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Chen S, Li L, Wu Z, Liu Y, Li F, Huang K, Wang Y, Chen Q, Wang X, Shen W, Zhang R, Shen Y, Lu L, Ding F, Dai Y. SerpinG1: A Novel Biomarker Associated With Poor Coronary Collateral in Patients With Stable Coronary Disease and Chronic Total Occlusion. J Am Heart Assoc 2022; 11:e027614. [PMID: 36515245 PMCID: PMC9798810 DOI: 10.1161/jaha.122.027614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background This study aimed to explore predictive biomarkers of coronary collateralization in patients with chronic total occlusion. Methods and Results By using a microarray expression profiling program downloaded from the Gene Expression Omnibus database, weighted gene coexpression network analysis was constructed to analyze the relationship between potential modules and coronary collateralization and screen out the hub genes. Then, the hub gene was identified and validated in an independent cohort of patients (including 299 patients with good arteriogenic responders and 223 patients with poor arteriogenic responders). Weighted gene coexpression network analysis showed that SERPING1 in the light-cyan module was the only gene that was highly correlated with both the gene module and the clinical traits. Serum levels of serpinG1 were significantly higher in patients with bad arteriogenic responders than in patients with good arteriogenic responders (472.53±197.16 versus 314.80±208.92 μg/mL; P<0.001) and were negatively associated with the Rentrop score (Spearman r=-0.50; P<0.001). Receiver operating characteristic curve analysis indicated that the area under the curve was 0.77 (95% CI, 0.72-0.81; P<0.001) for serum serpinG1 in prediction of bad arteriogenic responders. After adjusting for traditional cardiovascular risk factors, serum serpinG1 levels (per SD) remained an independent risk factor for bad arteriogenic responders (odds ratio, 2.20 [95% CI, 1.76-2.74]; P<0.001). Conclusions Our findings illustrate that SERPING1 screened by weighted gene coexpression network analysis was associated with poor collateralization in patients with chronic total occlusion.
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Affiliation(s)
- Shuai Chen
- Department of Vascular and Cardiology, Rui Jin HospitalShanghai Jiaotong University School of MedicineShanghaiChina,Institute of Cardiovascular DiseasesShanghai Jiaotong University School of MedicineShanghaiChina
| | - Le‐Ying Li
- Department of Vascular and Cardiology, Rui Jin HospitalShanghai Jiaotong University School of MedicineShanghaiChina,Institute of Cardiovascular DiseasesShanghai Jiaotong University School of MedicineShanghaiChina
| | - Zhi‐Ming Wu
- Department of Vascular and Cardiology, Rui Jin HospitalShanghai Jiaotong University School of MedicineShanghaiChina,Institute of Cardiovascular DiseasesShanghai Jiaotong University School of MedicineShanghaiChina
| | - Yong Liu
- Department of Nursing, Chongqing Medical and Pharmaceutical CollegeChongqingChina
| | - Fei‐Fei Li
- Department of Vascular and Cardiology, Rui Jin HospitalShanghai Jiaotong University School of MedicineShanghaiChina,Institute of Cardiovascular DiseasesShanghai Jiaotong University School of MedicineShanghaiChina
| | - Ke Huang
- Department of Vascular and Cardiology, Rui Jin HospitalShanghai Jiaotong University School of MedicineShanghaiChina,Institute of Cardiovascular DiseasesShanghai Jiaotong University School of MedicineShanghaiChina
| | - Yi‐Xuan Wang
- Department of Vascular and Cardiology, Rui Jin HospitalShanghai Jiaotong University School of MedicineShanghaiChina,Institute of Cardiovascular DiseasesShanghai Jiaotong University School of MedicineShanghaiChina
| | - Qiu‐Jing Chen
- Institute of Cardiovascular DiseasesShanghai Jiaotong University School of MedicineShanghaiChina
| | - Xiao‐Qun Wang
- Department of Vascular and Cardiology, Rui Jin HospitalShanghai Jiaotong University School of MedicineShanghaiChina,Institute of Cardiovascular DiseasesShanghai Jiaotong University School of MedicineShanghaiChina
