1
|
Hu Q, Luo K, Liu P, Mei Y. To discuss the mechanism of colchicine in the treatment of acute cerebral infarction based on network pharmacology. Medicine (Baltimore) 2022; 101:e30720. [PMID: 36197265 PMCID: PMC9509177 DOI: 10.1097/md.0000000000030720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
To explore the mechanism of action of colchicine in the treatment of acute cerebral infarction (ACI) based on network pharmacology. The Swiss Target Prediction Database and CTD database were used to predict the target information of colchicine. ACI-related targets were retrieved using the GeneCards database, and the target protein interaction network (PPI) and active ingredient-target network were obtained by combining Cytoscape 3.7.1 software and R language. Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis and gene function analysis (GO) enrichment analysis were performed using R language to preliminarily explore the multiple pharmacological mechanisms of action of colchicine. There were 200 targets identified by network parameter analysis; 958 ACI targets were identified. Overlapping comparisons allowed the extraction of 143 overlapping targets, and the top 30 targets were screened according to the topological isomerization parameters. Component-target networks were constructed. A PPI of overlapping targets was established to identify key targets. In addition, Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis and GO functional enrichment analysis were performed to explore the multiple mechanisms of action of colchicine in the treatment of ACI. Colchicine treatment of ACI is characterized by multi-component, multi-target and multi-pathway, and can exert complex network regulation through the interaction between different targets, providing a new idea and new basis for further exploration of the mechanism of action of colchicine in the treatment of ACI.
Collapse
Affiliation(s)
- Qiaoxia Hu
- Department of Geriatrics, the Affiliated Hospital of Medical School of Ningbo University, Institute of Geriatrics of Ningbo University, Ningbo, China
- *Correspondence: Qiaoxia Hu, Department of Geriatrics, the Affiliated Hospital of Medical School of Ningbo University, Institute of Geriatrics of Ningbo University, 247 Renmin Road, Ningbo 315020, China (e-mail: )
| | - Kena Luo
- Department of Geriatrics, the Affiliated Hospital of Medical School of Ningbo University, Institute of Geriatrics of Ningbo University, Ningbo, China
| | - Puheng Liu
- Department of Geriatrics, the Affiliated Hospital of Medical School of Ningbo University, Institute of Geriatrics of Ningbo University, Ningbo, China
| | - Yifei Mei
- Department of Geriatrics, the Affiliated Hospital of Medical School of Ningbo University, Institute of Geriatrics of Ningbo University, Ningbo, China
| |
Collapse
|
2
|
Simoni L, Alimehmeti I, Ceka A, Gina M, Tafaj E, Dibra A, Goda A. Gender Differences in Admissions and In-Hospital Outcomes of Patients With Acute Coronary Syndromes During the Coronavirus Disease 2019 Pandemic. Cureus 2022; 14:e23286. [PMID: 35449650 PMCID: PMC9013470 DOI: 10.7759/cureus.23286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2022] [Indexed: 11/20/2022] Open
Abstract
Background The incidence of acute coronary syndromes (ACS) decreased during the coronavirus disease 2019 (COVID-19) pandemic. Few studies have investigated gender differences in ACS admissions and outcomes during pandemics and have presented divergent results. This study aimed to investigate the effect of the COVID-19 pandemic on male and female hospitalizations and in-hospital outcomes in patients presenting with ACS. Methodology We designed a retrograde, single-center trial gathering data for ACS hospitalizations during the lockdown (March 9, 2020, to April 30, 2020) compared with the same timeframe of 2019. ACS hospitalizations were subgrouped as ST-elevation myocardial infarction (STEMI), non-STEMI (NSTEMI), and unstable angina (UA). We calculated the incidence rate ratio (IRR) to compare all-ACS and subgroups for male and female hospitalizations and the risk ratio (RR) to compare overall male/female mortality. Results This study included 321 ACS patients (238 males, 83 females) during the COVID-19 lockdown and 550 patients (400 males, 150 females) during 2019. The IRRs of all-ACS/males/females were significantly lower during the COVID-19 period at 0.58 (95% confidence interval (CI) = 0.44-0.76), 0.59 (95% CI = 0.43-0.75), and 0.55 (95% CI = 0.37-0.74), respectively. The IRR for STEMI was significantly lower among females (0.59 (95% CI = 0.39-0.89)), but not among males (0.76 (95% CI = 0.55-1.08)) The IRR for NSTEMI was not significantly lower, meanwhile it was significantly lower for UA among both males and females. The overall ACS mortality increased during the COVID-19 period (7.4% vs. 3.4%; RR = 2.16 (95% CI = 1.20-3.89)). Important increase was found in males (7.45% vs. 2.5%; RR = 3.02 (95% CI = 1.42-6.44)), but not in females (7.2% vs. 6%; RR = 1.20 (95% CI = 0.44-3.27). Conclusions The admissions of ACS reduced similarly in males and females during the COVID-19 pandemic. The admissions of STEMI reduced predominantly in females. We identified a substantial increase in the overall ACS mortality, but predominantly in males, reducing the differences between males and females. Further studies are necessary to better understand the increase in male mortality during the pandemic.
