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Davidson LT, Engvall J, Chisalita SI, Östgren CJ, Nyström FH. Plasma copeptin and markers of arterial disorder in patients with type 2 diabetes, a cross-sectional study. Cardiovasc Diabetol 2024; 23:200. [PMID: 38867292 PMCID: PMC11170787 DOI: 10.1186/s12933-024-02291-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 05/29/2024] [Indexed: 06/14/2024] Open
Abstract
OBJECTIVES There is currently limited understanding of the relationship between copeptin, the midregional portion of proadrenomedullin (MRproADM) and the midregional fragment of the N-terminal of proatrial natriuretic peptide (MRproANP), and arterial disorders. Toe brachial index (TBI) and aortic pulse wave velocity (aPWV) are established parameters for detecting arterial disorders. This study evaluated whether copeptin, MRproADM, and MRproANP were associated with TBI and aPWV in patients with type 2 diabetes with no history of cardiovascular disease (CVD). METHODS In the CARDIPP study, a cross-sectional analysis of 519 patients with type 2 diabetes aged 55-65 years with no history of CVD at baseline, had complete data on copeptin, MRproADM, MRproANP, TBI, and aPWV was performed. Linear regression analysis was used to investigate the associations between conventional CVD risk factors, copeptin, MRproADM, MRproANP, TBI, and aPWV. RESULTS Copeptin was associated with TBI (β-0.0020, CI-0.0035- (-0.0005), p = 0.010) and aPWV (β 0.023, CI 0.002-0.044, p = 0.035). These associations were independent of age, sex, diabetes duration, mean 24-hour ambulatory systolic blood pressure, glycated hemoglobin A1c, total cholesterol, estimated glomerular filtration rate, body mass index, and active smoking. CONCLUSIONS Plasma copeptin may be a helpful surrogate for identifying individuals at higher risk for arterial disorders. TRIAL REGISTRATION ClinicalTrials.gov identifier NCT010497377.
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Affiliation(s)
- Lee Ti Davidson
- Department of Emergency Medicine in Linköping, Department of Biomedical and Clinical Sciences, Linköping University, 581 83, Linköping, Sweden.
| | - Jan Engvall
- Department of Clinical Physiology in Linköping, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Centre for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
| | - Simona I Chisalita
- Department of Endocrinology in Linköping, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Carl Johan Östgren
- Division of Prevention, Rehabilitation and Community Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Centre for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
| | - Fredrik H Nyström
- Division of Diagnostics and Specialist Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
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Sharma P, Klarin D, Voight BF, Tsao PS, Levin MG, Damrauer SM. Evaluation of Plasma Biomarkers for Causal Association With Peripheral Artery Disease. Arterioscler Thromb Vasc Biol 2024; 44:1114-1123. [PMID: 38545784 PMCID: PMC11043009 DOI: 10.1161/atvbaha.124.320674] [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: 01/04/2024] [Accepted: 03/14/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND Hundreds of biomarkers for peripheral artery disease (PAD) have been reported in the literature; however, the observational nature of these studies limits causal inference due to the potential of reverse causality and residual confounding. We sought to evaluate the potential causal impact of putative PAD biomarkers identified in human observational studies through genetic causal inference methods. METHODS Putative circulating PAD biomarkers were identified from human observational studies through a comprehensive literature search based on terms related to PAD using PubMed, Cochrane, and Embase. Genetic instruments were generated from publicly available genome-wide association studies of circulating biomarkers. Two-sample Mendelian randomization was used to test the association of genetically determined biomarker levels with PAD using summary statistics from a genome-wide association study of 31 307 individuals with and 211 753 individuals without PAD in the Veterans Affairs Million Veteran Program and replicated in data from FinnGen comprised of 11 924 individuals with and 288 638 individuals without PAD. RESULTS We identified 204 unique circulating biomarkers for PAD from the observational literature, of which 173 were genetically instrumented using genome-wide association study results. After accounting for multiple testing (false discovery rate, <0.05), 10 of 173 (5.8%) biomarkers had significant associations with PAD. These 10 biomarkers represented categories including plasma lipoprotein regulation, lipid homeostasis, and protein-lipid complex remodeling. Observational literature highlighted different pathways including inflammatory response, negative regulation of multicellular organismal processes, and regulation of response to external stimuli. CONCLUSIONS Integrating human observational studies and genetic causal inference highlights several key pathways in PAD pathophysiology. This work demonstrates that a substantial portion of biomarkers identified in observational studies are not well supported by human genetic evidence and emphasizes the importance of triangulating evidence to understand PAD pathophysiology. Although the identified biomarkers offer insights into atherosclerotic development in the lower limb, their specificity to PAD compared with more widespread atherosclerosis requires further study.
