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Bai W, An S, Jia H, Xu J, Qin L. Relationship between triglyceride-glucose index and cognitive function among community-dwelling older adults: a population-based cohort study. Front Endocrinol (Lausanne) 2024; 15:1398235. [PMID: 39104819 PMCID: PMC11298491 DOI: 10.3389/fendo.2024.1398235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Accepted: 07/08/2024] [Indexed: 08/07/2024] Open
Abstract
Background The global increase in the aging population presents considerable challenges, particularly regarding cognitive impairment, a major concern for public health. This study investigates the association between the triglyceride-glucose (TyG) index, a measure of insulin resistance, and the risk of cognitive impairment in the elderly. Methods This prospective cohort study enrolled 2,959 participants aged 65 and above from the 2015 and 2020 waves of the China Health and Retirement Longitudinal Study (CHARLS). The analysis employed a logistic regression model to assess the correlation between the TyG index and cognitive impairment. Results The study included 2,959 participants, with a mean age of 71.2 ± 5.4 years, 49.8% of whom were female. The follow-up in 2020 showed a decrease in average cognitive function scores from 8.63 ± 4.61 in 2015 to 6.86 ± 5.45. After adjusting for confounding factors, a significant association was observed between TyG index quartiles and cognitive impairment. Participants in the highest quartile (Q4) of baseline TyG had a higher risk of cognitive impairment compared to those in the lowest quartile (Q1) (odds ratio [OR]: 1.97, 95% confidence intervals [CI]: 1.28-2.62, P<0.001). Conclusion The study highlights a significant connection between elevated TyG index levels and cognitive impairment among older adults in China. These findings suggest that targeted interventions to reduce the TyG index could mitigate cognitive impairment and potentially lower the incidence of dementia.
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Affiliation(s)
- Weimin Bai
- Department of Emergency, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, People’s Hospital of Henan University, Zhengzhou, China
| | - Shuang An
- Department of Pediatric Rehabilitation, Henan Children’s Hospital Zhengzhou Children’s Hospital, Children’s Hospital Affiliated to Zhengzhou University, Zhengzhou, China
| | - Hui Jia
- Department of Convalescent Four Areas Nine Departments, Navy Qingdao Special Service Recuperation Center, Qingdao, China
| | - Juan Xu
- Department of General Surgery, Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hangzhou, China
| | - Lijie Qin
- Department of Emergency, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, People’s Hospital of Henan University, Zhengzhou, China
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Neglia D, Caselli C, Maffei E, Cademartiri F, Meloni A, Bossone E, Saba L, Lee SE, Sung JM, Andreini D, Al-Mallah MH, Budoff MJ, Chinnaiyan K, Choi JH, Chun EJ, Conte E, Gottlieb I, Hadamitzky M, Kim YJ, Lee BK, Leipsic JA, Marques H, de Araújo Gonçalves P, Pontone G, Shin S, Stone PH, Samady H, Virmani R, Narula J, Shaw LJ, Bax JJ, Lin FY, Min JK, Chang HJ. Rapid Plaque Progression Is Independently Associated With Hyperglycemia and Low HDL Cholesterol in Patients With Stable Coronary Artery Disease: A PARADIGM Study. Circ Cardiovasc Imaging 2024; 17:e016481. [PMID: 39012946 DOI: 10.1161/circimaging.123.016481] [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: 02/13/2024] [Accepted: 05/15/2024] [Indexed: 07/18/2024]
Abstract
BACKGROUND We assessed whether combinations of cardiometabolic risk factors independently predict coronary plaque progression (PP) and major adverse cardiovascular events in patients with stable coronary artery disease. METHODS Patients with known or suspected stable coronary artery disease (60.9±9.3 years, 55.4% male) undergoing serial coronary computed tomography angiographies (≥2 years apart), with clinical characterization and follow-up (N=1200), were analyzed from the PARADIGM study (Progression of Atherosclerotic Plaque Determined by Computed Tomographic Angiography Imaging). Plaque volumes measured in coronary segments (≥2 mm in diameter) were summed to provide whole heart plaque volume (mm3) and percent atheroma volume (plaque volume/vessel volume×100; %) per patient at baseline and follow-up. Rapid PP was defined as a percent atheroma volume increase of ≥1.0%/y. Major adverse cardiovascular events included nonfatal myocardial infarction, death, and unplanned coronary revascularization. RESULTS In an interscan period of 3.2 years (interquartile range, 1.9), rapid PP occurred in 341 patients (28%). At multivariable analysis, the combination of cardiometabolic risk factors defined as metabolic syndrome predicted rapid PP (odds ratio, 1.51 [95% CI, 1.12-2.03]; P=0.007) together with older age, smoking habits, and baseline percent atheroma volume. Among single cardiometabolic variables, high fasting plasma glucose (diabetes or fasting plasma glucose >100 mg/dL) and low HDL-C (high-density lipoprotein cholesterol; <40 mg/dL in males and <50 mg/dL in females) were independently associated with rapid PP, in particular when combined (odds ratio, 2.37 [95% CI, 1.56-3.61]; P<0.001). In a follow-up of 8.23 years (interquartile range, 5.92-9.53), major adverse cardiovascular events occurred in 201 patients (17%). At multivariable Cox analysis, the combination of high fasting plasma glucose with high systemic blood pressure (treated hypertension or systemic blood pressure >130/85 mm Hg) was an independent predictor of events (hazard ratio, 1.79 [95% CI, 1.10-2.90]; P=0.018) together with family history, baseline percent atheroma volume, and rapid PP. CONCLUSIONS In patients with stable coronary artery disease, the combination of hyperglycemia with low HDL-C is associated with rapid PP independently of other risk factors, baseline plaque burden, and treatment. The combination of hyperglycemia with high systemic blood pressure independently predicts the worse outcome beyond PP. REGISTRATION URL: https://www.clinicaltrials.gov; Unique identifier: NCT02803411.
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Affiliation(s)
- Danilo Neglia
- Cardiovascular Department (D.N., C.C.), Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - Chiara Caselli
- Cardiovascular Department (D.N., C.C.), Fondazione Toscana Gabriele Monasterio, Pisa, Italy
- Institute of Clinical Physiology, Pisa, Italy (C.C.)
| | - Erica Maffei
- Department of Imaging (E.M., F.C., A.M.), Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - Filippo Cademartiri
- Department of Imaging (E.M., F.C., A.M.), Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - Antonella Meloni
- Department of Imaging (E.M., F.C., A.M.), Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - Eduardo Bossone
- Department of Public Health, University "Federico II," Naples, Italy (E.B.)
| | - Luca Saba
- Department of Radiology, University of Cagliari, Italy (L.S.)
| | - Sang-Eun Lee
- Division of Cardiology, Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, South Korea (S.-E.L., S.S.)
- CONNECT-AI Research Center (S.-E.L., J.M.S., H.-J.C.), Yonsei University College of Medicine, Seoul, South Korea
| | - Ji Min Sung
- CONNECT-AI Research Center (S.-E.L., J.M.S., H.-J.C.), Yonsei University College of Medicine, Seoul, South Korea
| | - Daniele Andreini
- IRCCS Ospedale Galeazzi Sant'Ambrogio, Milan, Italy (D.A., H.-J.C.)
- Department of Biomedical and Clinical Sciences (D.A., H.-J.C.), University of Milan, Italy
| | - Mouaz H Al-Mallah
- Houston Methodist DeBakey Heart & Vascular Center, Houston Methodist Hospital, TX (M.H.A.-M, H.-J.C.)
| | - Matthew J Budoff
- Department of Medicine, Lundquist Institute at Harbor-UCLA, Torrance, CA (M.J.B., H.-J.C.)
| | - Kavitha Chinnaiyan
- Department of Cardiology, William Beaumont Hospital, Royal Oak, MI (K.C., H.-J.C.)
| | - Jung Hyun Choi
- Pusan University Hospital, Busan, South Korea (J.H.C., H.-J.C.)
| | - Eun Ju Chun
- Seoul National University Bundang Hospital, Seongnam, South Korea (E.J.C., H.-J.C.)
| | - Edoardo Conte
- Centro Cardiologico Monzino IRCCS, Milan, Italy (E.C., G.P., H.-J.C.)
| | - Ilan Gottlieb
- Department of Radiology, Casa de Saude São Jose, Rio de Janeiro, Brazil (I.G., G.P., H.-J.C.)
| | - Martin Hadamitzky
- Department of Radiology and Nuclear Medicine, German Heart Center Munich, Germany (M.H., G.P., H.-J.C.)
| | - Yong Jin Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Cardiovascular Center, Seoul National University Hospital, South Korea (Y.J.K., G.P., H.-J.C.)
| | - Byoung Kwon Lee
- Gangnam Severance Hospital (B.K.L., G.P., H.-J.C.), Yonsei University College of Medicine, Seoul, South Korea
| | - Jonathon A Leipsic
- Department of Medicine and Radiology, University of British Columbia, Vancouver, Canada (JA.L, G.P., H.-J.C.)
| | - Hugo Marques
- UNICA, Unit of Cardiovascular Imaging, Hospital da Luz, Lisbon, Portugal (H.M., GP, H.-J.C.)
| | - Pedro de Araújo Gonçalves
- Department of Biomedical, Dental and Surgical Sciences (P.d.A.G., G.P., H.-J.C.), University of Milan, Italy
| | - Gianluca Pontone
- Gangnam Severance Hospital (B.K.L., G.P., H.-J.C.), Yonsei University College of Medicine, Seoul, South Korea
- Department of Biomedical, Dental and Surgical Sciences (P.d.A.G., G.P., H.-J.C.), University of Milan, Italy
- Centro Cardiologico Monzino IRCCS, Milan, Italy (E.C., G.P., H.-J.C.)
- Department of Radiology, Casa de Saude São Jose, Rio de Janeiro, Brazil (I.G., G.P., H.-J.C.)
- Department of Radiology and Nuclear Medicine, German Heart Center Munich, Germany (M.H., G.P., H.-J.C.)
- Department of Internal Medicine, Seoul National University College of Medicine, Cardiovascular Center, Seoul National University Hospital, South Korea (Y.J.K., G.P., H.-J.C.)
- Department of Medicine and Radiology, University of British Columbia, Vancouver, Canada (JA.L, G.P., H.-J.C.)
- UNICA, Unit of Cardiovascular Imaging, Hospital da Luz, Lisbon, Portugal (H.M., GP, H.-J.C.)
| | - Sanghoon Shin
- Division of Cardiology, Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, South Korea (S.-E.L., S.S.)
| | - Peter H Stone
- Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA (P.H.S., H.-J.C.)
| | - Habib Samady
- Georgia Heart Institute, Northeast Georgia Health System, Gainesville (H.S., H.-J.C.)
| | - Renu Virmani
- Department of Pathology, CVPath Institute, Gaithersburg, MD (R.V., H.-J.C.)
| | - Jagat Narula
- University of Texas Health Houston, TX (J.N., H.-J.C.)
| | - Leslee J Shaw
- Icahn School of Medicine at Mount Sinai, New York, NY (L.J.S., F.Y.L., H.-J.C.)
| | - Jeroen J Bax
- Department of Cardiology, Leiden University Medical Center, The Netherlands (J.J.B., H.-J.C.)
| | - Fay Y Lin
- Icahn School of Medicine at Mount Sinai, New York, NY (L.J.S., F.Y.L., H.-J.C.)
| | - James K Min
- Cleerly, Inc, New York, NY (J.K.M., H.-J.C.)
| | - Hyuk-Jae Chang
- CONNECT-AI Research Center (S.-E.L., J.M.S., H.-J.C.), Yonsei University College of Medicine, Seoul, South Korea
- Gangnam Severance Hospital (B.K.L., G.P., H.-J.C.), Yonsei University College of Medicine, Seoul, South Korea
- IRCCS Ospedale Galeazzi Sant'Ambrogio, Milan, Italy (D.A., H.-J.C.)
- Department of Biomedical and Clinical Sciences (D.A., H.-J.C.), University of Milan, Italy
- Department of Biomedical, Dental and Surgical Sciences (P.d.A.G., G.P., H.-J.C.), University of Milan, Italy
- Houston Methodist DeBakey Heart & Vascular Center, Houston Methodist Hospital, TX (M.H.A.-M, H.-J.C.)
- Department of Medicine, Lundquist Institute at Harbor-UCLA, Torrance, CA (M.J.B., H.-J.C.)
- Department of Cardiology, William Beaumont Hospital, Royal Oak, MI (K.C., H.-J.C.)
- Pusan University Hospital, Busan, South Korea (J.H.C., H.-J.C.)
- Seoul National University Bundang Hospital, Seongnam, South Korea (E.J.C., H.-J.C.)
- Centro Cardiologico Monzino IRCCS, Milan, Italy (E.C., G.P., H.-J.C.)
- Department of Radiology, Casa de Saude São Jose, Rio de Janeiro, Brazil (I.G., G.P., H.-J.C.)
- Department of Radiology and Nuclear Medicine, German Heart Center Munich, Germany (M.H., G.P., H.-J.C.)
- Department of Internal Medicine, Seoul National University College of Medicine, Cardiovascular Center, Seoul National University Hospital, South Korea (Y.J.K., G.P., H.-J.C.)
- Department of Medicine and Radiology, University of British Columbia, Vancouver, Canada (JA.L, G.P., H.-J.C.)
- UNICA, Unit of Cardiovascular Imaging, Hospital da Luz, Lisbon, Portugal (H.M., GP, H.-J.C.)
- Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA (P.H.S., H.-J.C.)
- Georgia Heart Institute, Northeast Georgia Health System, Gainesville (H.S., H.-J.C.)
- Department of Pathology, CVPath Institute, Gaithersburg, MD (R.V., H.-J.C.)
- University of Texas Health Houston, TX (J.N., H.-J.C.)
- Icahn School of Medicine at Mount Sinai, New York, NY (L.J.S., F.Y.L., H.-J.C.)
- Department of Cardiology, Leiden University Medical Center, The Netherlands (J.J.B., H.-J.C.)
- Cleerly, Inc, New York, NY (J.K.M., H.-J.C.)
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea (H.-J.C.)
