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Soleymani M, Masoudkabir F, Shabani M, Vasheghani-Farahani A, Behnoush AH, Khalaji A. Updates on Pharmacologic Management of Microvascular Angina. Cardiovasc Ther 2022; 2022:6080258. [PMID: 36382021 PMCID: PMC9626221 DOI: 10.1155/2022/6080258] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 08/29/2022] [Accepted: 10/17/2022] [Indexed: 01/14/2024] Open
Abstract
Microvascular angina (MVA), historically called cardiac syndrome X, refers to angina with nonobstructive coronary artery disease. This female-predominant cardiovascular disorder adds considerable health-related costs due to repeated diagnostic angiography and frequent hospital admissions. Despite the high prevalence of this diagnosis in patients undergoing coronary angiography, it is still a therapeutic challenge for cardiologists. Unlike obstructive coronary artery disease, with multiple evidence-based therapies and management guidelines, little is known regarding the management of MVA. During the last decade, many therapeutic interventions have been suggested for the treatment of MVA. However, there is a lack of summarization tab and update of current knowledge about pharmacologic management of MVA, mostly due to unclear pathophysiology. In this article, we have reviewed the underlying mechanisms of MVA and the outcomes of various medications in patients with this disease. Contrary to vasospastic angina in which normal angiogram is observed as well, nitrates are not effective in the treatment of MVA. Beta-blockers and calcium channel blockers have the strongest evidence of improving the symptoms. Moreover, the use of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, statins, estrogen, and novel antianginal drugs has had promising outcomes. Investigations are still ongoing for vitamin D, omega-3, incretins, and n-acetyl cysteine, which have resulted in beneficial initial outcomes. We believe that the employment of the available results and results of the future large-scale trials into cardiac care guidelines would help reduce the global cost of cardiac care tremendously.
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Affiliation(s)
- Mosayeb Soleymani
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzad Masoudkabir
- Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Cardiac Electrophysiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahsima Shabani
- Division of Cardiology, Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Ali Vasheghani-Farahani
- Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Cardiac Electrophysiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Hossein Behnoush
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Amirmohammad Khalaji
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Yao Y, Zhang X, Xu Y, Zhao Y, Song F, Tian Z, Zhao M, Liang Y, Ling W, Mao YH, Yang Y. Cyanidin-3- O-β-Glucoside Attenuates Platelet Chemokines and Their Receptors in Atherosclerotic Inflammation of ApoE -/- Mice. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2022; 70:8254-8263. [PMID: 35758304 DOI: 10.1021/acs.jafc.2c01844] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Platelet chemokines play well-established roles in the atherosclerotic inflammation. Cyanidin-3-O-β-glucoside (Cy-3-g) is one of the main bioactive compounds in anthocyanins, but its effects on chemokines during atherosclerosis have not been determined yet. In the present study, ApoE-/- mice were fed on the chow diet, high-fat diet (HFD), and HFD-supplemented Cy-3-g at 200, 400, and 800 mg/kg diet. After 16 weeks, Cy-3-g significantly alleviated the atherosclerotic lesion and inhibited platelet aggregation and activation. Moreover, Cy-3-g significantly reduced inflammatory chemokines CXCL4, CXCL7, CCL5, CXCL5, CXCL12, and CCL2 in plasma and downregulated CXCR4, CXCR7, and CCR5 on platelets and peripheral blood mononuclear cells. Besides, Cy-3-g decreased the mRNA of TNFα, IFNγ, ICAM-1, VCAM-1, CD68, MMP7, CCL5, CXCR4, and CCR5 in the aorta of mice. Therefore, it suggests that Cy-3-g plays important preventive roles in the process of atherosclerosis via attenuating chemokines and receptors in ApoE-/- mice.
