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Carella M, Magro D, Scola L, Pisano C, Guida E, Gervasi F, Giambanco C, Aronica TS, Frati G, Balistreri CR. CAR, mGPS and hs-mGPS: What is among them the best gero-biomarker for age-related diseases? And for what clinical application? Mech Ageing Dev 2024; 220:111952. [PMID: 38838917 DOI: 10.1016/j.mad.2024.111952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 05/21/2024] [Accepted: 05/26/2024] [Indexed: 06/07/2024]
Abstract
The identification of biomarkers linked to the onset, progression, and prevention of age-related diseases (ARD), in the era of personalized medicine, represents the best goal of geroscience. Geroscience has the fundamental role of exploring and identifying the biological mechanisms of aging to suggest interventions capable of stopping/delaying the many pathological conditions and disabilities related to age. Therefore, it has become its key priority, as well as that of clinical practice and research, based on identifying and validating a range of biomarkers, geromarkers, which can be used to diagnostic, prognostic, or predictive clinical purposes. Indeed, geromarkers have, the potential to predict ARD trajectories and facilitate targeted interventions to slow down the related disabilities. Here our attention is paid to the inflammatory indexes (CAR, mGPS, hs-mGPS) linked to the relationship between the plasma levels of two inflammatory analytes, the typical positive protein of the acute phase, and the negative one, i.e. c-reactive protein (CRP) and albumin, respectively. These indexes allow us to understand the magnitude of the two main mechanisms predicted to influence the aging process, including inflammation and immunosenescence, as well as the degree of ARD severity. Evidence on their relationship with ARD is widely reported and discussed, to understand which can represent the best ARD geromarker, and its clinical application.
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Affiliation(s)
- Miriam Carella
- Complex Operative Unit of Clinical Pathology, ARNAS Civico Di Cristina e Benfratelli Hospitals, Palermo 90127, Italy
| | - Daniele Magro
- Cellular, Molecular and Clinical Pathological Laboratory, Department of Biomedicine, Neuroscience and Advanced Diagnostics (Bi.N.D.), University of Palermo, Palermo 90134, Italy
| | - Letizia Scola
- Cellular, Molecular and Clinical Pathological Laboratory, Department of Biomedicine, Neuroscience and Advanced Diagnostics (Bi.N.D.), University of Palermo, Palermo 90134, Italy
| | - Calogera Pisano
- Department of Precision Medicine in Medicine, Surgery, Critical Areas, University of Palermo, Palermo 90127, Italy
| | - Eugenia Guida
- Specialized Laboratory of Oncology, ARNAS Civico Di Cristina e Benfratelli Hospitals, Palermo 90127, Italy
| | - Francesco Gervasi
- Specialized Laboratory of Oncology, ARNAS Civico Di Cristina e Benfratelli Hospitals, Palermo 90127, Italy
| | - Caterina Giambanco
- Complex Operative Unit of Clinical Pathology, ARNAS Civico Di Cristina e Benfratelli Hospitals, Palermo 90127, Italy
| | - Tommaso Silvano Aronica
- Complex Operative Unit of Clinical Pathology, ARNAS Civico Di Cristina e Benfratelli Hospitals, Palermo 90127, Italy
| | - Giacomo Frati
- IRCCS Neuromed, Pozzilli, Italy; Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
| | - Carmela Rita Balistreri
- Cellular, Molecular and Clinical Pathological Laboratory, Department of Biomedicine, Neuroscience and Advanced Diagnostics (Bi.N.D.), University of Palermo, Palermo 90134, Italy.
