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Ji Z, Liu G, Guo J, Zhang R, Su Y, Carvalho A, Qu Y, Zuo W, Yao Y, Lin J, Ma G. The Neutrophil-to-Lymphocyte Ratio Is an Important Indicator Predicting In-Hospital Death in AMI Patients. Front Cardiovasc Med 2021; 8:706852. [PMID: 34616780 PMCID: PMC8488114 DOI: 10.3389/fcvm.2021.706852] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 08/24/2021] [Indexed: 12/18/2022] Open
Abstract
Objective: To explore the role of neutrophil-to-lymphocyte ratio (NLR) in predicting the short-term prognosis of NSTEMI and STEMI. Methods: This study was a single-center, retrospective and observational study. 2618 patients including 1289 NSTMI and 1329 STEMI patients were enrolled from June 2013 to February 2018 in Zhongda Hospital, Southeast University. The demographic information, clinical characteristics, medical history, laboratory examination, treatment, and outcome of individuals at admission and during hospitalization were extracted from the electronic medical record system. Outcome was defined as the all-cause death during hospitalization. Results: (1) In the NSTEMI group, the ability of NLR in predicting in-hospital death (AUC = 0.746) was higher than the neutrophil-monocyte ratio (NMR) (AUC = 0.654), the platelet-lymphocyte ratio (PLR) (AUC = 0.603) and the lymphocyte-monocyte ratio (LMR) (AUC = 0.685), and also higher than AST (AUC = 0.621), CK (AUC = 0.595), LDH (AUC = 0.653) and TnI (AUC = 0.594). The AUC of NLR in the STEMI group was only 0.621. (2) The optimal cut-off value of NLR in NSTEMI group was 5.509 (Youden index = 0.447, sensitivity = 77.01%, specificity = 67.72%). After adjusting variables including age, sex, diabetes history, smoking history, LDL-C and Cr, the logistic regression showed that the patients with NLR>5.509 had higher hazard risk of death (HR4.356; 95%CI 2.552-7.435; P < 0.001) than the patients with NLR ≤ 5.509. (3) Stratification analysis showed that the in-hospital mortality of patients with NLR > 5.509 was 14.611-fold higher than those with NLR ≤ 5.509 in patients aged <76, much higher than the ratio in patients aged ≥ 76. For patients with creatinine levels ≤ 71, the in-hospital death risk in high NLR group was 10.065-fold higher than in low NLR group (95%CI 1.761-57.514, P = 0.009), while the HR was only 4.117 in patients with creatinine levels > 71. The HR in patients with or without diabetes were 6.586 and 3.375, respectively. The HR in smoking or no smoking patients were 6.646 and 4.145, respectively. The HR in patients with LDL-C ≥ 2.06 or <2.06 were 5.526 and 2.967 respectively. Conclusion: Compared to NMR, PLR, and LMR, NLR had the best ability in predicting in-hospital death after NSTEMI. Age, creatinine, LDL-C, diabetes and smoking history were all important factors affecting the predictive efficiency in NSTEMI. NLR had the limited predictive ability in STEMI.
