population. However, when segregated between paroxysmal and permanent, the difference for CRP was only observed in patients with a permanent condition. Plasma CCL2 was raised in both subgroups. Confounding factors were carefully considered, and multivariable analyses revealed that circulating CCL2 was significant and CRP was negligible to explain the presence of AF. The duration of the episode also bore a significant predictive value. Odd ratios for AF as a function of genotype did not differ from 1·0 for any of the individual CRP and CCL2 polymorphisms, or any combinations. CONCLUSIONS Elevated plasma CRP concentration per se does not increase atrial fibrillation risk. Values obtained for CCL2 suggest that inflammation is probably a consequence of AF. Our data also suggest that the effect of the duration of the episode should be further studied in the assessment of the actual role of inflammation.
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Affiliation(s)
- Josep M Alegret
- Secció de Cardiologia, Hospital Universitari de Sant Joan, IISPV, Universitat Rovira i Virgili, Reus, Spain.
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Abstract
Atrial fibrillation (AF) is associated with increased risk for stroke and systemic embolism. There is plausible evidence linking inflammation to the initiation and perpetuation of AF and AF-related thrombosis. Various inflammatory markers (C-reactive protein, tumor necrosis factor-α, interleukin-2, interleukin-6, and interleukin-8) have been associated with AF. Proposed mechanisms linking inflammation and the prothrombotic AF state include endothelial activation/damage, production of tissue factor from monocytes, increased platelet activation, and increased expression of fibrinogen. The present review aims to provide an update on the association of inflammation and AF, including the impact of inflammatory markers on clinical presentation and outcome of AF patients.
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Affiliation(s)
- Yutao Guo
- Haemostasis, Thrombosis and Vascular Biology Unit, University of Birmingham Centre for Cardiovascular Science, City Hospital, Birmingham, United Kingdom
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Serum carbohydrate antigen-125 is elevated in patients with chronic atrial fibrillation. ACTA ACUST UNITED AC 2012. [DOI: 10.1016/s1000-1948(12)60037-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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