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Cheng Y, Meng X, Gao H, Yang C, Li P, Li H, Chatterjee S, Rezende PC, Bonnet M, Li H, Zhang Z, Ji F, Zhang W. Long-term all-cause death prediction by coronary, aortic, and valvular calcification in patients with acute ST-segment elevation myocardial infarction. BMC Cardiovasc Disord 2024; 24:117. [PMID: 38373881 PMCID: PMC10877850 DOI: 10.1186/s12872-024-03758-6] [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: 11/02/2023] [Accepted: 02/01/2024] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND To determine the prognostic value of cumulative calcification score of coronary artery calcification (CAC), thoracic aortic calcification (TAC) and aortic valve calcification (AVC) in acute ST segment elevation myocardial infarction (STEMI) patients. METHODS This was a retrospective, single-center cohort study. A total of 332 STEMI patients who received primary percutaneous coronary intervention (PPCI) were enrolled in this study between January 2010 to October 2018. We assessed the calcification in the left anterior descending branch (LAD), left circumflex branch (LCX), right coronary artery (RCA), thoracic aorta, and aortic valve. Calcification of each part was counted as 1 point, and the cumulative calcification score was calculated as the sum of all points. The primary endpoint was all-cause mortality. Multivariate Cox proportional hazards models were used to determine association of cumulative calcification score with end points. The performance of the score was evaluated by receiver operating characteristic (ROC) curve analysis and absolute net reclassification improvement (NRI), compared with the Global Registry of Acute Coronary Events (GRACE) risk score. RESULTS The overall population's calcification score was 2.0 ± 1.6. During a mean follow-up time of 69.8 ± 29.3 months, the all-cause mortality rate was 12.1%. Kaplan-Meier curve showed that the score was significantly associated with mortality (log-rank p < 0.001). The multivariable Cox proportional hazard analyses showed that a calcification score of 4-5 was independently associated with all-cause death in STEMI patients [hazard ratio (HR) = 2.32, 95% confidence interval (CI): 1.01-5.31, p = 0.046]. The area under the ROC curve (AUC) of the calcification score was 0.67 (95% CI: 0.61-0.72), and the AUC of the GRACE score was 0.80 (95% CI: 0.75-0.84). There was no statistical difference in the predictive value between both scores for 3-year mortality in STEMI patients after PPCI (p = 0.06). Based on the NRI analysis, the calcification score showed better risk classification compared with the GRACE score (absolute NRI = 6.63%, P = 0.027). CONCLUSION The cumulative calcification score is independently associated with the long-term prognosis of STEMI patients after PPCI.
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Affiliation(s)
- Yalin Cheng
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Xuyang Meng
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Haiyang Gao
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Chenguang Yang
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Peng Li
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Hongfei Li
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Saurav Chatterjee
- Clinical Assistant Professor of Medicine, Northwell Health, Zucker School of Medicine, Hempstead, NY, USA
| | - Paulo Cury Rezende
- Instituto do Coração (InCor), Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Marc Bonnet
- Cardiology Department, Hospital of Annecy, Annecy, France
| | - Huimin Li
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Zunlei Zhang
- Department of Cardiology, People's Hospital of Weishan County, Jining, Shandong, 277600, China
| | - Fusui Ji
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, 100730, China.
| | - Wenduo Zhang
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, 100730, China.
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Kim JH, Noh HM, Song HJ, Lee S, Kim SG, Kim JK. Mediating effect of vascular calcification in galectin-3-related mortality in hemodialysis patients. Sci Rep 2024; 14:939. [PMID: 38195853 PMCID: PMC10776847 DOI: 10.1038/s41598-024-51383-2] [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: 07/31/2023] [Accepted: 01/04/2024] [Indexed: 01/11/2024] Open
Abstract
Galectin-3 levels have been studied as a potential biomarker for predicting cardiovascular (CV) risk and mortality in hemodialysis (HD) patients. Recently, a close relationship between galectin-3 and vascular calcification (VC) has been reported. Here, we investigated the role of VC as a mediating factor in the association between galectin-3 and mortality. Serum galectin-3 and baseline aortic arch calcification (AoAC) score were measured in 477 incident HD patients. Mortality data were obtained at a median follow-up of 40 months. Causal mediation analysis was performed to examine the effect of vascular risk factors on galectin-3-related mortality. The prevalence of AoAC in HD patients was 57% (n = 272), and elevated galectin-3 levels were associated with a significantly increased risk of AoAC. When the galectin-3 level was divided by the median level of 37 ng/mL, a higher galectin group increased the risk of all-cause mortality by 1.71-fold (95% CI 1.02-2.92, p = 0.048), even after adjustment for multiple CV risk factors. Mediation analysis showed that both the direct effect of the galectin-3 on mortality (β = 0.0368, bootstrapped 95% CI [0.0113-0.0622]) and the indirect effects were significant. AoAC score and high-sensitivity CRP levels significantly mediated the association between galectin-3 and mortality (total indirect effects: β = 0.0188, bootstrapped 95% CI [0.0066-0.0352]). This study suggests that the association between high galectin-3 and mortality may be partially mediated by higher VC and inflammatory state in HD patients.
