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Temtem M, Mendonça MI, Gomes Serrão M, Santos M, Sá D, Sousa F, Soares C, Rodrigues R, Henriques E, Freitas S, Borges S, Rodrigues M, Guerra G, Drumond Freitas A, Sousa AC, Palma Dos Reis R. Predictive improvement of adding coronary calcium score and a genetic risk score to a traditional risk model for cardiovascular event prediction. Eur J Prev Cardiol 2024; 31:709-715. [PMID: 38175668 DOI: 10.1093/eurjpc/zwae005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 12/27/2023] [Accepted: 12/28/2023] [Indexed: 01/05/2024]
Abstract
AIMS Coronary artery calcium score (CACS) and polygenic risk score have been used as novel markers to predict cardiovascular (CV) events of asymptomatic individuals compared with traditional scores. No previous studies have directly compared the additive capacity of these two markers relative to conventional scores. The aim of the study was to evaluate the change in CV risk prediction ability when CACS, genetic risk score (GRS), or both are added to Systematic Coronary Risk Evaluation 2 (SCORE2). METHODS AND RESULTS In a prospective, observational population-based study, 1002 asymptomatic subjects (mean age 53.1 ± 6.8 years, 73.8% male), free of clinical coronary disease and diabetes, were selected from GENEMACOR-study controls. SCORE2, CACS, and GRS were estimated to evaluate CV events' predictive and discriminative ability through Harrell's C-statistics. Net reclassification improvement (NRI) and integrated discrimination index were used to reclassify the population. Multivariable Cox proportional hazard ratio (HR) analysis assessed the variables independently associated with CV events. C-statistic demonstrated that the discriminative value for CV event occurrence was 0.608 for SCORE2, increasing to 0.749 (P = 0.001) when CACS was added, and improved to 0.802 (P = 0.0008) with GRS, showing a better discriminative capacity for CV events. Continuous NRI reclassified >70% of the population. Cox proportional analysis showed that the highest categories of SCORE2, CACS, and GRS remained in the equation with an HR of 2.9 (P = 0.003), 5.0 (P < 0.0001), and 3.2 (P = 0.003), respectively, when compared with the lowest categories. CONCLUSION In our population, CACS added to SCORE2 had better ability than GRS in CV event risk prediction, discrimination, and reclassification. However, adding the three scores can become clinically relevant, especially in intermediate-risk persons.
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Affiliation(s)
- Margarida Temtem
- Serviço de Cardiologia, SESARAM EPERAM, Hospital Central do Funchal, Avenida Luís de Camões, no 57, Funchal 9004-514, Portugal
| | - Maria Isabel Mendonça
- Centro de Investigação Dra. Maria Isabel Mendonça, SESARAM EPERAM, Hospital Central do Funchal, Avenida Luís de Camões, no 57, Funchal 9004-514, Portugal
| | - Marco Gomes Serrão
- Serviço de Cardiologia, SESARAM EPERAM, Hospital Central do Funchal, Avenida Luís de Camões, no 57, Funchal 9004-514, Portugal
| | - Marina Santos
- Serviço de Cardiologia, SESARAM EPERAM, Hospital Central do Funchal, Avenida Luís de Camões, no 57, Funchal 9004-514, Portugal
| | - Débora Sá
- Serviço de Cardiologia, SESARAM EPERAM, Hospital Central do Funchal, Avenida Luís de Camões, no 57, Funchal 9004-514, Portugal
| | - Francisco Sousa
- Serviço de Cardiologia, SESARAM EPERAM, Hospital Central do Funchal, Avenida Luís de Camões, no 57, Funchal 9004-514, Portugal
| | - Carolina Soares
- Serviço de Cardiologia, SESARAM EPERAM, Hospital Central do Funchal, Avenida Luís de Camões, no 57, Funchal 9004-514, Portugal
| | - Ricardo Rodrigues
- Serviço de Cardiologia, SESARAM EPERAM, Hospital Central do Funchal, Avenida Luís de Camões, no 57, Funchal 9004-514, Portugal
| | - Eva Henriques
- Centro de Investigação Dra. Maria Isabel Mendonça, SESARAM EPERAM, Hospital Central do Funchal, Avenida Luís de Camões, no 57, Funchal 9004-514, Portugal
| | - Sónia Freitas
- Centro de Investigação Dra. Maria Isabel Mendonça, SESARAM EPERAM, Hospital Central do Funchal, Avenida Luís de Camões, no 57, Funchal 9004-514, Portugal
| | - Sofia Borges
- Centro de Investigação Dra. Maria Isabel Mendonça, SESARAM EPERAM, Hospital Central do Funchal, Avenida Luís de Camões, no 57, Funchal 9004-514, Portugal
| | - Mariana Rodrigues
- Centro de Investigação Dra. Maria Isabel Mendonça, SESARAM EPERAM, Hospital Central do Funchal, Avenida Luís de Camões, no 57, Funchal 9004-514, Portugal
| | - Graça Guerra
- Centro de Investigação Dra. Maria Isabel Mendonça, SESARAM EPERAM, Hospital Central do Funchal, Avenida Luís de Camões, no 57, Funchal 9004-514, Portugal
| | - António Drumond Freitas
- Serviço de Cardiologia, SESARAM EPERAM, Hospital Central do Funchal, Avenida Luís de Camões, no 57, Funchal 9004-514, Portugal
| | - Ana Célia Sousa
- Centro de Investigação Dra. Maria Isabel Mendonça, SESARAM EPERAM, Hospital Central do Funchal, Avenida Luís de Camões, no 57, Funchal 9004-514, Portugal
- Faculdade de Medicina, Universidade da Madeira, Campus da Penteada, Funchal 9020-105, Portugal
| | - Roberto Palma Dos Reis
- Faculdade de Ciências Médicas, NOVA Medical School, Campo dos Mártires da Pátria 130, Lisboa 1169-056, Portugal
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Mirnezami AH, Drami I, Glyn T, Sutton PA, Tiernan J, Behrenbruch C, Guerra G, Waters PS, Woodward N, Applin S, Charles SJ, Rose SA, Denys A, Pape E, van Ramshorst GH, Baker D, Bignall E, Blair I, Davis P, Edwards T, Jackson K, Leendertse PG, Love-Mott E, MacKenzie L, Martens F, Meredith D, Nettleton SE, Trotman MP, van Hecke JJM, Weemaes AMJ, Abecasis N, Angenete E, Aziz O, Bacalbasa N, Barton D, Baseckas G, Beggs A, Brown K, Buchwald P, Burling D, Burns E, Caycedo-Marulanda A, Chang GJ, Coyne PE, Croner RS, Daniels IR, Denost QD, Drozdov E, Eglinton T, Espín-Basany E, Evans MD, Flatmark K, Folkesson J, Frizelle FA, Gallego MA, Gil-Moreno A, Goffredo P, Griffiths B, Gwenaël F, Harris DA, Iversen LH, Kandaswamy GV, Kazi M, Kelly ME, Kokelaar R, Kusters M, Langheinrich MC, Larach T, Lydrup ML, Lyons A, Mann C, McDermott FD, Monson JRT, Neeff H, Negoi I, Ng JL, Nicolaou M, Palmer G, Parnaby C, Pellino G, Peterson AC, Quyn A, Rogers A, Rothbarth J, Abu Saadeh F, Saklani A, Sammour T, Sayyed R, Smart NJ, Smith T, Sorrentino L, Steele SR, Stitzenberg K, Taylor C, Teras J, Thanapal MR, Thorgersen E, Vasquez-Jimenez W, Waller J, Weber K, Wolthuis A, Winter DC, Brangan G, Vimalachandran D, Aalbers AGJ, Abdul Aziz N, Abraham-Nordling M, Akiyoshi T, Alahmadi R, Alberda W, Albert M, Andric M, Angeles M, Antoniou A, Armitage J, Auer R, Austin KK, Aytac E, Baker RP, Bali M, Baransi S, Bebington B, Bedford M, Bednarski BK, Beets GL, Berg PL, Bergzoll C, Biondo S, Boyle K, Bordeianou L, Brecelj E, Bremers AB, Brunner M, Bui A, Burgess A, Burger JWA, Campain N, Carvalhal S, Castro L, Ceelen W, Chan KKL, Chew MH, Chok AK, Chong P, Christensen HK, Clouston H, Collins D, Colquhoun AJ, Constantinides J, Corr A, Coscia M, Cosimelli M, Cotsoglou C, Damjanovic L, Davies M, Davies RJ, Delaney CP, de Wilt JHW, Deutsch C, Dietz D, Domingo S, Dozois EJ, Duff M, Egger E, Enrique-Navascues JM, Espín-Basany E, Eyjólfsdóttir B, Fahy M, Fearnhead NS, Fichtner-Feigl S, Fleming F, Flor B, Foskett K, Funder J, García-Granero E, García-Sabrido JL, Gargiulo M, Gava VG, Gentilini L, George ML, George V, Georgiou P, Ghosh A, Ghouti L, Giner F, Ginther N, Glover T, Golda T, Gomez CM, Harris C, Hagemans JAW, Hanchanale V, Harji DP, Helbren C, Helewa RM, Hellawell G, Heriot AG, Hochman D, Hohenberger W, Holm T, Holmström A, Hompes R, Hornung B, Hurton S, Hyun E, Ito M, Jenkins JT, Jourand K, Kaffenberger S, Kapur S, Kanemitsu Y, Kaufman M, Kelley SR, Keller DS, Kersting S, Ketelaers SHJ, Khan MS, Khaw J, Kim H, Kim HJ, Kiran R, Koh CE, Kok NFM, Kontovounisios C, Kose F, Koutra M, Kraft M, Kristensen HØ, Kumar S, Lago V, Lakkis Z, Lampe B, Larsen SG, Larson DW, Law WL, Laurberg S, Lee PJ, Limbert M, Loria A, Lynch AC, Mackintosh M, Mantyh C, Mathis KL, Margues CFS, Martinez A, Martling A, Meijerink WJHJ, Merchea A, Merkel S, Mehta AM, McArthur DR, McCormick JJ, McGrath JS, McPhee A, Maciel J, Malde S, Manfredelli S, Mikalauskas S, Modest D, Morton JR, Mullaney TG, Navarro AS, Neto JWM, Nguyen B, Nielsen MB, Nieuwenhuijzen GAP, Nilsson PJ, Nordkamp S, O’Dwyer ST, Paarnio K, Pappou E, Park J, Patsouras D, Peacock O, Pfeffer F, Piqeur F, Pinson J, Poggioli G, Proud D, Quinn M, Oliver A, Radwan RW, Rajendran N, Rao C, Rasheed S, Rasmussen PC, Rausa E, Regenbogen SE, Reims HM, Renehan A, Rintala J, Rocha R, Rochester M, Rohila J, Rottoli M, Roxburgh C, Rutten HJT, Safar B, Sagar PM, Sahai A, Schizas AMP, Schwarzkopf E, Scripcariu D, Scripcariu V, Seifert G, Selvasekar C, Shaban M, Shaikh I, Shida D, Simpson A, Skeie-Jensen T, Smart P, Smith JJ, Solbakken AM, Solomon MJ, Sørensen MM, Spasojevic M, Steffens D, Stocchi L, Stylianides NA, Swartling T, Sumrien H, Swartking T, Takala H, Tan EJ, Taylor D, Tejedor P, Tekin A, Tekkis PP, Thaysen HV, Thurairaja R, Toh EL, Tsarkov P, Tolenaar J, Tsukada Y, Tsukamoto S, Tuech JJ, Turner G, Turner WH, Tuynman JB, Valente M, van Rees J, van Zoggel D, Vásquez-Jiménez W, Verhoef C, Vierimaa M, Vizzielli G, Voogt ELK, Uehara K, Wakeman C, Warrier S, Wasmuth HH, Weiser MR, Westney OL, Wheeler JMD, Wild J, Wilson M, Yano H, Yip B, Yip J, Yoo RN, Zappa MA. The empty pelvis syndrome: a core data set from the PelvEx collaborative. Br J Surg 2024; 111:znae042. [PMID: 38456677 PMCID: PMC10921833 DOI: 10.1093/bjs/znae042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 01/15/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND Empty pelvis syndrome (EPS) is a significant source of morbidity following pelvic exenteration (PE), but is undefined. EPS outcome reporting and descriptors of radicality of PE are inconsistent; therefore, the best approaches for prevention are unknown. To facilitate future research into EPS, the aim of this study is to define a measurable core outcome set, core descriptor set and written definition for EPS. Consensus on strategies to mitigate EPS was also explored. METHOD Three-stage consensus methodology was used: longlisting with systematic review, healthcare professional event, patient engagement, and Delphi-piloting; shortlisting with two rounds of modified Delphi; and a confirmatory stage using a modified nominal group technique. This included a selection of measurement instruments, and iterative generation of a written EPS definition. RESULTS One hundred and three and 119 participants took part in the modified Delphi and consensus meetings, respectively. This encompassed international patient and healthcare professional representation with multidisciplinary input. Seventy statements were longlisted, seven core outcomes (bowel obstruction, enteroperineal fistula, chronic perineal sinus, infected pelvic collection, bowel obstruction, morbidity from reconstruction, re-intervention, and quality of life), and four core descriptors (magnitude of surgery, radiotherapy-induced damage, methods of reconstruction, and changes in volume of pelvic dead space) reached consensus-where applicable, measurement of these outcomes and descriptors was defined. A written definition for EPS was agreed. CONCLUSIONS EPS is an area of unmet research and clinical need. This study provides an agreed definition and core data set for EPS to facilitate further research.
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Dalmonte S, Golinelli P, Oberhofer N, Strocchi S, Rossetti V, Berta L, Porzio M, Angelini L, Paruccini N, Villa R, Bertolini M, Delle Canne S, Cavallari M, D'Ercole L, Guerra G, Rosasco R, Cannillo B, D'Alessio A, Di Nicola E, Origgi D, De Marco P, Maldera A, Scabbio C, Rottoli F, Castriconi R, Lorenzini E, Pasquali G, Pietrobon F, Bregant P, Giovannini G, Favuzza V, Bruschi A, D'Urso D, Maestri D, De Novellis S, Fracassi A, Boschiroli L, Quattrocchi M, Gilio MA, Roberto E, Altabella L, Califano G, Cimmino MC, Bortoli E, Deiana E, Pagan L, Berardi P, Ardu V, Azzeroni R, Campoleoni M, Ravaglia V. Typical values of z-resolution for different Digital Breast Tomosynthesis systems evaluated in a multicenter study. Phys Med 2024; 119:103300. [PMID: 38325222 DOI: 10.1016/j.ejmp.2024.103300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 12/07/2023] [Accepted: 01/23/2024] [Indexed: 02/09/2024] Open
Abstract
PURPOSE The aim of the present study, conducted by a working group of the Italian Association of Medical Physics (AIFM), was to define typical z-resolution values for different digital breast tomosynthesis (DBT) models to be used as a reference for quality control (QC). Currently, there are no typical values published in internationally agreed QC protocols. METHODS To characterize the z-resolution of the DBT models, the full width at half maximum (FWHM) of the artifact spread function (ASF), a technical parameter that quantifies the signal intensity of a detail along reconstructed planes, was analyzed. Five different commercial phantoms, CIRS Model 011, CIRS Model 015, Modular DBT phantom, Pixmam 3-D, and Tomophan, were evaluated on reconstructed DBT images and 82 DBT systems (6 vendors, 9 models) in use at 39 centers in Italy were involved. RESULTS The ASF was found to be dependent on the detail size, the DBT angular acquisition range, the reconstruction algorithm and applied image processing. In particular, a progressively greater signal spread was observed as the detail size increased and the acquisition angle decreased. However, a clear correlation between signal spread and angular range width was not observed due to the different signal reconstruction and image processing strategies implemented in the algorithms developed by the vendors studied. CONCLUSIONS The analysis led to the identification of typical z-resolution values for different DBT model-phantom configurations that could be used as a reference during a QC program.
