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Choi JY, Yang YM. Association between high-sensitivity C-reactive protein and renal function in Korean adults: A sex-specific analysis of Korea National Health and Nutrition Examination Survey 2015 to 2018 data. Medicine (Baltimore) 2024; 103:e38769. [PMID: 39093734 PMCID: PMC11296482 DOI: 10.1097/md.0000000000038769] [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: 07/21/2023] [Accepted: 06/10/2024] [Indexed: 08/04/2024] Open
Abstract
This study aimed to investigate the association between high-sensitivity C-reactive protein (hs-CRP) levels, as a surrogate marker of systemic inflammation, and renal function among Korean adults grouped by age, sex, and body mass index. This study analyzed data obtained from the Korea National Health and Nutrition Examination Survey 2015 to 2018, a cross-sectional and nationally representative survey conducted by the Korean Centers for Disease Control and Prevention. Of the 22,451 subjects included in this study, 19,607 (87.3%) and 2844 (12.7%) had normal kidney function and incident chronic kidney disease, respectively. Reduced renal function was more frequently observed in subjects with high hs-CRP levels than in those with low hs-CRP levels (odds ratio [OR], 1.438; 95% confidence interval [CI], 1.234-1.674). In the group aged ≥ 65 years, the odds of reduced renal function were higher among subjects with a high hs-CRP level compared to those with a low hs-CRP level (OR, 1.528; 95% CI, 1.191-1.960). The association between hs-CRP level and renal function was observed only in women (OR, 2.485; 95% CI, 1.779-3.470) and further stratified by age and sex, the odds of reduced renal function were likely higher in women aged ≥ 65 years with a high hs-CRP level (OR, 2.338; 95% CI, 1.622-3.369). Moreover, reduced renal function was more observed in subjects aged ≥ 65 years and those with a body mass index < 25 kg/m2 (OR, 1.502; 95% CI, 1.087-2.075). This study showed that a high hs-CRP level likely contributes to the increased prevalence of reduced renal function. This association may aid the identification of individuals at high risk for reduced renal function, especially elderly women, in clinical or public health practice.
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Affiliation(s)
- Ji-Young Choi
- Department of Food and Nutrition, College of Natural Science and Public Health and Safety, Chosun University, Gwangju, Republic of Korea
| | - Young-Mo Yang
- Department of Pharmacy, College of Pharmacy, Chosun University, Gwangju, Republic of Korea
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Ma J, Xie H, Yuan C, Shen J, Chen J, Chen Q, Liu J, Tong Q, Sun J. The gut microbial signatures of patients with lacunar cerebral infarction. Nutr Neurosci 2024; 27:620-636. [PMID: 37538045 DOI: 10.1080/1028415x.2023.2242121] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
Abstract
BACKGROUND Emerging evidence revealed that gut microbial dysbiosis is involved in the pathogenesis of multiple neurological diseases, but there is little available data on the relationship between gut microbiota and lacunar cerebral infarction (LCI). METHODS Fecal samples from acute LCI patients (n = 65) and matched healthy controls (n = 65) were collected. The compositions and potential functions of the gut microbiota were estimated. RESULTS The results showed that there were significant gut microbial differences between LCI and control groups. Patients with LCI had higher abundances of genus Lactobacillus, Streptococcus, Veillonella, Acidaminococcus, Bacillus, Peptoclostridium, Intestinibacter, Alloscardovia and Cloacibacillus but lower proportions of genus Agathobacter and Lachnospiraceae_UCG-004. Investigating further these microbes such as Lactobacillus and Veillonella were correlated with clinical signs. Moreover, we found that 9 gene functions of gut microbiota were different between LCI patients and controls, which were associated with amino acid metabolism and inflammatory signal transduction. Notably, four optimal microbial markers were determined, and the combination of Streptococcus, Lactobacillus, Agathobacter, Lachnospiraceae_UCG-004 and the three risk factors achieved an area under the curve (AUC) value of 0.854 to distinguish LCI from controls. CONCLUSION These findings revealed the characterizing of gut microbiota in LCI patients and provided potential microbial biomarkers for clinical diagnosis of LCI.
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Affiliation(s)
- Jiaying Ma
- Department of Geriatrics, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Huijia Xie
- Department of Geriatrics, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Chengxiang Yuan
- Department of Neurology, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Jie Shen
- Department of Neurology, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Jiaxin Chen
- Department of Geriatrics, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Qionglei Chen
- Department of Geriatrics, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Jiaming Liu
- Department of Preventive Medicine, School of Public Health and Management, Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Qiuling Tong
- Department of Neurology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Jing Sun
- Department of Geriatrics, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
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Zhang S, Ren X, Zhang B, Lan T, Liu B. A Systematic Review of Statins for the Treatment of Nonalcoholic Steatohepatitis: Safety, Efficacy, and Mechanism of Action. Molecules 2024; 29:1859. [PMID: 38675679 PMCID: PMC11052408 DOI: 10.3390/molecules29081859] [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: 03/06/2024] [Revised: 04/10/2024] [Accepted: 04/17/2024] [Indexed: 04/28/2024] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD) is the liver component of a cluster of conditions, while its subtype, nonalcoholic steatohepatitis (NASH), emerges as a potentially progressive liver disorder that harbors the risk of evolving into cirrhosis and culminating in hepatocellular carcinoma (HCC). NASH and cardiovascular disease (CVD) have common risk factors, but compared to liver-related causes, the most common cause of death in NASH patients is CVD. Within the pharmacological armamentarium, statins, celebrated for their lipid-modulating prowess, have now garnered attention for their expansive therapeutic potential in NASH. Evidence from a plethora of studies suggests that statins not only manifest anti-inflammatory and antifibrotic properties but also impart a multifaceted beneficial impact on hepatic health. In this review, we used "statin", "NAFLD", "NASH", and "CVD" as the major keywords and conducted a literature search using the PubMed and Web of Science databases to determine the safety and efficacy of statins in patients and animals with NASH and NAFLD, and the mechanism of statin therapy for NASH. Simultaneously, we reviewed the important role of the intestinal microbiota in statin therapy for NASH, as it is hoped that statins will provide new insights into modulating the harmful inflammatory microbiota in the gut and reducing systemic inflammation in NASH patients.
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Affiliation(s)
- Shiqin Zhang
- School of Pharmacy, Guangdong Pharmaceutical University, Guangzhou 510006, China; (S.Z.); (X.R.); (B.Z.)
| | - Xiaoling Ren
- School of Pharmacy, Guangdong Pharmaceutical University, Guangzhou 510006, China; (S.Z.); (X.R.); (B.Z.)
| | - Bingzheng Zhang
- School of Pharmacy, Guangdong Pharmaceutical University, Guangzhou 510006, China; (S.Z.); (X.R.); (B.Z.)
| | - Tian Lan
- School of Pharmacy, Guangdong Pharmaceutical University, Guangzhou 510006, China; (S.Z.); (X.R.); (B.Z.)
- Department of Pharmacology, College of Pharmacy, Harbin Medical University, Harbin 150086, China
| | - Bing Liu
- School of Pharmacy, Guangdong Pharmaceutical University, Guangzhou 510006, China; (S.Z.); (X.R.); (B.Z.)
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4
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Sadowska A, Osiński P, Roztocka A, Kaczmarz-Chojnacka K, Zapora E, Sawicka D, Car H. Statins-From Fungi to Pharmacy. Int J Mol Sci 2023; 25:466. [PMID: 38203637 PMCID: PMC10779115 DOI: 10.3390/ijms25010466] [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: 11/30/2023] [Revised: 12/22/2023] [Accepted: 12/23/2023] [Indexed: 01/12/2024] Open
Abstract
Statins have been used in the treatment of hyperlipidemia, both as monotherapy and in combination therapy. Natural fermentation processes of fungi such as Monascus spp., Penicillium spp., Aspergillus terreus, and Pleurotus ostreatus have given rise to natural statins. Compactin (mevastatin), the original naturally occurring statin, is the primary biotransformation substrate in the manufacturing process of marketed drugs. Statins are classified into natural, semi-synthetic derivatives of natural statins, and synthetic ones. Synthetic statins differ from natural statins in their structural composition, with the only common feature being the HMG-CoA-like moiety responsible for suppressing HMG-CoA reductase. Statins do not differ significantly regarding their pleiotropic and adverse effects, but their characteristics depend on their pharmacokinetic parameters and chemical properties. This paper focuses on describing the processes of obtaining natural statins, detailing the pharmacokinetics of available statins, divided into natural and synthetic, and indicating their pleiotropic effects.
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Affiliation(s)
- Anna Sadowska
- Department of Experimental Pharmacology, Medical University of Bialystok, Szpitalna 37, 15-295 Bialystok, Poland; (D.S.); (H.C.)
| | - Patryk Osiński
- Student’s Pharmacological Club, Lazarski University, Świeradowska 43, 02-662 Warsaw, Poland; (P.O.); (A.R.); (K.K.-C.)
| | - Alicja Roztocka
- Student’s Pharmacological Club, Lazarski University, Świeradowska 43, 02-662 Warsaw, Poland; (P.O.); (A.R.); (K.K.-C.)
| | - Karolina Kaczmarz-Chojnacka
- Student’s Pharmacological Club, Lazarski University, Świeradowska 43, 02-662 Warsaw, Poland; (P.O.); (A.R.); (K.K.-C.)
| | - Ewa Zapora
- Department of Silviculture and Forest Use, Institute of Forest Sciences, Bialystok University of Technology, Wiejska 45E, 15351 Bialystok, Poland;
| | - Diana Sawicka
- Department of Experimental Pharmacology, Medical University of Bialystok, Szpitalna 37, 15-295 Bialystok, Poland; (D.S.); (H.C.)
| | - Halina Car
- Department of Experimental Pharmacology, Medical University of Bialystok, Szpitalna 37, 15-295 Bialystok, Poland; (D.S.); (H.C.)
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Zhao L, Ma D, Wang L, Su X, Feng L, Zhu L, Chen Y, Hao Y, Wang X, Feng J. Metabolic changes with the occurrence of atherosclerotic plaques and the effects of statins. Front Immunol 2023; 14:1301051. [PMID: 38143759 PMCID: PMC10739339 DOI: 10.3389/fimmu.2023.1301051] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 11/23/2023] [Indexed: 12/26/2023] Open
Abstract
Atherosclerosis is a common cardiovascular disease caused by the abnormal expression of multiple factors and genes influenced by both environmental and genetic factors. The primary manifestation of atherosclerosis is plaque formation, which occurs when inflammatory cells consume excess lipids, affecting their retention and modification within the arterial intima. This triggers endothelial cell (EC) activation, immune cell infiltration, vascular smooth muscle cell (VSMC) proliferation and migration, foam cell formation, lipid streaks, and fibrous plaque development. These processes can lead to vascular wall sclerosis, lumen stenosis, and thrombosis. Immune cells, ECs, and VSMCs in atherosclerotic plaques undergo significant metabolic changes and inflammatory responses. The interaction of cytokines and chemokines secreted by these cells leads to the onset, progression, and regression of atherosclerosis. The regulation of cell- or cytokine-based immune responses is a novel therapeutic approach for atherosclerosis. Statins are currently the primary pharmacological agents utilised for managing unstable plaques owing to their ability to enhance endothelial function, regulate VSMC proliferation and apoptosis by reducing cholesterol levels, and mitigate the expression and activity of inflammatory cytokines. In this review, we provide an overview of the metabolic changes associated with atherosclerosis, describe the effects of inflammatory responses on atherosclerotic plaques, and discuss the mechanisms through which statins contribute to plaque stabilisation. Additionally, we examine the role of statins in combination with other drugs in the management of atherosclerosis.
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Affiliation(s)
| | - Di Ma
- Bethune First Hospital, Jilin University, Changchun, China
| | - LiJuan Wang
- Bethune First Hospital, Jilin University, Changchun, China
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Fan R, Hu D, Wang M, Zheng H, Zhou Y, Zhang L. Integrated analysis of circRNA-associated ceRNA network in ischemic stroke. Front Genet 2023; 14:1153518. [PMID: 37323662 PMCID: PMC10267749 DOI: 10.3389/fgene.2023.1153518] [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: 01/29/2023] [Accepted: 05/18/2023] [Indexed: 06/17/2023] Open
Abstract
Introduction: Stroke, of which ischemic stroke (IS) is the major type, is the second leading cause of disability and death worldwide. Circular RNAs (circRNAs) are reported to play important role in the physiology and pathology of IS. CircRNAs often act as competing endogenous RNA (ceRNA) to regulate gene expression by acting as miRNA sponges. However, whole transcriptome-wide screenings of circRNA-mediated ceRNA networks associated with IS are still lacking. In the present study, we constructed a circRNA-miRNA-mRNA ceRNA network by whole transcriptome-wide analysis. Methods: CircRNAs, miRNAs and mRNAs expression profiles were downloaded from the Gene Expression Omnibus (GEO) datasets. We identified differentially expressed (DE) circRNAs, miRNAs, and mRNAs in IS patients. StarBase and CircBank databases were used to predict the miRNA targets of DEcircRNAs, and mirDIP database was used to predict the mRNA targets of DEmiRNAs. CircRNA-miRNA pairs and miRNA-mRNA pairs were established. Then, we identified hub genes via protein-protein interaction analysis and constructed a core ceRNA sub-network. Results: In total, 276 DEcircRNAs, 43 DEmiRNAs, and 1926 DEmRNAs were explored. The ceRNA network included 69 circRNAs, 24 miRNAs, and 92 mRNAs. The core ceRNA subnetwork included hsa_circ_0011474, hsa_circ_0023110, CDKN1A, FHL2, RPS2, CDK19, KAT6A, CBX1, BRD4, and ZFHX3. Discussion: In conclusion, we established a novel hsa_circ_0011474 - hsa-miR-20a-5p/hsa-miR-17-5p - CDKN1A ceRNA regulatory axis associated with IS. Our findings provide new insights into the pathogenesis of IS and offer promising diagnostic and predictive biomarkers.