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Lee SN, Lin A, Dey D, Berman DS, Han D. Application of Quantitative Assessment of Coronary Atherosclerosis by Coronary Computed Tomographic Angiography. Korean J Radiol 2024; 25:518-539. [PMID: 38807334 PMCID: PMC11136945 DOI: 10.3348/kjr.2023.1311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 02/29/2024] [Accepted: 03/23/2024] [Indexed: 05/30/2024] Open
Abstract
Coronary computed tomography angiography (CCTA) has emerged as a pivotal tool for diagnosing and risk-stratifying patients with suspected coronary artery disease (CAD). Recent advancements in image analysis and artificial intelligence (AI) techniques have enabled the comprehensive quantitative analysis of coronary atherosclerosis. Fully quantitative assessments of coronary stenosis and lumen attenuation have improved the accuracy of assessing stenosis severity and predicting hemodynamically significant lesions. In addition to stenosis evaluation, quantitative plaque analysis plays a crucial role in predicting and monitoring CAD progression. Studies have demonstrated that the quantitative assessment of plaque subtypes based on CT attenuation provides a nuanced understanding of plaque characteristics and their association with cardiovascular events. Quantitative analysis of serial CCTA scans offers a unique perspective on the impact of medical therapies on plaque modification. However, challenges such as time-intensive analyses and variability in software platforms still need to be addressed for broader clinical implementation. The paradigm of CCTA has shifted towards comprehensive quantitative plaque analysis facilitated by technological advancements. As these methods continue to evolve, their integration into routine clinical practice has the potential to enhance risk assessment and guide individualized patient management. This article reviews the evolving landscape of quantitative plaque analysis in CCTA and explores its applications and limitations.
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Affiliation(s)
- Su Nam Lee
- Department of Imaging and Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Division of Cardiology, Department of Internal Medicine, St. Vincent's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
| | - Andrew Lin
- Monash Cardiovascular Research Centre, Victorian Heart Institute, Monash University and MonashHeart, Monash Health, Melbourne, Australia
| | - Damini Dey
- Department of Imaging and Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Daniel S Berman
- Department of Imaging and Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Donghee Han
- Department of Imaging and Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
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Xiao K, Cao H, Yang B, Xv Z, Xiao L, Wang J, Ni S, Feng H, He Z, Xv L, Li J, Xv D. Association between the triglyceride glucose index and chronic total coronary occlusion: A cross-sectional study from southwest China. Nutr Metab Cardiovasc Dis 2024; 34:850-859. [PMID: 38161119 DOI: 10.1016/j.numecd.2023.10.036] [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: 03/21/2023] [Revised: 10/24/2023] [Accepted: 10/26/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND AND AIM Insulin resistance (IR) plays an important role in the atherosclerotic process, and the triglyceride glucose (TyG) index is a reliable indicator of IR and is strongly associated with cardiovascular disease. However, there are few studies regarding the relationship between the TyG index and chronic total coronary occlusion (CTO). Herein, the correlation between the TyG index and CTO, as well as their interactions with other traditional cardiovascular risk factors, were investigated. METHODS AND RESULTS We enrolled 2691 patients who underwent coronary angiography at Guangyuan Central Hospital from January 2019 to October 2021. TyG index results were used to create three groups using the trichotomous method. CTO was defined as complete occlusion of the coronary artery for ≥3 months. Univariate and multivariate logistic regression models, restricted cubic splines, receiver operating characteristic (ROC) curves, and subgroup analyses was performed. A significant correlation between the TyG index and CTO was noted. The risk of CTO was increased 2.09-fold in the group with the highest TyG compared with the lowest (OR, 2.09; 95 % CI, 1.05-4.17; P = 0.036). In addition, there was a linear dose-response relationship between the TyG index and CTO (nonlinear P = 0.614). The area under the ROC curve was 0.643 (95 % CI, 0.572-0.654). Using subgroup analyses, we observed that the TyG index was associated with a significantly higher risk of CTO in males and smokers. CONCLUSIONS An elevated TyG index was related to the risk of CTO and may constitute a meaningful predictor of CTO, particularly in males and in smokers.
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Affiliation(s)
- Kaiyong Xiao
- Department of Cardiology, Guangyuan Central Hospital, 16 Jingxiangzi, Guangyuan, Sichuan 628017, China.
| | - Huili Cao
- Department of Cardiology, The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, 030000, China
| | - Bin Yang
- Department of Cardiology, The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, 030000, China
| | - Zhe Xv
- Department of Pediatric, Guangyuan Central Hospital, 16 Jingxiangzi, Guangyuan, Sichuan 628017, China
| | - Lian Xiao
- Department of Cardiology, Guangyuan Central Hospital, 16 Jingxiangzi, Guangyuan, Sichuan 628017, China
| | - Jianping Wang
- Department of Cardiology, Guangyuan Central Hospital, 16 Jingxiangzi, Guangyuan, Sichuan 628017, China
| | - Shuiqing Ni
- Department of Cardiology, Guangyuan Central Hospital, 16 Jingxiangzi, Guangyuan, Sichuan 628017, China
| | - Hui Feng
- Medical Laboratory Center, Guangyuan Central Hospital, 16 Jingxiangzi, Guangyuan, Sichuan 628017, China
| | - Zhongwei He
- Department of Cardiology, Guangyuan Central Hospital, 16 Jingxiangzi, Guangyuan, Sichuan 628017, China
| | - Lei Xv
- Department of Cardiology, Guangyuan Central Hospital, 16 Jingxiangzi, Guangyuan, Sichuan 628017, China
| | - Juan Li
- Department of Cardiology, Guangyuan Central Hospital, 16 Jingxiangzi, Guangyuan, Sichuan 628017, China
| | - Dongmei Xv
- Department of Ultrasonography, Guangyuan Central Hospital, 16 Jingxiangzi, Guangyuan, Sichuan 628017, China
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Zhang N, Chi X, Zhou Z, Song Y, Li S, Xu J, Li J. Triglyceride-glucose index is associated with a higher risk of stroke in a hypertensive population. Cardiovasc Diabetol 2023; 22:346. [PMID: 38093283 PMCID: PMC10720217 DOI: 10.1186/s12933-023-02082-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 11/29/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND This study aimed to evaluate the association of triglyceride-glucose (TyG) index, an insulin resistance surrogate biomarker, with first stroke in a hypertensive population and to explore potential influencing factors. METHODS This study, a cohort study among a rural Chinese hypertensive population, utilized data from the China Stroke Primary Prevention Trial (CSPPT). The TyG index was calculated as ln [fasting triglyceride (mg/dL) × fasting glucose (mg/dL)/2]. Multivariate analysis using Cox proportional hazards models was conducted. RESULTS A total of 7569 hypertensive patients were included in this study. When TyG index was assessed as quartiles, compared with the reference group (Quartile 1), the hazard ratio of stroke was 1.04 in Quartile 2, 1.43 in Quartile 3, and 1.45 in Quartile 4, with a significant trend test (P = 0.013). When Quartiles 3 and 4 were combined (≥ 8.8), the hazard ratio was 1.41 compared with combined Quartiles 1 and 2 (< 8.8). Similar findings were observed for the association of TyG index with ischemic stroke. Further, a joint effect of baseline TyG index and age on first stroke was found. Using the group with TyG < 8.8 and age < 60 years as a reference, the highest hazard ratio of stroke was found in the group with a higher TyG index and aged 60 or greater (HR: 2.15, 95% CI 1.50, 3.07, P < 0.001). CONCLUSIONS In a hypertensive population, baseline TyG index was associated with a significantly higher risk of first stroke. In addition, age was a significant effect modifier for this association.
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Affiliation(s)
- Nan Zhang
- Department of Cardiology, Peking University First Hospital, No. 8 Xishiku St, Xicheng District, Beijing, 100034, China
| | - Xiying Chi
- Department of Cardiology, Peking University First Hospital, No. 8 Xishiku St, Xicheng District, Beijing, 100034, China
| | - Ziyi Zhou
- Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen, China
| | - Yun Song
- Shenzhen Evergreen Medical Institute, Shenzhen, China
| | - Shuqun Li
- Department of Gastrointestinal Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Jiafeng Xu
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Jianping Li
- Department of Cardiology, Peking University First Hospital, No. 8 Xishiku St, Xicheng District, Beijing, 100034, China.
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Yuan W, Shao Y, Zhao D, Zhang B. Correlation analysis of lipid accumulation index, triglyceride-glucose index and H-type hypertension and coronary artery disease. PeerJ 2023; 11:e16069. [PMID: 37727694 PMCID: PMC10506588 DOI: 10.7717/peerj.16069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 08/20/2023] [Indexed: 09/21/2023] Open
Abstract
Objective The current research was designed to explore the relationship between the lipid accumulation index (LAP), coronary artery disease (CAD), and the triglyceride-glucose (TyG) index in patient with H-type hypertension. Methods From June 2021 to January 2022, our hospital's information management system collected data on 186 patients with essential hypertension. The participants were categorized into two groups (H-type hypertension (n = 113) and non-H-type hypertension (n = 73)) based on their homocysteine levels. Both groups' general condition, lipid accumulation index, triglyceride-glucose index, and Gensini score were compared to determine the factors influencing the severity of CAD in H-type hypertension patients. Results There were statistically significant differences (P < 0.05) in homocysteine (Hcy, GLP-1 and SAA) level, LAP, and TyG indexes, but not in body mass index (BMI), smoking, sex, age, total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), fasting plasma glucose (FPG), diastolic blood pressure, and systolic blood pressure. Additionally, there were substantial variations between the two groups regarding the number of lesion branches, degree of stenosis, and Gensini score (P > 0.05). patient with grade III to IV lesions had substantially higher LAP and TyG indices than those with stage I to II (P < 0.05). TyG (OR = 2.687) and TyG-LAP (OR = 4.512) were the factors determining the incidence of coronary artery disease in H-type hypertension, according to multivariate logistic regression analysis. The lesion number, stenosis degree, and Gensini score (P < 0.05) varied among both groups. LAP and TyG indexes were substantially greater in patients with double and triple vessel lesions than in those without lesions or with single vessel lesions (P < 0.05); similarly, these two indexes were considerably higher in individuals with grade III to IV lesions than in patients with grade I to II lesions (P < 0.05). As per the Pearson correlation analysis, the LAP, TyG indices and SAAlevel were adversely connected to the Gensini score (r = 0.254, 0.262, 0.299, P < 0.05), the GLP-1 level was negatively correlated to the Gensini score (r = -0.291, P < 0.05). TyG (OR = 2.687) and TyG-LAP (OR = 4.512) were the factors determining the frequency of coronary artery disease in H-type hypertension, according to multivariate logistic regression analysis. Conclusion In conclusion, the LAP and TyG indexes were observed to be closely related to the degree of CAD in H-type individuals with hypertension, which can better understand the pathogenesis of coronary artery disease in patients with H-type hypertension and is of great significance for guiding clinical doctors to carry out personalized treatment and management.
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Affiliation(s)
- Wenwen Yuan
- Department of Cardiology, Qingdao Fuwai Cardiovascular Hospital, Qingdao, China
| | - Yan Shao
- Department of Cardiology, Qingdao Fuwai Cardiovascular Hospital, Qingdao, China
| | - Dong Zhao
- Department of ICU, Qingdao Fuwai Cardiovascular Hospital, Qingdao, China
| | - Bin Zhang
- Department of Cardiology, Qingdao Fuwai Cardiovascular Hospital, Qingdao, China
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Liang S, Wang C, Zhang J, Liu Z, Bai Y, Chen Z, Huang H, He Y. Triglyceride-glucose index and coronary artery disease: a systematic review and meta-analysis of risk, severity, and prognosis. Cardiovasc Diabetol 2023; 22:170. [PMID: 37415168 PMCID: PMC10327356 DOI: 10.1186/s12933-023-01906-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 06/28/2023] [Indexed: 07/08/2023] Open
Abstract
BACKGROUND The TyG index is an indicator of insulin resistance (IR), which is associated with the development and prognosis of cardiovascular disease. This study aimed to summarize the relationship between the TyG index and the risk, severity, and prognosis of coronary artery disease (CAD) by performing a systematic review and meta-analysis. METHODS The PubMed, EMBASE, The Cochrane Library, and Web of Science databases were searched for articles published from inception until May 1, 2023. Cross-sectional studies, retrospective or prospective cohort studies recruiting patients with CAD were included. For the analysis of CAD severity, the outcomes were coronary artery calcification, coronary artery stenosis, coronary plaque progression, multi-vessel CAD, and in-stent re-stenosis. For the analysis of CAD prognosis, the primary outcome was major adverse cardiovascular events (MACE). RESULTS Forty-one studies were included in this study. Compared to patients with the lowest TyG index, those with the highest TyG index had a higher CAD risk [odds ratio (OR): 1.94, 95% confidence interval (CI) 1.20-3.14, I2 = 91%, P = 0.007]. Additionally, these patients were more likely to have stenotic coronary arteries (OR: 3.49, 95% CI 1.71-7.12, I2 = 0%, P = 0.0006), progressed plaques (OR: 1.67, 95% CI 1.28-2.19, I2 = 0%, P = 0.002), and with more vessels involved (OR: 2.33, 95% CI 1.59-3.42, I2 = 0%, P < 0.0001). When calculated as a categorized variable, it appears that acute coronary syndrome (ACS) patients with higher TyG index levels may have a higher incidence rate of MACE [hazard ratio (HR): 2.09, 95% CI 1.68-2.62, I2 = 87%, P < 0.00001], whereas chronic coronary syndrome (CCS) or stable CAD patients with higher TyG index levels showed a trend towards an increased incidence rate of MACE (HR: 1.24, 95% CI 0.96-1.60, I2 = 85%, P = 0.09). When calculated as a continuous variable, ACS patients had an HR of 2.28 per 1-unit/1-standard deviation increment of the TyG index (95% CI 1.44-3.63, I2 = 95%, P = 0.0005). Similarly, CCS or stable CAD patients had an HR of 1.49 per 1-unit/1-standard deviation increment of the TyG index (95% CI 1.21-1.83, I2 = 75%, P = 0.0001). Myocardial infarction with non-obstructive coronary arteries patients had an HR of 1.85 per 1-unit increment of the TyG index (95% CI 1.17-2.93, P = 0.008). CONCLUSIONS The TyG index is a simple new synthetic index that has been proven to be a valuable tool in the whole-course management of CAD patients. Patients with higher TyG index levels are at a higher risk of CAD, more severe coronary artery lesions, and worse prognosis compared to those with lower TyG index levels.
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Affiliation(s)
- Shichu Liang
- Department of Cardiology, West China Hospital, Sichuan University, No.37 GuoXue Alley, Chengdu, 610041, China
| | - Cui Wang
- Department of Endocrinology & Metabolism, Laboratory of Endocrinology & Metabolism, and Rare Disease Center, West China Hospital, Sichuan University, Chengdu, China
| | - Jing Zhang
- Department of Cardiology, West China Hospital, Sichuan University, No.37 GuoXue Alley, Chengdu, 610041, China
- West China School of Nursing, Sichuan University, Chengdu, China
| | - Zhiyue Liu
- Department of Cardiology, West China Hospital, Sichuan University, No.37 GuoXue Alley, Chengdu, 610041, China
| | - Yanlin Bai
- West China School of Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zhonglan Chen
- Department of Cardiology, West China Hospital, Sichuan University, No.37 GuoXue Alley, Chengdu, 610041, China
- West China School of Nursing, Sichuan University, Chengdu, China
| | - He Huang
- Department of Cardiology, West China Hospital, Sichuan University, No.37 GuoXue Alley, Chengdu, 610041, China.
| | - Yong He
- Department of Cardiology, West China Hospital, Sichuan University, No.37 GuoXue Alley, Chengdu, 610041, China.
