1
|
Jiampo P, Tangkittikasem T, Boonyapiphat T, Senthong V, Torpongpun A. Real-World Heart Failure Burden in Thai Patients. Cardiol Ther 2024:10.1007/s40119-024-00355-8. [PMID: 38326588 DOI: 10.1007/s40119-024-00355-8] [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: 11/25/2023] [Accepted: 01/17/2024] [Indexed: 02/09/2024] Open
Abstract
INTRODUCTION Heart failure (HF) is one of the leading causes of hospitalization worldwide. In Thailand, data on HF burden remains limited. This study aimed to describe comprehensive evidence detailing the HF prevalence, hospital admission rates, in-hospital mortality, and overall mortality rates at the hospital level. METHOD All eligible adult patients' medical records from 2018 and 2019 were analyzed retrospectively at five hospitals in different regions. The patients were diagnosed with HF, as indicated by the International Classification of Diseases (ICD)-10 code I50. Descriptive statistics were used to examine the hospital burden as well as patients' clinical and outcome data. RESULTS A total of 7384 patients with HF were identified from five tertiary hospitals. Around half of the patients were male. The mean age was 67 years, and the main health insurance scheme was the Universal Coverage Scheme. The prevalence of HF was 0.1% in 2018 and 0.2% in 2019. Heart failure with preserved ejection fraction (HFpEF) was the most common type of HF in both visits, followed by heart failure with reduced ejection fraction (HFrEF) and heart failure with mildly reduced ejection fraction (HFmrEF). The proportion of HF hospitalizations was 1.2% in 2018 and 1.5% in 2019. The proportion of HF rehospitalizations versus hospitalizations in patients with HF was 22.7% in 2018 and 23.9% in 2019. The risk of rehospitalization was highest at 180 days after hospital discharge (87.8%). Among the patients with HF, the proportion of all-cause mortality was 9.1% in 2018 and 8.0% in 2019. Most of the deaths occurred within 30 days after hospitalization. CONCLUSION Our study demonstrated that the burden of HF in terms of hospitalization and in-hospital mortality was notably high when compared to similar studies conducted in Thailand and other countries.
Collapse
Affiliation(s)
- Panyapat Jiampo
- Bhumibol Adulyadej Hospital, Sai Mai District, Bangkok, Thailand
| | | | | | - Vichai Senthong
- Queen Sirikit Heart Center of the Northeast, Khon Kaen University, Mueang, Khon Kaen, Thailand
| | - Artit Torpongpun
- Chonburi Hospital, 69 Moo 2, Sukhumvit Road, Ban Suan, Mueang Chon Buri, Chon Buri, 20000, Thailand.
| |
Collapse
|
2
|
Ganokroj P, Muanpetch S, Deerochanawong C, Phimphilai M, Leelawattana R, Thongtang N, Krittayaphong R, Anthanont P, Vathesatogkit P, Sriphrapradang C, Senthong V, Torpongpun A, Suteerayongprasert P, Pengpong N, Sathavarodom N, Sunanta U, Porntharukchareon T, Kiatpanabhikul P, Kaewkrasaesin C, Suraamornkul S, Kongkit J, Umphonsathien M, Chattranukulchai P, Jiamjarasrungsi W, Khovidhunkit W. Gaps in the Care of Subjects with Familial Hypercholesterolemia: Insights from the Thai Familial Hypercholesterolemia Registry. J Atheroscler Thromb 2023; 30:1803-1816. [PMID: 37197952 DOI: 10.5551/jat.64081] [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] [Indexed: 05/19/2023] Open
Abstract
AIMS Familial hypercholesterolemia (FH) is currently underdiagnosed and undertreated. The establishment of a FH registry could facilitate a deeper understanding of this disease. We described the clinical characteristics of subjects with FH from the Thai FH Registry, compared our data with the regional and global data, and identified gaps in the care of these subjects. METHODS A multicenter, nationwide prospective FH registry was established in Thailand. Our data were compared with those of the European Atherosclerosis Society-FH Studies Collaboration. Multiple logistic regression analyses were performed for variables associated with lipid-lowering medication (LLM) use and the attainment of low-density lipoprotein-cholesterol (LDL-C) goal. RESULTS The study includes 472 subjects with FH (mean age at FH diagnosis: 46±12 years, 61.4% women). A history of premature coronary artery disease was found in 12%. The percentage of LLM use in subjects with a Dutch Lipid Clinic Network score of ≥ 6 (probable or definite FH) in our registry (64%) was slightly lower than the regional data but higher than the global data. Among those who received statins, 25.2% and 6.4% achieved LDL-C levels of <100 mg/dL and <70 mg/dL, respectively. Women with FH were less likely to achieve LDL-C <70 mg/dL (adjusted odds ratio: 0.22, 95% confidence interval: 0.06-0.71, p=0.012). CONCLUSIONS FH in Thailand was diagnosed late, and treatment was inadequate for the majority of subjects. Women with FH were less likely to achieve LDL-C goals. Our insights could potentially help raise awareness and narrow the gap in patient care.