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Affiliation(s)
- Rongli Fan
- Zhejiang Provincial Key Laboratory for Chemical and Biological Processing Technology of Farm Products, Department of Biological and Chemical Engineering, Zhejiang University of Science and Technology, Hangzhou, Zhejiang, China
| | - Die Hu
- Zhejiang Provincial Key Laboratory for Chemical and Biological Processing Technology of Farm Products, Department of Biological and Chemical Engineering, Zhejiang University of Science and Technology, Hangzhou, Zhejiang, China
| | - Maiqiu Wang
- Zhejiang Provincial Key Laboratory for Chemical and Biological Processing Technology of Farm Products, Department of Biological and Chemical Engineering, Zhejiang University of Science and Technology, Hangzhou, Zhejiang, China
| | - Huilin Zheng
- Zhejiang Provincial Key Laboratory for Chemical and Biological Processing Technology of Farm Products, Department of Biological and Chemical Engineering, Zhejiang University of Science and Technology, Hangzhou, Zhejiang, China
| | - Yifeng Zhou
- Zhejiang Provincial Key Laboratory for Chemical and Biological Processing Technology of Farm Products, Department of Biological and Chemical Engineering, Zhejiang University of Science and Technology, Hangzhou, Zhejiang, China
| | - Lei Zhang
- Zhejiang Provincial Key Laboratory for Chemical and Biological Processing Technology of Farm Products, Department of Biological and Chemical Engineering, Zhejiang University of Science and Technology, Hangzhou, Zhejiang, China
- Department of Information and Electronic Engineering, Zhejiang University of Science and Technology, Hangzhou, Zhejiang, China
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7
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Predictive Role of hsCRP in Recurrent Stroke Differed According to Severity of Cerebrovascular Disease: Analysis from a Prospective Cohort Study. J Clin Med 2023; 12:jcm12041676. [PMID: 36836211 PMCID: PMC9967664 DOI: 10.3390/jcm12041676] [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: 12/27/2022] [Revised: 01/26/2023] [Accepted: 02/16/2023] [Indexed: 02/22/2023] Open
Abstract
Elevated levels of high-sensitivity C-reactive protein (hsCRP) were associated with an increased risk of recurrent stroke. However, it is still unknown whether the predictive value of hsCRP differed according to the severity of cerebrovascular disease. We used the cohort of the prospective multicenter cohort study of the Third China National Stroke Registry (CNSR-III), in which 10,765 consecutive patients with acute ischemic stroke or transient ischemic attack (TIA) had hsCRP levels measured. Patients were classified into minor stroke, or TIA, and non-minor stroke. The primary outcome was a new stroke within 1 year. Cox proportional hazards models were used to assess the association of hsCRP and its outcome. Elevated levels of hsCRP were associated with an increased risk of recurrent stroke in minor stroke or TIA patients, irrespective of using a National Institutes of Health Stroke Scale (NIHSS) score of ≤3 (the highest quartile vs. the lowest quartile: adjusted hazard ratio, 1.48; 95% CI, 1.12-1.97; p = 0.007) or ≤5 (the highest quartile vs. the lowest quartile: adjusted hazard ratio, 1.45; 95% CI, 1.15-1.84; p = 0.002) to define minor stroke. Such association was more apparent in the large-artery atherosclerosis subtype. However, for the patients with non-minor stroke, the association of hsCRP with recurrent stroke disappeared.
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8
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Banait T, Wanjari A, Danade V, Banait S, Jain J. Role of High-Sensitivity C-reactive Protein (Hs-CRP) in Non-communicable Diseases: A Review. Cureus 2022; 14:e30225. [PMID: 36381804 PMCID: PMC9650935 DOI: 10.7759/cureus.30225] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Accepted: 10/10/2022] [Indexed: 11/06/2022] Open
Abstract
Non-communicable diseases like cardiovascular diseases, cerebrovascular diseases, diabetes mellitus, and cancer are very common causes of death worldwide. Therefore, the need to search for novel, affordable, and easily accessible biomarkers and risk factors for non-communicable diseases continues, which can predict the future risk of having these diseases with greater accuracy and precision. In this context, among available biomarkers, high-sensitivity C-reactive protein (Hs-CRP) is considered to be the best-suited marker. Various drug intervention trials demonstrated positive results in reducing Hs-CRP in individuals with raised levels. Numerous pharmacological and non-pharmacologic interventions in the form of lifestyle modifications, exercise, and cessation of smoking are being investigated to study their effect on reducing serum C-reactive protein (CRP) levels. This review article discusses the role of Hs-CRP and its isoforms in the pathogenesis of various disease conditions, factors affecting its serum concentration, its prognostic value, and its comparison with other risk factors. Further, its clinical significance in chronic inflammatory and degenerative diseases of the nervous system and other common non-communicable diseases, including recent advances in the management of various diseases, has also been discussed.
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Xu Q, Wu Q, Li H, Tian X, Zuo Y, Zhang Y, Zhang X, Lin Y, Wu Y, Wang Y, Wang A, Meng X. Joint High Level of Oxidized Low-Density Lipoprotein and High-Sensitivity C-Reactive Protein are Associated With Recurrent Stroke and Poor Functional Outcome in Minor Stroke or Transient Ischemic Attack. J Am Heart Assoc 2022; 11:e027665. [PMID: 36205258 PMCID: PMC9673654 DOI: 10.1161/jaha.122.027665] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Background Oxidized low‐density lipoprotein (oxLDL) and hs‐CRP (high‐sensitivity C‐reactive protein) plays an important role in cardiovascular diseases though inflammation and oxidative stress, etc. However, evidence on their combined effects on stroke prognosis is still limited. We aimed to explore the joint association of oxLDL and hs‐CRP with outcomes of minor stroke or transient ischemic attack. Methods and Results A subgroup of 3019 patients from the CHANCE trial (Clopidogrel in High‐Risk Patients With Acute Nondisabling Cerebrovascular Events) were analyzed. Baseline oxLDL and hs‐CRP levels were measured. The primary outcome was any stroke within 90 days. The secondary outcomes included any stroke within 1 year, and ischemic stroke, combined vascular events, and poor functional outcomes (modified Rankin Scale 2–6 or 3–6) at 90 days and 1 year. Vascular events outcomes were analyzed with Cox proportional hazards and poor functional outcomes with logistic models. Elevated oxLDL (>28.81 μg/dL) and hs‐CRP (>4.20 mg/L) was observed in 624 (20.67%) of the 3019 patients. Patients with oxLDL >28.81 μg/dL and hs‐CRP >4.20 mg/L had a higher risk of recurrent stroke within 90 days (adjusted hazard ratio, 1.52; 95% CI, 1.17–1.97), compared with those with oxLDL ≤28.81 μg/dL and hs‐CRP ≤4.20 mg/L, after adjusting relevant confounding factors (P=0.002). Similar results were observed for secondary outcomes (P<0.05 for all). Conclusions In patients with minor stroke or transient ischemic attack, joint high levels of oxLDL and hs‐CRP was associated with increased risk of recurrent stroke, combined vascular events, and poor functional outcome.
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Affiliation(s)
- Qin Xu
- Department of Neurology, Beijing Tiantan Hospital Capital Medical University Beijing China.,China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital Capital Medical University Beijing China
| | - Qiong Wu
- Department of Neurology The Second Hospital of Dalian Medical University Dalian China
| | - Hao Li
- Department of Neurology, Beijing Tiantan Hospital Capital Medical University Beijing China.,China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital Capital Medical University Beijing China
| | - Xue Tian
- Department of Neurology, Beijing Tiantan Hospital Capital Medical University Beijing China.,China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital Capital Medical University Beijing China.,Department of Epidemiology and Health Statistics, School of Public Health Capital Medical University Beijing China.,Beijing Municipal Key Laboratory of Clinical Epidemiology Beijing China
| | - Yingting Zuo
- Department of Neurology, Beijing Tiantan Hospital Capital Medical University Beijing China.,China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital Capital Medical University Beijing China.,Department of Epidemiology and Health Statistics, School of Public Health Capital Medical University Beijing China.,Beijing Municipal Key Laboratory of Clinical Epidemiology Beijing China
| | - Yijun Zhang
- Department of Neurology, Beijing Tiantan Hospital Capital Medical University Beijing China.,China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital Capital Medical University Beijing China
| | - Xiaoli Zhang
- Department of Neurology, Beijing Tiantan Hospital Capital Medical University Beijing China.,China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital Capital Medical University Beijing China
| | - Yongzhong Lin
- Department of Neurology The Second Hospital of Dalian Medical University Dalian China
| | - Yiping Wu
- Department of Neurology HanDan Central Hospital Handan China
| | - Yongjun Wang
- Department of Neurology, Beijing Tiantan Hospital Capital Medical University Beijing China.,China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital Capital Medical University Beijing China.,Advanced Innovation Center for Human Brain Protection Capital Medical University Beijing China.,Center for Excellence in Brain Science and Intelligence Technology Chinese Academy of Sciences Shanghai China
| | - Anxin Wang
- Department of Neurology, Beijing Tiantan Hospital Capital Medical University Beijing China.,China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital Capital Medical University Beijing China
| | - Xia Meng
- Department of Neurology, Beijing Tiantan Hospital Capital Medical University Beijing China.,China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital Capital Medical University Beijing China
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Zhang J, Wang X, Tian W, Wang T, Jia J, Lai R, Wang T, Zhang Z, Song L, Ju J, Xu H. The effect of various types and doses of statins on C-reactive protein levels in patients with dyslipidemia or coronary heart disease: A systematic review and network meta-analysis. Front Cardiovasc Med 2022; 9:936817. [PMID: 35966518 PMCID: PMC9363636 DOI: 10.3389/fcvm.2022.936817] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 07/04/2022] [Indexed: 11/25/2022] Open
Abstract
Objective The objective of this study was to measure the efficacy of various types and dosages of statins on C-reactive protein (CRP) levels in patients with dyslipidemia or coronary heart disease. Methods Randomized controlled trials were searched from PubMed, Embase, Cochrane Library, OpenGray, and ClinicalTrials.gov. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for data extraction and synthesis. The pairwise meta-analysis compared statins and controls using a random-effects model, and a network meta-analysis compared the types and dosages of statins using the Bayesian random-effects model. The PROSPERO registration number is CRD42021242067. Results The study included 37 randomized controlled trials with 17,410 participants and 20 interventions. According to the pairwise meta-analysis, statins significantly decreased CRP levels compared to controls (weighted mean difference [WMD] = −0.97, 95% confidence interval [CI] [−1.31, −0.64], P < 0.0001). In the network meta-analysis, simvastatin 40 mg/day appeared to be the best strategy for lowering CRP (Rank P = 0.18, WMD = −4.07, 95% CI = [−6.52, −1.77]). The same was true for the high-sensitivity CRP, non-acute coronary syndrome (ACS), <12 months duration, and clear measurement subgroups. In the CRP subgroup (rank P = 0.79, WMD = −1.23, 95% CI = [−2.48, −0.08]) and ≥12-month duration subgroup (Rank P = 0.40, WMD = −2.13, 95% CI = [−4.24, −0.13]), atorvastatin 80 mg/day was most likely to be the best. There were no significant differences in the dyslipidemia and ACS subgroups (P > 0.05). Node-splitting analysis showed no significant inconsistency (P > 0.05), except for the coronary heart disease subgroup. Conclusion Statins reduced serum CRP levels in patients with dyslipidemia or coronary heart disease. Simvastatin 40 mg/day might be the most effective therapy, and atorvastatin 80 mg/day showed the best long-term effect. This study provides a reference for choosing statin therapy based on LDL-C and CRP levels.
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Affiliation(s)
- Jie Zhang
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Xinyi Wang
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Graduate School, China Academy of Chinese Medical Sciences, Beijing, China
| | - Wende Tian
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Graduate School, China Academy of Chinese Medical Sciences, Beijing, China
| | - Tongxin Wang
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Jundi Jia
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Runmin Lai
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Graduate School, China Academy of Chinese Medical Sciences, Beijing, China
| | - Tong Wang
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Zihao Zhang
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Luxia Song
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Jianqing Ju
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- *Correspondence: Jianqing Ju
| | - Hao Xu
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Hao Xu
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The Effect of Statins on C-Reactive Protein in Stroke Patients: A Systematic Review of Clinical Trials. Mediators Inflamm 2021; 2021:7104934. [PMID: 34489618 PMCID: PMC8418548 DOI: 10.1155/2021/7104934] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 08/18/2021] [Indexed: 01/05/2023] Open
Abstract
Background Statins reportedly have anti-inflammatory effects aside from their lipid-lowering impact. We investigated the effects of statin therapy on the level of C-reactive protein (CRP) or highly sensitive CRP (hs-CRP), a liver-derived marker of systemic inflammation, among stroke patients. Methods An online search was performed in Scopus, PubMed/MEDLINE, ISI Web of Science, and Google Scholar up to November 2020 to recognize clinical trials investigating the effects of statins on the CRP level in stroke patients. Results Overall, nine studies (11 treatment arms) with 1659 participants met the inclusion criteria. Six out of 9 studies (8 out of 11 arms) were categorized as studies with a high-quality methodological approach using the Cochrane Collaboration's tool. Data from 5 treatment arms indicated a significant decrease in CRP concentration, and in one treatment arm, CRP concentration did not suggest any considerable alteration following statin therapy. Moreover, two treatment arms showed a significant reduction in hs-CRP concentration and three treatment arms revealed no significant alteration in hs-CRP concentration following statin therapy. Generally, results were heterogeneous and independent of the type of statin, statin dose, treatment duration, and changes in plasma low-density lipoprotein cholesterol concentration. Conclusion The results suggest that statin therapy could reduce and, therefore, could be considered in these patients as potential anti-inflammatory agents.
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Proute MC, Kothur N, Georgiou P, Serhiyenia T, Shi W, Kerolos ME, Pradeep R, Akram A, Khan S. The Effect of Statin Therapy on Inflammatory Biomarkers: A Systematic Review. Cureus 2021; 13:e18273. [PMID: 34722051 PMCID: PMC8545535 DOI: 10.7759/cureus.18273] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 09/25/2021] [Indexed: 11/28/2022] Open
Abstract
3-hydroxy-3-methylglutaryl-CoA (HMG-CoA) reductase inhibitors are commonly used drugs in the management of elevated lipid levels and cardiovascular disease. In cardiovascular diseases, among other common chronic conditions, inflammatory biomarkers are used to monitor disease progression and the risk of recurrent adverse events. We explored whether or not there was a positive effect on these biomarkers using HMG-CoA reductase inhibitors. The systematic review was conducted by gathering relevant papers mainly from three databases, identified through a generated Medical Subject Headings (MeSH) strategy. Identification of papers was subsequently followed by applying a selected inclusion and exclusion criteria to narrow the papers chosen for review. Post the application of stipulated criteria, 12 papers remained. They were subsequently assessed for risk of bias using a Cochrane risk analysis tool, identifying most as having some concerns of bias or low risk of bias. We found that HMG-CoA reductase inhibitors exhibit both a lipid-lowering effect addition to an anti-inflammatory effect.