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Affiliation(s)
- Yanling Yao
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-Sen University, Shenzhen, Guangdong Province 518107, China
- Guangdong Provincial Key Laboratory for Food, Nutrition and Health, Guangzhou, Guangdong Province 510080, China
- Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, Guangdong Province 510080, China
- The Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen, Guangdong Province 518033, China
| | - Xiandan Zhang
- The People's Hospital of Guangxi Zhuang Autonomous Region, Zhuang Autonomous Region, Nanning, Guangxi 530000, China
| | - Yixuan Xu
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-Sen University, Shenzhen, Guangdong Province 518107, China
- Guangdong Provincial Key Laboratory for Food, Nutrition and Health, Guangzhou, Guangdong Province 510080, China
- Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, Guangdong Province 510080, China
| | - Yimin Zhao
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-Sen University, Shenzhen, Guangdong Province 518107, China
- Guangdong Provincial Key Laboratory for Food, Nutrition and Health, Guangzhou, Guangdong Province 510080, China
- Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, Guangdong Province 510080, China
| | - Fenglin Song
- School of Food Science, Guangdong Pharmaceutical University, Guangzhou, Guangdong Province 510006, China
| | - Zezhong Tian
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-Sen University, Shenzhen, Guangdong Province 518107, China
- Guangdong Provincial Key Laboratory for Food, Nutrition and Health, Guangzhou, Guangdong Province 510080, China
- Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, Guangdong Province 510080, China
| | - Mingzhu Zhao
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-Sen University, Shenzhen, Guangdong Province 518107, China
- Guangdong Provincial Key Laboratory for Food, Nutrition and Health, Guangzhou, Guangdong Province 510080, China
- Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, Guangdong Province 510080, China
| | - Ying Liang
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-Sen University, Shenzhen, Guangdong Province 518107, China
- Guangdong Provincial Key Laboratory for Food, Nutrition and Health, Guangzhou, Guangdong Province 510080, China
- Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, Guangdong Province 510080, China
| | - Wenhua Ling
- Guangdong Provincial Key Laboratory for Food, Nutrition and Health, Guangzhou, Guangdong Province 510080, China
- Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, Guangdong Province 510080, China
| | - Yu-Heng Mao
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-Sen University, Shenzhen, Guangdong Province 518107, China
- Guangdong Provincial Key Laboratory for Food, Nutrition and Health, Guangzhou, Guangdong Province 510080, China
- Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, Guangdong Province 510080, China
| | - Yan Yang
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-Sen University, Shenzhen, Guangdong Province 518107, China
- Guangdong Provincial Key Laboratory for Food, Nutrition and Health, Guangzhou, Guangdong Province 510080, China
- Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, Guangdong Province 510080, China
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Makarewicz-Wujec M, Henzel J, Kępka C, Kruk M, Wardziak Ł, Trochimiuk P, Parzonko A, Dzielińska Z, Demkow M, Kozłowska-Wojciechowska M. Usefulness of MCP-1 Chemokine in the Monitoring of Patients with Coronary Artery Disease Subjected to Intensive Dietary Intervention: A Pilot Study. Nutrients 2021; 13:nu13093047. [PMID: 34578925 PMCID: PMC8467171 DOI: 10.3390/nu13093047] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 08/21/2021] [Accepted: 08/27/2021] [Indexed: 12/11/2022] Open
Abstract
