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Wu KL, Liang QH, Huang BT, Ding N, Li BW, Hao J. The plasma level of mCRP is linked to cardiovascular disease in antineutrophil cytoplasmic antibody-associated vasculitis. Arthritis Res Ther 2020; 22:228. [PMID: 33008437 PMCID: PMC7532103 DOI: 10.1186/s13075-020-02321-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 09/17/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND C-reactive protein (CRP) has two natural isomers: C-reactive protein pentamer (pCRP) and C-reactive protein monomer (mCRP). The levels of CRP are significantly elevated in patients with anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). mCRP not only activates the endothelial cells, platelets, leukocytes, and complements, but also has a proinflammatory structural subtype that can localize and deposit in inflammatory tissues. Thus, it regulates a variety of clinical diseases, such as ischemia/reperfusion (I/R) injury, Alzheimer's disease, age-related macular degeneration, and cardiovascular disease. We hypothesized that plasma mCRP levels are related to cardiovascular disease in AAV. METHODS In this cross-sectional study, 37 patients with AAV were assessed. Brain natriuretic peptide (BNP) and mCRP in plasma were assessed by enzyme-linked immunosorbent assay (ELISA). The acute ST-segment elevation myocardial infarction (STEMI) was diagnosed by coronary angiography, and the Gensini score calculated. Echocardiography evaluated the ejection fraction (EF%), left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), and left ventricular mass index (LVMI). Estimated glomerular filtration rate (eGFR) was calculated based on serum creatinine, age, and gender. RESULTS The plasma level of mCRP in AAV was significantly higher than that in healthy volunteers (P < 0.001). Then, mCRP and CRP levels were compared with and without STEMI complications in AAV. The plasma level of mCRP was higher, but that of CRP was lower in STEMI. The plasma level of mCRP was correlated with Birmingham vasculitis activity score (BVAS), eGFR, BNP, EF%, LVEDV, LVESV, LVMI, and STEMI complications' Gensini score in AAV; however, CRP did not correlate with BNP, EF%, LVEDV, LVESV, LVMI, and Gensini score. CONCLUSIONS The plasma level of mCRP was related to cardiovascular diseases in AAV patients.
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Affiliation(s)
- Kai-Li Wu
- Renal Division, Department of Medicine, The Affiliated Hospital of Inner Mongolia Medical University, Huhehot, 010050, Inner Mongolia, China
- Inner Mongolia Medical University, Huhehot, 010059, Inner Mongolia, China
| | - Qing-Hui Liang
- Inner Mongolia Medical University, Huhehot, 010059, Inner Mongolia, China
| | - Bin-Tao Huang
- Renal Division, Department of Medicine, The Affiliated Hospital of Inner Mongolia Medical University, Huhehot, 010050, Inner Mongolia, China
| | - Na Ding
- Renal Division, Department of Medicine, The Affiliated Hospital of Inner Mongolia Medical University, Huhehot, 010050, Inner Mongolia, China
- Inner Mongolia Medical University, Huhehot, 010059, Inner Mongolia, China
| | - Bo-Wei Li
- Renal Division, Department of Medicine, The Affiliated Hospital of Inner Mongolia Medical University, Huhehot, 010050, Inner Mongolia, China
- Inner Mongolia Medical University, Huhehot, 010059, Inner Mongolia, China
| | - Jian Hao
- Renal Division, Department of Medicine, The Affiliated Hospital of Inner Mongolia Medical University, Huhehot, 010050, Inner Mongolia, China.