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Affiliation(s)
- Zhenjun Ji
- Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Guiren Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
| | - Jiaqi Guo
- Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Rui Zhang
- Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Yamin Su
- Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Abdlay Carvalho
- Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Yangyang Qu
- Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Wenjie Zuo
- Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Yuyu Yao
- Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Jie Lin
- Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.,Department of Cardiology, Jiangsu Taizhou People's Hospital, The Fifth Affiliated Hospital of Nantong University, Taizhou, China
| | - Genshan Ma
- Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
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Luke K, Purwanto B, Herawati L, Al-Farabi MJ, Oktaviono YH. Predictive Value of Hematologic Indices in the Diagnosis of Acute Coronary Syndrome. Open Access Maced J Med Sci 2019; 7:2428-2433. [PMID: 31666841 PMCID: PMC6814467 DOI: 10.3889/oamjms.2019.666] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 08/09/2019] [Accepted: 08/11/2019] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Distinguishing between Acute Coronary Syndrom (ACS) and SCAD (Stable Coronary Artery Disease) requires advanced laboratory instrument and electrocardiogram. However, their availabilities in primary care settings in developing countries are limited. Hematologic changes usually occur in the ACS patient and might be valuable to distinguish ACS from SCAD. AIM This study compares the hematologic indices between ACS and SCAD patients and analyses its predictive value for ACS. MATERIAL AND METHODS A total of 191 patients (79 ACS and 112 SCAD) were enrolled in this study based on the inclusion criteria. Patient's characteristic, hematologic indices on admission, and the final diagnosis were obtained from medical records. Statistical analyses were done using SPSS 23.0. RESULTS In this research MCHC value (33.40 vs. 32.80 g/dL; p < 0.05); WBC (11.16 vs. 7.40 x109/L; p < 0.001); NLR (6.29 vs. 2.18; p < 0.001); and PLR (173.88 vs 122.46; p < 0.001) were significantly higher in ACS compared to SCAD patients. While MPV (6.40 vs. 10.00 fL; p < 0.001) was significantly lower in ACS patients. ROC curve analysis showed MPV had the highest AUC (95%) for ACS diagnosis with an optimum cut-off point at ≤ 8.35 fL (sensitivity 93.6% and specificity 97.3%). CONCLUSION There was a significant difference between hematologic indices between ACS and SCAD patients. MPV is the best indices to distinguish ACS.
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Affiliation(s)
- Kevin Luke
- Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Bambang Purwanto
- Department of Physiology, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Lilik Herawati
- Department of Physiology, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Makhyan Jibril Al-Farabi
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
- School of Management, Healthcare Entrepreneurship Division, University College London, Gower St, Bloomsbury, WC1E 6BT, London, UK
| | - Yudi Her Oktaviono
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
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Zhu J, Wu S, Hu S, Li H, Li M, Geng X, Wang H. NLRP3 inflammasome expression in peripheral blood monocytes of coronary heart disease patients and its modulation by rosuvastatin. Mol Med Rep 2019; 20:1826-1836. [PMID: 31257469 PMCID: PMC6625427 DOI: 10.3892/mmr.2019.10382] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 05/29/2019] [Indexed: 01/11/2023] Open
Abstract
Nucleotide-binding oligomerization domain, leucine rich repeat, and pyrin domain-containing protein 3 (NLRP3) inflammasome has been implicated in a series of physiological and pathological processes. However, its correlation in coronary heart disease (CHD) still remains to be elucidated. The present study aimed to determine the expression of NLRP3 inflammasome in peripheral blood monocytes (PBMCs) of stable angina pectoris (SAP) and acute myocardial infarction (AMI) patients. In addition, the effect of rosuvastatin on their activities was analyzed in vitro. A total of 60 participants with SAP (n=20), AMI (n=20) and non-CHD controls (n=20) were enrolled. Fluorescence-activated cell sorting, real-time PCR, western blotting and enzyme-linked immunosorbent assay were performed to reveal the role of NLRP3 inflammasome. NLRP3 inflammasome was expressed in the PBMCs, and revealed an increased expression along the downstream interleukin (IL)-1β and IL-18 in both SAP and AMI groups, compared to the control group. Moreover, there was a more marked increase in the expression of these indicators in AMI patients when compared to SAP patients. Interference with rosuvastatin in vitro revealed that the expression of NLRP3 inflammasome and its downstream cytokines were significantly downregulated in both SAP and AMI groups in a time-dependent manner. The activation of NLRP3 inflammasome may be involved in the development of CHD, and rosuvastatin could attenuate the inflammatory process of atherosclerosis by downregulating NLRP3 expression and its downstream mediators. These findings indicated a potential role of NLRP3 in the pathogenesis and management of CHD, and also provided new insights into the mechanistic framework of rosuvastatin activity.