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Affiliation(s)
- S Dalmonte
- Medical Physics Specialization School, University of Bologna, Bologna, Italy; Medical Physics Unit, AUSL Romagna, Ravenna, Italy.
| | - P Golinelli
- Medical Physics Unit, Azienda USL Modena, Modena, Italy
| | | | - S Strocchi
- Medical Physics Unit, ASST dei Sette Laghi, Varese, Italy
| | - V Rossetti
- Medical Physics Unit, Città della salute e della scienza, Torino, Italy
| | - L Berta
- Medical Physics Unit, Città della salute e della scienza, Torino, Italy
| | - M Porzio
- Medical Physics Unit, ASL CN1, Cuneo, Italy
| | - L Angelini
- Medical Physics Unit, AUSL Romagna, Ravenna, Italy
| | - N Paruccini
- Medical Physics Unit, ASST Monza, Monza, Italy
| | - R Villa
- Medical Physics Unit, ASST Monza, Monza, Italy
| | - M Bertolini
- Medical Physics Unit, Azienda AUSL - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - S Delle Canne
- Medical Physics Unit, Fatebenefratelli Isola Tiberina-Gemelli Isola, Roma, Italy
| | - M Cavallari
- Medical Physics Unit, IRCCS Fondazione Policlinico San Matteo, Pavia, Italy
| | - L D'Ercole
- Medical Physics Unit, IRCCS Fondazione Policlinico San Matteo, Pavia, Italy
| | - G Guerra
- Medical Physics Unit, Studio Associato Fisici Sanitari, Lugo, Italy
| | - R Rosasco
- Medical Physics Unit, ASL3 Sistema Sanitario Regione Liguria, Genova, Italy
| | - B Cannillo
- Medical Physics Unit, AOU Maggiore della Carità, Novara, Italy
| | - A D'Alessio
- Medical Physics Unit, AOU Maggiore della Carità, Novara, Italy
| | - E Di Nicola
- Medical Physics Unit, ASUR Marche Area Vasta3, Macerata, Italy
| | - D Origgi
- Medical Physics Unit, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - P De Marco
- Medical Physics Unit, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - A Maldera
- Medical Physics Unit, P.O. Dimiccoli - ASL BT, Barletta, Italy
| | - C Scabbio
- Medical Physics Unit, ASST Santi Paolo e Carlo - Presidio San Paolo, Milano, Italy
| | - F Rottoli
- Medical Physics Unit, ASST Santi Paolo e Carlo - Presidio San Paolo, Milano, Italy
| | - R Castriconi
- Medical Physics Unit, IRCCS Ospedale San Raffaele - Gruppo San Donato, Milano, Italy
| | - E Lorenzini
- Medical Physics Unit, Ospedale Civico di Carrara, Carrara, Italy
| | - G Pasquali
- Medical Physics Unit, ASST Bergamo Ovest, Treviglio, Italy
| | - F Pietrobon
- Medical Physics Unit, Ospedale di Belluno, Belluno, Italy
| | - P Bregant
- Medical Physics Unit, Ospedale Cattinara, Trieste, Italy
| | - G Giovannini
- Medical Physics Unit, ASL2 Ospedale Santa Corona, Pietra Ligure, Italy
| | - V Favuzza
- Medical Physics Unit, USL Toscana Centro, Empoli, Italy
| | - A Bruschi
- Medical Physics Unit, USL Toscana Centro, Empoli, Italy
| | - D D'Urso
- Medical Physics Unit, ULSS 2 Marca Trevigiana, Treviso, Italy
| | - D Maestri
- Medical Physics Unit, ULSS 2 Marca Trevigiana, Treviso, Italy
| | | | - A Fracassi
- Medical Physics Unit, ASL Pescara, Pescara, Italy
| | - L Boschiroli
- Medical Physics Unit, ASST Nord Milano, Milano, Italy
| | - M Quattrocchi
- Medical Physics Unit, Azienda Toscana Nord Ovest, Lucca, Italy
| | - M A Gilio
- Medical Physics Unit, Azienda Toscana Nord Ovest, Lucca, Italy
| | - E Roberto
- Medical Physics Unit, ASL CN2 Cuneo, Italy
| | - L Altabella
- Medical Physics Unit, AOUI VR, Verona, Italy
| | - G Califano
- Medical Physics Unit, AOR San Carlo Potenza, Potenza, Italy
| | - M C Cimmino
- Medical Physics Unit, USL Toscana sud est, Siena, Italy
| | - E Bortoli
- Medical Physics Unit, USL Toscana sud est, Grosseto, Italy
| | - E Deiana
- Medical Physics Unit, ASL Cagliari, Cagliari, Italy
| | - L Pagan
- Medical Physics Unit, Azienda USL Bologna, Bologna, Italy
| | - P Berardi
- Medical Physics Unit, Azienda USL Bologna, Bologna, Italy
| | - V Ardu
- Medical Physics Unit, Fondazione IRCCS Ca' Granda, Milano, Italy
| | - R Azzeroni
- Medical Physics Unit, Fondazione IRCCS Ca' Granda, Milano, Italy
| | - M Campoleoni
- Medical Physics Unit, Fondazione IRCCS Ca' Granda, Milano, Italy
| | - V Ravaglia
- Medical Physics Unit, AUSL Romagna, Ravenna, Italy
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West CT, West MA, Mirnezami AH, Drami I, Denys A, Glyn T, Sutton PA, Tiernan J, Behrenbruch C, Guerra G, Waters PS, Woodward N, Applin S, Charles SJ, Rose SA, Pape E, van Ramshorst GH, Aalbers AGJ, Abdul AN, Abecasis N, Abraham-Nordling M, Akiyoshi T, Alahmadi R, Alberda W, Albert M, Andric M, Angeles M, Angenete E, Antoniou A, Armitage J, Auer R, Austin KK, Aytac E, Aziz O, Bacalbasa N, Baker RP, Bali M, Baransi S, Baseckas G, Bebington B, Bedford M, Bednarski BK, Beets GL, Berg PL, Bergzoll C, Biondo S, Boyle K, Bordeianou L, Brecelj E, Bremers AB, Brown K, Brunner M, Buchwald P, Bui A, Burgess A, Burger JWA, Burling D, Burns E, Campain N, Carvalhal S, Castro L, Caycedo-Marulanda A, Ceelen W, Chan KKL, Chang GJ, Chew MH, Chok AK, Chong P, Christensen HK, Clouston H, Collins D, Colquhoun AJ, Constantinides J, Corr A, Coscia M, Cosimelli M, Cotsoglou C, Coyne PE, Croner RS, Damjanovic L, Daniels IR, Davies M, Davies RJ, Delaney CP, de Wilt JHW, Denost QD, Deutsch C, Dietz D, Domingo S, Dozois EJ, Drozdov E, Duff M, Egger E, Eglinton T, Enrique-Navascues JM, Espín-Basany E, Evans MD, Eyjólfsdóttir B, Fahy M, Fearnhead NS, Fichtner-Feigl S, Flatmark K, Fleming F, Flor B, Folkesson J, Foskett K, Frizelle FA, Funder J, Gallego MA, García-Granero E, García-Sabrido JL, Gargiulo M, Gava VG, Gentilini L, George ML, George V, Georgiou P, Ghosh A, Ghouti L, Gil-Moreno A, Giner F, Ginther N, Glover T, Goffredo P, Golda T, Gomez CM, Griffiths B, Gwenaël F, Harris C, Harris DA, Hagemans JAW, Hanchanale V, Harji DP, Helbren C, Helewa RM, Hellawell G, Heriot AG, Hochman D, Hohenberger W, Holm T, Holmström A, Hompes R, Hornung B, Hurton S, Hyun E, Ito M, Iversen LH, Jenkins JT, Jourand K, Kaffenberger S, Kandaswamy GV, Kapur S, Kanemitsu Y, Kaufman M, Kazi M, Kelley SR, Keller DS, Kelly ME, Kersting S, Ketelaers SHJ, Khan MS, Khaw J, Kim H, Kim HJ, Kiran R, Koh CE, Kok NFM, Kokelaar R, Kontovounisios C, Kose F, Koutra M, Kraft M, Kristensen HØ, Kumar S, Kusters M, Lago V, Lakkis Z, Lampe B, Langheinrich MC, Larach T, Larsen SG, Larson DW, Law WL, Laurberg S, Lee PJ, Limbert M, Loria A, Lydrup ML, Lyons A, Lynch AC, Mackintosh M, Mann C, Mantyh C, Mathis KL, Margues CFS, Martinez A, Martling A, Meijerink WJHJ, Merchea A, Merkel S, Mehta AM, McArthur DR, McCormick JJ, McDermott FD, McGrath JS, McPhee A, Maciel J, Malde S, Manfredelli S, Mikalauskas S, Modest D, Monson JRT, Morton JR, Mullaney TG, Navarro AS, Neeff H, Negoi I, Neto JWM, Nguyen B, Nielsen MB, Nieuwenhuijzen GAP, Nilsson PJ, Nordkamp S, O’Dwyer ST, Paarnio K, Palmer G, Pappou E, Park J, Patsouras D, Peacock A, Pellino G, Peterson AC, Pfeffer F, Piqeur F, Pinson J, Poggioli G, Proud D, Quinn M, Oliver A, Quyn A, Radwan RW, Rajendran N, Rao C, Rasheed S, Rasmussen PC, Rausa E, Regenbogen SE, Reims HM, Renehan A, Rintala J, Rocha R, Rochester M, Rohila J, Rothbarth J, Rottoli M, Roxburgh C, Rutten HJT, Safar B, Sagar PM, Sahai A, Saklani A, Sammour T, Sayyed R, Schizas AMP, Schwarzkopf E, Scripcariu D, Scripcariu V, Seifert G, Selvasekar C, Shaban M, Shaikh I, Shida D, Simpson A, Skeie-Jensen T, Smart NJ, Smart P, Smith JJ, Smith T, Solbakken AM, Solomon MJ, Sørensen MM, Spasojevic M, Steele SR, Steffens D, Stitzenberg K, Stocchi L, Stylianides NA, Swartling T, Sumrien H, Swartking T, Takala H, Tan EJ, Taylor C, Taylor D, Tejedor P, Tekin A, Tekkis PP, Teras J, Thanapal MR, Thaysen HV, Thorgersen E, Thurairaja R, Toh EL, Tsarkov P, Tolenaar J, Tsukada Y, Tsukamoto S, Tuech JJ, Turner G, Turner WH, Tuynman JB, Valente M, van Rees J, van Zoggel D, Vásquez-Jiménez W, Verhoef C, Vierimaa M, Vizzielli G, Voogt ELK, Uehara K, Wakeman C, Warrier S, Wasmuth HH, Weber K, Weiser MR, Westney OL, Wheeler JMD, Wild J, Wilson M, Wolthuis A, Yano H, Yip B, Yip J, Yoo RN, Zappa MA, Winter DC. Empty pelvis syndrome: PelvEx Collaborative guideline proposal. Br J Surg 2023; 110:1730-1731. [PMID: 37757457 PMCID: PMC10805575 DOI: 10.1093/bjs/znad301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/22/2023] [Accepted: 08/28/2023] [Indexed: 09/29/2023]
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Santos MR, Mendonça MI, Temtem M, Sá D, Sousa AC, Freitas S, Rodrigues M, Borges S, Guerra G, Ornelas I, Drumond A, Palma Dos Reis R. Transcription factor 21 gene and prognosis in a coronary population. Rev Port Cardiol 2023; 42:907-913. [PMID: 37391023 DOI: 10.1016/j.repc.2023.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 02/14/2023] [Accepted: 02/27/2023] [Indexed: 07/02/2023] Open
Abstract
INTRODUCTION AND OBJECTIVES Transcription factor 21 (TCF21) is a member of the basic helix-loop-helix (bHLH) transcription factor family, and is critical for embryogenesis of the heart. It regulates differentiation of epicardium-derived cells into smooth muscle cell (SMC) and fibroblast lineages. The biological role of TCF21 in the progression of atherosclerosis is the subject of debate. The aim of this study was to investigate the impact of the TCF21 rs12190287 gene variant on the prognosis of coronary artery disease (CAD) in a Portuguese population from Madeira island. METHODS We analyzed major adverse cardiovascular events (MACE) in 1713 CAD patients, mean age 53.3±7.8, 78.7% male, for 5.0±4.3 years. Genotype and allele distribution between groups with and without MACE was determined. The dominant genetic model (heterozygous GC plus homozygous CC) was used and compared with the wild GG to assess survival probability. Cox regression with risk factors and genetic models assessed variables associated with MACE. Kaplan-Meier analysis was used to estimate survival. RESULTS The wild homozygous GG, heterozygous GC and risk CC genotypes were found in 9.5%, 43.2% and 47.3% of the population, respectively. The dominant genetic model remained in the equation as an independent risk factor for MACE (HR 1.41; p=0.033), together with multivessel disease, chronic kidney disease, low physical activity and type 2 diabetes. The C allele in the dominant genetic model showed worse survival (22.5% vs. 44.3%) at 15 years of follow-up. CONCLUSION The TCF21 rs12190287 variant is a risk factor for CAD events. This gene may influence fundamental SMC processes in response to vascular stress, accelerating atherosclerosis progression, and may represent a target for future therapies.
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Affiliation(s)
- Marina Raquel Santos
- Centro de Investigação Dra. Maria Isabel Mendonça, Hospital Dr. Nélio Mendonça, SESARAM EPERAM, Funchal, Portugal.
| | - Maria Isabel Mendonça
- Centro de Investigação Dra. Maria Isabel Mendonça, Hospital Dr. Nélio Mendonça, SESARAM EPERAM, Funchal, Portugal
| | - Margarida Temtem
- Centro de Investigação Dra. Maria Isabel Mendonça, Hospital Dr. Nélio Mendonça, SESARAM EPERAM, Funchal, Portugal
| | - Débora Sá
- Centro de Investigação Dra. Maria Isabel Mendonça, Hospital Dr. Nélio Mendonça, SESARAM EPERAM, Funchal, Portugal
| | - Ana Célia Sousa
- Centro de Investigação Dra. Maria Isabel Mendonça, Hospital Dr. Nélio Mendonça, SESARAM EPERAM, Funchal, Portugal
| | - Sónia Freitas
- Centro de Investigação Dra. Maria Isabel Mendonça, Hospital Dr. Nélio Mendonça, SESARAM EPERAM, Funchal, Portugal
| | - Mariana Rodrigues
- Centro de Investigação Dra. Maria Isabel Mendonça, Hospital Dr. Nélio Mendonça, SESARAM EPERAM, Funchal, Portugal
| | - Sofia Borges
- Centro de Investigação Dra. Maria Isabel Mendonça, Hospital Dr. Nélio Mendonça, SESARAM EPERAM, Funchal, Portugal
| | - Graça Guerra
- Centro de Investigação Dra. Maria Isabel Mendonça, Hospital Dr. Nélio Mendonça, SESARAM EPERAM, Funchal, Portugal
| | - Ilídio Ornelas
- Centro de Investigação Dra. Maria Isabel Mendonça, Hospital Dr. Nélio Mendonça, SESARAM EPERAM, Funchal, Portugal
| | - António Drumond
- Serviço de Cardiologia, Hospital Dr. Nélio Mendonça, SESARAM EPERAM, Funchal, Portugal
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De Blasiis P, Caravaggi P, Fullin A, Leardini A, Lucariello A, Perna A, Guerra G, De Luca A. Postural stability and plantar pressure parameters in healthy subjects: variability, correlation analysis and differences under open and closed eye conditions. Front Bioeng Biotechnol 2023; 11:1198120. [PMID: 37545891 PMCID: PMC10399229 DOI: 10.3389/fbioe.2023.1198120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 07/03/2023] [Indexed: 08/08/2023] Open
Abstract
Introduction: The "postural control system" acts through biomechanical strategies and functional neuromuscular adaptations to maintain body balance under static and dynamic conditions. Postural stability and body weight distribution can be affected by external sensory inputs, such as different visual stimuli. Little information is available about the influence of visual receptors on stabilometric and plantar pressure parameters. The aim of this study was to analyze variability, correlations, and changes in these parameters under open- (OE) and closed-eye (CE) conditions. Methods: A total of 31 stabilometric and plantar pressure parameters were acquired in 20 young and healthy adults during baropodometric examination performed in bipedal standing under both visual conditions. Variability of parameters was evaluated via the coefficient of variation, correlation analysis via Pearson's R2, and statistical differences via the Wilcoxon test. Results: High intra-subject repeatability was found for all plantar pressure parameters and CoP-speed (CV < 40%) under OE and CE conditions, while CoP-sway area (CoPsa) and length surface function (LSF) showed larger variability (CV > 50%). Mean and peak pressures at midfoot and total foot loads showed the least number of significant correlations with other parameters under both visual conditions, whereas the arch-index and rearfoot loads showed the largest number of significant correlations. The limb side significantly affected most plantar pressure parameters. A trend of larger LSF and lower CoPsa and mean and peak pressures at the right forefoot was found under the CE condition. Discussion: The present study provides a deeper insight into the associations between postural stability and foot load. Interesting postural adaptations, particularly with respect to different visual stimuli, the effect of the dominant side, and the specific role of the midfoot in balance control were highlighted.
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Affiliation(s)
- P. De Blasiis
- Department of Mental and Physical Health and Preventive Medicine, Section of Human Anatomy, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - P. Caravaggi
- Movement Analysis Laboratory, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - A. Fullin
- Department of Mental and Physical Health and Preventive Medicine, Section of Human Anatomy, University of Campania “Luigi Vanvitelli”, Naples, Italy
- Department of Advanced Biomedical Sciences, University of Naples “Federico II”, Naples, Italy
| | - A. Leardini
- Movement Analysis Laboratory, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - A. Lucariello
- Department of Sport Sciences and Wellness, University of Naples “Parthenope”, Naples, Italy
| | - A. Perna
- Department of Medicine and Health Sciences “Vincenzo Tiberio”, University of Molise, Campobasso, Italy
| | - G. Guerra
- Department of Medicine and Health Sciences “Vincenzo Tiberio”, University of Molise, Campobasso, Italy
| | - A. De Luca
- Department of Mental and Physical Health and Preventive Medicine, Section of Human Anatomy, University of Campania “Luigi Vanvitelli”, Naples, Italy
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Pradegan N, Evangelista G, Tessari C, Guerra G, Ciccarelli G, Gallo M, Toscano G, Feltrin G, Tarzia V, Gerosa G. Uncontrolled Cardiac Arrest of Donor Heart Before Donation Does Not Affect Heart Transplant Recipient Outcomes: Proof of Concept for DCD Long-Term Outcomes. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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8
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Pradegan N, Evangelista G, Tessari C, Fabozzo A, Guerra G, Ciccarelli G, Gallo M, Toscano G, Angelini A, Gerosa G. A Very 37-Year Heart Transplantation Single-Center Experience: The Impact of Donor-Recipient Age Mismatch on Long-Term Outcomes. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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9
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Sá D, Mendonça MI, Santos M, Temtem M, Sousa AC, Rodrigues M, Henriques E, Freitas S, Borges S, Guerra G, Freitas AI, Ornelas I, Drumond A, Palma Dos Reis R. Poster No. 054 Genetic variation in the TCF21 gene is associated with the severity of coronary artery disease. Cardiovasc Res 2022. [DOI: 10.1093/cvr/cvac157.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
In vitro studies demonstrated that targeted deletion of the transcription factor encoding gene TCF21, was associated with vascular smooth muscle cell disruption. Recent research showed that TCF21 expression contribute to fibrous cap formation, preventing heart attacks.