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Estimating the incidence of the acute coronary syndrome: data from a Danish cohort of 138290 persons. ACTA ACUST UNITED AC 2016; 14:608-14. [DOI: 10.1097/hjr.0b013e328278522f] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Background Estimates of incidence are crucial to the planning of public health measures, but most studies of incidence of, for example, acute myocardial infarction (MI) are troubled by methodological problems such as; (i) selection biases of the patients being included for study, (ii) lack of identification and control of the cohort under observation, (iii) inconsistencies in the use of diagnostic criteria, and (iv) missing data. We aimed to measure directly the incidence of the entire spectrum of the acute coronary syndrome (ACS), consisting of unstable angina pectoris, MI and sudden cardiac death (SCD), by use of the new criteria for MI as proposed in 2000. Design Cohort study. Methods From a cohort of 138 290 residents of the municipality of Aarhus, Denmark, aged 30-69 years, with a demographic structure known at the individual population member level, we prospectively identified all consecutive ACS patients from 1 April 2000 to 31 March 2002. The population was identified from Danish Population Registers. Results A total of 189 victims of SCD and 457 ACS patients who survived until admission to hospital were present. Consequently, crude incidence rate of ACS was 234 per 100000 person-years. Unstable angina pectoris constituted for 16.9%, MI for 53.8% and SCD for 29.3% of ACS patients. Conclusions Crude incidence rates of ACS were 137 and 331 per 100 000 person years for women and men, respectively. The incidence rate of ACS, as measured directly, was insignificantly 6% higher than expected from Danish administrative databases. Eur J Cardiovasc Prev Rehabil 14:608-614 © 2007 The European Society of Cardiology
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Khurana S, Gupta S, Bhalla H, Nandwani S, Gupta V. Comparison of anti-inflammatory effect of atorvastatin with rosuvastatin in patients of acute coronary syndrome. J Pharmacol Pharmacother 2015; 6:130-5. [PMID: 26311995 PMCID: PMC4544133 DOI: 10.4103/0976-500x.162011] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Revised: 10/17/2014] [Indexed: 01/05/2023] Open
Abstract
Objectives: To compare anti-inflammatory effect of atorvastatin and rosuvastatin in patients of acute coronary syndrome. Materials and Methods: The study was a prospective, open-labeled, randomized and single-center study conducted on 100 patients of acute coronary syndrome. Patients were assigned to atorvastatin 40 mg daily or rosuvastatin 20 mg daily for 4 weeks. C-reactive protein (CRP) levels, lipid profiles, erythrocyte sedimentation rate (ESR) and adverse effects were measured at beginning and at the end of 4 weeks. Results: Baseline parameters and clinical profile did not differ between the two groups. CRP levels significantly decreased from beginning to the end of 4 weeks in both atorvastatin and rosuvastatin groups (from 35.48 to 23.07 mg/l and from 35.88 to 19.91 mg/l respectively, both P < 0.001). However, there was significant difference between the levels of CRP in patients of the rosuvastatin group as compared to the atorvastatin group (19.91 ± 6.32 vs 23.07 ± 7.47, P < 0.05). In addition, both the drugs were associated with a reduction in total cholesterol, LDL levels and ESR at the end of 4 weeks as compared to the beginning (P < 0.001 for all comparisons). Conclusion: Both atorvastatin (40 mg) and rosuvastatin (20 mg) are effective in decreasing CRP and LDL cholesterol levels even in a short duration of 4 weeks. Rosuvastatin was found to be more effective in decreasing CRP levels.
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Affiliation(s)
- Sushant Khurana
- Department of Pharmacology, Subharti Medical College, Meerut, Uttar Pradesh, India
| | - Surabhi Gupta
- Department of Pharmacology, Subharti Medical College, Meerut, Uttar Pradesh, India
| | - HiraLal Bhalla
- Department of Pharmacology, Subharti Medical College, Meerut, Uttar Pradesh, India
| | - Shefali Nandwani
- Department of Medicine, Subharti Medical College, Meerut, Uttar Pradesh, India
| | - Varad Gupta
- Department of Medicine, Subharti Medical College, Meerut, Uttar Pradesh, India
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Abstract
Apart from traditional risk factors, psychosocial characteristics are increasingly considered as potential predictors of cardiovascular disease (CVD). The concept of stress is relevant when discussing the relationship between psychosocial factors and CVD. Among stress types and definitions (ie, marital stress, work stress), “perceived stress” presents a global and comprehensive stress construct and is based on the concept that individuals actively interact with their environment, appraising potentially threatening or challenging events in the light of available coping resources. However, the role of perceived stress in CVD incidence has not yet been completely elucidated. Thus, we evaluate perceived stress as a CVD risk factor by reviewing the literature. We also discuss the relationship between negative affect and CVD development.
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Affiliation(s)
- Alexia L. Katsarou
- Department of Cardiology, School of Medicine, University of Thessaly, Larissa, Greece
| | - Filippos Triposkiadis
- Department of Cardiology, School of Medicine, University of Thessaly, Larissa, Greece
| | - Demosthenes Panagiotakos
- Department of Nutrition and Dietetics, Group of Biostatistics, Epidemiology and Research Methods, Harokopio, University, Athens, Greece
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Gupta A, Badyal DK, Khosla PP, Uppal B, Jaison TM, Chopra S. Effect of atorvastatin on hs-CRP in acute coronary syndrome. Br J Clin Pharmacol 2008; 66:411-3. [PMID: 18637893 DOI: 10.1111/j.1365-2125.2008.03172.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
AIMS To evaluate the effect of a lower dose (20 mg) of atorvastatin on hs-CRP concentrations in patients with ACS. METHODS Group A (n = 50) patients received atorvastatin 20 mg day(-1) for 4 weeks in addition to standard anti-anginal treatment. Group B (n = 50) patients received standard anti-anginal treatment without atorvastatin. RESULTS hs-CRP concentrations decreased in both groups, but the decrease was greater in group A. The decrease in hs-CRP was also significantly greater in the subgroups of smoking, hypertension and past history of cardiovascular disease with atorvastatin. CONCLUSIONS The use of a lower dose (20 mg) of atorvastatin can offer an attractive approach for early treatment of patients with ACS.