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Affiliation(s)
- Jian Zhu
- Department of Cardiology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233004, P.R. China
| | - Shili Wu
- Department of Cardiology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233004, P.R. China
| | - Sigan Hu
- Department of Cardiology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233004, P.R. China
| | - Hui Li
- Department of Cardiology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233004, P.R. China
| | - Miaonan Li
- Department of Cardiology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233004, P.R. China
| | - Xu Geng
- Department of Cardiology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233004, P.R. China
| | - Hongju Wang
- Department of Cardiology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233004, P.R. China
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Marini A, Naka KK, Vakalis K, Bechlioulis A, Bougiakli M, Giannitsi S, Nikolaou K, Antoniadou EI, Gartzonika C, Chasiotis G, Bairaktari E, Katsouras CS, Triantis G, Sionis D, Michalis LK. Extent of coronary artery disease in patients undergoing angiography for stable or acute coronary syndromes. Hellenic J Cardiol 2017; 58:115-121. [PMID: 28495650 DOI: 10.1016/j.hjc.2016.08.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 08/31/2016] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND We aimed to investigate whether the angiographic extent of coronary artery disease (CAD) differs in patients undergoing coronary angiography for stable CAD or acute coronary syndrome (ACS) and identify predictors of CAD extent in these patients. METHODS We enrolled 584 consecutive patients (463 with stable CAD, 121 with ACS) with angiographically established CAD (≥1 stenosis >25%). The Gensini score was used to assess the extent of coronary atherosclerosis. RESULTS Stable CAD patients had greater Framingham risk score and greater prevalence of hypertension, hypercholesterolemia, and diabetes (p<0.05 for all). Fasting glucose and systolic and diastolic blood pressure were higher, while high-sensitivity C-reactive protein (hsCRP) levels were lower in patients with stable CAD than in those with ACS (p<0.05 for all). No difference in Gensini score was observed between the two groups (p=0.118), but patients with ACS were more likely to have at least one significant epicardial angiographic lesion (>50% stenosis) (OR 2.0, p=0.022). Higher Gensini score was independently associated with (i) higher hsCRP and glucose levels, hypercholesterolemia, and increased age in stable CAD patients (R2 0.15, p<0001) and (ii) increased age and higher glucose and hsCRP levels in patients with ACS (R2 0.17, p<0001). CONCLUSIONS Patients undergoing coronary angiography for ACS or stable CAD presented with a similar extent of angiographic CAD, although patients with ACS had a higher prevalence of significant lesions in the presence of a better cardiovascular risk profile and higher inflammation levels. The extent of angiographic CAD in both the groups shared common determinants such as hsCRP, age, and hyperglycemia, but these appeared to explain only a small part of the variation of coronary atherosclerosis.
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Affiliation(s)
- Aikaterini Marini
- Michaelidion Cardiac Center, University of Ioannina, Ioannina, Greece
| | - Katerina K Naka
- Michaelidion Cardiac Center, University of Ioannina, Ioannina, Greece; 2(nd) Department of Cardiology, University of Ioannina, Ioannina, Greece
| | | | - Aris Bechlioulis
- Michaelidion Cardiac Center, University of Ioannina, Ioannina, Greece; 2(nd) Department of Cardiology, University of Ioannina, Ioannina, Greece
| | - Mara Bougiakli
- Michaelidion Cardiac Center, University of Ioannina, Ioannina, Greece
| | - Sophia Giannitsi
- Michaelidion Cardiac Center, University of Ioannina, Ioannina, Greece
| | | | | | | | - Georgios Chasiotis
- Laboratory of Biochemistry, University Hospital of Ioannina, Ioannina, Greece
| | - Eleni Bairaktari
- Laboratory of Biochemistry, University Hospital of Ioannina, Ioannina, Greece
| | - Christos S Katsouras
- Michaelidion Cardiac Center, University of Ioannina, Ioannina, Greece; 2(nd) Department of Cardiology, University of Ioannina, Ioannina, Greece
| | | | | | - Lampros K Michalis
- Michaelidion Cardiac Center, University of Ioannina, Ioannina, Greece; 2(nd) Department of Cardiology, University of Ioannina, Ioannina, Greece.
