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Karpouzas GA, Ormseth SR, van Riel PLCM, Gonzalez-Gay MA, Corrales A, Rantapää-Dahlqvist S, Sfikakis PP, Dessein P, Tsang L, Hitchon C, El-Gabalawy H, Pascual-Ramos V, Contreras-Yáñez I, Colunga-Pedraza IJ, Galarza-Delgado DA, Azpiri-Lopez JR, Semb AG, Misra DP, Hauge EM, Kitas G. Biological use influences the impact of inflammation on risk of major adverse cardiovascular events in rheumatoid arthritis. RMD Open 2024; 10:e004546. [PMID: 39043615 PMCID: PMC11268070 DOI: 10.1136/rmdopen-2024-004546] [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: 05/16/2024] [Accepted: 07/05/2024] [Indexed: 07/25/2024] Open
Abstract
OBJECTIVES Chronic inflammation promotes cardiovascular risk in rheumatoid arthritis (RA). Biological disease-modifying antirheumatic drugs (bDMARDs) improve disease activity and cardiovascular disease outcomes. We explored whether bDMARDs influence the impact of disease activity and inflammatory markers on long-term cardiovascular risk in RA. METHODS We studied 4370 participants without cardiovascular disease in a 10-country observational cohort of patients with RA. Endpoints were (1) major adverse cardiovascular events (MACE) encompassing myocardial infarction, stroke and cardiovascular death; and (2) any ischaemic cardiovascular events (iCVE) including MACE plus revascularisation, angina, transient ischaemic attack and peripheral arterial disease. RESULTS Over 26 534 patient-years, 239 MACE and 362 iCVE occurred. The interaction between 28-joint Disease Activity Score with C-reactive protein (DAS28-CRP) and bDMARD use was significant for MACE (p=0.017), suggesting the effect of DAS28-CRP on MACE risk differed among bDMARD users (n=515) and non-users (n=3855). DAS28-CRP (per unit increase) is associated with MACE risk in bDMARD non-users (HR 1.21 (95% CI 1.07 to 1.37)) but not users (HR 0.69 (95% CI 0.40 to 1.20)). The interaction between CRP (per log unit increase) and bDMARD use was also significant for MACE (p=0.011). CRP associated with MACE risk in bDMARD non-users (HR 1.16 (95% CI 1.04 to 1.30)), but not users (HR 0.65 (95% CI 0.36 to 1.17)). No interaction was observed between bDMARD use and DAS28-CRP (p=0.167) or CRP (p=0.237) for iCVE risk. CONCLUSIONS RA activity and inflammatory markers associated with risk of MACE in bDMARD non-users but not users suggesting the possibility of biological-specific benefits locally on arterial wall independently of effects on systemic inflammation.
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Affiliation(s)
- George Athanasios Karpouzas
- Internal Medicine - Rheumatology, The Lundquist Institute, Torrance, California, USA
- Rheumatology, Harbor-UCLA Medical Center, Torrance, California, USA
| | | | | | - Miguel A Gonzalez-Gay
- Rheumatology, Hospital Universitario Marques de Valdecilla, Santander, Cantabria, Spain
- IIS-Fundacion Jimenez Diaz, Madrid, Spain
| | - Alfonso Corrales
- Hospital Universitario Marques de Valdecilla, Santander, Cantabria, Spain
| | | | - Petros P Sfikakis
- First Dept. of Propedeutic Medicine, University of Athens, Athens, Attica, Greece
| | - Patrick Dessein
- School of Physiology, University of the Witwatersrand Johannesburg, Johannesburg, South Africa
| | - Linda Tsang
- Vrije Universiteit Brussel, Brussel, Belgium
| | - Carol Hitchon
- Rheumatology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Hani El-Gabalawy
- Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Virginia Pascual-Ramos
- Immunology and Rheumatology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico City, Mexico
| | - Irazú Contreras-Yáñez
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de Mexico, Mexico
| | - Iris J Colunga-Pedraza
- Rheumatology, Hospital Universitario Dr José Eleuterio González, Monterrey, Nuevo León, Mexico
| | | | | | - Anne Grete Semb
- Rheumatology and Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Durga Prasanna Misra
- Clinical Immunology and Rheumatology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Ellen-Margrethe Hauge
- Department of Joint and Connective Tissue Diseases, Aarhus Universitetshospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus Universitet, Aarhus, Midtjylland, Denmark
| | - George Kitas
- Department of Rheumatology, The Dudley Group NHS Foundation Trust, Dudley, West Midlands, UK
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Correlation of TET-2 Levels with Disease Evaluation in AMI Patients. CONTRAST MEDIA & MOLECULAR IMAGING 2022; 2022:9983071. [PMID: 35965615 PMCID: PMC9357739 DOI: 10.1155/2022/9983071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 06/29/2022] [Accepted: 07/01/2022] [Indexed: 11/17/2022]
Abstract
Objective To investigate the expression levels of Ten-Eleven Translocation-2 (TET-2) in patients with acute myocardial infarction (AMI) and correlations of TET-2 levels with disease severity. Methods A total of 150 patients with confirmed AMI were included in this study. According to the number of coronary artery lesions, the patients were divided into a single lesion group, two lesion group, and three lesion group. According to the Gensini scores, these patients were also assigned into three groups: the low-risk group, middle-risk group, and high-risk group. 150 patients without AMI confirmed by coronary angiography were included in the control group in the same period. TET-2 and cardiac troponin T (cTNT) levels were detected by ELISA analysis and compared among different groups. Pearson's correlation analysis was used to evaluate the correlations of TET-2 levels and cTNT levels/Gensini scores. The levels of TET-2 in AMI patients increased remarkably with the increase of disease severity. Patients in the single lesion group or low-risk group had the lowest levels of TET-2. Pearson correlation analysis indicated that TET-2 levels were positively associated with cTNT levels and Gensini scores, respectively (all P < 0.001). Conclusion The levels of TET-2 were upregulated in AMI patients and positively correlated with cTNT levels or Gensini scores, suggesting that the examination of TET-2 expression levels could be exploited for predicting the disease severity.
