1
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Hughes JW, Tooley J, Torres Soto J, Ostropolets A, Poterucha T, Christensen MK, Yuan N, Ehlert B, Kaur D, Kang G, Rogers A, Narayan S, Elias P, Ouyang D, Ashley E, Zou J, Perez MV. A deep learning-based electrocardiogram risk score for long term cardiovascular death and disease. NPJ Digit Med 2023; 6:169. [PMID: 37700032 PMCID: PMC10497604 DOI: 10.1038/s41746-023-00916-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 08/30/2023] [Indexed: 09/14/2023] Open
Abstract
The electrocardiogram (ECG) is the most frequently performed cardiovascular diagnostic test, but it is unclear how much information resting ECGs contain about long term cardiovascular risk. Here we report that a deep convolutional neural network can accurately predict the long-term risk of cardiovascular mortality and disease based on a resting ECG alone. Using a large dataset of resting 12-lead ECGs collected at Stanford University Medical Center, we developed SEER, the Stanford Estimator of Electrocardiogram Risk. SEER predicts 5-year cardiovascular mortality with an area under the receiver operator characteristic curve (AUC) of 0.83 in a held-out test set at Stanford, and with AUCs of 0.78 and 0.83 respectively when independently evaluated at Cedars-Sinai Medical Center and Columbia University Irving Medical Center. SEER predicts 5-year atherosclerotic disease (ASCVD) with an AUC of 0.67, similar to the Pooled Cohort Equations for ASCVD Risk, while being only modestly correlated. When used in conjunction with the Pooled Cohort Equations, SEER accurately reclassified 16% of patients from low to moderate risk, uncovering a group with an actual average 9.9% 10-year ASCVD risk who would not have otherwise been indicated for statin therapy. SEER can also predict several other cardiovascular conditions such as heart failure and atrial fibrillation. Using only lead I of the ECG it predicts 5-year cardiovascular mortality with an AUC of 0.80. SEER, used alongside the Pooled Cohort Equations and other risk tools, can substantially improve cardiovascular risk stratification and aid in medical decision making.
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Affiliation(s)
- J Weston Hughes
- Department of Computer Science, Stanford University, Palo Alto, CA, USA.
| | - James Tooley
- Department of Medicine, Stanford University, Palo Alto, CA, USA
| | - Jessica Torres Soto
- Department of Biomedical Informatics, Stanford University, Palo Alto, CA, USA
| | - Anna Ostropolets
- Department of Biomedical Informatics, Columbia University Irving Medical Center, New York, NY, USA
| | - Tim Poterucha
- Milstein Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Matthew Kai Christensen
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Neal Yuan
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Ben Ehlert
- Department of Biomedical Informatics, Stanford University, Palo Alto, CA, USA
| | | | - Guson Kang
- Department of Medicine, Stanford University, Palo Alto, CA, USA
| | - Albert Rogers
- Department of Medicine, Stanford University, Palo Alto, CA, USA
| | - Sanjiv Narayan
- Department of Medicine, Stanford University, Palo Alto, CA, USA
| | - Pierre Elias
- Department of Biomedical Informatics, Columbia University Irving Medical Center, New York, NY, USA
- Milstein Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - David Ouyang
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Euan Ashley
- Department of Medicine, Stanford University, Palo Alto, CA, USA
| | - James Zou
- Department of Computer Science, Stanford University, Palo Alto, CA, USA
- Department of Biomedical Data Science, Stanford University, Palo Alto, CA, USA
| | - Marco V Perez
- Department of Medicine, Stanford University, Palo Alto, CA, USA
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2
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Spoerl S, Gerken M, Fischer R, Spoerl S, Kirschneck C, Wolf S, Taxis J, Ludwig N, Biermann N, Reichert TE, Spanier G. Statin Use Ameliorates Survival in Oral Squamous Cell Carcinoma-Data from a Population-Based Cohort Study Applying Propensity Score Matching. Biomedicines 2023; 11:biomedicines11020369. [PMID: 36830906 PMCID: PMC9952960 DOI: 10.3390/biomedicines11020369] [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: 01/13/2023] [Revised: 01/24/2023] [Accepted: 01/25/2023] [Indexed: 01/31/2023] Open
Abstract
The anti-cancer properties of statins have attracted much attention recently, but little is known about the prognostic role of statins in oral squamous cell carcinoma (OSCC). In a retrospective approach, we analyzed a population-based cohort of 602 OSCC patients with primary curative tumor resection to negative margins and concomitant neck dissection between 2005-2017. Long-term medication with statins was correlated with overall survival (OAS) as well as recurrence-free survival (RFS) using uni- and multivariable Cox regression. Additionally, propensity score matching was applied to adjust for confounders. Statin use was present in 96 patients (15.9%) at a median age of 65.7 years. Statin treatment correlated with ameliorated survival in multivariable Cox regression in the complete cohort (OAS: HR 0.664; 95% CI 0.467-0.945, p = 0.023; RFS: HR 0.662; 95% CI 0.476-0.920, p = 0.014) as well as matched-pair cohort of OSCC patients (OAS: HR 0.691; 95% CI 0.479-0.997, p = 0.048; RFS: HR 0.694; 95% CI 0.493-0.976, p = 0.036) when compared to patients not taking statins at time of diagnosis. These findings were even more pronounced by sub-group analysis in the matched-pair cohort (age < 70 years). These data indicate that statin use might ameliorate the oncological outcome in primarily resected OSCC patients, but prospective clinical trials are highly recommended.