Collapse
Affiliation(s)
- Leonard Simoni
- Cardiovascular Disease, University Hospital Center Mother Teresa, Tirana, ALB
| | - Ilir Alimehmeti
- Occupational Health, Faculty of Medicine, University of Medicine, Tirana, ALB
| | - Astrit Ceka
- Cardiovascular Disease, University Hospital Center Mother Teresa, Tirana, ALB
| | - Mirald Gina
- Cardiovascular Disease, University Hospital Center Mother Teresa, Tirana, ALB
| | - Ermir Tafaj
- Cardiovascular Disease, University Hospital Center Mother Teresa, Tirana, ALB
| | - Alban Dibra
- Cardiovascular Disease, University Hospital Center Mother Teresa, Tirana, ALB
| | - Artan Goda
- Cardiovascular Disease, University Hospital Center Mother Teresa, Tirana, ALB
| |
Collapse
|
3
|
Stain N, Cheshire A, Ross C, Ridge D. An Exploration of the help-seeking experiences of patients in an allied professions-led rapid access chest pain pathway: a qualitative study. BMJ Open 2020; 10:e040468. [PMID: 33444203 PMCID: PMC7678391 DOI: 10.1136/bmjopen-2020-040468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE A number of studies have explored delayed help-seeking practices for acute coronary syndrome (ACS) and have indentified multiple intersecting factors which may play a role, for example, attributing symptoms, age, gender, ethnicity and contextual influences. However, the pathway to diagnosis for suspected coronary heart disease (CHD) symptoms in a rapid access chest pain clinic (RACPC) context is underexplored. The objective of this study was to examine patients' help-seeking experiences of accessing RACPC services, from the point at which they notice and interpret symptoms, to their decision to seek help from their general practitioner. DESIGN Qualitative study. SETTING Interviews were conducted in the RACPC at Queen Mary's Roehampton Hospital, London, UK. PARTICIPANTS Maximum variation sampling was used to recruit 30 participants (15 men and 15 women) referred to a RACPC, using sampling dimensions of age, ethnicity and occupation. METHODS Semi-structured interviews focussed on the patient experience of their pathway to the RACPC. Thematic analysis was used to analyse the interview data. RESULTS Participant interpretation of symptoms was shaped by multiple influences; reluctance to seek help contributed to delay; various factors acted as drivers as well as barriers to help-seeking; and GP referrals to RACPC were based on symptoms as well as patients' need for reassurance. CONCLUSION We found complex issues shaped the patient's decision-making when accessing the RACPC, including making sense of symptoms and help-seeking practices. These findings can be used to develop health promotion literature to encourage early help-seeking and improve RACPC services.