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Rammos A, Bechlioulis A, Kekiopoulou A, Kekiopoulos P, Katsouras CS, Sioka C. Myocardial Perfusion Imaging and C-Reactive Protein in Myocardial Ischemia: A Retrospective Single-Center Study. Life (Basel) 2024; 14:261. [PMID: 38398769 PMCID: PMC10890337 DOI: 10.3390/life14020261] [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: 01/05/2024] [Revised: 02/11/2024] [Accepted: 02/14/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Inflammation is an important mechanism in atherosclerosis and plaque formation. C-reactive protein (CRP) is a common inflammatory biomarker associated with the risk of coronary heart disease. We investigated the relationship of CRP with findings from myocardial perfusion imaging (MPI). METHODS In this retrospective study, 102 consecutive patients (mean age 71 years, 68% males) who underwent MPI (for diagnostic reasons or quantification of myocardial ischemia) and CRP determination (upper limit: 6 mg/L) within 1 month from MPI were included. The patients had no infection or recent acute coronary syndrome. RESULTS The median CRP level was 4 mg/L (2, 10) among the study population. Patients with raised CRP had higher summed stress score (SSS) (p = 0.006) and summed rest score (SRS) (p = 0.001) and higher risk for SSS > 3 (OR 9.25, 95% CI 2.03-42.13, p = 0.001) compared to those with low CRP. The association of SSS and SRS with CRP levels was more evident in patients over 70 years (p = 0.027 and p = 0.005, respectively). No significant difference in summed difference score was shown. The two groups had no difference in other risk factors (p > 0.05 for all comparisons). CONCLUSION a high level of CRP was associated with the presence and extent of stress-induced myocardial ischemia in MPI.
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Affiliation(s)
- Aidonis Rammos
- 2nd Department of Cardiology, University Hospital of Ioannina, 45110 Ioannina, Greece
| | - Aris Bechlioulis
- 2nd Department of Cardiology, University Hospital of Ioannina, 45110 Ioannina, Greece
| | - Areti Kekiopoulou
- Department of Nuclear Medicine, University Hospital of Ioannina, 45110 Ioannina, Greece
| | - Pavlos Kekiopoulos
- Department of Nuclear Medicine, University Hospital of Ioannina, 45110 Ioannina, Greece
| | - Christos S. Katsouras
- 2nd Department of Cardiology, University Hospital of Ioannina, 45110 Ioannina, Greece
| | - Chrissa Sioka
- Department of Nuclear Medicine, University Hospital of Ioannina, 45110 Ioannina, Greece
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Angelidis G, Giannakou S, Valotassiou V, Tsougos I, Tzavara C, Psimadas D, Theodorou E, Ziaka A, Ziangas C, Skoularigis J, Triposkiadis F, Georgoulias P. Long-Term Prognostic Value of Automated Measurements in Nuclear Cardiology: Comparisons with Expert Scoring. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1738. [PMID: 37893456 PMCID: PMC10607987 DOI: 10.3390/medicina59101738] [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: 08/16/2023] [Revised: 09/18/2023] [Accepted: 09/25/2023] [Indexed: 10/29/2023]
Abstract
Background and Objectives: Automated methods for the analysis of myocardial perfusion studies have been incorporated into clinical practice, but they are currently used as adjuncts to the visual interpretation. We aimed to investigate the role of automated measurements of summed stress score (SSS), summed rest score (SRS), and summed difference score (SDS) as long-term prognostic markers of morbidity and mortality, in comparison to the prognostic value of expert reading. Materials and Methods: The study was conducted at the Nuclear Medicine Laboratory of the University of Thessaly, in Larissa, Greece. A total of 378 consecutive patients with known or suspected coronary artery disease were enrolled in the study. All participants were referred to our laboratory for the performance of stress/rest myocardial perfusion single photon emission computed tomography. Automated measurements of SSS, SRS, and SDS were obtained by Emory Cardiac Toolbox (ECTb (Version 3.0), Emory University, Atlanta, GA, USA), Myovation (MYO, Xeleris version 3.05, GE Healthcare, Chicago, IL, USA), and Quantitative Perfusion SPECT (QPS (Version 4.0), Cedars-Sinai Medical Center, Los Angeles, CA, USA) software packages. Follow-up data were recorded after phone contacts, as well as through review of hospital records. Results: Expert scoring of SSS and SDS had significantly greater prognostic ability in comparison to all software packages (p < 0.001 for all comparisons). Similarly, ECTb-obtained SRS measurements had significantly lower prognostic ability in comparison to expert scoring (p < 0.001), while expert scoring of SRS showed significantly higher prognostic ability compared to MYO (p = 0.018) and QPS (p < 0.001). Conclusions: Despite the useful contribution of automated analyses in the interpretation of myocardial perfusion studies, expert reading should continue to have a crucial role, not only in clinical decision making, but also in the assessment of prognosis.
