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Reshadmanesh T, Behnoush AH, Farajollahi M, Khalaji A, Ghondaghsaz E, Ahangar H. Circulating Levels of Calprotectin as a Biomarker in Patients With Coronary Artery Disease: A Systematic Review and Meta-Analysis. Clin Cardiol 2024; 47:e24315. [PMID: 38961752 PMCID: PMC11222710 DOI: 10.1002/clc.24315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 06/10/2024] [Accepted: 06/18/2024] [Indexed: 07/05/2024] Open
Abstract
BACKGROUND Calprotectin, also known as MRP8/14, is generated by immune cells and is altered in several inflammatory diseases. Studies have assessed their levels in patients with coronary artery disease (CAD) and its subtypes (stable CAD and acute coronary syndrome [ACS]). Herein, we aimed to systematically investigate these associations through a systematic review and meta-analysis. METHODS A systematic search was conducted in four online databases, including PubMed, Scopus, Embase, and the Web of Science. Relevant studies were retrieved, screened, and extracted. Random-effect meta-analysis was performed for the calculation of standardized mean difference (SMD) and 95% confidence interval (CI). Blood calprotectin levels were compared between CAD patients and controls, as well as CAD subtypes. RESULTS A total of 20 studies were included in the systematic review and meta-analysis, comprising 3300 CAD patients and 1230 controls. Patients with CAD had significantly higher calprotectin levels (SMD 0.81, 95% CI 0.32-1.30, p < 0.01). Similarly, patients with ACS were reported to have higher levels compared to those with stable CAD. However, there was no significant difference in terms of blood calprotectin levels between stable CAD cases and healthy controls. Finally, studies have shown that calprotectin could be used as a diagnostic biomarker of CAD while also predicting major adverse events and mortality in these patients. CONCLUSION Based on our findings, calprotectin, as an inflammatory marker, could be used as a possible biomarker for patients with CAD and ACS. These suggest the possibility of pathophysiological pathways for this involvement and warrant further research on these associations as well as their clinical utility.
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Affiliation(s)
| | - Amir Hossein Behnoush
- School of MedicineTehran University of Medical SciencesTehranIran
- Non‐Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
| | | | - Amirmohammad Khalaji
- School of MedicineTehran University of Medical SciencesTehranIran
- Non‐Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Elina Ghondaghsaz
- Undergraduate Program in NeuroscienceUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | - Hassan Ahangar
- Department of Cardiology, School of Medicine, Mousavi HospitalZanjan University of Medical SciencesZanjanIran
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Park JY, Kim HJ, Chae JR, Cho YL, Kang WJ. Preclinical evaluation of an 18F-labeled Tenascin-C aptamer for PET imaging of atherosclerotic plaque in mouse models of atherosclerosis. Biochem Biophys Res Commun 2024; 703:149650. [PMID: 38377941 DOI: 10.1016/j.bbrc.2024.149650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Accepted: 02/06/2024] [Indexed: 02/22/2024]
Abstract
Tenascin-C is an extracellular matrix glycoprotein strongly expressed in coronary atherosclerotic plaque. Aptamers are single-stranded oligonucleotides that bind to specific target molecules with high affinity. This study hypothesized that tenascin-C expression at atherosclerotic plaque in vivo could be detected by tenascin-C specific aptamers using positron emission tomography (PET). This paper reports the radiosynthesis of a fluorine-18 (18F)-labeled tenascin-C aptamer for the biodistribution and PET imaging of the tenascin-C expression in apolipoprotein E-deficient (ApoE-/-) mice. The aortas ApoE-/- mice showed significantly increased positive areas of Oil red O staining than control C57BL/6 mice, and tenascin-C expression was detected in foam cells accumulated in the subendothelial lesions of ApoE-/- mice. The ex vivo biodistribution of the 18F-labeled tenascin-C aptamer showed significantly increased uptake at the aorta of ApoE-/- mice, and ex vivo autoradiography of aorta revealed the high accumulation of the 18F-labeled tenascin-C aptamer in the atherosclerotic lesions of ApoE-/- mice, which was consistent with the location of the atherosclerotic plaques detected by Oil red O staining. PET imaging of the 18F-labeled tenascin-C aptamer revealed a significantly higher mean standardized uptake in the aorta of the ApoE-/- mice than the control C57BL/6 mice. These data highlight the potential use of tenascin-C aptamer to diagnose atherosclerotic lesions in vivo.
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Affiliation(s)
- Jun Young Park
- Department of Nuclear Medicine, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Hyun Jeong Kim
- Department of Nuclear Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, 363 Dongbaekjukjeon-daero, Giheung-gu, Yongin, 16995, Republic of Korea
| | - Ju Ri Chae
- Department of Nuclear Medicine, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Ye Lim Cho
- Department of Nuclear Medicine, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Won Jun Kang
- Department of Nuclear Medicine, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
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Ferko N, Priest S, Almuallem L, Walczyk Mooradally A, Wang D, Oliva Ramirez A, Szabo E, Cabra A. Economic and healthcare resource utilization assessments of PET imaging in Coronary Artery Disease diagnosis: a systematic review and discussion of opportunities for future economic evaluations. J Med Econ 2024; 27:715-729. [PMID: 38650543 DOI: 10.1080/13696998.2024.2345507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 04/17/2024] [Indexed: 04/25/2024]
Abstract
AIMS This systematic literature review (SLR) consolidated economic and healthcare resource utilization (HCRU) evidence for positron emission tomography (PET) and single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) to inform future economic evaluations. MATERIALS AND METHODS An electronic search was conducted in MEDLINE, Embase, and Cochrane databases from 2012-2022. Economic and HCRU studies in adults who underwent PET- or SPECT-MPI for coronary artery disease (CAD) diagnosis were eligible. A qualitative methodological assessment of existing economic evaluations, HCRU, and downstream cardiac outcomes was completed. Exploratory meta-analyses of clinical outcomes were performed. RESULTS The search yielded 13,439 results, with 71 records included. Economic evaluations and comparative clinical trials were limited in number and outcome types (HCRU, downstream cardiac outcomes, and diagnostic performance) assessed. No studies included all outcome types and only one economic evaluation linked diagnostic performance to HCRU. The meta-analyses of comparative studies demonstrated significantly higher rates of early- and late-invasive coronary angiography and revascularization for PET- compared to SPECT-MPI; however, the rate of repeat testing was lower with PET-MPI. The rate of acute myocardial infarction was lower, albeit non-significant with PET- vs. SPECT-MPI. LIMITATIONS AND CONCLUSIONS This SLR identified economic and HCRU evaluations following PET- and SPECT-MPI for CAD diagnosis and determined that existing studies do not capture all pertinent outcome parameters or link diagnostic performance to downstream HCRU and cardiac outcomes, thus, resulting in simplified assessments of CAD burden. A limitation of this work relates to heterogeneity in study designs, patient populations, and follow-up times of existing studies. Resultingly, it was challenging to pool data in meta-analyses. Overall, this work provides a foundation for the development of comprehensive economic models for PET- and SPECT-MPI in CAD diagnosis, which should link diagnostic outcomes to HCRU and downstream cardiac events to capture the full CAD scope.