Purpose
Analyse the TCF21 rs12190287 gene and evaluate its association with atherosclerosis severity measured according to the coronary angiogram patients´ data. Methods: Prospective study with 1,639 coronary artery disease (CAD) patients (mean age 53.4 ± 7.8 years). Two age groups (< 55 and > 55 years) were stratified and analyzed. TCF21 rs12190287 G > C was genotyped in all patients. The severity of CAD was graded according to the number of obstructed coronary arteries with at least 70% narrowed lumen. Chi-squared tests and multivariate logistic regression models were analysed.
Results
The CC genotype was associated with > 70% obstructive lesions (vascular disease rate, 48.1%). Contrariwise, the GG wild genotype was associated with less severe obstructive disease (19.5%) (P = 0.003). When we stratified the TCF21 genotypes per age group (55 years), the CC genotype in the younger group had more obstructed disease (47.4%) when compared with GG (18.8%) (P = 0.012), but this effect was not significant in the older group. Multivariate analysis (logistic regression) showed that the CC genotype had a high risk of multivessel coronary disease (OR = 2.88; P = 0.001) than GG.
Conclusion
This work shows that the TCF21 wild genotype protects against CAD severity. In contrast, the CC genotype is associated with an increased risk of CAD severity.
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Sa D, Mendonca MI, Temtem M, Santos M, Serrao M, Sousa AC, Borges S, Freitas S, Rodrigues M, Henriques E, Guerra G, Ornelas I, Drumond A, Palma Dos Reis R. Genetic information or coronary artery calcium score? What is more helpful in today's clinical practice? Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Introduction
Coronary artery calcium (CAC) score has emerged as the most predictive cardiovascular risk marker in asymptomatic individuals, capable of adding prognostic information beyond the traditional risk factors (TRF). Genetic risk score (GRS) significantly improves cardiovascular genetic risk assessment at the individual level providing a more personalized measure of disease risk.
Purpose
We intend to evaluate which tool, added to TRF, is more valuable in predicting and discriminating cardiovascular events and death (MACE) - GRS or CAC score?
Methods
We performed a prospective study with 1153 participants without CAD history at baseline (74.2% male, age 51.7±8.3 years) during a mean follow-up of 5.4±3.4 years. We selected 14 SNPs previously associated with CAD presenting a risk (HR) for cardiovascular events ≥1. A weighted GRS was calculated, as the sum of these 14 risk alleles weighted by the corresponding effect size in prognostic (HR), and subsequently, subdivided into tertiles. CAC (Agatson) score was calculated in all participants and categorized into: low CAC (0≤CAC<100 or P<50); moderate CAC (100≤CAC<400 or P50–75) and high or severe CAC (CAC≥400 or P>75). Two models were created with TRF baseline (hypertension, smoking, body mass index, dyslipidemia, diabetes, chronic kidney disease, physical inactivity): 1) plus wGRS and 2) plus CAC score categories. Cox Regression Analyses and C-statistic assessed the predictive and discriminative capacity of both models.
Results
For model 1, Cox regression presented an HR of 4.292 for TRF (p=0.007) and 2.713 for 3rd tertile of wGRS (0.036). A modest but statistically significant improvement in MACE discriminative capacity was verified by adding wGRS to TRF, increasing the C-statistic from 0.617 to 0.687 (ΔC=0.070; p=0.013). On the other hand, model 2 better discriminated MACE when the CAC score (C-statistic = 0.765) was added to TRF (ΔC=0.148; p=0.001). Cox regression displayed an HR of 4.42 for TRF (p=0.015) and an HR of 4.55 for high-risk CAC score (p=0.001).
Conclusion
Our results suggest that adding a polygenic risk score to conventional risk factors provides a modest improvement in the discrimination of first-onset MACE. However, the CAC score added to the traditional model allows better discrimination of MACE compared to wGRS. CAC score could be helpful for MACE prediction, at least in individuals belonging to the higher genetic risk group. However, further investigation is required before clinical implementation.
Funding Acknowledgement
Type of funding sources: Public hospital(s). Main funding source(s): SESARAM EPERAM
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Affiliation(s)
- D Sa
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - M I Mendonca
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - M Temtem
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - M Santos
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - M Serrao
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - A C Sousa
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - S Borges
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - S Freitas
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - M Rodrigues
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - E Henriques
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - G Guerra
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - I Ornelas
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - A Drumond
- Hospital Funchal , Funchal , Portugal
| | - R Palma Dos Reis
- New University of Lisbon, Faculty of Medical Sciences , Lisbon , Portugal
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11
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Temtem M, Palma Dos Reis R, Serrao M, Sa D, Santos M, Soares C, Sousa AC, Rodrigues M, Freitas S, Henriques E, Borges S, Guerra G, Ornelas I, Drumond A, Mendonca MI. Prognostic role of adding a genetic risk score to the new European SCORE2 in a cardiovascular events prediction, in a moderate-risk region. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
The new SCORE2 provides risk estimates for the combined outcome of fatal and non-fatal cardiovascular disease (CVD) events, in contrast with SCORE's use for CVD mortality only. Genetic predisposition to CVD is not considered in SCORE2 for prevention and treatment.
Purpose
Evaluate the impact of adding a Genetic Risk Score (GRS) to the new European SCORE2 in MACE prediction and estimate the additional value in cardiovascular risk stratification in an asymptomatic Portuguese population.
Methods
A prospective study was performed in a population-based cohort of 1,100 individuals without known CVD and diabetes (mean age 53.3±6.9 years). For all included participants, SCORE2 was calculated and three risk categories were considered: low-, moderate- and high-risk. A 33-SNP GRS was constructed and two groups were analyzed: lower and higher than the GRS median. Kaplan-Meier survival curves were created and a Cox regression model was performed with the two scores to assess MACE risk. C-statistic methodology compared the model between SCORE2 solely and SCORE2 plus GRS.
Results
After Kaplan-Meier analysis for MACE occurrence, the high categories of SCORE 2 and GRS showed worst survival when compared to the lower categories (p<0.0001). Cox regression presented an HR of 8.528 (p=0.001) for high-risk SCORE2 and an HR of 4.520 (p<0.0001) for GRS higher than the median. C-statistic demonstrated that the SCORE2 predictive value was 0.678, increasing to 0.792 when GRS was included (p=0.0005).
Conclusions
In this work, combining SCORE2 with multiple genetic loci gathered into a GRS, improved the identification of patients with the worst prognosis. This new tool may be of great utility in risk stratification in primary prevention. Larger prospective multicenter cohorts with longer follow-up should reproduce and validate these findings.
Funding Acknowledgement
Type of funding sources: Public hospital(s). Main funding source(s): SESARAM EPERAM
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Affiliation(s)
- M Temtem
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - R Palma Dos Reis
- New University of Lisbon, Faculty of Medical Sciences , Lisbon , Portugal
| | - M Serrao
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - D Sa
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - M Santos
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - C Soares
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - A C Sousa
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - M Rodrigues
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - S Freitas
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - E Henriques
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - S Borges
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - G Guerra
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - I Ornelas
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - A Drumond
- Hospital Funchal , Funchal , Portugal
| | - M I Mendonca
- Funchal Hospital, Research Unit , Funchal , Portugal
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12
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Santos M, Mendonca MI, Temtem M, Sa D, Sousa AC, Freitas S, Rodrigues M, Henriques E, Borges S, Guerra G, Freitas AI, Ornelas I, Drumond A, Palma Dos Reis R. Transcription factor 21 and prognosis in a coronary population. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
TCF21 is a member of the basic helix-loop-helix (bHLH) transcriptor factor family, being critical for embryogenesis of the heart. It regulates epicardium-derived cells differentiation into smooth muscle (SMC) and fibroblast lineages. The biological roles of TCF21 in epicardial fate determination and the progression of atherosclerosis remains a controversial issue.
Purpose
Investigate the impact of the TCF21 rs12190287 G>C variant on the prognosis of a coronary artery disease (CAD) cohort.
Methods
A prospective study was performed with 1,713 CAD patients (mean age 53.3±7.8; 78.7% male) surveyed in terms of MACE occurrence in an extended follow-up of 5.0±4.3. TCF21 rs12190287 was genotyped and analysed using the dominant model (GC+CC) and, subsequently, compared with the wild-type GG to evaluate the survival probability by Kaplan-Meier. A Cox regression analysis with all the risk factors and genetic models was performed to assess the independent variables associated with the prognosis of CAD patients.
Results
GG wild genotype was present in 9.5% of the population, GC in 43.2% and the risk genotype CC accounted for 47.3% of the CAD patients. The dominant model GC+CC showed a worse survival throughout the follow-up period. After multivariate Cox regression analysis, this model remained in the equation as an independent risk factor for MACE occurrence with an HR of 1.41 (p=0.033) together with multivessel disease, physical inactivity, chronic kidney disease (CKD) and diabetes.
Conclusion
TCF21 rs12190287 is a risk factor for prognosis in our population. The role of this gene may influence fundamental SMC processes in response to vascular stress, accelerating atherosclerosis progression and may represent a target for future therapies.
Funding Acknowledgement
Type of funding sources: Public hospital(s). Main funding source(s): SESARAM EPERAM
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Affiliation(s)
- M Santos
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - M I Mendonca
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - M Temtem
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - D Sa
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - A C Sousa
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - S Freitas
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - M Rodrigues
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - E Henriques
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - S Borges
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - G Guerra
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - A I Freitas
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - I Ornelas
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - A Drumond
- Hospital Funchal , Funchal , Portugal
| | - R Palma Dos Reis
- New University of Lisbon, Faculty of Medical Sciences , Lisbon , Portugal
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Santos M, Mendonca MI, Sa D, Temtem M, Sousa AC, Henriques E, Rodrigues M, Freitas S, Borges S, Guerra G, Freitas AI, Ornelas I, Drumond A, Palma Dos Reis R. ZNF259 rs964184 variant is associated with dyslipidemia and coronary artery disease in the young population. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Coronary artery disease (CAD) is a dynamic inflammatory disease caused by atherosclerosis. GWAS showed that ZNF259 rs964184 encoding zinc finger protein (ZPR1) was associated with dyslipidemia and CAD. Recent research found that ZPR1 transcription is up-regulated in the brain of mice fed a high-fat diet, influencing the cell cycle, apoptosis, and RNA metabolism in neurons. This process at the heart vessels may increase oxidative stress and CAD.
Purpose
Study the association between the ZNF259 rs964184 C>G polymorphism with dyslipidemia and CAD susceptibility in a Portuguese population.
Methods
A case-control study was performed with 3,160 individuals, namely 1,723 CAD patients (mean age 53.3±7.9; 78.7% male) and 1,437 controls (mean age 52.8±7.8; 76.3% male). Participants were stratified into two age groups (<45 and >55 years). ZNF259 rs964184 C>G was genotyped and analysed using the dominant model (CG+GG vs CC). Multivariate logistic regression was performed in both age groups to investigate whether rs964184 polymorphism was associated with dyslipidemia and CAD susceptibility.
Results
The dominant model of ZNF259 was associated with dyslipidemia (OR=1.85; 95% CI: 1.22–2.79; p=0.003) and CAD (OR=1.46; 95% CI: 1.02–2.09; p=0.036) in the younger population under 45 years. In the >55 years group, this model was associated with dyslipidemia (OR 1.46; 95% CI: 1.06–2.01; p=0.020) but not with CAD. After multivariate logistic regression, the CG+GG remained an independent risk factor for CAD susceptibility only in the population <45 years (OR=1.60; 95% CI: 1.03–2.50; p=0.037).
Conclusion
ZNF259 rs964184 is a risk factor for dyslipidemia in the whole population. Dyslipidemia may up-regulate ZPR1 transcription, enhancing the vulnerability of coronary endothelial cells to both oxidative stress and inflammatory response, increasing CAD susceptibility. This mechanism seems more relevant at the cellular level in young patients representing a possible prophylactic and therapeutic target, especially in this age group.
Funding Acknowledgement
Type of funding sources: Public hospital(s). Main funding source(s): SESARAM EPERAM
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Affiliation(s)
- M Santos
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - M I Mendonca
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - D Sa
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - M Temtem
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - A C Sousa
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - E Henriques
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - M Rodrigues
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - S Freitas
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - S Borges
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - G Guerra
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - A I Freitas
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - I Ornelas
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - A Drumond
- Hospital Funchal , Funchal , Portugal
| | - R Palma Dos Reis
- New University of Lisbon, Faculty of Medical Sciences , Lisbon , Portugal
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Santos M, Mendonca MI, Sa D, Temtem M, Sousa AC, Freitas S, Rodrigues M, Henriques E, Borges S, Freitas AI, Guerra G, Ornelas I, Drumond A, Palma Dos Reis R. A Genetic Risk Score englobing variants associated with coronary artery disease is a good marker for prognosis in an asymptomatic population. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Genome-wide association studies have identified several loci linked to coronary artery disease, and coronary atherosclerosis progression. However, the impact of the genetic contribution to MACE occurrence in sub-clinical atherosclerosis is unknown.
Purpose
This study intended to assess the relationship between a set of single nucleotide popymorphism (SNP) associated with CAD by GWAS and the MACE occurrence in an asymptomatic population. After that evaluate whether a wGRS englobing these variants is useful to estimate the prognostic.
Methods
Prospective study performed in an asymptomatic cohort from GENEMACOR population-based sample of 1114 subjects aged 51.7±8.3, 74.2 male, without prior coronary artery disease. Coronary Artery Calcium (CAC) score was assessed by coronary computed tomography (Agatston method), and two categories were considered 1–99 and >100. 33 SNP were evaluate to assess the significantly associated with prognostic. A weighted (wGRS) was constructed as the sum of the risk alleles weighted by the corresponding effect size (HR). Cox regression analysis adjusted for the main risk factors, calcium score (CAC) and wGRS to assess the risk of MACE during follow-up. Kaplan Meier assessed the survival.
Results
Of the studied 33 SNPs previously associated with CAD (GWAS), only 4 presented the significant association with MACE occurrence: CDKN2B-AS1 rs4977574, HNF4A rs1884613,
APOE rs7412/rs429358A and GJA4A rs 618675. After Cox regression analysis the wGRS remained in the equation (HR=2.834); p=0.012, together with CAC score (HR 3.35); p=0.012; diabetes (HR=2.398); p=0.032 and age (HR=1.056; p=0.049. WGRS above the median presented a worst survival rate (p=0.006).
Conclusion
The wGRS englobing: CDKN2B-AS1 rs4977574, HNF4A rs1884613, APOE rs7412/rs429358A and GJA4A rs 618675 is independently associated with cardiovascular events in an asymptomatic population. CDKN2B-AS1 rs4977574 gene expression modulates the progression and severity of vascular calcification in vascular smooth muscle cells (VSMCs), HNF1α-AS1 is an important regulatory molecule in cancer biology and cardiovascular disease (its expression may regulate VSMCs, and high expression promotes atheroprotection). More research is crucial for understand prognosis in asymptomatic population.
Funding Acknowledgement
Type of funding sources: Public hospital(s). Main funding source(s): SESARAM EPE
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Affiliation(s)
- M Santos
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - M I Mendonca
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - D Sa
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - M Temtem
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - A C Sousa
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - S Freitas
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - M Rodrigues
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - E Henriques
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - S Borges
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - A I Freitas
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - G Guerra
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - I Ornelas
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - A Drumond
- Hospital Funchal , Funchal , Portugal
| | - R Palma Dos Reis
- New University of Lisbon, Faculty of Medical Sciences , Lisbon , Portugal
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Rodriguez Almaraz J, Guerra G, Wendt G, Chang S, Francis SS. P10.09.B Retroelement expression in glioma tumors exhibits subtype specific patterns. Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac174.174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
There are ~3 million transposable elements in the human genome constituting about 42% of all basepairs. Retroelements (REs) are ~90% of the transposable elements present in the human genome. Active REs are considered highly mutagenic and have been implicated in multiple steps of cancer development and progression, as well as in neurologic diseases. RE activity has functional effects on the genome, including the maintenance of centromere and telomere integrity, and deleterious gene expression. Previous studies have shown that certain families of RE (HERVK, L1, Alu) are expressed in gliomas, however, their specific role as arbitrators of oncogenesis or promoters of the innate anti-tumor immune response remains uncertain. Moreover, it has been shown that a soluble form of PD-L1 (sPD-L1) that blocks its inhibitory activity is produced by exaptation of an intronic endogenous retroelement (LINE-2A) in the gene encoding PD-L1, highlighting the importance of REs as potential therapeutic targets. In this analysis we aim to identify the unique patterns of RE expression across major subtypes of glioma.
Material and Methods
We conducted a differential expression analysis of 49 RE families using RNA-seq data measured in glioma tumors from The Cancer Genome Atlas (TCGA). RE counts were produced using the software REDiscoverTE. Pairwise comparisons between glioma subtypes (defined by WHO2021) were done using in 625 tumor samples adjusting for age, sex and race.
Results
10 of the 49 considered RE families exhibited significantly different (false discovery rate, FDR, <0.05) expression in at least one glioma subtype. Alu(Fold change, FC=1.5), RNA(FC=11.3), PiggyBac(FC=1.6), rRNA(FC=5.23) and Dong-R4(FC=1.8) were overexpressed in IDH-wildtype glioblastoma while Gypsy(FC=0.4) and CRP1(FC=0.26) were decreased in expression. scRNA (FC=2.7) were overexpressed in IDH-mutant oligodendroglioma compared to glioblastoma while Dong-R4 (FC = 0.53) showed decreased expression. LTR (FC=2.02) and tRNA-Deu (FC=1.46), showed increased expression in IDH-wildtype diffuse astrocytomas compared to IDH-mutant, 1p/19q-codeleted oligodendrogliomas while Gypsy (FC =0.41) showed decreased expression.
