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Lin HC, Chou SH, Fan PC, Zhu Z, Pan J, Li J, Chang CH, Wu VCC, Chen SW, Chu PH. The association between Day-1 urine cadmium excretion and 30-day mortality in patients with acute myocardial infarction: A multi-institutional cohort study. Int J Cardiol 2023; 371:397-401. [PMID: 36103945 DOI: 10.1016/j.ijcard.2022.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 09/02/2022] [Accepted: 09/06/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND The aim of this study was to investigate the relationship between day-1 urine cadmium excretion and 30-day mortality in patients with acute myocardial infarction (AMI) at two centers. METHODS A total of 286 patients (222 males and 64 females) with AMI from Huashan Hospital, Shanghai and Chang Gung Memorial Hospital, Taiwan were enrolled. Basic vital signs, history, laboratory results, and day-1 urine excretion of cadmium (D1UECd) were recorded. Disease severity was assessed during the first hospitalization using Killip score, APACHE II score, and SOFA score. The main endpoint was 30-day mortality. RESULTS Among the 286 patients, 218 were from Chung Gung Memorial Hospital and 68 were from Huashan Hospital with an average age of 64.2 years. Forty (14%) patients died within 30 days after AMI. The average 24-h urine cadmium level among the Chung Gung Memorial Hospital cohort was 1.5 ± 2.4 μg compared to 1.7 ± 1.7 μg among Huashan Hospital cohort, both higher than the local populations. A higher D1UECd level was significantly associated with a greater risk of 30-day mortality (odds ratio 1.68, 95% confidence interval 1.30-2.16) after controlling for a number of covariates. The ability of D1UECd to discriminate 30-day mortality was excellent, with a very high area under the curve (87.2%, 95% CI 82.0-92.5%). CONCLUSION D1UECd was positively correlated and an independent predictor of 30-day mortality in the enrolled AMI patients. D1UECd may be a simple, objective prognostic scoring system in AMI patients.
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Affiliation(s)
- Hung-Chen Lin
- Department of Cardiology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China; Department of Cardiology, Huashan Hospital of Fudan University, Shanghai, China
| | - Shing-Hsien Chou
- Division of Cardiology, Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taipei, Taiwan
| | - Pei-Chun Fan
- Department of Nephrology, Chang Gung Memorial Hospital, Linkou, Taiwan; Department of Nephrology, Kidney Research Center, Chang Gung Memorial Hospital, Taiwan
| | - Zhidong Zhu
- Department of Cardiology, Huashan Hospital of Fudan University, Shanghai, China
| | - Junjie Pan
- Department of Cardiology, Huashan Hospital of Fudan University, Shanghai, China
| | - Jian Li
- Department of Cardiology, Huashan Hospital of Fudan University, Shanghai, China
| | - Chih-Hsiang Chang
- Department of Nephrology, Chang Gung Memorial Hospital, Linkou, Taiwan; Department of Nephrology, Kidney Research Center, Chang Gung Memorial Hospital, Taiwan
| | - Victor Chien-Chia Wu
- Division of Cardiology, Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taipei, Taiwan
| | - Shao-Wei Chen
- Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Chang Gung Memorial Hospital, Linkou Medical Center, Chang Gung University, Taoyuan City, Taiwan
| | - Pao-Hsien Chu
- Division of Cardiology, Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taipei, Taiwan; Institute of Stem Cell and Translational Cancer Research, Chang Gung Memorial Hospital, Linkou, Taiwan.
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Lin HC, Hao WM, Chu PH. Cadmium and cardiovascular disease: An overview of pathophysiology, epidemiology, therapy, and predictive value. Rev Port Cardiol 2021; 40:611-617. [PMID: 34392906 DOI: 10.1016/j.repce.2021.07.031] [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: 09/06/2020] [Accepted: 01/09/2021] [Indexed: 11/26/2022] Open
Abstract
Cadmium is a widely distributed toxic heavy metal that has been associated with many diseases including chronic renal dysfunction, osteomalacia, acute heart failure, secondary hypertension, and atherosclerosis. Although several studies have suggested that cadmium may affect multiple systems by inducing lipid per oxidation in cells and disturbing the antioxidant system, the mechanism by which cadmium affects the cardiovascular system remains unclear. Recent studies on heart failure and acute myocardial infarction have shown that cadmium has good predictive ability for mortality in patients with cardiovascular disease. In this study, we briefly review the role of cadmium in cardiovascular disease, which may prompt further studies to investigate the potential association between cadmium and mortality in patients with cardiovascular disease.
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Affiliation(s)
- Hung-Chen Lin
- Department of Cardiology, Huashan Hospital of Fudan University, Shanghai, China; Shanghai Medical College, Fudan University, Shanghai, China
| | - Wei-Ming Hao
- Shanghai Medical College, Fudan University, Shanghai, China; Otorhinolaryngology Department of Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Pao-Hsien Chu
- Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan.
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Cadmium and cardiovascular disease: An overview of pathophysiology, epidemiology, therapy, and predictive value. Rev Port Cardiol 2021. [PMID: 34103231 DOI: 10.1016/j.repc.2021.01.009] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Cadmium is a widely distributed toxic heavy metal that has been associated with many diseases including chronic renal dysfunction, osteomalacia, acute heart failure, secondary hypertension, and atherosclerosis. Although several studies have suggested that cadmium may affect multiple systems by inducing lipid per oxidation in cells and disturbing the antioxidant system, the mechanism by which cadmium affects the cardiovascular system remains unclear. Recent studies on heart failure and acute myocardial infarction have shown that cadmium has good predictive ability for mortality in patients with cardiovascular disease. In this study, we briefly review the role of cadmium in cardiovascular disease, which may prompt further studies to investigate the potential association between cadmium and mortality in patients with cardiovascular disease.