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Affiliation(s)
| | | | | | | | - Di Wang
- EVERSANA, Burlington, Canada
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Arpanahi RA, Hashemi KH, Ahmadian MT, Mohammadi B, Hashemi SH. Coronary artery lipid accumulation prevention through vibrating piezo electric nano plates embedded in smart stent. Med Eng Phys 2023; 118:104021. [PMID: 37536831 DOI: 10.1016/j.medengphy.2023.104021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 04/24/2023] [Accepted: 07/10/2023] [Indexed: 08/05/2023]
Abstract
Considering the lipid concentration and side effects regarding the stents used by surgeons, a new heart stent model is proposed. In the new stent, a few piezo plates are designed and attached to the stents by which release of the lipids can take place due to the applied alternative voltages. Due to the vibrations of small-scale piezoelectric plates, the deposition of low-density-lipoproteins (LDL) floating in the blood flow in the coronary arteries is prevented. Small-scale effects are considered using nonlocal elasticity theory, and the interaction between fluid and solid is modeled using the Navier-Stokes equation. The effect of fluid parameters as well as applied voltage and geometry structure is reported. Developing of smart stents maybe the key for prevention of short time conventional stents failure.
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Affiliation(s)
- Reza Ahmadi Arpanahi
- School of Mechanical Engineering, Iran University of Science and Technology, Narmak, 16846-13114 Tehran, Iran
| | - Kamiar Hosseini Hashemi
- School of Mechanical Engineering, Iran University of Science and Technology, Narmak, 16846-13114 Tehran, Iran
| | | | - Bijan Mohammadi
- School of Mechanical Engineering, Iran University of Science and Technology, Narmak, 16846-13114 Tehran, Iran
| | - Shahrokh Hosseini Hashemi
- School of Mechanical Engineering, Iran University of Science and Technology, Narmak, 16846-13114 Tehran, Iran.
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Lee WE, Genetzakis E, Figtree GA. Novel Strategies in the Early Detection and Treatment of Endothelial Cell-Specific Mitochondrial Dysfunction in Coronary Artery Disease. Antioxidants (Basel) 2023; 12:1359. [PMID: 37507899 PMCID: PMC10376062 DOI: 10.3390/antiox12071359] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 06/26/2023] [Accepted: 06/26/2023] [Indexed: 07/30/2023] Open
Abstract
Although elevated cholesterol and other recognised cardiovascular risk factors are important in the development of coronary artery disease (CAD) and heart attack, the susceptibility of humans to this fatal process is distinct from other animals. Mitochondrial dysfunction of cells in the arterial wall, particularly the endothelium, has been strongly implicated in the pathogenesis of CAD. In this manuscript, we review the established evidence and mechanisms in detail and explore the potential opportunities arising from analysing mitochondrial function in patient-derived cells such as endothelial colony-forming cells easily cultured from venous blood. We discuss how emerging technology and knowledge may allow us to measure mitochondrial dysfunction as a potential biomarker for diagnosis and risk management. We also discuss the "pros and cons" of animal models of atherosclerosis, and how patient-derived cell models may provide opportunities to develop novel therapies relevant for humans. Finally, we review several targets that potentially alleviate mitochondrial dysfunction working both via direct and indirect mechanisms and evaluate the effect of several classes of compounds in the cardiovascular context.
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Affiliation(s)
- Weiqian E. Lee
- Kolling Institute, University of Sydney, Sydney, NSW 2006, Australia; (W.E.L.); (E.G.)
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia
| | - Elijah Genetzakis
- Kolling Institute, University of Sydney, Sydney, NSW 2006, Australia; (W.E.L.); (E.G.)
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia
| | - Gemma A. Figtree
- Kolling Institute, University of Sydney, Sydney, NSW 2006, Australia; (W.E.L.); (E.G.)
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia
- Department of Cardiology, Royal North Shore Hospital, Northern Sydney Local Health District, Sydney, NSW 2065, Australia
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Patel S, Guo MK, Abdul Samad M, Howe KL. Extracellular vesicles as biomarkers and modulators of atherosclerosis pathogenesis. Front Cardiovasc Med 2023; 10:1202187. [PMID: 37304965 PMCID: PMC10250645 DOI: 10.3389/fcvm.2023.1202187] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 04/20/2023] [Indexed: 06/13/2023] Open
Abstract
Extracellular vesicles (EVs) are small, lipid bilayer-enclosed structures released by various cell types that play a critical role in intercellular communication. In atherosclerosis, EVs have been implicated in multiple pathophysiological processes, including endothelial dysfunction, inflammation, and thrombosis. This review provides an up-to-date overview of our current understanding of the roles of EVs in atherosclerosis, emphasizing their potential as diagnostic biomarkers and their roles in disease pathogenesis. We discuss the different types of EVs involved in atherosclerosis, the diverse cargoes they carry, their mechanisms of action, and the various methods employed for their isolation and analysis. Moreover, we underscore the importance of using relevant animal models and human samples to elucidate the role of EVs in disease pathogenesis. Overall, this review consolidates our current knowledge of EVs in atherosclerosis and highlights their potential as promising targets for disease diagnosis and therapy.