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Affiliation(s)
- Steffen Spoerl
- Department of Cranio-Maxillofacial Surgery, University Hospital Regensburg, 93042 Regensburg, Germany
| | - Michael Gerken
- Tumor Center, Institute for Quality Management and Health Services Research, University of Regensburg, 93053 Regensburg, Germany
| | - René Fischer
- Department of Otorhinolaryngology, University Hospital Regensburg, 93042 Regensburg, Germany
| | - Silvia Spoerl
- Department of Internal Medicine 5, Hematology/Oncology, Friedrich-Alexander University Erlangen-Nürnberg, 91054 Erlangen, Germany
| | - Christian Kirschneck
- Department of Orthodontics, University Hospital Regensburg, 93042 Regensburg, Germany
| | - Stefanie Wolf
- Department of Otorhinolaryngology, St. Elisabeth Hospital Straubing, 94315 Straubing, Germany
| | - Juergen Taxis
- Department of Cranio-Maxillofacial Surgery, University Hospital Regensburg, 93042 Regensburg, Germany
| | - Nils Ludwig
- Department of Cranio-Maxillofacial Surgery, University Hospital Regensburg, 93042 Regensburg, Germany
| | - Niklas Biermann
- Department of Plastic and Reconstructive Surgery, University Hospital Regensburg, 93042 Regensburg, Germany
| | - Torsten E. Reichert
- Department of Cranio-Maxillofacial Surgery, University Hospital Regensburg, 93042 Regensburg, Germany
| | - Gerrit Spanier
- Department of Cranio-Maxillofacial Surgery, University Hospital Regensburg, 93042 Regensburg, Germany
- Correspondence:
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Reddy SM, Tsujimoto THM, Qaqish BF, Fine JP, Nicholson WK. Pregnancy-related factors may signal additional protection or risk of future cardiovascular diseases. BMC Womens Health 2022; 22:528. [PMID: 36528580 PMCID: PMC9759861 DOI: 10.1186/s12905-022-02125-x] [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: 07/14/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) guidelines recommend using the Pooled Cohort Equation (PCE) to assess 10-year CVD risk based on traditional risk factors. Pregnancy-related factors have been associated with future CVD. We examined the contribution of two pregnancy-related factors, (1) history of a low birthweight (LBW) infant and (2) breastfeeding to CVD risk accounting for traditional risk factors as assessed by the PCE. METHODS A nationally representative sample of women, ages 40-79, with a history of pregnancy, but no prior CVD, was identified using NHANES 1999-2006. Outcomes included (1) CVD death and (2) CVD death plus CVD surrogates. We used Cox proportional hazards models to adjust for PCE risk score. RESULTS Among 3,758 women, 479 had a LBW infant and 1,926 reported breastfeeding. Mean follow-up time was 12.1 years. Survival models showed a consistent reduction in CVD outcomes among women with a history of breastfeeding. In cause-specific survival models, breastfeeding was associated with a 24% reduction in risk of CVD deaths (HR 0.76; 95% CI 0.45─1.27, p = 0.30) and a 33% reduction in risk of CVD deaths + surrogate CVD, though not statistically significant. (HR 0.77; 95% CI 0.52─1.14, p = 0.19). Survival models yielded inconclusive results for LBW with wide confidence intervals (CVD death: HR 0.98; 95% CI 0.47─2.05; p = 0.96 and CVD death + surrogate CVD: HR 1.29; 95% CI 0.74─2.25; p = 0.38). CONCLUSION Pregnancy-related factors may provide important, relevant information about CVD risk beyond traditional risk factors. While further research with more robust datasets is needed, it may be helpful for clinicians to counsel women about the potential impact of pregnancy-related factors, particularly the positive impact of breastfeeding, on cardiovascular health.
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Affiliation(s)
- Shivani M. Reddy
- grid.62562.350000000100301493Division of Translational Health Sciences, RTI International, 307 Waverly Oaks Road, #1023, Waltham, MA 02452 USA
| | - Tamy H. M. Tsujimoto
- grid.10698.360000000122483208Department of Biostatistics, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, 3105-B McGavran-Greenberg Hall, CB 7420, Chapel Hill, NC 27599-7420 USA
| | - Bajhat F. Qaqish
- grid.10698.360000000122483208Department of Biostatistics, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, 3105-B McGavran-Greenberg Hall, CB 7420, Chapel Hill, NC 27599-7420 USA
| | - Jason P. Fine
- grid.10698.360000000122483208Department of Biostatistics, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, 3105-B McGavran-Greenberg Hall, CB 7420, Chapel Hill, NC 27599-7420 USA
| | - Wanda K. Nicholson
- grid.10698.360000000122483208School of Medicine, The University of North Carolina at Chapel Hill, 3027 Old Clinic Building CB#7570, Chapel Hill, USA
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4
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Becchetti C, Dirchwolf M, Schropp J, Magini G, Müllhaupt B, Immer F, Dufour J, Banz V, Berzigotti A, Bosch J. Use of statins after liver transplantation is associated with improved survival: results of a nationwide study. Aliment Pharmacol Ther 2022; 56:1194-1204. [PMID: 35979872 PMCID: PMC9545989 DOI: 10.1111/apt.17192] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 06/28/2022] [Accepted: 08/07/2022] [Indexed: 01/30/2023]
Abstract
BACKGROUND There is limited information on the effects of statins on the outcomes of liver transplantation (LT), regarding either their use by LT recipients or donors. AIM To analyse the association between statin exposure and recipient and graft survival. METHODS We included adult LT recipients with deceased donors in a nationwide prospective database study. Using a multistate modelling approach, we examined the effect of statins on the transition hazard between LT, biliary and vascular complications and death, allowing for recurring events. The observation time was 3 years. RESULTS We included 998 (696 male, 70%, mean age 54.46 ± 11.14 years) LT recipients. 14% of donors and 19% of recipients were exposed to statins during the study period. During follow-up, 141 patients died; there were 40 re-LT and 363 complications, with 66 patients having two or more complications. Treatment with statins in the recipient was modelled as a concurrent covariate and associated with lower mortality after LT (HR = 0.35; 95% CI 0.12-0.98; p = 0.047), as well as a significant reduction of re-LT (p = 0.004). However, it was not associated with lower incidence of complications (HR = 1.25; 95% CI = 0.85-1.83; p = 0.266). Moreover, in patients developing complications, statin use was significantly associated with decreased mortality (HR = 0.10; 95% CI = 0.01-0.81; p = 0.030), and reduced recurrence of complications (HR = 0.43; 95% CI = 0.20-0.93; p = 0.032). CONCLUSIONS Statin use by LT recipients may confer a survival advantage. Statin administration should be encouraged in LT recipients when clinically indicated.