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Affiliation(s)
- Pranav Sharma
- Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Derek Klarin
- Veterans Affairs Palo Alto Healthcare System, CA
- Division of Vascular Surgery, Stanford University School of Medicine, CA
| | - Benjamin F. Voight
- Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, United States
- Department of Genetics, University of Pennsylvania, Philadelphia, PA, United States
- Department of Systems Pharmacology and Translational Therapeutics, University of Pennsylvania, Philadelphia, PA, United State
| | - Philip S. Tsao
- Veterans Affairs Palo Alto Healthcare System, CA
- Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, CA
| | - Michael G. Levin
- Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, United States
- Division of Cardiovascular Medicine, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
| | - Scott M. Damrauer
- Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
- Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, United States
- Department of Genetics, University of Pennsylvania, Philadelphia, PA, United States
- Cardiovascular Institute, University of Pennsylvania, Philadelphia, PA, United States
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Özsoy M, Ataman M, Şahin SK, Şenocak İ, Varlibaş A, Yuvanç E, Çifci A, Başaralı MK, Kırtıl G, Yilmaz E. The Diagnostic Value of Soluble Triggering Receptor Expressed on Myeloid Cells for Patients with Acute Stone Pyelonephritis. Diagnostics (Basel) 2024; 14:777. [PMID: 38611690 PMCID: PMC11011740 DOI: 10.3390/diagnostics14070777] [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: 02/29/2024] [Revised: 03/30/2024] [Accepted: 04/04/2024] [Indexed: 04/14/2024] Open
Abstract
Soluble triggering receptor expressed on myeloid cells (sTREM-1) is a new biomarker that can be used for the diagnosis and monitoring of urinary system infections. This study aimed to evaluate the diagnostic performance of serum sTREM-1 in patients with a diagnosis of acute stone pyelonephritis (ASP). This prospective study included 46 patients with a diagnosis of ASP and a control group of 23 individuals without urinary system infection. Blood samples were taken from participants upon hospital admission, and basal serum sTREM-1 levels were analyzed using the ELISA method. Serum sTREM-1 concentrations were measured after treatment of ASP patients. Basal leukocyte counts, C-reactive protein (CRP) levels, procalcitonin (PCT), and sTREM-1 (98.6 vs. 68.4 pg/mL, p < 0.001) levels were higher in the ASP group compared to the control group. After treatment, the median leukocyte counts, PCT, and sTREM-1 levels decreased and were similar to those of the control group. The median CRP level also decreased after treatment, but it remained higher than that of the control group. In predicting patients with ASP, the baseline sTREM-1 exhibited a sensitivity of 74.6% and a specificity of 78.2%, while its diagnostic performance was lower than that of leukocyte counts, CRP, and PCT. Despite the findings that levels of sTREM-1 were higher upon hospital admission in patients with ASP and significantly decreased after treatment, the utility of sTREM-1 as a biomarker for predicting patients with ASP remains constrained when compared to established inflammatory markers.
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Affiliation(s)
- Metin Özsoy
- Department of Infectious Diseases and Clinical Microbiology, Health Sciences University, Ankara Training and Research Hospital, 06050 Ankara, Turkey
| | - Miraç Ataman
- Department Urology, Kırıkkale University Faculty of Medicine, 71300 Kırıkkale, Turkey; (M.A.); (S.K.Ş.); (İ.Ş.); (E.Y.); (E.Y.)
| | - Serhat Kazım Şahin
- Department Urology, Kırıkkale University Faculty of Medicine, 71300 Kırıkkale, Turkey; (M.A.); (S.K.Ş.); (İ.Ş.); (E.Y.); (E.Y.)
| | - İbrahim Şenocak
- Department Urology, Kırıkkale University Faculty of Medicine, 71300 Kırıkkale, Turkey; (M.A.); (S.K.Ş.); (İ.Ş.); (E.Y.); (E.Y.)
| | - Artuner Varlibaş
- Department Internal Medicine, Kırıkkale University Faculty of Medicine, 71300 Kırıkkale, Turkey; (A.V.); (A.Ç.)
| | - Ercan Yuvanç
- Department Urology, Kırıkkale University Faculty of Medicine, 71300 Kırıkkale, Turkey; (M.A.); (S.K.Ş.); (İ.Ş.); (E.Y.); (E.Y.)
| | - Aydın Çifci
- Department Internal Medicine, Kırıkkale University Faculty of Medicine, 71300 Kırıkkale, Turkey; (A.V.); (A.Ç.)
| | - Mustafa Kemal Başaralı
- Department Medical Biochemistry, Republic of Turkey Ministry of Health, General Directorate of Public Health, 06800 Ankara, Turkey;
| | - Gül Kırtıl
- Department of Medical Biochemistry, Health Sciences University, Ankara Training and Research Hospital, 06230 Ankara, Turkey;
| | - Erdal Yilmaz
- Department Urology, Kırıkkale University Faculty of Medicine, 71300 Kırıkkale, Turkey; (M.A.); (S.K.Ş.); (İ.Ş.); (E.Y.); (E.Y.)
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Popescu AI, Rata AL, Barac S, Popescu R, Onofrei RR, Vlad C, Vlad D. Narrative Review of Biological Markers in Chronic Limb-Threatening Ischemia. Biomedicines 2024; 12:798. [PMID: 38672153 PMCID: PMC11047884 DOI: 10.3390/biomedicines12040798] [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: 03/10/2024] [Revised: 03/30/2024] [Accepted: 04/01/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Chronic limb-threatening ischemia (CLTI), the advanced stage of peripheral arterial disease, is diagnosed in the presence of ischemic rest pain, non-healing ulcers, or gangrene. Several studies have demonstrated that inflammation and endothelial dysfunction are some of the main substrates of CLTI. METHODS A narrative review was conducted and reported according to PRISMA guidelines. Three databases were searched-Web of Science, Medline, and EMBASE-for the studies assessing CLTI and the biological markers related to it. RESULTS We included 22 studies, and all the markers identified (C-reactive protein, D-dimers, fibrinogen, cytokines, IL-6, TNF-α, ICAM-1 (Intracellular Adhesion Molecule-1), VCAM-1 (Vascular Cell Adhesion Molecule-1), neutrophile-to-lymphocytes ratio (NLR), IL-8, Pentraxin-3, neutrophil gelatinase-associated lipocalin (NGAL), calprotectin, E-selectin, P-selectin, neopterin, High-Mobility Group Box-1 protein (HGMB-1), Osteoprotegerin (OPG) and Sortilin) were positively associated with advanced CLTI, with major limb or major cardiovascular events in these patients. CONCLUSIONS All the studied markers had increased values in patients with CLTI, especially when associated with diabetes mellitus, proving a very important association between diabetes and major limb or cardiovascular events in these patients. There is a need for more studies to validate these markers in terms of diagnosis or prognosis in CLTI patients and in trying to find new medical strategies that target inflammation or endothelial dysfunction in these patients.
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Affiliation(s)
- Alexandra Ioana Popescu
- Pharmacology Department, Doctoral School, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Andreea Luciana Rata
- Surgical Emergencies Department, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Sorin Barac
- Vascular Surgery Department, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Roxana Popescu
- Cell and Molecular Biology Department, ”Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Roxana Ramona Onofrei
- Department of Rehabilitation, Physical Medicine and Rheumatology, Research Center for Assessment of Human Motion, Functionality and Disability, ”Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Cristian Vlad
- Pharmacology Department, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (C.V.); (D.V.)
| | - Daliborca Vlad
- Pharmacology Department, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (C.V.); (D.V.)