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Szeremeta A, Jura-Półtorak A, Zoń-Giebel A, Olczyk K, Komosińska-Vassev K. TNF-α Inhibitors in Combination with MTX Reduce Circulating Levels of Heparan Sulfate/Heparin and Endothelial Dysfunction Biomarkers (sVCAM-1, MCP-1, MMP-9 and ADMA) in Women with Rheumatoid Arthritis. J Clin Med 2022; 11:jcm11144213. [PMID: 35887981 PMCID: PMC9320287 DOI: 10.3390/jcm11144213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 07/13/2022] [Accepted: 07/19/2022] [Indexed: 11/16/2022] Open
Abstract
Sulfated glycosaminoglycans (sGAGs) are likely to play an important role in the development and progression of rheumatoid arthritis (RA)-associated atherosclerosis. The present study investigated the effect of anti-tumor necrosis factor-α (anti-TNF-α) therapy in combination with methotrexate on plasma sGAG levels and serum markers of endothelial dysfunction. Among sGAG types, plasma chondroitin/dermatan sulfate (CS/DS) and heparan sulfate/heparin (HS/H) were characterized using electrophoretic fractionation. Serum levels of soluble vascular cell adhesion molecule-1 (sVCAM-1), monocyte chemoattractant protein-1 (MCP-1), matrix metalloproteinase-9 (MMP-9) and asymmetric dimethylarginine (ADMA) were measured by immunoassays. The measurements were carried out four times: at baseline and after 3, 9 and 15 months of anti-TNF-α therapy. All analyzed parameters, excluding ADMA, were significantly elevated in patients with RA before the implementation of biological therapy compared to healthy subjects. Performed anti-TNF-α treatment led to a successive decrease in HS/H levels toward normal values, without any effect on CS/DS levels in female RA patients. The treatment was also effective at lowering the serum levels of sVCAM-1, MCP-1, MMP-9 and ADMA. Moreover, a significant positive correlation was found between the circulating HS/H and the 28 joint disease activity score based on the erythrocyte sedimentation rate (DAS28-ESR, r = 0.408; p <0.05), MCP-1 (r = 0.398; p <0.05) and ADMA (r = 0.396; p <0.05) in patients before the first dose of TNF-α inhibitor. In conclusion, a beneficial effect of anti-TNF-α therapy on cell-surface heparan sulfate proteoglycans (HSPGs)/HS turnover and endothelial dysfunction was observed in this study. This was manifested by a decrease in blood HS/H levels and markers of endothelial activation, respectively. Moreover, the decrease in the concentration of HS/H in the blood of patients during treatment, progressing with the decline in disease activity, indicates that the plasma HS/H profile may be useful for monitoring the efficacy of anti-TNF-α treatment in patients with RA.
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Affiliation(s)
- Anna Szeremeta
- Department of Clinical Chemistry and Laboratory Diagnostics, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, Jedności 8, 41-200 Sosnowiec, Poland; (A.J.-P.); (K.O.); (K.K.-V.)
- Correspondence: ; Tel.: +48-32-364-11-50
| | - Agnieszka Jura-Półtorak
- Department of Clinical Chemistry and Laboratory Diagnostics, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, Jedności 8, 41-200 Sosnowiec, Poland; (A.J.-P.); (K.O.); (K.K.-V.)
| | - Aleksandra Zoń-Giebel
- Department of Rheumatology and Rehabilitation, Specialty Hospital No. 1, Żeromskiego 7, 41-902 Bytom, Poland;
| | - Krystyna Olczyk
- Department of Clinical Chemistry and Laboratory Diagnostics, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, Jedności 8, 41-200 Sosnowiec, Poland; (A.J.-P.); (K.O.); (K.K.-V.)
| | - Katarzyna Komosińska-Vassev
- Department of Clinical Chemistry and Laboratory Diagnostics, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, Jedności 8, 41-200 Sosnowiec, Poland; (A.J.-P.); (K.O.); (K.K.-V.)