| | - Wei‐Feng Shen
- Department of Vascular and Cardiology, Rui Jin HospitalShanghai Jiaotong University School of MedicineShanghaiChina,Institute of Cardiovascular DiseasesShanghai Jiaotong University School of MedicineShanghaiChina
| | - Rui‐Yan Zhang
- Department of Vascular and Cardiology, Rui Jin HospitalShanghai Jiaotong University School of MedicineShanghaiChina,Shanghai Clinical Research Center for Interventional MedicineShanghaiChina
| | - Ying Shen
- Institute of Cardiovascular DiseasesShanghai Jiaotong University School of MedicineShanghaiChina
| | - Lin Lu
- Department of Vascular and Cardiology, Rui Jin HospitalShanghai Jiaotong University School of MedicineShanghaiChina,Institute of Cardiovascular DiseasesShanghai Jiaotong University School of MedicineShanghaiChina
| | - Feng‐Hua Ding
- Department of Vascular and Cardiology, Rui Jin HospitalShanghai Jiaotong University School of MedicineShanghaiChina,Shanghai Clinical Research Center for Interventional MedicineShanghaiChina
| | - Yang Dai
- Department of Vascular and Cardiology, Rui Jin HospitalShanghai Jiaotong University School of MedicineShanghaiChina,Institute of Cardiovascular DiseasesShanghai Jiaotong University School of MedicineShanghaiChina
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Ahn J, Heo S, Ahn SJ, Bang D, Lee SH. Differentially hypomethylated cell-free DNA and coronary collateral circulation. Clin Epigenetics 2022; 14:140. [PMID: 36320085 PMCID: PMC9628091 DOI: 10.1186/s13148-022-01349-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 10/02/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The factors affecting cardioprotective collateral circulation are still incompletely understood. Recently, characteristics, such as CpG methylation of cell-free DNA (cfDNA), have been reported as markers with clinical utility. The aim of this study was to evaluate whether cfDNA methylation patterns are associated with the grade of coronary collateral circulation (CCC). RESULT In this case-control study, clinical and angiographic data were obtained from 143 patients (mean age, 58 years, male 71%) with chronic total coronary occlusion. Enzymatic methyl-sequencing (EM-seq) libraries were prepared using the cfDNA extracted from the plasma. Data were processed to obtain the average methylation fraction (AMF) tables of genomic regions from which blacklisted regions were removed. Unsupervised analysis of the obtained AMF values showed that some of the changes in methylation were due to CCC. Through random forest preparation process, 256 differentially methylated region (DMR) candidates showing strong association with CCC were selected. A random forest classifier was then constructed, and the area under the curve of the receiver operating characteristic curve indicated an appropriate predictive function for CCC. Finally, 20 DMRs were identified to have significantly different AMF values between the good and poor CCC groups. Particularly, the good CCC group exhibited hypomethylated DMRs. Pathway analysis revealed five pathways, including TGF-beta signaling, to be associated with good CCC. CONCLUSION These data have demonstrated that differential hypomethylation was identified in dozens of cfDNA regions in patients with good CCC. Our results support the clinical utility of noninvasively obtained epigenetic signatures for predicting collateral circulation in patients with vascular diseases.
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Affiliation(s)
- Jongseong Ahn
- Department of Chemistry, Yonsei University, 50, Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea
| | | | - Soo-Jin Ahn
- Integrative Research Center for Cerebrovascular and Cardiovascular Diseases, Yonsei University College of Medicine, 50-1, Yonsei-ro, Seodaemun-gu, Seoul, Korea
| | - Duhee Bang
- Department of Chemistry, Yonsei University, 50, Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea.