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Takahara M, Soga Y, Fujihara M, Iida O, Kawasaki D. Sodium-glucose co-transporter 2 inhibitor use in patients with diabetes mellitus undergoing endovascular therapy for symptomatic peripheral artery disease. Cardiovasc Diabetol 2023; 22:273. [PMID: 37798619 PMCID: PMC10557214 DOI: 10.1186/s12933-023-01992-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 09/13/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND This study aimed to reveal the prevalence of sodium-glucose co-transporter 2 (SGLT2) inhibitor treatment and its association with restenosis risk in patients with diabetes mellitus undergoing endovascular therapy for symptomatic peripheral artery disease. METHODS We used the database of a multicenter prospective study registering patients with symptomatic peripheral artery disease undergoing femoropopliteal drug-coated balloon treatment in Japan. The current analysis included 1058 patients with diabetes mellitus free from end-stage renal disease. The association of clinical characteristics with SGLT2 inhibitor use was investigated using the logistic regression model. The propensity score matching was adopted to compare the primary patency, i.e., freedom from restenosis, after endovascular therapy between patients treated with and without a SGLT2 inhibitor. RESULTS The proportion of SGLT2 inhibitor treatment at revascularization was 14.8% (95% confidence interval, 12.8-17.1%). Younger age, increased body mass index, and increased hemoglobin A1c levels were independently associated with SGLT2 inhibitor use (all P < 0.05). The proportion of SGLT2 inhibitor reached 38.2% (95% confidence interval, 25.4-52.3%) in patients with the three associated factors. The propensity score-matching analysis demonstrated that primary patency was not different between patients treated with a SGLT2 inhibitor and those without it (72.0% [95% confidence interval, 64.1-80.9%] versus 67.8% [62.7-73.3%] at 2 years; P = 0.45). CONCLUSIONS SGLT2 inhibitors were not rarely used in patients with diabetes mellitus who underwent femoropopliteal endovascular therapy using a drug coated balloon for symptomatic peripheral artery disease in real-world settings. SGLT2 inhibitor treatment was not associated with an increased risk of restenosis.
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Affiliation(s)
- Mitsuyoshi Takahara
- Department of Diabetes Care Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita City, 565-0871, Osaka, Japan.
| | - Yoshimitsu Soga
- Department of Cardiology, Kokura Memorial Hospital, 3-2-1 Asano, Kokurakita-ku, Kitakyushu City, 802-0001, Japan
| | - Masahiko Fujihara
- Department of Cardiology, Kishiwada Tokushukai Hospital, 4-27-1, Kamoricho, Kishiwada City, 596-8522, Osaka, Japan
| | - Osamu Iida
- Cardiovascular Center, Kansai Rosai Hospital, 3-1-69 Inabaso, Amagasaki City, 660-8511, Hyogo, Japan
| | - Daizo Kawasaki
- Cardiovascular Division, Morinomiya Hospital, 2-1-88,Morinomiya, Joto-ku, Osaka City, 536-0025, Japan
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Khutornaya MV, Sinitsky MY, Sinitskaya AV, Asanov MА, Ponasenko AV, Grigoriev EV. TREM-1 as a Marker of Multiple Organ Failure in Cardiac Surgery. Immunol Invest 2023:1-15. [PMID: 37216493 DOI: 10.1080/08820139.2023.2215276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Systemic inflammatory response syndrome (SIRS) frequently accompanies early postoperative period after cardiac surgery and in some cases is complicated by multiple organ failure (MOF). Inherited variation in the innate immune response genes (e.g., TREM1) is among the major factors determining the development of SIRS and the risk of MOF. This research was aimed to study whether the polymorphisms within the TREM1 gene are associated with MOF after the coronary artery bypass graft (CABG) surgery. Here we enrolled 592 patients who underwent CABG surgery in the Research Institute for Complex Issues of Cardiovascular Diseases (Kemerovo, Russia) and documented 28 cases of MOF. Genotyping was performed by allele-specific PCR using TaqMan probes. In addition, we measured serum soluble triggering receptor expressed on myeloid cells 1 (sTREM-1) using enzyme-linked immunosorbent assay. Five polymorphisms (rs1817537, rs2234246, rs3804277, rs7768162 andrs4711668) within the TREM1 gene were significantly associated with MOF. Patients with MOF had higher serum sTREM-1 as compared with those without MOF at both pre- and post-intervention stages. Serum sTREM-1 was associated with the rs1817537,rs2234246 and rs3804277 polymorphisms within the TREM1 gene. Minor alleles within the TREM1 gene define the level of serum sTREM-1 and are associated with MOF after CABG surgery.
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Affiliation(s)
- Maria V Khutornaya
- Department of Experimental Medicine, Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo, Russia
| | - Maxim Yu Sinitsky
- Department of Experimental Medicine, Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo, Russia
| | - Anna V Sinitskaya
- Department of Experimental Medicine, Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo, Russia
| | - Maxim А Asanov
- Department of Experimental Medicine, Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo, Russia
| | - Anastasia V Ponasenko
- Department of Experimental Medicine, Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo, Russia
| | - Evgeny V Grigoriev
- Department of Experimental Medicine, Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo, Russia
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Xu C, Tian Q, Yu H, Ge W, Zheng H, Huang D. Predictive Value of the Ankle-Brachial Index for All-Cause and Cardio-Cerebrovascular Mortality. Angiology 2022:33197221121016. [PMID: 36052942 DOI: 10.1177/00033197221121016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The present study explored the relationship between the ankle-brachial index (ABI) (>.9) and all-cause or cardio-cerebrovascular mortality. Participant details were obtained from the National Health and Nutrition Examination Survey 1999-2004. The association between baseline ABI and the risk of mortality was evaluated by a priori defined quartile categories and on a continuous scale (per .1-unit change) with Cox regression models adjusted for demographic and traditional risk factors. A total of 7087 individuals (age: 59.6 ± 12.8 years) were included; 3612 (51.0%) were male. After an average follow-up of 12.2 years, 1926 deaths occurred. Kaplan-Meier analysis showed that the lowest ABI quartile (<1.06) was associated with the highest risk of all-cause, cardio-cerebrovascular and cancer mortality (all P < .001). However, after adjusting for potential confounders, ABI ranging between 1.06 and 1.12 was associated with the lowest risk of all-cause mortality (hazard ratio .88, 95% confidence interval .78-1.00, P < .05) compared with the reference group (<1.06). Besides, splines showed the relationship was nonlinear (P < .05) and the inflection point was 1.11. In conclusion, the level of ABI associated with the lowest risk of all-cause mortality was 1.11, under which a lower ABI was independently associated with an increased risk of all-cause mortality.