Monocyte chemotactic protein-1 (MCP-1) plays an important role in the entire atherosclerotic process, from atherogenesis to destabilisation of the atherosclerotic plaque. The purpose of this study is to evaluate the effect of the dietary approaches to stop hypertension (DASH) diet in patients with coronary artery disease on the MCP-1 plasma concentration and to evaluate the potential usefulness of this chemokine as a marker of change in the volume and composition of coronary plaque. Material and method. As part of the dietary intervention to stop coronary atherosclerosis in computed tomography (DISCO-CT) study, patients were randomised to an intervention group (n = 40) in which the DASH diet was introduced, and to a control group (n = 39) with no dietary intervention. In the DASH group, dietary counselling was provided at all follow-up visits within 12 months of the follow-up period. MCP-1 plasma concentration was determined using enzyme-linked immunosorbent assay (ELISA). Coronary plaque analysis was performed using a semi-automated plaque analysis software system (QAngioCT, Medis, The Netherlands). Results. In the DASH group, MCP-1 plasma concentration significantly decreased by 34.1 pg/mL (p = 0.01), while in the control group, the change in MPC-1 was not significant. Significant inverse correlations were revealed for the change in MCP-1 plasma concentration and change in the consumption of vitamin C and dietary fibre both in the DASH (r = −0.519, p = 0.0005; r = −0.353, p = 0.025, respectively) and in the control group (r = −0.488 p = 0.001; r = −0.502, p = 0.001, respectively). In patients with the highest decrease in percent atheroma volume (PAV), a significant positive correlation was observed between the change in MCP-1 plasma concentration and changes in PAV (r = 0.428, p = 0.033) and calcified plaque component (r = 0.468, p = 0.018), while the change in noncalcified plaque component correlated inversely with change in MCP1 (r = −0.459, p = 0.021). Conclusion. Dietary intervention based on the DASH diet model reduces the MCP-1plasma concentration, mostly due to an increased intake of plant-derived, fibre-rich foods and antioxidants. The change in MCP-1 plasma concentration seems to reflect changes in the atheroma volume and proportions between the calcified and non-calcified plaque elements.
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Affiliation(s)
- Magdalena Makarewicz-Wujec
- Department of Clinical Pharmacy and Pharmaceutical Care, Medical University of Warsaw, 02-091 Warsaw, Poland;
- Correspondence: (M.M.-W.); (J.H.); Tel.: +48-225-720-985 (M.M.-W.); +48-223-434-342 (J.H.)
| | - Jan Henzel
- Department of Coronary and Structural Heart Diseases, Cardinal Stefan Wyszynski Institute of Cardiology, 04-628 Warsaw, Poland; (C.K.); (M.K.); (Ł.W.); (P.T.); (Z.D.); (M.D.)
- Correspondence: (M.M.-W.); (J.H.); Tel.: +48-225-720-985 (M.M.-W.); +48-223-434-342 (J.H.)
| | - Cezary Kępka
- Department of Coronary and Structural Heart Diseases, Cardinal Stefan Wyszynski Institute of Cardiology, 04-628 Warsaw, Poland; (C.K.); (M.K.); (Ł.W.); (P.T.); (Z.D.); (M.D.)
| | - Mariusz Kruk
- Department of Coronary and Structural Heart Diseases, Cardinal Stefan Wyszynski Institute of Cardiology, 04-628 Warsaw, Poland; (C.K.); (M.K.); (Ł.W.); (P.T.); (Z.D.); (M.D.)
| | - Łukasz Wardziak
- Department of Coronary and Structural Heart Diseases, Cardinal Stefan Wyszynski Institute of Cardiology, 04-628 Warsaw, Poland; (C.K.); (M.K.); (Ł.W.); (P.T.); (Z.D.); (M.D.)
| | - Piotr Trochimiuk
- Department of Coronary and Structural Heart Diseases, Cardinal Stefan Wyszynski Institute of Cardiology, 04-628 Warsaw, Poland; (C.K.); (M.K.); (Ł.W.); (P.T.); (Z.D.); (M.D.)
| | - Andrzej Parzonko
- Department of Pharmacognosy and Molecular Basis of Phytotherapy, Medical University of Warsaw, 02-091 Warsaw, Poland;
| | - Zofia Dzielińska
- Department of Coronary and Structural Heart Diseases, Cardinal Stefan Wyszynski Institute of Cardiology, 04-628 Warsaw, Poland; (C.K.); (M.K.); (Ł.W.); (P.T.); (Z.D.); (M.D.)
| | - Marcin Demkow
- Department of Coronary and Structural Heart Diseases, Cardinal Stefan Wyszynski Institute of Cardiology, 04-628 Warsaw, Poland; (C.K.); (M.K.); (Ł.W.); (P.T.); (Z.D.); (M.D.)
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