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Affiliation(s)
- Sarvatit Patel
- Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Division of Vascular Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Mandy Kunze Guo
- Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Majed Abdul Samad
- Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada
| | - Kathryn L. Howe
- Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Division of Vascular Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada
- Peter Munk Cardiac Centre, University Health Network, Toronto, ON, Canada
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Sheikh MSA. Circulatory soluble LOX-1 is a novel predictor for coronary artery disease patients. Cardiovasc J Afr 2023; 34:104-108. [PMID: 36218037 PMCID: PMC10512050 DOI: 10.5830/cvja-2022-038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 07/02/2022] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND This study investigated the biomarker effect of soluble lectin-like oxidised low-density lipoprotein (sLOX-1) levels for the evaluation of stable and unstable coronary heart disease, correlating it with aging. METHODS This case-control study was conducted at the Cardiology Department of Xiangya Hospital between June 2015 and September 2018. Stable coronary artery disease (CAD) patients were confirmed by an invasive coronary angiogram, and American College of Cardiology as well as European Cardiology Society clinical protocols were used for the diagnosis of unstable CAD subjects. Plasma sLOX-1 levels were determined from 226 stable CAD patients, 138 unstable CAD subjects and 75 healthy participants by enzyme-linked immunosorbent assay. RESULTS Plasma sLOX-1 expressions were significantly elevated in stable CAD patients (4.5-fold) and unstable CAD patients (5.8-fold) above that of volunteer healthy participants. Moreover, between the stable and unstable patient groups, sLOX-1 concentrations were also statistically significantly different (p < 0.001). Levels of plasma sLOX-1 in the healthy female (30-60 years), and stable and unstable CAD female subjects (61-84 years) were markedly elevated compared with healthy male (30-60 years), as well as stable and unstable CAD male patients (61-84 years) (p < 0.001). Besides, in the female unstable CAD (61-84 years) subjects, circulatory sLOX-1 expressions were much higher than in the younger female unstable CAD (30-60 years) patients (p < 0.001). The stable CAD patients were clearly differentiated from healthy subjects with a high sensitivity of the area under the curve (AUC = 0.895). Unstable CAD patients and healthy subjects were also markedly different with a high sensitivity, as shown by AUC (0.902). Stable and unstable CAD subjects were differentiated with an AUC of 0.867. CONCLUSIONS Elevated plasma sLOX-1 levels could be regarded as a novel biomarker for detecting CAD patients and there was a significant association with gender and aging.
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Affiliation(s)
- Md Sayed Ali Sheikh
- Department of Internal Medicine, College of Medicine, Jouf University, Sakaka, Aljouf, Kingdom of Saudi Arabia. ,
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Kodeboina M, Piayda K, Jenniskens I, Vyas P, Chen S, Pesigan RJ, Ferko N, Patel BP, Dobrin A, Habib J, Franke J. Challenges and Burdens in the Coronary Artery Disease Care Pathway for Patients Undergoing Percutaneous Coronary Intervention: A Contemporary Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20095633. [PMID: 37174152 PMCID: PMC10177939 DOI: 10.3390/ijerph20095633] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 03/24/2023] [Accepted: 04/20/2023] [Indexed: 05/15/2023]
Abstract
Clinical and economic burdens exist within the coronary artery disease (CAD) care pathway despite advances in diagnosis and treatment and the increasing utilization of percutaneous coronary intervention (PCI). However, research presenting a comprehensive assessment of the challenges across this pathway is scarce. This contemporary review identifies relevant studies related to inefficiencies in the diagnosis, treatment, and management of CAD, including clinician, patient, and economic burdens. Studies demonstrating the benefits of integration and automation within the catheterization laboratory and across the CAD care pathway were also included. Most studies were published in the last 5-10 years and focused on North America and Europe. The review demonstrated multiple potentially avoidable inefficiencies, with a focus on access, appropriate use, conduct, and follow-up related to PCI. Inefficiencies included misdiagnosis, delays in emergency care, suboptimal testing, longer procedure times, risk of recurrent cardiac events, incomplete treatment, and challenges accessing and adhering to post-acute care. Across the CAD pathway, this review revealed that high clinician burnout, complex technologies, radiation, and contrast media exposure, amongst others, negatively impact workflow and patient care. Potential solutions include greater integration and interoperability between technologies and systems, improved standardization, and increased automation to reduce burdens in CAD and improve patient outcomes.
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Affiliation(s)
- Monika Kodeboina
- Cardiovascular Center Aalst, OLV Clinic, 9300 Aalst, Belgium
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80138 Naples, Italy
- Clinic for Internal Medicine and Cardiology, Marien Hospital, 52066 Aachen, Germany
| | - Kerstin Piayda
- Cardiovascular Center Frankfurt, 60389 Frankfurt, Germany
- Department of Cardiology and Vascular Medicine, Medical Faculty, Justus-Liebig-University Giessen, 35392 Giessen, Germany
| | | | | | | | | | | | | | | | | | - Jennifer Franke
- Cardiovascular Center Frankfurt, 60389 Frankfurt, Germany
- Philips Chief Medical Office, 22335 Hamburg, Germany
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Carpenter HJ, Ghayesh MH, Zander AC, Psaltis PJ. On the nonlinear relationship between wall shear stress topology and multi-directionality in coronary atherosclerosis. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2023; 231:107418. [PMID: 36842347 DOI: 10.1016/j.cmpb.2023.107418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 02/01/2023] [Accepted: 02/09/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND AND OBJECTIVE In this paper we investigate twelve multi-directional/topological wall shear stress (WSS) derived metrics and their relationships with the formation of coronary plaques in both computational fluid dynamics (CFD) and dynamic fluid-structure interaction (FSI) frameworks. While low WSS is one of the most established biomechanical markers associated with coronary atherosclerosis progression, alone it is limited. Multi-directional and topological WSS derived metrics have been shown to be important in atherosclerosis related mechanotransduction and near-wall transport processes. However, the relationships between these twelve WSS metrics and the influence of both FSI simulations and coronary dynamics is understudied. METHODS We first investigate the relationships between these twelve WSS derived metrics, stenosis percentage and lesion length through a parametric, transient CFD study. Secondly, we extend the parametric study to FSI, both with and without the addition of coronary dynamics, and assess their correlations. Finally, we present the case of a patient who underwent invasive coronary angiography and optical coherence tomography imaging at two time points 18 months apart. Associations between each of the twelve WSS derived metrics in CFD, static FSI and dynamic FSI simulations were assessed against areas of positive/negative vessel remodelling, and changes in plaque morphology. RESULTS 22-32% stenosis was the threshold beyond which adverse multi-directional/topological WSS results. Each metric produced a different relationship with changing stenoses and lesion length. Transient haemodynamics was impacted by coronary dynamics, with the topological shear variation index suppressed by up to 94%. These changes appear more critical at smaller stenosis levels, suggesting coronary dynamics could play a role in the earlier stages of atherosclerosis development. In the patient case, both dynamics and FSI vs CFD changes altered associations with measured changes in plaque morphology. An appendix of the linear fits between the various FSI- and CFD-based simulations is provided to assist in scaling CFD-based results to resemble the compliant walled characteristics of FSI more accurately. CONCLUSIONS These results highlight the potential for coronary dynamics to alter multi-directional/topological WSS metrics which could impact associations with changes in coronary atherosclerosis over time. These results warrant further investigation in a wider range of morphological settings and longitudinal cohort studies in the future.
