Pro-inflammatory genetic profile and familiarity of acute myocardial infarction

Endogenous Risk Factors of Cardiovascular Diseases (CVDs) in Military Professionals with a Special Emphasis on Military Pilots

Cardiovascular disease (CVD) risk factors can be categorized as non-modifiable and modifiable. Modifiable risk factors include some exogenous and behavioral factors that can be easily modified, whereas endogenous modifiable risk factors, such as hypertension, hyperlipidemia, diabetes, or obesity may be modified to a limited extend. An increased prevalence of CVDs as well as their risk factors have been observed in military personnel, as specific military-related stressors are highly correlated with acute cardiac disorders. Military pilots are a subpopulation with great CVD risk due to an accumulation of different psychological and physical stressors also considered to be CVD risk factors. This review presents data concerning CVD risk in military professionals, with a special emphasis on military pilots and crew members. We also discuss the usefulness of novel indicators related to oxidative stress, inflammation, or hormonal status as well as genetic factors as markers of CVD risk. For a correct and early estimation of CVD risk in asymptomatic soldiers, especially if no environmental risk factors coexist, the scope of performed tests should be increased with novel biomarkers. An indication of risk group among military professional, especially military pilots, enables the implementation the early preventive activities, which will prolong their state of health and military suitability.

Polimorfismo de genes de citocinas: ¿factores de riesgo cardiovascular en la población venezolana?

Objective

To examine whether the polymorphisms of the IL6, TNFA and IL10 genes represent a risk marker for acute myocardial infarction (AMI) and to analyze their correlation with risk factors, age of occurrence and type of AMI.

Method

Association study that included 310 unrelated Venezuelan individuals, grouped in 190 patients with AMI and 120 controls with or without cardiovascular risk factors. The IL6-174 G/C (rs1800795), TNFA -308 G/A (rs1800629), and IL10-1082 A/G (rs1800896), -819 C/T (rs1800871) and -592 C/A (rs1800872) polymorphisms were determined using the polymerase chain reaction technique with sequence-specific primers.

Results

Comparison of genotypic and allelic frequencies, using adjusted logistic regression analysis for risk factors, showed a significantly increased frequency of the genotype combination G/G-A/A of TNFA-308 G/A (odds ratio [OR]: 3.8; p = 0.00007), GG/-C/C of IL6-174 G/C (OR: 2.3; p = 0.009), A/G-G/G of IL10-1082 A/G (OR: 3.8; p = 0.00001) and the GCC haplotype of IL10 (OR: 3.71; p = 0.0053) in infarcted patients compared to controls. Interactions between the IL10-1082 A/G and TNFA-308 G/A polymorphisms and hypertension were observed.

Conclusions

The association of the variants of the TNFA, IL6 and IL10 genes with AMI suggest that the imbalance in the production of cytokines promotes an exacerbated inflammatory process, supporting the fundamental role of inflammation in all stages of the atherosclerotic process.

Family History for Cardio-Metabolic Diseases: A Predictor of Major Adverse Cardiovascular Events in Men With Erectile Dysfunction

BACKGROUND

Family history (FH) of cardiovascular (CV) disease is a known CV risk factor. However, it is rarely considered for CV risk stratification. Furthermore, FH for metabolic diseases is generally overlooked.

AIM

To evaluate, in a population of men with erectile dysfunction (ED), whether FH for cardio-metabolic diseases could provide insights into metabolic and sexual features and predict the occurrence of forthcoming major adverse CV events (MACE).

METHODS

A consecutive series of 4,693 individuals (aged 51.3 ± 13.3 years) attending an Andrology outpatient clinic for ED was studied. A subset of these (n = 1,595) was evaluated retrospectively for MACE occurrence.

OUTCOMES

Several metabolic and sexual function-related parameters were studied. For the retrospective study, information on an incident MACE was collected over a mean follow-up of 4.2 ± 2.5 years.