Collapse
Affiliation(s)
- Poranee Ganokroj
- Department of Laboratory Medicine, King Chulalongkorn Memorial Hospital and Chulalongkorn University
| | | | | | | | | | | | | | - Pimjai Anthanont
- Department of Medicine, Thammasat Hospital, Thammasat University
| | | | | | - Vichai Senthong
- Department of Medicine, Srinagarind Hospital, Khon Kaen University
| | - Artit Torpongpun
- Department of Medicine, Chonburi Hospital, Ministry of Public Health
| | | | | | | | | | | | | | | | | | - Jaruwan Kongkit
- Department of Medicine, Vachira Phuket Hospital, Ministry of Public Health
| | | | | | - Wiroj Jiamjarasrungsi
- Department of Preventive and Social Medicine, King Chulalongkorn Memorial Hospital and Chulalongkorn University
| | - Weerapan Khovidhunkit
- Department of Medicine, King Chulalongkorn Memorial Hospital and Chulalongkorn University
| |
Collapse
|
3
|
Wongsalap Y, Poolpun D, Keawhai K, Kitpluem N, Pansiri P, Malaimat S, Senthong V, Kengkla K. Pharmacotherapy treatment patterns at hospital discharge and clinical outcomes among patients with heart failure with reduced ejection fraction. Chronic Dis Transl Med 2023. [DOI: 10.1002/cdt3.59] [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] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
Affiliation(s)
- Yuttana Wongsalap
- Division of Clinical Pharmacy, Department of Pharmaceutical Care, School of Pharmaceutical Sciences University of Phayao Phayao Thailand
- Unit of Excellence on Pharmacogenomic Pharmacokinetic and Pharmacotherapeutic Researches (UP‐PER), School of Pharmaceutical Sciences University of Phayao Phayao Thailand
| | | | - Konrapee Keawhai
- Division of Clinical Pharmacy, Department of Pharmaceutical Care, School of Pharmaceutical Sciences University of Phayao Phayao Thailand
| | - Napusson Kitpluem
- Division of Clinical Pharmacy, Department of Pharmaceutical Care, School of Pharmaceutical Sciences University of Phayao Phayao Thailand
| | - Parichat Pansiri
- Division of Clinical Pharmacy, Department of Pharmaceutical Care, School of Pharmaceutical Sciences University of Phayao Phayao Thailand
| | - Siriluck Malaimat
- Division of Clinical Pharmacy, Department of Pharmaceutical Care, School of Pharmaceutical Sciences University of Phayao Phayao Thailand
| | - Vichai Senthong
- Cardiovascular Unit, Department of Medicine, Faculty of Medicine Khon Kaen University Khon Kaen Thailand
| | - Kirati Kengkla
- Division of Clinical Pharmacy, Department of Pharmaceutical Care, School of Pharmaceutical Sciences University of Phayao Phayao Thailand
- Center of Health Outcomes Research and Therapeutic Safety (Cohorts), School of Pharmaceutical Sciences University of Phayao Phayao Thailand
| |
Collapse
|
4
|
Jiampo P, Boonyapiphat T, Torpongpun A, Senthong V, Pongmesa T, Taepanich N, Tangkittikasem T. A retrospective study of characteristics and burden of heart failure in Thailand: an interim analysis. Eur Heart J 2023. [DOI: 10.1093/eurheartj/ehac779.038] [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: 01/26/2023] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Private company. Main funding source(s): Novartis (Thailand) Limited
Background/Introduction
Heart failure (HF) is a major health problem due to its significant prevalence, disease burden and cost, mainly driven by high rates of hospitalization and mortality. Although numerous studies have demonstrated HF burden in western countries, data on current burden of HF in Thailand are limited.
Purpose
To describe characteristics and burden of HF, in terms of HF subgroups, hospital visits/hospitalization from HF and mortality, in participating hospitals in Thailand in 2019.
Methods
We retrospectively reviewed hospital profiles and medical records of HF adult patients at the five study sites which located in different regions across Thailand. All patients were diagnosed (newly and existing) with HF during 2018-2019, as identified by the International Classification of Diseases (ICD)-10 coding "I50". The interim data cutoff was scheduled when 4,000 patients were included. Hospital burden and the patients’ clinical and outcome data were collected and analyzed with descriptive statistics.
Results
From 4,000 patients, a total of 2,826 patients had follow-up visits in 2019 and then included in this analysis. Most of them were female (51.8%) and the overall patients’ mean (SD) age was 67.6 (15.0). Among 1,668 patients with available baseline left ventricular ejection fraction (LVEF), HF with preserved EF (HFpEF) was the most common subgroup (47.3%), followed by HF with reduced EF (HFrEF (39.0%) and HF with mid-range EF (HFmrEF) (13.7%). Of the total hospital visits from HF, 11.5% (95% CI 10.8-12.3) were from unscheduled visits to emergency or outpatient departments. HFpEF accounted for the highest number of hospital visits for HF, both scheduled and unplanned visits (46.4%, 48.9%), followed by HFrEF (39.0%, 41.5%) and HFmrEF (14.6, 9.6%), respectively. Among these 2,826 HF patients, the numbers of hospitalizations and rehospitalization from HF were 2,553 and 447. The total rate of HF rehospitalization was highest at 30 days (39.1%, 95% CI 34.6-43.7), followed by at 180 days (26.8%, 95% CI 22.7, 30.9), and 60 days (23.5%, 95% CI 19.6-27.4), respectively. The rates of all-cause and CV deaths within identified HF patients were 8.6% (95% CI 7.6-9.7) and 7.2% (95% CI 6.3-8.2). HFrEF accounted for the highest proportions of both (re) hospitalization and deaths (all-cause and CV) while HFpEF had the highest number of total beds.
Conclusion
Among the studied patients, HFpEF was the most common form of HF and HF was associated with a substantial healthcare burden in Thailand. The hospitalization rates from HF were especially high during the first 30 days after discharge, with a number of visits being unplanned or emergency visits leading to high hospital resource utilization.
Collapse
Affiliation(s)
- P Jiampo
- Bhumibol Adulyadej Hospital Royal Thai Air Force, Cardiology Unit, Internal Medicine Department , Bangkok , Thailand
| | - T Boonyapiphat
- Lampang Hospital, Cardiology Division, Internal Medicine Department , Lampang , Thailand
| | - A Torpongpun
- Chonburi Hospital, Cardiology Division, Internal Medicine Department , Chonburi , Thailand
| | - V Senthong
- Queen Sirikit Heart Center of the Northeast, Cardiovascular Unit, Department of Medicine, Faculty of Medicine, Khon Kaen University , Khon Kaen , Thailand
| | - T Pongmesa
- Novartis(Thailand)Limited, Medical Affairs Division , Bangkok , Thailand
| | - N Taepanich
- Novartis(Thailand)Limited, Medical Affairs Division , Bangkok , Thailand
| | - T Tangkittikasem
- Udonthani Hospital, Cardiology Division, Internal Medicine Department , Udonthani , Thailand
| |
Collapse
|
5
|
Kyaw TS, Sukmak M, Nahok K, Sharma A, Silsirivanit A, Lert-Itthiporn W, Sansurin N, Senthong V, Anutrakulchai S, Sangkhamanon S, Pinlaor S, Selmi C, Hammock BD, Cha'on U. Monosodium glutamate consumption reduces the renal excretion of trimethylamine N-oxide and the abundance of Akkermansia muciniphila in the gut. Biochem Biophys Res Commun 2022; 630:158-166. [PMID: 36155062 PMCID: PMC9851609 DOI: 10.1016/j.bbrc.2022.09.038] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 09/09/2022] [Indexed: 01/21/2023]
Abstract
We previously demonstrated that monosodium glutamate (MSG) consumption increases trimethylamine (TMA) level in the renal tissue as well as dimethylamine and methylamine levels in urine of rats, suggesting the effects of MSG on humans. To better define the findings, we investigated whether MSG consumption alters serum trimethylamine N-oxide (TMAO) level, and as a consequence, induces kidney injury in the rat model. Adult male Wistar rats (n = 40) were randomized to be fed with a standard diet (control group) or a standard diet with 0.5, 1.5 or 3.0 g% MSG corresponding to 7, 21, or 42 g/day in 60 kg man, respectively in drinking water (MSG-treated groups), or a standard diet with 3.0 g% MSG in drinking water which was withdrawn after 4 weeks (MSG-withdrawal group). Blood and urine samples were collected to analyze the TMAO levels using 1H NMR and markers of kidney injury. Fecal samples were also collected for gut microbiota analysis. We found serum TMAO levels increased and urinary TMAO excretion decreased during MSG consumption, in parallel with the increase of the neutrophil gelatinase-associated lipocalin (NGAL) excretion which subsided with the withdrawal of MSG. The fecal 16 S rRNA analysis during MSG consumption showed gut microbiota changes with a consistent suppression of Akkermansia muciniphila, a mucin producing bacteria, but not of TMA-producing bacteria. In conclusions, our findings suggested that prolonged high dose MSG consumption may cause TMAO accumulation in the blood via reduction of renal excretion associated with acute kidney injury. The mechanisms by which MSG reduced TMAO excretion require further investigation.