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B-type natriuretic peptide signal peptide (BNPsp) in patients presenting with chest pain. Clin Biochem 2016; 49:645-650. [DOI: 10.1016/j.clinbiochem.2016.02.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Revised: 02/18/2016] [Accepted: 02/27/2016] [Indexed: 02/07/2023]
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Chen YL, Tsai TH, Sung PH, Wang HT, Lin HS, Chang WN, Lu CH, Chen SF, Huang CR, Tsai NW, Wu CJ, Yip HK. Levels of circulating neopterin in patients with severe carotid artery stenosis undergoing carotid stenting. J Atheroscler Thromb 2013; 21:129-39. [PMID: 24025753 DOI: 10.5551/jat.19539] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIMS The association between an elevated serum neopterin level and the development of coronary artery complex lesions has been extensively assessed; however, the correlation between the serum neopterin level and the development of carotid artery stenosis has seldom been reported. This study tested whether this biomarker is increased in patients with severe carotid artery stenosis(≥70%) undergoing carotid artery(CA) stenting and investigated independent predictors of an increased circulating neopterin level. METHODS Fifty patients with severe CA stenosis(CAS) undergoing CA stenting were consecutively enrolled in this study from January 2009 through December 2011. The serum neopterin levels of age- and gender-matched acute ischemic stroke(AIS) patients(n=120) and control subjects(CS)(n=33) were also measured. A blood sample was prospectively collected from each patient in the catheterization room. RESULTS The serum levels of neopterin were significantly higher in the CAS patients than in the AIS patients or CS and significantly higher in the AIS patients than in the CS(all p<0.001). An analysis of the variables of 170 patients(CAS+AIS) demonstrated that age, a previous history of stroke and severe CAS were significantly correlated with an increased serum level of neopterin(all p<0.005). A multivariate binary logistic regression analysis of the severe CAS patients(n=50) demonstrated that age and the creatinine level were independent predictors of a high neopterin level(neopterin level ≥16.52 ng/dL, i.e., according to the median value of neopterin)(all p<0.05). CONCLUSIONS The circulating neopterin levels are significantly higher in patients with severe CAS than in those with AIS. The presence of CAS, age and the creatinine level were significantly correlated with an increased serum neopterin level.
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Affiliation(s)
- Yung-Lung Chen
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine
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Yu DQ, Lin SG, Chen JY, Xue L, Li G, Dong HJ, Zhou YL. Effect of atorvastatin therapy on borderline vulnerable lesions in patients with acute coronary syndrome. Arch Med Sci 2011; 7:433-9. [PMID: 22295025 PMCID: PMC3258749 DOI: 10.5114/aoms.2011.23408] [Citation(s) in RCA: 13] [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: 12/09/2010] [Revised: 01/15/2011] [Accepted: 03/18/2011] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION It is still controversial whether borderline lesions with a vulnerable plaque should be stented early or simply treated pharmacologically. No data exist concerning the potential effects of statin therapy on borderline vulnerable lesions in patients with acute coronary syndrome (ACS). MATERIAL AND METHODS Fifty patients with ACS whose culprit lesions were classified as "borderline lesions" were enrolled. All patients were treated with atorvastatin (20 mg) for 12 months. Intravascular ultrasound (IVUS) was performed and matrix metalloproteinase-9 (MMP-9), tissue inhibitor of metalloproteinase-1 (TIMP-1), and high-sensitive C-reactive protein (hsCRP) levels were measured at baseline and 12-month follow-up. RESULTS At 12-month follow-up, we found: 1) IVUS revealed that minimal lumen cross-sectional area (CSA) increased but plaque/media (P&M) area and plaque burden decreased. A total of 25 soft plaques (50%) were transformed into fibrous plaques. 2) ApoB, MMP-9 and hsCRP levels decreased, but TIMP-1 level increased. 3) Stepwise multivariate linear regression analysis showed that the independent predictors for changes in P&M area/year were the decrease in MMP-9 and hsCRP levels. CONCLUSIONS Atorvastatin therapy stabilized borderline vulnerable plaques and reversed atherosclerosis progression in patients with ACS. Reversal of this progression was accompanied by a decrease in the levels of plasma MMP-9 and hsCRP. Changes in MMP-9 and hsCRP could predict vulnerable plaque stabilization.