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Affiliation(s)
- George Angelidis
- Nuclear Medicine Laboratory, University Hospital of Larissa, University of Thessaly, Mezourlo, 41110 Larissa, Greece
| | - Stavroula Giannakou
- Nuclear Medicine Laboratory, University Hospital of Larissa, University of Thessaly, Mezourlo, 41110 Larissa, Greece
| | - Varvara Valotassiou
- Nuclear Medicine Laboratory, University Hospital of Larissa, University of Thessaly, Mezourlo, 41110 Larissa, Greece
| | - Ioannis Tsougos
- Medical Physics Laboratory, University Hospital of Larissa, University of Thessaly, Mezourlo, 41110 Larissa, Greece
| | - Chara Tzavara
- Nuclear Medicine Laboratory, University Hospital of Larissa, University of Thessaly, Mezourlo, 41110 Larissa, Greece
| | - Dimitrios Psimadas
- Nuclear Medicine Laboratory, University Hospital of Larissa, University of Thessaly, Mezourlo, 41110 Larissa, Greece
| | - Evdoxia Theodorou
- Nuclear Medicine Laboratory, University Hospital of Larissa, University of Thessaly, Mezourlo, 41110 Larissa, Greece
| | - Anastasia Ziaka
- Nuclear Medicine Laboratory, University Hospital of Larissa, University of Thessaly, Mezourlo, 41110 Larissa, Greece
| | - Charalampos Ziangas
- Nuclear Medicine Laboratory, University Hospital of Larissa, University of Thessaly, Mezourlo, 41110 Larissa, Greece
| | - John Skoularigis
- Department of Cardiology, University Hospital of Larissa, University of Thessaly, Mezourlo, 41110 Larissa, Greece
| | - Filippos Triposkiadis
- Department of Cardiology, University Hospital of Larissa, University of Thessaly, Mezourlo, 41110 Larissa, Greece
| | - Panagiotis Georgoulias
- Nuclear Medicine Laboratory, University Hospital of Larissa, University of Thessaly, Mezourlo, 41110 Larissa, Greece
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Li X, Zheng J, Lu Y, Pan X. Risk Assessment of Death of Tumor-Related PTE by CAR Combined with DD Detection. Vasc Health Risk Manag 2022; 18:445-451. [PMID: 35769599 PMCID: PMC9234313 DOI: 10.2147/vhrm.s365323] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 06/01/2022] [Indexed: 11/23/2022] Open
Abstract
Objective To investigate the risk of death in patients with tumor-related PTE (pulmonary thromboembolism) detected by CAR (C-reactive protein/albumin ratio) combined with DD (D-dimer). Methods The peripheral hematology and coagulation-related indexes of 109 patients with tumor-related PTE diagnosed by PTCA were retrospectively analyzed, and the differences in relationship indexes between tumor-related PTE patients with good prognosis and poor prognosis were compared and analyzed. The receiver operating characteristic curve (ROC) was used to analyze the risk of death in patients with tumor-related PTE by CAR and DD. Results ① The values of CAR and DD in the poor prognosis group were 3.90 ± 2.69 and 21.25 ± 21.20, respectively, which were significantly higher than those in the good prognosis group (1.66 ± 1.77, 9.53 ± 3.57) (P all <0.01). ② WBC, NE and SII in tumor-related PTE patients with poor prognosis were significantly higher than those in patients with good prognosis, while Hb in patients with poor prognosis was significantly lower than that in patients with good prognosis. ③ There was a significant positive correlation between CAR and DD (P=0.018). ④ The values of CAR and DD in the death group were 4.07 ± 2.42 and 19.65 ± 20.48, respectively, which were significantly higher than those in the survival group (1.94 ± 2.12, 11.52 ± 15.84) (P all<0.05). ⑤ The results of logistic regression analysis showed that both CAR (P=0.000) and DD (P=0.031) were independent prognostic factors in patients with tumor-related PTE. ⑥ CAR combined with DD had high sensitivity (77.8%) and specificity (83.5%), and the Youden index was 0.613. ⑦ The area under the receiver operating characteristic curve of CAR combined with DD was the largest (up to 0.806). Conclusion CAR and DD were highly expressed in patients with poor prognosis of tumor-related PTE. CAR combined with DD detection is helpful to improve the correct assessment of the risk of death in patients with tumor-related PTE.