Collapse
Affiliation(s)
- Thin Su Kyaw
- Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand; Chronic Kidney Disease Prevention in the Northeast of Thailand (CKDNET), Khon Kaen University, Khon Kaen, 40002, Thailand.
| | - Manatsaphon Sukmak
- Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand; Chronic Kidney Disease Prevention in the Northeast of Thailand (CKDNET), Khon Kaen University, Khon Kaen, 40002, Thailand.
| | - Kanokwan Nahok
- Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand; Chronic Kidney Disease Prevention in the Northeast of Thailand (CKDNET), Khon Kaen University, Khon Kaen, 40002, Thailand.
| | - Amod Sharma
- Chronic Kidney Disease Prevention in the Northeast of Thailand (CKDNET), Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Atit Silsirivanit
- Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand.
| | - Worachart Lert-Itthiporn
- Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand.
| | - Nichapa Sansurin
- Northeast Laboratory Animal Center, Khon Kaen University, Khon Kaen, 40002, Thailand.
| | - Vichai Senthong
- Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand.
| | - Sirirat Anutrakulchai
- Chronic Kidney Disease Prevention in the Northeast of Thailand (CKDNET), Khon Kaen University, Khon Kaen, 40002, Thailand; Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand.
| | - Sakkarn Sangkhamanon
- Department of Pathology, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand.
| | - Somchai Pinlaor
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand.
| | - Carlo Selmi
- Rheumatology and Clinical Immunology, Humanitas Clinical and Research Center IRCCS, Rozzano, 20089, Milan, Italy; Department of Clinical Biosciences, Humanitas University, Pieve Emanuele, 20090, Milan, Italy.
| | - Bruce D Hammock
- Department of Entomology & Nematology and the UC Davis Comprehensive Cancer Research Center, University of California, Davis, CA, 95616, USA
| | - Ubon Cha'on
- Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand; Chronic Kidney Disease Prevention in the Northeast of Thailand (CKDNET), Khon Kaen University, Khon Kaen, 40002, Thailand.
| |
Collapse
|
6
|
Kotruchin P, Tangpaisarn T, Srimakam N, Phungoen P, Senthong V. Differential association between significant coronary stenosis and cardiac troponin T serial algorithms in renal dysfunction patients diagnosed with non-ST-segment elevation acute coronary syndromes. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehab849.072] [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
Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): Faculty of Medicine Khon Kaen University
Background
High-sensitivity cardiac troponin T (hs-cTnT) is recommended for diagnosing non-ST segment elevation acute coronary syndromes (NSTE-ACS). While the standard practice guidelines recommend using the 0,1-hour (hr) and 0,3-hr hs-cTnT algorithms, their efficacy has been not clearly established in chronic kidney disease (CKD) patients.
Purpose
We aimed to assess the differential associations between the two algorithms mentioned above with significant coronary stenosis in CKD patients.
Methods
This was a retrospective cohort study. Patients aged ≥18 years (yr) who were diagnosed with NSTE-ACS and had undergone coronary angiogram were recruited. The differential association between significant coronary stenosis and being ruled in based on the 0,1-hr and 0,3-hr hs-cTnT algorithm in both CKD patients and those normal renal function was analyzed and reported.
Results
There were 158 and 160 patients in the CKD group and the normal renal function group, respectively. The prevalence of significant coronary stenosis was higher in the CKD group (70.4% vs. 57.8%, P =0.028). Among CKD patients, factors associated with significant coronary stenosis were hypertension (OR =2.68; 95%CI 1.10-6.50) and being ruled in by the 0,3-hr algorithm (OR =3.65; 95%CI 1.27-10.52). In the normal renal function group, age (OR =1.04; 95%CI 1.01-1.06), male sex (OR =2.15; 95%CI 1.09-4.22), and being ruled in by the 0,1-hr algorithm (OR =3.12; 95%CI 1.20-8.10) were associated with significant coronary stenosis.