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Affiliation(s)
- Chiara Becchetti
- Department of Visceral Surgery and Medicine, InselspitalBern University Hospital, University of BernBernSwitzerland
| | - Melisa Dirchwolf
- Department of Visceral Surgery and Medicine, InselspitalBern University Hospital, University of BernBernSwitzerland
- Liver UnitHospital Privado de RosarioSanta FeArgentina
| | - Jonas Schropp
- Department of Visceral Surgery and Medicine, InselspitalBern University Hospital, University of BernBernSwitzerland
| | - Giulia Magini
- Service de TransplantationHôpitaux Universitaires de GenèveGenevaSwitzerland
| | - Beat Müllhaupt
- Swiss HPB (Hepato‐Pancreato‐Biliary) Center and Department of Gastroenterology and HepatologyUniversity Hospital ZurichZurichSwitzerland
| | - Franz Immer
- Swisstransplant, the Swiss National Foundation for Organ Donation and TransplantationBernSwitzerland
| | - Jean‐François Dufour
- Department of Visceral Surgery and Medicine, InselspitalBern University Hospital, University of BernBernSwitzerland
- Centre des Maladies Digestives LausanneLausanneSwitzerland
| | - Vanessa Banz
- Department of Visceral Surgery and Medicine, InselspitalBern University Hospital, University of BernBernSwitzerland
| | - Annalisa Berzigotti
- Department of Visceral Surgery and Medicine, InselspitalBern University Hospital, University of BernBernSwitzerland
| | - Jaume Bosch
- Department of Visceral Surgery and Medicine, InselspitalBern University Hospital, University of BernBernSwitzerland
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5
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Nguyen MA, Hoang HD, Rasheed A, Duchez AC, Wyatt H, Lynn Cottee M, Graber TE, Susser L, Robichaud S, Berber İ, Geoffrion M, Ouimet M, Kazan H, Maegdefessel L, Mulvihill EE, Alain T, Rayner KJ. miR-223 Exerts Translational Control of Proatherogenic Genes in Macrophages. Circ Res 2022; 131:42-58. [PMID: 35611698 PMCID: PMC9213086 DOI: 10.1161/circresaha.121.319120] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
A significant burden of atherosclerotic disease is driven by inflammation. Recently, microRNAs (miRNAs) have emerged as important factors driving and protecting from atherosclerosis. miR-223 regulates cholesterol metabolism and inflammation via targeting both cholesterol biosynthesis pathway and NFkB signaling pathways; however, its role in atherosclerosis has not been investigated. We hypothesize that miR-223 globally regulates core inflammatory pathways in macrophages in response to inflammatory and atherogenic stimuli thus limiting the progression of atherosclerosis.
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Affiliation(s)
- My-Anh Nguyen
- University of Ottawa Heart Institute, Canada (M.-A.N., A.R., A.-C.D., H.W., M.L.C., L.S., S.R., M.G., M.O., E.E.M., K.J.R.).,Department of Biochemistry, Microbiology and Immunology, Faculty of Medicine, University of Ottawa, Canada (M.-A.N., H.-D.H., A.R., M.L.C., L.S., S.R., M.O., E.E.M., T.A., K.J.R.)
| | - Huy-Dung Hoang
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada (H.-D.H., T.E.G., T.A.).,Department of Biochemistry, Microbiology and Immunology, Faculty of Medicine, University of Ottawa, Canada (M.-A.N., H.-D.H., A.R., M.L.C., L.S., S.R., M.O., E.E.M., T.A., K.J.R.)
| | - Adil Rasheed
- University of Ottawa Heart Institute, Canada (M.-A.N., A.R., A.-C.D., H.W., M.L.C., L.S., S.R., M.G., M.O., E.E.M., K.J.R.).,Department of Biochemistry, Microbiology and Immunology, Faculty of Medicine, University of Ottawa, Canada (M.-A.N., H.-D.H., A.R., M.L.C., L.S., S.R., M.O., E.E.M., T.A., K.J.R.)
| | - Anne-Claire Duchez
- University of Ottawa Heart Institute, Canada (M.-A.N., A.R., A.-C.D., H.W., M.L.C., L.S., S.R., M.G., M.O., E.E.M., K.J.R.)
| | - Hailey Wyatt
- University of Ottawa Heart Institute, Canada (M.-A.N., A.R., A.-C.D., H.W., M.L.C., L.S., S.R., M.G., M.O., E.E.M., K.J.R.).,Department of Biochemistry, Microbiology and Immunology, Faculty of Medicine, University of Ottawa, Canada (M.-A.N., H.-D.H., A.R., M.L.C., L.S., S.R., M.O., E.E.M., T.A., K.J.R.)
| | - Mary Lynn Cottee
- University of Ottawa Heart Institute, Canada (M.-A.N., A.R., A.-C.D., H.W., M.L.C., L.S., S.R., M.G., M.O., E.E.M., K.J.R.)
| | - Tyson E Graber
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada (H.-D.H., T.E.G., T.A.)
| | - Leah Susser
- University of Ottawa Heart Institute, Canada (M.-A.N., A.R., A.-C.D., H.W., M.L.C., L.S., S.R., M.G., M.O., E.E.M., K.J.R.).,Department of Biochemistry, Microbiology and Immunology, Faculty of Medicine, University of Ottawa, Canada (M.-A.N., H.-D.H., A.R., M.L.C., L.S., S.R., M.O., E.E.M., T.A., K.J.R.)
| | - Sabrina Robichaud
- University of Ottawa Heart Institute, Canada (M.-A.N., A.R., A.-C.D., H.W., M.L.C., L.S., S.R., M.G., M.O., E.E.M., K.J.R.).,Department of Biochemistry, Microbiology and Immunology, Faculty of Medicine, University of Ottawa, Canada (M.-A.N., H.-D.H., A.R., M.L.C., L.S., S.R., M.O., E.E.M., T.A., K.J.R.)
| | - İbrahim Berber
- Electrical and Computer Engineering Graduate Program, Antalya Bilim University, Turkey (I.B.)
| | - Michele Geoffrion
- University of Ottawa Heart Institute, Canada (M.-A.N., A.R., A.-C.D., H.W., M.L.C., L.S., S.R., M.G., M.O., E.E.M., K.J.R.)
| | - Mireille Ouimet
- University of Ottawa Heart Institute, Canada (M.-A.N., A.R., A.-C.D., H.W., M.L.C., L.S., S.R., M.G., M.O., E.E.M., K.J.R.).,Department of Biochemistry, Microbiology and Immunology, Faculty of Medicine, University of Ottawa, Canada (M.-A.N., H.-D.H., A.R., M.L.C., L.S., S.R., M.O., E.E.M., T.A., K.J.R.)
| | - Hilal Kazan
- Department of Computer Engineering, Antalya Bilim University, Turkey (H.K.)
| | - Lars Maegdefessel
- Department of Vascular and Endovascular Surgery, Technical University Munich, Germany (L.M.).,Department of Medicine, Karolinska Institute, Stockholm, Sweden (L.M.)
| | - Erin E Mulvihill
- University of Ottawa Heart Institute, Canada (M.-A.N., A.R., A.-C.D., H.W., M.L.C., L.S., S.R., M.G., M.O., E.E.M., K.J.R.).,Department of Biochemistry, Microbiology and Immunology, Faculty of Medicine, University of Ottawa, Canada (M.-A.N., H.-D.H., A.R., M.L.C., L.S., S.R., M.O., E.E.M., T.A., K.J.R.)
| | - Tommy Alain
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada (H.-D.H., T.E.G., T.A.).,Department of Biochemistry, Microbiology and Immunology, Faculty of Medicine, University of Ottawa, Canada (M.-A.N., H.-D.H., A.R., M.L.C., L.S., S.R., M.O., E.E.M., T.A., K.J.R.)
| | - Katey J Rayner
- University of Ottawa Heart Institute, Canada (M.-A.N., A.R., A.-C.D., H.W., M.L.C., L.S., S.R., M.G., M.O., E.E.M., K.J.R.).,Centre for Infection, Immunity & Inflammation, Faculty of Medicine, University of Ottawa, Canada (K.J.R.).,Department of Biochemistry, Microbiology and Immunology, Faculty of Medicine, University of Ottawa, Canada (M.-A.N., H.-D.H., A.R., M.L.C., L.S., S.R., M.O., E.E.M., T.A., K.J.R.)