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Affiliation(s)
- Matthew C Proute
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Nageshwar Kothur
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Petros Georgiou
- Research, Oxford University Hospitals NHS Foundation Trust, Oxford, GBR
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Tatsiana Serhiyenia
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Wangpan Shi
- Pathology, Chulalongkorn University, Bangkok, THA
- Pathology, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Mina E Kerolos
- General Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Roshini Pradeep
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Aqsa Akram
- Internal Medicine, Dallah Hospital, Riyadh, SAU
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Safeera Khan
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
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13
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Zhang N, Wu X, Tian M, Wang X, Ding J, Tian Y, Liang C, Zeng Z, Xiang H, Tan H. Additive interaction between potentially modifiable risk factors and ethnicity among individuals in the Han, Tujia and Miao populations with first-ever ischaemic stroke. BMC Public Health 2021; 21:1059. [PMID: 34082746 PMCID: PMC8173719 DOI: 10.1186/s12889-021-11115-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 05/23/2021] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND As a country with one-fifth of the global population, China has experienced explosive growth in ischaemic stroke (IS) burden with significant ethnic and geographic disparities. The aim of this study was to examine the differences in potentially modifiable risk factors for ischaemic stroke among the Han population and two ethnic minorities (Tujia and Miao). METHODS A case-control study was conducted with 324 cases of first-ever ischaemic stroke from the hospitals of the Xiangxi Tujia and Miao Autonomous Prefecture and 394 controls from communities covering the same area between May 1, 2018, and April 30, 2019. Structured questionnaires were administered, and physical examinations were performed in the same manner for cases and controls. Univariate and multivariate logistic regression analyses with adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were used to examine the association between risk factors and ischaemic stroke. An additive model was used to study the interaction between the modifiable risk factors and ethnicity with R software. RESULTS Higher high-sensitivity C-reactive protein levels (OR 50.54, 95%CI 29.76-85.85), higher monthly family income (4.18, 2.40-7.28), increased frequency of hot pot consumption (2.90, 1.21-6.93), diabetes mellitus (2.62, 1.48-4.62), a higher apolipoprotein (Apo)B/ApoA1 ratio (2.60, 1.39-4.85), hypertension (2.52, 1.45-4.40) and moderate-intensity physical activity (0.50, 0.28-0.89) were associated with ischaemic stroke. There was an additive interaction between the ApoB/ApoA1 ratio and ethnicity in the Tujia and Miao populations with first-ever ischaemic stroke (the relative excess risk due to the interaction was 5.75, 95% CI 0.58 ~ 10.92; the attributable proportion due to the interaction was 0.65, 95% CI 0.38 ~ 0.91; the synergy index was 3.66, 95% CI 1.35 ~ 9.93). CONCLUSIONS This is the first case-control study examining modifiable risk factors for ischaemic stroke among the Han population and two ethnic minorities (Tujia and Miao) in China. Some differences were observed in the impact of risk factors among these ethnic groups. Our results may help interpret health-related data, including surveillance and research, when developing strategies for stroke prevention.
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Affiliation(s)
- Na Zhang
- Hunan Provincial Key Laboratory of Clinical Epidemiology, Xiangya School of Public Health, Central South University, Changsha, Hunan, China.,Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China.,Hunan Provincial Institute of Geriatrics, Hunan Provincial People's Hospital (the First Affiliated Hospital of Hunan Normal University), Changsha, Hunan, China
| | - Xinrui Wu
- Hunan Provincial Key Laboratory of Clinical Epidemiology, Xiangya School of Public Health, Central South University, Changsha, Hunan, China.,Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Mengyuan Tian
- Hunan Provincial Key Laboratory of Clinical Epidemiology, Xiangya School of Public Health, Central South University, Changsha, Hunan, China.,Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Xiaolei Wang
- Hunan Provincial Key Laboratory of Clinical Epidemiology, Xiangya School of Public Health, Central South University, Changsha, Hunan, China.,Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Jian Ding
- Hunan Provincial Institute of Geriatrics, Hunan Provincial People's Hospital (the First Affiliated Hospital of Hunan Normal University), Changsha, Hunan, China
| | - Yong Tian
- Department of Neurology, the First Affiliated Hospital of Jishou University, the Tujia-Miao autonomous prefecture of Xiangxi, Hunan, China
| | - Chengcai Liang
- Department of Neurology, the First Affiliated Hospital of Jishou University, the Tujia-Miao autonomous prefecture of Xiangxi, Hunan, China
| | - Zhi Zeng
- Department of Neurology, the First Affiliated Hospital of Jishou University, the Tujia-Miao autonomous prefecture of Xiangxi, Hunan, China
| | - Hua Xiang
- Interventional Radiology Center, Hunan Provincial People's Hospital (the First Affiliated Hospital of Hunan Normal University), Changsha, Hunan, China.
| | - Hongzhuan Tan
- Hunan Provincial Key Laboratory of Clinical Epidemiology, Xiangya School of Public Health, Central South University, Changsha, Hunan, China. .,Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China.
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14
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McCabe JJ, O’Reilly E, Coveney S, Collins R, Healy L, McManus J, Mulcahy R, Moynihan B, Cassidy T, Hsu F, Worrall B, Murphy S, O’Donnell M, Kelly PJ. Interleukin-6, C-reactive protein, fibrinogen, and risk of recurrence after ischaemic stroke: Systematic review and meta-analysis. Eur Stroke J 2021; 6:62-71. [PMID: 33817336 PMCID: PMC7995315 DOI: 10.1177/2396987320984003] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 12/06/2020] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Recent randomised trials showed benefit for anti-inflammatory therapies in coronary disease but excluded stroke. The prognostic value of blood inflammatory markers after stroke is uncertain and guidelines do not recommend their routine measurement for risk stratification. METHODS We performed a systematic review and meta-analysis of studies investigating the association of C-reactive protein (CRP), interleukin-6 (IL-6) and fibrinogen and risk of recurrent stroke or major vascular events (MVEs). We searched EMBASE and Ovid Medline until 10/1/19. Random-effects meta-analysis was performed for studies reporting comparable effect measures. RESULTS Of 2,515 reports identified, 39 met eligibility criteria (IL-6, n = 10; CRP, n = 33; fibrinogen, n = 16). An association with recurrent stroke was reported in 12/26 studies (CRP), 2/11 (fibrinogen) and 3/6 (IL-6). On random-effects meta-analysis of comparable studies, CRP was associated with an increased risk of recurrent stroke [pooled hazard ratio (HR) per 1 standard-deviation (SD) increase in loge-CRP (1.14, 95% CI 1.06-1.22, p < 0.01)] and MVEs (pooled HR 1.21, CI 1.10-1.34, p < 0.01). Fibrinogen was also associated with recurrent stroke (HR 1.26, CI 1.07-1.47, p < 0.01) and MVEs (HR 1.31, 95% CI 1.15-1.49, p < 0.01). Trends were identified for IL-6 for recurrent stroke (HR per 1-SD increase 1.17, CI 0.97-1.41, p = 0.10) and MVEs (HR 1.22, CI 0.96-1.55, p = 0.10). CONCLUSION Despite evidence suggesting an association between inflammatory markers and post-stroke vascular recurrence, substantial methodological heterogeneity was apparent between studies. Individual-patient pooled analysis and standardisation of methods are needed to determine the prognostic role of blood inflammatory markers and to improve patient selection for randomised trials of inflammatory therapies.
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Affiliation(s)
- JJ McCabe
- Health Research Board (HRB) Stroke Clinical Trials Network Ireland (SCTNI), Dublin, Ireland
- Neurovascular Unit for Applied Translational and Therapeutics Research, Catherine McAuley Centre, Dublin, Ireland
- School of Medicine, University College Dublin, Dublin, Ireland
- Medicine for the Elderly Department/Stroke Medicine, Mater Misericordiae University Hospital, Dublin, Ireland
| | - E O’Reilly
- Health Research Board (HRB) Stroke Clinical Trials Network Ireland (SCTNI), Dublin, Ireland
| | - S Coveney
- Health Research Board (HRB) Stroke Clinical Trials Network Ireland (SCTNI), Dublin, Ireland
- Neurovascular Unit for Applied Translational and Therapeutics Research, Catherine McAuley Centre, Dublin, Ireland
- Department of Geriatric Medicine, Tallaght University Hospital, Dublin, Ireland
| | - R Collins
- Health Research Board (HRB) Stroke Clinical Trials Network Ireland (SCTNI), Dublin, Ireland
- Department of Geriatric Medicine, Tallaght University Hospital, Dublin, Ireland
| | - L Healy
- Health Research Board (HRB) Stroke Clinical Trials Network Ireland (SCTNI), Dublin, Ireland
- Department of Geriatric Medicine, Cork University Hospital, Cork, Ireland
| | - J McManus
- Health Research Board (HRB) Stroke Clinical Trials Network Ireland (SCTNI), Dublin, Ireland
- Department of Geriatric Medicine, University Hospital Limerick, Ireland
| | - R Mulcahy
- Health Research Board (HRB) Stroke Clinical Trials Network Ireland (SCTNI), Dublin, Ireland
- Department of Geriatric Medicine, Waterford University Hospital, Waterford, Ireland
| | - B Moynihan
- Health Research Board (HRB) Stroke Clinical Trials Network Ireland (SCTNI), Dublin, Ireland
- Department of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - T Cassidy
- School of Medicine, University College Dublin, Dublin, Ireland
- Department of Geriatric and Stroke Medicine, St Vincent’s University Hospital, Dublin, Ireland
| | - F Hsu
- The Department of Biostatistical Sciences, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - B Worrall
- Departments of Neurology and Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| | - S Murphy
- Health Research Board (HRB) Stroke Clinical Trials Network Ireland (SCTNI), Dublin, Ireland
- Neurovascular Unit for Applied Translational and Therapeutics Research, Catherine McAuley Centre, Dublin, Ireland
- School of Medicine, University College Dublin, Dublin, Ireland
- Medicine for the Elderly Department/Stroke Medicine, Mater Misericordiae University Hospital, Dublin, Ireland
| | - M O’Donnell
- Health Research Board (HRB) Stroke Clinical Trials Network Ireland (SCTNI), Dublin, Ireland
- Department of Geriatric Medicine, University Hospital Galway, Galway, Ireland
- Department of Translational Medicine, National University of Ireland Galway, Ireland
| | - PJ Kelly
- Health Research Board (HRB) Stroke Clinical Trials Network Ireland (SCTNI), Dublin, Ireland
- Neurovascular Unit for Applied Translational and Therapeutics Research, Catherine McAuley Centre, Dublin, Ireland
- Department of Neurology/Stroke Medicine, Mater Misericordiae University Hospital, Dublin, Ireland
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15
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Chen Z, He Y, Su Y, Sun Y, Zhang Y, Chen H. Association of inflammatory and platelet volume markers with clinical outcome in patients with anterior circulation ischaemic stroke after endovascular thrombectomy. Neurol Res 2021; 43:503-510. [PMID: 33402058 DOI: 10.1080/01616412.2020.1870359] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Background: To determine the correlation of inflammatory and platelet volume indices with the severity of stroke and 3-month clinical outcomes in patients with acute ischemic stroke (AIS) after endovascular thrombectomy (EVT).Methods: A retrospective analysis was conducted for AIS patients who underwent EVT at our hospital from 2015 to 2019. Inflammatory factors, including white blood count, neutrophil count, lymphocyte count, neutrophil to lymphocyte ratio (NLR), high-sensitivity C-reactive protein (hs-CRP), procalcitonin (PCT) and interleukin-6 (IL-6), and platelet volume indices, including platelet count (PC), mean platelet volume (MPV), platelet distribution width (PDW) and MPV/PC levels were assessed. Results were analyzed between patients with favorable and unfavorable outcomes at 3 months post-EVT.Results: A total of 257 AIS patients were included in the study. There were 86 (33.5%) patients with favorable functional outcomes at 3 months. Compared to patients with favorable outcomes, those with poor outcomes have lower lymphocyte count, higher neutrophil count and NLR levels. There were no differences in hs-CRP,PCT and IL-6 between the two groups. The correlation analysis showed that the increase in MPV, PDW, and MPV/PC was related to the high level of the NIHSS score at admission. Multivariate logistic regression analysis showed that higher NLR levels are an independent risk factor for unfavorable outcomes at 3 months (OR = 1.141; 95% CI 1.061 to 1.227, P = 0.000).Conclusions: MPV, PDW, and MPV/PC are associated with stroke severity. Higher NLR levels upon admission may predict unfavorable functional outcomes in patients with AIS after undergoing EVT.Abbreviations ACA: anterior cerebral artery; AIS: acute ischemic stroke; ASPECTS: alberta stroke program early CT score; BMI: body mass index; DBP: diastolic blood pressure; END: early neurological deterioration; EVT: endovascular thrombectomy; hs-CRP: high-sensitivity C-reactive protein; HT: hemorrhagic transformation; ICA: internal carotid artery; IL-6: interleukin-6; IS: ischemic progression; LAA: Large-Artery Atherosclerosis; MCA: middle cerebral artery; MPV: mean platelet volume; mTICI: modified thrombolysis in cerebral infarction; NIHSS: National Institute of Health stroke scale; NLR: neutrophil to lymphocyte ratio; OTP: onset-to-puncture; PC: platelet count; PCT: procalcitonin; PDW: platelet distribution width; SBP: systolic blood pressure; sICH: symptomatic intracerebral hemorrhageWBC: white blood cell.
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Affiliation(s)
- Zhongyun Chen
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yanbo He
- Department of Neurology, The Beijing Moslem People Hospital, Beijing, China
| | - Yingying Su
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yijia Sun
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yingbo Zhang
- Department of Neurology, Beijing Tsinghua Changgung Hospital Affiliated to Tsinghua University, Beijing, China
| | - Hongbo Chen
- Department of Neurology, Liangxiang Hospital of Beijing Fangshan District, Beijing, China
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16
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Zhang X, Zhang XF, Wang L, Guo DY, Zhang JM, Chen YG, Wang ZC, Pei LS, Chen JX, Shi YJ, Zou JB. Analysis of Clinical Efficacy of Traditional Chinese Medicine in Recovery Stage of Stroke: A Systematic Review and Meta-Analysis. Cardiovasc Ther 2020; 2020:7172052. [PMID: 33042224 PMCID: PMC7528130 DOI: 10.1155/2020/7172052] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 08/15/2020] [Accepted: 09/08/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND We provide an updated meta-analysis with detailed information on a combination of TCM and routine treatment. METHODS Retrieve appropriate articles with no language restrictions on keywords until 8 July 2019 in an electronic database. All trajectories are screened according to certain criteria. The quality of certified research was also evaluated. We made a detailed record of the results of the measurement. Meta-analysis was carried out by using the Revman 5.3 software. RESULTS Sixty-seven RCTs were included, and 6594 subjects were analyzed. Compared with routine treatment, the total effective rate (TER) of TCM combined with routine treatment was improved, and the recovery of stroke was also significantly accelerated. Regulation of blood lipids by notably shrinking the contents of TC, TG, and LDL and enhancing the levels of HDL. The levels of serum hs-CRP, WHV, and WLV decreased significantly, indicating that the expression of thrombomodulin was decreased after the comprehensive treatment of traditional Chinese medicines (TCMs). The combination of TCM treatment could enhance the protection of neural function by decreasing the NIHSS scoring while increasing the BI scoring. Paeoniae Radix Rubra, Angeticae Sinensis Radix, etc., can effectively improve the clinical symptoms of stroke convalescent patients and promote the recovery of neurological function. ACU of Baihui, Renzhong, etc., can improve the clinical rehabilitation effect of patients. However, our findings must be handled with care because of the small sample size and low quality of clinic trials cited. Other rigorous and large-scale RCTs are in need to confirm these results. CONCLUSION A combination of TCM and routine treatment in the treatment of stroke could improve TER, and it is beneficial to the rehabilitation of patients in the recovery period of apoplexy. These effects can be mediated by a combination of several mechanisms. Nevertheless, due to the limitations of this study, these results should be handled with caution.