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Irqsusi M, Mansouri AL, Ramaswamy A, Rexin P, Salman M, Mahmood S, Mirow N, Ghazi T, Ramzan R, Rastan AJ, Vogt S. Role of matrix metalloproteinases in mitral valve regurgitation: Association between the of MMP-1, MMP-9, TIMP-1, and TIMP-2 expression, degree of mitral valve insufficiency, and pathologic etiology. J Card Surg 2022; 37:1613-1622. [PMID: 35343608 DOI: 10.1111/jocs.16449] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 02/07/2022] [Accepted: 03/02/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND The pathogenesis of mitral valve insufficiency is not yet fully understood. Several studies stressed the role of matrix metalloproteinases (MMPs) in the emergence of valvular pathologies. The primary objective of the present study is to analyze the role of selected MMPs and their inhibitors in mitral valve insufficiency. PATIENTS AND METHODS Eighty patients (33 female/47 male, mean age 67 years) underwent cardiopulmonary bypass surgery for mitral valve reconstruction between 2007 and 2015. All patients suffered from mitral insufficiency (MI) Stages iii and iv. When tissue resection was acquired specimens were taken immediately frozen and used for histological examination. Expression of MMP-1, MMP-9, tissue inhibitor of metalloproteinase (TIMP)-1, and TIMP-2 was examined immunohistochemically and distribution was analyzed in regard to preoperative clinical, echocardiographic, and histopathological findings. RESULTS A clear correlation between the MMP expression and the MI degree of severity could be shown. The expression of MMPs proved to be high in relation to mild insufficiencies and relatively weak in the case of severe ones. Additionally, the etiology of the MI was considered in the analysis and a significant difference in the expression of MMPs between the mitral valves with endocarditis and the ones featuring a degenerative disease could be shown. Within the group of valves with degenerative diseases, no significant difference could be established between the subgroups (myxoid and sclerosed valves). CONCLUSION The increased expression of MMPs and their inhibitors in mild insufficiencies could prove that the molecular changes in the valve precede the macroscopical and thus the echocardiographically diagnosable changes. Hence, new options for early diagnosis and therapy of MIs should be examined in further studies, respectively. Herein, the correlation of the MMP blood levels with MMP tissue expression should be addressed for surgical therapeutical decisions.
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Affiliation(s)
- Marc Irqsusi
- Department of Cardiovascular Surgery, University Hospital Gießen and Marburg, Marburg, Germany
| | - Azza Labene Mansouri
- Department of Cardiovascular Surgery, University Hospital Gießen and Marburg, Marburg, Germany
| | - Anette Ramaswamy
- Institute for Pathology, University Hospital Gießen and Marburg, Marburg, Germany
| | - Peter Rexin
- Institute for Pathology, University Hospital Gießen and Marburg, Marburg, Germany
| | - Midhat Salman
- Department of Forensic Sciences, University of Health Sciences, Lahore, Pakistan
| | - Saqib Mahmood
- Department of Human Genetics and Molecular Biology, University of Health Sciences, Lahore, Pakistan
| | - Nikolas Mirow
- Department of Cardiovascular Surgery, University Hospital Gießen and Marburg, Marburg, Germany
| | - Tamer Ghazi
- Department of Cardiovascular Surgery, University Hospital Gießen and Marburg, Marburg, Germany
| | - Rabia Ramzan
- Department of Cardiovascular Surgery, University Hospital Gießen and Marburg, Marburg, Germany
| | - Ardawan J Rastan
- Department of Cardiovascular Surgery, University Hospital Gießen and Marburg, Marburg, Germany
| | - Sebastian Vogt
- Department of Cardiovascular Surgery, University Hospital Gießen and Marburg, Marburg, Germany
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Correlation Analysis of Acute Coronary Syndrome with Serum IL-18, MMP-9, hs-CRP, and Plasma FIB. BIOMED RESEARCH INTERNATIONAL 2022; 2022:5984184. [PMID: 35028315 PMCID: PMC8752213 DOI: 10.1155/2022/5984184] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 11/03/2021] [Indexed: 12/19/2022]
Abstract
Aim This study attempted to investigate the diagnostic value of interleukin-18 (IL-18), matrix metalloproteinase-9 (MMP-9), high-sensitivity C-reactive protein (hs-CRP), and fibrinogen (FIB) in acute coronary syndrome (ACS) and their correlation with the degree of vascular lesions. Materials and Methods Altogether 206 patients with coronary heart disease admitted to our hospital were selected as research objects, including 136 patients with ACS (group A), 70 patients with stable angina pectoris (SAP) (group B), and 60 patients with noncoronary heart disease who had normal coronary angiography during the same period were selected as group C. The levels of IL-18, MMP-9, and hs-CRP in the serum were detected by enzyme-linked immunosorbent assay (ELISA), and the level of FIB in plasma was detected by automatic coagulation analyzer. Results Serum IL-18, MMP-9, hs-CRP, and plasma FIB levels in group A were significantly higher than those in group B and group C (p < 0.05). ROC curve and multivariate logistic regression showed that the sensitivity and specificity of combined diagnosis of ACS with serum IL-18, MMP-9, hs-CRP, and plasma FIB were 86.03% and 95.71%, respectively. Serum IL-18, MMP-9, hs-CRP, and plasma FIB were positively correlated with Gensini grading (p < 0.001). Serum IL-18, MMP-9, hs-CRP, and plasma FIB levels were positively correlated (p < 0.001). Conclusion The combined detection of serum IL-18, MMP-9, hs-CRP, and plasma FIB has good diagnostic value for ACS, and these index levels are positively correlated with the degree of vascular lesions.