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Affiliation(s)
- Dan-Qing Yu
- Department of Cardiology, Guangdong Gerneral Hospital, Guangdong Provincial Cardiovascular Research Institute, Guangdong Provincial Academy of Medical Science, P. R. China
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Hikita H, Kuroda S, Kawaguchi N, Nakashima E, Fujinami T, Sugiyama T, Kamiishi T, Takahashi Y, Nozato T, Kuwahara T, Satoh A, Takahashi A, Isobe M. Differential Characteristics of Inflammatory Responses to Stent Implantation Between De Novo and Intrastent Restenosis Lesion in Patients With Stable Angina. Angiology 2011; 63:92-5. [DOI: 10.1177/0003319711408284] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Mechanical plaque rupture of coronary atherosclerotic plaque during stent implantation can increase serum levels of high-sensitivity C-reactive protein (hsCRP). Patients with stable angina pectoris were divided into 2 groups: one group included 186 patients with de novo lesion who underwent stent implantation (de novo group); the other group included 40 patients with intrastent restenosis (ISR) undergoing stent implantation (ISR group). The de novo group had a significant increase in hsCRP levels post stenting, while the ISR group showed no increase in hsCRP post stenting. Intravascular ultrasound with radiofrequency data analysis showed that the de novo group had larger percentage of both necrotic core area and fibrofatty area at the target lesion than the ISR group, while the ISR group had a larger percentage of fibrous area. Differential inflammatory response to stent implantation between the de novo plaque and in ISR lesion is related to lesion morphology.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Akira Satoh
- University of Tsukuba, Tsukuba, Ibaragi, Japan
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Unek IT, Bayraktar F, Solmaz D, Ellidokuz H, Sisman AR, Yuksel F, Yesil S. The levels of soluble CD40 ligand and C-reactive protein in normal weight, overweight and obese people. Clin Med Res 2010; 8:89-95. [PMID: 20660932 PMCID: PMC2910107 DOI: 10.3121/cmr.2010.889] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Obesity has been suggested as an independent risk factor for cardiovascular disease. Increasing evidence shows that engagement of soluble CD40 ligand (sCD40L) with its receptor plays a crucial role in the pathogenesis of atherosclerosis. The aim of the present study was to test whether obesity is associated with low-grade systemic inflammation as measured by serum high-sensitive C-reactive protein (hsCRP) and sCD40L concentration. METHODS Serum hsCRP and sCD40L concentrations were measured in 148 nondiabetic people. The participants were divided into three groups depending upon their body mass index (BMI) levels: Group 1 (normal weight), BMI<25 kg/m(2); Group 2 (overweight), BMI 25 kg/m(2) to 29.9 kg/m(2); and Group 3 (obese), BMI>or=30 kg/m(2). RESULTS Obese people had more elevated hsCRP levels than both their normal weight and overweight counterparts (P=0.000 and P=0.000, respectively). Similarly, serum concentrations of sCD40L were significantly higher, statistically, in obese subjects compared with normal weight subjects (P=0.003). In addition, obese subjects had higher values of sCD40L than overweight subjects, but the difference did not reach statistical significance (P=0.063). The levels of high-density lipoprotein cholesterol were significantly lower in obese subjects compared to normal weight subjects (P=0.048). The analysis of platelet count disclosed a statistically significant difference between obese subjects and normal weight subjects (P=0.028). The levels of BMI were positively correlated with the serum levels of hsCRP and sCD40L in all subjects (r=0.514, P=0.000 and r=0.283, P=0.000, respectively). Levels of hsCRP were positively correlated with waist circumference, fasting glucose, total cholesterol, triglyceride, low-density lipoprotein cholesterol, leukocytes, platelets, systolic and diastolic blood pressure. Similarly, soluble CD40L levels were positively correlated with waist circumference, fasting glucose and leukocytes. CONCLUSION Obese patients showed a significant increase of hsCRP and sCD40L levels compared with normal weight subjects, which might contribute to the known proinflammatory milieu found in these patients.