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Affiliation(s)
- Ji-Hwan Kim
- Department of Internal Medicine and Kidney Research Institute, Hallym University Sacred Heart Hospital, Pyungan-dong, Dongan-gu, Anyang, 431-070, Korea
| | - Hye-Mi Noh
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Hong Ji Song
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Sion Lee
- Department of Statistics and Institute of Statistics, Hallym University, Chuncheon, Korea
| | - Sung Gyun Kim
- Department of Internal Medicine and Kidney Research Institute, Hallym University Sacred Heart Hospital, Pyungan-dong, Dongan-gu, Anyang, 431-070, Korea
| | - Jwa-Kyung Kim
- Department of Internal Medicine and Kidney Research Institute, Hallym University Sacred Heart Hospital, Pyungan-dong, Dongan-gu, Anyang, 431-070, Korea.
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Zhang C, Zheng D, Feng W, Zhang H, Han F, He W, Liu A, Huang H, Chen J. Olanzapine: Association Between a Typical Antipsychotic Drug and Aortic Calcification. Front Cardiovasc Med 2021; 8:710090. [PMID: 34568454 PMCID: PMC8460775 DOI: 10.3389/fcvm.2021.710090] [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: 05/15/2021] [Accepted: 07/14/2021] [Indexed: 11/13/2022] Open
Abstract
Aims: This study concentrates on the relationship between antipsychotic drugs (APDs) and aortic calcification. Methods: All 56 patients with schizophrenia were divided into two groups according to aortic calcification index. APD equivalent dose was calculated via defined daily doses method. Results: In schizophrenia patients with higher aortic calcification index scores, APD equivalent doses were lower. APD equivalent dose was negatively related to aortic calcification index. Although equivalent APD dose in patients without olanzapine treatment was negatively related to aortic calcification index, it seems that equivalent APD dose did not associate with aortic calcification. Conclusion: Aortic calcification is negatively associated with APD dose in schizophrenia patients. Olanzapine seems to be vital to the relationship between aortic calcification and APD treatment.
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Affiliation(s)
- Chao Zhang
- Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Dongdong Zheng
- Department of Psychiatry, Psychiatric Hospital of Guangzhou Civil Affairs Bureau, Guangzhou, China
| | - Weijing Feng
- Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Huanji Zhang
- Cardiovascular Department, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Feng Han
- Department of Ultrasound, Cancer Center, Sun Yat-sen University, Guangzhou, China
| | - Wanbing He
- Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Aiting Liu
- Cardiovascular Department, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Hui Huang
- Cardiovascular Department, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Jie Chen
- Department of Radiation Oncology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
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An Investigation on the One-year Rate of Arteriovenous Fistula Failure and Its Related Factors in Patients with End-stage Renal Disease; an Experience in Golestan Province of Iran. Nephrourol Mon 2021. [DOI: 10.5812/numonthly.117420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Aortic arch calcification (AAC) is very common in hemodialysis patients and is associated with cardiovascular events and the incidence of arteriovenous fistula (AVF) failure. In order to predict the prognosis of patients, a study was conducted to determine the annual failure rate of AVF and its related factors. Methods: This cross-sectional study was performed on 145 patients with end-stage renal disease (ESRD) who were AVF candidates, visiting a referral center in Golestan province of Iran. After the insertion of intravenous arterial fistulas, posterior-anterior chest x-rays were captured, and the grafts were classified by a radiologist. Patients were followed for one year, and the rates of fistula failure (FF) and cardiovascular mortality were recorded. Finally, the data were entered into SPSS 19 software and analyzed by the Chi-square test. Results: Of 112 patients followed up for one year, 56.2% were men. During the one-year follow-up period, 5.3% of the patients developed arteriovenous FF, and this event was more common in men, but the difference was not statistically significant. The majority of the AVF candidates had a history of diabetes and hypertension, but no association was found between the one-year FF rate and these two diseases. Nearly 7.7% of the patients had grade III calcification, but no significant relationship was observed between the AAC grade and AVF failure rate. Conclusions: The rate of one-year FF was higher among ESRD patients with a history of chronic kidney diseases. Our results also demonstrated that the mortality rate is higher in patients with a high degree of AAC and patients with medical history (cardiovascular disease and diabetes).