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Pugliese L, Ricci F, Sica G, Scaglione M, Masala S. Non-Contrast and Contrast-Enhanced Cardiac Computed Tomography Imaging in the Diagnostic and Prognostic Evaluation of Coronary Artery Disease. Diagnostics (Basel) 2023; 13:2074. [PMID: 37370969 DOI: 10.3390/diagnostics13122074] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 06/07/2023] [Accepted: 06/11/2023] [Indexed: 06/29/2023] Open
Abstract
In recent decades, cardiac computed tomography (CT) has emerged as a powerful non-invasive tool for risk stratification, as well as the detection and characterization of coronary artery disease (CAD), which remains the main cause of morbidity and mortality in the world. Advances in technology have favored the increasing use of cardiac CT by allowing better performance with lower radiation doses. Coronary artery calcium, as assessed by non-contrast CT, is considered to be the best marker of subclinical atherosclerosis, and its use is recommended for the refinement of risk assessment in low-to-intermediate risk individuals. In addition, coronary CT angiography (CCTA) has become a gate-keeper to invasive coronary angiography (ICA) and revascularization in patients with acute chest pain by allowing the assessment not only of the extent of lumen stenosis, but also of its hemodynamic significance if combined with the measurement of fractional flow reserve or perfusion imaging. Moreover, CCTA provides a unique incremental value over functional testing and ICA by imaging the vessel wall, thus allowing the assessment of plaque burden, composition, and instability features, in addition to perivascular adipose tissue attenuation, which is a marker of vascular inflammation. There exists the potential to identify the non-obstructive lesions at high risk of progression to plaque rupture by combining all of these measures.
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Affiliation(s)
- Luca Pugliese
- Radiology Unit, Department of Medical-Surgical Sciences and Translational Medicine, Sapienza University of Rome, Sant'Andrea University Hospital, 00189 Rome, Italy
| | - Francesca Ricci
- Radiology Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy
| | - Giacomo Sica
- Radiology Unit, Monaldi Hospital, 80131 Napoli, Italy
| | - Mariano Scaglione
- Radiology Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy
| | - Salvatore Masala
- Radiology Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy
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9
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Lu YW, Tsai CT, Chou RH, Tsai YL, Kuo CS, Huang PH, Lin SJ. Sex difference in the association of the triglyceride glucose index with obstructive coronary artery disease. Sci Rep 2023; 13:9652. [PMID: 37316697 DOI: 10.1038/s41598-023-36135-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 05/30/2023] [Indexed: 06/16/2023] Open
Abstract
Insulin resistance (IR) is associated with cardiovascular disease in non-diabetic patients. The triglyceride-glucose (TyG) index, incorporating serum glucose and insulin concentrations, is a surrogate insulin resistance marker. We investigated its association with obstructive coronary artery disease (CAD) and sex differences therein. Patients with stable angina pectoris requiring invasive coronary angiography between January 2010 and December 2018 were enrolled. They were divided into two groups according to TyG index. Two interventional cardiologists diagnosed obstructive CAD by angiography review. Demographic characteristics and clinical outcomes were compared between groups. Relative to lower index, patients with higher (≥ 8.60) TyG index had higher BMIs and more prevalent hypertension, diabetes, and elevated lipid profiles [total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides (TG), fasting plasma glucose (FPG)]. Higher TyG index increased women's obstructive CAD risk after multivariate adjustment (adjusted odds ratio (aOR) 2.15, 95% confidence interval (95% CI) 1.08-4.26, p = 0.02) in non-diabetic populations compared with men. No sex difference was found for diabetic patients. Higher TyG index significantly increased the obstructive CAD risk, overall and for non-diabetic women. Larger-scale studies are needed to confirm our findings.
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Affiliation(s)
- Ya-Wen Lu
- Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan
- Cardiovascular Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chuan-Tsai Tsai
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Taipei, Taiwan
- Cardiovascular Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ruey-Hsin Chou
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Taipei, Taiwan
- Cardiovascular Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Critical Care Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yi-Lin Tsai
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Taipei, Taiwan
- Cardiovascular Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chin-Sung Kuo
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Division of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Po-Hsun Huang
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Taipei, Taiwan.
- Cardiovascular Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan.
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
- Department of Critical Care Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
| | - Shing-Jong Lin
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Taipei, Taiwan
- Cardiovascular Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
- Taipei Heart Institute, Taipei Medical University, Taipei, Taiwan
- Division of Cardiology, Heart Center, Cheng-Hsin General Hospital, Taipei, Taiwan
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10
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Oancea AF, Jigoranu RA, Morariu PC, Miftode RS, Trandabat BA, Iov DE, Cojocaru E, Costache II, Baroi LG, Timofte DV, Tanase DM, Floria M. Atrial Fibrillation and Chronic Coronary Ischemia: A Challenging Vicious Circle. Life (Basel) 2023; 13:1370. [PMID: 37374152 DOI: 10.3390/life13061370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 05/31/2023] [Accepted: 06/07/2023] [Indexed: 06/29/2023] Open
Abstract
Atrial fibrillation, the most frequent arrhythmia in clinical practice and chronic coronary syndrome, is one of the forms of coronary ischemia to have a strong dual relationship. Atrial fibrillation may accelerate atherosclerosis and may increase oxygen consumption in the myocardium, creating a mismatch between supply and demand, thus promoting the development or worsening of coronary ischemia. Chronic coronary syndrome alters the structure and function of gap junction proteins, affecting the conduction of action potential and leading to ischemic necrosis of cardiomyocytes and their replacement with fibrous tissue, in this way sustaining the focal ectopic activity in atrial myocardium. They have many risk factors in common, such as hypertension, obesity, type 2 diabetes mellitus, and dyslipidemia. It is vital for the prognosis of patients to break this vicious circle by controlling risk factors, drug therapies, of which antithrombotic therapy may sometimes be challenging in terms of prothrombotic and bleeding risk, and interventional therapies (revascularization and catheter ablation).
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Affiliation(s)
- Alexandru Florinel Oancea
- Department of Internal Medicine, Faculty of Medicine, University of Medicine and Pharmacy Grigore T. Popa, 700115 Iasi, Romania
- Cardiology Clinic, St. Spiridon Emergency Hospital, 700115 Iasi, Romania
| | - Raul Alexandru Jigoranu
- Department of Internal Medicine, Faculty of Medicine, University of Medicine and Pharmacy Grigore T. Popa, 700115 Iasi, Romania
- Cardiology Clinic, St. Spiridon Emergency Hospital, 700115 Iasi, Romania
| | - Paula Cristina Morariu
- Department of Internal Medicine, Faculty of Medicine, University of Medicine and Pharmacy Grigore T. Popa, 700115 Iasi, Romania
- Internal Medicine Clinic, St. Spiridon Emergency Hospital, 700115 Iasi, Romania
| | - Radu-Stefan Miftode
- Department of Internal Medicine, Faculty of Medicine, University of Medicine and Pharmacy Grigore T. Popa, 700115 Iasi, Romania
- Cardiology Clinic, St. Spiridon Emergency Hospital, 700115 Iasi, Romania
| | - Bogdan Andrei Trandabat
- Department of Internal Medicine, Faculty of Medicine, University of Medicine and Pharmacy Grigore T. Popa, 700115 Iasi, Romania
- Cardiology Clinic, St. Spiridon Emergency Hospital, 700115 Iasi, Romania
| | - Diana Elena Iov
- Department of Internal Medicine, Faculty of Medicine, University of Medicine and Pharmacy Grigore T. Popa, 700115 Iasi, Romania
- Internal Medicine Clinic, St. Spiridon Emergency Hospital, 700115 Iasi, Romania
| | - Elena Cojocaru
- Department of Internal Medicine, Faculty of Medicine, University of Medicine and Pharmacy Grigore T. Popa, 700115 Iasi, Romania
- Department of Morphofunctional Sciences-Pathology, Pediatric Hospital, 700115 Iasi, Romania
| | - Irina Iuliana Costache
- Department of Internal Medicine, Faculty of Medicine, University of Medicine and Pharmacy Grigore T. Popa, 700115 Iasi, Romania
- Cardiology Clinic, St. Spiridon Emergency Hospital, 700115 Iasi, Romania
| | - Livia Genoveva Baroi
- Department of Internal Medicine, Faculty of Medicine, University of Medicine and Pharmacy Grigore T. Popa, 700115 Iasi, Romania
- Surgery Clinic, St. Spiridon Emergency Hospital, 700115 Iasi, Romania
| | - Daniel Vasile Timofte
- Department of Internal Medicine, Faculty of Medicine, University of Medicine and Pharmacy Grigore T. Popa, 700115 Iasi, Romania
- Surgery Clinic, St. Spiridon Emergency Hospital, 700115 Iasi, Romania
| | - Daniela Maria Tanase
- Department of Internal Medicine, Faculty of Medicine, University of Medicine and Pharmacy Grigore T. Popa, 700115 Iasi, Romania
- Internal Medicine Clinic, St. Spiridon Emergency Hospital, 700115 Iasi, Romania
| | - Mariana Floria
- Department of Internal Medicine, Faculty of Medicine, University of Medicine and Pharmacy Grigore T. Popa, 700115 Iasi, Romania
- Internal Medicine Clinic, St. Spiridon Emergency Hospital, 700115 Iasi, Romania
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11
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Williams MC. Predictors of Plaque Progression on Coronary Computed Tomography Angiography. JACC Cardiovasc Imaging 2023; 16:505-507. [PMID: 36752440 DOI: 10.1016/j.jcmg.2022.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 11/29/2022] [Indexed: 01/27/2023]
Affiliation(s)
- Michelle C Williams
- British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, Scotland, United Kingdom.
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12
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FU R, ZHAO YY, CUI KY, YANG JG, XU HY, YIN D, SONG WH, WANG HJ, ZHU CG, FENG L, WANG ZF, WANG QS, LU Y, DOU KF, YANG YJ. Triglyceride glucose index predicts in-hospital mortality in patients with ST-segment elevation myocardial infarction who underwent primary angiography. J Geriatr Cardiol 2023; 20:185-194. [PMID: 37091264 PMCID: PMC10114195 DOI: 10.26599/1671-5411.2023.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2023] Open
Abstract
OBJECTIVES To assess the correlation between triglyceride glucose (TyG) index and in-hospital mortality in patients with ST-segment elevation myocardial infarction (STEMI). METHODS A total of 2190 patients with STEMI who underwent primary angiography within 12 h from symptom onset were selected from the prospective, nationwide, multicenter CAMI registry. TyG index was calculated with the formula: Ln [fasting triglycerides (mmol/L) × fasting glucose (mmol/L)/2]. Patients were divided into three groups according to the tertiles of TyG index. The primary endpoint was in-hospital mortality. RESULTS Overall, 46 patients died during hospitalization, in-hospital mortality was 1.5%, 2.2%, 2.6% for tertile 1, tertile 2, and tertile 3, respectively. However, TyG index was not significantly correlated with in-hospital mortality in single-variable logistic regression analysis. Nonetheless, after adjusting for age and sex, TyG index was significantly associated with higher mortality when regarded as a continuous variable (adjusted OR = 1.75, 95% CI: 1.16-2.63) or categorical variable (tertile 3 vs. tertile 1: adjusted OR = 2.50, 95% CI: 1.14-5.49). Furthermore, TyG index, either as a continuous variable (adjusted OR = 2.54, 95% CI: 1.42-4.54) or categorical variable (tertile 3 vs. tertile 1: adjusted OR = 3.57, 95% CI: 1.24-10.29), was an independent predictor of in-hospital mortality after adjusting for multiple confounders in multivariable logistic regression analysis. In subgroup analysis, the prognostic effect of high TyG index was more significant in patients with body mass index < 18.5 kg/m2 (P interaction = 0.006). CONCLUSIONS This study showed that TyG index was positively correlated with in-hospital mortality in STEMI patients who underwent primary angiography, especially in underweight patients.
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Affiliation(s)
- Rui FU
- Cardiometabolic Medicine Center, Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, National Clinical Research Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yan-Yan ZHAO
- Medical Research & Biometrics Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Kong-Yong CUI
- Cardiometabolic Medicine Center, Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, National Clinical Research Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jin-Gang YANG
- Coronary Heart Disease Center, Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, National Clinical Research Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hai-Yan XU
- Coronary Heart Disease Center, Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, National Clinical Research Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Dong YIN
- Cardiometabolic Medicine Center, Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, National Clinical Research Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wei-Hua SONG
- Cardiometabolic Medicine Center, Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, National Clinical Research Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hong-Jian WANG
- Cardiometabolic Medicine Center, Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, National Clinical Research Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Cheng-Gang ZHU
- Cardiometabolic Medicine Center, Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, National Clinical Research Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lei FENG
- Cardiometabolic Medicine Center, Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, National Clinical Research Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhi-Fang WANG
- Department of Cardiology, Xinxiang Central Hospital, the Fourth Clinical College of Xinxiang Medical University, Henan Province, China
| | - Qing-Sheng WANG
- Department of Cardiology, Qinhuangdao First Hospital, Hebei Province, China
| | - Ye LU
- Medical Research & Biometrics Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ke-Fei DOU
- Cardiometabolic Medicine Center, Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, National Clinical Research Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- (DOU KF)
| | - Yue-Jin YANG
- Coronary Heart Disease Center, Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, National Clinical Research Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- (YANG YJ)
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13
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Pan W, Ren Y, Yang F, Wang M, Li X, Yin D. Triglyceride glucose index is associated with obstructive coronary artery disease in hypertensive patients. Cardiovasc Diabetol 2023; 22:9. [PMID: 36635731 PMCID: PMC9838016 DOI: 10.1186/s12933-023-01739-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 01/06/2023] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Hypertension is a leading risk of coronary artery disease (CAD). Triglyceride glucose index (TyG) is a surrogate of insulin resistance (IR). Few studies explore the association between TyG and the incidence of obstructive CAD (OCAD) in hypertensive patients. METHODS We retrospectively screened 1841 hypertensive subjects who were free of a history of CAD and underwent coronary computed tomography angiography (CCTA) because of chest pain. TyG index was calculated as ln (fasting TG [mg/dL] * fasting glucose [mg/dL]/2). The outcome of this research was OCAD, which was defined as the presence of diameter stenosis ≥ 50% in any of the four major epicardial coronary arteries detected on CCTA. RESULTS A total of 310 (16.8%) patients developed obstructive CAD. The restricted cubic spline (RCS) analysis showed a J-shaped relationship between TyG and OCAD and the OR for OCAD increased as the TyG rose over 8.61 (OR perSD) 1.64, 95% CI 1.13-2.54, p = 0.008). After full adjustments for confounding covariates, patients with TyG index in tertile 3 (T3) had 2.12 times (95% CI 1.80 to 3.81) and in T2 had 2.01 times (95% CI 1.40 to 2.88) as high as the risk of OCAD compared with patients in T1 (p for trend = 0.001). When regarding TyG as a continuous variable, 1-SD increase elevated 49% (OR (95%CI), 1.49 (1.30-1.74)) risk of obstructive CAD (p = 0.007). This positive effect was still consistent across the subgroups (p for interaction > 0.05). CONCLUSION TyG index was associated with the incidence of obstructive CAD in hypertensive patients.