Conclusions
Being ruled in according to the 0,3-hr algorithm was significantly associated with coronary stenosis in CKD patients, making this a likely algorithm of choice in these patients. Abstract Figure. Adjusted OR of a coronary stenosis
Collapse
Affiliation(s)
- P Kotruchin
- Khon Kaen University, Emergency Medicine, Khon Kaen, Thailand
| | - T Tangpaisarn
- Khon Kaen University, Emergency Medicine, Khon Kaen, Thailand
| | - N Srimakam
- Khon Kaen University, Emergency Medicine, Khon Kaen, Thailand
| | - P Phungoen
- Khon Kaen University, Emergency Medicine, Khon Kaen, Thailand
| | - V Senthong
- Khon Kaen University, Internal Medicine, Khon Kaen, Thailand
| |
Collapse
|
7
|
Tangpaisarn T, Srimakam N, Senthong V, Phungoen P, Kotruchin P. Differential Association Between Significant Coronary Stenosis and Cardiac Troponin T Serial Algorithms in Chronic Kidney Disease Patients Diagnosed with Non-ST-Segment Elevation Acute Coronary Syndromes. Open Access Emerg Med 2022; 14:41-49. [PMID: 35140532 PMCID: PMC8818962 DOI: 10.2147/oaem.s348378] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 01/17/2022] [Indexed: 11/23/2022] Open
Abstract
Background Methods Results Conclusion
Collapse
Affiliation(s)
- Thanat Tangpaisarn
- Department of Emergency Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Nirut Srimakam
- Department of Emergency Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Vichai Senthong
- Department of Internal Medicine, Faculty of Medicine Srinagarind Hospital, Khon Kaen University, Khon Kaen, Thailand
| | - Pariwat Phungoen
- Department of Emergency Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Praew Kotruchin
- Department of Emergency Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Correspondence: Praew Kotruchin, Department of Emergency Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand, Tel +66 65 5269 422, Email
| |
Collapse
|
8
|
Khamsai S, Junkrasien C, Limpawattana P, Chindaprasirt J, Senthong V, Boonsawat W, Sawanyawisuth K. Prevalence and risk factors for persistent atrial fibrillation in obstructive sleep apnea. Sleep Sci 2022; 15:448-452. [DOI: 10.5935/1984-0063.20220077] [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] [Received: 07/29/2021] [Accepted: 04/04/2022] [Indexed: 11/11/2022] Open
|
9
|
Saeseow S, Chattakul P, Khamsai S, Limpawattana P, Chindaprasirt J, Chotmongkol V, Silaruks S, Senthong V, Sawanyawisuth K. Predictors for Obesity Hypoventilation Syndrome in Thai Population. Sleep Med Res 2021. [DOI: 10.17241/smr.2019.00318e] [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: 11/13/2022] Open
|
10
|
Rattanawong P, Senthong V. Hyponatremia induced Brugada syndrome mimicking ST segment elevation myocardial infarction. J Arrhythm 2021; 37:1377-1379. [PMID: 34621444 PMCID: PMC8485814 DOI: 10.1002/joa3.12617] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 07/31/2021] [Accepted: 08/03/2021] [Indexed: 11/08/2022] Open
Abstract
Seventy-three year-old male with history of diabetes, hypertension, and chronic kidney disease stage 3 presented with epigastric pain and hyponatremia. ECG showed new ST segment elevation at precordial leads consistent with Cove-type Brugada ECG pattern. Cardiac catheterization revealed non-significant coronary artery stenosis. He experienced pre-syncope and palpitations a year prior to admission with family history sudden cardiac death. Brugada syndrome was diagnosed. Cove-type Brugada ECG pattern and palpitations resolved with corrected sodium to 135.
Collapse
Affiliation(s)
| | - Vichai Senthong
- Cardiovascular Unit Faculty of Medicine Khon Kaen University Khon Kaen Thailand
| |
Collapse
|
11
|
Khamsai S, Sawanyawisuth K, Senthong V, Limpawattana P, Chindaprasirt J, Maleewong W, Tiamkao S, Chotmongkol V. Predictive models for Angiostrongylus cantonensis and Gnathostoma spinigerum infection in pathologically or serologically proved eosinophilic meningitis. Am J Transl Res 2021; 13:10413-10420. [PMID: 34650710 PMCID: PMC8506999] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 06/06/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE The two most common causes of eosinophilic meningitis (EOM) are the parasites: Angiostrongylus cantonensis and Gnathostoma spinigerum. This study aimed to evaluate whether clinical factors can predict either neuroangiostrongyliasis or gnathostomiasis in EOM patients. MATERIALS AND METHODS We included reports of patients with eosinophils in the CSF and either serological or pathological diagnosis of neuroangiostrongyliasis or gnathostomiasis published in 2014 or earlier and available on PubMed. Predictive clinical models were generated for neuroangiostrongyliasis and gnathostomiasis. RESULTS In total, 155 patients were included in the study, 24 in the gnathostomiasis group and 131 in the neuroangiostrongyliasis group. According to the separate models, factors associated with neuroangiostrongyliais were gender of male, Pila/Pomacea snail exposure, and headache, and independent factors for gnathostomiasis were weakness (adjusted odds ratio 50.8) and radicular pain (adjusted odds ratio 35.3). The combined model identified two independent factors for neuroangiostrongyliasis: weakness and radicular pain. The laboratory models revealed that xanthochromic CSF perfectly predicted both neuroangiostrongyliasis and gnathostomiasis. Two other predictive factors were blood eosinophilia and CSF eosinophils, which positively predicted gnathostomiasis (adjusted odds ratios of 1.13 and 1.08, respectively). CONCLUSION Clinical factors may be predictive of neuroangiostrongyliasis and gnathostomiasis in EOM.
