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Gan TM, Ye YY, Mo GL, Li JY. Progress of uric acid in cardiovascular disease. Cardiovasc Endocrinol Metab 2024; 13:e0300. [PMID: 38633361 PMCID: PMC11019825 DOI: 10.1097/xce.0000000000000300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Accepted: 03/10/2024] [Indexed: 04/19/2024]
Abstract
Due to the global prevalence of hyperuricemia (HUA), there is growing interest in research on uric acid (UA). HUA is a common condition that has various adverse consequences, including gout and kidney disease. However, recent studies have also implicated UA in the development of cardiovascular diseases (CVD) such as atrial fibrillation (AF) and coronary heart disease (CHD). Experimental and clinical research has extensively demonstrated the detrimental effects of elevated serum UA levels on cardiovascular health. Furthermore, serum UA levels have been identified as predictors of CVD outcomes following percutaneous coronary intervention (PCI) and catheter ablation. Additionally, the use of UA-lowering therapy holds important implications for the management of CVD. This review aims to consolidate the current evidence on the relationship between serum UA and CVD.
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Affiliation(s)
- Tian-ming Gan
- Department of Cardiology, Affiliated Hospital of Guilin Medical University, Guilin, China
| | - Yu-yu Ye
- Department of Cardiology, Affiliated Hospital of Guilin Medical University, Guilin, China
| | - Guan-lian Mo
- Department of Cardiology, Affiliated Hospital of Guilin Medical University, Guilin, China
| | - Jin-yi Li
- Department of Cardiology, Affiliated Hospital of Guilin Medical University, Guilin, China
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Li W, Song Y. Red cell distribution width to albumin ratio is a risk factor for atrial fibrillation in subjects hospitalized with coronary angiography. BMC Cardiovasc Disord 2024; 24:95. [PMID: 38331757 PMCID: PMC10854169 DOI: 10.1186/s12872-024-03772-8] [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: 07/19/2023] [Accepted: 02/05/2024] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND Red cell distribution width to albumin ratio (RAR) has been demonstrated to be associated with the risk of cardiovascular diseases. However, it is still unknown whether the RAR affects atrial fibrillation (AF). Therefore, this study aimed to investigate the association between RAR and AF in subjects hospitalized with coronary angiography. METHODS A total of 2436 participants were retrospectively included. Red cell distribution width, albumin and other data were collected. AF was confirmed using 12-lead electrocardiogram (ECG) or 24-h Holter. All participants were divided into four groups according to the RAR values by quartile (Q1, Q2, Q3, Q4). Univariate and multivariate logistic regression were performed to examine the correlation between RAR and AF. RESULTS Among the 2436 participants, 227 (9.3%) AF cases were observed. The RDW and RAR were significantly higher in AF group than in non-AF group (all P < 0.001). Univariate logistic regression showed an positive association between RAR and AF (P < 0.001). In multivariate logistic regression, RAR was found to be an independent risk factor of AF after adjusting for confounding factors (OR:2.015, 95%CI:1.315-3.089, P = 0.001). CONCLUSIONS The present study indicated that elevated RAR level was independently correlated with increased risk of AF in subjects hospitalized with coronary angiography.
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Affiliation(s)
- Wenhua Li
- Department of Cardiology, Wujin Hospital Affiliated With Jiangsu University, Changzhou, 213017, China
- Department of Cardiology, the Wujin Clinical College of Xuzhou Medical University, Changzhou, 213017, China
| | - Yanbin Song
- Department of Cardiology, Wujin Hospital Affiliated With Jiangsu University, Changzhou, 213017, China.
- Department of Cardiology, the Wujin Clinical College of Xuzhou Medical University, Changzhou, 213017, China.
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Liu W, Ding K, Bao J, Hu Y, Gui Y, Ye L, Wang L. Relationship between uric acid to albumin ratio and in-stent restenosis in patients with coronary artery disease undergoing drug-eluting stenting. Coron Artery Dis 2023; 34:589-594. [PMID: 37855441 PMCID: PMC10602219 DOI: 10.1097/mca.0000000000001300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 09/20/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND In-stent restenosis (ISR) in patients undergoing percutaneous coronary intervention (PCI) to treat coronary artery disease (CAD) is an urgent issue in clinical practice. Recent studies have highlighted uric acid-albumin ratio (UAR) as a new marker for evaluating inflammation and oxidative stress, capable of predicting cardiovascular ailments. We aimed to examine the correlation between UAR levels and ISR in patients who underwent drug-eluting stent (DES) implantation. METHODS We included 503 patients with CAD who underwent initial DES implantation and angiography during the follow-up period. Based on coronary angiographic findings, the patients were categorized into ISR (n = 73) and non-ISR groups (n = 430). Before angiography, laboratory parameters were measured for all enrolled patients. To ascertain the influential factors linked to ISR, multivariate logistic regression analysis was performed. The predictive capability of UAR in determining ISR was assessed using receiver operating characteristic (ROC) curve analysis. Statistical significance was set at P < 0.05. RESULTS Multivariate logistic regression analysis revealed that diabetes mellitus, stent length, UAR, albumin levels, and C-reactive protein levels independently predicted ISR. ROC curve analysis revealed that UAR had an area under the curve of 0.767 (95% CI: 0.709 - 0.826) for predicting ISR and demonstrated that UAR outperformed the individual predictive abilities of uric acid and albumin for ISR. CONCLUSION UAR was associated with ISR in patients with CAD undergoing PCI with DES implantation. Moreover, ROC curve analysis demonstrated that UAR exhibited superior predictive accuracy for ISR compared with evaluating uric acid and albumin levels separately.