Conclusion
We have shown that expression of certain RE families within gliomas have subtype-specific patterns. While it is well established that RE expression is dysregulated in cancer, our analysis is the first at exploring a wide range of retroelements in the context of glioma by subtype. Given the important role of REs in transcriptional control, genomic instability, chromosomal rearrangements, and oncogenic activation, the identification of individual families and specific REs in glioma holds an intrinsic value to potential biomarkers and immunotherapy targets.
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Affiliation(s)
| | - G Guerra
- University of California, San Francisco , San Francisco, CA , United States
| | - G Wendt
- University of California, San Francisco , San Francisco, CA , United States
| | - S Chang
- University of California, San Francisco , San Francisco, CA , United States
| | - S S Francis
- University of California, San Francisco , San Francisco, CA , United States
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Knight O, Guerra G, Mashreghi MF, Kallinich T, Rückert T, Romagnani C. POS0167 A PROTEOGENOMIC MAP OF NATURAL KILLER CELLS IN OLIGOARTICULAR JUVENILE IDIOPATHIC ARTHRITIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundNatural Killer (NK) cells are innate lymphocytes which are specialised for recognising stressed cells, classically divided into cytotoxic (CD56dim) and cytokine-producing (CD56bright) populations. During oligoarticular Juvenile Idiopathic Arthritis (oligo-JIA), an unknown trigger induces the recruitment of peripheral immune cells into synovial joints, which in turn creates a chronic inflammatory environment. This can result in joint contractures and extraarticular complications, highlighting the requirement for early disease intervention. The contribution of NK cells toward immunopathology during the early stages of disease and in subsequent arthritic flares is unknown, providing a potential avenue for understanding disease course and therapeutic intervention.ObjectivesWe aimed to assess the contribution of NK cells to the early pathogenesis of oligo-JIA by identifying inflammatory signatures present in patient synovia, and which signals could induce them.MethodsPeripheral blood (PB) and synovial fluid (SF) were drawn from 4 patients at the first clinical presentation of oligo-JIA. Flow-cytometry Activated Cell-Sorting (FACS) was used to unbiasedly isolate NK cells (CD3-CD7+), and single cell RNA-sequencing (scRNA-Seq) paired with oligonucleotide-tagged antibodies (CITE-Seq) performed, allowing us to generate a proteogenomic dataset of 35,609 NK cells. Antibody-derived-tags were used to delineate whether cells were isolated from PB or SF, and a community detection algorithm was used to cluster neighbours of cells for differential gene expression.ResultsWe identified 468 differentially expressed genes (>0.2 log2 fold change) between peripheral and synovial NK cells, among which were CD56bright- and CD56dim-specific genes, and a synovia-specific signature. Antibody-tag measurements confirmed the majority of synovial NK cells to be phenotypically CD56bright, with a spectrum of modified gene expression patterns compared of those in the periphery. 6 distinct synovial clusters were identified by community detection, among which were a large number of proliferating cells, a transitionary CD56bright population, and 2 uniquely activated signatures.ConclusionSynovial NK cells possess a significantly different transcriptomic identity compared with those in the periphery. However, though they share a gene signature that is most comparable to blood CD56bright NK cells, it is not identical. Uniquely activated subpopulations also provide the first evidence of NK cell activation during oligo-JIA pathogenesis, suggesting that these cells could hold therapeutic potential.AcknowledgementsStefanie Bartsch, Kathleen Necke, Carl-Christoph Goetzke, Anne Sae Lim von Stuckrad and all other members of the TargArt ConsortiumDisclosure of InterestsNone declared
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Moioli V, Seghezzi M, Previtali G, Dominoni P, Guerra G, Buoro S. T236 Alterations of the complete blood count in natalizumab-treated patients with multiple sclerosis. Clin Chim Acta 2022. [DOI: 10.1016/j.cca.2022.04.724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Seghezzi M, Previtali G, Moioli V, Marozzi R, Ravasio R, Guerra G, Alessio M. W037 Is it time to abandon timed collection urine for random urine samples? Clin Chim Acta 2022. [DOI: 10.1016/j.cca.2022.04.168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Previtali G, Seghezzi M, Moioli V, Cimpoies E, Ravasio R, Guerra G, Alessio M. T207 Anti transglutaminase antibodies could predict the development of celiac disease 5 years before the diagnosis. Clin Chim Acta 2022. [DOI: 10.1016/j.cca.2022.04.691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Sidoli C, Zambon A, Tassistro E, Rossi E, Mossello E, Inzitari M, Cherubini A, Marengoni A, Morandi A, Bellelli G, Tarasconi A, Sella M, Paternò G, Faggian G, Lucarelli C, De Grazia N, Alberto C, Porcella L, Nardiello I, Chimenti E, Zeni M, Romairone E, Minaglia C, Ceccotti C, Guerra G, Mantovani G, Monacelli F, Minaglia C, Candiani T, Santolini F, Minaglia C, Rosso M, Bono V, Sibilla S, Dal Santo P, Ceci M, Barone P, Schirinzi T, Formenti A, Nastasi G, Isaia G, Gonella D, Battuello A, Casson S, Calvani D, Boni F, Ciaccio A, Rosa R, Sanna G, Manfredini S, Cortese L, Rizzo M, Prestano R, Greco A, Lauriola M, Gelosa G, Piras V, Arena M, Cosenza D, Bellomo A, LaMontagna M, Gabbani L, Lambertucci L, Perego S, Parati G, Basile G, Gallina V, Pilone G, Giudice C, Pietrogrande L, Mosca M, Corazzin I, Rossi P, Nunziata V, D’Amico F, Grippa A, Giardini S, Barucci R, Cossu A, Fiorin L, Arena M, Distefano M, Lunardelli M, Brunori M, Ruffini I, Abraham E, Varutti A, Fabbro E, Catalano A, Martino G, Leotta D, Marchet A, Dell’Aquila G, Scrimieri A, Davoli M, Casella M, Cartei A, Polidori G, Basile G, Brischetto D, Motta S, Saponara R, Perrone P, Russo G, Del D, Car C, Pirina T, Franzoni S, Cotroneo A, Ghiggia F, Volpi G, Menichetti C, Bo M, Panico A, Calogero P, Corvalli G, Mauri M, Lupia E, Manfredini R, Fabbian F, March A, Pedrotti M, Veronesi M, Strocchi E, Borghi C, Bianchetti A, Crucitti A, DiFrancesco V, Fontana G, Geriatria A, Bonanni L, Barbone F, Serrati C, Ballardini G, Simoncelli M, Ceschia G, Scarpa C, Brugiolo R, Fusco S, Ciarambino T, Biagini C, Tonon E, Porta M, Venuti D, DelSette M, Poeta M, Barbagallo G, Trovato G, Delitala A, Arosio P, Reggiani F, Zuliani G, Ortolani B, Mussio E, Girardi A, Coin A, Ruotolo G, Castagna A, Masina M, Cimino R, Pinciaroli A, Tripodi G, Cassadonte F, Vatrano M, Scaglione L, Fogliacco P, Muzzuilini C, Romano F, Padovani A, Rozzini L, Cagnin A, Fragiacomo F, Desideri G, Liberatore E, Bruni A, Orsitto G, Franco M, Bonfrate L, Bonetto M, Pizio N, Magnani G, Cecchetti G, Longo A, Bubba V, Marinan L, Cotelli M, Turla M, Brunori M, Sessa M, Abruzzi L, Castoldi G, LoVetere D, Musacchio C, Novello M, Cavarape A, Bini A, Leonardi A, Seneci F, Grimaldi W, Seneci F, Fimognari F, Bambar V, Saitta A, Corica F, Braga M, Servi, Ettorre E, Camellini Bellelli CG, Annoni G, Marengoni A, Bruni A, Crescenzo A, Noro G, Turco R, Ponzetto M, Giuseppe L, Mazzei B, Maiuri G, Costaggiu D, Damato R, Fabbro E, Formilan M, Patrizia G, Santuar L, Gallucci M, Minaglia C, Paragona M, Bini P, Modica D, Abati C, Clerici M, Barbera I, NigroImperiale F, Manni A, Votino C, Castiglioni C, Di M, Degl’Innocenti M, Moscatelli G, Guerini S, Casini C, Dini D, DeNotariis S, Bonometti F, Paolillo C, Riccardi A, Tiozzo A, SamySalamaFahmy A, Riccardi A, Paolillo C, DiBari M, Vanni S, Scarpa A, Zara D, Ranieri P, Alessandro M, Calogero P, Corvalli G, Di F, Pezzoni D, Platto C, D’Ambrosio V, Ivaldi C, Milia P, DeSalvo F, Solaro C, Strazzacappa M, Bo M, Panico A, Cazzadori M, Bonetto M, Grasso M, Troisi E, Magnani G, Cecchetti G, Guerini V, Bernardini B, Corsini C, Boffelli S, Filippi A, Delpin K, Faraci B, Bertoletti E, Vannucci M, Crippa P, Malighetti A, Caltagirone C, DiSant S, Bettini D, Maltese F, Formilan M, Abruzzese G, Minaglia C, Cosimo D, Azzini M, Cazzadori M, Colombo M, Procino G, Fascendini S, Barocco F, Del P, D’Amico F, Grippa A, Mazzone A, Cottino M, Vezzadini G, Avanzi S, Brambilla C, Orini S, Sgrilli F, Mello A, Lombardi Muti LE, Dijk B, Fenu S, Pes C, Gareri P, Castagna A, Passamonte M, Rigo R, Locusta L, Caser L, Rosso G, Cesarini S, Cozzi R, Santini C, Carbone P, Cazzaniga I, Lovati R, Cantoni A, Ranzani P, Barra D, Pompilio G, Dimori S, Cernesi S, Riccò C, Piazzolla F, Capittini E, Rota C, Gottardi F, Merla L, Barelli A, Millul A, De G, Morrone G, Bigolari M, Minaglia C, Macchi M, Zambon F, D’Amico F, D’Amico F, Pizzorni C, DiCasaleto G, Menculini G, Marcacci M, Catanese G, Sprini D, DiCasalet T, Bocci M, Borga S, Caironi P, Cat C, Cingolani E, Avalli L, Greco G, Citerio G, Gandini L, Cornara G, Lerda R, Brazzi L, Simeone F, Caciorgna M, Alampi D, Francesconi S, Beck E, Antonini B, Vettoretto K, Meggiolaro M, Garofalo E, Bruni A, Notaro S, Varutti R, Bassi F, Mistraletti G, Marino A, Rona R, Rondelli E, Riva I, Cortegiani A, Pistidda L, D’Andrea R, Querci L, Gnesin P, Todeschini M, Lugano M, Castelli G, Ortolani M, Cotoia A, Maggiore S, DiTizio L, Graziani R, Testa I, Ferretti E, Castioni C, Lombardi F, Caserta R, Pasqua M, Simoncini S, Baccarini F, Rispoli M, Grossi F, Cancelliere L, Carnelli M, Puccini F, Biancofiore G, Siniscalchi A, Laici C, Mossello E, Torrini M, Pasetti G, Palmese S, Oggioni R, Mangani V, Pini S, Martelli M, Rigo E, Zuccalà F, Cherri A, Spina R, Calamai I, Petrucci N, Caicedo A, Ferri F, Gritti P, Brienza N, Fonnesu R, Dessena M, Fullin G, Saggioro D. Prevalence and features of delirium in older patients admitted to rehabilitation facilities: a multicenter study. Aging Clin Exp Res 2022; 34:1827-1835. [PMID: 35396698 DOI: 10.1007/s40520-022-02099-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 02/16/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND Delirium is thought to be common across various settings of care; however, still little research has been conducted in rehabilitation. AIM We investigated the prevalence of delirium, its features and motor subtypes in older patients admitted to rehabilitation facilities during the three editions of the "Delirium Day project". METHODS We conducted a cross-sectional study in which 1237 older patients (age ≥ 65 years old) admitted to 50 Italian rehabilitation wards during the three editions of the "Delirium Day project" (2015 to 2017) were included. Delirium was evaluated through the 4AT and its motor subtype with the Delirium Motor Subtype Scale. RESULTS Delirium was detected in 226 patients (18%), and the most recurrent motor subtype was mixed (37%), followed by hypoactive (26%), hyperactive (21%) and non-motor one (16%). In a multivariate Poisson regression model with robust variance, factors associated with delirium were: disability in basic (PR 1.48, 95%CI: 1.17-1.9, p value 0.001) and instrumental activities of daily living (PR 1.58, 95%CI: 1.08-2.32, p value 0.018), dementia (PR 2.10, 95%CI: 1.62-2.73, p value < 0.0001), typical antipsychotics (PR 1.47, 95%CI: 1.10-1.95, p value 0.008), antidepressants other than selective serotonin reuptake inhibitors (PR 1.3, 95%CI: 1.02-1.66, p value 0.035), and physical restraints (PR 2.37, 95%CI: 1.68-3.36, p value < 0.0001). CONCLUSION This multicenter study reports that 2 out 10 patients admitted to rehabilitations had delirium on the index day. Mixed delirium was the most prevalent subtype. Delirium was associated with unmodifiable (dementia, disability) and modifiable (physical restraints, medications) factors. Identification of these factors should prompt specific interventions aimed to prevent or mitigate delirium.
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Zucchelli A, Manzoni F, Morandi A, Di Santo S, Rossi E, Valsecchi MG, Inzitari M, Cherubini A, Bo M, Mossello E, Marengoni A, Bellelli G, Tarasconi A, Sella M, Auriemma S, Paternò G, Faggian G, Lucarelli C, De Grazia N, Alberto C, Margola A, Porcella L, Nardiello I, Chimenti E, Zeni M, Giani A, Famularo S, Romairone E, Minaglia C, Ceccotti C, Guerra G, Mantovani G, Monacelli F, Minaglia C, Candiani T, Ballestrero A, Minaglia C, Santolini F, Minaglia C, Rosso M, Bono V, Sibilla S, Dal Santo P, Ceci M, Barone P, Schirinzi T, Formenti A, Nastasi G, Isaia G, Gonella D, Battuello A, Casson S, Calvani D, Boni F, Ciaccio A, Rosa R, Sanna G, Manfredini S, Cortese L, Rizzo M, Prestano R, Greco A, Lauriola M, Gelosa G, Piras V, Arena M, Cosenza D, Bellomo A, LaMontagna M, Gabbani L, Lambertucci L, Perego S, Parati G, Basile G, Gallina V, Pilone G, Giudice C, De F, Pietrogrande L, De B, Mosca M, Corazzin I, Rossi P, Nunziata V, D‘Amico F, Grippa A, Giardini S, Barucci R, Cossu A, Fiorin L, Arena M, Distefano M, Lunardelli M, Brunori M, Ruffini I, Abraham E, Varutti A, Fabbro E, Catalano A, Martino G, Leotta D, Marchet A, Dell‘Aquila G, Scrimieri A, Davoli M, Casella M, Cartei A, Polidori G, Basile G, Brischetto D, Motta S, Saponara R, Perrone P, Russo G, Del D, Car C, Pirina T, Franzoni S, Cotroneo A, Ghiggia F, Volpi G, Menichetti C, Bo M, Panico A, Calogero P, Corvalli G, Mauri M, Lupia E, Manfredini R, Fabbian F, March A, Pedrotti M, Veronesi M, Strocchi E, Bianchetti A, Crucitti A, Di Francesco V, Fontana G, Bonanni L, Barbone F, Serrati C, Ballardini G, Simoncelli M, Ceschia G, Scarpa C, Brugiolo R, Fusco S, Ciarambino T, Biagini C, Tonon E, Porta M, Venuti D, DelSette M, Poeta M, Barbagallo G, Trovato G, Delitala A, Arosio P, Reggiani F, Zuliani G, Ortolani B, Mussio E, Girardi A, Coin A, Ruotolo G, Castagna A, Masina M, Cimino R, Pinciaroli A, Tripodi G, Cannistrà U, Cassadonte F, Vatrano M, Cassandonte F, Scaglione L, Fogliacco P, Muzzuilini C, Romano F, Padovani A, Rozzini L, Cagnin A, Fragiacomo F, Desideri G, Liberatore E, Bruni A, Orsitto G, Franco M, Bonfrate L, Bonetto M, Pizio N, Magnani G, Cecchetti G, Longo A, Bubba V, Marinan L, Cotelli M, Turla M, Brunori M, Sessa M, Abruzzi L, Castoldi G, LoVetere D, Musacchio C, Novello M, Cavarape A, Bini A, Leonardi A, Seneci F, Grimaldi W, Fimognari F, Bambara V, Saitta A, Corica F, Braga M, Ettorre E, Camellini C, Marengoni A, Bruni A, Crescenzo A, Noro G, Turco R, Ponzetto M, Giuseppe L, Mazzei B, Maiuri G, Costaggiu D, Damato R, Fabbro E, Patrizia G, Santuari L, Gallucci M, Minaglia C, Paragona M, Bini P, Modica D, Abati C, Clerici M, Barbera I, NigroImperiale F, Manni A, Votino C, Castiglioni C, Di M, Degl‘Innocenti M, Moscatelli G, Guerini S, Casini C, Dini D, DeNotariis S, Bonometti F, Paolillo C, Riccardi A, Tiozzo A, SamySalamaFahmy A, Riccardi A, Paolillo C, DiBari M, Vanni S, Scarpa A, Zara D, Ranieri P, Calogero P, Corvalli G, Pezzoni D, Gentile S, Morandi A, Platto C, D‘Ambrosio V, Faraci B, Ivaldi C, Milia P, DeSalvo F, Solaro C, Strazzacappa M, Bo M, Panico A, Cazzadori M, Confente S, Bonetto M, Magnani G, Cecchetti G, Guerini V, Bernardini B, Corsini C, Boffelli S, Filippi A, Delpin K, Bertoletti E, Vannucci M, Tesi F, Crippa P, Malighetti A, Caltagirone C, DiSant S, Bettini D, Maltese F, Formilan M, Abruzzese G, Minaglia C, Cosimo D, Azzini M, Cazzadori M, Colombo M, Procino G, Fascendini S, Barocco F, Del P, D‘Amico F, Grippa A, Mazzone A, Riva E, Dell‘Acqua D, Cottino M, Vezzadini G, Avanzi S, Orini S, Sgrilli F, Mello A, Lombardi L, Muti E, Dijk B, Fenu S, Pes C, Gareri P, Castagna A, Passamonte M, De F, Rigo R, Locusta L, Caser L, Rosso G, Cesarini S, Cozzi R, Santini C, Carbone P, Cazzaniga I, Lovati R, Cantoni A, Ranzani P, Barra D, Pompilio G, Dimori S, Cernesi S, Riccò C, Piazzolla F, Capittini E, Rota C, Gottardi F, Merla L, Barelli A, Millul A, De G, Morrone G, Bigolari M, Minaglia C, Macchi M, Zambon F, D‘Amico F, D‘Amico F, Pizzorni C, DiCasaleto G, Menculini G, Marcacci M, Catanese G, Sprini D, DiCasalet T, Bocci M, Borga S, Caironi P, Cat C, Cingolani E, Avalli L, Greco G, Citerio G, Gandini L, Cornara G, Lerda R, Brazzi L, Simeone F, Caciorgna M, Alampi D, Francesconi S, Beck E, Antonini B, Vettoretto K, Meggiolaro M, Garofalo E, Bruni A, Notaro S, Varutti R, Bassi F, Mistraletti G, Marino A, Rona R, Rondelli E, Riva I, Scapigliati A, Cortegiani A, Vitale F, Pistidda L, D‘Andrea R, Querci L, Gnesin P, Todeschini M, Lugano M, Castelli G, Ortolani M, Cotoia A, Maggiore S, DiTizio L, Graziani R, Testa I, Ferretti E, Castioni C, Lombardi F, Caserta R, Pasqua M, Simoncini S, Baccarini F, Rispoli M, Grossi F, Cancelliere L, Carnelli M, Puccini F, Biancofiore G, Siniscalchi A, Laici C, Mossello E, Torrini M, Pasetti G, Palmese S, Oggioni R, Mangani V, Pini S, Martelli M, Rigo E, Zuccalà F, Cherri A, Spina R, Calamai I, Petrucci N, Caicedo A, Ferri F, Gritti P, Brienza N, Fonnesu R, Dessena M, Fullin G, Saggioro D. The association between low skeletal muscle mass and delirium: results from the nationwide multi-centre Italian Delirium Day 2017. Aging Clin Exp Res 2022; 34:349-357. [PMID: 34417734 PMCID: PMC8847195 DOI: 10.1007/s40520-021-01950-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 07/31/2021] [Indexed: 01/22/2023]
Abstract
Introduction Delirium and sarcopenia are common, although underdiagnosed, geriatric
syndromes. Several pathological mechanisms can link delirium and low skeletal muscle mass, but few studies have investigated their association. We aimed to investigate (1) the association between delirium and low skeletal muscle mass and (2) the possible role of calf circumference mass in finding cases with delirium. Methods The analyses were conducted employing the cross-sectional “Delirium Day” initiative, on patient 65 years and older admitted to acute hospital medical wards, emergency departments, rehabilitation wards, nursing homes and hospices in Italy in 2017. Delirium was diagnosed as a 4 + score at the 4-AT scale. Low skeletal muscle mass was operationally defined as calf circumference ≤ 34 cm in males and ≤ 33 cm in females. Logistic regression models were used to investigate the association between low skeletal muscle mass and delirium. The discriminative ability of calf circumference was evaluated using non-parametric ROC analyses. Results A sample of 1675 patients was analyzed. In total, 73.6% of participants had low skeletal muscle mass and 24.1% exhibited delirium. Low skeletal muscle mass and delirium showed an independent association (OR: 1.50; 95% CI 1.09–2.08). In the subsample of patients without a diagnosis of dementia, the inclusion of calf circumference in a model based on age and sex significantly improved its discriminative accuracy [area under the curve (AUC) 0.69 vs 0.57, p < 0.001]. Discussion and conclusion Low muscle mass is independently associated with delirium. In patients without a previous diagnosis of dementia, calf circumference may help to better identify those who develop delirium. Supplementary Information The online version contains supplementary material available at 10.1007/s40520-021-01950-8.
