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García-Camarero T, Remuzgo-Martínez S, Genre F, López-Mejías R, Pulito-Cueto V, Veiga G, Lee Hwang DH, Sáinz Laso F, Gil Ongay A, González-Gay MÁ, de la Torre Hernández JM. Serum and genetic markers related to rapid clinical progression of coronary artery disease. REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2023; 76:1013-1020. [PMID: 37201714 DOI: 10.1016/j.rec.2023.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 04/24/2023] [Indexed: 05/20/2023]
Abstract
INTRODUCTION AND OBJECTIVES Patients with clinically evident coronary artery disease differ in their rate of progression, which impacts prognosis. We aimed to characterize serum and genetic markers in patients with rapid clinical progression (RCP) of coronary artery disease vs those with long standing stable (LSS) disease. METHODS Retrospective study of cases (RCP) and controls (LSS) (1:2). Patients requiring ≥ 2 revascularizations due to atherosclerotic progression in the 10 years after a first angioplasty were considered to be RCP and those without events during the same period after the first angioplasty were considered to have LSS disease. After patient selection, we analyzed serum values, mRNA expression and genetic polymorphisms of inflammatory markers, including interleukin-6, C-reactive protein, and tumor necrosis factor (TNF)-a, and atherogenic markers consisted of proprotein convertase subtilisin/kexin type 9 (PCSK9), low-density lipoprotein receptor, sterol regulatory element binding transcription factor 2, and apolipoprotein-B. RESULTS The study included 180 patients (58 RCP and 122 LSS). Demographic characteristics, classic risk factors and the extent of coronary disease were similar in the 2 groups. Patients with RCP showed higher serum levels of interleukin-6 and PCSK9 and higher TNF mRNA expression. Interleukin-6 rs180075C, TNF rs3093664 non-G and PCSK9 rs2483205 T alleles conferred a risk of RCP (P<.05 in all cases). Among patients with RCP, 51.7% had all 3 risk alleles vs 18% of those with LSS (P<.001). CONCLUSIONS We suggest the existence of specific phenotypic and genotypic markers associated with RCP of coronary artery disease that could help to individualize the type and intensity of treatment.
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Affiliation(s)
- Tamara García-Camarero
- Departamento de Cardiología, Hospital Universitario Marqués de Valdecilla, Instituto de Investigación Valdecilla, Santander, Cantabria, Spain.
| | | | - Fernanda Genre
- Instituto de Investigación Valdecilla, Santander, Cantabria, Spain
| | | | | | - Gabriela Veiga
- Departamento de Cardiología, Hospital Universitario Marqués de Valdecilla, Instituto de Investigación Valdecilla, Santander, Cantabria, Spain
| | - Dae-Hyun Lee Hwang
- Departamento de Cardiología, Hospital Universitario Marqués de Valdecilla, Instituto de Investigación Valdecilla, Santander, Cantabria, Spain
| | - Fermín Sáinz Laso
- Departamento de Cardiología, Hospital Universitario Marqués de Valdecilla, Instituto de Investigación Valdecilla, Santander, Cantabria, Spain
| | - Aritz Gil Ongay
- Departamento de Cardiología, Hospital Universitario Marqués de Valdecilla, Instituto de Investigación Valdecilla, Santander, Cantabria, Spain
| | - Miguel Ángel González-Gay
- Departamento de Medicina y Psiquiatría, Universidad de Cantabria, Santander, Cantabria, Spain; Instituto de Investigación Sanitaria-Fundación Jiménez Díaz, Madrid, Spain
| | - José M de la Torre Hernández
- Departamento de Cardiología, Hospital Universitario Marqués de Valdecilla, Instituto de Investigación Valdecilla, Santander, Cantabria, Spain
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Wang GH, Jin J, Sun LZ. Effect of lipoprotein-associated phospholipase A2 inhibitor on insulin resistance in streptozotocin-induced diabetic pregnant rats. Endocr J 2018; 65:903-913. [PMID: 29925744 DOI: 10.1507/endocrj.ej17-0351] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