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Affiliation(s)
- Xue Zhang
- Shaanxi Province Key Laboratory of New Drugs and Chinese Medicine Foundation Research, Pharmacy College, Shaanxi University of Chinese Medicine, Xianyang, China 712046
| | - Xiao-Fei Zhang
- Shaanxi Province Key Laboratory of New Drugs and Chinese Medicine Foundation Research, Pharmacy College, Shaanxi University of Chinese Medicine, Xianyang, China 712046
| | - Lin Wang
- Shaanxi Province Key Laboratory of New Drugs and Chinese Medicine Foundation Research, Pharmacy College, Shaanxi University of Chinese Medicine, Xianyang, China 712046
| | - Dong-Yan Guo
- Shaanxi Province Key Laboratory of New Drugs and Chinese Medicine Foundation Research, Pharmacy College, Shaanxi University of Chinese Medicine, Xianyang, China 712046
| | - Jia-Min Zhang
- Shaanxi Province Key Laboratory of New Drugs and Chinese Medicine Foundation Research, Pharmacy College, Shaanxi University of Chinese Medicine, Xianyang, China 712046
| | - Yong-Gang Chen
- Shaanxi Province Key Laboratory of New Drugs and Chinese Medicine Foundation Research, Pharmacy College, Shaanxi University of Chinese Medicine, Xianyang, China 712046
| | - Zhi-Chao Wang
- Shaanxi Province Key Laboratory of New Drugs and Chinese Medicine Foundation Research, Pharmacy College, Shaanxi University of Chinese Medicine, Xianyang, China 712046
| | - Li-Shan Pei
- Shaanxi Province Key Laboratory of New Drugs and Chinese Medicine Foundation Research, Pharmacy College, Shaanxi University of Chinese Medicine, Xianyang, China 712046
| | - Jiang-Xue Chen
- Shaanxi Province Key Laboratory of New Drugs and Chinese Medicine Foundation Research, Pharmacy College, Shaanxi University of Chinese Medicine, Xianyang, China 712046
| | - Ya-Jun Shi
- Shaanxi Province Key Laboratory of New Drugs and Chinese Medicine Foundation Research, Pharmacy College, Shaanxi University of Chinese Medicine, Xianyang, China 712046
| | - Jun-Bo Zou
- Shaanxi Province Key Laboratory of New Drugs and Chinese Medicine Foundation Research, Pharmacy College, Shaanxi University of Chinese Medicine, Xianyang, China 712046
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17
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Hosomi N, Kitagawa K, Nagai Y, Nakagawa Y, Aoki S, Nezu T, Kagimura T, Maruyama H, Origasa H, Minematsu K, Uchiyama S, Matsumoto M. Different Influences of Statin Treatment in Preventing At-Risk Stroke Subtypes: A Post Hoc Analysis of J-STARS. J Atheroscler Thromb 2020; 27:449-460. [PMID: 31534062 PMCID: PMC7242230 DOI: 10.5551/jat.50518] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Aims: To understand the different influences of statins on the incidence rate of each stroke subtype in association with low-density lipoprotein (LDL) cholesterol levels, we performed a post hoc analysis on the data from the Japan Statin Treatment Against Recurrent Stroke (J-STARS) study. Methods: Subjects (n = 1,578) were divided into three groups according to their mean postrandomized LDL cholesterol level (< 100, 100–120, and ≥ 120 mg/dL) until the last observation before the event or the end of follow-up. A Cox proportional hazard model for time to events was used for calculating adjusted hazard ratios, 95% confidence intervals, and the trend tests. Results: The event rates for atherothrombotic stroke did not decrease in accordance with the postrandomized LDL cholesterol level subgroups of either the control or the pravastatin group (p = 0.15 and 0.33 for the trend, respectively). In the control group, however, no atherothrombotic stroke event was observed in the subgroup of the low postrandomized LDL cholesterol level (less than 100 mg/dL). The event rates for atherothrombotic stroke were lower in the middle postrandomized LDL cholesterol level subgroup (100–120 mg/dL) of the pravastatin group than that of the control group. The event rates for lacunar stroke decreased in the lower postrandomized LDL cholesterol level subgroup of the control group but not of the pravastatin group (p = 0.004 and 0.06 for the trend, respectively). Conclusions: Statins showed different influences on the risks of atherothromobotic and lacunar stroke according to postrandomized LDL cholesterol levels.
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Affiliation(s)
- Naohisa Hosomi
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Kazuo Kitagawa
- Department of Neurology, Tokyo Women's Medical University School of Medicine
| | - Yoji Nagai
- Center for Clinical Research, Kobe University Hospital
| | - Yoko Nakagawa
- Division of Medical Statistics, Translational Research Center for Medical Innovation, Foundation for Biomedical Research and Innovation at Kobe
| | - Shiro Aoki
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Tomohisa Nezu
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Tatsuo Kagimura
- Division of Medical Statistics, Translational Research Center for Medical Innovation, Foundation for Biomedical Research and Innovation at Kobe
| | - Hirofumi Maruyama
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Hideki Origasa
- Division of Biostatistics and Clinical Epidemiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences
| | | | - Shinichiro Uchiyama
- Clinical Research Center, International University of Health and Welfare, Center for Brain and Cerebral Vessels, Sanno Hospital and Sanno Medical Center
| | - Masayasu Matsumoto
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences.,Sakai City Medical Center, Sakai City Hospital Organization
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18
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Parikh NS, Merkler AE, Iadecola C. Inflammation, Autoimmunity, Infection, and Stroke: Epidemiology and Lessons From Therapeutic Intervention. Stroke 2020; 51:711-718. [PMID: 32078460 DOI: 10.1161/strokeaha.119.024157] [Citation(s) in RCA: 70] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Neal S Parikh
- From the Department of Neurology, Columbia University Medical College (N.S.P.), Weill Cornell Medicine, New York, NY.,Clinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute (N.S.P., A.E.M., C.I.), Weill Cornell Medicine, New York, NY.,Department of Neurology (N.S.P., A.E.M., C.I.), Weill Cornell Medicine, New York, NY
| | - Alexander E Merkler
- Clinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute (N.S.P., A.E.M., C.I.), Weill Cornell Medicine, New York, NY.,Department of Neurology (N.S.P., A.E.M., C.I.), Weill Cornell Medicine, New York, NY
| | - Costantino Iadecola
- Clinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute (N.S.P., A.E.M., C.I.), Weill Cornell Medicine, New York, NY.,Department of Neurology (N.S.P., A.E.M., C.I.), Weill Cornell Medicine, New York, NY
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19
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Liu L, Gao B, Wang J, Yang C, Wu S, Wu Y, Chen S, Li Q, Zhang H, Wang G, Chen M, Zhao MH, Zhang L. Reduction in Serum High-Sensitivity C-Reactive Protein Favors Kidney Outcomes in Patients with Impaired Fasting Glucose or Diabetes. J Diabetes Res 2020; 2020:2720905. [PMID: 32587865 PMCID: PMC7303740 DOI: 10.1155/2020/2720905] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 05/22/2020] [Accepted: 05/27/2020] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE We aimed to evaluate whether the reduction in serum high-sensitivity C-reactive protein (hs-CRP) favors kidney outcomes. METHODS This study was a subanalysis including patients with impaired fasting glucose or diabetes of the Kailuan cohort study. The predictor was based on two consecutive visits of hs-CRP levels in 2006 and 2008. A total of 3924 patients with hs-CRP ≥ 3 mg/L in 2006 were divided into two groups according to whether the levels of hs-CRP were reduced in 2008: Group 1: no reduction: hs-CRP ≥ 3 mg/L in 2008; Group 2: reduction: hs-CRP < 3 mg/L in 2008. Kidney outcomes include kidney function decline and development and progression of proteinuria and were followed up until the end of 2015. RESULTS There were 3905, 2049, and 493 patients included into our analysis for the outcomes of kidney function decline and the development and progression of proteinuria, respectively. A total of 398, 297, and 47 events occurred after 5 years of follow-up, respectively. Cox regression revealed that patients with reduction in hs-CRP have lower risk of kidney function decline (HR 0.71, 95% CI 0.57-0.89, and P = 0.002) and development of proteinuria (0.77, 0.61-0.99, and P = 0.038) after controlling for potential confounders as compared to those with no reduction in hs-CRP levels. CONCLUSIONS Reduction in serum hs-CRP levels favors kidney outcomes in patients with impaired fasting glucose or diabetes.
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Affiliation(s)
- Lili Liu
- Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Key Laboratory of Renal Disease, Ministry of Health of China, Key Laboratory of Chronic Kidney Disease Prevention and Treatment, Ministry of Education, Beijing 100034, China
| | - Bixia Gao
- Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Key Laboratory of Renal Disease, Ministry of Health of China, Key Laboratory of Chronic Kidney Disease Prevention and Treatment, Ministry of Education, Beijing 100034, China
| | - Jinwei Wang
- Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Key Laboratory of Renal Disease, Ministry of Health of China, Key Laboratory of Chronic Kidney Disease Prevention and Treatment, Ministry of Education, Beijing 100034, China
| | - Chao Yang
- Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Key Laboratory of Renal Disease, Ministry of Health of China, Key Laboratory of Chronic Kidney Disease Prevention and Treatment, Ministry of Education, Beijing 100034, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, Tangshan 063001, China
| | - Yuntao Wu
- Department of Cardiology, Kailuan General Hospital, Tangshan 063001, China
| | - Shuohua Chen
- Department of Health Care Center, Kailuan General Hospital, Tangshan 063001, China
| | - Qiuyun Li
- Department of Endocrinology, Kailuan General Hospital, Tangshan 063001, China
| | - Huifen Zhang
- Department of Laboratory, Kailuan General Hospital, Tangshan 063001, China
| | - Guodong Wang
- Department of Cardiology, Kailuan General Hospital, Tangshan 063001, China
| | - Min Chen
- Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Key Laboratory of Renal Disease, Ministry of Health of China, Key Laboratory of Chronic Kidney Disease Prevention and Treatment, Ministry of Education, Beijing 100034, China
| | - Ming-hui Zhao
- Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Key Laboratory of Renal Disease, Ministry of Health of China, Key Laboratory of Chronic Kidney Disease Prevention and Treatment, Ministry of Education, Beijing 100034, China
- Peking-Tsinghua Center for Life Sciences, Beijing 100034, China
| | - Luxia Zhang
- Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Key Laboratory of Renal Disease, Ministry of Health of China, Key Laboratory of Chronic Kidney Disease Prevention and Treatment, Ministry of Education, Beijing 100034, China
- National Institute of Health Data Science at Peking University, Beijing 100191, China
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Nezu T, Hosomi N, Kitagawa K, Nagai Y, Nakagawa Y, Aoki S, Kagimura T, Maruyama H, Origasa H, Minematsu K, Uchiyama S, Matsumoto M. Effect of Statin on Stroke Recurrence Prevention at Different Infarction Locations: A Post Hoc Analysis of The J-STARS Study. J Atheroscler Thromb 2019; 27:524-533. [PMID: 31554765 PMCID: PMC7355099 DOI: 10.5551/jat.51391] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Aim: Posterior circulation stroke (PCS) has different clinical features and prognosis compared with anterior circulation stroke (ACS), and whether the effect of statin therapy on stroke prevention differs according to infarction location remains unclear. This post hoc analysis of the J-STARS study aimed to compare the usefulness of statin at different infarction locations (i.e., ACS and PCS). Methods: In the J-STARS study, 1578 patients were randomly assigned to the pravastatin or control group. The subjects were divided into two subgroups (ACS and PCS groups) based on the arteries responsible for the infarction. Cox proportional hazards models were used to investigate whether the all stroke recurrence rate was different between the ACS and PCS groups. Results: The PCS group (n = 499) had a significantly higher prevalence of diabetes than the ACS group (n = 1022) (30.7% vs. 19.8%, P < 0.001). During the follow-up (4.9 ± 1.4 years), the incidence of all stroke was significantly lower in the pravastatin group than in the control group among patients with PCS (adjusted hazard ratio [HR] 0.46, 95% confidence interval [CI] 0.25–0.83, P = 0.009); however, the stroke recurrence rates were not significantly different between both groups among patients with ACS (adjusted HR 1.32, 95% CI 0.93–1.88, P = 0.123). A significant interaction between the ACS and PCS groups in terms of pravastatin effects was noted (P = 0.003 for interaction). Conclusions: Pravastatin significantly reduced the recurrence rate of all stroke among patients with PCS. Thus, the effect of statin on the recurrence of stroke may differ according to infarction location.