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6
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Neumann JT, Thao LTP, Callander E, Carr PR, Qaderi V, Nelson MR, Reid CM, Woods RL, Orchard SG, Wolfe R, Polekhina G, Williamson JD, Trauer JM, Newman AB, Murray AM, Ernst ME, Tonkin AM, McNeil JJ. A multistate model of health transitions in older people: a secondary analysis of ASPREE clinical trial data. THE LANCET. HEALTHY LONGEVITY 2022; 3:e89-e97. [PMID: 35224525 PMCID: PMC8880962 DOI: 10.1016/s2666-7568(21)00308-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
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7
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Liu H, Liu J, Liu Z, Wang Q, Liu J, Feng D, Zou J. Lycopene Reduces Cholesterol Absorption and Prevents Atherosclerosis in ApoE -/- Mice by Downregulating HNF-1α and NPC1L1 Expression. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2021; 69:10114-10120. [PMID: 34428895 DOI: 10.1021/acs.jafc.1c03160] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Our previous study showed that lycopene reduced the absorption of cholesterol in Caco-2 cells through inhibiting Niemann-Pick C1-Like 1 (NPC1L1) expression. Herein, we aimed to explore whether lycopene supplementation can decrease cholesterol absorption in the intestine and prevent atherosclerosis progression in high-fat diet (HFD)-fed apolipoprotein E knockout (ApoE-/-) mice. Male ApoE-/- mice were fed a high-fat diet with or without lycopene for 19 weeks. Supplementation of lycopene markedly lowered serum total cholesterol and low-density lipoprotein cholesterol (LDL-C) levels. Additionally, serum high-density lipoprotein cholesterol (HDL-C) levels were increased after lycopene administration. Lycopene also downregulated the expression of NPC1L1 and hepatocyte nuclear factor-1α (HNF-1α) in the small intestine. Furthermore, the Oil Red O staining of the aorta and aortic sinus showed that lycopene supplementation remarkably reduced atherosclerotic lesions. These results indicated that lycopene inhibited intestinal cholesterol absorption and protected against HFD-induced atherosclerosis through inhibiting HNF-1α and NPC1L1 expression. Lycopene exhibits a potential antiatherosclerotic effect through suppressing intestinal cholesterol absorption.
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Affiliation(s)
- Hao Liu
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou 510280, China
| | - Jun Liu
- Department of Cardiology, Guangdong Second Provincial General Hospital, Guangzhou 510317, China
| | - Zhenhao Liu
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou 510280, China
| | - Qi Wang
- Department of Cardiology, The Sixth Affiliated Hospital of South China University of Technology, Foshan 528200, China
| | - Junqiang Liu
- Department of Cardiology, The Sixth Affiliated Hospital of South China University of Technology, Foshan 528200, China
| | - Dan Feng
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Jun Zou
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou 510280, China
- Department of Cardiology, The Sixth Affiliated Hospital of South China University of Technology, Foshan 528200, China
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8
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Nayor M, Shen L, Hunninghake GM, Kochunov P, Barr RG, Bluemke DA, Broeckel U, Caravan P, Cheng S, de Vries PS, Hoffmann U, Kolossváry M, Li H, Luo J, McNally EM, Thanassoulis G, Arnett DK, Vasan RS. Progress and Research Priorities in Imaging Genomics for Heart and Lung Disease: Summary of an NHLBI Workshop. Circ Cardiovasc Imaging 2021; 14:e012943. [PMID: 34387095 PMCID: PMC8486340 DOI: 10.1161/circimaging.121.012943] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Imaging genomics is a rapidly evolving field that combines state-of-the-art bioimaging with genomic information to resolve phenotypic heterogeneity associated with genomic variation, improve risk prediction, discover prevention approaches, and enable precision diagnosis and treatment. Contemporary bioimaging methods provide exceptional resolution generating discrete and quantitative high-dimensional phenotypes for genomics investigation. Despite substantial progress in combining high-dimensional bioimaging and genomic data, methods for imaging genomics are evolving. Recognizing the potential impact of imaging genomics on the study of heart and lung disease, the National Heart, Lung, and Blood Institute convened a workshop to review cutting-edge approaches and methodologies in imaging genomics studies, and to establish research priorities for future investigation. This report summarizes the presentations and discussions at the workshop. In particular, we highlight the need for increased availability of imaging genomics data in diverse populations, dedicated focus on less common conditions, and centralization of efforts around specific disease areas.