This paper aims to investigate the influence of lipoprotein-associated phospholipase A2 (Lp-PLA2) inhibitor, darapladib, on insulin resistance (IR) in streptozotocin (STZ)-induced diabetic pregnant rats. The rat models were divided into Control (normal pregnancy), STZ + saline (STZ-induced diabetic pregnant rats), STZ + Low-dose and STZ + High-dose darapladib (STZ-induced diabetic pregnant rats treated with low-/high-dose darapladib) groups. Pathological changes were observed by Hematoxylin-eosin (HE) and Immunohistochemistry staining. Lp-PLA2 levels were determined by enzyme-linked immunosorbent assay (ELISA). An automatic biochemical analyzer was used to measure the serum levels of biochemical indicators, and homeostatic model assessment for insulin resistance (HOMA-IR) and insulin sensitivity index (ISI) were calculated. Western blot was applied to determine levels of inflammatory cytokines. Compared with Control group, rats in the STZ + saline group were significantly decreased in body weight, the number of embryo implantation, the number of insulin positive cells and pancreatic islet size as well as the islet endocrine cells, and high-density lipoprotein (HDL-C) level, but substantially increased in Lp-PLA2, low-density lipoprotein (LDL-C), fatty acids (FFA), serum total cholesterol (TC), triglyceride (TG) levels. Moreover, the increased fasting plasma glucose (FPG) and HOMA-IR and inflammatory cytokines but decreased fasting insulin (FINS) and ISI were also found in diabetic pregnant rats. On the contrary, rats in the darapladib-treated groups were just opposite to the STZ + saline group, and STZ + High-dose group improved better than STZ + Low-dose group. Thus, darapladib can improve lipid metabolism, and enhance insulin sensitivity of diabetic pregnant rats by regulating inflammatory cytokines.
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Affiliation(s)
- Guo-Hua Wang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu, China
- Department of Obstetrics and Gynecology, The First People's Hospital of Lianyungang City, Affiliated Hospital of Xuzhou Medical University, Lianyungang 222000, China
| | - Jun Jin
- Department of Clinical Laboratory, The First People's Hospital of Lianyungang City, Affiliated Hospital of Xuzhou Medical University, Lianyungang 222000, China
| | - Li-Zhou Sun
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu, China
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Kang J, Park KW, Lee MS, Zheng C, Han JK, Yang HM, Kang HJ, Koo BK, Kim HS. The natural course of nonculprit coronary artery lesions; analysis by serial quantitative coronary angiography. BMC Cardiovasc Disord 2018; 18:130. [PMID: 29954346 PMCID: PMC6027760 DOI: 10.1186/s12872-018-0870-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 06/21/2018] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Nonculprit lesions are the major cause of future cardiovascular events. However, the natural course of nonculprit lesions and angiographic predictors of plaque progression are not well-studied. The purpose of our study was to observe the natural course of nonculprit lesions, and to identify predictors of unanticipated future events and angiographic progression in nonculprit lesions. METHODS We analyzed 640 nonculprit lesions with a length of ≥2 mm and luminal narrowing ≥30% from 320 patients who had two serial angiographic follow-ups; 9 to 13 months post-PCI and 24 months post-PCI. The study endpoints were nonculprit-ischemia driven revascularization (IDR) and the rate of diameter stenosis (DS) progression. Those with progression of DS > 12%/year were defined as 'rapid progressors'. RESULTS During the median follow-up period of 737 days, 20 lesions in 20 patients (6.3%) required nonculprit-IDR. Independent predictors of nonculprit-IDR were diabetes (hazard ratio [HR] 2.93, 95% confidence interval [CI] 1.072-8.007, p = 0.036) and lesion type B2/C (HR 4.017, 95% CI 1.614-9.997, p = 0.003). The presence of one or both of the two major risk factors was associated with significant DS progression (3.0 ± 6.8% vs. 3.5 ± 6.1% vs. 6.8 ± 9.9% for lesions with 0, 1 and both risk factors, p < 0.001). Among the 640 lesions, 38 lesions (5.9%) in 33 patients were rapid progressors, while risk factors of rapid progressors included lesion type B2/C as a lesion-related risk factor (HR 1.998, 95% CI 1.006-3.791, p = 0.048) and diabetes mellitus as a patient-related risk factor (HR 3.725, 95% CI 1.937-7.538, p < 0.001). Lesions with both risk factors (type B2/C lesions in diabetic patients) were at the highest risk of rapid progression (odds ratio 3.250, 95% CI 1.451-7.282), compared to type A/B1 lesions in non-diabetic patients. CONCLUSION Nonculprit-IDR was not uncommon during the 2-year follow up period in our population. The major risk factors of nonculprit lesion progression were diabetes and lesion type B2/C. TRIAL REGISTRATION Retrospectively registered and approved by the institutional review board of Seoul National University Hospital (No.: 1801-138-918) on February 2nd, 2018.