RESULTS

A greater number of cardio-metabolic FH factors were associated with a worse metabolic profile, including higher waist circumference, triglycerides, glucose, glycosylated hemoglobin, and diastolic blood pressure, as well as lower high-density lipoprotein cholesterol. An increased number of FH factors were associated with worse erectile function (odds ratio = 1.14[1.07;1.23], P < .0001), impaired penile dynamic peak systolic velocity, and lower testosterone levels. In the retrospective study, a positive cardiometabolic FH was associated with a significantly higher incidence of MACEs, even after adjusting for age and comorbidities (hazard ratio = 1.51[1.06-2.16], P = .023). Interestingly, when dividing the sample into high- and low-risk categories according to several CV risk factors (age, previous MACEs, high-density lipoprotein cholesterol, and comorbidities), FH was confirmed as a predictor of incident MACE only among the low-risk individuals.

CLINICAL IMPLICATIONS

Investigating FH for cardio-metabolic diseases is a quick and easy task that could help clinicians in identifying, among individuals with ED, those who deserve careful evaluation of CV and metabolic risk factors. Moreover, considering FH for CV risk stratification could predict MACEs in individuals who, according to conventional CV risk factors, would be erroneously considered at low risk.

STRENGTHS & LIMITATIONS

The large sample size and the systematic collection of MACEs through an administrative database, with no risk of loss at follow-up, represent strengths. The use of administrative database for MACE collection may lead to some misclassifications. The specific population of the study limits the generalizability of the results.

CONCLUSION

FH is simple and inexpensive information that should be part of the CV risk assessment in all men with ED because it helps in the identification of those who need lifestyle and risk factor modifications and whose risk would otherwise be overlooked. Rastrelli G, Yannas D, Mucci B, et al. Family History for Cardio-Metabolic Diseases: A Predictor of Major Adverse Cardiovascular Events in Men With Erectile Dysfunction. J Sex Med 2020;17:2370-2381.

Association of IL-10-1082A/G polymorphism with cardiovascular disease risk: Evidence from a case-control study to an updated meta-analysis

BACKGROUND

Previous studies have generated controversial results about the association of interleukin 10 (IL-10) gene polymorphisms (-1082G/A) in the progression of cardiovascular disease (CVD). Therefore, this study processed a systemic meta-analysis to verify this association.

METHODS

The publication studies on the IL-10 (-1082G/A) polymorphism and CVDs risk were obtained by searching PubMed and Embase databases. We analyzed the genotype data for meta-analysis. The results were evaluated by odds ratios (ORs) and 95% confidence intervals (CIs). Meanwhile, our meta-analysis was also performed sensitivity analyses, heterogeneity test, and identification of publication bias.

RESULTS

The present meta-analysis suggested that the risk with allele G is lower than with allele A for CVD. The G allele of IL-10 (-1082) could increase the risk of CVDs in the 31 case-control studies for all genetic models. (OR = 1.10, 95% CI: 1.04-1.15 for the allele model A vs. G; OR = 0.87, 95% CI: 0.72-1.04 for the dominant model GG+AG vs. AA; OR = 1.03, 95% CI: 1.02-1.05 for the recessive model GG vs. AG + AA; OR = 1.06, 95% CI = 1.03-1.10 for the homozygote comparison model GG vs. AA; and OR = 0.88, 95% CI = 0.73-1.06 for the heterozygote comparison model AG vs. AA).

CONCLUSIONS

In genetic models, the association between the IL-10 (-1082G/A) polymorphism and CVDs risk was significant. This meta-analysis proposes that the IL-10 (-1082G/A) polymorphism may serve as a risk factor for CVDs.