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Afifi N, Khalifa MMM, Al Anany AAMMM, Hassan HGEMA. Cardiac calcium score in systemic sclerosis. Clin Rheumatol 2021; 41:105-114. [PMID: 34495426 DOI: 10.1007/s10067-021-05887-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 08/10/2021] [Accepted: 08/11/2021] [Indexed: 11/28/2022]
Abstract
Cardiac coronary Ca score (CCS), and extra coronary Ca score (ECCS) estimation in asymptomatic systemic sclerosis (SSc) patients and their relation to different disease and patients' variables. The CCS and ECCS were estimated in asymptomatic 20 SSc patients compared to 20 age and sex-matched healthy control using non-contrast cardiac computed tomography. All were applied for cardiac history taking, examination, echocardiography, body mass index (BMI), complete blood picture, erythrocyte sedimentation rate, and lipid profile estimation. The SSc patients were 11 females and 9 males with a mean age of (42.55 ± 9.145) and mean disease duration (12.9 ± 6.774). CCS was reported in 9 (45%) SSc cases and 2 (10%) of the control; (p = 0.013) and was significantly greater in SSc patients (58.4 ± 175.443) than in the control group (0.7 ± 2.25); (p = 0.01). The ECCS was significantly higher in SSc cases (194.45 ± 586.511) than control group (2.8 ± 7.8); (p = 0.001) and reported in 16 (80%) SSc cases and 3 (15%) of controls; (p = 0.000). Limited scleroderma cases had higher scores than diffuse type. Patients with total ca score (> 100) were older (p = 0.016), had longer disease duration (p = 0.001) and greater BMI (p = 0.002). Significant correlation was found between the log-transformed CCS and disease duration, age, BMI, left ventricular mass, and mass index. Systemic sclerosis patients are at increased risk of subclinical cardiovascular disease determined by cardiac Ca scoring as a noninvasive and reliable method. Extra coronary calcification may be an earlier indicator for this. Disease duration is a determinant risk factor for cardiac calcification in SSc. Key Points • Although the association between interleukin-6 (IL-6) promoter polymorphism and rheumatic arthritis (RA) has been discussed in the previous meta-analysis, their conclusions are inconsistent. • Systemic sclerosis patients are at high risk of accelerated atherosclerosis and cardiovascular diseases. Coronary atherosclerosis was previously estimated in SSc patients through coronary angiography. A novel method of assessing coronary artery disease is the coronary calcium score, as determined by multidetector computed tomography, it measures coronary artery calcification that occurs in atherosclerotic plaque. In this study, the cardiac coronary and extra coronary Ca score were evaluated in relation to disease characteristics in asymptomatic SSC patients for early detection of coronary artery disease.
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Affiliation(s)
- Naglaa Afifi
- Department of Internal Medicine and Rheumatology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
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Association of Aortic Arch Calcification on Chest X-ray with Procedural Thromboembolism after Mechanical Thrombectomy for Acute Ischemic Stroke. MEDICINA-LITHUANIA 2021; 57:medicina57090859. [PMID: 34577782 PMCID: PMC8467333 DOI: 10.3390/medicina57090859] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 08/20/2021] [Accepted: 08/23/2021] [Indexed: 11/29/2022]
Abstract
Background and Objective: Procedural thromboembolism after a mechanical thrombectomy (MT) for an acute ischemic stroke (AIS) has rarely been studied. It may occur from the artery-to-artery embolization of atherosclerotic plaque in the aortic arch. We investigated the relationship between aortic arch calcification (AoAC) on a chest X-ray and procedural thromboembolism on diffusion-weighted imaging (DWI) after an MT. Materials and Methods: From January 2017 to December 2020, 131 patients underwent DWI within two days following an MT for an AIS. Procedural thromboembolism was defined as new DWI-positive lesions in other territories from the occluded artery on DWI within two days after MT. Results: Procedural thromboembolism was observed in 30 (22.9%) patients. Procedural thromboembolism was associated with old age (72.3 ± 9.44 vs. 65.7 ± 12.8 years, p = 0.003), a longer procedural time (77.6 ± 37.6 vs. 60.1 ± 29.7 min, p = 0.024), and AoAC (calcification (73.3%) vs. no calcification (29.7%), p < 0.001). Multivariable logistic regression analysis showed that procedural thromboembolism was independently associated with AoAC (adjusted odds ratio (OR): 6.107, adjusted 95% confidence interval (CI): 2.374–15.705, p < 0.001) and a longer procedural time (adjusted OR: 1.015, adjusted 95% CI: 1.001–1.030, p = 0.031). Conclusions: Procedural thromboembolism after an MT for an AIS was related to AoAC on a chest X-ray and a longer procedural time. Our results suggest that although rapid recanalization is the most crucial goal of an MT for an AIS, the importance of the careful advance of the guiding catheter through the aortic arch should not be underestimated to reduce the risk of procedural thromboembolism, especially in patients with AoAC on a chest X-ray.