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6
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Todorova VK, Wei JY, Makhoul I. Subclinical doxorubicin-induced cardiotoxicity update: role of neutrophils and endothelium. Am J Cancer Res 2021; 11:4070-4091. [PMID: 34659877 PMCID: PMC8493405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 07/23/2021] [Indexed: 06/13/2023] Open
Abstract
Doxorubicin (DOX) is a highly effective chemotherapy agent that often causes cardiotoxicity. Despite a number of extensive studies, the risk for DOX cardiotoxicity remains unpredictable. The majority of the studies on DOX-induced cardiotoxicity have been focused on the effects on cardiomyocytes that lead to contractile dysfunction. The roles of systemic inflammation, endothelial injury and neutrophil recruitment, all induced by the DOX, are increasingly recognized as the mechanisms that trigger the development and progression of DOX-induced cardiomyopathy. This review explores recent data regarding the possible mechanisms and biomarkers of early subclinical DOX-associated cardiotoxicity.
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Affiliation(s)
- Valentina K Todorova
- Division of Medical Oncology/Department of Internal Medicine, University of Arkansas for Medical SciencesLittle Rock, Arkansas, USA
- Department of Geriatrics, University of Arkansas for Medical SciencesLittle Rock, Arkansas, USA
| | - Jeanne Y Wei
- Department of Geriatrics, University of Arkansas for Medical SciencesLittle Rock, Arkansas, USA
| | - Issam Makhoul
- Division of Medical Oncology/Department of Internal Medicine, University of Arkansas for Medical SciencesLittle Rock, Arkansas, USA
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Shirakawa T, Fujisue K, Nakamura S, Yamamoto N, Oshima S, Matsumura T, Tsunoda R, Hirai N, Koide S, Tayama S, Kikuta K, Hirose T, Maruyama H, Fujimoto K, Kajiwara I, Sakamoto T, Nakao K, Sakaino N, Nagayoshi Y, Hokamaki J, Shimomura H, Sakamoto K, Yamamoto E, Izumiya Y, Kaikita K, Hokimoto S, Ogawa H, Tsujita K. Dose-Dependent Inhibitory Effect of Rosuvastatin in Japanese Patients with Acute Myocardial Infarction on Serum Concentration of Matrix Metalloproteinases-INVITATION Trial. J Atheroscler Thromb 2021; 29:229-241. [PMID: 33408315 PMCID: PMC8803556 DOI: 10.5551/jat.59477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Aim:
Matrix metalloproteinases (MMPs) play critical roles in acute myocardial infarction (AMI). This trial was conducted to determine the potential effects of higher-dose rosuvastatin on circulating MMP levels in patients with AMI.
Methods:
This was a multicenter, open-label, 1:1 randomized, parallel-group study. Patients with AMI were randomly assigned to the appropriate-dose group (10 mg rosuvastatin once daily) or the low-dose group (2.5 mg rosuvastatin once daily) within 24 hours after percutaneous coronary intervention. MMP-2 and MMP-9 levels were measured on day 1 and at week 4, 12, and 24 after enrollment. The primary endpoint was the change in MMP levels at 24 weeks after enrollment. The secondary endpoints were change in MMP levels at day 1 and weeks 4 and 12 after enrollment.
Results:
Between August 2017 and October 2018, 120 patients with AMI from 19 institutions were randomly assigned to either the appropriate-dose or the low-dose group. There were 109 patients who completed the 24-week follow-up. The primary endpoint for both MMP-2 and MMP-9 was not significantly different between the two groups. The change in the active/total ratio of MMP-9 at week 12 after baseline was significantly lower in the appropriate-dose group compared with the low-dose group (0.81 [−52.8–60.1]% vs. 70.1 [−14.5–214.2]%,
P
=0.004), while the changes in MMP-2 were not significantly different between the two groups during the study period.