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Affiliation(s)
- Wenquan Liu
- Jinzhou Medical University, Jinzhou, Liaoning Province, China
- Heart Center, Department of Cardiovascular Medicine, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Kun Ding
- Heart Center, Department of Cardiovascular Medicine, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Jiaqi Bao
- The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yilan Hu
- The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yang Gui
- Heart Center, Department of Cardiovascular Medicine, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Lifang Ye
- Heart Center, Department of Cardiovascular Medicine, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Lihong Wang
- Heart Center, Department of Cardiovascular Medicine, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China
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Liu D, Li Y, Zhao Q. Effects of Inflammatory Cell Death Caused by Catheter Ablation on Atrial Fibrillation. J Inflamm Res 2023; 16:3491-3508. [PMID: 37608882 PMCID: PMC10441646 DOI: 10.2147/jir.s422002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 08/08/2023] [Indexed: 08/24/2023] Open
Abstract
Atrial fibrillation (AF) poses a serious healthcare burden on society due to its high morbidity and the resulting serious complications such as thrombosis and heart failure. The principle of catheter ablation is to achieve electrical isolation by linear destruction of cardiac tissue, which makes AF a curable disease. Currently, catheter ablation does not have a high long-term success rate. The current academic consensus is that inflammation and fibrosis are central mechanisms in the progression of AF. However, artificially caused inflammatory cell death by catheter ablation may have a significant impact on structural and electrical remodeling, which may affect the long-term prognosis. This review first focused on the inflammatory response induced by apoptosis, necrosis, necroptosis, pyroptosis, ferroptosis and their interaction with arrhythmia. Then, we compared the differences in cell death induced by radiofrequency ablation, cryoballoon ablation and pulsed-field ablation. Finally, we discussed the structural and electrical remodeling caused by inflammation and the association between inflammation and the recurrence of AF after catheter ablation. Collectively, pulsed-field ablation will be a revolutionary innovation with faster, safer, better tissue selectivity and less inflammatory response induced by apoptosis-dominated cell death.
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Affiliation(s)
- Dishiwen Liu
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, 430060, People’s Republic of China
- Cardiovascular Research Institute, Wuhan University, Wuhan, 430060, People’s Republic of China
- Hubei Key Laboratory of Cardiology, Wuhan, 430060, People’s Republic of China
| | - Yajia Li
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, 430060, People’s Republic of China
- Cardiovascular Research Institute, Wuhan University, Wuhan, 430060, People’s Republic of China
- Hubei Key Laboratory of Cardiology, Wuhan, 430060, People’s Republic of China
| | - Qingyan Zhao
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, 430060, People’s Republic of China
- Cardiovascular Research Institute, Wuhan University, Wuhan, 430060, People’s Republic of China
- Hubei Key Laboratory of Cardiology, Wuhan, 430060, People’s Republic of China
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Xu H, Chen X, Zhang Y, Zhu K, Zhao J, Qin F, Tao H. Clinical Outcomes and Predictors of Late Recurrence in Young Patients with Atrial Fibrillation after Catheter Ablation. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2023; 2023:7892185. [PMID: 37284170 PMCID: PMC10241581 DOI: 10.1155/2023/7892185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Figures] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 02/05/2023] [Accepted: 02/10/2023] [Indexed: 06/08/2023]
Abstract
Background Catheter ablation (CA) is an established treatment for atrial fibrillation (AF), but the recurrence of AF is not neglected. Young patients with AF were generally more symptomatic and intolerant to long-term drug treatment. We aim to explore clinical outcomes and predictors of late recurrence (LR) in AF patients younger than 45 years after CA to better manage them. Methods We retrospectively studied 92 symptomatic AF patients who accepted CA from September 1, 2019, to August 31, 2021. Baseline clinical data (including N-terminal prohormone of brain natriuretic peptide, NT-proBNP), ablation outcomes, and follow-up outcomes were collected. Patients were followed up at 3, 6, 9, and 12 months. Follow-up data were available for 82/92 (89.1%) patients. Results One-year arrhythmia-free survival was 81.7% (67/82) in our study group. Major complications occurred in 3/82 (3.7%) patients with an acceptable rate. The value of ln(NT-proBNP) (P = 0.025, odds ratio [OR] = 1.977, 95% confidence interval [CI] 1.087-3.596) and a family history of AF (P = 0.041, HR = 9.269, 95% CI 1.097-78.295) could independently predict AF recurrence. The ROC analysis of ln(NT-proBNP) showed that NT-proBNP greater than 200.05 pg/ml (area under the curve: 0.772, 95% CI 0.642-0.902, P = 0.001, sensitivity 0.800, specificity 0.701) was the cut-off point for predicting late recurrence. Conclusions CA is a safe and effective treatment for AF patients younger than 45 years. Elevated NT-proBNP level and a family history of AF could be used as predictors for late recurrence in young patients. The result of this study may help us take more comprehensive management of those with high-recurrence risks to reduce disease burden and improve quality of life.
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Affiliation(s)
- Haonan Xu
- Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, No. 1, Longhu Middle Ring Road, Zhengzhou 450000, China
| | - Xiaowei Chen
- Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, No. 1, Longhu Middle Ring Road, Zhengzhou 450000, China
| | - Yubin Zhang
- Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, No. 1, Longhu Middle Ring Road, Zhengzhou 450000, China
| | - Kui Zhu
- Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, No. 1, Longhu Middle Ring Road, Zhengzhou 450000, China
| | - Jiangtao Zhao
- Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, No. 1, Longhu Middle Ring Road, Zhengzhou 450000, China
| | - Fen Qin
- Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, No. 1, Longhu Middle Ring Road, Zhengzhou 450000, China
| | - Hailong Tao
- Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, No. 1, Longhu Middle Ring Road, Zhengzhou 450000, China
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