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Jokkel Z, Forgo B, Hani-Gaius Ghattas C, Piroska M, Szabó H, Tarnoki DL, Tarnoki AD, Lee S, Sung J. Heritability of Cardiothoracic Ratio and Aortic Arch Calcification in Twins. ACTA ACUST UNITED AC 2021; 57:medicina57050421. [PMID: 33925456 PMCID: PMC8146378 DOI: 10.3390/medicina57050421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 04/24/2021] [Indexed: 11/16/2022]
Abstract
Background and Objectives: Aortic arch calcification (AoAC) is associated with a variety of cardiovascular complications. The measurement and grading of AoAC using posteroanterior (PA) chest X-rays are well established. The cardiothoracic ratio (CTR) can be simultaneously measured with PA chest X-rays and used as an index of cardiomegaly. The genetic and environmental contributions to the degree of the AoAC and CTR are not well understood. The purpose of this study was to investigate the effect of genetics and environmental factors on the AoAC and CTR. Materials and Methods: A total of 684 twins from the South Korean twin registry (261 monozygotic, MZ and 81 dizygotic, DZ pairs; mean age 38.6 ± 7.9 years, male/female = 264/420) underwent PA chest X-rays. Cardiovascular risk factors and anthropometric data were also collected. The AoAC and CTR were measured and graded using a standardized method. A structural equation method was used to calculate the proportion of variance explained by genetic and environmental factors behind AoAC and CTR. Results: The within-pair differences were low regarding the grade of AoAC, with only a few twin pairs showing large intra-pair differences. We found that the thoracic width showed high heritability (0.67, 95% CI: 0.59–0.73, p = 1). Moderate heritability was detected regarding cardiac width (0.54, 95% CI: 0.45–0.62, p = 0.572) and CTR (0.54, 95% CI: 0.44–0.62, p = 0.701). Conclusions: The heritable component was significant regarding thoracic width, cardiac width, and the CTR.
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Affiliation(s)
- Zsofia Jokkel
- Medical Imaging Centre, Semmelweis University, 78/A Üllői Street, 1082 Budapest, Hungary; (C.H.-G.G.); (M.P.); (H.S.); (D.L.T.); (A.D.T.)
- Correspondence:
| | - Bianka Forgo
- Department of Radiology, Faculty of Medicine and Health, Örebro University, Fakultetsgatan 1, 702 81 Örebro, Sweden;
| | - Christopher Hani-Gaius Ghattas
- Medical Imaging Centre, Semmelweis University, 78/A Üllői Street, 1082 Budapest, Hungary; (C.H.-G.G.); (M.P.); (H.S.); (D.L.T.); (A.D.T.)
| | - Marton Piroska
- Medical Imaging Centre, Semmelweis University, 78/A Üllői Street, 1082 Budapest, Hungary; (C.H.-G.G.); (M.P.); (H.S.); (D.L.T.); (A.D.T.)
| | - Helga Szabó
- Medical Imaging Centre, Semmelweis University, 78/A Üllői Street, 1082 Budapest, Hungary; (C.H.-G.G.); (M.P.); (H.S.); (D.L.T.); (A.D.T.)
| | - David L. Tarnoki
- Medical Imaging Centre, Semmelweis University, 78/A Üllői Street, 1082 Budapest, Hungary; (C.H.-G.G.); (M.P.); (H.S.); (D.L.T.); (A.D.T.)
| | - Adam D. Tarnoki
- Medical Imaging Centre, Semmelweis University, 78/A Üllői Street, 1082 Budapest, Hungary; (C.H.-G.G.); (M.P.); (H.S.); (D.L.T.); (A.D.T.)
| | - Sooji Lee
- Genome and Health Big Data Laboratory, Department of Public Health, Graduate School of Public Health, Seoul National University, 1 Gwanak-ro Gwanak-gu, Seoul 08826, Korea; (S.L.); (J.S.)
- Institute of Health and Environment, Seoul National University, 1 Gwanak-ro Gwanak-gu, Seoul 08826, Korea
| | - Joohon Sung
- Genome and Health Big Data Laboratory, Department of Public Health, Graduate School of Public Health, Seoul National University, 1 Gwanak-ro Gwanak-gu, Seoul 08826, Korea; (S.L.); (J.S.)
- Institute of Health and Environment, Seoul National University, 1 Gwanak-ro Gwanak-gu, Seoul 08826, Korea
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