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Affiliation(s)
- Chang Xu
- Department of Neurology, 546775Geriatric Hospital of Nanjing Medical University, Jiangsu Province Official Hospital, Nanjing, China.,Cognitive Impairment Research Institute of Geriatric Hospital of Nanjing Medical University, 546775Jiangsu Province Official Hospital, Nanjing, China
| | - Qi Tian
- Department of Neurology, 546775Geriatric Hospital of Nanjing Medical University, Jiangsu Province Official Hospital, Nanjing, China.,Cognitive Impairment Research Institute of Geriatric Hospital of Nanjing Medical University, 546775Jiangsu Province Official Hospital, Nanjing, China
| | - Hao Yu
- Jangsu Provincial Center for Disease Control and Prevention
| | - Wei Ge
- Department of Chinese Traditional Medicine, 546775Geriatric Hospital of Nanjing Medical University, Jiangsu Province Official Hospital, Nanjing, China
| | - Huifen Zheng
- Department of Neurology, 546775Geriatric Hospital of Nanjing Medical University, Jiangsu Province Official Hospital, Nanjing, China.,Cognitive Impairment Research Institute of Geriatric Hospital of Nanjing Medical University, 546775Jiangsu Province Official Hospital, Nanjing, China
| | - Danqing Huang
- Department of Neurology, 546775Geriatric Hospital of Nanjing Medical University, Jiangsu Province Official Hospital, Nanjing, China.,Cognitive Impairment Research Institute of Geriatric Hospital of Nanjing Medical University, 546775Jiangsu Province Official Hospital, Nanjing, China
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Zembron-Lacny A, Dziubek W, Tylutka A, Wacka E, Morawin B, Bulinska K, Stefanska M, Wozniewski M, Szuba A. Assessment of Serum Neopterin as a Biomarker in Peripheral Artery Disease. Diagnostics (Basel) 2021; 11:diagnostics11101911. [PMID: 34679610 PMCID: PMC8534562 DOI: 10.3390/diagnostics11101911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 10/11/2021] [Accepted: 10/12/2021] [Indexed: 11/16/2022] Open
Abstract
Neopterin (NPT), a pyrazino-pyrimidine compound mainly produced by activated macrophages, has been regarded as a proinflammatory and proatherosclerotic agent. The study was designed to evaluate NPT level and its interaction with conventional peripheral artery disease (PAD) biomarkers and vascular regenerative potential in severe PAD. The study included 59 patients (females n = 17, males n = 42) aged 67.0 ± 8.2 years classified into two groups based on ankle-brachial index (ABI) measurements (ABI ≤ 0.9 n = 43, ABI ≤ 0.5 n = 16). A total of 60 subjects aged 70.4 ± 5.5 years (females n = 42, males n = 18) with ABI > 0.9 constituted a reference group. NPT concentration reached values above 10 nmol/L in patients with PAD, which differed significantly from reference group (8.15 ± 1.33 nmol/L). High levels of CRP > 5 mg/L, TC > 200 mg/dL as well as lipoproteins LDL > 100 mg/dL and non-HDL > 130 mg/dL were found in the same group, indicating the relationship between NPT and conventional atherogenic markers. The endothelial progenitor cells (EPCs) tended toward lower values in patients with ABI ≤ 0.5 when compared to reference group, and inversely correlated with NPT. These findings indicate a crucial role of NPT in atheromatous process and its usefulness in monitoring PAD severity. However, the role of NPT in chronic PAD needs further studies including relatively high number of subjects.
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Affiliation(s)
- Agnieszka Zembron-Lacny
- Department of Applied and Clinical Physiology, Collegium Medicum University of Zielona Gora, 65-417 Zielona Gora, Poland; (A.Z.-L.); (A.T.); (B.M.)
| | - Wioletta Dziubek
- Faculty of Physiotherapy, University School of Physical Education in Wroclaw, 51-612 Wroclaw, Poland; (W.D.); (K.B.); (M.S.); (M.W.)
| | - Anna Tylutka
- Department of Applied and Clinical Physiology, Collegium Medicum University of Zielona Gora, 65-417 Zielona Gora, Poland; (A.Z.-L.); (A.T.); (B.M.)
| | - Eryk Wacka
- Collegium Medicum, University of Zielona Gora, 65-417 Zielona Gora, Poland
- Correspondence: ; Tel.: +48-534-100-354
| | - Barbara Morawin
- Department of Applied and Clinical Physiology, Collegium Medicum University of Zielona Gora, 65-417 Zielona Gora, Poland; (A.Z.-L.); (A.T.); (B.M.)
| | - Katarzyna Bulinska
- Faculty of Physiotherapy, University School of Physical Education in Wroclaw, 51-612 Wroclaw, Poland; (W.D.); (K.B.); (M.S.); (M.W.)
| | - Malgorzata Stefanska
- Faculty of Physiotherapy, University School of Physical Education in Wroclaw, 51-612 Wroclaw, Poland; (W.D.); (K.B.); (M.S.); (M.W.)
| | - Marek Wozniewski
- Faculty of Physiotherapy, University School of Physical Education in Wroclaw, 51-612 Wroclaw, Poland; (W.D.); (K.B.); (M.S.); (M.W.)