Conclusions:
This study could not demonstrate the superiority of appropriate-dose of rosuvastatin in inhibiting serum MMPs levels in patients with AMI.
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Affiliation(s)
- Takuhiro Shirakawa
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, and Center for Metabolic Regulation of Healthy Aging (CMHA), Kumamoto University.,Department of Cardiovascular Medicine, Fukuoka Tokushukai Medical Center
| | - Koichiro Fujisue
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, and Center for Metabolic Regulation of Healthy Aging (CMHA), Kumamoto University
| | - Shinichi Nakamura
- Division of Cardiology, Japan Community Health care Organization Hitoyoshi Medical Center
| | | | | | - Toshiyuki Matsumura
- Division of Cardiology, Japan Labor Health and Welfare Organization Kumamoto Rosai Hospital
| | - Ryusuke Tsunoda
- Division of Cardiology, Japanese Red Cross Kumamoto Hospital
| | - Nobutaka Hirai
- Division of Cardiology, Kumamoto Regional Medical Center
| | - Shunichi Koide
- Division of Cardiology, Health Insurance Kumamoto General Hospital
| | - Shinji Tayama
- Division of Cardiology, Health Insurance Kumamoto General Hospital
| | | | - Toyoki Hirose
- Division of Cardiology, Minamata City General Hospital & Medical Center
| | - Hideki Maruyama
- Division of Cardiology, Minamata City General Hospital & Medical Center
| | - Kazuteru Fujimoto
- Department of Cardiology, National Hospital Organization Kumamoto Medical Center
| | | | - Tomohiro Sakamoto
- Division of Cardiology, Saiseikai Kumamoto Hospital Cardiovascular Center
| | - Koichi Nakao
- Division of Cardiology, Saiseikai Kumamoto Hospital Cardiovascular Center
| | | | | | | | - Hideki Shimomura
- Department of Cardiovascular Medicine, Fukuoka Tokushukai Medical Center
| | - Kenji Sakamoto
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, and Center for Metabolic Regulation of Healthy Aging (CMHA), Kumamoto University
| | - Eiichiro Yamamoto
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, and Center for Metabolic Regulation of Healthy Aging (CMHA), Kumamoto University
| | - Yasuhiro Izumiya
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, and Center for Metabolic Regulation of Healthy Aging (CMHA), Kumamoto University.,Department of Cardiovascular Medicine, Osaka City University Graduate School of Medicine
| | - Koichi Kaikita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, and Center for Metabolic Regulation of Healthy Aging (CMHA), Kumamoto University
| | - Seiji Hokimoto
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, and Center for Metabolic Regulation of Healthy Aging (CMHA), Kumamoto University
| | | | - Kenichi Tsujita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, and Center for Metabolic Regulation of Healthy Aging (CMHA), Kumamoto University
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Kook H, Jang DH, Kim JH, Cho JY, Joo HJ, Cho SA, Park JH, Hong SJ, Yu CW, Lim DS. Identification of plaque ruptures using a novel discriminative model comprising biomarkers in patients with acute coronary syndrome. Sci Rep 2020; 10:20228. [PMID: 33214686 PMCID: PMC7677551 DOI: 10.1038/s41598-020-77413-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 10/26/2020] [Indexed: 12/11/2022] Open
Abstract
Soluble lectin-like oxidized low-density lipoprotein receptor-1 (sLOX-1), neutrophil gelatinase-associated lipocalin (NGAL), and matrix metalloproteinase-9 (MMP-9) are inflammatory biomarkers involved in plaque destabilization resulting in acute coronary syndrome (ACS). This study aimed to investigate the diagnostic value of a combination of biomarkers to discriminate plaque ruptures in the setting of ACS. Eighty-five ACS patients with optical coherence tomography (OCT) images of the culprit plaque were included and categorized into two groups: ACS with plaque rupture (Rupture group, n = 42) or without plaque rupture (Non-rupture group, n = 43) verified by OCT. A discriminative model of plaque rupture using several biomarkers was developed and validated. The Rupture group had higher white blood cell (WBC) counts and peak creatine kinase-myocardial band (CK-MB) levels (13.39 vs. 2.69 ng/mL, p = 0.0016). sLOX-1 (227.9 vs. 51.7 pg/mL, p < 0.0001) and MMP-9 (13.4 vs. 6.45 ng/mL, p = 0.0313) levels were significantly higher in the Rupture group, whereas NGAL showed a trend without statistical significance (59.03 vs. 53.80 ng/mL, p = 0.093). Receiver operating characteristic curves to differentiate Rupture group from Non-rupture group calculated the area under the curve for sLOX-1 (p < 0.001), MMP-9 (p = 0.0274), and NGAL (p = 0.0874) as 0.763, 0.645, and 0.609, respectively. A new combinatorial discriminative model including sLOX-1, MMP-9, WBC count, and the peak CK-MB level showed an area under the curve of 0.8431 (p < 0.001). With a cut-off point of 0.614, the sensitivity and specificity of plaque rupture were 62.2% and 97.6%, respectively. The new discriminative model using sLOX-1, MMP-9, WBC count, and peak CK-MB levels could better identify plaque rupture than each individual biomarker in ACS patients.