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Affiliation(s)
- Weili Pan
- grid.452435.10000 0004 1798 9070Department of Cardiology, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning China
| | - Yongkui Ren
- grid.452435.10000 0004 1798 9070Department of Cardiology, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning China
| | - Fan Yang
- grid.459353.d0000 0004 1800 3285Department of Cardiology, the Affiliated Zhongshan Hospital of Dalian University, Dalian, Liaoning China
| | - Minxian Wang
- grid.452435.10000 0004 1798 9070Department of Cardiology, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning China
| | - Xinsheng Li
- grid.452435.10000 0004 1798 9070Department of Cardiology, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning China
| | - Da Yin
- Department of Cardiology, Shenzhen People's Hospital, 2nd Clinical Medical College of JINAN University, 1st Affiliated Hospital of the Southern University of Science and Technology. No. 1017 Dongmen North Road, Luohu District, Shenzhen, China.
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14
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Sun T, Huang X, Zhang B, Ma M, Chen Z, Zhao Z, Zhou Y. Prognostic significance of the triglyceride-glucose index for patients with ischemic heart failure after percutaneous coronary intervention. Front Endocrinol (Lausanne) 2023; 14:1100399. [PMID: 36814584 PMCID: PMC9939475 DOI: 10.3389/fendo.2023.1100399] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 01/26/2023] [Indexed: 02/09/2023] Open
Abstract
BACKGROUND In previous studies, the TyG index (triglyceride-glucose index) has been proven to be closely associated with the prognosis of cardiovascular disease. However, the impact of TyG index on the prognosis of patients with ischemic HF (heart failure) undergoing PCI (percutaneous coronary intervention) is still unclear. METHOD In this study, 2055 patients with ischemic HF were retrospectively enrolled and classified into four groups based on quartiles of the TyG index. The primary endpoint was MACE (major adverse cardiovascular events) consisting of all-cause mortality, non-fatal MI (myocardial infarction), and any revascularization. The incidence of the endpoints among the four groups was assessed through Kaplan-Meier survival analysis. The independent correlation between TyG index and endpoints was analyzed with multivariate Cox regression models. Besides, the RCS (restricted cubic spline) analysis was performed to examine the nonlinear relationship between TyG index and MACE. RESULT The incidence of MACE was significantly higher in participants with a higher TyG index. The positive association between the TyG index and MACE was also confirmed in the Kaplan-Meier survival analyses. Multivariate cox proportional hazards analysis indicated that the TyG index was independently associated with the increased risk of MACE, regardless of whether TyG was a continuous [TyG, per 1-unit increase, HR (hazard ratio) 1.41, 95% CI (confidence interval) 1.22-1.62, P < 0.001] or categorical variable [quartile of TyG, the HR (95% CI) values for quartile 4 was 1.92 (1.48-2.49), with quartile 1 as a reference]. In addition, the nonlinear association of TyG index with MACE was shown through RCS model and the risk of MACE increased as the TyG index increased in general (Nonlinear p=0.0215). Besides, no obvious interaction was found in the association of TyG with MACE between the DM (diabetes mellitus) group and the no-DM group. CONCLUSION Among patients with ischemic HF undergoing PCI, the TyG index was correlated with MACE independently and positively.
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15
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Uddin MN, Emran TB. Prevention of Progression and Remission in Public Health Sectors: Bangladesh Perspectives. ATLANTIS HIGHLIGHTS IN CHEMISTRY AND PHARMACEUTICAL SCIENCES 2023:131-150. [DOI: 10.2991/978-94-6463-130-2_15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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16
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Li X, Li Y, Lian P, Lv Q, Liu F. Silencing lncRNA HCG18 regulates GPX4-inhibited ferroptosis by adsorbing miR-450b-5p to avert sorafenib resistance in hepatocellular carcinoma. Hum Exp Toxicol 2023; 42:9603271221142818. [PMID: 36786348 DOI: 10.1177/09603271221142818] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
Ferroptosis is potential to relieve drug resistance in hepatocellular carcinoma (HCC). Glutathione peroxidase 4 (GPX4) is a critical modulator of ferroptosis. This study discussed the mechanism of GPX4-inhibited ferroptosis in sorafenib resistance in HCC. HCG18 in HCC cells was detected. Sorafenib resistant (SR) cell line Huh7-SR cells were treated with sorafenib (0, 2.5, 5, 7.5, 10 μM). After silencing HCG18 in Huh7-SR cells, cell activity, proliferation and apoptosis were detected. The levels of iron, the concentration of MDA, GSH and lipid reactive oxygen species (ROS) were measured to evaluate the ferroptosis. The downstream mechanism of HCG18 was predicted and verified. Huh7-SR cells were infected with lentivirus sh-HCG18 to establish xenograft tumor model. HCG18 was elevated in HCC cells and associated with sorafenib resistance. Silencing HCG18 inhibited cell proliferation, promoted apoptosis, and impaired sorafenib resistance. Ferroptosis was inhibited in Huh7-SR cells, while silencing HCG18 inhibited sorafenib resistance by promoting ferroptosis. GPX4 overexpression averted the promotion of sh-HCG18 on ferroptosis, thereby reducing sorafenib resistance. HCG18 sponged miR-450b-5p to regulate GPX4. Collectively, Silencing HCG18 inhibits GPX4 by binding to miR-450b-5p, promotes GPX4-inhibited ferroptosis, and averts sorafenib resistance in HCC.
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Affiliation(s)
- Xiaoming Li
- Department of Hepatobiliary Surgery, 531675The Second Hospital of Shandong University, Jinan, China
| | - Yunhui Li
- Department of Hepatobiliary Surgery, People's Hospital Affiliated to Shandong First Medical University, Laiwu, China
| | - Peilong Lian
- Department of Hepatobiliary Surgery, 531675The Second Hospital of Shandong University, Jinan, China
| | - Qigang Lv
- Department of Hepatobiliary Surgery, 531675The Second Hospital of Shandong University, Jinan, China
| | - Fangfeng Liu
- Department of Hepatobiliary Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China.,Department of Hepatobiliary Surgery, 34708Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China
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17
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Wang K, Xu L, Liu L, Zhan S, Wang S, Song Y. Sex differences in the association between the change in triglyceride‑glucose index and cognitive decline: A population-based cohort study. J Affect Disord 2022; 316:42-49. [PMID: 35952934 DOI: 10.1016/j.jad.2022.08.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 06/14/2022] [Accepted: 08/06/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Previous studies indicated that insulin resistance (IR) was related to cognitive decline. This study aimed to investigate whether triglyceride-glucose (TyG) as a surrogate marker of IR can detect the association between IR and cognitive decline, and explore sex-specific association between the longitudinal change in TyG index and cognitive decline in the middle-aged and elderly population in China. METHODS Data from the China Health and Retirement Longitudinal Study, which include 2358 females and 2062 males, were used. The TyG index was calculated as ln (fasting triglyceride [mg/dL] × fasting blood glucose [mg/dL] / 2). Cognitive score was measured by word recall test and mental status test. Logistic regression was used to assess the association between change in TyG index and cognitive decline in men and women from 2011 to 2015, respectively. Subgroup analysis by age was also performed. RESULTS The fourth quartile of change in TyG index was significantly associated with the increased risk of decline in global cognition compared with the first quartile in men [odds ratio (OR) 1.32, 95 % CI 1.03 to 1.71]. Stratified by age groups, the significant association between TyG index and cognitive decline was only found in men aged under 60 years old (OR 1.51, 95 % CI 1.07 to 2.13). LIMITATIONS We only observed the association between TyG index and cognitive decline, but not the severity of the decline. CONCLUSIONS The increased TyG index is related to the risk of cognitive decline in men. This study provided new evidence for formulating sex-specific prevention and treatment strategies for cognitive decline.
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Affiliation(s)
- Kai Wang
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China; Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, China; Shandong Engineering Laboratory of Prevention and Control for Endocrine and Metabolic Diseases, Jinan, China; Shandong Institute of Endocrine & Metabolic Diseases, Jinan, China
| | - Lu Xu
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China
| | - Lili Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Siyan Zhan
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China; Center for Intelligent Public Health, Institute for Artificial Intelligence, Peking University, Beijing, China.
| | - Shengfeng Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.
| | - Yongfeng Song
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China; Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, China; Shandong Engineering Laboratory of Prevention and Control for Endocrine and Metabolic Diseases, Jinan, China; Shandong Institute of Endocrine & Metabolic Diseases, Jinan, China.
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18
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Zhao ZW, Liu C, Zhao Q, Xu YK, Cheng YJ, Sun TN, Zhou YJ. Triglyceride-glucose index and non-culprit coronary plaque characteristics assessed by optical coherence tomography in patients following acute coronary syndrome: A cross-sectional study. Front Cardiovasc Med 2022; 9:1019233. [PMID: 36312238 PMCID: PMC9596751 DOI: 10.3389/fcvm.2022.1019233] [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: 08/14/2022] [Accepted: 09/27/2022] [Indexed: 11/14/2022] Open
Abstract
Background Triglyceride-glucose (TyG) index, a novel surrogate marker of insulin resistance, has been demonstrated to be significantly associated with cardiovascular disease. It remains indistinct regarding the association between TyG index and non-culprit coronary plaque characteristics in patients following acute coronary syndrome (ACS). Methods The present study retrospectively recruited patients who were diagnosed with ACS and underwent non-culprit optical coherence tomography (OCT) examination. The study population was divided into 2 groups based on the median of TyG index, which was calculated as Ln [fasting triglyceride (TG) (mg/dL) × fasting blood glucose (FBG) (mg/dL)/2]. The non-culprit plaque characteristics were determined by interpreting OCT images in accordance with the standard of previous consensus. Results 110 patients (54.8 ± 12.1 years, 24.5% female) with 284 non-culprit plaques were included in the current analysis. TyG index was closely associated with high-risk plaque characteristics. Elevated TyG index was consistent to be an independent indicator for thin-cap fibroatheroma (TCFA) [odds ratio (OR) for per 1-unit increase 4.940, 95% confidence interval (CI) 1.652–14.767, P = 0.004; OR for taking lower median as reference 2.747, 95% CI 1.234–7.994, P = 0.011] and ruptured plaque (OR for per 1–unit increase 7.065, 95% CI 1.910–26.133, P = 0.003; OR for taking lower median as reference 4.407, 95% CI 1.208–16.047, P = 0.025) in fully adjusted model. The predictive value of TyG index for TCFA and ruptured plaque was moderate–to–high, with the area under the receiver operating characteristic curve (AUC) of 0.754 and 0.699 respectively. The addition of TyG index into a baseline model exhibited an incremental effect on the predictive value for TCFA, manifested as an increased AUC (0.681, 95% CI 0.570–0.793 vs. 0.782, 95% CI 0.688–0.877, P = 0.042), and significant continuous net reclassification improvement (0.346, 95% CI 0.235–0.458, P < 0.001) and integrated discrimination improvement (0.221, 95% CI 0.017–0.425, P = 0.034). TyG index failed to play an incremental effect on predicting ruptured plaque. Conclusion TyG index, which is simply calculated from fasting TG and FBG, can be served as an important and independent risk predictor for high-risk non-culprit coronary plaques in patients following ACS.
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Affiliation(s)
- Zi-Wei Zhao
- Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Department of Cardiology, Clinical Center for Coronary Heart Disease, Beijing Anzhen Hospital, Beijing Institute of Heart Lung and Blood Vessel Disease, Capital Medical University, Beijing, China
| | - Chi Liu
- Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Department of Cardiology, Clinical Center for Coronary Heart Disease, Beijing Anzhen Hospital, Beijing Institute of Heart Lung and Blood Vessel Disease, Capital Medical University, Beijing, China
| | - Qi Zhao
- Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Ying-Kai Xu
- Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Department of Cardiology, Clinical Center for Coronary Heart Disease, Beijing Anzhen Hospital, Beijing Institute of Heart Lung and Blood Vessel Disease, Capital Medical University, Beijing, China
| | - Yu-Jing Cheng
- Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Department of Cardiology, Clinical Center for Coronary Heart Disease, Beijing Anzhen Hospital, Beijing Institute of Heart Lung and Blood Vessel Disease, Capital Medical University, Beijing, China
| | - Tie-Nan Sun
- Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Department of Cardiology, Clinical Center for Coronary Heart Disease, Beijing Anzhen Hospital, Beijing Institute of Heart Lung and Blood Vessel Disease, Capital Medical University, Beijing, China
| | - Yu-Jie Zhou
- Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Department of Cardiology, Clinical Center for Coronary Heart Disease, Beijing Anzhen Hospital, Beijing Institute of Heart Lung and Blood Vessel Disease, Capital Medical University, Beijing, China,*Correspondence: Yu-Jie Zhou
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19
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Caselli C, Di Giorgi N, Ragusa R, Lorenzoni V, Smit J, El Mahdiui M, Buechel RR, Teresinska A, Pizzi MN, Roque A, Poddighe R, Knuuti J, Schütte M, Parodi O, Pelosi G, Scholte A, Rocchiccioli S, Neglia D. Association of MMP9 with adverse features of plaque progression and residual inflammatory risk in patients with chronic coronary syndrome (CCS). Vascul Pharmacol 2022; 146:107098. [PMID: 36100166 DOI: 10.1016/j.vph.2022.107098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 08/18/2022] [Accepted: 08/26/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS MMP-9 is a predictor of atherosclerotic plaque instability and adverse cardiovascular events, but longitudinal data on the association between MMP9 and coronary disease progression are lacking. This study is aimed at investigating whether MMP9 is associated with atherosclerotic plaque progression and the related molecular basis in stable patients with chronic coronary syndrome (CCS). METHODS MMP9 serum levels were measured in 157 CCS patients (58 ± 8 years of age; 66% male) undergoing coronary computed tomography angiography at baseline and after a follow up period of 6.5 ± 1.1 years to assess progression of Total, Fibrous, Fibro-fatty, Necrotic Core, and Dense Calcium plaque volumes (PV). Gene expression analysis was evaluated in whole blood using a transcriptomic approach by RNA-seq. RESULTS At multivariate analysis, serum MMP9 was associated with annual change of Total and Necrotic Core PV (Coefficient 3.205, SE 1.321, P = 0.017; 1.449, SE 0.690, P = 0.038, respectively), while MMP9 gene expression with Necrotic Core PV (Coefficient 70.559, SE 32.629, P = 0.034), independently from traditional cardiovascular risk factors, medications, and presence of obstructive CAD. After transcriptomic analysis, MMP9 expression was linked to expression of genes involved in the innate immunity. CONCLUSIONS Among CCS patients, MMP9 is an independent predictive marker of progression of adverse coronary plaques, possibly reflecting the activity of inflammatory pathways conditioning adverse plaque phenotypes. Thus, blood MMP9 might be used for the identification of patients with residual risk even with optimal management of classical cardiovascular risk factors who may derive the greatest benefit from targeted anti-inflammatory drugs.