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Affiliation(s)
- Matthew Nayor
- Cardiology Division, Department of Medicine, Massachusetts
General Hospital, Harvard Medical School, Boston, MA
| | - Li Shen
- Department of Biostatistics, Epidemiology and Informatics,
Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Gary M. Hunninghake
- Division of Pulmonary and Critical Care Medicine, Harvard
Medical School, Brigham and Women’s Hospital, Boston, MA
| | - Peter Kochunov
- Maryland Psychiatric Research Center, Department of
Psychiatry, University of Maryland School of Medicine, Baltimore, MD
| | - R. Graham Barr
- Department of Medicine and Department of Epidemiology,
Mailman School of Public Health, Columbia University Irving Medical Center, New
York, NY
| | - David A. Bluemke
- Department of Radiology, University of Wisconsin-Madison
School of Medicine and Public Health, Madison, WI
| | - Ulrich Broeckel
- Section of Genomic Pediatrics, Department of Pediatrics,
Medicine and Physiology, Children’s Research Institute and Genomic Sciences
and Precision Medicine Center, Medical College of Wisconsin, Milwaukee, WI
| | - Peter Caravan
- Institute for Innovation in Imaging, Athinoula A. Martinos
Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical
School, Charlestown, MA
| | - Susan Cheng
- Department of Cardiology, Smidt Heart Institute,
Cedars-Sinai Medical Center, Los Angeles, CA
| | - Paul S. de Vries
- Human Genetics Center, Department of Epidemiology, Human
Genetics, and Environmental Sciences, School of Public Health, The University of
Texas Health Science Center at Houston, Houston, TX
| | - Udo Hoffmann
- Department of Radiology, Harvard Medical School,
Massachusetts General Hospital, Boston, Massachusetts
| | - Márton Kolossváry
- Department of Radiology, Harvard Medical School,
Massachusetts General Hospital, Boston, Massachusetts
| | - Huiqing Li
- Division of Cardiovascular Sciences, National Heart,
Lung, and Blood Institute, Bethesda, MD
| | - James Luo
- Division of Cardiovascular Sciences, National Heart,
Lung, and Blood Institute, Bethesda, MD
| | - Elizabeth M. McNally
- Center for Genetic Medicine, Northwestern University
Feinberg School of Medicine, Chicago, IL
| | - George Thanassoulis
- Preventive and Genomic Cardiology, McGill University
Health Center and Research Institute, Montreal, Quebec, Canada
| | - Donna K. Arnett
- College of Public Health, University of Kentucky,
Lexington KY
| | - Ramachandran S. Vasan
- Sections of Preventive Medicine and Epidemiology, and
Cardiology, Department of Medicine, Department of Epidemiology, Boston University
Schools of Medicine and Public Health, and Center for Computing and Data Sciences,
Boston University, Boston, MA
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9
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Riveros-Mckay F, Weale ME, Moore R, Selzam S, Krapohl E, Sivley RM, Tarran WA, Sørensen P, Lachapelle AS, Griffiths JA, Saffari A, Deanfield J, Spencer CCA, Hippisley-Cox J, Hunter DJ, O'Sullivan JW, Ashley EA, Plagnol V, Donnelly P. Integrated Polygenic Tool Substantially Enhances Coronary Artery Disease Prediction. CIRCULATION-GENOMIC AND PRECISION MEDICINE 2021; 14:e003304. [PMID: 33651632 PMCID: PMC8284388 DOI: 10.1161/circgen.120.003304] [Citation(s) in RCA: 72] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Supplemental Digital Content is available in the text. Background: There is considerable interest in whether genetic data can be used to improve standard cardiovascular disease risk calculators, as the latter are routinely used in clinical practice to manage preventative treatment. Methods: Using the UK Biobank resource, we developed our own polygenic risk score for coronary artery disease (CAD). We used an additional 60 000 UK Biobank individuals to develop an integrated risk tool (IRT) that combined our polygenic risk score with established risk tools (either the American Heart Association/American College of Cardiology pooled cohort equations [PCE] or UK QRISK3), and we tested our IRT in an additional, independent set of 186 451 UK Biobank individuals. Results: The novel CAD polygenic risk score shows superior predictive power for CAD events, compared with other published polygenic risk scores, and is largely uncorrelated with PCE and QRISK3. When combined with PCE into an IRT, it has superior predictive accuracy. Overall, 10.4% of incident CAD cases were misclassified as low risk by PCE and correctly classified as high risk by the IRT, compared with 4.4% misclassified by the IRT and correctly classified by PCE. The overall net reclassification improvement for the IRT was 5.9% (95% CI, 4.7–7.0). When individuals were stratified into age-by-sex subgroups, the improvement was larger for all subgroups (range, 8.3%–15.4%), with the best performance in 40- to 54-year-old men (15.4% [95% CI, 11.6–19.3]). Comparable results were found using a different risk tool (QRISK3) and also a broader definition of cardiovascular disease. Use of the IRT is estimated to avoid up to 12 000 deaths in the United States over a 5-year period. Conclusions: An IRT that includes polygenic risk outperforms current risk stratification tools and offers greater opportunity for early interventions. Given the plummeting costs of genetic tests, future iterations of CAD risk tools would be enhanced with the addition of a person’s polygenic risk.
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Affiliation(s)
- Fernando Riveros-Mckay
- Genomics plc, Oxford, United Kingdom (F.R.-M., M.E.W., R.M., S.S., E.K., R.M.S., W.A.T., P.S., A.S.L., J.A.G., A.S., C.C.A.S., V.P., P.D.)
| | - Michael E Weale
- Genomics plc, Oxford, United Kingdom (F.R.-M., M.E.W., R.M., S.S., E.K., R.M.S., W.A.T., P.S., A.S.L., J.A.G., A.S., C.C.A.S., V.P., P.D.)
| | - Rachel Moore
- Genomics plc, Oxford, United Kingdom (F.R.-M., M.E.W., R.M., S.S., E.K., R.M.S., W.A.T., P.S., A.S.L., J.A.G., A.S., C.C.A.S., V.P., P.D.)
| | - Saskia Selzam
- Genomics plc, Oxford, United Kingdom (F.R.-M., M.E.W., R.M., S.S., E.K., R.M.S., W.A.T., P.S., A.S.L., J.A.G., A.S., C.C.A.S., V.P., P.D.)
| | - Eva Krapohl
- Genomics plc, Oxford, United Kingdom (F.R.-M., M.E.W., R.M., S.S., E.K., R.M.S., W.A.T., P.S., A.S.L., J.A.G., A.S., C.C.A.S., V.P., P.D.)
| | - R Michael Sivley
- Genomics plc, Oxford, United Kingdom (F.R.-M., M.E.W., R.M., S.S., E.K., R.M.S., W.A.T., P.S., A.S.L., J.A.G., A.S., C.C.A.S., V.P., P.D.)
| | - William A Tarran
- Genomics plc, Oxford, United Kingdom (F.R.-M., M.E.W., R.M., S.S., E.K., R.M.S., W.A.T., P.S., A.S.L., J.A.G., A.S., C.C.A.S., V.P., P.D.)
| | - Peter Sørensen
- Genomics plc, Oxford, United Kingdom (F.R.-M., M.E.W., R.M., S.S., E.K., R.M.S., W.A.T., P.S., A.S.L., J.A.G., A.S., C.C.A.S., V.P., P.D.)
| | - Alexander S Lachapelle
- Genomics plc, Oxford, United Kingdom (F.R.-M., M.E.W., R.M., S.S., E.K., R.M.S., W.A.T., P.S., A.S.L., J.A.G., A.S., C.C.A.S., V.P., P.D.)
| | - Jonathan A Griffiths
- Genomics plc, Oxford, United Kingdom (F.R.-M., M.E.W., R.M., S.S., E.K., R.M.S., W.A.T., P.S., A.S.L., J.A.G., A.S., C.C.A.S., V.P., P.D.)
| | - Ayden Saffari
- Genomics plc, Oxford, United Kingdom (F.R.-M., M.E.W., R.M., S.S., E.K., R.M.S., W.A.T., P.S., A.S.L., J.A.G., A.S., C.C.A.S., V.P., P.D.)
| | - John Deanfield
- Institute of Cardiovascular Sciences, University College London, United Kingdom (J.D.)