Collapse
Affiliation(s)
- Nolan Stain
- Cardiac Physiology, Barts Health NHS Trust, London, UK
| | - Anna Cheshire
- College of Liberal Arts and Sciences, University of Westminster, London, UK
| | - Catherine Ross
- The Office of Chief Scientific Officer, NHS England, London, UK
| | - Damien Ridge
- College of Liberal Arts and Sciences, University of Westminster, London, UK
| |
Collapse
|
4
|
Barbero U, Moncalvo C, Trabattoni D, Pavani M, Amoroso GR, Bocchino PP, Truffa Giachet A, Saglietto A, Monticone S, Secco GG, Campo G, Verardi R, Iannaccone M, Galvani M, Ugo F, Infantino V, Olivotti L, Mennuni M, Vercellino M, Gili S, Zucchetti O, Casella G, Giammaria M, De Benedictis M, Tolomeo P, Doronzo B, Grosso Marra W, Rognoni A, Montefusco A, Patti G, Mancone M, De Ferrari GM, D’Ascenzo F. Gender differences in acute coronary syndromes patterns during the COVID-19 outbreak. AMERICAN JOURNAL OF CARDIOVASCULAR DISEASE 2020; 10:506-513. [PMID: 33224602 PMCID: PMC7675165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 09/29/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Mortality from acute coronary syndromes (ACS) is strictly related to early management. As female patients usually experience longer delays before diagnosis and treatment, we assessed whether women were more affected by the dramatic drop in hospital admissions for ACS during the Covid-19 pandemic. METHODS We performed a retrospective analysis of clinical and angiographic characteristics of consecutive patients who were admitted for ACS at 15 hospitals in Northern Italy comparing men and women data. The study period was defined as the time between the first confirmed case of Covid-19 in Italy (February 20, 2020) and March 31, 2020. We compared hospitalization rates between the study period and two control periods: the corresponding period during the previous year (February 20 to March 31, 2019) and the earlier period during the same year (January 1 to February 19, 2020). Incidence rate ratios comparing the study period with each of the control periods were calculated with the use of Poisson regression. RESULTS Of the 547 patients who were hospitalized for ACS during the study period, only 127 (23%) were females, accounting for a mean of 3.1 admissions per day, while ACS hospitalized males were 420, with a mean of 10.2 admissions per day. There was a significant decrease driven by a similar reduction in ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI) diagnosis in both sexes compared to the control periods. A trend toward a greater reduction in admitted females was shown in the intra-year control period (46% admission reduction in females vs 37% in males, with females accounting for 26% of ACS, P=0.10) and a significant reduction when compared to the previous year control period (40% admission reduction in females vs 23% in males, with females accounting for 28% of ACS, P=0.03), mainly related to Unstable Angina diagnosis. CONCLUSION The Covid-19 pandemic period closed the gap between men and women in ACS, with similar rates of reduction of hospitalized STEMI and NSTEMI and a trend toward greater reduction in UA admission among women. Furthermore, many typical differences between males and females regarding ischemic heart disease presentations and vessel distribution were leveled.
Collapse
Affiliation(s)
| | | | - Daniela Trabattoni
- Department of Cardiovascular Sciences, IRCCS Centro Cardiologico Monzino, University of MilanItaly
| | | | | | - Pier Paolo Bocchino
- Division of Cardiology, A.O.U Città della Salute e della Scienza di TorinoTurin, Italy
| | | | - Andrea Saglietto
- Division of Cardiology, A.O.U Città della Salute e della Scienza di TorinoTurin, Italy
| | - Silvia Monticone
- Division of Internal Medicine 4 and Hypertension Unit, Department of Medical Sciences, University of TurinTorino, Italy
| | - Gioel Gabrio Secco
- Department of Cardiology, Interventional Cardiology and Cardiac Surgery Unit, Azienda Ospedaliera SS Antonio e Biagio e Cesare ArrigoAlessandria, Italy
| | - Gianluca Campo
- Cardiology Unit, Azienda Ospedaliera Universitaria di FerraraFerrara, Italy
- Maria Cecilia Hospital, GVM Care & ResearchCotignola, Ravenna Italy
| | - Roberto Verardi
- Division of Cardiology, A.O.U Città della Salute e della Scienza di TorinoTurin, Italy
- Department of Cardiology, Maggiore Hospital Carlo Alberto PizzardiBologna, Italy