Collapse
Affiliation(s)
- Sittichai Khamsai
- Department of Medicine, Faculty of Medicine, Khon Kaen UniversityKhon Kaen 40002, Thailand
| | - Kittisak Sawanyawisuth
- Department of Medicine, Faculty of Medicine, Khon Kaen UniversityKhon Kaen 40002, Thailand
| | - Vichai Senthong
- Department of Medicine, Faculty of Medicine, Khon Kaen UniversityKhon Kaen 40002, Thailand
| | - Panita Limpawattana
- Department of Medicine, Faculty of Medicine, Khon Kaen UniversityKhon Kaen 40002, Thailand
| | - Jarin Chindaprasirt
- Department of Medicine, Faculty of Medicine, Khon Kaen UniversityKhon Kaen 40002, Thailand
| | - Wanchai Maleewong
- Department of Parasitology, Faculty of Medicine, Khon Kaen UniversityKhon Kaen 40002, Thailand
| | - Somsak Tiamkao
- Department of Medicine, Faculty of Medicine, Khon Kaen UniversityKhon Kaen 40002, Thailand
| | - Verajit Chotmongkol
- Department of Medicine, Faculty of Medicine, Khon Kaen UniversityKhon Kaen 40002, Thailand
| |
Collapse
|
12
|
Rattanatham R, Settasatian N, Komanasin N, Kukongviriyapan U, Sawanyawisuth K, Intharaphet P, Senthong V, Settasatian C. Association of Combined TCF7L2 and KCNQ1 Gene Polymorphisms with Diabetic Micro- and Macrovascular Complications in Type 2 Diabetes Mellitus. Diabetes Metab J 2021; 45:578-593. [PMID: 33752320 PMCID: PMC8369220 DOI: 10.4093/dmj.2020.0101] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 09/27/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Vascular complications are the major morbid consequences of type 2 diabetes mellitus (T2DM). The transcription factor 7-like 2 (TCF7L2), potassium voltage-gated channel subfamily Q member 1 (KCNQ1), and inwardly-rectifying potassium channel, subfamily J, member 11 gene (KCNJ11) are common T2DM susceptibility genes in various populations. However, the associations between polymorphisms in these genes and diabetic complications are controversial. This study aimed to investigate the effects of combined gene-polymorphisms within TCF7L2, KCNQ1, and KCNJ11 on vascular complications in Thai subjects with T2DM. METHODS We conducted a case-control study comprising 960 T2DM patients and 740 non-diabetes controls. Single nucleotide polymorphisms in TCF7L2, KCNQ1, and KCNJ11 were genotyped and evaluated for their association with diabetic vascular complications. RESULTS The gene variants TCF7L2 rs290487-T, KCNQ1 rs2237892-C, and KCNQ1 rs2237897-C were associated with increased risk of T2DM. TCF7L2 rs7903146-C, TCF7L2 rs290487-C, KCNQ1 rs2237892-T, and KCNQ1 rs2237897-T revealed an association with hypertension. The specific combination of risk-alleles that have effects on T2DM and hypertension, TCF7L2 rs7903146-C, KCNQ1 rs2237892-C, and KCNQ1 rs2237897-T, as genetic risk score (GRS), pronounced significant association with coronary artery disease (CAD), cumulative nephropathy and CAD, and cumulative microvascular and macrovascular complications (respective odds ratios [ORs] with 95% confidence interval [95% CI], comparing between GRS 2-3 and GRS 5-6, were 7.31 [2.03 to 26.35], 3.92 [1.75 to 8.76], and 2.33 [1.13 to 4.79]). CONCLUSION This study demonstrated, for the first time, the effect conferred by specific combined genetic variants in TCF7L2 and KCNQ1 on diabetic vascular complications, predominantly with nephropathy and CAD. Such a specific pattern of gene variant combination may implicate in the progression of T2DM and life-threatening vascular complications.
Collapse
Affiliation(s)
- Rujikorn Rattanatham
- Biomedical Sciences Program, Graduate School, Khon Kaen University, Khon Kaen, Thailand
- Cardiovascular Research Group, Khon Kaen University, Khon Kaen, Thailand
- Department of Medical Technology, School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat, Thailand
| | - Nongnuch Settasatian
- Cardiovascular Research Group, Khon Kaen University, Khon Kaen, Thailand
- School of Medical Technology, Faculty of Associated Medical Science, Khon Kaen University, Khon Kaen, Thailand
| | - Nantarat Komanasin
- Cardiovascular Research Group, Khon Kaen University, Khon Kaen, Thailand
- School of Medical Technology, Faculty of Associated Medical Science, Khon Kaen University, Khon Kaen, Thailand
| | - Upa Kukongviriyapan
- Cardiovascular Research Group, Khon Kaen University, Khon Kaen, Thailand
- Department of Physiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | | | - Phongsak Intharaphet
- Cardiovascular Research Group, Khon Kaen University, Khon Kaen, Thailand
- Queen Sirikit Heart Center of the Northeast, Khon Kaen University, Khon Kaen, Thailand
| | - Vichai Senthong
- Cardiovascular Research Group, Khon Kaen University, Khon Kaen, Thailand
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Queen Sirikit Heart Center of the Northeast, Khon Kaen University, Khon Kaen, Thailand
| | - Chatri Settasatian
- Cardiovascular Research Group, Khon Kaen University, Khon Kaen, Thailand
- Department of Pathology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Corresponding author: Chatri Settasatian https://orcid.org/0000-0002-2555-8700 Department of Pathology, Faculty of Medicine, Khon Kaen University, 123 Mittraphap Rd, Muang Khon Kaen District, Khon Kaen 40002, Thailand E-mail:
| |
Collapse
|
13
|
Wongsalap Y, Ungsriwong S, Kumtep W, Saokaew S, Senthong V, Kengkla K. Efficacy and Safety of Low-Dose Prasugrel Versus Clopidogrel in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention: a Systematic Review and Meta-analysis. Cardiovasc Drugs Ther 2021; 36:991-1000. [PMID: 34169380 DOI: 10.1007/s10557-021-07202-1] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/12/2021] [Indexed: 12/12/2022]
Abstract
PURPOSE To assess the efficacy and safety of low-dose prasugrel compared to clopidogrel based on the occurrence of major adverse cardiac events (MACEs) and major bleeding in patients with acute coronary syndromes (ACS) undergoing percutaneous coronary intervention (PCI). METHODS The PubMed, Embase, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov databases were systematically searched up to May 2020 to identify relevant randomized controlled trials (RCTs) and observational studies. A meta-analysis was conducted using a random effects model to estimate relative risks (RRs) with 95% confidence intervals (CIs). The primary efficacy and safety endpoints were MACE and major bleeding, respectively. RESULTS Three RCTs (n = 2884) and five observational studies (n = 30,117) were included. A meta-analysis of RCTs revealed no significant differences in terms of MACE (RR 0.92, 95% CI 0.74 to 1.16) or major bleeding (RR 0.97, 95% CI 0.57 to 1.65) between low-dose prasugrel and clopidogrel. A meta-analysis of observational studies revealed no significant difference in terms of MACE (RR 1.13, 95% CI 0.82 to 1.55) between the two groups, but low-dose prasugrel was associated with a significantly increased risk of major bleeding (RR 1.33, 95% CI 1.02 to 1.72). CONCLUSIONS We found that low-dose prasugrel was not associated with changes in MACE or major bleeding compared with clopidogrel in RCTs. However, analysis of data from observational studies revealed that low-dose prasugrel was associated with an increased risk of major bleeding compared with clopidogrel.