| | - Sang-Hak Lee
- Division of Cardiology, Severance Hospital, Yonsei University College of Medicine, 50-1, Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea.,Pohang University of Science and Technology (POSTECH), Pohang, Korea
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Shen Y, Wang XQ, Dai Y, Wang YX, Zhang RY, Lu L, Ding FH, Shen WF. Diabetic dyslipidemia impairs coronary collateral formation: An update. Front Cardiovasc Med 2022; 9:956086. [PMID: 36072863 PMCID: PMC9441638 DOI: 10.3389/fcvm.2022.956086] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 08/01/2022] [Indexed: 11/13/2022] Open
Abstract
Coronary collateralization is substantially impaired in patients with type 2 diabetes and occlusive coronary artery disease, which leads to aggravated myocardial ischemia and a more dismal prognosis. In a diabetic setting, altered serum lipid profiles and profound glycoxidative modification of lipoprotein particles induce endothelial dysfunction, blunt endothelial progenitor cell response, and severely hamper growth and maturation of collateral vessels. The impact of dyslipidemia and lipid-lowering treatments on coronary collateral formation has become a topic of heightened interest. In this review, we summarized the association of triglyceride-based integrative indexes, hypercholesterolemia, increased Lp(a) with its glycoxidative modification, as well as quantity and quality abnormalities of high-density lipoprotein with impaired collateral formation. We also analyzed the influence of innovative lipid-modifying strategies on coronary collateral development. Therefore, clinical management of diabetic dyslipidemia should take into account of its effect on coronary collateralization in patients with occlusive coronary artery disease.
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Affiliation(s)
- Ying Shen
- Department of Cardiovascular Medicine, School of Medicine, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Xiao Qun Wang
- Department of Cardiovascular Medicine, School of Medicine, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Yang Dai
- Department of Cardiovascular Medicine, School of Medicine, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Yi Xuan Wang
- Department of Cardiovascular Medicine, School of Medicine, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Rui Yan Zhang
- Department of Cardiovascular Medicine, School of Medicine, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Clinical Research Center for Interventional Medicine, Shanghai, China
| | - Lin Lu
- Department of Cardiovascular Medicine, School of Medicine, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China
- Institute of Cardiovascular Disease, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Feng Hua Ding
- Department of Cardiovascular Medicine, School of Medicine, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China
- *Correspondence: Feng Hua Ding,
| | - Wei Feng Shen
- Department of Cardiovascular Medicine, School of Medicine, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China
- Institute of Cardiovascular Disease, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Wei Feng Shen,
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Serum CTRP9 Reflects Coronary Collateralization in Nondiabetic Patients with Obstructive Coronary Artery Disease. BIOMED RESEARCH INTERNATIONAL 2022; 2022:8537686. [PMID: 35309173 PMCID: PMC8930261 DOI: 10.1155/2022/8537686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 02/14/2022] [Accepted: 02/15/2022] [Indexed: 11/17/2022]
Abstract
Aim. To explore the association between the serum C1q/tumor necrosis factor-related protein 9 (CTRP9) and the formation of coronary collateral circulation in obstructive coronary artery disease (CAD). Methods. A total of 206 patients who underwent coronary angiography at Beijing Anzhen Hospital and had epicardial arteries with at least 95% stenotic lesion were enrolled. Blood samples were taken after an overnight fasting before the coronary angiography. Serum CTRP9 level was measured using commercial enzyme linked immunosorbent assay (ELISA) kit. The development of coronary collateralization was determined according to the Rentrop classification system. Rentrop score 0-1 was graded as impaired or less-developed coronary collateralization (
) while the Rentrop score 2-3 was defined as well-developed collateralization (
). Results. Serum CTRP9 level was significantly higher in well-developed collateralization and diabetes groups (
). To further explore the association between the CTRP9 level and coronary collateralization, the enrolled participants were divided into 3 tertiles according to the serum CTRP9 level. The prevalence of impaired coronary collateralization decreased stepwise with the increasing CTRP9 tertiles (
for trend <0.001). Multivariate regression analysis showed that the serum CTRP9 is independently associated with well-developed collateralization, with an OR (95% CI) of 4.49 (1.75-11.55) and 8.98 (2.75-29.35) in the tertiles 2 and 3, respectively. The following subgroup and receiver-operating characteristic (ROC) analysis also indicated that the diagnostic value of serum CTRP9 level for detecting the formation of collateralization persisted only in nondiabetic participants. Lastly, adding the serum CTRP9 into the baseline model could increase the diagnostic value of established model consisting of relevant factor for the discrimination of well-developed collateralization only in the nondiabetic group (
). Conclusions. Serum CTRP9 reflects well-developed coronary collateralization in nondiabetic patients with obstructive CAD, and
indicated a greater chance to forming well-developed coronary collaterals.