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Affiliation(s)
- Tomohisa Nezu
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Naohisa Hosomi
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Kazuo Kitagawa
- Department of Neurology, Tokyo Women's Medical University School of Medicine
| | - Yoji Nagai
- Center for Clinical Research, Kobe University Hospital
| | - Yoko Nakagawa
- Division of Medical Statistics, Translational Research Informatics Center, Foundation for Biomedical Research and Innovation
| | - Shiro Aoki
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Tatsuo Kagimura
- Division of Medical Statistics, Translational Research Informatics Center, Foundation for Biomedical Research and Innovation
| | - Hirofumi Maruyama
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Hideki Origasa
- Division of Biostatistics and Clinical Epidemiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences
| | | | - Shinichiro Uchiyama
- Clinical Research Center for Medicine, International University of Health and Welfare, Center for Brain and Cerebral Vessels, Sanno Hospital and Sanno Medical Center
| | - Masayasu Matsumoto
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences.,Sakai City Medical Center, Sakai City Hospital Organization
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Baram SM, Karima S, Shateri S, Tafakhori A, Fotouhi A, Lima BS, Rajaei S, Mahdavi M, Tehrani HS, Aghamollaii V, Aghamiri SH, Mansouri B, Gharahje S, Kabiri S, Hosseinizadeh M, Shahamati SZ, Alborzi AT. Functional improvement and immune-inflammatory cytokines profile of ischaemic stroke patients after treatment with boswellic acids: a randomized, double-blind, placebo-controlled, pilot trial. Inflammopharmacology 2019; 27:1101-1112. [DOI: 10.1007/s10787-019-00627-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Accepted: 07/31/2019] [Indexed: 12/13/2022]
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Abstract
Aging, as a physiological process mediated by numerous regulatory pathways and transcription factors, is manifested by continuous progressive functional decline and increasing risk of chronic diseases. There is an increasing interest to identify pharmacological agents for treatment and prevention of age-related disease in humans. Animal models play an important role in identification and testing of anti-aging compounds; this step is crucial before the drug will enter human clinical trial or will be introduced to human medicine. One of the main goals of animal studies is better understanding of mechanistic targets, therapeutic implications and side-effects of the drug, which may be later translated into humans. In this chapter, we summarized the effects of different drugs reported to extend the lifespan in model organisms from round worms to rodents. Resveratrol, rapamycin, metformin and aspirin, showing effectiveness in model organism life- and healthspan extension mainly target the master regulators of aging such as mTOR, FOXO and PGC1α, affecting autophagy, inflammation and oxidative stress. In humans, these drugs were demonstrated to reduce inflammation, prevent CVD, and slow down the functional decline in certain organs. Additionally, potential anti-aging pharmacologic agents inhibit cancerogenesis, interfering with certain aspects of cell metabolism, proliferation, angioneogenesis and apoptosis.
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Wada S, Koga M, Minematsu K, Toyoda K, Suzuki R, Kagimura T, Nagai Y, Aoki S, Nezu T, Hosomi N, Origasa H, Ohtsuki T, Maruyama H, Yasaka M, Kitagawa K, Uchiyama S, Matsumoto M. Baseline Carotid Intima-Media Thickness and Stroke Recurrence During Secondary Prevention With Pravastatin. Stroke 2019; 50:1586-1589. [DOI: 10.1161/strokeaha.119.024968] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Shinichi Wada
- From the Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan (S.W., M.K., K.M., K.T., R.S.)
| | - Masatoshi Koga
- From the Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan (S.W., M.K., K.M., K.T., R.S.)
| | - Kazuo Minematsu
- From the Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan (S.W., M.K., K.M., K.T., R.S.)
| | - Kazunori Toyoda
- From the Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan (S.W., M.K., K.M., K.T., R.S.)
| | - Rieko Suzuki
- From the Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan (S.W., M.K., K.M., K.T., R.S.)
| | - Tatsuo Kagimura
- Foundation for Biomedical Research and Innovation at Kobe, Translational Research Center for Medical Innovation, Japan (T.K.)
| | - Yoji Nagai
- Center for Clinical Research, Kobe University Hospital, Japan (Y.N.)
| | - Shiro Aoki
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (S.A., T.N., N.H., T.O., H.M., M.M.)
| | - Tomohisa Nezu
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (S.A., T.N., N.H., T.O., H.M., M.M.)
| | - Naohisa Hosomi
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (S.A., T.N., N.H., T.O., H.M., M.M.)
| | - Hideki Origasa
- Division of Biostatistics and Clinical Epidemiology, University of Toyama Graduate School of Medicine and Pharmaceutical Science, Japan (H.O.)
| | - Toshiho Ohtsuki
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (S.A., T.N., N.H., T.O., H.M., M.M.)
- Stroke Center, Kinki University Hospital, Osakasayama, Japan (T.O.)
| | - Hirofumi Maruyama
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (S.A., T.N., N.H., T.O., H.M., M.M.)
| | - Masahiro Yasaka
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (S.A., T.N., N.H., T.O., H.M., M.M.)
- Department of Cerebrovascular Medicine and Neurology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan (M.Y.)
| | - Kazuo Kitagawa
- Department of Neurology, Tokyo Women’s Medical University, Japan (K.K.)
| | - Shinichiro Uchiyama
- Clinical Research Center for Medicine, International University of Health and Welfare, Center for Brain and Cerebral Vessels, Sanno Hospital and Sanno Medical Center, Tokyo, Japan (S.U.)
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Recurrence Rate and Relevant Associated Factors of Stroke among Patients with Small Artery Occlusion in Northern China. Sci Rep 2019; 9:2834. [PMID: 30808986 PMCID: PMC6391422 DOI: 10.1038/s41598-019-39207-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 01/14/2019] [Indexed: 12/22/2022] Open
Abstract
Small artery occlusion (SAO) is responsible for 31.3% of all ischemic strokes in China. However, reports regarding the recurrence rate of SAO in China are rare. We aimed to assess the recurrence rate and factors associated with SAO in China. All consecutive patients with SAO hospitalized at Tianjin Huanhu Hospital from 2005 to 2014 were recruited. We assessed the association between stroke subtype, severity, and disease history with recurrence at 3, 12, and 36 months of onset using multivariate logistic regression analysis. A total of 2,524 SAO patients were included in this study, including 1696 (67.2%) men and 828 (32.8%) women. The recurrence rates were 3.1% at 3 months, 12.7% at 12 months, and 36.5% at 36 months. Compared with women, men had a higher risk of recurrence at 3 months after SAO (P = 0.003). Old age and severity of stroke were also associated with a higher risk of recurrence (P < 0.05). Patients with an elevated C-reactive protein had a higher risk of recurrence at 12 months (P = 0.003). On the other hand, the risk of recurrence at 12 months was 39% lower in patients who consumed alcohol than in those who did not (P = 0.037). Hypertension, atrial fibrillation, and obesity were independent risk factors of recurrence at 36 months. These findings suggest that modification of risk factors in patients with SAO, particularly men, is essential for reducing the rate of recurrence and the overall burden of stroke in China.
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Nishida Y, Kubota Y, Iso H, Tamakoshi A. Self-Reported Eczema in Relation with Mortality from Cardiovascular Disease in Japanese: the Japan Collaborative Cohort Study. J Atheroscler Thromb 2019; 26:775-782. [PMID: 30700678 PMCID: PMC6753243 DOI: 10.5551/jat.46383] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Aim: Previous studies suggested a positive association between eczema and cardiovascular disease (CVD), probably through enhanced systemic inflammation. However, several studies reported null findings about eczema and CVD, so the evidence is still controversial. Methods: We asked 85,099 participants (35,489 men and 49,610 women), aged 40 to 79 years, without a history of CVD or cancer at baseline between 1988 and 1990, to complete a lifestyle questionnaire, including information eczema frequency (seldom, sometimes or often). Results: During the 6,389,818 person-years of follow-up, there were 1,174 deaths from coronary heart disease (CHD), 979 from heart failure, 366 from cardiac arrhythmia, 2,454 from total stroke, 1,357 from ischemic stroke, 1,013 from hemorrhagic stroke, and 201 from aortic aneurysm or dissection. The multivariable-adjusted model showed that individuals who “sometimes” or “often” had eczema had 0.82 (95%confidence interval (CI): 0.69–0.97) or 1.26 (95%CI: 1.01–1.56) times the risk of mortality from CHD, respectively, compared to those who “seldom” did. Individuals who “often” had 1.30 (95%CI: 1.05–1.61) times the risk of mortality from CHD, compared to those who “seldom or sometimes” did. There was no association of eczema with mortality from other CVD, or no interaction between eczema and sex or age, in relation to any CVD mortality risk. Conclusions: Self-reported frequent eczema was associated with increased risk of mortality from CHD, but not other major CVD, in a Japanese general population. Since steroid usage was not considered, future studies should include it as a potential confounding factor.
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Affiliation(s)
- Yoko Nishida
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine
| | - Yasuhiko Kubota
- Osaka Center for Cancer and Cardiovascular Disease Prevention
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine
| | - Akiko Tamakoshi
- Department of Public Health, Hokkaido University Faculty of Medicine
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Effects of arm swing exercise training on cardiac autonomic modulation, cardiovascular risk factors, and electrolytes in persons aged 60-80 years with prehypertension: A randomized controlled trial. J Exerc Sci Fit 2019; 17:47-54. [PMID: 30740133 PMCID: PMC6353723 DOI: 10.1016/j.jesf.2018.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 09/25/2018] [Accepted: 11/01/2018] [Indexed: 11/21/2022] Open
Abstract
Background/Objective This study aimed to investigate the effect and carry-over effect of arm swing exercise (ASE) training on cardiac autonomic modulation, cardiovascular risk factors, and blood electrolytes in older persons with prehypertension. Methods Subjects were 50 individuals with prehypertension (aged 66.90 ± 5.50 yr, body mass index 23.84 ± 3.65 kg/m2). They were randomly assigned into ASE group and control group. Subjects in the ASE group underwent an ASE training program for 3 months at a frequency of 30 min/day, 3 days/week. Subjects in the control group maintained their daily routine activities minus regular exercise. Blood pressure, heart rate variability (HRV), cardiovascular risk factors including blood glucose, lipid profile, high-sensitive C-reactive protein (hsCRP), and electrolytes were evaluated on 3 occasions: before and after the 3-month intervention, and 1 month after intervention ended. Results Following the 3-month intervention, systolic blood pressure (SBP) and serum hsCRP concentration were significantly lower, while serum high-density lipoprotein (HDL)-cholesterol, potassium (K+), magnesium (Mg2+) concentrations, standard deviation of normal R-R intervals (RMSSD) and high frequency (HF) power values were higher in the ASE group when compared with the control group (p < 0.05). At the 1-month follow-up interval, SBP and serum hsCRP concentration remained lower while serum HDL-cholesterol and K+ concentrations remained higher in the ASE group as compared to the control group (p < 0.05). Conclusion ASE training decreased SBP and serum hsCRP concentration, increased serum HDL-cholesterol, K+, and Mg2+ concentrations and increased RMSSD and HF power values in older persons with prehypertension. In addition, there were carry-over effects of ASE training i.e. decreased SBP and serum hsCRP concentration as well as increased serum HDL-cholesterol and K+ concentrations.
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Cai Z, He W, Zhuang FJ, Chen Y. The role of high high-sensitivity C-reactive protein levels at admission on poor prognosis after acute ischemic stroke. Int J Neurosci 2018; 129:423-429. [PMID: 30332913 DOI: 10.1080/00207454.2018.1538139] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Plasma high hypersensitive C-reactive protein (hs-CRP) levels are associated with risk and prognosis of vascular diseases. The clinical implications of markedly elevated hs-CRP levels are more discovered in the onset and development of stroke. The aim of this study is to determine the association of plasma hs-CRP levels on the prognosis in patients with acute ischemic stroke. METHODS Retrospective analysis of a single-center database of consecutive cases for acute cerebral infarction (ACI) from January 1 2012 to December 30 2016 was performed. Significant predictors of the dependent variable variance were identified by standard linear, univariate and multivariate, or binary logistic regression modeling. Multivariate regression analysis was introduced to investigate the relationship between plasma hs-CRP levels at admission and change in National Institutes of Health Stroke Scale (NIHSS) score at discharge. RESULTS The percentages of hypertension, diabetes mellitus, hyperlipidemia, atrial fibrillation, body mass index (BMI) and chronic kidney disease were raised with the increase of hs-CRP plasma concentration at admission among all patients (p < 0.05). ACI patients with large-artery atherosclerosis had an increasing percentage with the increase of hs-CRP mean value (p < 0.05). The initial NIHSS scores, the acute infection rate and age advance also increased with the increase of hs-CRP plasma concentration at admission (p < 0.05). The ratio of neurological improvement increased with the decrease of plasma hs-CRP concentration (p < 0.05). The neurological deterioration and poor prognosis increased with the increase of plasma hs-CRP concentration (p < 0.05). CONCLUSION High plasma hs-CRP levels are associated with worse outcomes in the ACI patients. Monitoring plasma hs-CRP levels and cutting down the elevated plasma hs-CRP levels will be beneficial in screening and treatment decisions for the prognosis of acute ischemic stroke.
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Affiliation(s)
- Zhiyou Cai
- a Department of Neurology , Chongqing General Hospital University of Chinese Academy of Sciences , Chongqing , Chongqing , People's Republic of China
| | - Wenbo He
- b Department of Neurology , Renmin Hospital Hubei University of Medicine , Shiyan , Hubei Province , People's Republic of China
| | - Feng-Juan Zhuang
- b Department of Neurology , Renmin Hospital Hubei University of Medicine , Shiyan , Hubei Province , People's Republic of China
| | - Yan Chen
- b Department of Neurology , Renmin Hospital Hubei University of Medicine , Shiyan , Hubei Province , People's Republic of China
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Kitagawa K, Hosomi N, Nagai Y, Kagimura T, Ohtsuki T, Maruyama H, Origasa H, Minematsu K, Uchiyama S, Nakamura M, Matsumoto M. Cumulative Effects of LDL Cholesterol and CRP Levels on Recurrent Stroke and TIA. J Atheroscler Thromb 2018; 26:432-441. [PMID: 30318492 PMCID: PMC6514170 DOI: 10.5551/jat.45989] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
AIMS To investigate the relative contribution of on-treatment low-density lipoprotein (LDL) cholesterol and C-reactive protein (CRP) to the risk of recurrent stroke and transient ischemic attack (TIA) in patients with history of ischemic stroke. METHODS A total of 1095 patients with non-cardioembolic ischemic stroke were randomized into two groups: control and patients receiving 10 mg of pravastatin per day. After excluding 18 patients who did not have baseline CRP data, the effects of LDL cholesterol and CRP on recurrent stroke and TIA were prospectively assessed in 1077 patients. RESULTS During the follow-up of 4.9±1.4 years, there were 131 recurrent stroke or TIA cases. Patients with ontreatment LDL cholesterol <120 mg/dL showed 29% reduction in recurrent stroke and TIA than those with LDL cholesterol ≥ 120 mg/dL (event rate 2.20 vs. 3.11 per 100 person-years, hazard ratio [HR] 0.71, 95% confidence interval (CI) 0.50-0.99, p=0.048). Patients with CRP <1 mg/L had 32% reduction compared with that of patients with CRP ≥ 1 mg/L (event rate 2.26 vs. 3.40 per 100 person-years; HR 0.68, 95% CI 0.48-0.96, p=0.031). Although LDL cholesterol and CRP levels were not correlated in individual patients, those who achieved both LDL cholesterol <120 mg/dL and CRP <1 mg/L showed 51% reduction compared with that of patients with LDL cholesterol ≥ 120 mg/dL and CRP ≥ 1 mg/L (event rate 2.02 vs. 4.19 per 100 person-years; HR 0.49, 95% CI 0.31-0.79). CONCLUSIONS The control of both LDL cholesterol and CRP levels appears to be effective for preventing recurrent stroke and TIA in patients with non-cardiogenic ischemic stroke.