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Affiliation(s)
- Harry J Carpenter
- School of Mechanical Engineering, University of Adelaide, Adelaide, South Australia 5005, Australia.
| | - Mergen H Ghayesh
- School of Mechanical Engineering, University of Adelaide, Adelaide, South Australia 5005, Australia.
| | - Anthony C Zander
- School of Mechanical Engineering, University of Adelaide, Adelaide, South Australia 5005, Australia
| | - Peter J Psaltis
- Vascular Research Centre, Lifelong Health Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia 5000, Australia; Adelaide Medical School, University of Adelaide, Adelaide, South Australia 5005, Australia; Department of Cardiology, Central Adelaide Local Health Network, Adelaide, South Australia 5000, Australia
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Vieira WA, Paranhos LR, Meneses-Santos D, Floriano LO, Borges GH, Sponchiado-Junior EC, de-Jesus-Soares A. Association between the prevalence of pulp stones and calcified atherosclerotic plaques: a systematic review and meta-analysis. Dentomaxillofac Radiol 2023; 52:20230004. [PMID: 37052394 PMCID: PMC10170168 DOI: 10.1259/dmfr.20230004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 03/08/2023] [Accepted: 03/09/2023] [Indexed: 04/14/2023] Open
Abstract
OBJECTIVE To evaluate the association between the prevalence of pulp stones (PS) in permanent teeth and calcified atherosclerotic plaques (CAP). METHODS An electronic search was performed in 10 databases to locate observational studies that investigated the association between PS in permanent teeth and CAP, published until March 2022. Two reviewers performed the search, selection and extraction of data from eligible studies. The individual risk of bias of eligible studies was assessed using the JBI Critical Appraisal Tools. The meta-analysis was conducted using fixed and random effects and odds ratio (OR) as an effect measure with a 95% confidence interval (CI). The heterogeneity between the studies was quantified using the I² test. The certainty of evidence was evaluated using the GRADE approach. RESULTS The electronic search resulted in 2968 records, of which only 7 studies were considered eligible. The total sample consisted of 3770 participants from 5 countries. All studies showed biases of confounding factors and exposure assessment. Based on six studies and with very low certainty of evidence, the meta-analysis showed that patients with PS were more likely to also have CAP in carotid or coronary arteries (OR: 1.70; 95% CI: 1.21; 2.38, I² = 0%). CONCLUSIONS Limited evidence suggests that there is a positive association between the prevalence of PS in permanent teeth detected using panoramic radiography and CAP in the coronary or carotid arteries.
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Affiliation(s)
- Walbert A. Vieira
- Department of Restorative Dentistry, Endodontics Division, School of Dentistry of Piracicaba, UniversidadeEstadual de Campinas, Piracicaba, Brazil
| | - Luiz Renato Paranhos
- Division of Preventive and Community Dentistry, School of Dentistry, Universidade Federal de Uberlândia, Uberlândia, Brazil
| | - Daniela Meneses-Santos
- Department of Morphology, Center of Biological Sciences and Health, Universidade Federal de Sergipe, São Cristóvão, SE, Brazil
| | - Luiz Otávio Floriano
- Undergraduate student in dentistry, School of Dentistry, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil
| | - Guilherme Henrique Borges
- Postgraduate Program in Dentistry, School of Dentistry, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil
| | | | - Adriana de-Jesus-Soares
- Department of Restorative Dentistry, Endodontics Division, School of Dentistry of Piracicaba, UniversidadeEstadual de Campinas, Piracicaba, Brazil
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Fabricius Ekenberg L, Høfsten DE, Rasmussen SM, Mølgaard J, Hasbak P, Sørensen HBD, Meyhoff CS, Aasvang EK. Wireless Single-Lead versus Standard 12-Lead ECG, for ST-Segment Deviation during Adenosine Cardiac Stress Scintigraphy. SENSORS (BASEL, SWITZERLAND) 2023; 23:2962. [PMID: 36991673 PMCID: PMC10051714 DOI: 10.3390/s23062962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 03/05/2023] [Accepted: 03/06/2023] [Indexed: 06/19/2023]
Abstract
Wearable wireless electrocardiographic (ECG) monitoring is well-proven for arrythmia detection, but ischemia detection accuracy is not well-described. We aimed to assess the agreement of ST-segment deviation from single- versus 12-lead ECG and their accuracy for the detection of reversible ischemia. Bias and limits of agreement (LoA) were calculated between maximum deviations in ST segments from single- and 12-lead ECG during 82Rb PET-myocardial cardiac stress scintigraphy. Sensitivity and specificity for reversible anterior-lateral myocardial ischemia detection were assessed for both ECG methods, using perfusion imaging results as a reference. Out of 110 patients included, 93 were analyzed. The maximum difference between single- and 12-lead ECG was seen in II (-0.019 mV). The widest LoA was seen in V5, with an upper LoA of 0.145 mV (0.118 to 0.172) and a lower LoA of -0.155 mV (-0.182 to -0.128). Ischemia was seen in 24 patients. Single-lead and 12-lead ECG both had poor accuracy for the detection of reversible anterolateral ischemia during the test: single-lead ECG had a sensitivity of 8.3% (1.0-27.0%) and specificity of 89.9% (80.2-95.8%), and 12-lead ECG a sensitivity of 12.5% (3.0-34.4%) and a specificity of 91.3% (82.0-96.7%). In conclusion, agreement was within predefined acceptable criteria for ST deviations, and both methods had high specificity but poor sensitivity for the detection of anterolateral reversible ischemia. Additional studies must confirm these results and their clinical relevance, especially in the light of the poor sensitivity for detecting reversible anterolateral cardiac ischemia.