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Affiliation(s)
- Hyungdon Kook
- Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital, Korea University School of Medicine, #73, Inchon-ro, Seongbuk-gu, Seoul, 02841, Korea
| | - Duck Hyun Jang
- Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital, Korea University School of Medicine, #73, Inchon-ro, Seongbuk-gu, Seoul, 02841, Korea
| | - Jong-Ho Kim
- Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital, Korea University School of Medicine, #73, Inchon-ro, Seongbuk-gu, Seoul, 02841, Korea
| | - Jae-Young Cho
- Department of Cardiovascular Medicine, Regional Cardiocerebrovascular Center, Wonkwang University Medical Center, Iksan, Korea
| | - Hyung Joon Joo
- Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital, Korea University School of Medicine, #73, Inchon-ro, Seongbuk-gu, Seoul, 02841, Korea
| | - Sang-A Cho
- Health Insurance Review and Assessment Service, Wonju, Korea
| | - Jae Hyoung Park
- Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital, Korea University School of Medicine, #73, Inchon-ro, Seongbuk-gu, Seoul, 02841, Korea
| | - Soon Jun Hong
- Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital, Korea University School of Medicine, #73, Inchon-ro, Seongbuk-gu, Seoul, 02841, Korea
| | - Cheol Woong Yu
- Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital, Korea University School of Medicine, #73, Inchon-ro, Seongbuk-gu, Seoul, 02841, Korea.
| | - Do-Sun Lim
- Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital, Korea University School of Medicine, #73, Inchon-ro, Seongbuk-gu, Seoul, 02841, Korea.
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9
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Wang JC, Chien WC, Chung CH, Lin CY, Hsu CW, Lin CS, Tsai SH. Association between surgical repair of aortic aneurysms and the diagnosis of subsequent cardiovascular diseases. J Cardiol 2020; 75:621-627. [DOI: 10.1016/j.jjcc.2019.12.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 11/25/2019] [Accepted: 12/08/2019] [Indexed: 11/27/2022]
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Yu D, Wang T, Huang J, Fang X, Fan H, Yi G, Liu Q, Zhang Y, Zeng X, Liu Q. MicroRNA‐9 overexpression suppresses vulnerable atherosclerotic plaque and enhances vascular remodeling through negative regulation of the p38MAPK pathway via OLR1 in acute coronary syndrome. J Cell Biochem 2019; 121:49-62. [DOI: 10.1002/jcb.27830] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 09/14/2018] [Indexed: 12/16/2022]
Affiliation(s)
- Dao‐Rui Yu
- Department of Pharmacology School of Basic Medicine and Life Science, Hainan Medical University Haikou China
| | - Tao Wang
- Department of nursing humanities, International Nursing School, Hainan Medical University
| | - Jing Huang
- Department of Pharmacology School of Basic Medicine and Life Science, Hainan Medical University Haikou China
| | - Xing‐Yue Fang
- Department of Pharmacology School of Basic Medicine and Life Science, Hainan Medical University Haikou China
| | - Hao‐Fei Fan
- Department of Pharmacology School of Basic Medicine and Life Science, Hainan Medical University Haikou China
| | - Guo‐Hui Yi
- Instrument testing center, Public Research Laboratory, Hainan Medical University
| | - Qiang Liu
- Department of Pharmacology School of Basic Medicine and Life Science, Hainan Medical University Haikou China
| | - Yu Zhang
- Department of Pharmacology, School of Pharmacy, Nanjing Medical University
| | - Xiang‐Zhou Zeng
- Department of Pharmacology School of Basic Medicine and Life Science, Hainan Medical University Haikou China
| | - Qi‐Bing Liu
- Department of Pharmacology School of Basic Medicine and Life Science, Hainan Medical University Haikou China
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Shchinova AM, Shlevkova GV, Filatova AY, Potekhina AV, Osokina AK, Romasov IV, Zharova EA, Noeva EA, Samko AN, Masenko VP, Arefieva TI, Provatorov SI. [Preprocedural high - sensitivity C-reactive protein (hsCRP) decrease during intensive atorvastatin therapy: the presumable impact on atherosclerosis progression after coronary stenting]. TERAPEVT ARKH 2019; 91:10-15. [PMID: 32598808 DOI: 10.26442/00403660.2019.09.000144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Indexed: 11/22/2022]
Abstract
Proinflammatory status is the risk factor for coronary atherosclerosis progression after coronary stenting (CS). Intensive statin treatment is associated with hsCRP concentration decline. AIM to evaluate prognostic significance of preprocedural hsCRP level reduction with intensive statin regimen for coronary atherosclerosis progression during one year after CS. MATERIALS AND METHODS We enrolled 102 patients with stable angina who were on list for scheduled CS. Group I (n=37) patients received atorvastatin 80 mg for 7 days before and 3 months after CS with further dose adjustment according to LDL; group II (n=65) patients received atorvastatin 20-40 mg/day for LDL goal achievement. HsCRP level was assessed at baseline, before CS and after 1, 3, 6 and 12 months. Coronary atherosclerosis progression was defined as new ≥50% stenosis or ≥30% increase of ≥20% pre - existing stenosis according to coronary angiography (CA) 1 year after CS. RESULTS Baseline concentration of hsCRP was comparable: 0.21 (0.13; 0.38) vs. 0.20 (0.1; 0.44) mg/dl in groups I and II, respectively (p>0.05). In group I significant hsCRP level decrease to 0.14 (0.07; 0.32) mg/dl (p.