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Affiliation(s)
- Jeehoon Kang
- Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, 101 Daehakro, Jongno Gu, Seoul, 110-744, South Korea
| | - Kyung Woo Park
- Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, 101 Daehakro, Jongno Gu, Seoul, 110-744, South Korea.
| | - Michael S Lee
- Division of Cardiology, University of California Los Angeles Medical Center, Los Angeles, CA, USA
| | - Chengbin Zheng
- Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, 101 Daehakro, Jongno Gu, Seoul, 110-744, South Korea
| | - Jung-Kyu Han
- Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, 101 Daehakro, Jongno Gu, Seoul, 110-744, South Korea
| | - Han-Mo Yang
- Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, 101 Daehakro, Jongno Gu, Seoul, 110-744, South Korea
| | - Hyun-Jae Kang
- Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, 101 Daehakro, Jongno Gu, Seoul, 110-744, South Korea
| | - Bon-Kwon Koo
- Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, 101 Daehakro, Jongno Gu, Seoul, 110-744, South Korea
| | - Hyo-Soo Kim
- Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, 101 Daehakro, Jongno Gu, Seoul, 110-744, South Korea
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Shah P, Bajaj S, Virk H, Bikkina M, Shamoon F. Rapid Progression of Coronary Atherosclerosis: A Review. THROMBOSIS 2015; 2015:634983. [PMID: 26823982 PMCID: PMC4707354 DOI: 10.1155/2015/634983] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Revised: 12/06/2015] [Accepted: 12/08/2015] [Indexed: 11/17/2022]
Abstract
Atherosclerosis is chronic disease, the prevalence of which has increased steadily as the population ages. Vascular injury is believed to be critical initiating event in pathogenesis of spontaneous atherosclerosis. Syndrome of accelerated atherosclerosis has been classically described in patients undergoing heart transplantation, coronary artery bypass graft, and percutaneous transluminal coronary angioplasty. In contrast to spontaneous atherosclerosis, denuding endothelial injury followed by thrombus formation and initial predominant smooth muscle cell proliferation is believed to be playing a significant role in accelerated atherosclerosis. There is no universal definition of rapid progression of atherosclerosis. However most studies describing the phenomenon have used the following definition: (i) > or = 10% diameter reduction of at least one preexisting stenosis > or = 50%, (ii) > or = 30% diameter reduction of a preexisting stenosis <50%, and (iii) progression of a lesion to total occlusion within few months. Recent studies have described the role of coronary vasospasm, human immunodeficiency virus, various inflammatory markers, and some genetic mutations as predictors of rapid progression of atherosclerosis. As research in the field of vascular biology continues, more factors are likely to be implicated in the pathogenesis of rapid progression of atherosclerosis.
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Affiliation(s)
- Priyank Shah
- Department of Cardiology, 703 Main Street, Paterson, NJ 07503, USA
| | - Sharad Bajaj
- Department of Cardiology, 703 Main Street, Paterson, NJ 07503, USA
| | - Hartaj Virk
- Department of Cardiology, 703 Main Street, Paterson, NJ 07503, USA
| | - Mahesh Bikkina
- Department of Cardiology, 703 Main Street, Paterson, NJ 07503, USA
| | - Fayez Shamoon
- Department of Cardiology, 703 Main Street, Paterson, NJ 07503, USA
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