| | - Andrzej Szuba
- Department of Angiology, Hypertension and Diabetology Medical University Wroclaw, 50-556 Wroclaw, Poland;
- WROVASC An Integrated Cardiovascular Centre, Specialist District Hospital in Wroclaw, Centre for Research and Development Wroclaw, 51-124 Wroclaw, Poland
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An elevated ankle-brachial index is not a valid proxy for peripheral medial arterial calcification. Atherosclerosis 2021; 323:13-19. [PMID: 33770564 DOI: 10.1016/j.atherosclerosis.2021.03.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 03/04/2021] [Accepted: 03/11/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND AIMS The ankle brachial index (ABI) is often used as a proxy for medial arterial calcification (MAC) in studies investigating MAC as a cardiovascular risk factor, but evidence supporting this hypothesis is sparse. This study aims to investigate the use of an elevated ABI as proxy for MAC, as visualized with computed tomography (CT). METHODS Cross-sectional data of 718 participants with, or at risk of cardiovascular disease was used. The ABI was calculated using cutoffs >1.4 and > 1.3. The presence of MAC was assessed in the crural and femoral arteries by CT imaging. Modified Poisson regression was used to assess the association between an elevated ABI and the presence of MAC, and test characteristics were calculated. RESULTS MAC was found in 25.0% of participants. An ABI >1.4 was found in 8.7% of participants, of whom 45.2% had MAC. An elevated ABI was significantly associated with the presence of MAC (RR 1.74, CI: 1.26-2.40). However, poor positive specific agreement (23.3%, CI: 13.9-34.3), sensitivity (15.7%, CI: 10.4-21.1) and positive predictive value (45.2%, CI: 32.8-57.5) were found. Despite good specificity (93.6%, CI: 91.6-95.7) the area under the receiving operator curve remained poor (54.7%, CI: 51.8-57.6). Negative specific agreement (84.5%, CI: 81.4-87.0) and negative predictive value (77.0%, CI: 73.7-80.2) were acceptable. CONCLUSIONS An elevated ABI is insufficient to serve as a true diagnostic proxy for MAC. Studies that have drawn conclusions on the association between MAC and cardiovascular disease, solely based on the ABI, are likely to underestimate the found effects.
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Perl L, Bental T, Vaknin-Assa H, Assali A, Codner P, Talmor-Barkan Y, Greenberg G, Samara A, Witberg G, Orvin K, Kornowski R. Independent Impact of Peripheral Artery Disease on Percutaneous Coronary Intervention. J Am Heart Assoc 2020; 9:e017655. [PMID: 33283578 PMCID: PMC7955381 DOI: 10.1161/jaha.120.017655] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Background Peripheral artery disease (PAD) is a known risk factor for adverse outcomes in patients undergoing percutaneous coronary intervention. However, in some studies PAD is not an independent risk factor. We sought to examine the independent impact of PAD on a large prospective percutaneous coronary intervention registry. Methods and Results From our single‐center prospective percutaneous coronary intervention registry, we have retrospectively analyzed 25 690 patients (years 2004–2018). We examined the influence of PAD on short‐ and long‐term outcomes using both regression and propensity‐matched analyses. Patients with documented PAD (n=1610, 6.3% of total) were older (66.7±10.8 versus 65.4±12.1, P<0.01), had higher rates of diabetes mellitus (69.3% versus 46.3%, P<0.01), hypertension (92.1% versus 76.1%, P<0.01) and renal failure (38.3% versus 18.2%, P<0.01). There were no differences in the rates of stable versus acute presentations, but less were treated with Prasugrel and Ticagrelor (3.3% versus 8.0% and 7.9% versus 11.9%, respectively, P<0.001 for both). Both 30‐day and 3‐year rates of all‐cause death and major adverse cardiac events were higher for patients with PAD versus control (4.9% versus 2.1% and 7.3% versus 3.3% death and major adverse cardiac events at 30 days, respectively; 43.4% versus 29.0% and 55.0% versus 37.8%, respectively at 3 years, P<0.001 for all). Following multivariate analysis, the presence of PAD was associated with a higher risk of both death (hazard ratio [HR], 1.66; CI 1.52–1.83; P<0.001) and major adverse cardiac events (HR, 1.51; CI, 1.40–1.64; P<0.001). Conclusions PAD constitutes an independent risk factor for adverse outcomes in patients undergoing percutaneous coronary intervention. Further studies are needed to ascertain which effective therapies may mitigate this risk.
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Affiliation(s)
- Leor Perl
- Department of Cardiology Rabin Medical Center Petach-Tikva Israel.,Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
| | - Tamir Bental
- Department of Cardiology Rabin Medical Center Petach-Tikva Israel.,Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
| | - Hana Vaknin-Assa
- Department of Cardiology Rabin Medical Center Petach-Tikva Israel.,Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
| | - Abid Assali
- Department of Cardiology Rabin Medical Center Petach-Tikva Israel.,Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel.,Department of Cardiology Meir Medical Center Kfar-Saba Israel
| | - Pablo Codner
- Department of Cardiology Rabin Medical Center Petach-Tikva Israel.,Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
| | - Yeela Talmor-Barkan
- Department of Cardiology Rabin Medical Center Petach-Tikva Israel.,Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
| | - Gabriel Greenberg
- Department of Cardiology Rabin Medical Center Petach-Tikva Israel.,Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
| | - Abed Samara
- Department of Cardiology Rabin Medical Center Petach-Tikva Israel.,Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
| | - Guy Witberg
- Department of Cardiology Rabin Medical Center Petach-Tikva Israel.,Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
| | - Katia Orvin
- Department of Cardiology Rabin Medical Center Petach-Tikva Israel.,Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
| | - Ran Kornowski
- Department of Cardiology Rabin Medical Center Petach-Tikva Israel.,Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
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11
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Fasting serum copeptin and asymptomatic peripheral artery disease: No association in patients with type 1 diabetes mellitus. DIABETES & METABOLISM 2020; 47:101207. [PMID: 33160031 DOI: 10.1016/j.diabet.2020.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 10/20/2020] [Accepted: 10/21/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVE As copeptin is associated with lower-extremity amputation in patients with type 1 diabetes mellitus (T1DM), our study aimed to address the putative association between copeptin and asymptomatic peripheral artery disease (aPAD) in those patients. DESIGN AND METHODS This observational cross-sectional study included 112 patients with T1DM from a larger cohort (ClinicalTrials.gov: NCT02910271), selected (1:2) as per the presence of aPAD (n = 37) or not (n = 75). aPAD was evaluated by ankle-brachial index (ABI), toe-brachial index (TBI), and peripheral Doppler ultrasound. The two groups of patients were matched by age, gender distribution and duration of T1DM. Fasting serum copeptin was measured by high-sensitivity ELISA, and its relationships with clinical and biochemical variables as well as aPAD were evaluated too. RESULTS The study population was aged 42 ± 8 years, duration of T1DM was 27 ± 7 years, and mean HbA1c was 7.7 ± 1.1%. No significant differences in copeptin concentrations were found between patients with or without aPAD (16.9 ± 10.8 vs 17.3 ± 14.7 pmol/L, respectively; P = 0.462). Considering all patients as a whole, copeptin correlated with systolic blood pressure (SBP; ρ = -0.209, P = 0.027), eGFR ρ = -0.271, P = 0.004), and serum sodium (ρ = -0.208, P = 0.027), but not with ABI (ρ = -0.068, P = 0.476). Stepwise multiple linear regression analysis (R2: 0.059; P = 0.035) retained SBP (β: -0.219, 95% CI: -1.391; -0.089) as the only significant predictor of copeptin concentration. CONCLUSION As serum copeptin does not appear to be associated with aPAD in patients with T1DM, further studies are now needed to elucidate whether it has any other potential role to play in the subclinical vascular disease of this patient population.