| | - Chris C A Spencer
- Genomics plc, Oxford, United Kingdom (F.R.-M., M.E.W., R.M., S.S., E.K., R.M.S., W.A.T., P.S., A.S.L., J.A.G., A.S., C.C.A.S., V.P., P.D.)
| | - Julia Hippisley-Cox
- Department of Primary Care Health Sciences (J.H.-C.), University of Oxford, United Kingdom
| | - David J Hunter
- Nuffield Department of Population Health (D.J.H.), University of Oxford, United Kingdom
| | - Jack W O'Sullivan
- Division of Cardiology, Department of Medicine, Stanford University School of Medicine, CA (J.W.O., E.A.A.)
| | - Euan A Ashley
- Division of Cardiology, Department of Medicine, Stanford University School of Medicine, CA (J.W.O., E.A.A.)
| | - Vincent Plagnol
- Genomics plc, Oxford, United Kingdom (F.R.-M., M.E.W., R.M., S.S., E.K., R.M.S., W.A.T., P.S., A.S.L., J.A.G., A.S., C.C.A.S., V.P., P.D.)
| | - Peter Donnelly
- Genomics plc, Oxford, United Kingdom (F.R.-M., M.E.W., R.M., S.S., E.K., R.M.S., W.A.T., P.S., A.S.L., J.A.G., A.S., C.C.A.S., V.P., P.D.)
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10
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Jarrah MI, Ababneh MJ, Tawalbeh LI, Hammoudeh AJ, Barukba HM, Othman A. Statin eligibility based on the ACC/AHA guidelines among Middle Eastern patients with diabetes mellitus presenting with acute myocardial infarction. Ann Med Surg (Lond) 2021; 61:148-154. [PMID: 33425348 PMCID: PMC7782195 DOI: 10.1016/j.amsu.2020.12.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 12/16/2020] [Accepted: 12/20/2020] [Indexed: 12/02/2022] Open
Abstract
Background Statin eligibility based on the American College of Cardiology/American Heart Association cholesterol guidelines among patients with diabetes admitted with first time acute myocardial infarction has not been evaluated in the Middle East. Purpose To assess statin eligibility for diabetic patients admitted with first time myocardial infarction in Jordan according to ACC/AHA guidelines. Methods Consecutive patients admitted with a first acute myocardial infarction who were not taking statins, and had their serum lipoproteins measured upon hospital admission were enrolled in the study. Statin eligibility among patients with diabetes admitted with first time myocardial infarction was determined based on the ACC/AHA guidelines. Results Of 774 patients enrolled, 292 (37.30%) had diabetes. Compared with non-diabetic patients, those with diabetes were females, older, more hypertension, more hypercholesterolemia, more triglycerides, more diastolic blood pressure, less smokers and less low density lipoprotein. Among patients with diabetes, 242 diabetic patients (82.9%) were statin eligible, including 20 (6.90%) for having high serum levels of low density lipoprotein cholesterol (LDL-C) >190 mg/dL, and 222 (76%) for being aged 40–75 years with LDL-C 70–189 mg/dL. No patient had a calculated atherosclerotic cardiovascular risk score ≥7.5%. On the other hand, 393 non-diabetic patients (81.3%) were statin eligible, including 41 (8.50%) for having high serum levels of low density lipoprotein cholesterol (LDL-C) >190 mg/dL, and 351 (72.80%) for being aged 40–75 years with LDL-C 70–189 mg/dL. Conclusions Based on the ACC/AHA guidelines, the majority of patients with diabetes admitted with first acute myocardial infarction would have been eligible for statin treatment if they have LDL-c >190 mg/dl or aged 40–75 years old and they have their LDL 70–189 mg/gl. More efforts should be taken for patients who are female, older than 50 years, hypertensive, elevated diastolic blood pressure have hypercholesterolemia, and elevated triglycerides because of their significant association with diabetes. 83% of patients with diabetes mellitus presenting with MI, were statin eligible. 393 non-diabetic patients (81.3%) were statin eligible in the current sample. No diabetic or non-diabetic patients has a 10 year ASCVR score between 5 and 7.4 Statin was eligible in the same proportion among diabetic and diabetic patients.
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Affiliation(s)
- Mohamad I Jarrah
- Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Muhannad J Ababneh
- Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Loai Issa Tawalbeh
- Faculty of Nursing, Al al-Bayt University Al-Mafraq, P.O. Box: 130049, 25113, Jordan
| | - Ayman J Hammoudeh
- Department of Cardiology, and Coronary Computed Tomography Section, Istishari Hospital, Amman, Jordan
| | - Hanan M Barukba
- Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Ahmad Othman
- Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
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11
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Campbell DJT, Lee-Krueger RCW, McBrien K, Anderson T, Quan H, Leung AA, Chen G, Lu M, Naugler C, Butalia S. Strategies for enhancing the initiation of cholesterol lowering medication among patients at high cardiovascular disease risk: a qualitative descriptive exploration of patient and general practitioners' perspectives on a facilitated relay intervention in Alberta, Canada. BMJ Open 2020; 10:e038469. [PMID: 33234627 PMCID: PMC7689086 DOI: 10.1136/bmjopen-2020-038469] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 10/17/2020] [Accepted: 10/28/2020] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE The objective of our study was to explore the perspectives of patients and general practitioners (GPs) regarding interventions to increase initiation of cholesterol lowering medication (or statins), including a proposed laboratory-based facilitated relay intervention. DESIGN Qualitative descriptive study using interviews and focus groups for data collection, and thematic analysis for data analysis. SETTING Primary care providers and patients in Calgary, Alberta, Canada. PARTICIPANTS 17 GPs with primarily community-based, non-academic practices with at least 1 year of practice experience participated in semistructured interviews. 14 patients at high risk of cardiovascular disease participated in focus groups. MAIN OUTCOME MEASURES Exploration of strategies that might be used to enhance the prescription of, and adherence to statin therapy for patients with statin-indicated conditions. RESULTS GPs proposed a variety of interventions to improve statin prescription, including electronic record audit solutions, GP directed education, and patient-oriented campaigns. Patients expressed that they may benefit from being provided access to their laboratory test results, as well as targeted education. Both parties provided positive feedback on the proposed laboratory-based facilitated relay intervention, while pointing out areas for improvement. Notably, GPs were concerned that the patient-directed component of the intervention might jeopardise therapeutic relationships, and patients were concerned about accidental disclosure of personal health information. Important considerations for the design of facilitated relay messaging should include brevity, simplicity and the provision of contact information for inquiries. CONCLUSIONS GPs and patients described several suggestions for increasing statin initiation and welcomed the proposal of a laboratory-based facilitated relay strategy. These findings support further testing of this intervention which may enhance GPs' ability to successfully engage patients in cardiovascular risk reduction through statin therapy.