Collapse
Affiliation(s)
- Yuttana Wongsalap
- School of Pharmaceutical Sciences, University of Phayao, Phayao, Thailand.,Division of Pharmacy Practice, Department of Pharmaceutical Care, School of Pharmaceutical Sciences, University of Phayao, Phayao, Thailand.,Center of Health Outcomes Research and Therapeutic Safety (Cohorts), School of Pharmaceutical Sciences, University of Phayao, Phayao, 56000, Thailand.,Unit of Excellence On Clinical Outcomes Research and IntegratioN (UNICORN), School of Pharmaceutical Sciences, University of Phayao, Phayao, Thailand
| | | | - Wanalee Kumtep
- School of Pharmaceutical Sciences, University of Phayao, Phayao, Thailand
| | - Surasak Saokaew
- School of Pharmaceutical Sciences, University of Phayao, Phayao, Thailand.,Division of Pharmacy Practice, Department of Pharmaceutical Care, School of Pharmaceutical Sciences, University of Phayao, Phayao, Thailand.,Center of Health Outcomes Research and Therapeutic Safety (Cohorts), School of Pharmaceutical Sciences, University of Phayao, Phayao, 56000, Thailand.,Unit of Excellence On Clinical Outcomes Research and IntegratioN (UNICORN), School of Pharmaceutical Sciences, University of Phayao, Phayao, Thailand.,Biofunctional Molecule Exploratory Research Group, Biomedicine Research Advancement Centre, School of Pharmacy, Monash University Malaysia, Selangor Darul Ehsan, Bandar Sunway, Malaysia.,Novel Bacteria and Drug Discovery Research Group, Microbiome and Bioresource Research Strength, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Selangor DarulEhsan, Bandar Sunway, Malaysia
| | - Vichai Senthong
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Kirati Kengkla
- School of Pharmaceutical Sciences, University of Phayao, Phayao, Thailand. .,Division of Pharmacy Practice, Department of Pharmaceutical Care, School of Pharmaceutical Sciences, University of Phayao, Phayao, Thailand. .,Center of Health Outcomes Research and Therapeutic Safety (Cohorts), School of Pharmaceutical Sciences, University of Phayao, Phayao, 56000, Thailand. .,Unit of Excellence On Clinical Outcomes Research and IntegratioN (UNICORN), School of Pharmaceutical Sciences, University of Phayao, Phayao, Thailand.
| |
Collapse
|
14
|
Khamsai S, Chootrakool A, Limpawattana P, Chindaprasirt J, Sukeepaisarnjaroen W, Chotmongkol V, Silaruks S, Senthong V, Sittichanbuncha Y, Sawunyavisuth B, Sawanyawisuth K. Hypertensive crisis in patients with obstructive sleep apnea-induced hypertension. BMC Cardiovasc Disord 2021; 21:310. [PMID: 34162333 PMCID: PMC8220687 DOI: 10.1186/s12872-021-02119-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 06/11/2021] [Indexed: 11/18/2022] Open
Abstract
Background Hypertensive crisis is an urgent/emergency condition. Although obstructive sleep apnea (OSA) in resistant hypertension has been thoroughly examined, information regarding the risk factors and prevalence of hypertensive crisis in co-existing OSA and hypertension is limited. This study thus aimed to determine prevalence of and risk factors for hypertensive crisis in patients with hypertension caused by OSA. Methods The inclusion criteria were age of 18 years or over and diagnosis of co-existing OSA and hypertension. Those patients with other causes of secondary hypertension were excluded. Patients were categorized by occurrence of hypertensive crisis. Factors associated with hypertensive crisis were calculated using multivariate logistic regression analysis. Results There were 121 patients met the study criteria. Of those, 19 patients (15.70%) had history of hypertensive crisis. Those patients in hypertensive crisis group had significant higher systolic and diastolic blood pressure at regular follow-ups than those without hypertensive crisis patients (177 vs. 141 mmHg and 108 vs. 85 mmHg; p value < 0.001 for both factors). After adjusted for age, sex, and Mallampati classification, only systolic blood pressure was independently associated with hypertensive crisis with adjusted odds ratio (95% CI) of 1.046 (1.012, 1.080). Conclusions The prevalence of hypertensive crisis in co-existing OSA and hypertension was 15.70% and high systolic blood pressure or uncontrolled blood pressure associated with hypertensive crisis in patients with OSA-associated hypertension. ![]()
Collapse
Affiliation(s)
- Sittichai Khamsai
- Department of Medicine, Faculty of Medicine, Khon Kaen University, 123 Mitraparp Road, Khon Kaen, 40002, Thailand
| | - Apichart Chootrakool
- Department of Medicine, Faculty of Medicine, Khon Kaen University, 123 Mitraparp Road, Khon Kaen, 40002, Thailand
| | - Panita Limpawattana
- Department of Medicine, Faculty of Medicine, Khon Kaen University, 123 Mitraparp Road, Khon Kaen, 40002, Thailand
| | - Jarin Chindaprasirt
- Department of Medicine, Faculty of Medicine, Khon Kaen University, 123 Mitraparp Road, Khon Kaen, 40002, Thailand
| | - Wattana Sukeepaisarnjaroen
- Department of Medicine, Faculty of Medicine, Khon Kaen University, 123 Mitraparp Road, Khon Kaen, 40002, Thailand
| | - Verajit Chotmongkol
- Department of Medicine, Faculty of Medicine, Khon Kaen University, 123 Mitraparp Road, Khon Kaen, 40002, Thailand
| | - Songkwan Silaruks
- Department of Medicine, Faculty of Medicine, Khon Kaen University, 123 Mitraparp Road, Khon Kaen, 40002, Thailand
| | - Vichai Senthong
- Department of Medicine, Faculty of Medicine, Khon Kaen University, 123 Mitraparp Road, Khon Kaen, 40002, Thailand
| | - Yuwares Sittichanbuncha
- Department of Emergency Medicine, Mahidol University, Ramathibodi Hospital, Bangkok, Thailand
| | - Bundit Sawunyavisuth
- Department of Marketing, Faculty of Business Administration and Accountancy, Khon Kaen University, Khon Kaen, Thailand
| | - Kittisak Sawanyawisuth
- Department of Medicine, Faculty of Medicine, Khon Kaen University, 123 Mitraparp Road, Khon Kaen, 40002, Thailand.