Predictive Value of Prothrombin Time for All-cause Mortality in Acute Myocardial Infarction Patients

Acute myocardial infarction (AMI) is a serious cardiovascular disease caused by acute or persistent ischemic and anoxia of the coronary artery. A more practical and effective risk model is still remained to be established for AMI patients. This study aims to investigate the predictive value of prothrombin time (PT) in AMI patients. In this study, 2734 AMI patients available in the public MIMIC III clinical database were investigated, with 629 deaths occurring within 2-year follow-up. More than 20 risk factors including demographics, clinical disease history, laboratory test information, surgery history, and mediation information were analyzed as potential predictors for all-cause mortality in AMI patients. After adjustment for other covariates, PT was showed to be a significant risk factor for all-cause mortality in AMI patients (adjusted hazard ratio, 4.04; 95% confidence interval, 2.83 to 5.75) from Cox regression analysis. We also developed a comprehensive risk model for AMI mortality using multivariate Cox proportional hazards model based on the above 20 risk factors. Combined with PT, the model achieved a good accuracy with an AUC (area under ROC curve) of 0.843. Overall, PT is an independent predictor for 2-year mortality in AMI, and it might be useful in identifying AMI patients with a high risk for mortality.

Intercellular adhesion molecule 1 rs5498 polymorphism is associated with the risk of myocardial infarction

Several studies addressed the association between Intercellular adhesion molecule 1 (ICAM-1) rs5498 polymorphism and Myocardial Infarction (MI) risk. However, they addressed conflicting findings. Therefore, the aim of this study was to explore whether ICAM-1 gene rs5498 polymorphism plays an important role in modifying the risk of MI. A meta-analysis was conducted on the association between ICAM-1 rs5498 polymorphism and MI. 12 eligible studies involving 1,696 cases and 3,039 controls were included in the meta-analysis. Meta-analysis revealed that ICAM-1 rs5498 polymorphism showed a strongly positive correlation with MI and could be viewed as a protective factor for MI. Furthermore, subgroup analysis according to ethnicity indicated that ICAM-1 rs5498 polymorphism decreased the risk of MI among Caucasian and Asian populations. In conclusion, ICAM-1 rs5498 polymorphism was associated with the decreased risk of MI. Larger sample size studies with more diverse ethnic populations are needed to confirm these findings.

Association Between 3 IL-10 Gene Polymorphisms and Cardiovascular Disease Risk: Systematic Review With Meta-Analysis and Trial Sequential Analysis

Previous studies have yielded controversial results related to the contribution of interleukin 10 (IL-10) gene polymorphisms (IL-10 -592C/A, IL-10 -1082G/A, and IL-10 -819C/T) in the progression of cardiovascular disease (CVD). Thus, we performed a meta-analysis to summarize this situation.Eligible studies were retrieved by searching PubMed, Embase, Web of Science, and Cochrane Library with the last search up to July 7, 2015. Data were pooled by odds ratios (ORs) and their 95% confidence intervals (CIs). False-positive report probability (FPRP) analysis was conducted for all significant findings. Genotype-based mRNA expression analysis was also performed using data from 270 individuals with different ethnicities.Finally, 19 studies for IL-10 -592C/A polymorphism (7284 cases and 7469 controls), 21 studies for IL-10 -1082G/A polymorphism (8263 cases and 5765 controls), and 12 studies for IL-10 -819C/T polymorphism (4502 cases and 3190 controls) were included in the meta-analyses. With respect to IL-10 -819C/T polymorphism, statistically significant decreased CVD risk was found when all studies were pooled into the meta-analysis (T vs C: OR = 0.91, 95% CI = 0.84-0.98; TT + TC vs CC: OR = 0.90, 95% CI = 0.81-1.00). Subgroup analyses stratified by disease subtype suggested the -819C/T polymorphism was significantly associated with a decreased CAD risk (T vs C: OR = 0.90, 95% CI = 0.83-0.97; TT vs CC: OR = 0.81, 95% CI = 0.66-1.00; TT vs TC + CC: OR = 0.82, 95% CI = 0.69-0.98; TT + TC vs CC: OR = 0.89, 95% CI = 0.80-0.99), which was noteworthy finding as evaluated by FPRP. However, with regard to IL-10 -592C/A and IL-10 -1082G/A polymorphisms, no significant association with CVD risk was observed in the overall and subgroup analyses.In conventional meta-analyses, the results suggested that IL-10 -819C/T polymorphism was associated with decreased risk of CVD, especially CAD outcome, whereas IL-10 -592C/A and IL-10 -1082G/A polymorphisms might have no influence on the susceptibility of CVD. However, trial sequential analysis does not allow us to draw any solid conclusion for the association between IL-10 -592C/A or IL-10 -1082G/A polymorphism and CVD risk. Further large and well-designed studies are still needed.