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Affiliation(s)
- David J T Campbell
- Department of Medicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
- Department of Cardiac Sciences, University of Calgary, Calgary, Alberta, Canada
| | | | - Kerry McBrien
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
- Department of Family Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Todd Anderson
- Department of Cardiac Sciences, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
| | - Hude Quan
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Alexander A Leung
- Department of Medicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Guanmin Chen
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Mingshan Lu
- Department of Economics, University of Calgary, Calgary, Alberta, Canada
| | - Christopher Naugler
- Department of Pathology & Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Sonia Butalia
- Department of Medicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
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12
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Wang X, Liu Y, Lu F, Li H, Gao P, Wei D. Dipeptide Frequency of Word Frequency and Graph Convolutional Networks for DTA Prediction. Front Bioeng Biotechnol 2020; 8:267. [PMID: 32318557 PMCID: PMC7147459 DOI: 10.3389/fbioe.2020.00267] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 03/13/2020] [Indexed: 11/13/2022] Open
Abstract
Deep learning is an effective method to capture drug-target binding affinity, but low accuracy is still an obstacle to be overcome. Thus, we propose a novel predictor for drug-target binding affinity based on dipeptide frequency of word frequency encoding and a hybrid graph convolutional network. Word frequency characteristics of natural language are used to improve the frequency characteristics of peptides to express target proteins. For each drug molecules, the five different features of drug atoms and the atomic bond relationships are expressed as graphs. The obtained protein features and graph structure are used as the input of convolution neural network and the input of graph convolution neural network, respectively. A prediction model is established to predict the drug affinity by calculating the hidden relationship. In the KIBA data set test experiment, the consistency coefficient of the model is 0.901, which is 0.01 higher than the existing model, and the MSE (mean square error) of the model is 0.126, which is 5% lower than the existing model. In Davis data set test experiment, the consistency coefficient of the model is 0.895, which is 0.006 higher than the existing model, and the MSE of the model is 0.220, which is 4% lower than the existing model. These results show that our proposed method can not only predict the affinity better than those existing models, but also outperform unitary deep learning approaches.
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Affiliation(s)
- Xianfang Wang
- School of Computer Science and Technology, Henan Institute of Technology, Xinxiang, China.,School of Computer and Information Engineering, Henan Normal University, Xinxiang, China
| | - Yifeng Liu
- School of Computer and Information Engineering, Henan Normal University, Xinxiang, China
| | - Fan Lu
- School of Computer and Information Engineering, Henan Normal University, Xinxiang, China
| | - Hongfei Li
- School of Computer and Information Engineering, Henan Normal University, Xinxiang, China
| | - Peng Gao
- School of Computer and Information Engineering, Henan Normal University, Xinxiang, China
| | - Dongqing Wei
- School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, China
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13
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14
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Superko HR, Williams PT, Dansinger M, Schaefer E. Trends in low-density lipoprotein-cholesterol blood values between 2012 and 2017 suggest sluggish adoption of the recent 2013 treatment guidelines. Clin Cardiol 2018; 42:101-110. [PMID: 30444024 DOI: 10.1002/clc.23115] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 11/07/2018] [Accepted: 11/13/2018] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Over a 14-year period, age-adjusted high total cholesterol (≥240 mg/dL) in the United States declined from 18.3% in 1999 to 2000 to 11.0% in 2013 to 2014, coinciding with the 2001 National Cholesterol Education Program Adult Treatment Panel (ATP)-III guidelines that endorsed low-density lipoprotein (LDL)-cholesterol blood value goals. Statin treatment recommendations were revised by the American College of Cardiology and the American Heart Association (ACC/AHA) in November 2013 to a "risk-based prescription" approach that did not utilize blood cholesterol values. This increased dosage and expanded the statin-eligible population by an estimated 12.8 million US adults. These changes should further lower total and LDL cholesterol concentrations nationally. METHODS We examined data from 507 752 patients nationally aged ≥16 years whose fasting bloods were sent to Boston Heart Diagnostics for direct LDL-cholesterol measurements. Between 2012 and 2017, age-adjusted concentrations were examined by analysis of covariance and LDL-cholesterol ≥160 mg/dL by logistic regression. RESULTS Contrary to expectations, age-adjusted mean LDL-cholesterol concentrations (±SE, mg/dL) increased significantly (P < 10-16 ) in men (2012:113.8 ± 0.3; 2013:115.3 ± 0.2; 2014:114.7 ± 0.2; 2015:116.0 ± 0.2; 2016:117.6 ± 0.2; and 2017:117.1 ± 0.2 mg/dL) and women (2012:119.5 ± 0.3; 2013:120.7 ± 0.2; 2014:119.8 ± 0.02; 2015:120.8 ± 0.2; 2016:122.7 ± 0.1; and 2017:123.8 ± 0.2 mg/dL). The percentage with LDL-cholesterol ≥160 mg/dL also increased significantly (P < 10-9 ) in men and women. Similar results were obtained for ages 40 to 75 years olds (corresponding to ACC/AHA guidelines). CONCLUSION These results provide additional evidence that declining blood LDL-cholesterol levels observed following the ATP-III recommendations, did not further decline (actually increased) following the 2013 ACC/AHA recommendations.
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Affiliation(s)
- H Robert Superko
- Cholesterol, Genetics, and Heart Disease Institute, Carmel, California
| | | | - Michael Dansinger
- Boston Heart Diagnostics, Framingham, Massachusetts.,Department of Internal Medicine, Tuft's University, Medford, Massachusetts
| | - Ernst Schaefer
- Boston Heart Diagnostics, Framingham, Massachusetts.,Department of Internal Medicine, Tuft's University, Medford, Massachusetts
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15
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Zou J, Zhang S, Li P, Zheng X, Feng D. Supplementation with curcumin inhibits intestinal cholesterol absorption and prevents atherosclerosis in high-fat diet-fed apolipoprotein E knockout mice. Nutr Res 2018; 56:32-40. [PMID: 30055772 DOI: 10.1016/j.nutres.2018.04.017] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2017] [Revised: 04/24/2018] [Accepted: 04/26/2018] [Indexed: 10/17/2022]
Abstract
Atherosclerosis is a major cause of cardiovascular disease caused by high cholesterol. Reduced intestinal cholesterol absorption has been shown to exert strong cholesterol-lowering and antiatherogenic effects. Previously, we reported that curcumin reduced cholesterol absorption in high-fat diet-fed hamster by downregulating the intestinal expression of Niemann-Pick C1-like 1. Here, we tested the hypothesis that supplementation with curcumin can also reduce intestinal cholesterol absorption in high-fat diet-fed apolipoprotein E knockout (ApoE-/-) mice and prevent atherosclerosis development. ApoE-/- mice were fed a high-fat diet supplemented with or without curcumin (0.1% w/w) for 16 weeks. Aortic sinus sections revealed that curcumin supplementation reduced the extent of atherosclerotic lesions by 45%. Curcumin treatment also reduced cholesterol accumulation in the aortas by 56% and lowered plasma total cholesterol and low-density lipoprotein cholesterol levels. Moreover, the antiatherogenic and cholesterol-lowering effects of curcumin coincided with a significant decrease in intestinal cholesterol absorption. It was reduced by nearly 51%, and the decreased cholesterol absorption was modulated by inhibiting the intestinal expression of Niemann-Pick C1-like 1, predominantly in the duodenal and jejunal segments of the small intestine. These findings support the hypothesis that curcumin supplementation reduces intestinal cholesterol absorption and prevents atherosclerosis in high-fat diet-fed ApoE-/- mice. Curcumin affords a potent antiatherogenic action by inhibiting intestinal cholesterol absorption in the mouse.