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Guerra G, Ravaglia V, Pozzi R, Cenni P, Scrittori N. Characterizing iron deposition in healthy and multiple sclerosis patients using susceptibility weighted imaging in MR. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00470-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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23
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Ravaglia V, Angelini L, Bertolini M, Della Gala G, Fabbri C, Fabbri S, Farnedi S, Vacchieri I, Golinelli P, Guerra G, Ortenzia O, Pagan L, Savini A, Scrittori N, Venturi G. Small-size details detection performance of digital breast tomosynthesis, synthetic 2D and conventional full-field digital mammography images for different mammography systems: a multicenter study. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00240-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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24
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Ravaglia V, Angelini L, Bertolini M, Della Gala G, Fabbri C, Fabbri S, Farnedi S, Vacchieri I, Guerra G, Lorenzini E, Mazzocchi S, Niespolo A, Ortenzia O, Pagan L, Quattrocchi M, Savini A, Scrittori N, Venturi G, Golinelli P. Average glandular dose in digital breast tomosynthesis systems: a multicenter study. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00239-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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25
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Temtem M, Serrao M, Mendonca MI, Santos M, Sousa JA, Mendonca F, Sousa AC, Freitas S, Henriques E, Rodrigues M, Borges S, Guerra G, Drumond A, Palma Dos Reis R. Is there a different impact of traditional risk factors on calcium score, in an asymptomatic population? Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The coronary calcium score has been increasingly used to stratify and predict cardiovascular risk, particularly in low and intermediate-risk persons. Understanding which determinants have more impact on coronary calcium score level, could lead to the development of new stricter preventive measures for reducing coronary artery calcification (CAC) and, consequently, cardiovascular risk.
Purpose
Our study aimed to investigate the impact of the traditional risk factors (TRFs) on the CAC score level and if there is a different association between this TRFs and CAC score degrees, in an asymptomatic population.
Methods
The study cohort comprised 1,122 consecutive asymptomatic individuals without known coronary artery disease (CAD) belonging to the healthy controls of GENEMACOR study and referred for computed tomography for CAC scoring assessment. The traditional risk factors considered were (1) current cigarette smoking, (2) dyslipidemia, (3) diabetes mellitus, (4) hypertension and (5) family history of coronary artery disease. According to the Hoff's nomogram, 3 categories were created: low CAC (0≤CAC<100 and P<50); moderate CAC (100≤CAC<400 or P50–75) and high or severe CAC (CAC≥400 or P>75). We evaluated the association of the different TRFs with these levels of CAC score (Chi-square test). Finally, we performed a logistic regression model adjusted for all significant TRFs selected in the bivariate analyses.
Results
Smoking was significantly associated with high levels of CAC score, 28.4% vs 21.7%; p=0.038 as well as hypertension, 58.8% vs 45.6%; p=0.001, type 2 diabetes 21.1% vs 9.6%; p<0.0001, dyslipidemia, 73.0% vs 66.1%; p=0.057. Family history did not show a significant association with CAC (p=0.717). Then, we constructed a logistic regression model adjusted the significant risk factors in previous analysis. The final multivariate analysis, selected as independent predictors of high CAC: Type 2 diabetes; OR=2.309; 95% CI 1.533–3.479; p<0.0001, hypertension; OR=1.627; 95% CI 1.185–2.233; p=0.003, and smoking, OR=1.565; 95% CI 1.102–2.222; p=0.012.
Conclusions
In this study, well-known and modifiable cardiovascular risk factors are associated with high calcium score levels. However, hypertension and diabetes seem to be preferentially associated with higher CAC scores, while tobacco, although it has a significant association, seems to be not so strong as diabetes and hypertension. This concept may mean that smoking has its primary role in plaque instability and not so much in the growing and calcification of plaques.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Temtem
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - M Serrao
- Hospital Dr. Nelio Mendonca, Funchal, Portugal
| | - M I Mendonca
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - M Santos
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - J A Sousa
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - F Mendonca
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - A C Sousa
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - S Freitas
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - E Henriques
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - M Rodrigues
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - S Borges
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - G Guerra
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - A Drumond
- Hospital Dr. Nelio Mendonca, Funchal, Portugal
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26
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Temtem M, Serrao M, Mendonca MI, Santos M, Sousa A, Mendonca F, Sousa AC, Henriques E, Freitas S, Rodrigues M, Borges S, Guerra G, Drumond A, Palma Dos Reis R. Is HNF4A gene, a risk factor or protection against coronary artery disease? Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.3196] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Hepatocyte nuclear factor4 A (HNF4A) gene was considered by GWAS associated with atherosclerosis and CAD susceptibility. Loss-of-function mutations in human hepatocyte nuclear factor 4α (HNF4α), a transcriptor factor encoded by the HNF4A gene, are associated with maturity-onset diabetes of the young and lipid disorders. However, the mechanisms underlying the lipid disorders are poorly understood.
Aim
We propose identifying the genetic predisposition to atherosclerosis progression and events occurrence or regression and better prognosis, through a cohort study from GENEMACOR population.
Methods
We investigated a cohort of 1,712 patients who underwent coronary angiography with more than 70% stenosis of at least one main coronary vessel. 33 SNPs associated with the risk of CAD in previous GWAS were genotyped by TaqMan assays methodology. We evaluated the best genetic model associated with CAD prognosis (events) with a 95% CI in bivariate analysis. The hazard function was performed by a Cox survival regression model adjusted for age, sex, type 2 diabetes, hypertension, and hypercholesterolemia, to evaluate their relationship with the event's incidence. Finally, we constructed Kaplan–Meier cumulative-event curves for the significant genetic variants.
Results
Our evaluation revealed a SNP paradoxically associated with protection from atherosclerosis progression and events occurrence: rs1884613 C>G in the HNF4A gene on chromosome 20 dominant model [OR=0.653; 95% CI (0.522–0.817); p=0.0002]. Cox survival regression model showed a CAD protective effect of HNF4A with a Hazard ratio (HR) of 0.771; p=0.007. The Kaplan-Meier cumulative event analysis disclosed that the CG+GG vs CC genotype of rs1884613 HNF4α was associated with a better prognosis (Breslow test, p=0.004) at the end of the follow-up.
Conclusion
We identified, in this study, one SNPs paradoxically associated with a better CAD prognosis rs1884613 in HNF4A. The HNF4A gene variants could induce loss of HNF4α function, modifying and modulating hepatic lipase and lipid metabolism conferring a beneficial effect on atherosclerosis progression and events occurrence.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Temtem
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - M Serrao
- Hospital Dr. Nelio Mendonca, Funchal, Portugal
| | - M I Mendonca
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - M Santos
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - A Sousa
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - F Mendonca
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - A C Sousa
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - E Henriques
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - S Freitas
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - M Rodrigues
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - S Borges
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - G Guerra
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - A Drumond
- Hospital Dr. Nelio Mendonca, Funchal, Portugal
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27
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Sousa JA, Mendonca MI, Santos M, Temtem M, Mendonca F, Sousa AC, Rodrigues M, Freitas S, Henriques E, Borges S, Guerra G, Drumond A, Palma Dos Reis R. Epicardial adipose tissue volume improves cardiovascular risk reclassification: the Framingham Risk Score example. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Epicardial adipose tissue (EAT) volume can be noninvasively detected by CT and has been suggested to predict major adverse cardiovascular events (MACE). Framingham Risk Score is one of a number of scoring systems used to determine an individual's chances of developing cardiovascular disease, hence identifying who is most likely to benefit from prevention.
Objectives
The purpose of this study was to determine net reclassification improvement (NRI) and improved risk prediction based on EAT volume, in comparison to a traditionally known cardiovascular risk score, such as the Framingham.
Methods
895 asymptomatic volunteers were prospectively enrolled in a single Portuguese center (mean age 51.9±7.7, 78.5% male) and underwent a median follow-up time of 3.7 years (IQR 5.0). EAT volume was measured by Cardiac Computed Tomography (CCT) using a modified simplified method. For NRI assessment, EAT volume as a continuous variable was added to the Framingham Risk Score.
Results
After 3.7 median years of follow-up, 27 patients developed a MACE. Using NRI, the net proportion of events (netNRIe) that assigned a higher risk was 33.3% (better reclassified), and the net ratio of non-events (netNRIne) was 24.7%, resulting in a net reclassification index (netNRI) of 58.0%. When the new marker was included in the model, 58.0% of patients were better reclassified. In our work, a total of 33.3% of patients who suffered events (n=27) were correctly reclassified and assigned a higher risk.
Conclusion
EAT volume results in a high reclassification rate in an asymptomatic, low-risk population, demonstrating the benefit of this marker beyond traditional risk assessment models. Our study supports its application, especially in carefully selected individuals.
Funding Acknowledgement
Type of funding sources: None. Figure 1
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Affiliation(s)
- J A Sousa
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - M I Mendonca
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - M Santos
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - M Temtem
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - F Mendonca
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - A C Sousa
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - M Rodrigues
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - S Freitas
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - E Henriques
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - S Borges
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - G Guerra
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - A Drumond
- Hospital Dr. Nelio Mendonca, Funchal, Portugal
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28
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Temtem M, Serrao M, Mendonca MI, Santos M, Sousa JA, Mendonca F, Sousa AC, Rodrigues M, Freitas S, Henriques E, Borges S, Guerra G, Drumond A, Palma Dos Reis R. The significant role of coronary artery calcification score in asymptomatic patients with metabolic syndrome. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Metabolic syndrome (MetS) is a clinical condition composed of metabolic and cardiovascular risk factors, such as abdominal obesity, hyperglycemia, dyslipidemia and hypertension. Many patients with MetS suffer major adverse cardiovascular events (MACE) that are not adequately identified by traditional risk assessment, suggesting the need for early detection of subclinical coronary heart disease to identify those at high-risk. Coronary artery calcification (CAC) screening has added utility in categorizing patients with low, intermediate and high cardiovascular risk.
Purpose
Evaluate the prognostic role of CAC score in asymptomatic population patients with metabolic syndrome in cardiovascular events risk prediction.
Methods
A total of 1,122 asymptomatic individuals without known coronary heart disease, enrolled from GENEMACOR study, were followed for a mean of 5.3±3.4 years for the primary endpoint of all-cause of cardiovascular events. All were referred for computed tomography for the CAC scoring assessment. According to the Hoff's nomogram, 3 categories were created: low CAC (0≤CAC<100 or P<50); moderate CAC (100≤CAC<400 or P50–75) and high or severe CAC (CAC≥400 or P>75). In a subgroup of 507 individuals with MetS and 615 controls, CAC values were compared by T-student and association of CAC severity with events occurrence was evaluated. Finally, a logistic regression model adjusted for CAC severity was performed in patients with MetS.
Results
Among our population, the extent of CAC differs significantly between men and women in the same age group. Patients with Mets (23.2%, n=115) had higher CAC scores than controls (219.0±486.0 vs 115.8±370.8, p<0.0001). In this cohort, with higher CAC scores, 46.7% vs 22.5% had MACEs (p=0.049) during the follow-up. The logistic regression analysis revealed that CAC≥400 is a MACE predictor (OR=4.326, CI 95% 1.241–15.080, p=0.021) in patients with MetS.
Conclusion
Our results point to the importance of the inclusion of CAC screening in patients with MetS to further stratify those patients that, despite tight control of cardiovascular risk factors, may benefit from more intensive therapies. This tool is a useful and straightforward method that could have a significant impact on the prognosis of future cardiovascular disease in patients with MetS.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Temtem
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - M Serrao
- Hospital Dr. Nelio Mendonca, Funchal, Portugal
| | - M I Mendonca
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - M Santos
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - J A Sousa
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - F Mendonca
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - A C Sousa
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - M Rodrigues
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - S Freitas
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - E Henriques
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - S Borges
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - G Guerra
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - A Drumond
- Hospital Dr. Nelio Mendonca, Funchal, Portugal
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29
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Sousa A, Mendonca MI, Santos M, Temtem M, Mendonca F, Sousa AC, Rodrigues M, Freitas S, Henriques E, Borges S, Guerra G, Drumond A, Palma Dos Reis R. Epicardial adipose tissue (EAT) volume is related to subclinical atherosclerosis and major adverse cardiovascular events (MACE) in asymptomatic subjects. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Epicardial adipose tissue (EAT) is an emerging cardiovascular risk marker. It has been suggested to be an inflammatory mediator with a role in subclinical atherosclerosis and coronary artery disease. However, its prognostic relevance in hard clinical outcomes remains thoroughly unexplored in the literature.
Purpose
Evaluate the prognostic relevance of EAT, regarding the occurrence of major adverse cardiovascular events (MACE) in an asymptomatic population.
Methods
895 asymptomatic volunteers were prospectively enrolled in a single Portuguese center (mean age 51.9±7.7, 78.5% male) and underwent a median follow-up time of 3.7 years (IQR 5.0). EAT volume was measured by Cardiac Computed Tomography (CCT) using a modified simplified method. Participants were distributed into two groups, above and below the EAT-volume median. We compared both groups regarding the occurrence of MACE through univariate analysis, Kaplan-Meier Survival curves and log-rank test. Association to subclinical atherosclerosis was addressed using correlation between EAT volume and calcium score (Agatson).
Results
There is a strong correlation between EAT volume and calcium score (r=0.205, p<0.0001), sustaining that it may play an important role in mediating coronary artery disease and subclinical atherosclerosis. Patients with higher EAT volume, were exposed to higher occurrence of MACE on follow-up [70.4% (19 of 27) vs 49.4% (429 of 868), p=0.032] with a clearer separation of the curves after 5.7 years.