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12
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Watanabe T. Neopterin derivatives - a novel therapeutic target rather than biomarker for atherosclerosis and related diseases. VASA 2020; 50:165-173. [PMID: 32924886 DOI: 10.1024/0301-1526/a000903] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
This review provides an updated overview of the emerging roles of neopterin derivatives in atherosclerosis. Neopterin, a metabolite of guanosine triphosphate, is produced by interferon-γ-activated macrophages and is expressed at high levels in atheromatous plaques within the human carotid and coronary arteries as well as in the aorta. Plasma concentrations of neopterin are higher in patients with carotid, cerebral, and coronary artery diseases as well as aortic aneurysm. The concentration of neopterin is positively correlated with the severity of coronary artery disease. However, a prospective cohort study showed that neopterin contributes to protection against plaque formation in carotid arteries in patients with atherosclerosis. Moreover, using both in vitro and in vivo experiments, a recent study has shown the atheroprotective effects of neopterin. Neopterin suppresses the expression of monocyte chemotactic protein-1, vascular cell adhesion molecule-1, and intercellular adhesion molecule-1 in endothelial cells, and thereby suppresses the adhesion of monocytes to endothelial cells. It also suppresses the inflammatory phenotype of monocyte-derived macrophages. In addition, neopterin suppresses oxidized low-density lipoprotein-induced foam cell formation in macrophages and the migration and proliferation of vascular smooth muscle cells. Neopterin injection into apolipoprotein E-deficient (Apoe-/-) mice suppresses the development of atherosclerotic lesions. A neopterin derivative tetrahydroneopterin (BH4), also known as a cofactor for nitric oxide (NO) synthases, suppresses atherosclerosis and vascular injury-induced neointimal hyperplasia in Apoe-/- mice. BH4 administration improves endothelial dysfunction in patients with coronary artery disease. These findings suggest that neopterin production may increase to counteract the progression of atherosclerosis, as neopterin contributes to atheroprotection. Otherwise, the increased neopterin levels in atherosclerosis may reflect a compensatory mechanism associated with inducible NO synthase upregulation in macrophages to supply BH4 for high output NO production caused by decreased endothelial NO synthase in atherosclerosis. Therefore, neopterin derivatives are a novel therapeutic target for atherosclerosis and related diseases.
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Affiliation(s)
- Takuya Watanabe
- Department of Internal Medicine, Ushioda General Hospital/Clinic, Yokohama, Japan
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13
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Sonoda H, Nakamura K, Tamakoshi A. Ankle-Brachial Index is a Predictor of Future Incident Chronic Kidney Disease in a General Japanese Population. J Atheroscler Thromb 2019; 26:1054-1061. [PMID: 31061261 PMCID: PMC6927805 DOI: 10.5551/jat.47779] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 02/28/2019] [Indexed: 12/17/2022] Open
Abstract
AIMS The ankle-brachial index (ABI) can be a prognostic marker for chronic kidney disease (CKD) in Western populations. Since there is little relevant evidence for Asian populations, we investigated the relationship between ABI and the risk of incident CKD in a general Japanese population. METHODS The cohort included 5,072 participants aged 30-79 without a history of renal disease or cerebro-cardiovascular disease. Incident CKD, defined as an estimated glomerular filtration rate <60 (mL/min/1.73 m2) and/or proteinuria (≥ 1+ on urine dipstick), was compared among participants grouped according to baseline ABI: 0.90-0.99, 1.00-1.09, 1.10-1.19, 1.20-1.29, and 1.30-1.39. Hazard ratios for incident CKD were estimated using a Cox proportional hazards model, with the ABI 1.10-1.19 group serving as the reference. RESULTS The CKD incidence rate (/100 person-years) was 1.80 during the mean follow-up period of 5.1 years. The CKD incidence rate was 3.04 in the ABI category 0.90-0.99, 1.58 in ABI 1.00-1.09, 1.72 in ABI 1.10-1.19, 2.01 in ABI 1.20-1.29, and 3.33 in ABI 1.30-1.39. The hazard ratios for developing CKD were 2.14 (95% confidence interval 1.16-3.92) in ABI 0.90-0.99, 1.08 (0.83-1.41) in ABI 1.00-1.09, 1.03 (0.83-1.29) in ABI 1.20-1.29, and 1.37 (0.77-2.47) in ABI 1.30-1.39, after adjusting for age, sex, systolic blood pressure, diabetes, and other confounding factors. CONCLUSIONS In a general Japanese population, an ABI of 0.90-0.99 was associated with an increased risk of incident CKD, independent of traditional cardiovascular risk factors.