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Affiliation(s)
| | | | | | | | - A K Osokina
- National Medical Research Center of Cardiology
| | - I V Romasov
- National Medical Research Center of Cardiology
| | - E A Zharova
- National Medical Research Center of Cardiology
| | - E A Noeva
- National Medical Research Center of Cardiology
| | - A N Samko
- National Medical Research Center of Cardiology
| | - V P Masenko
- National Medical Research Center of Cardiology
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12
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JIANG Y, NI K, FANG M, LI J. The Effects of Serum hs-CRP on the Incidence of Lung Cancer in Male Patients with Pulmonary Tuberculosis. IRANIAN JOURNAL OF PUBLIC HEALTH 2019; 48:1265-1269. [PMID: 31497547 PMCID: PMC6708544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND This study intended to investigate the effects of serum high-sensitivity C-reactive protein (hs-CRP) on the incidence of lung cancer in male patients with pulmonary tuberculosis. METHODS A total of 1091 male patients with pulmonary tuberculosis in Zhejiang Cancer Hospital, Hangzhou, China from Jan 2009 to Jan 2012 were selected as the research objects. All patients were followed up from the beginning of hospitalization. According to serum hs-CRP level, patients were divided into two groups: group A (hs-CRP < 1 mg/L) and group B (hs-CRP > 3 mg/L). The relationship between baseline hs-CRP and the risk of lung cancer in patients with pulmonary tuberculosis was analyzed by multivariate Cox proportional risk regression model, and the serum levels of hs-CRP between lung cancer patients in all groups and other non-lung cancer patients were compared. RESULTS There were differences in age, drinking, smoking, diabetes history, body mass index (BMI), thyroglobulin (TG), history of hypertension and hyperglycemia among the three groups (P=0.036, 0.018, 0.040, 0.029, 0.006, 0.034, 0.020, 0.010). The serum levels of hs-CRP in patients with squamous carcinoma, adenocarcinoma and small cell carcinoma were significantly higher than those in non-lung cancer patients (P=0.022, 0.043, 0.011). The incidence rates of lung cancer in patients in group B and C were 1.37 and 1.69 times higher than that in group A, respectively. CONCLUSION The increased serum level of hs-CRP will increase the incidence rate of lung cancer in male patients with pulmonary tuberculosis.