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Lee CK, Liao CW, Meng SW, Wu WK, Chiang JY, Wu MS. Lipids and Lipoproteins in Health and Disease: Focus on Targeting Atherosclerosis. Biomedicines 2021; 9:biomedicines9080985. [PMID: 34440189 PMCID: PMC8393881 DOI: 10.3390/biomedicines9080985] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 08/01/2021] [Accepted: 08/04/2021] [Indexed: 12/15/2022] Open
Abstract
Despite advances in pharmacotherapy, intervention devices and techniques, residual cardiovascular risks still cause a large burden on public health. Whilst most guidelines encourage achieving target levels of specific lipids and lipoproteins to reduce these risks, increasing evidence has shown that molecular modification of these lipoproteins also has a critical impact on their atherogenicity. Modification of low-density lipoprotein (LDL) by oxidation, glycation, peroxidation, apolipoprotein C-III adhesion, and the small dense subtype largely augment its atherogenicity. Post-translational modification by oxidation, carbamylation, glycation, and imbalance of molecular components can reduce the capacity of high-density lipoprotein (HDL) for reverse cholesterol transport. Elevated levels of triglycerides (TGs), apolipoprotein C-III and lipoprotein(a), and a decreased level of apolipoprotein A-I are closely associated with atherosclerotic cardiovascular disease. Pharmacotherapies aimed at reducing TGs, lipoprotein(a), and apolipoprotein C-III, and enhancing apolipoprotein A-1 are undergoing trials, and promising preliminary results have been reported. In this review, we aim to update the evidence on modifications of major lipid and lipoprotein components, including LDL, HDL, TG, apolipoprotein, and lipoprotein(a). We also discuss examples of translating findings from basic research to potential therapeutic targets for drug development.
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Affiliation(s)
- Chih-Kuo Lee
- College of Medicine, National Taiwan University, Taipei 100, Taiwan; (C.-K.L.); (C.-W.L.); (S.-W.M.); (W.-K.W.)
- Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu 300, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei 100, Taiwan
| | - Che-Wei Liao
- College of Medicine, National Taiwan University, Taipei 100, Taiwan; (C.-K.L.); (C.-W.L.); (S.-W.M.); (W.-K.W.)
- Department of Internal Medicine, National Taiwan University Cancer Center, Taipei 106, Taiwan
| | - Shih-Wei Meng
- College of Medicine, National Taiwan University, Taipei 100, Taiwan; (C.-K.L.); (C.-W.L.); (S.-W.M.); (W.-K.W.)
- Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu 300, Taiwan
| | - Wei-Kai Wu
- College of Medicine, National Taiwan University, Taipei 100, Taiwan; (C.-K.L.); (C.-W.L.); (S.-W.M.); (W.-K.W.)
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei 100, Taiwan
| | - Jiun-Yang Chiang
- College of Medicine, National Taiwan University, Taipei 100, Taiwan; (C.-K.L.); (C.-W.L.); (S.-W.M.); (W.-K.W.)
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei 100, Taiwan
- Division of Cardiology, Department of Internal Medicine and Cardiovascular Center, National Taiwan University Hospital, Taipei 100, Taiwan
- Correspondence: (J.-Y.C.); (M.-S.W.)
| | - Ming-Shiang Wu
- College of Medicine, National Taiwan University, Taipei 100, Taiwan; (C.-K.L.); (C.-W.L.); (S.-W.M.); (W.-K.W.)