Conclusion
In an asymptomatic population, EAT volume seems to be related to subclinical atherosclerosis and to the occurrence of adverse cardiovascular events on long-term follow-up. Our study addresses some unanswered questions, such as the prognostic relevance of EAT as an emerging cardiovascular risk marker.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- A Sousa
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - M I Mendonca
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - M Santos
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - M Temtem
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - F Mendonca
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - A C Sousa
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - M Rodrigues
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - S Freitas
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - E Henriques
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - S Borges
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - G Guerra
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - A Drumond
- Hospital Dr. Nelio Mendonca, Funchal, Portugal
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30
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Santos M, Mendonca MI, Temtem M, Sousa JA, Mendonca F, Sousa AC, Freitas S, Henriques E, Rodrigues M, Borges S, Guerra G, Drumond A, Palma Dos Reis R. Assessing the clinical utility of a genetic risk score associated with type 2 diabetes in a southern European population. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
The development of personalized susceptibility profiles based on genetic information to aid prediction, early detection and prevention of type 2 diabetes (T2D) with potential clinical application, begins to awaken interest in the scientific community. However, its clinical translation is controversial.
Objective
Evaluate the clinical utility of a genetic risk score (GRS) created with the GWAS-derived genetic variants associated to T2D to predict and discriminate the susceptibility to Type 2 diabetes, in a Southern European population with and without T2D.
Methods and results
We studied through a case-control with 3,139 subjects (772 with T2D and 2,367 without) the usefulness of implementing a GRS in clinical practice. We constructed a multiplicative GRS (mGRS) calculated using 10 SNPs of genetic loci robustly associated to T2D (HNF4A rs1884613, IGF2BP2 rs4402960, PPARG rs1801282, TCF7L2 rs7903146, SLC30A8 rs1326634, MC4R rs17782313, ADIPOQ rs266729, FTO rs8050136, TAS2R50 rs1376251 and APO E rs7412 and rs429358), to evaluate the prediction and discrimination of T2D. Two logistic regression models were performed the first with age, sex and BMI. The second with these three risk factors plus hypertension, LDL >130mg/dl and physical inactivity. Logistic regression models, receiver operating characteristic analyses (ROC curve) were used. Each model was analysed individually and added with mGRS to calculate the area under the ROC curve (AUC), which may be considered a global estimate of each model's predictive power. The inclusion of GRS in the first model increased the discriminative power of T2D (AUC=0.669 to 0.692; p<0.0001. In the second model, the increase was AUC=0.712 to 0.729; p<0.0001.
Conclusions
Adding genomic information to traditional models improves the ability to predict and discriminate type 2 Diabetes slightly, compared to traditional models alone. Nevertheless, this increase is not sufficiently robust for translation in clinical practice. However, clinicians should be conscious that T2D genetic research is experiencing a dramatic revolution and stay optimistic that these innovative studies translate into improved care for diabetic patients.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Santos
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - M I Mendonca
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - M Temtem
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - J A Sousa
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - F Mendonca
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - A C Sousa
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - S Freitas
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - E Henriques
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - M Rodrigues
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - S Borges
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - G Guerra
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - A Drumond
- Hospital Dr. Nelio Mendonca, Funchal, Portugal
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31
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Mendonca F, Mendonca MI, Santos M, Temtem M, Sousa JA, Sousa AC, Henriques E, Freitas S, Rodrigues M, Borges S, Guerra G, Drumond A, Palma Dos Reis R. Genomic prediction of cardiovascular events in a coronary Southern European population. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Traditional and clinical risk factors are indicators of atherosclerosis over time and strong independent predictors of cardiovascular events, but it is unknown whether other genetic markers could provide information about the evolution of atherosclerotic coronary artery disease (CAD).
Objective
We propose identifying the genetic predisposition to atherosclerotic plaque progression and events occurrence, through a study cohort from GENEMACOR study population.
Methods
We performed a study with a cohort of 1,712 patients who underwent coronary angiography with more than 70% stenosis of at least one main coronary vessel, during a mean follow-up of 5 years (amplitude range 20 years). 33 SNPs associated with risk of CAD in previous GWAS, were genotyped by TaqMan assays methodology. The best model in the bivariate analysis at 95% CI with all genetic variants was generated, to investigate their association with prognostic and events occurrence. The hazard function at a set of confounding-variables was determined to evaluate their relationship with the event's incidence by the Cox survival analysis regression model. Finally, we constructed Kaplan–Meier cumulative-event curves for the significant variants.
Results
The analysis revealed two SNPs associated with the progression of atherosclerosis and events occurrence: rs12190287 G>C in the TCF21 gene on chromosome 10 (dominant model; OR=1.542; 95% CI 1.069 – 2.224; p=0.020) and the rs1333049 G>C in the CDKN2-AS1 gene on chromosome 9 (recessive model; OR=1.228; 95% CI 1.001 – 1.518; p=0.050). The Kaplan-Meier cumulative event curves in the TCF21 variant rs12190287 G> C showed that the GC+CC vs GG genotype was associated with a worse prognosis (log-rank test, p=0.016) and the CDKN2B-AS1 rs1333049 G> C revealed that the CC vs GG+GC genotype also presented severe prognosis and more events at the end of the follow-up period (log-rank test, p=0.046).
Conclusion
We have identified two SNPs associated with the prognosis of CAD, rs12190287 of TCF21 gene and rs1333049 of CDKN2-AS1 gene. Both are in non-coding enhancer regions and regulate transcriptional mechanisms shared among multiple CAD risk loci and could provide new insights into CAD's pathophysiology identifying core mechanisms for therapeutic intervention modulating the disease risk.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- F Mendonca
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - M I Mendonca
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - M Santos
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - M Temtem
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - J A Sousa
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - A C Sousa
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - E Henriques
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - S Freitas
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - M Rodrigues
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - S Borges
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - G Guerra
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - A Drumond
- Hospital Dr. Nelio Mendonca, Funchal, Portugal
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32
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Mendonca F, Mendonca MI, Temtem M, Santos M, Sousa JA, Sousa AC, Henriques E, Freitas S, Rodrigues M, Borges S, Guerra G, Drumond A, Palma Dos Reis R. A genetic risk score predicts recurrent events after myocardial infarction in young patients with a low level of traditional risk factors. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.3198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Coronary Heart Disease (CAD) is a multifactorial disease, including environmental and genetic risk factors. Current smoking, dyslipidemia and diabetes have a significant impact in long- term mortality and morbidity. However, several genetic variants associated with CAD but not with traditional risk factors (TRFs) has been reported to improve prediction of events and extended mortality, in younger CAD people.
Aim
To evaluate the clinical utility of a GRS composed by variants from GWAS associated to CAD but not with TRF to predict life-long residual risk in patients under 55 years old and a low level of TRFs.
Methods
We conducted a prospective study with 573 consecutive patients aged <55 years presenting with AMI and a low level of TRFs (without diabetes and with LDL cholesterol >150 mg/ml). We analysed several biochemical markers and performed a GRS with variants not associated with TRFs (TCF21 rs12190287, CDKN2B-AS1 rs1333049, CDKN2B rs4977574, PHACTR1 rs1332844, MIA3 rs17465637, ADAMTS7 rs3825807, ZC3HC1 rs11556924, SMAD3 rs17228212 and GJA4 rs618675). We studied the GRS association with a primary composite endpoint of all-cause vascular morbidity and mortality including recurrent acute coronary syndrome (myocardial infarct and unstable angina), coronary revascularization (coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI), re-hospitalization for heart failure, ischemic stroke and cardiovascular dead.
Results
A total of 573 patients were studied and followed up for a mean of 4.7±4.0 years. There were 169 recurrent cardiovascular events. The GRS was sub-divided into terciles, verifying that patients in the third tercile (high risk) had a higher number of risk alleles. Compared with the low-risk GRS tercile, the multivariate-adjusted HR for recurrences was 1.520 (95% CI 1.011–2.286); p=0.044 for the intermediate-risk group and was 2.051 (95% CI 1.382–3.044); p<0.0001 for the high-risk group. Inclusion of the GRS in the model with TRFs alone (low risk) improved the C-statistic analysis (C-statistic = 0.030; p=0.004), cNRI (continuous net reclassification improvement) (30.8%), and the IDI (integrated discrimination improvement index) (0.022).
Conclusions
A multilocus GRS may identify young coronary disease patients with a low level of TRFs but at significant risk of long-term events recurrence. The genetic information may improve prediction discrimination, and reclassification over the conventional risk factors alone, providing better cost-effective therapeutic strategies.
Funding Acknowledgement
Type of funding sources: None. Figure 1
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Affiliation(s)
- F Mendonca
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - M I Mendonca
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - M Temtem
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - M Santos
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - J A Sousa
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - A C Sousa
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - E Henriques
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - S Freitas
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - M Rodrigues
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - S Borges
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - G Guerra
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - A Drumond
- Hospital Dr. Nelio Mendonca, Funchal, Portugal
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Soares C, Temtem M, Mendonca MI, Sousa JA, Santos M, Sousa AC, Rodrigues M, Henriques E, Freitas S, Borges S, Guerra G, Drumond A, Palma Dos Reis R. Comparison between a genetic risk score and the European SCORE in cardiovascular events prediction in a primary prevention population. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
The risk for Coronary Artery Disease (CAD) can be estimated using different scores, such as the European SCORE (Systematic Coronary Risk Evaluation) scale or genetic risk score (GRS). The addition of GRS to the European SCORE may increase the precision of predicting MACE (Major Adverse Cardiovascular Events).
Purpose
This study aims to compare the European SCORE and the multiplicative genetic risk score (mGRS) in predicting MACE.
Methods and results
The study included 1110 asymptomatic individuals without known CAD from GENEMACOR prospective registry. We defined the primary endpoint of all-cause cardiovascular events.
The study population had mean age of 51.6 years, 74.1% male and had risk factors of diabetes (11.6%), dyslipidemia (67.5%), hypertension (48.1%) and smoking (22.9%). Using C-index methodology, mGRS score was superior to SCORE in predicting MACE (mGRS = 0.832 Vs SCORE = 0.615; p=0.014).
Conclusions
The mGRS score was superior to SCORE in predicting MACE in an asymptomatic and free of CAD population. Genetic information may improve cardiovascular risk stratification in primary prevention.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- C Soares
- Hospital Dr. Nelio Mendonca, Funchal, Portugal
| | - M Temtem
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - M I Mendonca
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - J A Sousa
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - M Santos
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - A C Sousa
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - M Rodrigues
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - E Henriques
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - S Freitas
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - S Borges
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - G Guerra
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - A Drumond
- Hospital Dr. Nelio Mendonca, Funchal, Portugal
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Santos M, Mendonca MI, Temtem M, Sousa JA, Mendonca F, Monteiro J, Sousa AC, Freitas S, Henriques E, Guerra G, Drumond A, Palma Dos Reis R. Is the TCF21 gene protection or risk for coronary artery disease? Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.3359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
TCF21 is expressed in cells that migrate into the developing plaque facilitating the repair of the vessel wall. However, the rs12190287 risk allele (C) of TCF21 can lead to reduced TCF21 expression being a risk factor for CAD.
Purpose
Investigate whether the variant rs12190287 G>C of TCF21 gene represents a risk factor for CAD in a Southern European population.
Methods
Case-control with 3139 individuals, 1723 CAD patients and 1416 controls, adjusted for age and gender. Genotyping of TCF21 rs12190287 G>C was performed by TaqMan Real-Time PCR. CAD association of each genetic model was evaluated.
Multivariate logistic regression analysis adjusted for confound variables: smoking status, dyslipidemia, diabetes, physical inactivity, and hypertension, was made.
Results
TCF21 rs12190287 G>C has shown significant genotypic differences between cases and controls: GG 9.5% vs 11.9%; GC 43.2% vs 46.5% and CC 47.3% vs 41.6%. CAD risk was significant in all models: dominant (OR 1.28; 95% CI: 1.02–1.61; p=0.033); recessive (OR 1.26; 95% CI: 1.09–1.45; p=0.001); additive (OR 1.20; 95% CI: 1.08–1.34; p=0.001). After multivariate analysis, TCF21 variant was independently associated with CAD.
Conclusion
TCF21 variant rs12190287 G>C may be a risk factor for CAD. It is plausible that TCF21 loci exert its protective effect by promoting infiltration of fibromyocytes in the coronary wall lesion and fibrous layer and loss of TCF21 expression can result in fewer fibromyocytes to fibrous cap increasing vulnerability of the plaque.
Funding Acknowledgement
Type of funding sources: None. Variables associated with CAD risk
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Affiliation(s)
- M Santos
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - M I Mendonca
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - M Temtem
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - J A Sousa
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - F Mendonca
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - J Monteiro
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - A C Sousa
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - S Freitas
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - E Henriques
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - G Guerra
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - A Drumond
- Hospital Dr. Nelio Mendonca, Funchal, Portugal
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Sousa JA, Mendonça MI, Serrão M, Borges S, Henriques E, Freitas S, Tentem M, Santos M, Freitas P, Ferreira A, Guerra G, Drumond A, Palma Reis R. Epicardial Adipose Tissue: The Genetics Behind an Emerging Cardiovascular Risk Marker. Clin Med Insights Cardiol 2021; 15:11795468211029244. [PMID: 34276231 PMCID: PMC8255575 DOI: 10.1177/11795468211029244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 06/07/2021] [Indexed: 12/16/2022]
Abstract
Evidence points epicardial adipose tissue (EAT) as an emerging cardiovascular risk marker. Whether genetic polymorphisms linked with atherosclerosis are associated with higher EAT is still unknown. We aim to assess the role of genetic burden of atherosclerosis and its association to EAT in a cohort of asymptomatic individuals without coronary disease. A total of 996 participants were prospectively enrolled in a single Portuguese center. EAT volume was measured by Cardiac Computed Tomography and participants were distributed into 2 groups, above and below median EAT. SNPs were genotyped and linked to their respective pathophysiological axes. A multiplicative genetic risk score (mGRS) was constructed, representing the genetic burden of the studied SNPs. To evaluate the association between genetics and EAT, we compared both groups by global mGRS, mGRS by functional axes, and SNPs individually. Individuals above-median EAT were older, had a higher body mass index (BMI) and higher prevalence of hypertension, metabolic syndrome, diabetes, and dyslipidemia. They presented higher GRS, that remained an independent predictor of higher EAT volumes. The group with more EAT consistently presented higher polymorphic burden across numerous pathways. After adjustment, age, BMI, and mGRS of each functional axis emerged as independently related to higher EAT volumes. Amongst the 33 SNPs, MTHFR677 polymorphism emerged as the only significant and independent predictor of higher EAT volumes. Patients with higher polymorphism burden for atherosclerosis present higher EAT volumes. We present the first study in a Portuguese population, evaluating the genetic profile of EAT through GWAS and GRS, casting further insight into this complicated matter.
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Affiliation(s)
- João Adriano Sousa
- Centro de Investigação Dra Maria Isabel Mendonça, Hospital Dr Nélio Mendonça, SESARAM, EPERAM, Funchal, Madeira, Portugal
| | - Maria Isabel Mendonça
- Centro de Investigação Dra Maria Isabel Mendonça, Hospital Dr Nélio Mendonça, SESARAM, EPERAM, Funchal, Madeira, Portugal
| | - Marco Serrão
- Centro de Investigação Dra Maria Isabel Mendonça, Hospital Dr Nélio Mendonça, SESARAM, EPERAM, Funchal, Madeira, Portugal
| | - Sofia Borges
- Centro de Investigação Dra Maria Isabel Mendonça, Hospital Dr Nélio Mendonça, SESARAM, EPERAM, Funchal, Madeira, Portugal
| | - Eva Henriques
- Centro de Investigação Dra Maria Isabel Mendonça, Hospital Dr Nélio Mendonça, SESARAM, EPERAM, Funchal, Madeira, Portugal
| | - Sónia Freitas
- Centro de Investigação Dra Maria Isabel Mendonça, Hospital Dr Nélio Mendonça, SESARAM, EPERAM, Funchal, Madeira, Portugal
| | - Margarida Tentem
- Centro de Investigação Dra Maria Isabel Mendonça, Hospital Dr Nélio Mendonça, SESARAM, EPERAM, Funchal, Madeira, Portugal
| | - Marina Santos
- Centro de Investigação Dra Maria Isabel Mendonça, Hospital Dr Nélio Mendonça, SESARAM, EPERAM, Funchal, Madeira, Portugal
| | - Pedro Freitas
- Hospital Santa Cruz, Centro Hospitalar Lisboa Ocidental, CHLO, Carnaxide, Portugal
| | - António Ferreira
- Hospital Santa Cruz, Centro Hospitalar Lisboa Ocidental, CHLO, Carnaxide, Portugal
| | - Graça Guerra
- Centro de Investigação Dra Maria Isabel Mendonça, Hospital Dr Nélio Mendonça, SESARAM, EPERAM, Funchal, Madeira, Portugal
| | - António Drumond
- Centro de Investigação Dra Maria Isabel Mendonça, Hospital Dr Nélio Mendonça, SESARAM, EPERAM, Funchal, Madeira, Portugal
| | - Roberto Palma Reis
- Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa, Portugal
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Mendonça MI, Henriques E, Borges S, Sousa AC, Pereira A, Santos M, Temtem M, Freitas S, Monteiro J, Sousa JA, Rodrigues R, Guerra G, Reis RPD. Genetic information improves the prediction of major adverse cardiovascular events in the GENEMACOR population. Genet Mol Biol 2021; 44:e20200448. [PMID: 34137427 PMCID: PMC8201463 DOI: 10.1590/1678-4685-gmb-2020-0448] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 04/04/2021] [Indexed: 11/21/2022] Open
Abstract
The inclusion of a genetic risk score (GRS) can modify the risk prediction of coronary artery disease (CAD), providing an advantage over the use of traditional models. The predictive value of the genetic information on the recurrence of major adverse cardiovascular events (MACE) remains controversial. A total of 33 genetic variants previously associated with CAD were genotyped in 1587 CAD patients from the GENEMACOR study. Of these, 18 variants presented an hazard ratio >1, so they were selected to construct a weighted GRS (wGRS). MACE discrimination and reclassification were evaluated by C-Statistic, Net Reclassification Index and Integrated Discrimination Improvement methodologies. After the addition of wGRS to traditional predictors, the C-index increased from 0.566 to 0.572 (p=0.0003). Subsequently, adding wGRS to traditional plus clinical risk factors, this model slightly improved from 0.620 to 0.622 but with statistical significance (p=0.004). NRI showed that 17.9% of the cohort was better reclassified when the primary model was associated with wGRS. The Kaplan-Meier estimator showed that, at 15-year follow-up, the group with a higher number of risk alleles had a significantly higher MACE occurrence (p=0.011). In CAD patients, wGRS improved MACE risk prediction, discrimination and reclassification over the conventional factors, providing better cost-effective therapeutic strategies.