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Affiliation(s)
- Xinran Li
- Department of Hematology and Oncology, Suzhou Medical College of Soochow University, Taicang Hospital Affiliated of Soochow University, Taicang City, Jiangsu Province, People's Republic of China
| | - Jiamin Zheng
- Department of Hematology and Oncology, Suzhou Medical College of Soochow University, Taicang Hospital Affiliated of Soochow University, Taicang City, Jiangsu Province, People's Republic of China
| | - Ye Lu
- Department of Hematology and Oncology, Suzhou Medical College of Soochow University, Taicang Hospital Affiliated of Soochow University, Taicang City, Jiangsu Province, People's Republic of China
| | - Xiangtao Pan
- Department of Hematology and Oncology, Suzhou Medical College of Soochow University, Taicang Hospital Affiliated of Soochow University, Taicang City, Jiangsu Province, People's Republic of China
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Relationship between ECG Findings and Serum Biomarkers in COVID-19 Patients. JOURNAL OF CARDIOVASCULAR EMERGENCIES 2021. [DOI: 10.2478/jce-2021-0013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract
Background and aim: The aim of this study was to evaluate the relationship between ECG findings and blood parameters indicative of inflammation and myocardial injury in COVID-19 patients.
Methods: The study included 159 females and 194 males. Demographics, ECG findings (axis, rhythm, branch block, ST- and T-wave changes, premature ventricular contractions, early repolarization, S1Q3T3, fragmented QRS [fQRS], rate, PR, QRS, QT interval, QTc, P-wave dispersion) and albumin, D-dimer, ferritin, pro-BNP, procalcitonin, protein, troponin T, neutrophil-to-lymphocyte ratio (NLR), C-reactive protein/albumin ratio (CAR) were recorded.
Results: In the study, 45% of the cases were female and 55% were male. The mean age of the included patients was 45.7 ± 24.4 years. The most frequent comorbidities were chronic obstructive pulmonary disease (COPD) and hypertension (HT) in both groups. The incidence of fQRS on the 1st day was significantly higher in patients with negative COVID-19 test (23% for positive RT-PCR versus 35.6% for negative RT-PCR, p = 0.016). QTc values on the 3rd and 5th day were significantly higher in patients with negative RT-PCR (p = 0.045 and p = 0.042, respectively). Albumin and procalcitonin were significantly higher in patients with positive COVID-19 test results (p = 0.018 and p <0.001, respectively). Patients with fragmented QRS presented significantly lower serum albumin (40.62 ± 4.73 g/L vs. 42.92 ± 3.72 g/L, p = 0.01), and protein levels (p = 0.02), as well as lower lymphocyte count, and significantly higher levels of C-reactive protein (47.01 ± 65.01 mg/L vs. 24.55 ± 44.17 mg/L, p = 0.001), D-dimer (p = 0.009), neutrophil count, pro-BNP (p = 0.004), troponin T (p <0.001), NRL and CAR (1.28 ± 1.83 versus 0.6 ± 1.11, p <0.001).
Conclusion: Patients with COVID-19 infection presented significantly higher levels of C-reactive protein, D-dimer, neutrophil, pro-BNP, procalcitonin, troponin T, NLR, and CAR, and significantly lower levels of albumin, lymphocyte count, and serum proteins, indicating the level of inflammation and its relationship with myocardial injury. Further follow-up studies are required, on larger patient sets, for the development of risk prediction tools in COVID-19 patients.
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