Association between three interleukin-10 gene polymorphisms and coronary artery disease risk: a meta-analysis

BACKGROUND

Previous studies have investigated the associations between interleukin-10 (IL-10) gene polymorphisms (-592C/A, -819C/T and -1082G/A) and risk of coronary artery disease (CAD). However, the results were inconsistent. The aim of this study was to clarify the relationship between IL-10 polymorphisms and CAD risk by a meta-analysis approach.

METHODS

The PubMed, Embase, Web of Science, China National Knowledge Infrastructure (CNKI) and Wanfang databases were searched according to predefined criteria for all relevant studies published before June 1, 2015. Pooled odds ratios (ORs) and 95% confidence intervals (95% CIs) were computed to assess the association.

RESULTS

24 eligible studies were enrolled including 9736 CAD patients and 8606 controls. We observed a significant decreased risk of CAD for IL-10 -819C/T polymorphism (T allele vs. C allele:OR = 0.91, 95% CI = 0.84-0.99; TT vs. CT + CC:OR = 0.82, 95% CI = 0.69-0.98), especially in Asians (T allele vs. C allele:OR = 0.76, 95% CI = 0.60-0.96; TT vs. CC:OR = 0.51, 95% CI = 0.27-0.96; TT vs. CT + CC:OR = 0.62, 95% CI = 0.44-0.88). Moreover, we found IL-10 -1082G/A polymorphism might contribute to an increased CAD risk in Asians (AA vs. GG:OR = 1.89, 95% CI = 1.36-2.64; AA vs. AG + GG:OR = 1.39, 95% CI = 1.14-1.68) but not in other ethnic groups. However, no significant association between the IL-10 -592C/A polymorphism and CAD risk was observed.

CONCLUSIONS

Our results indicated that IL-10 -819C/T and IL-10 -1082G/A polymorphisms significantly and race-specifically correlate with CAD risk.

Polymorphisms in IL-10 and INF-γ genes are associated with early atherosclerosis in coronary but not in carotid arteries: A study of 122 autopsy cases of young adults

Atherosclerosis is a complex disease, involving both genetic and environmental factors. However, the influence of genetic variations on its early development remains unclear. This study examined the association of 12 different polymorphisms with atherosclerosis severity in anterior descending coronary (DA, n = 103) and carotid arteries (CA, n = 66) of autopsied young adults (< 30 years old). Histological sections (H-E) were classified according to the American Heart Association. Polymorphisms in ACE, TNF-α (− 308G/A and − 238 G/A), IFN-γ (+ 874 A/T), MMP-9 (− 1562 C/T), IL-10 (− 1082 A/G and − 819 C/T), NOS3 (894 G/T), ApoA1 (rs964184), ApoE (E2E3E4 isoforms), and TGF-β (codons 25 and 10) genes were genotyped by gel electrophoresis or automatic DNA sequencing. Firearm projectile or car accident was the main cause of death, and no information about classical risk factors was available. Histological analysis showed high prevalence of type III atherosclerotic lesions in both DA (69%) and CA (39%) arteries, while severe type IV and V lesions were observed in 14% (DA) and 33% (CA). Allele frequencies and genotype distributions were determined. Among the polymorphisms studied, IFN-γ and IL-10 (− 1082 A/G) were related to atherosclerosis severity in DA artery. No association between genotypes and lesion severity was found in CA. In conclusion, we observed that the high prevalence of early atherosclerosis in young adults is associated with IFN-γ (p < 0.001) and IL-10 (p = 0.013) genotypes. This association is blood vessel dependent. Our findings suggest that the vascular system presents site specialization, and specific genetic variations may provide future biomarkers for early disease identification.