| |
Collapse
|
15
|
Khamsai S, Kachenchart S, Sawunyavisuth B, Limpawattana P, Chindaprasirt J, Senthong V, Chotmongkol V, Pongkulkiat P, Sawanyawisuth K. Prevalence and Risk Factors of Obstructive Sleep Apnea in Hypertensive Emergency. J Emerg Trauma Shock 2021; 14:104-107. [PMID: 34321809 PMCID: PMC8312912 DOI: 10.4103/jets.jets_47_20] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 04/12/2020] [Revised: 05/23/2020] [Accepted: 06/23/2020] [Indexed: 11/23/2022] Open
Abstract
Introduction: Obstructive sleep apnea (OSA) is a common factor associated with hypertensive crises. There is limited evidence of prevalence and risk factors of OSA in hypertensive emergency. Methods: This study recruited adult patients who diagnosed as hypertensive emergency and tested for OSA. The study period was between July 2019 and January 2020. The patients were categorized as OSA and non-OSA groups by the evidence from polysomnography. Prevalence and risk factors for OSA were executed. Results: During the study, there were 52 eligible patients. Of those, 30 patients (57.69%) were diagnosed with OSA. The stepwise logistic regression analysis for predicting OSA had two remaining factors: body mass index and diastolic blood pressure. Only body mass index was independently associated with OSA with an adjusted odds ratio of 1.166 (95% confidence interval of 1.033, 1.316). The body mass index of 25.02 kg/m2 gave sensitivity and specificity of 80.00% and 59.09%, respectively. The area under the receiver operating characteristic curve was 70.98%. Conclusion: OSA had high incidence rate in patients with hypertensive emergency. High body mass index was a predictor for OSA associated with hypertensive emergency.
Collapse
Affiliation(s)
- Sittichai Khamsai
- Department of Medicine, Faculty of Medicine, Sleep Apnea Research Group, Khon Kaen University, Khon Kaen, Thailand
| | - Sitthan Kachenchart
- Department of Medicine, Faculty of Medicine, Sleep Apnea Research Group, Khon Kaen University, Khon Kaen, Thailand
| | - Bundit Sawunyavisuth
- Department of Marketing, Faculty of Business Administration and Accountancy, Khon Kaen University, Khon Kaen, Thailand
| | - Panita Limpawattana
- Department of Medicine, Faculty of Medicine, Sleep Apnea Research Group, Khon Kaen University, Khon Kaen, Thailand
| | - Jarin Chindaprasirt
- Department of Medicine, Faculty of Medicine, Sleep Apnea Research Group, Khon Kaen University, Khon Kaen, Thailand
| | - Vichai Senthong
- Department of Medicine, Faculty of Medicine, Sleep Apnea Research Group, Khon Kaen University, Khon Kaen, Thailand
| | - Verajit Chotmongkol
- Department of Medicine, Faculty of Medicine, Sleep Apnea Research Group, Khon Kaen University, Khon Kaen, Thailand
| | - Patnarin Pongkulkiat
- Department of Medicine, Faculty of Medicine, Sleep Apnea Research Group, Khon Kaen University, Khon Kaen, Thailand
| | - Kittisak Sawanyawisuth
- Department of Medicine, Faculty of Medicine, Sleep Apnea Research Group, Khon Kaen University, Khon Kaen, Thailand
| |
Collapse
|
16
|
Khamsai S, Mahawarakorn P, Limpawattana P, Chindaprasirt J, Sukeepaisarnjaroen W, Silaruks S, Senthong V, Sawunyavisuth B, Sawanyawisuth K. Prevalence and factors correlated with hypertension secondary from obstructive sleep apnea. Multidiscip Respir Med 2021; 16:777. [PMID: 34650797 PMCID: PMC8447556 DOI: 10.4081/mrm.2021.777] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 06/25/2021] [Indexed: 12/28/2022] Open
Abstract
Background In 2003, the JNC 7 reported obstructive sleep apnea (OSA) as a cause of secondary hypertension. The prevalence of OSA in hypertension ranges from 30-80%. There are limited data on the prevalence and risk factors of OSA in hypertensive patients. This study thus aimed to evaluate prevalence and clinical predictors of obstructive sleep apnea (OSA) in these patients. Methods This was a cross-sectional study and conducted at the hypertension clinic at Khon Kaen University’s Srinagarind Hospital, Thailand. We enrolled patients with hypertension treated at the clinic. OSA was defined as apnea-hypopnea index of 5 events/hour or over according to cardiopulmonary monitoring. Patients whose hypertension was due to any other causes were excluded. The prevalence of OSA was calculated and risk factors for OSA were analyzed using multivariate logistic regression. Results There were 726 hypertensive patients treated at the clinic. Out of those, 253 (34.8%) were randomly studied and categorized as either non-OSA (147 patients, 58.1%) or OSA (106 patients, 41.9%). There were four independent factors associated with OSA-induced hypertension: age, sex, history of snoring, and history of headache. Headache had an adjusted odds ratio (95% confidence interval) of 3.564 (95% confidence interval of 1.510, 8.411). Conclusion Age, male sex, history of snoring, and headache were independent predictors of hypertension caused by OSA.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | - Bundit Sawunyavisuth
- Department of Marketing, Faculty of Business Administration and Accountancy, Khon Kaen University, Khon Kaen, Thailand
| | | |
Collapse
|
17
|
Soontornrungsun B, Khamsai S, Sawunyavisuth B, Limpawattana P, Chindaprasirt J, Senthong V, Chotmongkol V, Sawanyawisuth K. Obstructive sleep apnea in patients with diabetes less than 40 years of age. Diabetes Metab Syndr 2020; 14:1859-1863. [PMID: 32992217 DOI: 10.1016/j.dsx.2020.09.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [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: 03/11/2020] [Revised: 05/02/2020] [Accepted: 09/06/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND AND AIM Obstructive sleep apnea (OSA) is known to be associated with diabetes mellitus (DM). Age is factor associated with different clinical features of OSA. There is limited data on clinical differences of young DM patients with OSA versus older DM patients with OSA. This study aimed to find clinical differences of DM coexisting with OSA between young age group and older. METHODS This is a retrospective, analytical study conducted at Srinagarind Hospital, Thailand. The inclusion criteria were adult patients diagnosed as DM with OSA. The study period was between January 2008 and December 2019. The diagnosis of OSA was made by presence of apnea hypopnea index (AHI) of ≥5 times/hour by polysomnography. Clinical predictors of OSA in young DM patients with age under 40 years were executed. RESULTS There were 56 patients in the young diabetes mellitus group, while there were 137 patients in the older diabetes mellitus group. The mean (SD) age of diagnosis for diabetes mellitus of both groups were 31.61 (6.53) and 54.68 (7.62) years, respectively. There were three independent predictors for DM in the young: atrial fibrillation (AF), body mass index (BMI) and glomerular filtration rate (GFR). Presence of AF perfectly predicted DM with OSA in age over 40 years. The adjusted odds ratio for BMI and GFR were 1.29 (95% CI 1.05, 1.58) and 1.06 (1.01, 1.13). The BMI over 32 kg/m2 and GFR over 77 ml/min/m2 gave sensitivity of 80.00%. CONCLUSIONS Young DM patients with OSA had more severe OSA, were more obese, had better renal function, and had fewer AF than the older ones.