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Affiliation(s)
- Chiara Caselli
- Institute of Clinical Physiology CNR, Via G. Moruzzi 1, Pisa, Italy.
| | | | - Rosetta Ragusa
- Institute of Clinical Physiology CNR, Via G. Moruzzi 1, Pisa, Italy.
| | - Valentina Lorenzoni
- Sant'Anna School of Advanced Studies, Piazza Martiri della Libertà, 33, Pisa, Italy.
| | - Jeff Smit
- Department of Cardiology, Heart Lung Center, Leiden University Medical Centre, Albinusdreef 2, RC, Leiden, the Netherlands.
| | - Mohammed El Mahdiui
- Department of Cardiology, Heart Lung Center, Leiden University Medical Centre, Albinusdreef 2, RC, Leiden, the Netherlands.
| | - Ronny R Buechel
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital and University of Zurich, Switzerland.
| | | | - Maria N Pizzi
- Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Albert Roque
- Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | | | - Juhani Knuuti
- PET Center, Turku University Hospital and University of Turku, Kiinamyllynkatu 4-8, Turku, Finland.
| | - Moritz Schütte
- Alacris Theranostics GmbH, Max-Planck-Straße 3, 12489 Berlin, Germany.
| | - Oberdan Parodi
- Fondazione Toscana G. Monasterio, Via G. Moruzzi 1, Pisa, Italy
| | - Gualtiero Pelosi
- Institute of Clinical Physiology CNR, Via G. Moruzzi 1, Pisa, Italy.
| | - Arthur Scholte
- Department of Cardiology, Heart Lung Center, Leiden University Medical Centre, Albinusdreef 2, RC, Leiden, the Netherlands.
| | | | - Danilo Neglia
- Fondazione Toscana G. Monasterio, Via G. Moruzzi 1, Pisa, Italy.
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20
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Indraratna P, Khasanova E, Gulsin GS, Tzimas G, Takagi H, Park KH, Lin FY, Shaw LJ, Lee SE, Narula J, Bax JJ, Chang HJ, Leipsic J. Plaque progression: Where, why, and how fast? A review of what we have learned from the analysis of patient data from the PARADIGM registry. J Cardiovasc Comput Tomogr 2022; 16:294-302. [PMID: 34824029 DOI: 10.1016/j.jcct.2021.11.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 10/20/2021] [Accepted: 11/10/2021] [Indexed: 12/28/2022]
Abstract
Ischemic heart disease is the most common cause of mortality worldwide. The pathophysiology of myocardial infarction relates to temporal changes of atherosclerotic plaque culminating in plaque rupture, erosion or hemorrhage and the subsequent thrombotic response. Coronary computed tomographic angiography (CCTA) provides the ability to visualize and quantify plaque, and plaque progression can be measured on a per-patient basis by comparing findings of serial CCTA. The Progression of AtheRosclerotic PlAque DetermIned by Computed TomoGraphic Angiography IMaging (PARADIGM) registry was established with the objective of identifying patterns of plaque progression in a large population. The registry comprises over 2000 patients with multiple CCTA scans performed at least two years apart. Unlike previous CCTA registries, a semi-automated plaque quantification technique permitting detailed analysis of plaque progression was performed on all patients with interpretable studies. Since the registry was established, 19 peer-reviewed publications were identified, and all are reviewed and summarized in this article.
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Affiliation(s)
- Praveen Indraratna
- University of British Columbia and Department of Radiology, St. Paul's Hospital, Vancouver, Canada; Prince of Wales Clinical School, UNSW Sydney, Sydney, Australia.
| | - Elina Khasanova
- University of British Columbia and Department of Radiology, St. Paul's Hospital, Vancouver, Canada
| | - Gaurav S Gulsin
- University of British Columbia and Department of Radiology, St. Paul's Hospital, Vancouver, Canada; Department of Cardiovascular Sciences, University of Leicester and the Leicester NIHR Biomedical Research Centre, Leicester, United Kingdom
| | - Georgios Tzimas
- University of British Columbia and Department of Radiology, St. Paul's Hospital, Vancouver, Canada; Department of Heart Vessels, Cardiology Service, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Hidenobu Takagi
- University of British Columbia and Department of Radiology, St. Paul's Hospital, Vancouver, Canada; Department of Diagnostic Radiology, Tohoku University Hospital, Miyagi, Japan
| | - Keun-Ho Park
- University of British Columbia and Department of Radiology, St. Paul's Hospital, Vancouver, Canada; Division of Cardiology, Department of Internal Medicine, Chosun University Hospital, Gwangju, Republic of Korea
| | - Fay Y Lin
- Department of Radiology, New York-Presbyterian Hospital, Weill Cornell Medicine, New York, USA
| | - Leslee J Shaw
- Department of Radiology, New York-Presbyterian Hospital, Weill Cornell Medicine, New York, USA
| | - Sang-Eun Lee
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea; Yonsei-Cedars-Sinai Integrative Cardiovascular Imaging Research Center, Yonsei University College of Medicine, Yonsei University Health System, South Korea
| | - Jagat Narula
- Icahn School of Medicine at Mount Sinai, Mount Sinai Heart, Zena and Michael A. Wiener Cardiovascular Institute, and Marie-Josée and Henry R. Kravis Center for Cardiovascular Health, New York, NY, USA
| | - Jeroen J Bax
- Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Hyuk-Jae Chang
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea
| | - Jonathon Leipsic
- University of British Columbia and Department of Radiology, St. Paul's Hospital, Vancouver, Canada
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21
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Shi R, Gao Y, Shen LL, Shi K, Wang J, Jiang L, Li Y, Yang ZG. The effect of LDL-C status on the association between increased coronary artery calcium score and compositional plaque volume progression in statins-treated diabetic patients: evaluated using serial coronary CTAs. Cardiovasc Diabetol 2022; 21:121. [PMID: 35773708 PMCID: PMC9248151 DOI: 10.1186/s12933-022-01556-y] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 06/19/2022] [Indexed: 02/08/2023] Open
Abstract
Background In statins-treated diabetic mellitus (DM) patients, longitudinal coronary CTA (CCTA) evidence is scarce regarding the relationship between coronary Agatston artery calcification scores (CACs) and coronary plaque progression. This study was designed to investigate whether the association between CACs progression and compositional plaque volumes (PVs) progression differed between follow-up low-density lipoprotein cholesterol (LDL-C) controlled and uncontrolled groups in statins-treated DM patients. Methods From January 2015 to June 2021, 208 patients who submitted serial clinically indicated CCTAs in our hospital were included in this study. Participants were further subdivided into LDL-C controlled (n = 75) and LDL-C uncontrolled (n = 133) groups according to whether the LDL-C reached the treatment goals at follow-up. Baseline and follow-up CCTA image datasets were quantified analysis at per-patient and per-plaque levels. The annual change of total PV (TPV), calcific PV(CPV), non-calcific PV (NCPV), low-density non-calcific PV (LD-NCPV), and CACs were assessed and further compared according to follow-up LDL-C status. The effect of CACs progression on the annual change of componential PVs was evaluated according to follow-up LDL-C status at both per-patient and per-plaque levels. Results The annual change of CACs was positively associated with the annual change of TPV (β = 0.43 and 0.61, both p < 0.001), CPV (β = 0.23 and β = 0.19, p < 0.001 and p = 0.004, respectively), NCPV (β = 0.20 and β = 0.42, p < 0.001 and p = 0.006, respectively), and LD-NCPV (β = 0.08 and 0.13, p < 0.001 and p = 0.001, respectively) both on per-patients and per-plaque levels. LDL-C status had no effect on the annual change of TPV, CPV, NCPV, and LD-NCPV (all p > 0.05). After adjusting for confounding factors, on the per-patient level, the increase in CACs was independently associated with annual change of TPV (β = 0.650 and 0.378, respectively, both p < 0.001), CPV (β = 0.169 and 0.232, respectively, p = 0.007 and p < 0.001), NCPV (β = 0.469 and 0.144, respectively, both p = 0.001), and LD-NCPV (β = 0.082 and 0.086, respectively, p = 0.004 and p = 0.006) in LDL-C controlled and LDL-C uncontrolled group. On the per-plaque level, the increase in CACs was independently associated with the annual change of NCPV and LD-NCPV in LDL-C uncontrolled patient (β = 0.188 and 0.106, p < 0.001), but not in LDL-C controlled group (β = 0.268 and 0.056, p = 0.085 and 0.08). Conclusions The increase of CACs in statins-treated DM patients indicates the progression of compositional PVs. From a per-plaque perspective, there might be increased instability of individual plaques concomitant with CACs increase in LDL-C uncontrolled patients. Supplementary Information The online version contains supplementary material available at 10.1186/s12933-022-01556-y.
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Affiliation(s)
- Rui Shi
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Yue Gao
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Li-Ling Shen
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Ke Shi
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Jin Wang
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Li Jiang
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Yuan Li
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, 610041, Sichuan, China.
| | - Zhi-Gang Yang
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, 610041, Sichuan, China.
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22
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Prognostic significance of multiple triglycerides-derived metabolic indices in patients with acute coronary syndrome. J Geriatr Cardiol 2022; 19:456-468. [PMID: 35845160 PMCID: PMC9248272 DOI: 10.11909/j.issn.1671-5411.2022.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Triglyceride (TG) and its related metabolic indices, all recognized as surrogates of insulin resistance, have been demonstrated to be relevant to clinical prognosis. However, the relative value of these TG-related indices for predicting cardiovascular events among patients with acute coronary syndrome (ACS) has not been examined. METHODS The TG, the triglyceride-glucose (TyG) index, the atherogenic index of plasma, TG to high-density lipoprotein cholesterol ratio, and the lipoprotein combine index were assessed in 1694 ACS patients undergoing percutaneous coronary intervention. The primary endpoint was major adverse cardiovascular event (MACE), which was the composite of all-cause mortality, stroke, myocardial infarction, or unplanned repeat revascularization. RESULTS During a median follow-up of 31 months, 345 patients (20.4%) had MACE. The risk of the MACE was increased with higher TG and the four TG-derived metabolic indices [TG-adjusted hazard ratio (HR) = 1.002, 95% CI: 1.001-1.003; TyG index-adjusted HR = 1.736, 95% CI: 1.398-2.156; atherogenic index of plasma-adjusted HR = 2.513, 95% CI: 1.562-4.043; TG to high-density lipoprotein cholesterol ratio-adjusted HR = 1.148, 95% CI: 1.048-1.258; and lipoprotein combine index-adjusted HR = 1.009, 95% CI: 1.004-1.014; P < 0.001 for all indices]. TG and all the four indices significantly improved the predictive ability for MACE in addition to the baseline model. Among them, TyG index showed the best ability for predicting MACE compared with the other three indices from all the three measurements ( P < 0.05 for all comparison). CONCLUSIONS TG and TG-derived metabolic indices were all strongly associated with MACE among ACS patients undergoing percutaneous coronary intervention. Among all the indices, TyG index showed the best ability to predict the risk of MACE.
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23
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Chen J, Lai K, Yong X, Yin H, Chen Z, Wang H, Chen K, Zheng J. Silencing METTL3 Stabilizes Atherosclerotic Plaques by Regulating the Phenotypic Transformation of Vascular Smooth Muscle Cells via the miR-375-3p/PDK1 Axis. Cardiovasc Drugs Ther 2022; 37:471-486. [PMID: 35704246 DOI: 10.1007/s10557-022-07348-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/16/2022] [Indexed: 12/27/2022]
Abstract
PURPOSE Atherosclerosis (AS) is a primary cause of cardiovascular diseases. This study investigated the mechanism of methyltransferase-like 3 (METTL3) in AS plaques via modulating the phenotypic transformation of vascular smooth muscle cells (VSMCs). METHODS AS mouse models and MOVAS cell models were established through high-fat diet and the treatment of ox-LDL, respectively. METTL3 expression in AS models was detected via RT-qPCR and Western blot. The AS plaques, lipid deposition, and collagen fibers were examined via histological staining. The levels of Ly-6c, α-SMA, and OPN were examined via Western blot. The blood lipid indexes in mouse aortic tissues were determined using kits. The proliferation and migration of MOVAS cells were detected via CCK-8 and Transwell assays. The m6A modification level of mRNA was quantified. The binding relationship between pri-miR-375 and DGCR8, and the enrichment of m6A on pri-miR-375 were detected via RIP. The binding relationship between miR-375-3p and 3-phosphoinositide-dependent protein kinase-1 (PDK1) was verified via dual-luciferase assay. Joint experiments were designed to investigate the role of miR-375-3P/PDK1 in the phenotypic transformation of VSMCs. RESULTS METTL3 was highly expressed in AS. Silencing METTL3 alleviated AS progression and stabilized AS plaques in mice, and limited the phenotypic transformation of VSMCs induced by ox-LDL. Silencing METTL3 inhibited m6A level and decreased the binding of DGCR8 to pri-miR-375 and further limited miR-375-3p expression. miR-375-3p targeted PDK1 transcription. miR-375-3p upregulation or PDK1 downregulation facilitated the phenotypic transformation of VSMCs. CONCLUSION METTL3-mediated m6A modification promoted VSMC phenotype transformation and made AS plaques more vulnerable via the miR-375-3p/PDK1 axis.
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Affiliation(s)
- Jingquan Chen
- Department of Vascular Surgery, Affiliated Hospital of North Sichuan Medical College, No.1 Maoyuan south road, Shunqing district, Nanchong, 637000, Sichuan, China
| | - Kun Lai
- Department of Vascular Surgery, Affiliated Hospital of North Sichuan Medical College, No.1 Maoyuan south road, Shunqing district, Nanchong, 637000, Sichuan, China
| | - Xi Yong
- Department of Vascular Surgery, Affiliated Hospital of North Sichuan Medical College, No.1 Maoyuan south road, Shunqing district, Nanchong, 637000, Sichuan, China
| | - Hongshun Yin
- Department of Vascular Surgery, Affiliated Hospital of North Sichuan Medical College, No.1 Maoyuan south road, Shunqing district, Nanchong, 637000, Sichuan, China
| | - Zhilong Chen
- Department of Vascular Surgery, Affiliated Hospital of North Sichuan Medical College, No.1 Maoyuan south road, Shunqing district, Nanchong, 637000, Sichuan, China
| | - Haifei Wang
- Department of Vascular Surgery, Affiliated Hospital of North Sichuan Medical College, No.1 Maoyuan south road, Shunqing district, Nanchong, 637000, Sichuan, China
| | - Kai Chen
- Department of Vascular Surgery, Affiliated Hospital of North Sichuan Medical College, No.1 Maoyuan south road, Shunqing district, Nanchong, 637000, Sichuan, China
| | - Jianghua Zheng
- Department of Vascular Surgery, Affiliated Hospital of North Sichuan Medical College, No.1 Maoyuan south road, Shunqing district, Nanchong, 637000, Sichuan, China.