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Twelve SNPs were associated with atherosclerosis severity in autopsied young adults.

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We found high prevalence of type III lesions in coronary and carotid arteries.

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Even severe lesions (types IV and V) were found in DA (14%) and CA (33%) arteries.

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Lesion severity was associated with IL-10 and IFN-γ genotype.

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The association was observed only in coronary, but not in carotid artery.

Polymorphisms of the LTA gene may contribute to the risk of myocardial infarction: a meta-analysis

Objective

The lymphotoxin-α (LTA), as one of the mediators of inflammation, may play an important role in the pathogenesis of myocardial infarction (MI). Genetic association studies (GAS) that have investigated the association between three common polymorphisms (A252G, G10A and C804A) of the LTA gene and susceptibility to MI have produced contradictory and inconclusive results. The aim of this meta-analysis is to provide a relatively comprehensive account of the association of these polymorphisms with susceptibility to MI.

Methods

A literature search for eligible GAS published before October 15, 2013 was conducted in the PubMed, Embase, Web of Science, Cochrane Library, and CNKI (China National Knowledge Infrastructure) databases. We performed a meta-analysis of fifteen case-control studies with a total of 22,549 MI patients and 16,105 healthy controls.

Results

For LTA A252G, a borderline significant overall association was found, indicating that GG genotype may confer an increased susceptibility to MI compared to AA and AG genotypes. Based on an ethnicity stratification analysis, a significant association was observed in Asians, but not in Caucasians. For LTA G10A, no significant overall association was found. However, subgroup analysis based on ethnicity suggested that the 10A allele may confer a significant increased susceptibility to MI only in Asian populations. For LTA C804A, the combined results revealed a significantly increased susceptibility to MI for carriers of the 804A allele in both overall analysis and stratified analyses.

Conclusion

This meta-analysis shows that LTA C804A may be associated with an increased susceptibility to MI, whereas LTA A252G and G10A may confer a significant increased susceptibility to MI only in Asians. Thus, these polymorphisms of the LTA gene can probably be used with other genetic markers together to identify individuals at high susceptibility to MI especially in Asians.

A systematic review and meta-analysis of the association between angiotensin II type 1 receptor A1166C gene polymorphism and myocardial infarction susceptibility

BACKGROUND AND AIM

Many reported studies have been conducted to investigate the association of angiotensin II type 1 receptor (AT1R) A1166C gene polymorphism with myocardial infarction (MI) susceptibility. However, the results from those reports are still conflicting. This meta-analysis was performed to study the relationship between AT1R A1166C gene polymorphism and MI risk.

METHOD

The databases of PubMed, Embase, and Cochrane Library were searched as of 1 March 2012, and eligible investigations were recruited into this meta-analysis.

RESULTS

Eighteen investigations were identified for the analysis of association between AT1R A1166C gene polymorphism and MI risk, 11 in Caucasians, three in Asians, two in Africans, one in the population of Brazil and one in the population of Durban, South Africa . There was a marked association between AT1R C allele and MI susceptibility for overall populations (odds ratio (OR)=1.12, 95% confidence interval (CI): 1.01-1.25, p=0.03), and AT1R AA genotype was associated with a lower risk of MI in overall populations (OR=0.87, 95% CI: 0.78-0.98, p=0.02). However, AT1R A1166C gene polymorphism was not associated with MI risk in the sub-groups of Caucasians, Asians, Africans, Brazil and Durban populations.

CONCLUSIONS

C allele is a risk factor for the MI susceptibility in overall populations, and AA genotype might be a protective factor against the MI risk in overall populations. However, more case-control association investigations on larger, stratified populations are required in the future.