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Affiliation(s)
- Ankur Gupta
- Department of Pharmacology, Christian Medical College and Hospital, Ludhiana-141 008, India
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Kalantzi K, Korantzopoulos P, Tzimas P, Katsouras CS, Goudevenos JA, Milionis HJ. The relative value of metabolic syndrome and cardiovascular risk score estimates in premature acute coronary syndromes. Am Heart J 2008; 155:534-40. [PMID: 18294493 DOI: 10.1016/j.ahj.2007.10.038] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2007] [Accepted: 10/25/2007] [Indexed: 11/27/2022]
Abstract
BACKGROUND To compare the relative value of metabolic syndrome (MetS) and cardiovascular risk score estimates in patients with acute coronary syndromes (ACS) aged <45 years. PATIENTS AND METHODS Two hundred consecutive patients (183 men, mean age 40.8 +/- 3.5 years) presented with a first-ever ACS, and 200 age-and sex-matched controls were evaluated. Metabolic syndrome diagnostic criteria, European Risk SCORE estimation function, and the Framingham Risk Score (FRS) were assessed in all participants. RESULTS The prevalence of the MetS was significantly higher in the patients' group compared with the control group (51.5% vs 26.0%, P < .001). No subjects with a SCORE >1.0% were identified. The mean 10-year FRS for patients and controls was 13.03% +/- 7.96% and 10.02 +/- 8.10%, respectively (P < .001), whereas only 22.5% of ACS patients had a 10-year risk >20.0% compared with 14.5% of controls (P = .04). After controlling for potential confounders, MetS was associated with 1.93 (95% CI 1.13-3.28, P = .01) higher odds of having an ACS. Moreover, the odds had a positive association with the increasing cumulative number of MetS components. Crude and adjusted ORs for the FRS were 1.05 (95% CI 1.029-1.08, P = .001) and 0.98 (95% CI 0.92-1.05, P = NS), respectively. CONCLUSION Metabolic syndrome is highly associated with ACS in subjects <45 years of age and seems to be more valuable than established cardiovascular risk calculators.
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Milionis HJ, Kalantzi KJ, Papathanasiou AJ, Kosovitsas AA, Doumas MT, Goudevenos JA. Metabolic syndrome and risk of acute coronary syndromes in patients younger than 45 years of age. Coron Artery Dis 2007; 18:247-52. [PMID: 17496487 DOI: 10.1097/mca.0b013e328035f8c4] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE There is a paucity of data with regard to the association of the metabolic syndrome with cardiovascular risk in young adults. We investigated the association of the metabolic syndrome with acute coronary syndrome in adults aged 45 years or younger. PATIENTS AND METHODS A total of 136 consecutive patients (128 men and eight women; mean age, 41.2+/-3.7 years) presenting with a first-ever acute coronary syndrome, and 136 age-matched and sex-matched controls were evaluated. The diagnosis of the metabolic syndrome was established according to the Adult Treatment Panel III criteria. RESULTS The prevalence of the metabolic syndrome was significantly higher in the patients' group compared with the control group (40.4 versus 23.5%; P=0.003). Multivariate logistic regression analysis showed that smoking, positive family history of premature coronary artery disease, and the metabolic syndrome were associated with odds ratios 4.46 (95% confidence interval, 2.30-8.66; P<0.001), 3.11 (95% confidence interval, 1.71-5.66; P<0.001), and 1.97 (95% confidence interval, 1.08-3.56; P=0.02) higher odds, respectively, of having an acute coronary syndrome, after taking into account the matching for age and sex and controlling for potential confounders. Moreover, a 10-mg/dl increase in total cholesterol was associated with 1.06 higher odds of having an acute coronary syndrome. Analysis of interaction showed that smoking and a positive family history of premature coronary artery disease in young individuals with metabolic syndrome had an incremental effect on the odds of suffering an acute coronary syndrome (odds ratio, 7.12; 95% confidence interval, 2.42-20.96; P<0.001). CONCLUSION The metabolic syndrome is highly associated with acute coronary syndrome in patients younger than 45 years of age, indicating the need for early and intensive preventive measures.