| | | | - Marcello Galvani
- U.O.C. Cardiologia, Dipartimento Cardiovascolare AUSL Romagna, Ospedale Morgagni, Forlì, e Unità di Ricerca Cardiovascolare, Fondazione Cardiologica SaccoForlì, Italy
| | - Fabrizio Ugo
- Division of Cardiology, Presidio Ospedaliero Sant’Andrea di VercelliVercelli, Italy
| | | | - Luca Olivotti
- Division of Cardiology, Ospedale Santa CoronaPietra Ligure, Italy
| | - Marco Mennuni
- Coronary Care Unit and Catheterization laboratory, A.O.U. Maggiore della CaritàNovara, Italy
| | - Matteo Vercellino
- Department of Cardiology, Interventional Cardiology and Cardiac Surgery Unit, Azienda Ospedaliera SS Antonio e Biagio e Cesare ArrigoAlessandria, Italy
| | - Sebastiano Gili
- Department of Cardiovascular Sciences, IRCCS Centro Cardiologico Monzino, University of MilanItaly
| | - Ottavio Zucchetti
- Cardiology Unit, Azienda Ospedaliera Universitaria di FerraraFerrara, Italy
| | - Gianni Casella
- Department of Cardiology, Maggiore Hospital Carlo Alberto PizzardiBologna, Italy
| | | | | | - Paolo Tolomeo
- Cardiology Unit, Azienda Ospedaliera Universitaria di FerraraFerrara, Italy
| | | | | | - Andrea Rognoni
- Coronary Care Unit and Catheterization laboratory, A.O.U. Maggiore della CaritàNovara, Italy
| | - Antonio Montefusco
- Division of Cardiology, A.O.U Città della Salute e della Scienza di TorinoTurin, Italy
| | - Giuseppe Patti
- Coronary Care Unit and Catheterization laboratory, A.O.U. Maggiore della CaritàNovara, Italy
| | - Massimo Mancone
- Department of Cardiovascular, Respiratory, Nephrology, Anesthesiology and Geriatric Sciences, Sapienza University of RomeRome, Italy
| | | | - Fabrizio D’Ascenzo
- Division of Cardiology, A.O.U Città della Salute e della Scienza di TorinoTurin, Italy
| |
Collapse
|
5
|
Power TP, Ke X, Zhao Z, Bonine NG, Cziraky MJ, Grabner M, Barron JJ, Quimbo R, Vangerow B, Toth PP. Clinical characteristics, patterns of lipid-lowering medication use, and health care resource utilization and costs among patients with atherosclerotic cardiovascular disease. Vasc Health Risk Manag 2018; 14:23-36. [PMID: 29440909 PMCID: PMC5804267 DOI: 10.2147/vhrm.s146266] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Purpose The aim of this study was to investigate real-world patient characteristics, medication use, and health care resource utilization (HCRU) and costs among patients with clinical atherosclerotic cardiovascular disease (ASCVD) as defined by 2013 American College of Cardiology/American Heart Association (ACC/AHA) guidelines, to examine burden of disease and unmet needs, such as potential undertreatment. Patients and methods This retrospective cohort study utilized a nationally representative managed care database to identify newly diagnosed ASCVD patients between January 1, 2007, and November 30, 2012 (index = first ASCVD diagnosis date) in the USA. Patients had ≥12-month pre-index (baseline) and ≥12-month post-index (follow-up) health plan enrollment and no baseline lipid-lowering medication (LLM). Patient characteristics, LLM utilization patterns, HCRU, and costs were examined for all patients and by subgroups based on LLM use pattern and/or follow-up low-density lipoprotein cholesterol (LDL-C) levels. Results A total of 128,017 ASCVD patients were identified with a mean (SD) age of 59 (13) years, 43.1% female, and 48.8% with ≥36-month follow-up. Within 12-month follow-up, 10.6% had high-intensity statins and 56.9% had no LLM fills. Baseline mean (SD) all-cause costs were $8,852 ($25,608). At 12-month follow-up, mean (SD) all-cause and ASCVD-related costs were $31,443 ($54,040) and $20,289 ($45,159), respectively. The 36-month analyses showed similar distributions. Multivariable analyses showed that age, gender, region, health insurance type, baseline comorbidities, baseline use of specific medications, baseline lipid profiles, and index ASCVD type were significantly associated with all-cause and ASCVD-related health care costs. Conclusion Patients have nonoptimal treatment for ASCVD and substantial HCRU and costs associated with residual risk. Unmet needs and cost burdens of ASCVD patients merit additional investigation.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | - Peter P Toth
- CGH Medical Center, Sterling, IL.,Johns Hopkins University School of Medicine, Baltimore, MD, USA
| |
Collapse
|