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Affiliation(s)
- Kazuo Kitagawa
- Department of Neurology, Tokyo Women's Medical University
| | - Naohisa Hosomi
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Yoji Nagai
- Clinical and Translational Research Center, Kobe University Hospital
| | - Tatsuo Kagimura
- Foundation for Biomedical Research and Innovation at Kobe, Translational Research Center for Medical Innovation
| | | | - Hirofumi Maruyama
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Hideki Origasa
- Division of Biostatistics and Clinical Epidemiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences
| | | | - Shinichiro Uchiyama
- Clinical Research Center, International University of Health and Welfare, Center for Brain and Cerebral Vessels, Sanno Hospital and Medical Center
| | | | - Masayasu Matsumoto
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences.,Sakai City Medical Center, Sakai City Hospital Organization
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Asada Y, Yamashita A, Sato Y, Hatakeyama K. Thrombus Formation and Propagation in the Onset of Cardiovascular Events. J Atheroscler Thromb 2018; 25:653-664. [PMID: 29887539 PMCID: PMC6099067 DOI: 10.5551/jat.rv17022] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Ischemic cardiovascular disease is a major cause of morbidity and mortality worldwide and thrombus formation on disrupted atherosclerotic plaques is considered to trigger its onset. Although the activation of platelets and coagulation pathways has been investigated intensively, the mechanisms of thrombus formation on disrupted plaques have not been understood in detail. Platelets are thought to play a central role in the formation of arterial thrombus because of rapid flow conditions; however, thrombus that develops on disrupted plaques consistently includes large amounts of fibrin in addition to aggregated platelets. While, thrombus does not always become large enough to completely occlude the vascular lumen, indicating that the propagation of thrombus is also critical for the onset of cardiovascular events. Various factors, such as vascular wall thrombogenicity, altered blood flow and imbalanced blood hemostasis, modulate thrombus formation and propagation on disrupted plaques. Pathological findings derived from humans and experimental animal models of atherothrombosis have identified important factors that affect thrombus formation and propagation, namely platelets, extrinsic and intrinsic coagulation factors, proinflammatory factors, plaque hypoxia and blood flow alteration. These findings might provide insight into the mechanisms of thrombus formation and propagation on disrupted plaques that lead to the onset of cardiovascular events.
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Affiliation(s)
- Yujiro Asada
- Department of Pathology, Faculty of Medicine, University of Miyazaki
| | - Atsushi Yamashita
- Department of Pathology, Faculty of Medicine, University of Miyazaki
| | - Yuichiro Sato
- Department of Diagnostic Pathology, University of Miyazaki Hospital, University of Miyazaki
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Konishi T, Funayama N, Yamamoto T, Hotta D, Nomura R, Nakagaki Y, Murahashi T, Kamiyama K, Yoshimoto T, Aoki T, Tanaka S. Stabilization of symptomatic carotid atherosclerotic plaques by statins: a clinico-pathological analysis. Heart Vessels 2018; 33:1311-1324. [PMID: 29789903 PMCID: PMC6208692 DOI: 10.1007/s00380-018-1193-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 05/18/2018] [Indexed: 01/13/2023]
Abstract
Human and animal studies have revealed a stabilization of atherosclerotic plaques by statins. However, the stabilization of human carotid plaques has not been thoroughly described pathologically. This analysis explored the relationship between statin therapy and plaque stability in carotid endarterectomy (CEA) specimens. We analyzed specimens harvested between May 2015 and February 2017, from 79 consecutive patients presenting with > 70% carotid artery stenoses, of whom 66 were untreated (group 1) and 13 treated (group 2) with a statin. Immunohistochemistry was performed, using an endothelial specific antibody to CD31, CD34 and platelet derived growth factor receptor-β. The prevalence of plaque ruptures (P = 0.009), lumen thrombi (P = 0.009), inflammatory cells (P = 0.008), intraplaque hemorrhages (P = 0.030) and intraplaque microvessels (P < 0.001) was significantly lower in group 2 than in group 1. Among 66 patients presenting with strokes and infarct sizes > 1.0 cm3 on magnetic resonance imaging, the mean infarct volume was significantly smaller (P = 0.031) in group 2 (4.2 ± 2.5 cm3) than in group 1 (8.2 ± 7.1 cm3). The difference in mean concentration of low-density lipoprotein cholesterol between group 1 (121 ± 32 mg/dl) and group 2 (105 ± 37 mg/dl) was non-significant (P = 0.118). This analysis of plaques harvested from patients undergoing CEA suggests that statin therapy mitigates the plaque instability, which, in patients presenting with strokes, might decrease infarct volume.
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Affiliation(s)
- Takao Konishi
- Department of Cardiology, Hokkaido Cardiovascular Hospital, 1-30, West 13, South 27, Chuou-ku, Sapporo, 064-8622, Japan. .,Department of Cancer Pathology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
| | - Naohiro Funayama
- Department of Cardiology, Hokkaido Cardiovascular Hospital, 1-30, West 13, South 27, Chuou-ku, Sapporo, 064-8622, Japan
| | - Tadashi Yamamoto
- Department of Cardiology, Hokkaido Cardiovascular Hospital, 1-30, West 13, South 27, Chuou-ku, Sapporo, 064-8622, Japan
| | - Daisuke Hotta
- Department of Cardiology, Hokkaido Cardiovascular Hospital, 1-30, West 13, South 27, Chuou-ku, Sapporo, 064-8622, Japan
| | - Ryota Nomura
- Department of Neurosurgery, Nakamura Memorial Hospital, Sapporo, Japan
| | - Yusuke Nakagaki
- Department of Neurosurgery, Nakamura Memorial Hospital, Sapporo, Japan
| | - Takeo Murahashi
- Department of Neurosurgery, Nakamura Memorial Hospital, Sapporo, Japan
| | - Kenji Kamiyama
- Department of Neurosurgery, Nakamura Memorial Hospital, Sapporo, Japan
| | - Tetsuyuki Yoshimoto
- Department of Neurosurgery, Kashiwaba Neurosurgical Hospital, Sapporo, Japan
| | - Takeshi Aoki
- Department of Neurosurgery, Hokkaido Neurosurgical Memorial Hospital, Sapporo, Japan
| | - Shinya Tanaka
- Department of Cancer Pathology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
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32
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Ham SY, Song SW, Nam SB, Park SJ, Kim S, Song Y. Effects of chronic statin use on 30-day major adverse cardiac and cerebrovascular events after thoracic endovascular aortic repair. THE JOURNAL OF CARDIOVASCULAR SURGERY 2018; 59:836-843. [PMID: 29616526 DOI: 10.23736/s0021-9509.18.10463-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND Cardiac and cerebrovascular complications are major causes of adverse outcomes following thoracic endovascular aortic repair (TEVAR). The benefits of statins have been established, but little is known about their impact on patients undergoing TEVAR. We investigated whether chronic statin use protected against early postoperative major adverse cardiac and cerebrovascular events (MACCEs) after TEVAR. METHODS We retrospectively reviewed 211 patients who underwent TEVAR between February 2013 and March 2017 classified into two groups, those with acute aortic syndrome (AAS, N.=79) and those without (non-AAS, N.=132). Patients were subdivided according to preoperative statin therapy for ≥3 months or not. The primary endpoint was 30-day MACCE, defined as myocardial infarction, stroke, arrhythmia, cardiovascular death, or cerebrovascular death. Acute kidney injury (AKI) occurrence within 48 hours was also evaluated. Multivariate logistic regression analysis was performed to identify independent risk factors for MACCEs and AKI. RESULTS Incidence of MACCEs (1% vs. 11%, P=0.019) was significantly lower in the statin group than in the no-statin group in non-AAS patients. Multivariate logistic regression analysis revealed statin use (odds ratio 0.85, 95% confidence interval 0.01-0.95, P=0.046) as an independent predictor for MACCE in non-AAS patients. The AKI incidence was significantly higher in the statin group than in the no-statin group in AAS patients (44% vs. 15%, P=0.018). CONCLUSIONS In patients undergoing TEVAR, chronic statin use was associated with reduced 30-day MACCEs in non-AAS patients, but not in AAS patients. It might rather be associated with increased risk of AKI in AAS patients.
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Affiliation(s)
- Sung Y Ham
- Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, South Korea.,Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, South Korea
| | - Suk W Song
- Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Seoul, South Korea
| | - Sang B Nam
- Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, South Korea.,Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, South Korea
| | - Soo J Park
- Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, South Korea.,Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, South Korea
| | - Sijin Kim
- Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Young Song
- Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, South Korea - .,Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, South Korea
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33
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Hosomi N, Kitagawa K, Nagai Y, Nakagawa Y, Aoki S, Nezu T, Kagimura T, Maruyama H, Origasa H, Minematsu K, Uchiyama S, Matsumoto M. Desirable Low-Density Lipoprotein Cholesterol Levels for Preventing Stroke Recurrence. Stroke 2018; 49:865-871. [DOI: 10.1161/strokeaha.117.018870] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 01/27/2018] [Accepted: 02/01/2018] [Indexed: 11/16/2022]
Affiliation(s)
- Naohisa Hosomi
- From the Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (N.H., S.A., T.N., H.M., M.M.); Department of Neurology, Tokyo Women’s Medical University School of Medicine, Japan (K.K.); Center for Clinical Research, Kobe University Hospital, Japan (Y. Nagai); Division of Medical Statistics, Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, Kobe, Japan (Y. Nakagawa, T.K.)
| | - Kazuo Kitagawa
- From the Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (N.H., S.A., T.N., H.M., M.M.); Department of Neurology, Tokyo Women’s Medical University School of Medicine, Japan (K.K.); Center for Clinical Research, Kobe University Hospital, Japan (Y. Nagai); Division of Medical Statistics, Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, Kobe, Japan (Y. Nakagawa, T.K.)
| | - Yoji Nagai
- From the Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (N.H., S.A., T.N., H.M., M.M.); Department of Neurology, Tokyo Women’s Medical University School of Medicine, Japan (K.K.); Center for Clinical Research, Kobe University Hospital, Japan (Y. Nagai); Division of Medical Statistics, Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, Kobe, Japan (Y. Nakagawa, T.K.)
| | - Yoko Nakagawa
- From the Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (N.H., S.A., T.N., H.M., M.M.); Department of Neurology, Tokyo Women’s Medical University School of Medicine, Japan (K.K.); Center for Clinical Research, Kobe University Hospital, Japan (Y. Nagai); Division of Medical Statistics, Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, Kobe, Japan (Y. Nakagawa, T.K.)
| | - Shiro Aoki
- From the Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (N.H., S.A., T.N., H.M., M.M.); Department of Neurology, Tokyo Women’s Medical University School of Medicine, Japan (K.K.); Center for Clinical Research, Kobe University Hospital, Japan (Y. Nagai); Division of Medical Statistics, Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, Kobe, Japan (Y. Nakagawa, T.K.)
| | - Tomohisa Nezu
- From the Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (N.H., S.A., T.N., H.M., M.M.); Department of Neurology, Tokyo Women’s Medical University School of Medicine, Japan (K.K.); Center for Clinical Research, Kobe University Hospital, Japan (Y. Nagai); Division of Medical Statistics, Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, Kobe, Japan (Y. Nakagawa, T.K.)
| | - Tatsuo Kagimura
- From the Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (N.H., S.A., T.N., H.M., M.M.); Department of Neurology, Tokyo Women’s Medical University School of Medicine, Japan (K.K.); Center for Clinical Research, Kobe University Hospital, Japan (Y. Nagai); Division of Medical Statistics, Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, Kobe, Japan (Y. Nakagawa, T.K.)
| | - Hirofumi Maruyama
- From the Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (N.H., S.A., T.N., H.M., M.M.); Department of Neurology, Tokyo Women’s Medical University School of Medicine, Japan (K.K.); Center for Clinical Research, Kobe University Hospital, Japan (Y. Nagai); Division of Medical Statistics, Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, Kobe, Japan (Y. Nakagawa, T.K.)
| | - Hideki Origasa
- From the Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (N.H., S.A., T.N., H.M., M.M.); Department of Neurology, Tokyo Women’s Medical University School of Medicine, Japan (K.K.); Center for Clinical Research, Kobe University Hospital, Japan (Y. Nagai); Division of Medical Statistics, Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, Kobe, Japan (Y. Nakagawa, T.K.)
| | - Kazuo Minematsu
- From the Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (N.H., S.A., T.N., H.M., M.M.); Department of Neurology, Tokyo Women’s Medical University School of Medicine, Japan (K.K.); Center for Clinical Research, Kobe University Hospital, Japan (Y. Nagai); Division of Medical Statistics, Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, Kobe, Japan (Y. Nakagawa, T.K.)
| | - Shinichiro Uchiyama
- From the Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (N.H., S.A., T.N., H.M., M.M.); Department of Neurology, Tokyo Women’s Medical University School of Medicine, Japan (K.K.); Center for Clinical Research, Kobe University Hospital, Japan (Y. Nagai); Division of Medical Statistics, Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, Kobe, Japan (Y. Nakagawa, T.K.)
| | - Masayasu Matsumoto
- From the Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (N.H., S.A., T.N., H.M., M.M.); Department of Neurology, Tokyo Women’s Medical University School of Medicine, Japan (K.K.); Center for Clinical Research, Kobe University Hospital, Japan (Y. Nagai); Division of Medical Statistics, Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, Kobe, Japan (Y. Nakagawa, T.K.)
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34
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Saji N, Tone S, Murotani K, Yagita Y, Kimura K, Sakurai T. Cilostazol May Decrease Plasma Inflammatory Biomarkers in Patients with Recent Small Subcortical Infarcts: A Pilot Study. J Stroke Cerebrovasc Dis 2018; 27:1639-1645. [PMID: 29454567 DOI: 10.1016/j.jstrokecerebrovasdis.2018.01.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 01/14/2018] [Accepted: 01/18/2018] [Indexed: 10/18/2022] Open
Abstract
BACKGROUND The mechanism of progressive neurological deficit in patients with recent small subcortical infarcts has not yet been clarified. Inflammatory biomarkers and the use of cilostazol may be associated with this phenomenon. METHODS Between May 2013 and April 2014, we evaluated consecutive first-ever patients with stroke due to recent small subcortical infarcts within 48 hours of onset. We divided patients into 2 groups according to the use of antiplatelet agents (cilostazol with or without aspirin versus aspirin alone). Plasma biomarkers such as matrix metalloproteinase-9, interleukin-6, high sensitive C-reactive protein, and amyloid β precursor protein (APP770, indicating endothelial dysfunction) were measured twice: (1) within 24 hours; and (2) 1 week after their admission. Multivariable logistic regression analyses were performed to identify the variables independently associated with progressive neurological deficit and poor functional outcome. RESULTS We analyzed 41 patients (male: 63.4%, mean age: 70.8 years). Most of the patients (90%) who were treated with cilostazol were concomitantly treated with aspirin. Matrix metalloproteinase-9 and high sensitive C-reactive protein were higher in patients with progressive neurological deficit compared with those without. APP770 were more likely to be decreased in cilostazol group compared with aspirin group. Multivariable analyses show that traditional risk factors such as age and National Institutes of Health Stroke Scale scores were independently associated with both progressive neurological deficit and poor functional outcome. CONCLUSIONS Inflammatory biomarkers may be associated with progressive neurological deficit. Early initiation of cilostazol may decrease the levels of plasma biomarkers.