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Affiliation(s)
- Luna Fabricius Ekenberg
- Department of Anesthesiology, Centre for Cancer and Organ Diseases, Rigshospitalet Copenhagen University Hospital, Blegdamsvej 9, 2200 Copenhagen, Denmark
| | - Dan Eik Høfsten
- Department of Cardiology, Rigshospitalet Copenhagen University Hospital, 2100 Copenhagen, Denmark
| | - Søren M. Rasmussen
- Biomedical Signal Processing & AI Research Group, Digital Health Section, Department of Health Technology, Technical University of Denmark, 2800 Kgs. Lyngby, Denmark
| | - Jesper Mølgaard
- Department of Anesthesiology, Centre for Cancer and Organ Diseases, Rigshospitalet Copenhagen University Hospital, Blegdamsvej 9, 2200 Copenhagen, Denmark
| | - Philip Hasbak
- Department of Clinical Physiological and Nuclear Medicine, Center for Diagnostics, Rigshospitalet Copenhagen University Hospital, 2100 Copenhagen, Denmark
| | - Helge B. D. Sørensen
- Biomedical Signal Processing & AI Research Group, Digital Health Section, Department of Health Technology, Technical University of Denmark, 2800 Kgs. Lyngby, Denmark
| | - Christian S. Meyhoff
- Department of Anaesthesia and Intensive Care, Copenhagen University Hospital-Bispebjerg and Frederiksberg Hospital, 2400 Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Eske K. Aasvang
- Department of Anesthesiology, Centre for Cancer and Organ Diseases, Rigshospitalet Copenhagen University Hospital, Blegdamsvej 9, 2200 Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, 2200 Copenhagen, Denmark
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Lankala CR, Yasir M, Ishak A, Mekhail M, Kalyankar P, Gupta K. Application of Nanotechnology for Diagnosis and Drug Delivery in Atherosclerosis: A New Horizon of Treatment. Curr Probl Cardiol 2023; 48:101671. [PMID: 36828044 DOI: 10.1016/j.cpcardiol.2023.101671] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 02/17/2023] [Indexed: 02/25/2023]
Abstract
Cardiovascular diseases are the leading cause of death worldwide, with atherosclerosis being a prominent risk factor for their development. The current diagnostic criteria for atherosclerosis rely primarily on imaging techniques, including an angiogram. However, current diagnostic procedures fail to provide insights into the plaque's burden and composition. Therefore, nanotechnology is recommended as a novel drug delivery method in treating atherosclerosis and resulting cardiovascular diseases to enhance clinical outcomes. This review discusses the different approaches in which nanotechnology can be applied in the diagnosis and drug delivery of cardiovascular diseases. A systematic review was carried out in line with the PRISMA reporting guidelines, with the literature databases PubMed, Scopus, and Web of Science being screened for relevant literature. Any study that discussed and reported on the application of nanotechnology for either the diagnosis or drug delivery in atherosclerotic patients was included in this review, with each novel design identified in the citations being contrasted to that of the other literature. Moreover, the efficacy of this technology was compared to current diagnostic and drug delivery methods. The search strategy yielded 14 studies relevant to the aims of this review. Nine assessed the therapeutic applications of nanotechnology, 3 solely assessed the diagnostic applications of nanotechnology, and 2 discussed the diagnostic and therapeutic applications. The nanoparticle designs differed significantly between studies; however, all noted a superior therapeutic and diagnostic benefit compared to current approaches to diagnosing and treating atherosclerosis. Multifunctional nanoparticles are a feasible and appropriate novel approach to diagnosing and treating atherosclerosis.
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Affiliation(s)
- Chetan Reddy Lankala
- Department of Internal Medicine, Uzhhorod National University, Uzhhorod, Ukraine
| | - Mohamed Yasir
- Department of Research, California Institute of Behavioral Neurosciences and Psychology, Fairfield, CA.
| | - Angela Ishak
- Department of Research and Academic Affairs, Larkin Health System, South Miami, Florida
| | - Mario Mekhail
- Department of Internal Medicine, NYU Langone Long Island Community Hospital
| | - Pravin Kalyankar
- Department of Internal Medicine, Fortis Escorts Hospital, Faridabad, Haryana, India
| | - Kamal Gupta
- Department of Cardiology, Fortis Escorts Hospital, Faridabad, Haryana, India
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13
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Chandrakumar H, Khatun N, Gupta T, Graham-Hill S, Zhyvotovska A, McFarlane SI. The Effects of Bariatric Surgery on Cardiovascular Outcomes and Cardiovascular Mortality: A Systematic Review and Meta-Analysis. Cureus 2023; 15:e34723. [PMID: 36909063 PMCID: PMC9998117 DOI: 10.7759/cureus.34723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2023] [Indexed: 02/10/2023] Open
Abstract
Obesity is a major public health problem that is associated with serious comorbidities and premature mortality. Cardiovascular disease (CVD) is the major cause of morbidity and mortality associated with obesity. Lifestyle modifications, pharmacological therapy, and weight reduction surgery are the major interventions to date available for obesity management. Bariatric surgery has been increasingly utilized as a therapeutic option for obesity. In this meta-analysis, we aim to assess the effects of bariatric surgery on CVD outcomes and cardiovascular mortality. This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. PubMed, Embase, Cochrane Library, Google Scholar, and Web of Science were searched until 03/01/2022. Our search included three types of bariatric surgery: Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy, and gastric banding (GB). All were searched in conjunction with "coronary artery disease," "ischemic heart disease," "myocardial infarction," "cerebrovascular accident," "stroke," "atrial fibrillation," "heart failure," "arrhythmias," and "mortality." We included 49 studies meeting the study criteria. Bariatric surgery showed a beneficial effect on coronary artery disease (CAD) (hazard ratio (HR) of 0.68 {95% confidence interval (CI): 0.52-0.91}, p = 0.008), myocardial infarction (MI) (HR of 0.53 {95% CI: 0.44-0.64}, p < 0.01) heart failure (HF) (HR of 0.45 {95% CI: 0.37-0.55}, p < 0.01), cerebrovascular accident (CVA) (HR of 0.68 {95% CI: 0.59-0.78}, p < 0.01), and cardiovascular mortality (HR of 0.48 {95% CI: 0.40-0.57}, p < 0.01). The effect on atrial fibrillation (AF) did not reach statistical significance: HR of 0.81 (95% CI: 0.65-1.01), p = 0.07. Our study, that is, an updated meta-analysis, including the three types of procedure, confirms beneficial effects on the major CVD outcomes, including coronary artery disease, myocardial infarction, cerebrovascular accident, and heart failure, and on CVD mortality. This study provides updated insights into the long-term CV effects of bariatric surgery, an increasingly common intervention for obesity.