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei 100, Taiwan
- Correspondence: (J.-Y.C.); (M.-S.W.)
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Lee S, Park JM, Ann SJ, Kang M, Cheon EJ, An DB, Choi YR, Lee CJ, Oh J, Park S, Kang SM, Lee SH. Cholesterol Efflux and Collateral Circulation in Chronic Total Coronary Occlusion: Effect-Circ Study. J Am Heart Assoc 2021; 10:e019060. [PMID: 33634702 PMCID: PMC8174259 DOI: 10.1161/jaha.120.019060] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background The mechanism through which high‐density lipoprotein (HDL) induces cardioprotection is not completely understood. We evaluated the correlation between cholesterol efflux capacity (CEC), a functional parameter of HDL, and coronary collateral circulation (CCC). We additionally investigated whether A1BP (apoA1‐binding protein) concentration correlates with CEC and CCC. Methods and Results In this case‐control study, clinical and angiographic data were collected from 226 patients (mean age, 58 years; male, 72%) with chronic total coronary occlusion. CEC was assessed using a radioisotope and J774 cells, and human A1BP concentration was measured using enzyme‐linked immunosorbent assay. Differences between the good and poor CCC groups were compared, and associations between CEC, A1BP, and other variables were evaluated. Predictors of CCC were identified by multivariable logistic regression analysis. The CEC was higher in the good than in the poor CCC group (22.0±4.6% versus 20.2±4.7%; P=0.009). In multivariable analyses including age, sex, HDL‐cholesterol levels, age (odds ratio [OR], 0.96; P=0.003), and CEC (OR, 1.10; P=0.004) were identified as the independent predictors of good CCC. These relationships remained significant after additional adjustment for diabetes mellitus, acute coronary syndrome, and Gensini score. The A1BP levels were not significantly correlated with CCC (300 pg/mL and 283 pg/mL in the good CCC and poor CCC groups, respectively, P=0.25) or CEC. Conclusions The relationship between higher CEC and good CCC indicates that well‐functioning HDL may contribute to CCC and may be cardioprotective; this suggests that a specific function of HDL can have biological and clinical consequences.
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Affiliation(s)
- Seonhwa Lee
- Division of Cardiology Department of Internal Medicine Severance HospitalYonsei University College of MedicineYonsei University Health System Seoul Korea
| | - Jung Mi Park
- Department of Biostatistics and Computing Graduate School Yonsei University Seoul Korea
| | - Soo-Jin Ann
- Integrative Research Center for Cerebrovascular and Cardiovascular Diseases Yonsei University College of MedicineYonsei University Health System Seoul Korea
| | - Moonjong Kang
- Department of Biostatistics and Computing Graduate School Yonsei University Seoul Korea
| | - Eun Jeong Cheon
- Integrative Research Center for Cerebrovascular and Cardiovascular Diseases Yonsei University College of MedicineYonsei University Health System Seoul Korea
| | - Dan Bi An
- Graduate Program of Science for Aging Graduate School Yonsei University Seoul Korea
| | - Yu Ri Choi
- Graduate Program of Science for Aging Graduate School Yonsei University Seoul Korea
| | - Chan Joo Lee
- Division of Cardiology Department of Internal Medicine Severance HospitalYonsei University College of MedicineYonsei University Health System Seoul Korea
| | - Jaewon Oh
- Division of Cardiology Department of Internal Medicine Severance HospitalYonsei University College of MedicineYonsei University Health System Seoul Korea
| | - Sungha Park
- Division of Cardiology Department of Internal Medicine Severance HospitalYonsei University College of MedicineYonsei University Health System Seoul Korea
| | - Seok-Min Kang
- Division of Cardiology Department of Internal Medicine Severance HospitalYonsei University College of MedicineYonsei University Health System Seoul Korea
| | - Sang-Hak Lee
- Division of Cardiology Department of Internal Medicine Severance HospitalYonsei University College of MedicineYonsei University Health System Seoul Korea
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