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Affiliation(s)
- Hiroshi Sonoda
- Department of Public Health, Hokkaido University Graduate School of Medicine, Sapporo, Japan
- Keijinkai Maruyama Clinic, Sapporo, Japan
| | - Koshi Nakamura
- Department of Public Health, Hokkaido University Faculty of Medicine, Sapporo, Japan
| | - Akiko Tamakoshi
- Department of Public Health, Hokkaido University Faculty of Medicine, Sapporo, Japan
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14
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Potier L, Roussel R, Marre M, Bjornstad P, Cherney DZ, El Boustany R, Fumeron F, Venteclef N, Gautier JF, Hadjadj S, Mohammedi K, Velho G. Plasma Copeptin and Risk of Lower-Extremity Amputation in Type 1 and Type 2 Diabetes. Diabetes Care 2019; 42:2290-2297. [PMID: 31582427 PMCID: PMC6973542 DOI: 10.2337/dc19-1062] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 09/10/2019] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Diabetes is the leading cause of nontraumatic lower-extremity amputations (LEAs). Identification of patients with foot ulcers at risk for amputation remains clinically challenging. Plasma copeptin, a surrogate marker of vasopressin, is associated with the risk of cardiovascular and renal complications in diabetes. RESEARCH DESIGN AND METHODS We assessed the association between baseline plasma copeptin and risk of LEA during follow-up in four cohorts of people with type 1 (GENESIS, n = 503, and GENEDIAB, n = 207) or type 2 diabetes (DIABHYCAR, n = 3,101, and SURDIAGENE, n = 1,452) with a median duration of follow-up between 5 and 10 years. Copeptin concentration was measured in baseline plasma samples by an immunoluminometric assay. RESULTS In the pooled cohorts with type 1 diabetes (n = 710), the cumulative incidence of LEA during follow-up by increasing tertiles (tertile 1 [TER1], TER2, and TER3) of baseline plasma copeptin was 3.9% (TER1), 3.3% (TER2), and 10.0% (TER3) (P = 0.002). Cox regression analyses confirmed the association of copeptin with LEA: hazard ratio (HR) for 1 SD increment of log[copeptin] was 1.89 (95% CI 1.28-2.82), P = 0.002. In the pooled cohorts of type 2 diabetes (n = 4,553), the cumulative incidence of LEA was 1.1% (TER1), 2.9% (TER2), and 3.6% (TER3) (P < 0.0001). In Cox regression analyses, baseline plasma copeptin was significantly associated with LEA: HR for 1 SD increment of log[copeptin] was 1.42 (1.15-1.74), P = 0.001. Similar results were observed in the cohort with type 2 diabetes for lower-limb revascularization (HR 1.20 [95% CI 1.03-1.39], P = 0.02). CONCLUSIONS Baseline plasma copeptin is associated with cumulative incidence of LEA in cohorts of people with both type 1 and type 2 diabetes and may help to identify patients at risk for LEA.
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Affiliation(s)
- Louis Potier
- Department of Diabetology, Endocrinology and Nutrition, DHU FIRE, Bichat Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France .,Université de Paris, Paris, France.,INSERM, UMRS 1138, Cordeliers Research Center, Paris, France
| | - Ronan Roussel
- Department of Diabetology, Endocrinology and Nutrition, DHU FIRE, Bichat Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France.,Université de Paris, Paris, France.,INSERM, UMRS 1138, Cordeliers Research Center, Paris, France
| | - Michel Marre
- Department of Diabetology, Endocrinology and Nutrition, DHU FIRE, Bichat Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France.,Université de Paris, Paris, France.,INSERM, UMRS 1138, Cordeliers Research Center, Paris, France.,Section of Endocrinology, Department of Pediatrics, and Division of Nephrology, Department of Medicine, University of Colorado School of Medicine, Aurora, CO
| | - Petter Bjornstad
- Section of Endocrinology, Department of Pediatrics, and Division of Nephrology, Department of Medicine, University of Colorado School of Medicine, Aurora, CO
| | - David Z Cherney
- Division of Nephrology, Department of Medicine, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Ray El Boustany
- Department of Diabetology, Endocrinology and Nutrition, DHU FIRE, Bichat Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France.,INSERM, UMRS 1138, Cordeliers Research Center, Paris, France
| | - Frédéric Fumeron
- Université de Paris, Paris, France.,INSERM, UMRS 1138, Cordeliers Research Center, Paris, France
| | | | - Jean-François Gautier
- Université de Paris, Paris, France.,INSERM, UMRS 1138, Cordeliers Research Center, Paris, France.,Department of Diabetes, Clinical Investigation Centre (CIC-9504), Lariboisière Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Samy Hadjadj
- L'Institut du thorax, INSERM, CNRS, Université de Nantes, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Kamel Mohammedi
- Department of Diabetology, Endocrinology and Nutrition, Hôpital Haut-Lévêque, Bordeaux, France.,Bordeaux University, Bordeaux, France.,INSERM U1219 "Bordeaux Population Health," Bordeaux, France
| | - Gilberto Velho
- INSERM, UMRS 1138, Cordeliers Research Center, Paris, France
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15
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Takahara M, Iida O, Kohsaka S, Soga Y, Fujihara M, Shinke T, Amano T, Ikari Y. Presentation Pattern of Lower Extremity Endovascular Intervention versus Percutaneous Coronary Intervention. J Atheroscler Thromb 2019; 27:761-768. [PMID: 31748468 PMCID: PMC7458786 DOI: 10.5551/jat.53330] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
AIM The aim of the current study is to describe the presentation pattern of symptomatic peripheral artery disease undergoing endovascular therapy (EVT) in comparison to symptomatic coronary artery disease undergoing percutaneous coronary intervention (PCI) based on data from nationwide databases. METHODS Data were extracted from the nationwide procedural databases of EVT and PCI in Japan (J-EVT and J-PCI) between 2012 and 2017. The presentation pattern was investigated using a Poisson regression model, including the month, seasonality, and weekend (versus weekday) as the explanatory variables. Seasonality was expressed as a cosine function of a 12-month period, and its significance was evaluated using the Fisher-Yates shuffle method. RESULTS A total of 41,906 and 62,585 cases underwent EVT for critical limb ischemia (CLI) and intermittent claudication (IC), respectively, whereas 518,858 and 504,139 cases underwent PCI for acute coronary syndrome (ACS) and stable angina (SA). The procedural volume increased by 21.6%, 12.3%, 4.5%, and 3.6% per year in CLI, IC, ACS, and SA. CLI and ACS, but not IC or SA, showed a significant volume seasonality. Compared with ACS, CLI demonstrated a larger peak-to-trough ratio of seasonality (1.75 versus 1.21; P<0.001), and a later peak appearance (February-March versus January-February by 1.37 months; P<0.001). The procedural volume on weekends relative to weekdays was smaller for SA, IC, and CLI than for ACS. These distinct features were observed in a diabetic population and a non-diabetic population. CONCLUSIONS The current study analyzed nationwide procedural databases and demonstrated the presentation pattern of symptomatic PAD and CAD warranting revascularization.