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Affiliation(s)
- Harshith Chandrakumar
- Internal Medicine, State University of New York (SUNY) Downstate Health Sciences University Hospital, Brooklyn, USA
| | - Nazima Khatun
- Internal Medicine, State University of New York (SUNY) Downstate Health Sciences University Hospital, Brooklyn, USA
| | - Tanuj Gupta
- Internal Medicine, State University of New York (SUNY) Downstate Health Sciences University Hospital, Brooklyn, USA
| | | | | | - Samy I McFarlane
- Internal Medicine, State University of New York (SUNY) Downstate Health Sciences University Hospital, Brooklyn, USA
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Wójcik W, Mezhiievska I, Pavlov SV, Lewandowski T, Vlasenko OV, Maslovskyi V, Volosovych O, Kobylianska I, Moskovchuk O, Ovcharuk V, Lewandowska A. Medical Fuzzy-Expert System for Assessment of the Degree of Anatomical Lesion of Coronary Arteries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:979. [PMID: 36673734 PMCID: PMC9859614 DOI: 10.3390/ijerph20020979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 12/30/2022] [Accepted: 01/01/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Today, cardiovascular diseases cause 47% of all deaths among the European population, which is 4 million cases every year. In Ukraine, CAD accounts for 65% of the mortality rate from circulatory system diseases of the able-bodied population and is the main cause of disability. The aim of this study is to develop a medical expert system based on fuzzy sets for assessing the degree of coronary artery lesions in patients with coronary artery disease. METHODS The method of using fuzzy sets for the implementation of an information expert system for solving the problems of medical diagnostics, in particular, when assessing the degree of anatomical lesion of the coronary arteries in patients with various forms of coronary artery disease, has been developed. RESULTS The paper analyses the main areas of application of mathematical methods in medical diagnostics, and formulates the principles of diagnostics, based on fuzzy logic. The developed models and algorithms of medical diagnostics are based on the ideas and principles of artificial intelligence and knowledge engineering, the theory of experiment planning, the theory of fuzzy sets and linguistic variables. The expert system is tested on real data. Through research and comparison of the results of experts and the created medical expert system, the reliability of supporting the correct decision making of the medical expert system based on fuzzy sets for assessing the degree of anatomical lesion of the coronary arteries in patients with various forms of coronary artery disease with the assessment of experts was 95%, which shows the high efficiency of decision making. CONCLUSIONS The practical value of the work lies in the possibility of using the automated expert system for the solution of the problems of medical diagnosis based on fuzzy logic for assessing the degree of anatomical lesion of the coronary arteries in patients with various forms of coronary artery disease. The proposed concept must be further validated for inter-rater consistency and reliability. Thus, it is promising to create expert medical systems based on fuzzy sets for assessing the degree of disease pathology.
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Affiliation(s)
- Waldemar Wójcik
- Faculty of Electrical Engineering and Computer Science, Lublin University of Technology, Nadbystrzycka 38d, 20-618 Lublin, Poland
| | - Iryna Mezhiievska
- Department of Internal Medicine No. 3, National Pirogov Memorial Medical University, Pirogov Str. 56, 21018 Vinnytsya, Ukraine
| | - Sergii V. Pavlov
- Laboratory of Biomedical Optics, Faculty for Infocommunications, Radioelectronics and Nanosystems, Vinnytsia National Technical University, Khmelnytske Shose 95, 21021 Vinnytsia, Ukraine
| | - Tomasz Lewandowski
- Institute of Technical Engineering, State School of Technology and Economics in Jaroslaw, 37-500 Jaroslaw, Poland
| | - Oleh V. Vlasenko
- Laboratory of Experimental Neurophysiology, National Pirogov Memorial Medical University, 21018 Vinnytsia, Ukraine
| | - Valentyn Maslovskyi
- Department of Internal Medicine No. 3, National Pirogov Memorial Medical University, Pirogov Str. 56, 21018 Vinnytsya, Ukraine
| | - Oleksandr Volosovych
- Department of Biomedical Engineering and Optic-Electronic Systems, Vinnytsia National Technical University, Khmelnytske Shose 95, 21021 Vinnytsia, Ukraine
| | - Iryna Kobylianska
- Department of Life Safety and Safety Pedagogy, Vinnytsia National Technical University, Khmelnytske Shose 95, 21021 Vinnytsia, Ukraine
| | - Olha Moskovchuk
- Department of Pedagogy, Vinnytsia Mykhailo Kotsiubynskyi State Pedagogical University, Ostrozhsky Str. 32, 21000 Vinnytsia, Ukraine
| | - Vasyl Ovcharuk
- Department of Physical Education, Vinnytsia National Technical University, Khmelnytske Shose 95, 21021 Vinnytsia, Ukraine
| | - Anna Lewandowska
- Institute of Healthcare, State University of Technology and Economics in Jaroslaw, Czarniecki Street 16, 37-500 Jaroslaw, Poland
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Forde H, Davenport C, Rochfort KD, Wallace RG, Durkan E, Agha A, Thompson CJ, Tormey WT, O'Gorman DJ, Cummins PM, Smith D. Serum OPG/TRAIL ratio predicts the presence of cardiovascular disease in people with type 2 diabetes mellitus. Diabetes Res Clin Pract 2022; 189:109936. [PMID: 35662613 DOI: 10.1016/j.diabres.2022.109936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 04/28/2022] [Accepted: 05/30/2022] [Indexed: 11/19/2022]
Abstract
AIMS Cardiovascular disease (CVD) is the leading cause of mortality in type 2 diabetes mellitus (T2DM). Epidemiological studies suggest serum Osteoprotegrin (OPG)/Tumour-necrosis-factor-related-apoptosis-inducing- ligand (TRAIL) ratio may be a useful marker of cardiovascular risk. This study aimed to compare serum levels of TRAIL, OPG and OPG/TRAIL ratio in people with T2DM, with and without a history of CVD, and controls; and to determine which of these indices, if any, predict cardiovascular risk. METHODS In this single centre observational study of 133 participants, people with T2DM, with and without a history of a cardiovascular event in the last 5 years, were recruited along with a control cohort without T2DM or CVD. Demographic information and anthropometric measurements were recorded. Blood samples were taken and OPG and TRAIL were measured using ELISA. RESULTS People with T2DM and CVD had higher OPG/TRAIL ratios compared to controls or those with a new diagnosis of T2DM. After adjustment for potential confounding factors, OPG/TRAIL ratio was significantly associated with the presence of CVD in people with T2DM and an OPG/TRAIL ratio cut-off > 38.6 predicted the presence of CVD in this cohort with a sensitivity of 80% and specificity of 82%. CONCLUSION This study suggests that OPG/TRAIL ratio may have a role as a biomarker of CVD in people with T2DM.