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Affiliation(s)
- Ilkay Tugba Unek
- Dokuz Eylul University School of Medicine, Department of Internal Medicine, 35340, Inciralti, Izmir, Turkey.
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Association of inflammatory markers with angiographic severity and extent of coronary artery disease. Atherosclerosis 2009; 206:335-9. [DOI: 10.1016/j.atherosclerosis.2009.01.041] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2008] [Revised: 01/26/2009] [Accepted: 01/26/2009] [Indexed: 11/20/2022]
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Flores-Alfaro E, Parra-Rojas I, Salgado-Bernabé AB, Chávez-Maldonado JP, Salazar-Martinez E. Cardiovascular risk evaluated by C-reactive protein levels in diabetic and obese Mexican subjects. Circ J 2008; 72:1170-4. [PMID: 18577830 DOI: 10.1253/circj.72.1170] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Previous studies have reported elevated levels of C-reactive protein (CRP) in obese and diabetic subjects, but it is unclear whether both these conditions have an additive effect on the variability of serum CRP levels. METHODS AND RESULTS The study enrolled 385 men and women who were classified into 4 groups: (1) diabetes (n=97), (2) obesity (n=108), (3) diabetes/obesity (n=78), and (4) healthy (n=102). All were Mexican subjects from Guerrero State. Serum high-sensitivity CRP (hs-CRP) levels were higher in both type 2 diabetes mellitus (T2DM)/obesity and obesity (5.1 mg/L) groups than in the diabetics (1.8 mg/L) without obesity. Only the measurements of obesity were strongly related to hs-CRP (body mass index, r=0.46 and waist circumference, r=0.41). The presence of T2DM and obesity explain 20% of the circulating hs-CRP level, following waist circumference (16%), leukocyte count (10%), diastolic blood pressure (6%), and female gender (4%). Obese subjects (odds ratio (OR)=6.3) and T2DM/obesity patients (OR=6.9) showed high risk for coronary disease and this effect was increased in T2DM/obesity women (OR=9.9). Also, abdominal obesity was associated with high coronary disease risk (OR=5.4), showing an increase in women (OR=7.3). CONCLUSION High hs-CRP levels are related to obesity and central distribution of body fat, leading to a higher cardiovascular risk among Mexican subjects.