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Affiliation(s)
- Naoki Saji
- Department of Stroke Medicine, Kawasaki Medical School, Japan; Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, Japan.
| | - Shigenobu Tone
- Department of Biochemistry, Kawasaki Medical School, Japan; Laboratory of Molecular Developmental Biology, Graduate School of Science and Engineering, Tokyo Denki University, Japan
| | - Kenta Murotani
- Division of Biostatistics, Clinical Research Center, Aichi Medical University, Japan
| | - Yoshiki Yagita
- Department of Stroke Medicine, Kawasaki Medical School, Japan
| | - Kazumi Kimura
- Department of Neurological Science, Nippon Medical School Graduate School of Medicine, Japan
| | - Takashi Sakurai
- Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, Japan
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35
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Michikawa T, Okamura T. Is Childhood Exposure to Parental Smoking a Risk Factor for Future Cardiovascular Disease? J Atheroscler Thromb 2017; 24:1204-1205. [PMID: 28724852 PMCID: PMC5742365 DOI: 10.5551/jat.ed082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Takehiro Michikawa
- Environmental Epidemiology Section, Centre for Health and Environmental Risk Research, National Institute for Environmental Studies
| | - Tomonori Okamura
- Department of Preventive Medicine and Public Health, Keio University School of Medicine
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36
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Koga M, Toyoda K, Minematsu K, Yasaka M, Nagai Y, Aoki S, Nezu T, Hosomi N, Kagimura T, Origasa H, Kamiyama K, Suzuki R, Ohtsuki T, Maruyama H, Kitagawa K, Uchiyama S, Matsumoto M. Long-Term Effect of Pravastatin on Carotid Intima-Media Complex Thickness: The J-STARS Echo Study (Japan Statin Treatment Against Recurrent Stroke). Stroke 2017; 49:107-113. [PMID: 29191850 PMCID: PMC5753816 DOI: 10.1161/strokeaha.117.018387] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 10/19/2017] [Accepted: 10/23/2017] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND PURPOSE The effect of statins on progression of carotid intima-media complex thickness (IMT) has been shown exclusively in nonstroke Western patients. This study aimed to determine the effect of low-dose pravastatin on carotid IMT in Japanese patients with noncardioembolic ischemic stroke. METHODS This is a substudy of the J-STARS trial (Japan Statin Treatment Against Recurrent Stroke), a multicenter, randomized, open-label, parallel-group trial to examine whether pravastatin reduces stroke recurrence. Patients were randomized to receive pravastatin (10 mg daily, usual dose in Japan; pravastatin group) or not to receive any statins (control group). The primary outcome was IMT change of the common carotid artery for a 5-year observation period. IMT change was compared using mixed-effects models for repeated measures. RESULTS Of 864 patients registered in this substudy, 71 without baseline ultrasonography were excluded, and 388 were randomly assigned to the pravastatin group and 405 to the control group. Baseline characteristics were not significantly different, except National Institutes of Health Stroke Scale scores (median, 0 [interquartile range, 0-2] versus 1 [interquartile range, 0-2]; P=0.019) between the 2 groups. Baseline IMT (mean±SD) was 0.887±0.155 mm in the pravastatin group and 0.887±0.152 mm in the control group (P=0.99). The annual change in the IMT at 5-year visit was significantly reduced in the pravastatin group as compared with that in the control group (0.021±0.116 versus 0.040±0.118 mm; P=0.010). CONCLUSIONS The usual Japanese dose of pravastatin significantly reduced the progression of carotid IMT at 5 years in patients with noncardioembolic stroke. CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT00361530.
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Affiliation(s)
- Masatoshi Koga
- From the Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan (M.K., K.T., K.M., R.S.); Department of Cerebrovascular Medicine and Neurology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan (M.Y.); Clinical & Translational Research Center, Kobe University Hospital, Japan (Y.N.); Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (S.A., T.N., N.H., T.O., H.M., M.M.); Foundation for Biomedical Research and Innovation, Translational Research Informatics Center, Kobe, Japan (T.K.); Division of Biostatistics and Clinical Epidemiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Japan (H.O.); Department of Neurosurgery and Stroke Center, Nakamura Memorial Hospital, Sapporo, Japan (K.K.); Stroke Center, Kinki University, Osakasayama, Japan (T.O.); Department of Neurology, Tokyo Women's Medical University, Japan (K.K.); International University of Health and Welfare, Center for Brain and Cerebral Vessels, Sanno Hospital and Sanno Medical Center, Tokyo, Japan (S.U.); and Japan Community Healthcare Organization Hoshigaoka Medical Center, Hirakata (M.M.).
| | - Kazunori Toyoda
- From the Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan (M.K., K.T., K.M., R.S.); Department of Cerebrovascular Medicine and Neurology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan (M.Y.); Clinical & Translational Research Center, Kobe University Hospital, Japan (Y.N.); Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (S.A., T.N., N.H., T.O., H.M., M.M.); Foundation for Biomedical Research and Innovation, Translational Research Informatics Center, Kobe, Japan (T.K.); Division of Biostatistics and Clinical Epidemiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Japan (H.O.); Department of Neurosurgery and Stroke Center, Nakamura Memorial Hospital, Sapporo, Japan (K.K.); Stroke Center, Kinki University, Osakasayama, Japan (T.O.); Department of Neurology, Tokyo Women's Medical University, Japan (K.K.); International University of Health and Welfare, Center for Brain and Cerebral Vessels, Sanno Hospital and Sanno Medical Center, Tokyo, Japan (S.U.); and Japan Community Healthcare Organization Hoshigaoka Medical Center, Hirakata (M.M.)
| | - Kazuo Minematsu
- From the Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan (M.K., K.T., K.M., R.S.); Department of Cerebrovascular Medicine and Neurology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan (M.Y.); Clinical & Translational Research Center, Kobe University Hospital, Japan (Y.N.); Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (S.A., T.N., N.H., T.O., H.M., M.M.); Foundation for Biomedical Research and Innovation, Translational Research Informatics Center, Kobe, Japan (T.K.); Division of Biostatistics and Clinical Epidemiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Japan (H.O.); Department of Neurosurgery and Stroke Center, Nakamura Memorial Hospital, Sapporo, Japan (K.K.); Stroke Center, Kinki University, Osakasayama, Japan (T.O.); Department of Neurology, Tokyo Women's Medical University, Japan (K.K.); International University of Health and Welfare, Center for Brain and Cerebral Vessels, Sanno Hospital and Sanno Medical Center, Tokyo, Japan (S.U.); and Japan Community Healthcare Organization Hoshigaoka Medical Center, Hirakata (M.M.)
| | - Masahiro Yasaka
- From the Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan (M.K., K.T., K.M., R.S.); Department of Cerebrovascular Medicine and Neurology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan (M.Y.); Clinical & Translational Research Center, Kobe University Hospital, Japan (Y.N.); Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (S.A., T.N., N.H., T.O., H.M., M.M.); Foundation for Biomedical Research and Innovation, Translational Research Informatics Center, Kobe, Japan (T.K.); Division of Biostatistics and Clinical Epidemiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Japan (H.O.); Department of Neurosurgery and Stroke Center, Nakamura Memorial Hospital, Sapporo, Japan (K.K.); Stroke Center, Kinki University, Osakasayama, Japan (T.O.); Department of Neurology, Tokyo Women's Medical University, Japan (K.K.); International University of Health and Welfare, Center for Brain and Cerebral Vessels, Sanno Hospital and Sanno Medical Center, Tokyo, Japan (S.U.); and Japan Community Healthcare Organization Hoshigaoka Medical Center, Hirakata (M.M.)
| | - Yoji Nagai
- From the Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan (M.K., K.T., K.M., R.S.); Department of Cerebrovascular Medicine and Neurology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan (M.Y.); Clinical & Translational Research Center, Kobe University Hospital, Japan (Y.N.); Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (S.A., T.N., N.H., T.O., H.M., M.M.); Foundation for Biomedical Research and Innovation, Translational Research Informatics Center, Kobe, Japan (T.K.); Division of Biostatistics and Clinical Epidemiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Japan (H.O.); Department of Neurosurgery and Stroke Center, Nakamura Memorial Hospital, Sapporo, Japan (K.K.); Stroke Center, Kinki University, Osakasayama, Japan (T.O.); Department of Neurology, Tokyo Women's Medical University, Japan (K.K.); International University of Health and Welfare, Center for Brain and Cerebral Vessels, Sanno Hospital and Sanno Medical Center, Tokyo, Japan (S.U.); and Japan Community Healthcare Organization Hoshigaoka Medical Center, Hirakata (M.M.)
| | - Shiro Aoki
- From the Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan (M.K., K.T., K.M., R.S.); Department of Cerebrovascular Medicine and Neurology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan (M.Y.); Clinical & Translational Research Center, Kobe University Hospital, Japan (Y.N.); Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (S.A., T.N., N.H., T.O., H.M., M.M.); Foundation for Biomedical Research and Innovation, Translational Research Informatics Center, Kobe, Japan (T.K.); Division of Biostatistics and Clinical Epidemiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Japan (H.O.); Department of Neurosurgery and Stroke Center, Nakamura Memorial Hospital, Sapporo, Japan (K.K.); Stroke Center, Kinki University, Osakasayama, Japan (T.O.); Department of Neurology, Tokyo Women's Medical University, Japan (K.K.); International University of Health and Welfare, Center for Brain and Cerebral Vessels, Sanno Hospital and Sanno Medical Center, Tokyo, Japan (S.U.); and Japan Community Healthcare Organization Hoshigaoka Medical Center, Hirakata (M.M.)
| | - Tomohisa Nezu
- From the Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan (M.K., K.T., K.M., R.S.); Department of Cerebrovascular Medicine and Neurology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan (M.Y.); Clinical & Translational Research Center, Kobe University Hospital, Japan (Y.N.); Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (S.A., T.N., N.H., T.O., H.M., M.M.); Foundation for Biomedical Research and Innovation, Translational Research Informatics Center, Kobe, Japan (T.K.); Division of Biostatistics and Clinical Epidemiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Japan (H.O.); Department of Neurosurgery and Stroke Center, Nakamura Memorial Hospital, Sapporo, Japan (K.K.); Stroke Center, Kinki University, Osakasayama, Japan (T.O.); Department of Neurology, Tokyo Women's Medical University, Japan (K.K.); International University of Health and Welfare, Center for Brain and Cerebral Vessels, Sanno Hospital and Sanno Medical Center, Tokyo, Japan (S.U.); and Japan Community Healthcare Organization Hoshigaoka Medical Center, Hirakata (M.M.)
| | - Naohisa Hosomi
- From the Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan (M.K., K.T., K.M., R.S.); Department of Cerebrovascular Medicine and Neurology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan (M.Y.); Clinical & Translational Research Center, Kobe University Hospital, Japan (Y.N.); Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (S.A., T.N., N.H., T.O., H.M., M.M.); Foundation for Biomedical Research and Innovation, Translational Research Informatics Center, Kobe, Japan (T.K.); Division of Biostatistics and Clinical Epidemiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Japan (H.O.); Department of Neurosurgery and Stroke Center, Nakamura Memorial Hospital, Sapporo, Japan (K.K.); Stroke Center, Kinki University, Osakasayama, Japan (T.O.); Department of Neurology, Tokyo Women's Medical University, Japan (K.K.); International University of Health and Welfare, Center for Brain and Cerebral Vessels, Sanno Hospital and Sanno Medical Center, Tokyo, Japan (S.U.); and Japan Community Healthcare Organization Hoshigaoka Medical Center, Hirakata (M.M.)
| | - Tatsuo Kagimura
- From the Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan (M.K., K.T., K.M., R.S.); Department of Cerebrovascular Medicine and Neurology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan (M.Y.); Clinical & Translational Research Center, Kobe University Hospital, Japan (Y.N.); Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (S.A., T.N., N.H., T.O., H.M., M.M.); Foundation for Biomedical Research and Innovation, Translational Research Informatics Center, Kobe, Japan (T.K.); Division of Biostatistics and Clinical Epidemiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Japan (H.O.); Department of Neurosurgery and Stroke Center, Nakamura Memorial Hospital, Sapporo, Japan (K.K.); Stroke Center, Kinki University, Osakasayama, Japan (T.O.); Department of Neurology, Tokyo Women's Medical University, Japan (K.K.); International University of Health and Welfare, Center for Brain and Cerebral Vessels, Sanno Hospital and Sanno Medical Center, Tokyo, Japan (S.U.); and Japan Community Healthcare Organization Hoshigaoka Medical Center, Hirakata (M.M.)
| | - Hideki Origasa
- From the Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan (M.K., K.T., K.M., R.S.); Department of Cerebrovascular Medicine and Neurology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan (M.Y.); Clinical & Translational Research Center, Kobe University Hospital, Japan (Y.N.); Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (S.A., T.N., N.H., T.O., H.M., M.M.); Foundation for Biomedical Research and Innovation, Translational Research Informatics Center, Kobe, Japan (T.K.); Division of Biostatistics and Clinical Epidemiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Japan (H.O.); Department of Neurosurgery and Stroke Center, Nakamura Memorial Hospital, Sapporo, Japan (K.K.); Stroke Center, Kinki University, Osakasayama, Japan (T.O.); Department of Neurology, Tokyo Women's Medical University, Japan (K.K.); International University of Health and Welfare, Center for Brain and Cerebral Vessels, Sanno Hospital and Sanno Medical Center, Tokyo, Japan (S.U.); and Japan Community Healthcare Organization Hoshigaoka Medical Center, Hirakata (M.M.)
| | - Kenji Kamiyama
- From the Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan (M.K., K.T., K.M., R.S.); Department of Cerebrovascular Medicine and Neurology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan (M.Y.); Clinical & Translational Research Center, Kobe University Hospital, Japan (Y.N.); Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (S.A., T.N., N.H., T.O., H.M., M.M.); Foundation for Biomedical Research and Innovation, Translational Research Informatics Center, Kobe, Japan (T.K.); Division of Biostatistics and Clinical Epidemiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Japan (H.O.); Department of Neurosurgery and Stroke Center, Nakamura Memorial Hospital, Sapporo, Japan (K.K.); Stroke Center, Kinki University, Osakasayama, Japan (T.O.); Department of Neurology, Tokyo Women's Medical University, Japan (K.K.); International University of Health and Welfare, Center for Brain and Cerebral Vessels, Sanno Hospital and Sanno Medical Center, Tokyo, Japan (S.U.); and Japan Community Healthcare Organization Hoshigaoka Medical Center, Hirakata (M.M.)