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Affiliation(s)
- Haralampos J Milionis
- Department of Internal Medicine, School of Medicine, University of Ioannina, Greece.
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Panagiotakos DB, Pitsavos C, Kourlaba G, Mantas Y, Zombolos S, Kogias Y, Antonoulas A, Stravopodis P, Stefanadis C. Sex-related characteristics in hospitalized patients with acute coronary syndromes – the Greek Study of Acute Coronary Syndromes (GREECS). Heart Vessels 2007; 22:9-15. [PMID: 17285439 DOI: 10.1007/s00380-006-0932-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2005] [Accepted: 06/24/2006] [Indexed: 11/30/2022]
Abstract
We studied the sex-specific distribution of various factors in hospitalized patients who presented with acute coronary syndromes (ACS), as well as the annual incidence and the in-hospital and short-term outcomes in males and females. A sample of six hospitals located in Greek urban and rural regions was selected. In these hospitals we recorded almost all nonfatal admissions with a first event of ACS, from October 2003 to September 2004. Sociodemographic, clinical, dietary, and other lifestyle characteristics were recorded. A total of 2,172 patients were included in the study (1,649, 76% male and 523, 24% female). The annual incidence rate was almost three times higher in males than in females (34 per 10,000 males and 10.9 per 10,000 females). The highest frequency of events was observed in winter, in both sexes. Females had higher in-hospital mortality rate as compared to males (5.7% vs 3.2%, P = 0.007), while the 30-day mortality and rehospitalization rate was 17% in male and 16% in female patients. The most common discharged diagnosis for males was Q-wave myocardial infraction (35%), while females were more likely to suffer from unstable angina (42%). Females were older than males, waited longer between seeking and receiving medical advice, and were more likely to have a history of hypertension, obesity, and diabetes mellitus as compared to males. On the other hand, males were more likely to be smokers, to follow a more typical Mediterranean diet, and to be more physically active (P < 0.05). We revealed a sex-related difference in the profile of clinical characteristics and other cardiovascular risk factors in hospitalized patients for ACS.
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Pitsavos C, Panagiotakos DB, Antonoulas A, Zombolos S, Kogias Y, Mantas Y, Stravopodis P, Kourlaba G, Stefanadis C. Epidemiology of acute coronary syndromes in a Mediterranean country; aims, design and baseline characteristics of the Greek study of acute coronary syndromes (GREECS). BMC Public Health 2005; 5:23. [PMID: 15771779 PMCID: PMC555594 DOI: 10.1186/1471-2458-5-23] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2005] [Accepted: 03/16/2005] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The present study GREECS was conducted in order to evaluate the annual incidence of acute coronary syndromes (ACS) and to delineate the role of clinical, biochemical, lifestyle and behavioral characteristics on the severity of disease. In this work we present the design, methodology of the study and various baseline characteristics of people with ACS. METHODS/DESIGN A sample of 6 hospitals located in Greek urban and rural regions was selected. In these hospitals we recorded almost all admissions due to ACS, from October 2003 to September 2004. Socio-demographic, clinical, dietary, psychological and other lifestyle characteristics were recorded. 2172 patients were included in the study (76% were men and 24% women). The crude annual incidence rate was 22.6 per 10,000 people and the highest frequency of events was observed in winter. The in-hospital mortality rate was 4.3%. The most common discharged diagnosis for men was Q-wave MI, while for women it was unstable angina. DISCUSSION This study aims to demonstrate current information about the epidemiology of patients who suffer from ACS, in Greece.
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Affiliation(s)
- Christos Pitsavos
- First Cardiology Clinic, School of Medicine, University of Athens, Greece
| | | | - Antonis Antonoulas
- First Cardiology Clinic, School of Medicine, University of Athens, Greece
| | - Spyros Zombolos
- First Cardiology Clinic, School of Medicine, University of Athens, Greece
| | - Yannis Kogias
- First Cardiology Clinic, School of Medicine, University of Athens, Greece
| | - Yannis Mantas
- First Cardiology Clinic, School of Medicine, University of Athens, Greece
| | - Peter Stravopodis
- First Cardiology Clinic, School of Medicine, University of Athens, Greece
| | - Georgia Kourlaba
- First Cardiology Clinic, School of Medicine, University of Athens, Greece
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