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Guo X, Maehara A, Yang M, Wang L, Zheng J, Samady H, Mintz GS, Giddens DP, Tang D. Predicting Coronary Stenosis Progression Using Plaque Fatigue From IVUS-Based Thin-Slice Models: A Machine Learning Random Forest Approach. Front Physiol 2022; 13:912447. [PMID: 35620594 PMCID: PMC9127388 DOI: 10.3389/fphys.2022.912447] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 04/22/2022] [Indexed: 11/22/2022] Open
Abstract
Introduction: Coronary stenosis due to atherosclerosis restricts blood flow. Stenosis progression would lead to increased clinical risk such as heart attack. Although many risk factors were found to contribute to atherosclerosis progression, factors associated with fatigue is underemphasized. Our goal is to investigate the relationship between fatigue and stenosis progression based on in vivo intravascular ultrasound (IVUS) images and finite element models. Methods: Baseline and follow-up in vivo IVUS and angiography data were acquired from seven patients using Institutional Review Board approved protocols with informed consent obtained. Three hundred and five paired slices at baseline and follow-up were matched and used for plaque modeling and analysis. IVUS-based thin-slice models were constructed to obtain the coronary biomechanics and stress/strain amplitudes (stress/strain variations in one cardiac cycle) were used as the measurement of fatigue. The change of lumen area (DLA) from baseline to follow-up were calculated to measure stenosis progression. Nineteen morphological and biomechanical factors were extracted from 305 slices at baseline. Correlation analyses of these factors with DLA were performed. Random forest (RF) method was used to fit morphological and biomechanical factors at baseline to predict stenosis progression during follow-up. Results: Significant correlations were found between stenosis progression and maximum stress amplitude, average stress amplitude and average strain amplitude (p < 0.05). After factors selection implemented by random forest (RF) method, eight morphological and biomechanical factors were selected for classification prediction of stenosis progression. Using eight factors including fatigue, the overall classification accuracy, sensitivity and specificity of stenosis progression prediction with RF method were 83.61%, 86.25% and 80.69%, respectively. Conclusion: Fatigue correlated positively with stenosis progression. Factors associated with fatigue could contribute to better prediction for atherosclerosis progression.
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Affiliation(s)
- Xiaoya Guo
- School of Science, Nanjing University of Posts and Telecommunications, Nanjing, China
| | - Akiko Maehara
- The Cardiovascular Research Foundation, Columbia University, New York, NY, United States
| | - Mingming Yang
- Department of Cardiology, Zhongda Hospital, Southeast University, Nanjing, China
| | - Liang Wang
- School of Biological Science and Medical Engineering, Southeast University, Nanjing, China
| | - Jie Zheng
- Mallinckrodt Institute of Radiology, Washington University, St. Louis, MO, United States
| | - Habib Samady
- Department of Medicine, Emory University School of Medicine, Atlanta, GA, United States
| | - Gary S Mintz
- The Cardiovascular Research Foundation, Columbia University, New York, NY, United States
| | - Don P Giddens
- Department of Medicine, Emory University School of Medicine, Atlanta, GA, United States
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, United States
| | - Dalin Tang
- School of Biological Science and Medical Engineering, Southeast University, Nanjing, China
- Mathematical Sciences Department, Worcester Polytechnic Institute, Worcester, MA, United States
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25
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Li Z, He Y, Wang S, Li L, Yang R, Liu Y, Cheng Q, Yu L, Zheng Y, Zheng H, Gao S, Yu C. Association between triglyceride glucose index and carotid artery plaque in different glucose metabolic states in patients with coronary heart disease: a RCSCD-TCM study in China. Cardiovasc Diabetol 2022; 21:38. [PMID: 35277186 PMCID: PMC8917731 DOI: 10.1186/s12933-022-01470-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 02/28/2022] [Indexed: 01/14/2023] Open
Abstract
Background The triglyceride glucose (TyG) index serves as a surrogate indicator of insulin resistance. However, there is limited evidence on the association between the TyG index and carotid artery plaque (CAP) in patients with coronary heart disease (CHD). Methods The 10,535 CHD patients were divided according to TyG index quartiles (Q1: TyG index < 8.52; Q2: 8.52 ≤ TyG index < 8.93; Q3: 8.93 ≤ TyG index ≤ 9.40; Q4: TyG index > 9.40). The presence or absence of CAP was determined by carotid ultrasonography. Logistic regression was used to analyze the relationship between the TyG index and CAP in CHD patients. The relationship between the TyG index and CAP in according to sex, age groups, and glucose metabolism states were also assessed. Results The baseline analysis showed that there were significant differences in related parameters among CHD patients divided into four groups according to the quartile of the TyG index. In the multi-adjusted modles, compared to Q1 of the TyG index, the odds ratios (OR) for Q4 of the TyG index for CAP were 1.37 (95% confidence interval [CI] 1.28–1.47) in CHD patients. The association between the TyG index and CAP in female (OR: 1.35; 95% CI 1.29–1.43) was higher than that in male (OR: 1.20; 95% CI 1.13–1.27). The OR value of middle-aged (≤ 60 years old) patients (OR: 1.34; 95% CI 1.26–1.42) was higher than that in elderly (> 60 years old) patients (OR: 1.16; 95% CI 1.11–1.22). In different glucose metabolism states, the TyG index of CHD patients was significantly related to the risk of CAP, with the highest OR value observed for diabetes (OR: 1.36; 95% CI 1.26–1.46). Conclusions The TyG index and CAP showed a significant association in CHD patients. This association between TyG index and CAP in CHD patients is higher in female than in male, and the association in middle-aged and elderly patients is higher than that in elderly patients. In the condition of DM, the association between TyG index and carotid artery plaque in CHD patients is higher. Graphical abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s12933-022-01470-3.
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26
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Jiang ZZ, Zhu JB, Shen HL, Zhao SS, Tang YY, Tang SQ, Liu XT, Jiang TA. A High Triglyceride-Glucose Index Value Is Associated With an Increased Risk of Carotid Plaque Burden in Subjects With Prediabetes and New-Onset Type 2 Diabetes: A Real-World Study. Front Cardiovasc Med 2022; 9:832491. [PMID: 35310963 PMCID: PMC8927542 DOI: 10.3389/fcvm.2022.832491] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 02/09/2022] [Indexed: 12/30/2022] Open
Abstract
Background The triglyceride-glucose (TyG) index has been proposed as a convincing indicator of insulin resistance and has been found to be associated with atherosclerosis among diabetic patients. However, the relationship between the TyG index and arteriosclerosis in subjects with prediabetes and new-onset type 2 diabetes (T2D) remains uncertain. The purpose of this study was to assess the degree of carotid plaque burden in patients with prediabetes and new-onset T2D and to investigate the association between the TyG index and the degree of carotid plaque burden in this population. Methods This was a cross-sectional observational study that included 716 subjects aged 40–70 years old with prediabetes or new-onset T2D. Demographic, anthropometric, and laboratory measurements were collected. Participants underwent carotid arteriosclerosis evaluation by ultrasonography, and the degree of atherosclerosis was evaluated according to the carotid plaque burden. The TyG index was calculated. Results The population was stratified into high or low TyG index groups according to the median TyG index value. Higher values were associated with a higher BMI and waist circumference as well as higher total cholesterol, triglyceride, low-density lipoprotein cholesterol, plasma glucose, glycated hemoglobin, fasting C-peptide, and C-reactive protein levels (P < 0.001). The high TyG index group had a higher atherosclerotic plaque burden than the low TyG index group (P < 0.001). Multiclassification logistic regression analysis showed that the TyG index was positively associated with a high plaque burden [odds ratio (OR): 16.706, 95% confidence interval (CI): 3.988–69.978, P = 0.000], while no association was found between the TyG index and a low/moderate plaque burden. This association remained consistent in the subgroup analysis. In multiple linear regression analysis, sex, age, and the TyG index were found to be independently associated with carotid plaque burden. For each unit increase in the TyG index, the risk of a high carotid plaque burden increased 1.595-fold. Conclusion A high TyG index was positively associated with a high carotid plaque burden in subjects with prediabetes and new-onset T2D. Clinicians should pay close attention to the TyG index to help these patients receive the greatest benefit from early intervention.
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Affiliation(s)
- Zhen-zhen Jiang
- Department of Ultrasound Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Department of Ultrasound, Shaoxing People's Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Shaoxing, China
| | - Jian-bo Zhu
- Department of Ultrasound, Shaoxing People's Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Shaoxing, China
| | - Hua-liang Shen
- Department of Ultrasound, Shaoxing People's Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Shaoxing, China
| | - Shan-shan Zhao
- Department of Ultrasound, Shaoxing People's Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Shaoxing, China
| | - Yun-yi Tang
- Department of Ultrasound, Shaoxing People's Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Shaoxing, China
| | - Shao-qi Tang
- Department of Ultrasound, Shaoxing People's Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Shaoxing, China
| | - Xia-tian Liu
- Department of Ultrasound, Shaoxing People's Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Shaoxing, China
- Xia-tian Liu
| | - Tian-an Jiang
- Department of Ultrasound Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Pulsed Power Translational Medicine of Zhejiang Province, Hangzhou, China
- Zhejiang University Cancer Center, Zhejiang, China
- *Correspondence: Tian-an Jiang
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27
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Williams MC, Earls JP, Hecht H. Quantitative assessment of atherosclerotic plaque, recent progress and current limitations. J Cardiovasc Comput Tomogr 2022; 16:124-137. [PMID: 34326003 DOI: 10.1016/j.jcct.2021.07.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 06/29/2021] [Accepted: 07/09/2021] [Indexed: 12/11/2022]
Abstract
An important advantage of computed tomography coronary angiography (CCTA) is its ability to visualize the presence and severity of atherosclerotic plaque, rather than just assessing coronary artery stenoses. Until recently, assessment of plaque subtypes on CCTA relied on visual assessment of the extent of calcified/non-calcified plaque, or visually identifying high-risk plaque characteristics. Recent software developments facilitate the quantitative assessment of plaque volume or burden on CCTA, and the identification of subtypes of plaque based on their attenuation density. These techniques have shown promise in single and multicenter studies, demonstrating that the amount and type of plaque are associated with subsequent cardiac events. However, there are a number of limitations to the application of these techniques, including the limitations imposed by the spatial resolution of current CT scanners, challenges from variations between reconstruction algorithms, and the additional time to perform these assessments. At present, these are a valuable research technique, but not yet part of routine clinical practice. Future advances that improve CT resolution, standardize acquisition techniques and reconstruction algorithms and automate image analysis will improve the clinical utility of these techniques. This review will discuss the technical aspects of quantitative plaque analysis and present pro and con arguments for the routine use of quantitative plaque analysis on CCTA.
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Affiliation(s)
- Michelle C Williams
- BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK.
| | - James P Earls
- George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Harvey Hecht
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
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28
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Luo JW, Duan WH, Yu YQ, Song L, Shi DZ. Prognostic Significance of Triglyceride-Glucose Index for Adverse Cardiovascular Events in Patients With Coronary Artery Disease: A Systematic Review and Meta-Analysis. Front Cardiovasc Med 2021; 8:774781. [PMID: 34926622 PMCID: PMC8674619 DOI: 10.3389/fcvm.2021.774781] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 10/29/2021] [Indexed: 01/04/2023] Open
Abstract
Background: Insulin resistance (IR) represents a critical regulator in the development and progress of coronary artery disease (CAD). Triglyceride-glucose (TyG) index, a novel surrogate biomarker of IR, has been implicated in several cardiovascular diseases. Accordingly, we conduct a meta-analysis to elucidate the relationship between TyG index and adverse cardiovascular events in patients with CAD. Methods: To identify the studies examining the predictive capacity of the TyG index for adverse cardiovascular events in the setting of CAD, we performed a comprehensive literature retrieval of Scopus, PubMed, EMBASE, and Web of Science, from the inception of databases to October 5, 2021. We pooled the adjusted hazard ratio (HR) along with 95% CI using a random-effects model. The primary outcome was a composite of major adverse cardiovascular events (MACEs), including all-cause death, cardiovascular death (CV death), myocardial infarction (MI), stroke, hospitalization for unstable angina or heart failure, and revascularization. The secondary outcomes were all-cause death, CV death, MI, stroke, and revascularization. Additionally, we conducted subgroup analyses stratified by diabetes status, age, body mass index (BMI), low-density lipoprotein cholesterol (LDL-C), category of TyG index, sample size, follow-up duration, and study design. Results: About 12 studies involving 28,795 patients with CAD were finally taken into the quantitative analysis. Our findings showed that there was a 2.14-fold higher risk of MACEs among CAD populations in the highest TyG group compared with those in the lowest TyG group (HR: 2.14, 95% CI: 1.69–2.71, P < 0.001). A greater risk of MACEs was observed in participants with higher BMI than those with lower BMI (P = 0.03 for interaction). In the analysis of secondary outcomes, we also observed a markedly increased risk of MI, stroke, and revascularization in the highest TyG group compared with the lowest TyG group. No evidence of a significant association between TyG index and CV mortality or all-cause mortality in patients with CAD was identified. Conclusions: The elevated TyG index is a promising predictive factor of adverse cardiovascular events in patients with CAD. Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO, identifier: CRD42021228521.