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Affiliation(s)
- Mitsuyoshi Takahara
- The Japanese Association of Cardiovascular Intervention and Therapeutics.,Department of Diabetes Care Medicine, Osaka University Graduate School of Medicine.,Department of Health Quality Assessment, The University of Tokyo
| | - Osamu Iida
- The Japanese Association of Cardiovascular Intervention and Therapeutics.,Cardiovascular Center, Kansai Rosai Hospital
| | - Shun Kohsaka
- The Japanese Association of Cardiovascular Intervention and Therapeutics.,Department of Cardiology, Keio University School of Medicine
| | - Yoshimitsu Soga
- The Japanese Association of Cardiovascular Intervention and Therapeutics.,Department of Cardiology, Kokura Memorial Hospital
| | - Masahiko Fujihara
- The Japanese Association of Cardiovascular Intervention and Therapeutics.,Department of Cardiology, Kishiwada Tokushukai Hospital
| | - Toshiro Shinke
- The Japanese Association of Cardiovascular Intervention and Therapeutics.,Division of Cardiovascular Medicine, Department of Internal Medicine, Showa University School of Medicine
| | - Tetsuya Amano
- The Japanese Association of Cardiovascular Intervention and Therapeutics.,Department of Cardiology, Aichi Medical University
| | - Yuji Ikari
- The Japanese Association of Cardiovascular Intervention and Therapeutics.,Department of Cardiology, Tokai University
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Fatemi S, Acosta S, Gottsäter A, Melander O, Engström G, Dakhel A, Zarrouk M. Copeptin, B-type natriuretic peptide and cystatin C are associated with incident symptomatic PAD. Biomarkers 2019; 24:615-621. [PMID: 31215249 DOI: 10.1080/1354750x.2019.1631886] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Purpose: The aim of this study is to evaluate plasma biomarkers as predictors for peripheral arterial disease (PAD). Materials and methods: Prospective longitudinal cohort study of middle-aged individuals from the cardiovascular cohort of the Malmö Diet and Cancer study (MDCS) (n = 5550; 1991-94). Cystatin C, copeptin, N-terminal pro-B-type natriuretic peptide (N-BNP), midregional proatrial natriuretic peptide (MR-proANP), mid-regional proadrenomedullin (MR-proADM), and conventional risk factors were measured at baseline. The diagnosis of symptomatic PAD was validated in 97% of the cases. Results: Cumulative incidence of PAD during median follow up of 23.4 years was 4.4% (men 5.9%, women 3.3%). Adjusted for age, sex, smoking, body mass index, hypertension, diabetes mellitus and total cholesterol, copeptin (hazard ratio [HR] 1.46; 95% confidence interval [CI] 1.19-1.80), N-BNP (HR 1.28; 95% CI 1.11-1.48), and cystatin C (HR 1.19; 95% CI 1.10-1.29) were independently associated with incident PAD. Subjects with the three biomarkers copeptin, N-BNP, and cystatin C in the highest quartiles, ran a high risk of incident PAD (HR 3.29; 95% CI 1.76-6.17) compared to those with no biomarker in the highest quartile. Conclusion: Copeptin, N-BNP, and cystatin C were associated with incident symptomatic PAD, implying that these biomarkers are sensitive indicators of early subclinical PAD. Clinical significance First prospective longitudinal cohort study evaluating Cystatin C, copeptin, N-terminal pro-B-type natriuretic peptide (N-BNP), midregional proatrial natriuretic peptide (MR-proANP), and mid-regional proadrenomedullin (MR-proADM) as predictors for peripheral arterial disease (PAD). Copeptin, N-BNP, and Cystatin C where independently associated with incident symptomatic PAD after adjustment for conventional risk factors. Copeptin, N-BNP, and Cystatin C seem to be sensitive indicators of early subclinical PAD.
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Affiliation(s)
- Shahab Fatemi
- a Department of Clinical Sciences, Malmö, Lund University , Malmö , Sweden.,b Department of Internal Medicine and Emergency Medicine, Vascular Centre , Malmö , Sweden
| | - Stefan Acosta
- a Department of Clinical Sciences, Malmö, Lund University , Malmö , Sweden.,c Department of Cardiothoracic and Vascular Surgery, Vascular Centre , Malmö , Sweden
| | - Anders Gottsäter
- a Department of Clinical Sciences, Malmö, Lund University , Malmö , Sweden.,c Department of Cardiothoracic and Vascular Surgery, Vascular Centre , Malmö , Sweden
| | - Olle Melander
- a Department of Clinical Sciences, Malmö, Lund University , Malmö , Sweden.,b Department of Internal Medicine and Emergency Medicine, Vascular Centre , Malmö , Sweden
| | - Gunnar Engström
- a Department of Clinical Sciences, Malmö, Lund University , Malmö , Sweden
| | - Ardwan Dakhel
- a Department of Clinical Sciences, Malmö, Lund University , Malmö , Sweden.,c Department of Cardiothoracic and Vascular Surgery, Vascular Centre , Malmö , Sweden
| | - Moncef Zarrouk
- a Department of Clinical Sciences, Malmö, Lund University , Malmö , Sweden.,c Department of Cardiothoracic and Vascular Surgery, Vascular Centre , Malmö , Sweden
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