| | - Rieko Suzuki
- From the Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan (M.K., K.T., K.M., R.S.); Department of Cerebrovascular Medicine and Neurology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan (M.Y.); Clinical & Translational Research Center, Kobe University Hospital, Japan (Y.N.); Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (S.A., T.N., N.H., T.O., H.M., M.M.); Foundation for Biomedical Research and Innovation, Translational Research Informatics Center, Kobe, Japan (T.K.); Division of Biostatistics and Clinical Epidemiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Japan (H.O.); Department of Neurosurgery and Stroke Center, Nakamura Memorial Hospital, Sapporo, Japan (K.K.); Stroke Center, Kinki University, Osakasayama, Japan (T.O.); Department of Neurology, Tokyo Women's Medical University, Japan (K.K.); International University of Health and Welfare, Center for Brain and Cerebral Vessels, Sanno Hospital and Sanno Medical Center, Tokyo, Japan (S.U.); and Japan Community Healthcare Organization Hoshigaoka Medical Center, Hirakata (M.M.)
| | - Toshiho Ohtsuki
- From the Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan (M.K., K.T., K.M., R.S.); Department of Cerebrovascular Medicine and Neurology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan (M.Y.); Clinical & Translational Research Center, Kobe University Hospital, Japan (Y.N.); Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (S.A., T.N., N.H., T.O., H.M., M.M.); Foundation for Biomedical Research and Innovation, Translational Research Informatics Center, Kobe, Japan (T.K.); Division of Biostatistics and Clinical Epidemiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Japan (H.O.); Department of Neurosurgery and Stroke Center, Nakamura Memorial Hospital, Sapporo, Japan (K.K.); Stroke Center, Kinki University, Osakasayama, Japan (T.O.); Department of Neurology, Tokyo Women's Medical University, Japan (K.K.); International University of Health and Welfare, Center for Brain and Cerebral Vessels, Sanno Hospital and Sanno Medical Center, Tokyo, Japan (S.U.); and Japan Community Healthcare Organization Hoshigaoka Medical Center, Hirakata (M.M.)
| | - Hirofumi Maruyama
- From the Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan (M.K., K.T., K.M., R.S.); Department of Cerebrovascular Medicine and Neurology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan (M.Y.); Clinical & Translational Research Center, Kobe University Hospital, Japan (Y.N.); Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (S.A., T.N., N.H., T.O., H.M., M.M.); Foundation for Biomedical Research and Innovation, Translational Research Informatics Center, Kobe, Japan (T.K.); Division of Biostatistics and Clinical Epidemiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Japan (H.O.); Department of Neurosurgery and Stroke Center, Nakamura Memorial Hospital, Sapporo, Japan (K.K.); Stroke Center, Kinki University, Osakasayama, Japan (T.O.); Department of Neurology, Tokyo Women's Medical University, Japan (K.K.); International University of Health and Welfare, Center for Brain and Cerebral Vessels, Sanno Hospital and Sanno Medical Center, Tokyo, Japan (S.U.); and Japan Community Healthcare Organization Hoshigaoka Medical Center, Hirakata (M.M.)
| | - Kazuo Kitagawa
- From the Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan (M.K., K.T., K.M., R.S.); Department of Cerebrovascular Medicine and Neurology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan (M.Y.); Clinical & Translational Research Center, Kobe University Hospital, Japan (Y.N.); Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (S.A., T.N., N.H., T.O., H.M., M.M.); Foundation for Biomedical Research and Innovation, Translational Research Informatics Center, Kobe, Japan (T.K.); Division of Biostatistics and Clinical Epidemiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Japan (H.O.); Department of Neurosurgery and Stroke Center, Nakamura Memorial Hospital, Sapporo, Japan (K.K.); Stroke Center, Kinki University, Osakasayama, Japan (T.O.); Department of Neurology, Tokyo Women's Medical University, Japan (K.K.); International University of Health and Welfare, Center for Brain and Cerebral Vessels, Sanno Hospital and Sanno Medical Center, Tokyo, Japan (S.U.); and Japan Community Healthcare Organization Hoshigaoka Medical Center, Hirakata (M.M.)
| | - Shinichiro Uchiyama
- From the Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan (M.K., K.T., K.M., R.S.); Department of Cerebrovascular Medicine and Neurology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan (M.Y.); Clinical & Translational Research Center, Kobe University Hospital, Japan (Y.N.); Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (S.A., T.N., N.H., T.O., H.M., M.M.); Foundation for Biomedical Research and Innovation, Translational Research Informatics Center, Kobe, Japan (T.K.); Division of Biostatistics and Clinical Epidemiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Japan (H.O.); Department of Neurosurgery and Stroke Center, Nakamura Memorial Hospital, Sapporo, Japan (K.K.); Stroke Center, Kinki University, Osakasayama, Japan (T.O.); Department of Neurology, Tokyo Women's Medical University, Japan (K.K.); International University of Health and Welfare, Center for Brain and Cerebral Vessels, Sanno Hospital and Sanno Medical Center, Tokyo, Japan (S.U.); and Japan Community Healthcare Organization Hoshigaoka Medical Center, Hirakata (M.M.)
| | - Masayasu Matsumoto
- From the Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan (M.K., K.T., K.M., R.S.); Department of Cerebrovascular Medicine and Neurology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan (M.Y.); Clinical & Translational Research Center, Kobe University Hospital, Japan (Y.N.); Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (S.A., T.N., N.H., T.O., H.M., M.M.); Foundation for Biomedical Research and Innovation, Translational Research Informatics Center, Kobe, Japan (T.K.); Division of Biostatistics and Clinical Epidemiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Japan (H.O.); Department of Neurosurgery and Stroke Center, Nakamura Memorial Hospital, Sapporo, Japan (K.K.); Stroke Center, Kinki University, Osakasayama, Japan (T.O.); Department of Neurology, Tokyo Women's Medical University, Japan (K.K.); International University of Health and Welfare, Center for Brain and Cerebral Vessels, Sanno Hospital and Sanno Medical Center, Tokyo, Japan (S.U.); and Japan Community Healthcare Organization Hoshigaoka Medical Center, Hirakata (M.M.)
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Shimomura R, Nezu T, Hosomi N, Aoki S, Sugimoto T, Kinoshita N, Araki M, Takahashi T, Maruyama H, Matsumoto M. Alpha-2-macroglobulin as a Promising Biological Marker of Endothelial Function. J Atheroscler Thromb 2017; 25:350-358. [PMID: 29093276 PMCID: PMC5906188 DOI: 10.5551/jat.41335] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Aims: Alpha-2-macroglobulin (α2MG) is thought to be associated with inflammatory reactions and procoagulant properties that might cause ischemic stroke. Endothelial dysfunction plays an important role in atherosclerosis development and in the occurrence of cardiovascular events. In this study, we investigated whether serum α2MG levels, endothelial function, and endothelial progenitor cell (EPC) number were associated in patients with chronic stroke or cardiovascular risk factors. Methods: Patients with a history of stroke or any established cardiovascular risk factors were enrolled in this study (n = 102; 69 men, 70.1 ± 9.2 years). Endothelial function was assessed by flow-mediated dilation (FMD). EPC numbers (CD34+/CD133+) were measured using flow cytometry (n = 91). Serum α2MG levels were measured by nephelometry. Results: Patients in the highest tertile of serum α2MG levels were older (P = 0.019) and more frequently exhibited dyslipidemia (P = 0.021). Univariate-regression analysis revealed that increased α2MG levels were negatively associated with FMD values (r = −0.25; P = 0.010), whereas increased EPC numbers were positively associated (r = 0.21; P = 0.044). Multivariate-regression analysis adjusted for male gender, hypertension, and severe white-matter lesions showed that serum α2MG levels were independently associated with FMD values (standardized partial regression coefficient [β] −0.185; P = 0.033), although not significantly associated with EPC numbers. Conclusion: Serum α2MG levels might reflect endothelial dysfunction evaluated by FMD in patients with chronic stroke or cardiovascular risk factors.
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Affiliation(s)
- Ryo Shimomura
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical Sciences
| | - Tomohisa Nezu
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical Sciences
| | - Naohisa Hosomi
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical Sciences
| | - Shiro Aoki
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical Sciences
| | - Takamichi Sugimoto
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical Sciences
| | - Naoto Kinoshita
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical Sciences
| | - Mutsuko Araki
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical Sciences
| | - Tetsuya Takahashi
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical Sciences
| | - Hirofumi Maruyama
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical Sciences
| | - Masayasu Matsumoto
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical Sciences.,Hoshigaoka Medical Center, Japan Community Healthcare Organization (JCHO)
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38
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Hosomi N, Nagai Y, Kitagawa K, Nakagawa Y, Aoki S, Nezu T, Kagimura T, Maruyama H, Origasa H, Minematsu K, Uchiyama S, Matsumoto M. Pravastatin Reduces the Risk of Atherothrombotic Stroke when Administered within Six Months of an Initial Stroke Event. J Atheroscler Thromb 2017; 25:262-268. [PMID: 28924103 PMCID: PMC5868512 DOI: 10.5551/jat.40196] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aims: The J-STARS study examined whether pravastatin (10 mg/day) reduces recurrence of stroke in non-cardioembolic ischemic stroke patients who were enrolled within 1 month to 3 years after initial stroke events (ClinicalTrials.gov, NCT00221104). The main results showed that the frequency of atherothrombotic stroke was low in pravastatin-treated patients, although no effect of pravastatin was found for the other stroke subtypes. We evaluated differences of early (within 6 months) or late (after 6 months) pravastatin treatment benefits on the incidence of stroke or transient ischemic attack (TIA), as well as atherothrombotic stroke and the other subtypes. Methods: Subjects in the J-STARS study were classified into two cohorts, depending on whether they enrolled early (1 to 6 months) or late (6 months to 3 years) following initial stroke events. Results: A total of 1578 patients (491 female, 66.2 ± 8.5 years) were randomly assigned to either the pravastatin group (n = 793; n = 426 in the early cohort, n = 367 in the late cohort) or the control group (n = 785; n = 417 in the early cohort, n = 368 in the late cohort). During the follow-up of 4.9 ± 1.4 years, the rate of atherothrombotic stroke was lower in the pravastatin group compared to controls in the early cohort (0.24 vs. 0.88%/year, p = 0.01) but not in the late cohort (0.17 vs. 0.39%/year, p = 0.29). However, this difference of pravastatin effect on atherothrombotic stroke was not significantly interacted by the early or late cohort (p = 0.59). The incidence rates of other stroke subtype were not different in between pravastatin and control groups despite the timing of entry. Conclusions: Pravastatin is likely to reduce atherothrombotic stroke in patients enrolled within 6 months after stroke onset. However, the clinical efficacy for prevention of recurrent stroke was not conclusive with earlier statin treatment.
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Affiliation(s)
- Naohisa Hosomi
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Yoji Nagai
- Center for Clinical Research, Kobe University Hospital
| | - Kazuo Kitagawa
- Department of Neurology, Tokyo Women's Medical University School of Medicine
| | - Yoko Nakagawa
- Division of Medical Statistics, Translational Research Informatics Center, Foundation for Biomedical Research and Innovation
| | - Shiro Aoki
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Tomohisa Nezu
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Tatsuo Kagimura
- Division of Medical Statistics, Translational Research Informatics Center, Foundation for Biomedical Research and Innovation
| | - Hirofumi Maruyama
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Hideki Origasa
- Division of Biostatistics and Clinical Epidemiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences
| | | | - Shinichiro Uchiyama
- International University of Health and Welfare, Center for Brain and Cerebral Vessels, Sanno Hospital and Sanno Medical Center
| | - Masayasu Matsumoto
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences.,Hoshigaoka Medical Center, Japan Community Healthcare Organization (JCHO)
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39
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Wang D, Juonala M, Viikari JSA, Wu F, Hutri-Kähönen N, Raitakari OT, Magnussen CG. Exposure to Parental Smoking in Childhood is Associated with High C-Reactive Protein in Adulthood: The Cardiovascular Risk in Young Finns Study. J Atheroscler Thromb 2017; 24:1231-1241. [PMID: 28724840 PMCID: PMC5742368 DOI: 10.5551/jat.40568] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Aim: Children exposed to parental smoking are at increased long-term risk of subclinical atherosclerosis in adulthood. However, it has not been quantified if exposure to parental smoking in childhood is associated with adult systemic inflammation. This study aimed to determine if childhood exposure to parental smoking was associated with high-sensitivity C-reactive protein (hsCRP) in adulthood. Methods: This longitudinal analysis of 2,511 participants used data from the Cardiovascular Risk in Young Finns Study, a prospective cohort of Finnish children. In 1980 or 1983, parents self-reported their smoking status and serum hsCRP was collected up to 31 years later in adulthood. Results: Compared with children with non-smoking parents, the relative risk of developing high hsCRP (> 3 mg/L) in adulthood increased among those with 1 or both parents who smoked [relative risk (RR), 1.3; 95%confidence interval (CI), 1.0–1.8] after adjustment for socioeconomic status, cardiovascular risk factors, and smoking status in childhood and adulthood. Moreover, children exposed to mother smoking [RR, 2.4; 95% CI, 1.3–4.2] had highest risk of developing high hsCRP in adulthood compared with those exposed to father smoking [RR, 1.6; 95% CI, 1.2–2.3] and both parents smoking [RR, 1.4; 95% CI, 0.9–2.0]. Conclusion: Our findings suggest that children exposed to parental smoking are at increased risk of having high hsCRP in adulthood. Limiting children's exposure to passive smoking may have long-term benefits on general low-grade inflammation.
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Affiliation(s)
- Di Wang
- Department of Anesthesiology, Anhui Provincial Hospital, Anhui Medical University.,Menzies Institute for Medical Research, University of Tasmania
| | - Markus Juonala
- Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital
| | - Jorma S A Viikari
- Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital
| | - Feitong Wu
- Menzies Institute for Medical Research, University of Tasmania
| | - Nina Hutri-Kähönen
- Department of Pediatrics, University of Tampere School of Medicine and Tampere University Hospital
| | - Olli T Raitakari
- Department of Clinical Physiology and Nuclear Medicine, University of Turku and Turku University Hospital.,Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku
| | - Costan G Magnussen
- Menzies Institute for Medical Research, University of Tasmania.,Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku
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