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Affiliation(s)
- H Forde
- Department of Endocrinology, Beaumont Hospital and RCSI Medical School, Beaumont, Dublin 9, Ireland; School of Biotechnology, Dublin City University, Glasnevin, Dublin 9, Ireland.
| | - C Davenport
- Department of Endocrinology, Beaumont Hospital and RCSI Medical School, Beaumont, Dublin 9, Ireland; School of Biotechnology, Dublin City University, Glasnevin, Dublin 9, Ireland
| | - K D Rochfort
- School of Nursing, Psychotherapy, and Community Health, Dublin City University, Glasnevin, Dublin 9, Ireland
| | - R G Wallace
- School of Biotechnology, Dublin City University, Glasnevin, Dublin 9, Ireland
| | - E Durkan
- School of Health and Human Performance, Dublin City University, Glasnevin, Dublin 9, Ireland
| | - A Agha
- Department of Endocrinology, Beaumont Hospital and RCSI Medical School, Beaumont, Dublin 9, Ireland
| | - C J Thompson
- Department of Endocrinology, Beaumont Hospital and RCSI Medical School, Beaumont, Dublin 9, Ireland
| | - W T Tormey
- Department of Chemical Pathology, Beaumont Hospital, Beaumont, Dublin 9, Ireland
| | - D J O'Gorman
- School of Health and Human Performance, Dublin City University, Glasnevin, Dublin 9, Ireland; National Institute for Cellular Biotechnology, Dublin City University, Glasnevin, Dublin 9, Ireland
| | - P M Cummins
- School of Biotechnology, Dublin City University, Glasnevin, Dublin 9, Ireland
| | - D Smith
- Department of Endocrinology, Beaumont Hospital and RCSI Medical School, Beaumont, Dublin 9, Ireland
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Park H, Kang DY, Lee CW. Functional Angioplasty: Definitions, Historical Overview, and Future Perspectives. Korean Circ J 2022; 52:34-46. [PMID: 34989193 PMCID: PMC8738709 DOI: 10.4070/kcj.2021.0363] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 11/26/2021] [Accepted: 11/30/2021] [Indexed: 01/09/2023] Open
Abstract
Myocardial ischemia plays a central role in the pathophysiology of angina pectoris. Percutaneous coronary intervention (PCI) guidance has evolved from anatomic stenosis to physiologic evidence of flow limitation. However, there is no evidence that one guidance is superior to another in improving clinical outcomes after PCI. Hallmarks of inducible ischemia such as electrocardiographic changes and wall motion abnormalities may be more clinically relevant as the reference standard to define ischemia-inducing lesions. Considering all available evidence, PCI should be considered as symptomatic therapy without altering the atherosclerotic process, and reserved for patients with inducible ischemia who are non-responsive to medical therapy. Percutaneous coronary intervention (PCI) is used to treat obstructive coronary artery disease (CAD). The role of PCI is well defined in acute coronary syndrome, but that for stable CAD remains debatable. Although PCI generally relieves angina in patients with stable CAD, it may not change its prognosis. The extent and severity of CAD are major determinants of prognosis, and complete revascularization (CR) of all ischemia-causing lesions might improve outcomes. Several studies have shown better outcomes with CR than with incomplete revascularization, emphasizing the importance of functional angioplasty. However, different definitions of inducible myocardial ischemia have been used across studies, making their comparison difficult. Various diagnostic tools have been used to estimate the presence, extent, and severity of inducible myocardial ischemia. However, to date, there are no agreed reference standards of inducible myocardial ischemia. The hallmarks of inducible myocardial ischemia such as electrocardiographic changes and regional wall motion abnormalities may be more clinically relevant as the reference standard to define ischemia-causing lesions. In this review, we summarize studies regarding myocardial ischemia, PCI guidance, and possible explanations for similar findings across studies. Also, we provide some insights into the ideal definition of inducible myocardial ischemia and highlight the appropriate PCI strategy.
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Affiliation(s)
- Hanbit Park
- Division of Cardiology, Department of Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea
| | - Do-Yoon Kang
- Division of Cardiology, Department of Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Cheol Whan Lee
- Division of Cardiology, Department of Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
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17
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Pulipati VP, Alenghat FJ. The impact of lipid-lowering medications on coronary artery plaque characteristics. Am J Prev Cardiol 2021; 8:100294. [PMID: 34877559 PMCID: PMC8627965 DOI: 10.1016/j.ajpc.2021.100294] [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: 09/09/2021] [Revised: 10/29/2021] [Accepted: 11/06/2021] [Indexed: 11/28/2022] Open
Abstract
Atherosclerosis is the predominant cause of coronary artery disease. The last several decades have witnessed significant advances in lipid-lowering therapies, which comprise a central component of atherosclerotic cardiovascular disease prevention. In addition to cardiovascular risk reduction with dyslipidemia management, some lipid-based therapies show promise at the level of the atherosclerotic plaque itself through mechanisms governing lipid accumulation, plaque stability, local inflammation, endothelial dysfunction, and thrombogenicity. The capacity of lipid-lowering therapies to modify atherosclerotic plaque burden, size, composition, and vulnerability should correlate with their ability to reduce disease progression. This review discusses plaque characteristics, diagnostic modalities to evaluate these characteristics, and how they are altered by current and emerging lipid-lowering therapies, all in human coronary artery disease.