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Zhao H, Pan Y, Wang C, Guo Y, Yao N, Wang H, Li B. The Effects of Metal Exposures on Charlson Comorbidity Index Using Zero-Inflated Negative Binomial Regression Model: NHANES 2011-2016. Biol Trace Elem Res 2021; 199:2104-2111. [PMID: 32816137 DOI: 10.1007/s12011-020-02331-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 08/05/2020] [Indexed: 01/09/2023]
Abstract
BACKGROUND With the rising incidence of chronic diseases, and the increase of aging population has led to multimorbidity a serious public health problem. The aim of this study was to explore the association between metal exposures and Charlson comorbidity index (CCI), which will provide valuable information for improving quality of life and reducing mortality. METHODS The study sample consists of three continuous cycles (2011-2016) of the National Health and Nutrition Examination Survey (NHANES), and 4901 eligible subjects were included in the study. Zero-inflated negative binomial (ZINB) model was utilized to investigate the effects in metal exposures on CCI, which includes spot urine (arsenic, mercury, and cadmium), whole blood (manganese, selenium, and lead), and serum (copper and zinc). RESULTS In count part (CCI ≥ 0), holding other variables constant, the expected change in CCI for a one-unit increase in blood selenium is 0.997 (RR = 0.997, p = 0.017). In logit part (CCI = 0), the log odds of having CCI equals zero would increase by 0.659, 1.073, and 0.963 for every additional urinary cadmium (OR = 0.659, p = 0.007), blood lead (OR = 1.073, p = 0.023), blood manganese (OR = 0.963, p = 0.025), respectively. CONCLUSIONS Our findings indicated that cadmium and manganese were likely to increase mortality. Inversely, selenium and lead might be positive on people's health. The findings may be extremely essential for preventing diseases and improving life quality.
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Affiliation(s)
- Hantong Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Avenue, Changchun, 130021, People's Republic of China
| | - Yingan Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Avenue, Changchun, 130021, People's Republic of China
| | - Changcong Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Avenue, Changchun, 130021, People's Republic of China
| | - Yinpei Guo
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Avenue, Changchun, 130021, People's Republic of China
| | - Nan Yao
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Avenue, Changchun, 130021, People's Republic of China
| | - Han Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Avenue, Changchun, 130021, People's Republic of China
| | - Bo Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Avenue, Changchun, 130021, People's Republic of China.
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McCarty MF. Nutraceutical, Dietary, and Lifestyle Options for Prevention and Treatment of Ventricular Hypertrophy and Heart Failure. Int J Mol Sci 2021; 22:ijms22073321. [PMID: 33805039 PMCID: PMC8037104 DOI: 10.3390/ijms22073321] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 03/22/2021] [Accepted: 03/22/2021] [Indexed: 12/12/2022] Open
Abstract
Although well documented drug therapies are available for the management of ventricular hypertrophy (VH) and heart failure (HF), most patients nonetheless experience a downhill course, and further therapeutic measures are needed. Nutraceutical, dietary, and lifestyle measures may have particular merit in this regard, as they are currently available, relatively safe and inexpensive, and can lend themselves to primary prevention as well. A consideration of the pathogenic mechanisms underlying the VH/HF syndrome suggests that measures which control oxidative and endoplasmic reticulum (ER) stress, that support effective nitric oxide and hydrogen sulfide bioactivity, that prevent a reduction in cardiomyocyte pH, and that boost the production of protective hormones, such as fibroblast growth factor 21 (FGF21), while suppressing fibroblast growth factor 23 (FGF23) and marinobufagenin, may have utility for preventing and controlling this syndrome. Agents considered in this essay include phycocyanobilin, N-acetylcysteine, lipoic acid, ferulic acid, zinc, selenium, ubiquinol, astaxanthin, melatonin, tauroursodeoxycholic acid, berberine, citrulline, high-dose folate, cocoa flavanols, hawthorn extract, dietary nitrate, high-dose biotin, soy isoflavones, taurine, carnitine, magnesium orotate, EPA-rich fish oil, glycine, and copper. The potential advantages of whole-food plant-based diets, moderation in salt intake, avoidance of phosphate additives, and regular exercise training and sauna sessions are also discussed. There should be considerable scope for the development of functional foods and supplements which make it more convenient and affordable for patients to consume complementary combinations of the agents discussed here. Research Strategy: Key word searching of PubMed was employed to locate the research papers whose findings are cited in this essay.
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Affiliation(s)
- Mark F McCarty
- Catalytic Longevity Foundation, 811 B Nahant Ct., San Diego, CA 92109, USA
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Zhuang X, Ni A, Liao L, Guo Y, Dai W, Jiang Y, Zhou H, Hu X, Du Z, Wang X, Liao X. Environment-wide association study to identify novel factors associated with peripheral arterial disease: Evidence from the National Health and Nutrition Examination Survey (1999–2004). Atherosclerosis 2018; 269:172-177. [DOI: 10.1016/j.atherosclerosis.2018.01.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 12/08/2017] [Accepted: 01/11/2018] [Indexed: 12/11/2022]
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