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Affiliation(s)
- Jin-Wen Luo
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Science, Beijing, China
| | - Wen-Hui Duan
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Science, Beijing, China
| | - Yan-Qiao Yu
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Lei Song
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Da-Zhuo Shi
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Science, Beijing, China
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29
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Szilveszter B, Vattay B, Bossoussou M, Vecsey-Nagy M, Simon J, Merkely B, Maurovich-Horvat P, Kolossváry M. CAD-RADS may underestimate coronary plaque progression as detected by serial CT angiography. Eur Heart J Cardiovasc Imaging 2021; 23:1530-1539. [PMID: 34687544 PMCID: PMC9584618 DOI: 10.1093/ehjci/jeab215] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 10/11/2021] [Indexed: 11/30/2022] Open
Abstract
Aims We wished to assess whether different clinical definitions of coronary artery disease (CAD) [segment stenosis and involvement score (SSS, SIS), Coronary Artery Disease—Reporting and Data System (CAD-RADS)] affect which patients are considered to progress and which risk factors affect progression. Methods and results We enrolled 115 subsequent patients (60.1 ± 9.6 years, 27% female) who underwent serial coronary computed tomography angiography (CTA) imaging with >1year between the two examinations. CAD was described using SSS, SIS, and CAD-RADS. Linear mixed models were used to investigate the effects of risk factors on the overall amount of CAD and the effect on annual progression rate of different definitions. Coronary plaque burdens were SSS 4.63 ± 4.06 vs. 5.67 ± 5.10, P < 0.001; SIS 3.43 ± 2.53 vs. 3.89 ± 2.65, P < 0.001; CAD-RADS 0:8.7% vs. 0.0% 1:44.3% vs. 40.9%, 2:34.8% vs. 40.9%, 3:7.0% vs. 9.6% 4:3.5% vs. 6.1% 5:1.7% vs. 2.6%, P < 0.001, at baseline and follow-up, respectively. Overall, 53.0%, 29.6%, and 28.7% of patients progressed over time based on SSS, SIS, and CAD-RADS, respectively. Of the patients who progressed based on SSS, only 54% showed changes in CAD-RADS. Smoking and diabetes increased the annual progression rate of SSS by 0.37/year and 0.38/year, respectively (both P < 0.05). Furthermore, each year increase in age raised SSS by 0.12 [confidence interval (CI) 0.05–0.20, P = 0.001] and SIS 0.10 (CI 0.06–0.15, P < 0.001), while female sex was associated with 2.86 lower SSS (CI −4.52 to −1.20, P < 0.001) and 1.68 SIS values (CI −2.65 to −0.77, P = 0.001). Conclusion CAD-RADS could not capture the progression of CAD in almost half of patients with serial CTA. Differences in CAD definitions may lead to significant differences in patients who are considered to progress, and which risk factors are considered to influence progression.
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Affiliation(s)
- Bálint Szilveszter
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, 68 Városmajor st, 1122 Budapest, Hungary
| | - Borbála Vattay
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, 68 Városmajor st, 1122 Budapest, Hungary
| | - Melinda Bossoussou
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, 68 Városmajor st, 1122 Budapest, Hungary
| | - Milán Vecsey-Nagy
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, 68 Városmajor st, 1122 Budapest, Hungary
| | - Judit Simon
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, 68 Városmajor st, 1122 Budapest, Hungary
| | - Béla Merkely
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, 68 Városmajor st, 1122 Budapest, Hungary
| | - Pál Maurovich-Horvat
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, 68 Városmajor st, 1122 Budapest, Hungary.,Medical Imaging Centre, Semmelweis University, 2 Korányi Sándor st, 1083 Budapest, Hungary
| | - Márton Kolossváry
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, 68 Városmajor st, 1122 Budapest, Hungary
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30
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Triglycerides and low HDL cholesterol predict coronary heart disease risk in patients with stable angina. Sci Rep 2021; 11:20714. [PMID: 34671067 PMCID: PMC8528835 DOI: 10.1038/s41598-021-00020-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 10/05/2021] [Indexed: 12/12/2022] Open
Abstract
We assessed whether high triglycerides (TG) and low high-density lipoprotein cholesterol (HDL-C) levels, expressed by an increased TG/HDL-C ratio, predict coronary atherosclerotic disease (CAD) outcomes in patients with stable angina. We studied 355 patients (60 ± 9 years, 211 males) with stable angina who underwent coronary computed tomography angiography (CTA), were managed clinically and followed for 4.5 ± 0.9 years. The primary composite outcome was all-cause mortality and non-fatal myocardial infarction. At baseline, the proportion of males, patients with metabolic syndrome, diabetes and obstructive CAD increased across TG/HDL-C ratio quartiles, together with markers of insulin resistance, hepatic and adipose tissue dysfunction and myocardial damage, with no difference in total cholesterol or LDL-C. At follow-up, the global CTA risk score (HR 1.06, 95% confidence interval (CI) 1.03–1.09, P = 0.001) and the IV quartile of the TG/HDL-C ratio (HR 2.85, 95% CI 1.30–6.26, P < 0.01) were the only independent predictors of the primary outcome. The TG/HDL-C ratio and the CTA risk score progressed over time despite increased use of lipid-lowering drugs and reduction in LDL-C. In patients with stable angina, high TG and low HDL-C levels are associated with CAD related outcomes independently of LDL-C and treatments. Trial registration. EVINCI study: ClinicalTrials.gov NCT00979199, registered September 17, 2009; SMARTool study: ClinicalTrials.gov NCT04448691, registered June 26, 2020.
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31
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Aimo A, Chiappino S, Clemente A, Della Latta D, Martini N, Georgiopoulos G, Panichella G, Piagneri V, Storti S, Monteleone A, Passino C, Chiappino D, Emdin M, Gimelli A, Neglia D. The triglyceride/HDL cholesterol ratio and TyG index predict coronary atherosclerosis and outcome in the general population. Eur J Prev Cardiol 2021; 29:e203-e204. [PMID: 34626171 DOI: 10.1093/eurjpc/zwab164] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Alberto Aimo
- Institute of Life Sciences, Scuola Superiore Sant'Anna, Piazza Martiri della Libertà 33, 56127, Pisa, Italy.,Cardiology Division, Fondazione Toscana Gabriele Monasterio, Via Moruzzi 1, 56124 Pisa, Italy
| | - Sara Chiappino
- Cardiology Division, Fondazione Toscana Gabriele Monasterio, Via Moruzzi 1, 56124 Pisa, Italy
| | - Alberto Clemente
- Cardiology Division, Fondazione Toscana Gabriele Monasterio, Via Moruzzi 1, 56124 Pisa, Italy
| | - Daniele Della Latta
- Cardiology Division, Fondazione Toscana Gabriele Monasterio, Via Moruzzi 1, 56124 Pisa, Italy
| | - Nicola Martini
- Cardiology Division, Fondazione Toscana Gabriele Monasterio, Via Moruzzi 1, 56124 Pisa, Italy
| | - Georgios Georgiopoulos
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens 157 72, Greece.,School of Biomedical Engineering and Imaging Sciences, King's College London, Strand, London WC2R 2LS, UK
| | - Giorgia Panichella
- Institute of Life Sciences, Scuola Superiore Sant'Anna, Piazza Martiri della Libertà 33, 56127, Pisa, Italy
| | - Valeria Piagneri
- Cardiology Division, Fondazione Toscana Gabriele Monasterio, Via Moruzzi 1, 56124 Pisa, Italy
| | - Simona Storti
- Cardiology Division, Fondazione Toscana Gabriele Monasterio, Via Moruzzi 1, 56124 Pisa, Italy
| | - Angelo Monteleone
- Cardiology Division, Fondazione Toscana Gabriele Monasterio, Via Moruzzi 1, 56124 Pisa, Italy
| | - Claudio Passino
- Institute of Life Sciences, Scuola Superiore Sant'Anna, Piazza Martiri della Libertà 33, 56127, Pisa, Italy.,Cardiology Division, Fondazione Toscana Gabriele Monasterio, Via Moruzzi 1, 56124 Pisa, Italy
| | - Dante Chiappino
- Cardiology Division, Fondazione Toscana Gabriele Monasterio, Via Moruzzi 1, 56124 Pisa, Italy
| | - Michele Emdin
- Institute of Life Sciences, Scuola Superiore Sant'Anna, Piazza Martiri della Libertà 33, 56127, Pisa, Italy.,Cardiology Division, Fondazione Toscana Gabriele Monasterio, Via Moruzzi 1, 56124 Pisa, Italy
| | - Alessia Gimelli
- Cardiology Division, Fondazione Toscana Gabriele Monasterio, Via Moruzzi 1, 56124 Pisa, Italy
| | - Danilo Neglia
- Institute of Life Sciences, Scuola Superiore Sant'Anna, Piazza Martiri della Libertà 33, 56127, Pisa, Italy.,Cardiology Division, Fondazione Toscana Gabriele Monasterio, Via Moruzzi 1, 56124 Pisa, Italy
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Neglia D, Aimo A, Lorenzoni V, Caselli C, Gimelli A. Triglyceride-glucose index predicts outcome in patients with chronic coronary syndrome independently of other risk factors and myocardial ischaemia. EUROPEAN HEART JOURNAL OPEN 2021; 1:oeab004. [PMID: 35919094 PMCID: PMC9242059 DOI: 10.1093/ehjopen/oeab004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 05/22/2021] [Accepted: 06/09/2021] [Indexed: 05/27/2023]
Abstract
AIMS The triglyceride-glucose (TyG) index, a surrogate marker of insulin resistance (IR), is a prognostic risk factor in the general population. We aimed to assess whether it is an independent predictor of outcome also in patients with chronic coronary syndrome (CCS). METHODS AND RESULTS TyG index was evaluated in 1097 consecutive patients (75% men, median age 72 years) with known (26%) or suspected coronary artery disease (CAD), undergoing stress-rest myocardial perfusion scintigraphy, and coronary angiography and followed up for a median of 4.5 years. Moderate/severe perfusion abnormalities during stress (summed stress score >7) were documented in 60% of patients, obstructive CAD in 74%, and 36% underwent early revascularization. TyG index was 8.9 (median, interquartile interval 8.6-9.2). Cardiac death or myocardial infarction occurred in 103 patients and all-cause death in 65. After correction for clinical risk factors, LV function and common bio-humoral variables, TyG index (HR 2.42, 95% CI 1.57-3.72, P < 0.001), and moderate/severe stress perfusion abnormalities (hazard ratio (HR) 2.17, 95% confidence interval (CI) 1.25-3.77, P < 0.001) independently predicted cardiac events. TyG index (HR 3.64, 95%CI 2.22-5.96, P < 0.001) and high-sensitivity C-reactive protein (HR 1.11, 95% CI 1.04-1.19, P = 0.002) independently predicted all-cause death. CONCLUSION In patients with CCS, the TyG index identifies a cardiometabolic profile associated with an additional risk of cardiac events, over the presence of myocardial ischaemia and independently of other clinical, common bio-humoral or imaging risk determinants.
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Affiliation(s)
- Danilo Neglia
- Fondazione CNR/Regione Toscana Gabriele Monasterio, Cardiovascular and Imaging Departments, CNR Research Area, Via G. Moruzzi 1, Pisa 56124, Italy
- Scuola Superiore Sant'Anna, Piazza Martiri della Libertà 33, Pisa 56127, Italy
| | - Alberto Aimo
- Fondazione CNR/Regione Toscana Gabriele Monasterio, Cardiovascular and Imaging Departments, CNR Research Area, Via G. Moruzzi 1, Pisa 56124, Italy
- Scuola Superiore Sant'Anna, Piazza Martiri della Libertà 33, Pisa 56127, Italy
| | - Valentina Lorenzoni
- Scuola Superiore Sant'Anna, Piazza Martiri della Libertà 33, Pisa 56127, Italy
| | - Chiara Caselli
- Fondazione CNR/Regione Toscana Gabriele Monasterio, Cardiovascular and Imaging Departments, CNR Research Area, Via G. Moruzzi 1, Pisa 56124, Italy
- CNR Institute of Clinical Physiology, CNR Research Area, Via G. Moruzzi n. 1, Pisa 56124, Italy
| | - Alessia Gimelli
- Fondazione CNR/Regione Toscana Gabriele Monasterio, Cardiovascular and Imaging Departments, CNR Research Area, Via G. Moruzzi 1, Pisa 56124, Italy
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33
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Wu S, Xu L, Wu M, Chen S, Wang Y, Tian Y. Association between triglyceride-glucose index and risk of arterial stiffness: a cohort study. Cardiovasc Diabetol 2021; 20:146. [PMID: 34271940 PMCID: PMC8285795 DOI: 10.1186/s12933-021-01342-2] [Citation(s) in RCA: 79] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 07/09/2021] [Indexed: 02/27/2023] Open
Abstract
BACKGROUND Triglyceride-glucose (TyG) index, a simple surrogate marker of insulin resistance, has been reported to be associated with arterial stiffness. However, previous studies were limited by the cross-sectional design. The purpose of this study was to explore the longitudinal association between TyG index and progression of arterial stiffness. METHODS A total of 6028 participants were derived from the Kailuan study. TyG index was calculated as ln [fasting triglyceride (mg/dL) × fasting glucose (mg/dL)/2]. Arterial stiffness was measured using brachial-ankle pulse wave velocity (baPWV). Arterial stiffness progression was assessed by the annual growth rate of repeatedly measured baPWV. Multivariate linear regression models were used to estimate the cross-sectional association of TyG index with baPWV, and Cox proportional hazard models were used to investigate the longitudinal association between TyG index and the risk of arterial stiffness. RESULTS Multivariate linear regression analyses showed that each one unit increase in the TyG index was associated with a 39 cm/s increment (95%CI, 29-48 cm/s, P < 0.001) in baseline baPWV and a 0.29 percent/year increment (95%CI, 0.17-0.42 percent/year, P < 0.001) in the annual growth rate of baPWV. During 26,839 person-years of follow-up, there were 883 incident cases with arterial stiffness. Participants in the highest quartile of TyG index had a 58% higher risk of arterial stiffness (HR, 1.58; 95%CI, 1.25-2.01, P < 0.001), as compared with those in the lowest quartile of TyG index. Additionally, restricted cubic spline analysis showed a significant dose-response relationship between TyG index and the risk of arterial stiffness (P non-linearity = 0.005). CONCLUSION Participants with a higher TyG index were more likely to have a higher risk of arterial stiffness. Subjects with a higher TyG index should be aware of the following risk of arterial stiffness progression, so as to establish lifestyle changes at an early stage.
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Affiliation(s)
- Shouling Wu
- Department of Cardiology, Kailuan General Hospital, North China University of Science and Technology, No.57 Xinhua East Street, Tangshan, 063000, China
| | - Luli Xu
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, Wuhan, 430030, China.,Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, Wuhan, 430030, China
| | - Mingyang Wu
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, Wuhan, 430030, China.,Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, Wuhan, 430030, China
| | - Shuohua Chen
- Department of Cardiology, Kailuan General Hospital, North China University of Science and Technology, No.57 Xinhua East Street, Tangshan, 063000, China
| | - Youjie Wang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, Wuhan, 430030, China.,Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, Wuhan, 430030, China
| | - Yaohua Tian
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, Wuhan, 430030, China. .,Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, Wuhan, 430030, China.