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Affiliation(s)
- Maria Isabel Mendonça
- Hospital Central do Funchal, Unidade de Investigação, Serviço de Saúde da Região, SESARAM, EPERAM, Funchal, Portugal
| | - Eva Henriques
- Hospital Central do Funchal, Unidade de Investigação, Serviço de Saúde da Região, SESARAM, EPERAM, Funchal, Portugal
| | - Sofia Borges
- Hospital Central do Funchal, Unidade de Investigação, Serviço de Saúde da Região, SESARAM, EPERAM, Funchal, Portugal
| | - Ana Célia Sousa
- Hospital Central do Funchal, Unidade de Investigação, Serviço de Saúde da Região, SESARAM, EPERAM, Funchal, Portugal
| | - Andreia Pereira
- Hospital Central do Funchal, Unidade de Investigação, Serviço de Saúde da Região, SESARAM, EPERAM, Funchal, Portugal
| | - Marina Santos
- Hospital Central do Funchal, Unidade de Investigação, Serviço de Saúde da Região, SESARAM, EPERAM, Funchal, Portugal
| | - Margarida Temtem
- Hospital Central do Funchal, Unidade de Investigação, Serviço de Saúde da Região, SESARAM, EPERAM, Funchal, Portugal
| | - Sónia Freitas
- Hospital Central do Funchal, Unidade de Investigação, Serviço de Saúde da Região, SESARAM, EPERAM, Funchal, Portugal
| | - Joel Monteiro
- Hospital Central do Funchal, Unidade de Investigação, Serviço de Saúde da Região, SESARAM, EPERAM, Funchal, Portugal
| | - João Adriano Sousa
- Hospital Central do Funchal, Unidade de Investigação, Serviço de Saúde da Região, SESARAM, EPERAM, Funchal, Portugal
| | - Ricardo Rodrigues
- Hospital Central do Funchal, Unidade de Investigação, Serviço de Saúde da Região, SESARAM, EPERAM, Funchal, Portugal
| | - Graça Guerra
- Hospital Central do Funchal, Unidade de Investigação, Serviço de Saúde da Região, SESARAM, EPERAM, Funchal, Portugal
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Gallo M, do Nascimento D, Nunes N, de Sousa F, Boniatti J, de Aguiar J, Medeiros J, Esteves A, Guerra G, Ferreira L, Regis L, Seiceira R, Moncorvo F, Chaves M. Forced Degradation Study and Development of a Stability-Indicating Method for Amoxicillin Capsules According to ANVISA Guidelines. J BRAZIL CHEM SOC 2021. [DOI: 10.21577/0103-5053.20210111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
This study aimed to develop a reliable stability-indicating method (SIM) for amoxicillin 500 mg capsules (DP-drug product). A literature review addressing amoxicillin (AMX; DS-drug substance) forced degradation studies and the existing SIMs was conducted to verify the most significant outcomes. Subsequently, the forced degradation of DP and DS was carried out following the Brazilian Health Surveillance Agency (ANVISA) guidelines, including thermal degradation (dry and wet heat), acidic and alkaline hydrolyses, hydrogen peroxide oxidation, reaction with copper, and photodegradation. Both DS and DP were more susceptible to 0.015 M NaOH, resulting in approximately 50% degradation. AMX DS and DP were not significantly photodegraded, but some degradation products (PDegs) showed susceptibility to light exposure. Thermodegraded samples showing ≥ 10% degradation exhibited modified profiles in thermogravimetric (TG) and differential scanning calorimetric (DSC) analyses. The X-ray powder diffraction patterns (XRPD) of DS samples exposed to dry and wet heat displayed complete amorphization of AMX, attesting to the occurrence of physical degradation concomitantly with chemical degradation, which can alter the drug’s bioavailability. In contrast, the thermodegraded DP samples exhibited intact AMX crystals interspersed with the amorphous form, perhaps partly protected by the excipient. The validated SIM was able to detect and quantify about 80 PDegs.
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Temtem M, Serrao M, Pereira A, Santos M, Mendonca F, Sousa J, Monteiro J, Sousa A, Freitas S, Henriques E, Guerra G, Ornelas I, Drumond A, Palma Dos Reis R, Mendonca M. TCF21 variant is a risk factor for coronary artery disease and will it be a prognostic marker? Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
TCF21 gene, encodes a basic-helix- loop- helix transcription factor, playing a critical action in the development of epicardial progenitor cells that give rise to coronary artery smooth muscle cells (SMC) and cardiac fibroblasts. Recent data suggest that TCF21 may play a role in the state of differentiation of SMC precursor cells that migrate to vascular lesions and contribute to fibrous cap.
Purpose
Investigate the association of TCF21 rs12190287G>C variant with coronary artery disease (CAD) in a Portuguese population and its role on the prognosis.
Methods
Case-control study with 3120 participants, 1687 coronary patients with at least 75% obstruction of a major coronary artery and 1433 controls. Genotyping used the TaqMan technique (Applied Biosystems) and then a univariate and multivariate logistic regression analysis were performed. After a mean follow-up of 5.01±4.2 years (interquartile range 1.96–7.57), the occurrence of the combined Major Adverse Cardiovascular Events (MACE) (Cardiovascular Mortality, non-fatal Myocardial Infarction, new Revascularization, Cerebrovascular Disease and Peripheric Vascular Disease) were registered and analysed by Cox regression. Finally, Kaplan-Meier survival estimate was performed.
Results
In the total population, GC+CC genotype was found to be associated with CAD with an OR of 1.285; CI: 1.022–1.614; p=0.031. After multivariate logistic regression, adjusted to traditional risk factors, the association with CAD remained significant for this genotype (OR=1.340; CI: 1.042–1.723; p=0.022).After Cox regression adjusted for confounding variables (age and sex, hypertension, diabetes, smoking, dyslipidemia, eGFR, Ejection fraction <55) the mutated genotype remained a significant predictor of MACE (HR=1.420; CI: 1.032–1.953; p=0.031). The individuals carrying the mutated allele (GC+CC) at the mean follow-up showed an event probability of 36.1%, whereas the wild population (GG) presented only 23.4%. The Log-Rank test showed significant differences between the two curves (p=0.019).
Conclusion
The mutated TCF21 variant can provide a new marker to identify patients at high cardiovascular risk and may representa potential target for gene therapy in future.
Figure 1
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- M Temtem
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - M Serrao
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - A Pereira
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - M Santos
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - F Mendonca
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - J.A Sousa
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - J Monteiro
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - A.C Sousa
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - S Freitas
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - E Henriques
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - G Guerra
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - I Ornelas
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - A Drumond
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - R Palma Dos Reis
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - M.I Mendonca
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
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Söderberg B, Guerra G, Fagerstrom T, Permpool K, Phaipool S. The SÖderberg Socket 2.0: A Technical Note. Can Prosthet Orthot J 2020; 2:33505. [PMID: 37614769 PMCID: PMC10443462 DOI: 10.33137/cpoj.v2i2.33505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Accepted: 03/06/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Transtibial prosthesis socket trim lines have remained fairly consistent over the past decade, and based on methods such as a supracondylar cuff suspension. However, with vacuum suspension methods, trim lines can change. OBJECTIVE An objective of this technical note was to inform practitioners how to fabricate a socket in a better way. A step-by-step fabrication guide is provided for the prosthetist. METHODS A unilateral transtibial amputee was selected for this technical note. We provide a detailed description of the different steps of fabrication as well as patient feedback. The fabrication involved fabrication of a vacuum socket using Pre-preg carbon fiber and anti-bacterial Ethylene-Vinyl-Acetate (EVA), as a proximal flexible brim. FINDINGS The properties of EVA and Pre-preg carbon fiber allow for fabrication of a transtibial socket with a flexible proximal brim. The new design resulted in greater comfort and increased range of motion in the patient studied. The patient subjectively noted enhanced squatting and cycling capabilities while using the updated socket and flexible proximal brim. CONCLUSION This technical note presented a fabrication guide for a new style of socket and preliminary patient feedback. Clinical studies evaluating functional and biomechanical effects of this new socket design are needed.
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Affiliation(s)
- B Söderberg
- Centre of Excellence for Prosthetics and Orthotics, Scandinavian Orthopaedic Laboratory, Bangkok, Thailand
| | - G Guerra
- Sirindhorn School of Prosthetics and Orthotics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - T Fagerstrom
- Centre of Excellence for Prosthetics and Orthotics, Scandinavian Orthopaedic Laboratory, Bangkok, Thailand
| | - K Permpool
- Centre of Excellence for Prosthetics and Orthotics, Scandinavian Orthopaedic Laboratory, Bangkok, Thailand
- Sirindhorn School of Prosthetics and Orthotics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - S Phaipool
- Centre of Excellence for Prosthetics and Orthotics, Scandinavian Orthopaedic Laboratory, Bangkok, Thailand
- Sirindhorn School of Prosthetics and Orthotics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Sousa J, Mendonca M, Pereira A, Mendonca F, Monteiro J, Neto M, Sousa AC, Henriques E, Freitas S, Guerra G, Borges S, Ornelas I, Drumond A, Palma Dos Reis R. P3399Influence of TCF21 rs12190287 in the coronary artery disease risk prediction. An association study in a Portuguese population. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
TCF21 is a member of the basic-helix-loop-helix (bHLH) transcriptor factor family, being critical for embryogenesis of the heart, kidney and spleen. TCF21 also regulates epicardium-derived cells differentiation into smooth muscle and fibroblast lineages.
Aim
Investigate the impact of TCF21 rs12190287 in the prediction and discrimination of CAD risk, individually or into a genetic risk score (GRS) formed by a set of 13 genetic variants.
Methods
We performed a case-control study with 3050 subjects (1619 coronary patients with 53.3±8 years; 78.9% male and 1431 controls with 52.8±8 years; 76.6% male) from GENEMACOR study. We investigated all traditional risk factors (TRF), as well as 13 genetic variants from GWAS with unknown pathophysiological pathway so far, including TCF21 (rs12190287), ZC3HC1 (rs11556924), PSRC1/SORTI (rs599839), PHACTR1 (rs1332844), MIA3 (rs17465637), SMAD3 (rs17228212), ZNF259 (rs964184), ADAMTS7 (rs3825807), CDKN2B (rs4977574), 9p21.3 (rs1333049), KIF6 (rs20455), PCSK9 (rs2114580) and GJA4 (rs618675). A multiplicative genetic risk score with these 13 genetic variants (m13GRS), was calculated. Subsequently, two logistic regressions were performed; primarily with all the TRF and all the genes individually and the second with TRF and m13GRS.
Results
The first multivariate analysis shows that, besides the strong association of the TRF with CAD risk (with smoking status on the top of the list, with an OR of 3.2; p<0.0001), TCF21 rs12190287 was the most significant variant from all the studied genetic set with a CAD risk of 1.5 (95% CI: 1.1–1.9; p=0.004), followed by the well-known genetic determinant CDKN2B rs4977574 (OR=1.4; 95% CI: 1.1–1.7; p<0.002) and ZC3HC1 rs11556924 (OR=1.3; 95% CI: 1.0–1.7; p=0.034). When GRS is included to the model, all the TRF remain in the equation by the same order, and the m13GRS persisted as an independent predictor for CAD risk (OR=1.7; 95% CI: 1.4–2.0; p<0.0001).
Conclusion
TCF21 rs12190287 is a risk factor for CAD in the Portuguese population, either individually or incorporated in a m13GRS. TCF21 risk is independent from TRF. In the future, TCF21 can provide a new clues to identify patients at high cardiovascular risk and become a potential target for gene therapy.
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Affiliation(s)
- J Sousa
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - M Mendonca
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - A Pereira
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - F Mendonca
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - J Monteiro
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - M Neto
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - A C Sousa
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - E Henriques
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - S Freitas
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - G Guerra
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - S Borges
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - I Ornelas
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - A Drumond
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - R Palma Dos Reis
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
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Sousa J, Mendonca M, Pereira A, Mendonca F, Neto M, Monteiro J, Sousa AC, Rodrigues M, Henriques E, Guerra G, Borges S, Ornelas I, Drumond A, Palma Dos Reis R. P3423The contribution of genetics to premature CAD through different degrees of lifestyle factors: a matter of relative significance? Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Coronary artery disease (CAD) is a multifactorial process with substantial genetic contribution. However, genetic predisposition among patients with a different number of lifestyle factors and premature CAD, remains a complex and thoroughly unexplored topic.
Objective
To evaluate, in a young population, the importance of conventional risk factors as well as of a genetic risk score in the appearance of CAD.
Methods
A case-control study was conducted with 1075 patients from the GENEMACOR study population, under 50 years-old (555 cases, 86.8% male, mean age 44.1±4.9 years and 520 controls, 86.2% male, mean age 44.3±4.8 years). Univariate analysis addressed the association of different modifiable risk factors with premature CAD. Genetic risk score (GRS) was computed comprising 33 genetic risk variants in a multiplicative method. GRS was evaluated according to the number of traditional risk factors and risk for premature CAD was estimated and its independent predictive value estimated by logistic regression.
Results
72.6% of patients had ≥3 risk factors vs 31.2% of controls (p<0.0001). In comparison with having no risk factors (rf), patients with 1 rf had an OR of 2.79 (1.19–6.53; p=0.015), patients with 2 risk factors had a OR of 6.87 (3.03–15–57, p<0.0001) and patients with 3 modifiable risk factors had a OR of 24.17 (10.87–53.73, p<0.0001) – graph 1. In this young population, mean GRS level was consistently higher among patients with coronary artery disease comparing with a healthy population (0.6±0.6 vs 0.4±0.4, p<0.0001, respectively) – graph 2. GRS in multivariate analysis, proved to be an independent predictor for premature CAD (OR 1.71, CI95% 1.25–2.34, p=0.001).
Conclusion
In our population, GRS was an independent predictor for premature CAD. In young patients with ≥3 risk factors, genetics play a less decisive role in the development of CAD. Even in young patients, modifiable risk factors should be addressed aggressively as they may represent a higher burden than genetic predisposition itself.
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Affiliation(s)
- J Sousa
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - M Mendonca
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - A Pereira
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - F Mendonca
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - M Neto
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - J Monteiro
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - A C Sousa
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - M Rodrigues
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - E Henriques
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - G Guerra
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - S Borges
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - I Ornelas
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | | | - R Palma Dos Reis
- New University of Lisbon, Faculty of Medical Sciences, Lisbon, Portugal
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Tejera A, Pérez-Sánchez L, Guerra G, Arriola-Velásquez AC, Alonso H, Arnedo MA, Rubiano G, Martel P. Natural radioactivity in algae arrivals on the Canary coast and dosimetry assessment. Sci Total Environ 2019; 658:122-131. [PMID: 30577011 DOI: 10.1016/j.scitotenv.2018.12.140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 12/07/2018] [Accepted: 12/10/2018] [Indexed: 06/09/2023]
Abstract
Nowadays, the use of wild and culture harvest seaweed in food industry is a booming productive sector. In this context, a radiological characterization of five globally common seaweed species that were collected in arrival on Gran Canaria coast was carried out. The studied algae species were Cymopolia barbata, Lobophora variegata, Sargassum vulgare, Dictyota dichotoma and Haliptilon virgatum. Radionuclides analysed by alpha and gamma spectrometry were 238U, 234U, 235U, 210Po, 234Th, 226Ra, 210Pb, 228Th, 224Ra, 40K and 7Be. Activity concentrations, ratios, and concentration factors (CF) were determined for all samples collected. The CF in algae was higher for reactive-particle radionuclides (210Po, 234Th, 228Th and 210Pb) than for conservative ones (40K and the uranium isotopes). 210Po, 228Th and 234Th CF were one or two orders of magnitude higher than those recommended by the IAEA. L. variegata, C. barbata and S. vulgare showed a clear preference for 210Pb and 210Po, for uranium radioisotopes, and for 40K and 234Th, respectively. A dosimetry assessment due to seaweed ingestion showed considerable values of annual committed effective dose for H. virgatum (605 ± 19 μSv/y), L. variegata (574 ± 17 μSv/y) and D. dichotoma (540 ± 30 μSv/y). Hence, this study suggests that an algae radiological characterization is recommended as part of the product valorising process.