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Affiliation(s)
- Jun Zou
- Department of Cardiology, Affiliated NanHai Hospital of Southern Medical University, 528200, China
| | - Shanshan Zhang
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, 510080, China
| | - Peiyang Li
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, 510080, China
| | - Xiumei Zheng
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, 510080, China
| | - Dan Feng
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, 510080, China.
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16
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Løgstrup BB, Ellingsen T, Pedersen AB, Kjaersgaard A, Bøtker HE, Maeng M. Development of heart failure in patients with rheumatoid arthritis: A Danish population-based study. Eur J Clin Invest 2018; 48:e12915. [PMID: 29464714 DOI: 10.1111/eci.12915] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Accepted: 02/15/2018] [Indexed: 12/22/2022]
Abstract
BACKGROUND To investigate the incidence of heart failure (HF) and ischaemic heart disease (IHD) in different time spans following incident rheumatoid arthritis (RA) and, furthermore, to investigate the impact of IHD on the development of HF and the impact of different treatment era of RA. MATERIALS AND METHODS This matched cohort study used nationwide, prospectively collected data. From the total Danish population of approximately 5.7 million inhabitants, we identified 51 859 patients (between 1995 and July 2016) with incident RA and a sex- and age-matched cohort from the general population (256 653 persons). RESULTS The hazard ratio (HR) for HF among RA patients compared with persons from comparison cohort was 2.28 within the first year of index date, 1.39 within the 1-5 years of index date and 1.38 within the 5-10 years of index date. No difference was identified regarding different treatment era of RA. For IHD, the subdistribution hazard ratio (sHR) was 1.93 within the first year of index date, 1.26 within the 1-5 years of index date and 1.31 within the 5-10 years of index date. Coronary revascularization was also more common within the first year after diagnosis of RA. An increased risk of percutaneous coronary intervention and coronary artery bypass grafting within 10 years following the RA diagnosis was observed. HR for new onset of HF in RA without IHD was 1.23, while the HR for new onset of HF in patients with RA and IHD was 2.06. CONCLUSIONS Rheumatoid arthritis patients had higher rates of HF and IHD throughout the entire observation period compared to the comparison cohort. RA was associated with a larger risk of developing HF.
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Affiliation(s)
- Brian B Løgstrup
- Department of Cardiology, Aarhus University Hospital, Skejby, Denmark
| | - Torkell Ellingsen
- Clinic for Rational and Innovative Patient Pathways, Regional Hospital Silkeborg, Silkeborg, Denmark.,Department of Rheumatology, Odense University Hospital, Odense, Denmark
| | - Alma B Pedersen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Anders Kjaersgaard
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Hans-Erik Bøtker
- Department of Cardiology, Aarhus University Hospital, Skejby, Denmark
| | - Michael Maeng
- Department of Cardiology, Aarhus University Hospital, Skejby, Denmark
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Lin H, Tang X, Shen P, Zhang D, Wu J, Zhang J, Lu P, Si Y, Gao P. Using big data to improve cardiovascular care and outcomes in China: a protocol for the CHinese Electronic health Records Research in Yinzhou (CHERRY) Study. BMJ Open 2018; 8:e019698. [PMID: 29440217 PMCID: PMC5829949 DOI: 10.1136/bmjopen-2017-019698] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Data based on electronic health records (EHRs) are rich with individual-level longitudinal measurement information and are becoming an increasingly common data source for clinical risk prediction worldwide. However, few EHR-based cohort studies are available in China. Harnessing EHRs for research requires a full understanding of data linkages, management, and data quality in large data sets, which presents unique analytical opportunities and challenges. The purpose of this study is to provide a framework to establish a uniquely integrated EHR database in China for scientific research. METHODS AND ANALYSIS The CHinese Electronic health Records Research in Yinzhou (CHERRY) Study will extract individual participant data within the regional health information system of an eastern coastal area of China to establish a longitudinal population-based ambispective cohort study for cardiovascular care and outcomes research. A total of 1 053 565 Chinese adults aged over 18 years were registered in the health information system in 2009, and there were 23 394 deaths from 1 January 2009 to 31 December 2015. The study will include information from multiple epidemiological surveys; EHRs for chronic disease management; and health administrative, clinical, laboratory, drug and electronic medical record (EMR) databases. Follow-up of fatal and non-fatal clinical events is achieved through records linkage to the regional system of disease surveillance, chronic disease management and EMRs (based on diagnostic codes from the International Classification of Diseases, tenth revision). The CHERRY Study will provide a unique platform and serve as a valuable big data resource for cardiovascular risk prediction and population management, for primary and secondary prevention of cardiovascular events in China. ETHICS AND DISSEMINATION The CHERRY Study was approved by the Peking University Institutional Review Board (IRB00001052-16011) in April 2016. Results of the study will be disseminated through published journal articles, conferences and seminar presentations, and on the study website (http://www.cherry-study.org).
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Affiliation(s)
- Hongbo Lin
- Yinzhou District Center for Disease Control and Prevention, Ningbo, China
| | - Xun Tang
- Department of Epidemiology and Biostatistics, Peking University Health Science Center, Beijing, China
| | - Peng Shen
- Yinzhou District Center for Disease Control and Prevention, Ningbo, China
| | - Dudan Zhang
- Department of Epidemiology and Biostatistics, Peking University Health Science Center, Beijing, China
| | - Jinguo Wu
- Wonders Information Co. Ltd, Shanghai, China
| | | | - Ping Lu
- Wonders Information Co. Ltd, Shanghai, China
| | - Yaqin Si
- Department of Epidemiology and Biostatistics, Peking University Health Science Center, Beijing, China
| | - Pei Gao
- Department of Epidemiology and Biostatistics, Peking University Health Science Center, Beijing, China
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