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Affiliation(s)
- Eugenia Flores-Alfaro
- Autonomous University of Guerrero, Laboratory of Chronic Diseases, Chilpancingo, Guerrero, Mexico
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Inflammatory changes during the 'common cold' are associated with platelet activation and increased reactivity of platelets to agonists. Blood Coagul Fibrinolysis 2008; 18:713-8. [PMID: 17982310 DOI: 10.1097/mbc.0b013e328201c77e] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Epidemiologic studies have shown increased rates of myocardial infarction after upper respiratory tract infections. We hypothesized that changes in platelet activation and reactivity and inflammation occur during the 'common cold'. Previously healthy individuals with viral upper respiratory tract infections were studied (n = 18). Venous blood samples were obtained during the time of infection and again after 6 weeks. Platelet reactivity was higher during the 'common cold' as measured by low-dose ADP-induced aggregation (46 +/- 28 versus 27 +/- 21% 6 weeks after presentation, P = 0.003) and was higher than control individuals (22 +/- 8%, P = 0.003). Platelet P-selectin expression increased during illness (2.3 +/- 0.2% CD62-positive platelets versus 1.8 +/- 0.1% at 6 weeks after presentation, P = 0.017; and 1.7 +/- 0.2% in the control group, P = 0.03). C-reactive protein (3.7 +/- 1.3 versus 2.2 +/- 1.5 mg/l, P = 0.004) and tumor necrosis factor-alpha (27.6 +/- 28 versus 12.7 +/- 9 pg/ml, P = 0.03) were increased during the 'common cold'. There were no significant differences in levels of soluble P-selectin (P = 0.18), soluble vascular adhesion molecule-1 (P = 0.59) and soluble intercellular adhesion molecule-1 (P = 0.23). Increased platelet reactivity and activation during the 'common cold' are associated with inflammation as measured by increased levels of C-reactive protein and tumor necrosis factor-alpha, but not increased levels of endothelial markers. These findings support a pro-aggregatory state that, in part, explains the thrombotic events shown by epidemiological studies.
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Oguz A, Uzunlulu M. Short Term Fluvastatin Treatment Lowers Serum Asymmetric Dimethylarginine Levels in Patients With Metabolic Syndrome. Int Heart J 2008; 49:303-11. [DOI: 10.1536/ihj.49.303] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Aytekin Oguz
- Department of Internal Medicine, Goztepe Training and Research Hospital
| | - Mehmet Uzunlulu
- Department of Internal Medicine, Goztepe Training and Research Hospital
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Mirjanić-Azarić B, Avram S, Trninić D, Rašeta N, Đerić M. C-reactive protein and HDL-cholesterol level in the patients with suspected acute myocardial infarction immediately after reception at the Internal Medicine surgery. SCRIPTA MEDICA 2007. [DOI: 10.5937/scrimed0702065m] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Erzen B, Sabovic M, Sebestjen M, Keber I, Poredos P. Interleukin-6 Correlates with Endothelial Dysfunction in Young Post-Myocardial Infarction Patients. Cardiology 2006; 107:111-6. [PMID: 16864964 DOI: 10.1159/000094588] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2005] [Accepted: 05/15/2006] [Indexed: 11/19/2022]
Abstract
BACKGROUND The estimation of coronary risk based on consideration of classical risk factors is insufficient in young patients with myocardial infarction who have low expressions of classical risk factors. Endothelial dysfunction (ED) and markers of vascular inflammation may be more appropriate for risk estimation. The relations among ED and inflammation markers in such patients have not yet been explored. PATIENTS AND METHODS Twenty-one patients (on average 44 years old) in the stable phase after myocardial infarction, with low expressions of risk factors, were included in the study. The control group consisted of 25 healthy age-matched males. ED was estimated by ultrasound measurement of the endothelium-dependent dilatation of the brachial artery. The following inflammation markers were measured: hsCRP, interleukin-6 (IL-6), tumour necrosis factor-alpha (TNF-alpha), ICAM-1, VCAM-1, selectin-P and selectin-E. RESULTS Patients had a significantly reduced level of endothelium-dependent vasodilatation (5.6 +/- 3.5 vs. 8.8 +/- 6.5%, p < 0.05), and an increased level of IL-6 (3.2 [1.5-8.4] vs. 1.4 [0.9-2.3] ng/ml; p < 0.01). All other inflammation markers were comparable to controls. We found a significant negative correlation between ED and the levels of IL-6 (r = -0.54, p = 0.012). CONCLUSION It appears that IL-6 is the most valuable circulating marker of ED, and consequently a useful marker of coronary risk.
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Affiliation(s)
- Barbara Erzen
- Department of Vascular Diseases, University Medical Centre, Ljubljana, Slovenia
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