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Affiliation(s)
- Vishnu Priya Pulipati
- Section of Cardiology, University of Chicago Medicine, 5841 S. Maryland Avenue, MC 6080, Chicago, IL 60637, United States
| | - Francis J Alenghat
- Section of Cardiology, University of Chicago Medicine, 5841 S. Maryland Avenue, MC 6080, Chicago, IL 60637, United States.,Pritzker School of Medicine, University of Chicago, Chicago, United States
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18
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Oktay V, Keskin B, Serin E, Oksen D, Kaya A, Ozkan AA. Comparison of transradial versus transfemoral diagnostic coronary angiography in terms of oxidative stress: Which option is more physiological? EUR J INFLAMM 2021. [DOI: 10.1177/20587392211028073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
In this randomized, single-center, clinical study we aimed to compare the oxidative stress response in patients undergoing diagnostic transradial or transfemoral elective coronary angiography. Sixty patients with stable angina pectoris undergoing elective coronary angiography to either transradial ( n = 30) or transfemoral ( n = 30) approach were included. The levels of plasma total oxidative status (TOS) were measured and compared just before and immediately after the procedure in both groups. The clinical and laboratory findings were compatible between the two groups. Although the levels of plasma total oxidative status after coronary angiography were increased in both groups (TF pTOS 20. ± :3; 34 ± 3 vs TR pTOS 18 ± 2; 23 ± 4), this was more pronounced in the transfemoral group as compared with the transradial group (ΔpTOS: 11 ± 4 vs 4 ± 3, p < 0.001) In correlation analysis, TOS levels and white blood cell counts ( r = 0.25, p = 0.042), total cholesterol levels ( r = 0.267, p = 0.041), triglyceride levels ( r = 0.253, p = 0.049), serum creatinine levels ( r = 0.260, p = 0.043) were found to be moderately positively correlated. This study showed that oxidative stress response associated with heart catheterization is more evident in patients undergoing transfemoral coronary angiography versus transradial coronary angiography.
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Affiliation(s)
- Veysel Oktay
- Department of Cardiology, Istanbul University Cerrahpasa, Institute of Cardiology, Istanbul, Turkey
| | - Bengisu Keskin
- Department of Cardiology, Istanbul University Cerrahpasa, Institute of Cardiology, Istanbul, Turkey
| | - Ebru Serin
- Department of Cardiology, Istanbul University Cerrahpasa, Institute of Cardiology, Istanbul, Turkey
| | - Dogac Oksen
- Department of Cardiology, Istanbul University Cerrahpasa, Institute of Cardiology, Istanbul, Turkey
| | - Aysem Kaya
- Deparment of Biochemistry, Istanbul University Cerrahpasa, Institute of Cardiology, Istanbul, Turkey
| | - Alev Arat Ozkan
- Department of Cardiology, Istanbul University Cerrahpasa, Institute of Cardiology, Istanbul, Turkey
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19
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Kabzinski J, Maczynska M, Majsterek I. MicroRNA as a Novel Biomarker in the Diagnosis of Head and Neck Cancer. Biomolecules 2021; 11:844. [PMID: 34198889 PMCID: PMC8228566 DOI: 10.3390/biom11060844] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 05/28/2021] [Accepted: 06/01/2021] [Indexed: 02/07/2023] Open
Abstract
Head and neck squamous cell carcinoma is the sixth most common cancer worldwide, with 890,000 new cases and 450,000 deaths in 2018, and although the survival statistics for some patient groups are improving, there is still an urgent need to find a fast and reliable biomarker that allows early diagnosis. This niche can be filled by microRNA, small single-stranded non-coding RNA molecules, which are expressed in response to specific events in the body. This article presents the potential use of microRNAs in the diagnosis of HNSCC, compares the advances in this field to other diseases, especially other cancers, and discusses the detailed use of miRNA as a biomarker in profiling and predicting the treatment outcome with radiotherapy and immunotherapy. Potential problems and difficulties related to the development of this promising technology, and areas on which future research should be focused in order to overcome these difficulties, were also indicated.
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Affiliation(s)
| | | | - Ireneusz Majsterek
- Department of Clinical Chemistry and Biochemistry, Medical University of Lodz, al. Kościuszki 4, 90-419 Łódź, Poland; (J.K.); (M.M.)
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20
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Zhu C, Ma J, Ji Z, Shen J, Wang Q. Recent Advances of Cell Membrane Coated Nanoparticles in Treating Cardiovascular Disorders. Molecules 2021; 26:3428. [PMID: 34198794 PMCID: PMC8201295 DOI: 10.3390/molecules26113428] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 05/30/2021] [Accepted: 06/03/2021] [Indexed: 01/13/2023] Open
Abstract
Cardiovascular diseases (CVDs) are the leading cause of death worldwide, causing approximately 17.9 million deaths annually, an estimated 31% of all deaths, according to the WHO. CVDs are essentially rooted in atherosclerosis and are clinically classified into coronary heart disease, stroke and peripheral vascular disorders. Current clinical interventions include early diagnosis, the insertion of stents, and long-term preventive therapy. However, clinical diagnostic and therapeutic tools are subject to a number of limitations including, but not limited to, potential toxicity induced by contrast agents and unexpected bleeding caused by anti-platelet drugs. Nanomedicine has achieved great advancements in biomedical area. Among them, cell membrane coated nanoparticles, denoted as CMCNPs, have acquired enormous expectations due to their biomimetic properties. Such membrane coating technology not only helps avoid immune clearance, but also endows nanoparticles with diverse cellular and functional mimicry. In this review, we will describe the superiorities of CMCNPs in treating cardiovascular diseases and their potentials in optimizing current clinical managements.
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Affiliation(s)
- Chaojie Zhu
- Department of Cardiology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China;
- Chu Kochen Honors College, Zhejiang University, Hangzhou 310058, China; (J.M.); (Z.J.)
- Institute of Pharmaceutics, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China
| | - Junkai Ma
- Chu Kochen Honors College, Zhejiang University, Hangzhou 310058, China; (J.M.); (Z.J.)
- Institute of Pharmaceutics, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China
| | - Zhiheng Ji
- Chu Kochen Honors College, Zhejiang University, Hangzhou 310058, China; (J.M.); (Z.J.)
- Institute of Pharmaceutics, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China
| | - Jie Shen
- Department of Pharmacy, School of Medicine, Zhejiang University City College, Hangzhou 310015, China
| | - Qiwen Wang
- Department of Cardiology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China;
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