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Zhu Y, Liu K, Chen M, Liu Y, Gao A, Hu C, Li H, Zhu H, Han H, Zhang J, Zhao Y. Triglyceride-glucose index is associated with in-stent restenosis in patients with acute coronary syndrome after percutaneous coronary intervention with drug-eluting stents. Cardiovasc Diabetol 2021; 20:137. [PMID: 34238294 PMCID: PMC8268452 DOI: 10.1186/s12933-021-01332-4] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 06/30/2021] [Indexed: 12/19/2022] Open
Abstract
Background The triglyceride-glucose (TyG) index is an alternative marker of insulin resistance (IR) and is closely associated with the prevalence and prognosis of atherosclerotic cardiovascular disease (ASCVD). However, the association between the TyG index and in-stent restenosis (ISR) after drug-eluting stent (DES) implantation in patients with acute coronary syndrome (ACS) remains unknown. Methods The present study retrospectively recruited patients who were admitted for ACS and underwent coronary angiography at 6 to 24 months after successful DES-based percutaneous coronary intervention (PCI). In addition, we calculated the TyG index with the following formula: Ln(fasting triglyceride [mg/dL] × fasting blood glucose [mg/dL]/2) and divided patients into 3 groups according to the tertile of the TyG index. Most importantly, multivariate logistic regression analysis models were also constructed to assess the association between the TyG index and DES-ISR in patients with ACS. Results A total of 1574 patients with ACS (58.4 ± 9.4 years, 77.4% male) were included in this study. At the median follow-up time of 12 (9–14) months, the prevalence of DES-ISR increased stepwise with the increasing tertile of the TyG index (11.6% vs 17.3% vs 19.4%, p = 0.002), and the TyG index was also higher in the ISR group than in the non-ISR group (9.00 ± 0.58 vs 8.84 ± 0.61, p < 0.001). In addition, the positive association between the TyG index and the prevalence of DES-ISR was also determined in the fully adjusted model (TyG, per 1-unit increase: OR 1.424, 95% CI 1.116 to 1.818, p = 0.005; tertile of TyG, the OR (95% CI) values for tertile 2 and tertile 3 were 1.454 (1.013 to 2.087) and 1.634 (1.125 to 2.374), respectively, with tertile 1 as a reference). The association was also reflected in most subgroups. Moreover, adding the TyG index to the predictive model for DES-ISR in patients with ACS could contribute to an increase in C-statistics (0.675 vs 0.659, p = 0.010), categorical net reclassification improvement (0.090, p < 0.001), and integrated discrimination improvement (0.004, p = 0.040). Conclusion An elevated TyG index was independently and positively associated with DES-ISR in patients with ACS who underwent PCI. However, the incremental predictive value of the TyG index for DES-ISR was slight. To further confirm our findings, future studies are needed. Supplementary Information The online version contains supplementary material available at 10.1186/s12933-021-01332-4.
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Affiliation(s)
- Yong Zhu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China
| | - Kesen Liu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China
| | - Maolin Chen
- Department of Emergency, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China
| | - Yan Liu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China
| | - Ang Gao
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China
| | - Chengping Hu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China
| | - Hong Li
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China
| | - Huagang Zhu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China
| | - Hongya Han
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China
| | - Jianwei Zhang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China
| | - Yingxin Zhao
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China.
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35
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Rajbhandari J, Fernandez CJ, Agarwal M, Yeap BXY, Pappachan JM. Diabetic heart disease: A clinical update. World J Diabetes 2021; 12:383-406. [PMID: 33889286 PMCID: PMC8040078 DOI: 10.4239/wjd.v12.i4.383] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 02/27/2021] [Accepted: 03/13/2021] [Indexed: 02/06/2023] Open
Abstract
Diabetes mellitus (DM) significantly increases the risk of heart disease, and DM-related healthcare expenditure is predominantly for the management of cardiovascular complications. Diabetic heart disease is a conglomeration of coronary artery disease (CAD), cardiac autonomic neuropathy (CAN), and diabetic cardiomyopathy (DCM). The Framingham study clearly showed a 2 to 4-fold excess risk of CAD in patients with DM. Pathogenic mechanisms, clinical presentation, and management options for DM-associated CAD are somewhat different from CAD among nondiabetics. Higher prevalence at a lower age and more aggressive disease in DM-associated CAD make diabetic individuals more vulnerable to premature death. Although common among diabetic individuals, CAN and DCM are often under-recognised and undiagnosed cardiac complications. Structural and functional alterations in the myocardial innervation related to uncontrolled diabetes result in damage to cardiac autonomic nerves, causing CAN. Similarly, damage to the cardiomyocytes from complex pathophysiological processes of uncontrolled DM results in DCM, a form of cardiomyopathy diagnosed in the absence of other causes for structural heart disease. Though optimal management of DM from early stages of the disease can reduce the risk of diabetic heart disease, it is often impractical in the real world due to many reasons. Therefore, it is imperative for every clinician involved in diabetes care to have a good understanding of the pathophysiology, clinical picture, diagnostic methods, and management of diabetes-related cardiac illness, to reduce morbidity and mortality among patients. This clinical review is to empower the global scientific fraternity with up-to-date knowledge on diabetic heart disease.
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Affiliation(s)
- Jake Rajbhandari
- College of Medical and Dental Sciences, University of Birmingham Medical School, Birmingham B15 2TH, United Kingdom
| | | | - Mayuri Agarwal
- Department of Endocrinology and Metabolism, Pilgrim Hospital, Boston PE21 9QS, United Kingdom
| | - Beverly Xin Yi Yeap
- Department of Medicine, The University of Manchester Medical School, Manchester M13 9PL, United Kingdom
| | - Joseph M Pappachan
- Department of Endocrinology and Metabolism, Lancashire Teaching Hospitals NHS Trust, Preston PR2 9HT, United Kingdom
- Faculty of Science, Manchester Metropolitan University, Manchester M15 6BH, United Kingdom
- Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PL, United Kingdom
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36
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Won KB, Heo R, Park HB, Lee BK, Lin FY, Hadamitzky M, Kim YJ, Sung JM, Conte E, Andreini D, Pontone G, Budoff MJ, Gottlieb I, Chun EJ, Cademartiri F, Maffei E, Marques H, de Araújo Gonçalves P, Leipsic JA, Lee SE, Shin S, Choi JH, Virmani R, Samady H, Chinnaiyan K, Berman DS, Narula J, Shaw LJ, Bax JJ, Min JK, Chang HJ. Atherogenic index of plasma and the risk of rapid progression of coronary atherosclerosis beyond traditional risk factors. Atherosclerosis 2021; 324:46-51. [PMID: 33813155 DOI: 10.1016/j.atherosclerosis.2021.03.009] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 03/03/2021] [Accepted: 03/10/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIMS The atherogenic index of plasma (AIP) has been suggested as a marker of plasma atherogenicity. This study aimed to assess the association between AIP and the rapid progression of coronary atherosclerosis using serial coronary computed tomography angiography (CCTA). METHODS A total of 1488 adults (60.9 ± 9.2 years, 58.9% male) who underwent serial CCTA with a median inter-scan period of 3.4 years were included. AIP was defined as the base 10 logarithm of the ratio of the concentrations of triglyceride to high-density lipoprotein cholesterol. Rapid plaque progression (RPP) was defined as the change of percentage atheroma volume (PAV) ≥1.0%/year. All participants were divided into three groups based on AIP tertiles. RESULTS Baseline total PAV (median [interquartile range (IQR)]) (%) (group I [lowest]: 1.91 [0.00, 6.21] vs. group II: 2.82 [0.27, 8.83] vs. group III [highest]: 2.70 [0.41, 7.50]), the annual change of total PAV (median [IQR]) (%/year) (group I: 0.27 [0.00, 0.81] vs. group II: 0.37 [0.04, 1.11] vs. group III: 0.45 [0.06, 1.25]), and the incidence of RPP (group I: 19.7% vs. group II: 27.3% vs. group III: 31.4%) were significantly different among AIP tertiles (all p < 0.05). In multiple logistic regression analysis, the risk of RPP was increased in group III (odds ratio: 1.52, 95% confidence interval: 1.02-2.26; p = 0.042) compared to group I after adjusting for clinical factors and baseline total PAV. CONCLUSIONS Based on serial CCTA findings, AIP is an independent predictive marker for RPP beyond traditional risk factors.
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Affiliation(s)
- Ki-Bum Won
- Department of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea; Department of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea; Yonsei-Cedars-Sinai Integrative Cardiovascular Imaging Research Center, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea
| | - Ran Heo
- Yonsei-Cedars-Sinai Integrative Cardiovascular Imaging Research Center, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea; Department of Cardiology, Hanyang University Seoul Hospital, Hanyang University College of Medicine, Seoul, South Korea
| | - Hyung-Bok Park
- Yonsei-Cedars-Sinai Integrative Cardiovascular Imaging Research Center, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea; Department of Cardiology, Catholic Kwandong University International St. Mary's Hospital, Incheon, South Korea
| | - Byoung Kwon Lee
- Department of Cardiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Fay Y Lin
- Department of Radiology, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, NY, USA
| | - Martin Hadamitzky
- Department of Radiology and Nuclear Medicine, German Heart Center Munich, Munich, Germany
| | - Yong-Jin Kim
- Division of Cardiology, Seoul National University College of Medicine, Cardiovascular Center, Seoul National University Hospital, Seoul, South Korea
| | - Ji Min Sung
- Department of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea; Yonsei-Cedars-Sinai Integrative Cardiovascular Imaging Research Center, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea
| | | | | | | | - Matthew J Budoff
- Department of Medicine, Lundquist Institute at Harbor UCLA Medical Center, Torrance, CA, USA
| | - Ilan Gottlieb
- Department of Radiology, Casa de Saude São Jose, Rio de Janeiro, Brazil
| | - Eun Ju Chun
- Seoul National University Bundang Hospital, Sungnam, South Korea
| | | | - Erica Maffei
- Department of Radiology, Area Vasta 1/ASUR Marche, Urbino, Italy
| | - Hugo Marques
- UNICA, Unit of Cardiovascular Imaging, Hospital da Luz, Lisboa, Portugal
| | - Pedro de Araújo Gonçalves
- UNICA, Unit of Cardiovascular Imaging, Hospital da Luz, Lisboa, Portugal; Nova Medical School, Lisbon, Portugal
| | - Jonathon A Leipsic
- Department of Medicine and Radiology, University of British Columbia, Vancouver, BC, Canada
| | - Sang-Eun Lee
- Yonsei-Cedars-Sinai Integrative Cardiovascular Imaging Research Center, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea; Department of Cardiology, Ewha Womans University Seoul Hospital, Seoul, South Korea
| | - Sanghoon Shin
- Yonsei-Cedars-Sinai Integrative Cardiovascular Imaging Research Center, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea; Department of Cardiology, Ewha Womans University Seoul Hospital, Seoul, South Korea
| | - Jung Hyun Choi
- Department of Cardiology, Pusan University Hospital, Busan, South Korea
| | - Renu Virmani
- Department of Pathology, CVPath Institute, Gaithersburg, MD, USA
| | - Habib Samady
- Department of Cardiology, Emory University School of Medicine, Atlanta, GA, USA
| | | | - Daniel S Berman
- Department of Imaging and Medicine, Cedars Sinai Medical Center, Los Angeles, CA, USA
| | - Jagat Narula
- Icahn School of Medicine at Mount Sinai, Mount Sinai Heart, Zena and Michael A. Wiener Cardiovascular Institute, And Marie-Josée and Henry R. Kravis Center for Cardiovascular Health, New York, NY, USA
| | - Leslee J Shaw
- Department of Radiology, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, NY, USA
| | - Jeroen J Bax
- Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands
| | - James K Min
- Department of Radiology, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, NY, USA
| | - Hyuk-Jae Chang
- Department of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea; Yonsei-Cedars-Sinai Integrative Cardiovascular Imaging Research Center, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea.
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37
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Wang A, Wang G, Liu Q, Zuo Y, Chen S, Tao B, Tian X, Wang P, Meng X, Wu S, Wang Y, Wang Y. Triglyceride-glucose index and the risk of stroke and its subtypes in the general population: an 11-year follow-up. Cardiovasc Diabetol 2021; 20:46. [PMID: 33602208 PMCID: PMC7893902 DOI: 10.1186/s12933-021-01238-1] [Citation(s) in RCA: 69] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 02/01/2021] [Indexed: 12/27/2022] Open
Abstract
Background Triglyceride-glucose (TyG) index was recently suggested to be a reliable surrogate marker of insulin resistance. We aim to investigate the associations between baseline and long-term TyG index with subsequent stroke and its subtypes in a community-based cohort. Methods A total of 97,653 participants free of history of stroke in the Kailuan Study were included. TyG index was calculated as ln (fasting triglyceride [mg/dL] × fasting glucose [mg/dL]/2). Baseline TyG index was measured during 2006–2007. Updated cumulative average TyG index used all available TyG index from baseline to the outcome events of interest or the end of follow up. The outcome was the first occurrence of stroke, including ischemic stroke, intracerebral hemorrhage and subarachnoid hemorrhage. The associations of TyG index with outcomes were explored with Cox regression. Results During a median of 11.02 years of follow-up, 5122 participants developed stroke of whom 4277 were ischemic stroke, 880 intracerebral hemorrhage, and 144 subarachnoid hemorrhage. After adjusting for confounding variables, compared with participants in the lowest quartile of baseline TyG index, those in the third and fourth quartile were associated with an increased risk of stroke (adjusted hazard ratio [HR] 1.22, 95% confidence interval [CI] 1.12–1.33, and adjusted HR 1.32, 95% CI 1.21–1.44, respectively, P for trend < 0.001). We also found a linear association between baseline TyG index with stroke. Similar results were found for ischemic stroke. However, no significant associations were observed between baseline TyG index and risk of intracranial hemorrhage. Parallel results were observed for the associations of updated cumulative average TyG index with outcomes. Conclusions Elevated levels of both baseline and long-term updated cumulative average TyG index can independently predict stroke and ischemic stroke but not intracerebral hemorrhage in the general population during an 11-year follow-up.
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Affiliation(s)
- Anxin Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119, South 4th Ring West Road, Fengtai District, Beijing, 100070, China.,China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Guangyao Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119, South 4th Ring West Road, Fengtai District, Beijing, 100070, China.,China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Qian Liu
- Graduate School, North China University of Science and Technology, Tangshan, China
| | - Yingting Zuo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Shuohua Chen
- Department of Cardiology, Kailuan General Hospital, North China University of Science and Technology, No.57 Xinhua East Street, Lubei District, Tangshan, 063000, China
| | - Boni Tao
- School of Public Health, North China University of Science and Technology, Tangshan, China
| | - Xue Tian
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Penglian Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119, South 4th Ring West Road, Fengtai District, Beijing, 100070, China.,China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xia Meng
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119, South 4th Ring West Road, Fengtai District, Beijing, 100070, China.,China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, North China University of Science and Technology, No.57 Xinhua East Street, Lubei District, Tangshan, 063000, China.
| | - Yongjun Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119, South 4th Ring West Road, Fengtai District, Beijing, 100070, China. .,China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
| | - Yilong Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119, South 4th Ring West Road, Fengtai District, Beijing, 100070, China. .,China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
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