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Affiliation(s)
- Youhua JIANG
- Department of Thoracic Surgery, Zhejiang Cancer Hospital, Hangzhou 310000, P.R. China
| | - Kewei NI
- Department of Cardio-Thoracic Surgery, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou 310000, P.R. China
| | - Meiyu FANG
- Department of Comprehensive Medical Oncology, Zhejiang Cancer Hospital, Hangzhou 310000, P.R. China
| | - Junling LI
- State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou 510060, P.R. China,Corresponding Author:
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Dose-dependent INhibitory effect of rosuVastatin In Japanese patienTs with Acute myocardial infarcTION on serum concentration of matrix metalloproteinases - INVITATION trial. J Cardiol 2018; 72:350-355. [PMID: 29735336 DOI: 10.1016/j.jjcc.2018.03.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 02/24/2018] [Accepted: 03/22/2018] [Indexed: 11/23/2022]
Abstract
BACKGROUND Acute myocardial infarction (AMI) is mainly characterized by the rupture of lipid-rich vulnerable atherosclerotic plaque. The matrix metalloproteinases (MMPs) have been shown to play a critical role in inflammatory processes underlying plaque rupture. Some reports suggested statins inhibit the increased MMP levels after AMI. However, there are a few comparison studies between the different dosages of the same statin and circulating levels of MMPs. PURPOSE This study will preliminarily investigate the potential effects of appropriate or low dose of rosuvastatin on circulating MMPs levels in AMI patients. Moreover, we will also obtain plasma from patients while undergoing diagnostic angiography to determine differences in various cardiac sites and peripheral vessels. METHODS This study is a multicenter, open-label, randomized, parallel-group study to be conducted to compare the appropriate or low dose of rosuvastatin in the effect on serum levels of inflammatory markers in AMI patients. The eligible patients undergoing percutaneous coronary intervention (PCI) will be randomly assigned to receive either appropriate or low-dose rosuvastatin daily using a web-based randomization software within 24h after PCI. The low-dose group will be treated with rosuvastatin 2.5mg once daily with a follow-up. The appropriate-dose group will begin treatment with rosuvastatin 5mg once daily, and the dose of rosuvastatin will be titrated to 10mg within 4 weeks. During administration of the study treatment, subjects will undergo laboratory testing including MMPs and be monitored for the occurrence of adverse events up to 24 weeks. The primary endpoint will be the change rate of MMPs at 24 weeks after administration. CONCLUSIONS INVITATION will compare the appropriate or low dose of rosuvastatin in the effects on serum levels of inflammatory markers including MMPs in AMI patients. This study will provide significant information on rosuvastatin as an anti-inflammatory agent for AMI.
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Sun R, Wang L, Guan C, Cao W, Tian B. Carotid Atherosclerotic Plaque Features in Patients with Acute Ischemic Stroke. World Neurosurg 2018; 112:e223-e228. [PMID: 29325936 DOI: 10.1016/j.wneu.2018.01.026] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 01/02/2018] [Accepted: 01/04/2018] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To investigate the carotid atherosclerotic plaque features in patients with acute ischemic stroke. METHODS A total of 288 patients meeting the included criteria were enrolled and divided into an ulcerated plaque group (n = 139) and a nonulcerated plaque group (n = 149). Patients in the ulcerated plaque group were further subdivided into <50% and ≥50% stenosis groups. Carotid plaque component characteristics including luminal stenosis, carotid plaque volume, hypoechoic plaque volume, and hyperechoic plaque volume were analyzed by color Doppler ultrasound measurement. Associations between ulcerated plaque and carotid plaque features were also evaluated. The relationships among the levels of MMP-9, hs-CRP, and carotid stenosis rate were detected by enzyme-linked immunosorbent assay. RESULTS The plaque volume, hypoechoic plaque volume, and luminal stenosis in the ulcerated plaque group were higher than that of the nonulcerated plaque group (P < 0.05). Ulcerated plaque was positively associated with luminal stenosis, plaque volume, and hypoechoic plaque volume after adjusting for sex and age. The result remained similar after adjusting for age, sex, and carotid luminal stenosis. The levels of MMP-9 and hs-CRP in the ulcerated plaque group were significantly higher than those of the nonulcerated plaque group (P < 0.01). For the ulcerated plaque group, the higher the carotid stenosis rate, the higher the level of MMP-9 and hs-CRP. CONCLUSIONS Higher carotid atherosclerosis plaque volume, hypoechoic plaque volume, and luminal carotid stenosis may be symptoms of ulcerated plaque. Increased MMP-9 and hs-CRP levels could be used as adjunctive therapies of carotid stenosis at the molecular level.
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Affiliation(s)
- Runming Sun
- Department of Neurology, People's Hospital of Linzi District, Affiliated to Binzhou Medical College, Zibo, China.
| | - Lixia Wang
- Department of Endocrinology, People's Hospital of Linzi District, Affiliated to Binzhou Medical College, Zibo, China
| | - Cuiling Guan
- Department of Neurology, Provincial Hospital Affiliated to Shandong University, Jinan, Shandong Province, China
| | - Wenyuan Cao
- Department of Neurology, People's Hospital of Linzi District, Affiliated to Binzhou Medical College, Zibo, China
| | - Bing Tian
- Department of Ultrasonography, People's Hospital of Linzi District, Affiliated to Binzhou Medical College, Zibo, China
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Liu HY, Zhou J, Tong H, Tang Y, Wang XF, Zhou QC. Quantitative evaluation of atherosclerotic plaques and intraplaque neovascularization using contrast-enhanced ultrasound after treatment with atorvastatin in rabbits. Biomed Pharmacother 2017; 92:277-284. [DOI: 10.1016/j.biopha.2017.04.068] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 04/01/2017] [Indexed: 12/21/2022] Open
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Clinical characteristics and prognosis of acute coronary syndrome in young women and men: A systematic review and meta-analysis of prospective studies. Int J Cardiol 2017; 228:837-843. [DOI: 10.1016/j.ijcard.2016.11.148] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 11/06/2016] [Indexed: 11/23/2022]
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