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Affiliation(s)
- A Tejera
- Physics Department, Universidad de Las Palmas de Gran Canaria, 35017 Las Palmas de Gran Canaria, Spain.
| | - L Pérez-Sánchez
- Physics Department, Universidad de Las Palmas de Gran Canaria, 35017 Las Palmas de Gran Canaria, Spain
| | - G Guerra
- Physics Department, Universidad de Las Palmas de Gran Canaria, 35017 Las Palmas de Gran Canaria, Spain
| | - A C Arriola-Velásquez
- Physics Department, Universidad de Las Palmas de Gran Canaria, 35017 Las Palmas de Gran Canaria, Spain
| | - H Alonso
- Physics Department, Universidad de Las Palmas de Gran Canaria, 35017 Las Palmas de Gran Canaria, Spain
| | - M A Arnedo
- Physics Department, Universidad de Las Palmas de Gran Canaria, 35017 Las Palmas de Gran Canaria, Spain
| | - G Rubiano
- Physics Department, Universidad de Las Palmas de Gran Canaria, 35017 Las Palmas de Gran Canaria, Spain
| | - P Martel
- Physics Department, Universidad de Las Palmas de Gran Canaria, 35017 Las Palmas de Gran Canaria, Spain
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Pereira A, Mendonca MI, Borges S, Sousa AC, Freitas S, Henriques E, Rodrigues M, Freitas AI, Guerra G, Freitas C, Pereira D, Brehm A, Reis RPD. Additional value of a combined genetic risk score to standard cardiovascular stratification. Genet Mol Biol 2018; 41:766-774. [PMID: 30571812 PMCID: PMC6415604 DOI: 10.1590/1678-4685-gmb-2017-0173] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 01/29/2018] [Indexed: 01/01/2023] Open
Abstract
The utility of genetic risk scores (GRS) as independent risk predictors remains
inconclusive. Here, we evaluate the additive value of a multi-locus GRS to the
Framingham risk score (FRS) in coronary artery disease (CAD) risk prediction. A
total of 2888 individuals (1566 coronary patients and 1322 controls) were
divided into three subgroups according to FRS. Multiplicative GRS was determined
for 32 genetic variants associated to CAD. Logistic Regression and Area Under
the Curve (AUC) were determined first, using the TRF for each FRS subgroup, and
secondly, adding GRS. Different models (TRF, TRF+GRS) were used to classify the
subjects into risk categories for the FRS 10-year predicted risk. The
improvement offered by GRS was expressed as Net Reclassification Index and
Integrated Discrimination Improvement. Multivariate analysis showed that GRS was
an independent predictor for CAD (OR = 1.87; p<0.0001).
Diabetes, arterial hypertension, dyslipidemia and smoking status were also
independent CAD predictors (p<0.05). GRS added predictive
value to TRF across all risk subgroups. NRI showed a significant improvement in
all categories. In conclusion, GRS provided a better incremental value in
intermediate subgroup. In this subgroup, inclusion of genotyping may be
considered to better stratify cardiovascular risk.
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Affiliation(s)
- Andreia Pereira
- Unidade de Investigação, Hospital Dr. Nélio Mendonça, Funchal, Portugal.,Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa-Portugal
| | | | - Sofia Borges
- Unidade de Investigação, Hospital Dr. Nélio Mendonça, Funchal, Portugal
| | - Ana Célia Sousa
- Unidade de Investigação, Hospital Dr. Nélio Mendonça, Funchal, Portugal.,Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa-Portugal
| | - Sónia Freitas
- Unidade de Investigação, Hospital Dr. Nélio Mendonça, Funchal, Portugal
| | - Eva Henriques
- Unidade de Investigação, Hospital Dr. Nélio Mendonça, Funchal, Portugal
| | - Mariana Rodrigues
- Unidade de Investigação, Hospital Dr. Nélio Mendonça, Funchal, Portugal
| | - Ana Isabel Freitas
- Unidade de Investigação, Hospital Dr. Nélio Mendonça, Funchal, Portugal.,Laboratório de Genética Humana, Universidade da Madeira, Campus Universitário da Penteada, Madeira, Portugal
| | - Graça Guerra
- Unidade de Investigação, Hospital Dr. Nélio Mendonça, Funchal, Portugal.,Laboratório de Genética Humana, Universidade da Madeira, Campus Universitário da Penteada, Madeira, Portugal
| | - Carolina Freitas
- Unidade de Investigação, Hospital Dr. Nélio Mendonça, Funchal, Portugal
| | - Décio Pereira
- Unidade de Investigação, Hospital Dr. Nélio Mendonça, Funchal, Portugal
| | - António Brehm
- Laboratório de Genética Humana, Universidade da Madeira, Campus Universitário da Penteada, Madeira, Portugal
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Sousa AC, Reis RP, Pereira A, Borges S, Freitas AI, Guerra G, Gouveia S, Góis T, Nóbrega L, Rodrigues M, Henriques E, Freitas S, Ornelas I, Pereira D, Brehm A, Mendonça MI. [Genetic Polymorphisms Associated with the Onset of Arterial Hypertension in a Portuguese Population]. ACTA MEDICA PORT 2018; 31:542-550. [PMID: 30387422 DOI: 10.20344/amp.9184] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 07/10/2018] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Arterial hypertension is a complex, multifactorial disease, controlled by genetic and environmental factors. OBJECTIVE Evaluate the genetic susceptibility for developing arterial hypertension and its association with the traditional risk factors in the outbreak of this pathology. MATERIAL AND METHODS Case-control study with 1712 individuals, mean age of 51.0 ± 7.9 years (860 hypertensive patients and 852 controls). Biochemical and traditional risk factors, and genetic variants were evaluated: ACE I/D rs4340, ACE A2350G rs4343, AGT T174M rs4762, AGT M235T rs699 AGTR1 A1166C rs5186, CYP11B2 -344 C/T rs1799998, ADRB1 R389G rs1801253, ADRB2 R16G rs1042713, ADD1 G460W rs4961, SCNN1G G173A rs5718, GNB3 C825T rs5443, ATP2B1 A/G rs2681472, CYP17A1 T/C rs11191548, SLC4A2 C/T rs2303934. The risk of each gene for hypertension was estimated by the dominant, recessive, co-dominant and multiplicative models. By logistic regression, variables associated with hypertension were evaluated. ROC curves were first performed with traditional risk factors and then adding the genetic variants associated with hypertension. Data were analyzed by SPSS for Windows 19.0 and MedCalc v. 13.3.3.0. RESULTS The genetic variants ADD1 G460W, GNB3 C825T, ACE I/D, ACE A2350G were associated with hypertension. ROC curve with traditional risk factors and these variants showed an increase in the predictive capacity of hypertension (p = 0.018). DISCUSSION According to the results of our study, the genetic variants found to be associated with hypertension were: ACE I/D rs4340, ACE A2350G rs4343, ADD1 G460W rs4961 and GNB3 C825T rs5443. The first two variants are associated with hypertension by interfering with the renin-angiotensin-aldosterone system, which plays an important role in regulating blood pressure. It should be noted that genes encoding the components of renin-angiotensin-aldosterone system are natural candidates for the development and progression of hypertension. In our population alpha-aducin polymorphism (ADD1 G460W rs4961) was also associated with hypertension. In a Portuguese population, known to have high salt intake, it makes sense that this polymorphism which is relevant in salt and water management may consequently be relevant in the onset of hypertension. The genetic variant GNB3 C825T rs5443 that affects intracellular signalling was also found to be a strong risk candidate for hypertension. Initially, with the elaboration of the ROC curve and calculation of the AUC using only with traditional risk factors and later by adding the variants ADD1 G460W, GNB3 C825T, ACE I/D and ACE A2350G to the traditional risk factors, we verified that genetic polymorphisms increased the predictive risk of hypertension, when compared to the risk given only by traditional risk factors, with statistical significance (p = 0.018). This suggests that hypertension is a multifactorial disease that results from the interaction of environmental, genetic and lifestyle factors that interact with each other and lead to the advent of this important pathology. CONCLUSION In our study, the hypertension-associated polymorphisms are linked to the renin-angiotensin-aldosterone axis (ACE I/D, ACE A2350G), as well as to salt and water management (ADD1 G460W, GNB3 C825T). Through a multivariate analysis, it was concluded that these two last genetic variants together with four of the traditional risk factors (smoking, alcohol consumption, obesity and diabetes) are associated in a significant and independent way with essential hypertension. In a predictive model of hypertension, the introduction of genetic variants slightly increases the predictive value of the model.
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Affiliation(s)
- Ana Célia Sousa
- Unidade de Investigação. Hospital Doutor Nélio Mendonça. Funchal. Portugal
| | - Roberto Palma Reis
- Faculdade de Ciências Médicas. Universidade Nova de Lisboa. Lisboa. Portugal
| | - Andreia Pereira
- Unidade de Investigação. Hospital Doutor Nélio Mendonça. Funchal. Portugal
| | - Sofia Borges
- Unidade de Investigação. Hospital Doutor Nélio Mendonça. Funchal. Portugal
| | - Ana Isabel Freitas
- Unidade de Investigação. Hospital Doutor Nélio Mendonça. Funchal. Portugal
| | - Graça Guerra
- Unidade de Investigação. Hospital Doutor Nélio Mendonça. Funchal. Portugal
| | - Sara Gouveia
- Unidade de Investigação. Hospital Doutor Nélio Mendonça. Funchal. Portugal
| | - Teresa Góis
- Unidade de Investigação. Hospital Doutor Nélio Mendonça. Funchal. Portugal
| | - Lino Nóbrega
- Unidade de Investigação. Hospital Doutor Nélio Mendonça. Funchal. Portugal
| | - Mariana Rodrigues
- Unidade de Investigação. Hospital Doutor Nélio Mendonça. Funchal. Portugal
| | - Eva Henriques
- Unidade de Investigação. Hospital Doutor Nélio Mendonça. Funchal. Portugal
| | - Sónia Freitas
- Unidade de Investigação. Hospital Doutor Nélio Mendonça. Funchal. Portugal
| | - Ilídio Ornelas
- Unidade de Investigação. Hospital Doutor Nélio Mendonça. Funchal. Portugal
| | - Décio Pereira
- Unidade de Investigação. Hospital Doutor Nélio Mendonça. Funchal. Portugal
| | - António Brehm
- Laboratório de Genética Humana. Universidade da Madeira. Funchal. Portugal
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Pereira A, Palma Dos Reis R, Rodrigues R, Monteiro J, Sousa JA, Sousa AC, Henriques E, Rodrigues M, Guerra G, Borges S, Ornelas I, Drumond A, Mendonca MI. P1685Gene - Environment interactions in the cellular axis of ischemic cardiopathy using machine learning models. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- A Pereira
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - R Palma Dos Reis
- New University of Lisbon, Faculty of Medical Sciences, Lisbon, Portugal
| | - R Rodrigues
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - J Monteiro
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - J A Sousa
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - A C Sousa
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - E Henriques
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - M Rodrigues
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - G Guerra
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - S Borges
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - I Ornelas
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - A Drumond
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - M I Mendonca
- Funchal Hospital, Research Unit, Funchal, Portugal
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Sousa AC, Palma dos Reis R, Pereira A, Borges S, Gouveia S, Spínola A, Freitas AI, Guerra G, Góis T, Rodrigues M, Henriques E, Ornelas I, Freitas C, Pereira D, Brehm A, Mendonça MI. The genetic variant C825T of the beta 3 subunit of G protein is associated with hypertension in a Portuguese population. Revista Portuguesa de Cardiologia (English Edition) 2018. [DOI: 10.1016/j.repce.2017.09.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
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47
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Sousa AC, Reis RPD, Pereira A, Borges S, Gouveia S, Spínola A, Freitas AI, Guerra G, Góis T, Rodrigues M, Henriques E, Ornelas I, Freitas C, Pereira D, Brehm A, Mendonça MI. The genetic variant C825T of the beta 3 subunit of G protein is associated with hypertension in a Portuguese population. Rev Port Cardiol 2018; 37:499-507. [PMID: 29853161 DOI: 10.1016/j.repc.2017.09.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 07/19/2017] [Accepted: 09/24/2017] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Hypertension is an important public health problem, affecting about 25% of the adult population worldwide.1 Genetic and environmental factors contribute to its pathogenesis. The T allele of the C825T polymorphism of the beta 3 subunit of G protein (rs5443) leads to the production of a truncated variant that enhances intracellular signaling and may interfere with the regulation of blood pressure. This genetic variant has been described as a risk factor for hypertension, although study results are controversial. OBJECTIVE The objective of this study was to analyze the association of the C825T polymorphism of the GNB3 gene with the occurrence of hypertension in a Portuguese population from the Madeira archipelago. METHODS A case-control study was performed with 1641 Caucasian individuals (mean age 50.6±8.1 years), 848 with hypertension and 793 controls. Blood was collected from all participants for biochemical and genetic analysis, including genotyping of the C825T polymorphism. Logistic regression analysis was performed to determine which variables were significantly associated with the onset of hypertension. Statistical analyses were performed using IBM SPSS version 19.0 and p-values <0.05 were considered statistically significant. RESULTS In our study, there was a significant association between the C825T polymorphism of the GNB3 gene and the occurrence of hypertension (odds ratio 1.275; 95% confidence interval 1.042-1.559; p=0.018) in the dominant model, after multivariate analysis. CONCLUSION We conclude that the C825T polymorphism of the beta 3 subunit of G protein is significantly and independently associated with the occurrence of hypertension in the study population.
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Affiliation(s)
- Ana Célia Sousa
- Unidade de Investigação, Hospital Doutor Nélio Mendonça, Funchal, Portugal.
| | | | - Andreia Pereira
- Unidade de Investigação, Hospital Doutor Nélio Mendonça, Funchal, Portugal
| | - Sofia Borges
- Unidade de Investigação, Hospital Doutor Nélio Mendonça, Funchal, Portugal
| | - Sara Gouveia
- Unidade de Investigação, Hospital Doutor Nélio Mendonça, Funchal, Portugal
| | - Adelaide Spínola
- Unidade de Investigação, Hospital Doutor Nélio Mendonça, Funchal, Portugal
| | - Ana Isabel Freitas
- Unidade de Investigação, Hospital Doutor Nélio Mendonça, Funchal, Portugal; Laboratório de Genética Humana, Universidade da Madeira, Funchal, Portugal
| | - Graça Guerra
- Unidade de Investigação, Hospital Doutor Nélio Mendonça, Funchal, Portugal; Laboratório de Genética Humana, Universidade da Madeira, Funchal, Portugal
| | - Teresa Góis
- Unidade de Investigação, Hospital Doutor Nélio Mendonça, Funchal, Portugal
| | - Mariana Rodrigues
- Unidade de Investigação, Hospital Doutor Nélio Mendonça, Funchal, Portugal
| | - Eva Henriques
- Unidade de Investigação, Hospital Doutor Nélio Mendonça, Funchal, Portugal
| | - Ilídio Ornelas
- Unidade de Investigação, Hospital Doutor Nélio Mendonça, Funchal, Portugal
| | - Carolina Freitas
- Unidade de Investigação, Hospital Doutor Nélio Mendonça, Funchal, Portugal
| | - Décio Pereira
- Unidade de Investigação, Hospital Doutor Nélio Mendonça, Funchal, Portugal
| | - António Brehm
- Laboratório de Genética Humana, Universidade da Madeira, Funchal, Portugal
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Zuccolo E, Negri S, Pellavio G, Scarpellino G, Laforenza U, Sancini G, Guerra G, Moccia F. Acetylcholine induces Ca2 + signals and nitric oxide release from human brain micrINS;ovascular endothelial cells. Vascul Pharmacol 2018. [DOI: 10.1016/j.vph.2017.12.049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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49
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Zuccolo E, Di Nezza F, Laforenza U, Kheder D, Pellavio G, Rosti V, Ambrosone L, Guerra G, Moccia F. Nicotinic acid adenine dinucleotide phosphate (NAADP) gates two pore channel 1 to mediate Ca2 + release from acidic Ca2 + signals in human endothelial progenitor cells. Vascul Pharmacol 2018. [DOI: 10.1016/j.vph.2017.12.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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50
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Simkins J, Anjan S, Morillas-Rodriguez JA, Greissman SR, Abbo LM, Camargo JF, Ruiz P, Vianna R, Guerra G, Salama S, Morris MI. Screening for Zika virus in deceased organ donors in Florida. Am J Transplant 2018; 18:731-736. [PMID: 29116671 DOI: 10.1111/ajt.14582] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 10/19/2017] [Accepted: 10/22/2017] [Indexed: 01/25/2023]
Abstract
Zika virus (ZIKV) cases have been detected across the United States (US) and locally acquired cases have been reported in Florida. Currently, there are no ZIKV screening guidelines and no data on the incidence among organ donors in the US. This retrospective study was conducted at Jackson Memorial-Miami Transplant Institute. Positive ZIKV tests in local deceased organ donors were investigated from 6/2016 to 1/2017. We evaluated demographics and risk factors for ZIKV infection among organ donors and transplant outcomes among recipients of donors with positive ZIKV testing. One hundred forty-two donors were analyzed. Ten percent had traveled to ZIKV-endemic countries and 19% had outdoor occupations. Only 3% had positive ZIKV IGG. None had a positive ZIKV IGM or PCR. ZIKV-positive donors were more likely to have traveled to ZIKV-endemic countries (50% vs. 9%, P = .05). The kidneys from a ZIKV-positive donor were transplanted in our hospital with no 6-month rejection, graft failure, or death in the recipients. Our study demonstrated a low prevalence of ZIKV among deceased donors in our community. Despite local ZIKV transmission, ZIKV was more common in donors who traveled to ZIKV-endemic countries. This cohort demonstrated excellent outcomes in recipients of ZIKV IGG-positive donors. However, larger studies are needed.
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Affiliation(s)
- J Simkins
- Division of Infectious Diseases, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | - S Anjan
- Division of Infectious Diseases, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | | | - S R Greissman
- University of Miami Miller School of Medicine, Miami, FL, USA
| | - L M Abbo
- Division of Infectious Diseases, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | - J F Camargo
- Division of Infectious Diseases, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | - P Ruiz
- Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - R Vianna
- Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - G Guerra
- Division of Nephrology, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | - S Salama
- Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - M I Morris
- Division of Infectious Diseases, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
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