Collapse
Affiliation(s)
- Benjawan Soontornrungsun
- Department of Medicine, Faculty of Medicine, Sleep Apnea Research Group, Khon Kaen University, Khon Kaen, Thailand
| | - Sittichai Khamsai
- Department of Medicine, Faculty of Medicine, Sleep Apnea Research Group, Khon Kaen University, Khon Kaen, Thailand
| | - Bundit Sawunyavisuth
- Department of Marketing, Faculty of Business Administration and Accountancy, Khon Kaen University, Khon Kaen, Thailand
| | - Panita Limpawattana
- Department of Medicine, Faculty of Medicine, Sleep Apnea Research Group, Khon Kaen University, Khon Kaen, Thailand
| | - Jarin Chindaprasirt
- Department of Medicine, Faculty of Medicine, Sleep Apnea Research Group, Khon Kaen University, Khon Kaen, Thailand
| | - Vichai Senthong
- Department of Medicine, Faculty of Medicine, Sleep Apnea Research Group, Khon Kaen University, Khon Kaen, Thailand
| | - Verajit Chotmongkol
- Department of Medicine, Faculty of Medicine, Sleep Apnea Research Group, Khon Kaen University, Khon Kaen, Thailand
| | - Kittisak Sawanyawisuth
- Department of Medicine, Faculty of Medicine, Sleep Apnea Research Group, Khon Kaen University, Khon Kaen, Thailand.
| |
Collapse
|
18
|
Sarutipaiboon I, Settasatian N, Komanasin N, Kukongwiriyapan U, Sawanyawisuth K, Intharaphet P, Senthong V, Settasatian C. Association of Genetic Variations in NRF2, NQO1, HMOX1, and MT with Severity of Coronary Artery Disease and Related Risk Factors. Cardiovasc Toxicol 2020; 20:176-189. [PMID: 31332605 DOI: 10.1007/s12012-019-09544-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
NRF2 is a transcription factor which, during oxidative stress, activates transcription of its target antioxidant genes. Polymorphisms in NRF2 and its target antioxidant genes: HMOX-1, NQO1, and MT, have been associated with cardiovascular diseases (CVDs) and diabetes in various ethnic groups, however, with variable results. The aim of this study was to investigate the association of NRF2, HMOX-1, NQO1, and MT gene polymorphisms with CVD risk factors in Thais. The study was conducted in two groups: group with high-risk for coronary artery disease (CAD) and health check-up group. Polymorphisms in NRF2 (rs6721961), NQO1 (rs1800566), MT1A (rs11640851), and HMOX-1 (rs2071746) were genotyped. Expressions of NRF2, HMOX-1, and NQO1 were also determined. In high-risk group, NRF2 rs6721961-TT was associated with CAD [OR (95% CI) 5.07 (1.42-18.10)] and severity of coronary atherosclerosis [Gensini score > 32, OR (95% CI) 4.31 (1.67-11.09)]; rs6721961 GT and TT revealed significant association with lower mRNA expression than GG (p = 0.021). NQO1 rs1800566 also revealed association with CAD, only in female. Combined effect of NQO1-rs1800566, HMOX1-rs2071746, and MT1A-rs11640851 was evaluated on the risks of DM and hypertension. With a combination of risk alleles as genetic risk score (GRS), the highest GRS (score 6) increased risk for hypertension, comparing with GRS 0-2 [OR (95% CI) 1.89 (1.02-3.49)]; group with score 5-6 revealed association with risk of DM [OR (95% CI) 1.481 (1.08-2.04)]. In conclusion, NRF2 rs6721961 associated with CAD and severity of coronary atherosclerosis. NQO1 rs1800566 also associated with CAD, only in female. Combined polymorphisms of three NRF2-regulated genes increased risk of DM and hypertension.
Collapse
Affiliation(s)
- Ingkarat Sarutipaiboon
- Biomedical Sciences Program, Graduate School, Khon Kaen University, Khon Kaen, 40002, Thailand.,Cardiovascular Research Group, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Nongnuch Settasatian
- School of Medical Technology, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, 40002, Thailand.,Cardiovascular Research Group, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Nantarat Komanasin
- School of Medical Technology, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, 40002, Thailand.,Cardiovascular Research Group, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Upa Kukongwiriyapan
- Department of Physiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand.,Cardiovascular Research Group, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Kittisak Sawanyawisuth
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Phongsak Intharaphet
- Queen Sirikit Heart Center of the Northeast Hospital, Khon Kaen University, Khon Kaen, 40002, Thailand.,Cardiovascular Research Group, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Vichai Senthong
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand.,Queen Sirikit Heart Center of the Northeast Hospital, Khon Kaen University, Khon Kaen, 40002, Thailand.,Cardiovascular Research Group, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Chatri Settasatian
- Department of Pathology, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand. .,Cardiovascular Research Group, Khon Kaen University, Khon Kaen, 40002, Thailand.
| |
Collapse
|
19
|
Sawanyawisuth K, Sawanyawisuth K, Senthong V, Limpawattana P, Intapan PM, Maleewong W, Prasongdee T, Naonongwai S, Tiamkao S, Chotmongkol V, Khamsai S. Clinical features and course of Angiostrongylus cantonensis eosinophilic meningitis in patients receiving supportive therapy. Food Waterborne Parasitol 2020; 21:e00095. [PMID: 33294648 PMCID: PMC7689049 DOI: 10.1016/j.fawpar.2020.e00095] [Citation(s) in RCA: 3] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 09/08/2020] [Accepted: 09/14/2020] [Indexed: 11/24/2022] Open
Abstract
Acute severe headache is the main presentation of eosinophilic meningitis (EOM) caused by Angiostrongylus cantonensis. Oral corticosteroid treatment is effective in reduction of duration of headache but may be contraindicated in particular patients. This study investigated clinical features and clinical course of eosinophilic meningitis caused by A. cantonensis if left untreated. Additionally, factors associated with duration of headache were evaluated. We conducted a retrospective study between 1997 and 2019 at a university hospital in Thailand. The inclusion criteria were adult patients who were diagnosed with EOM, had a positive serological test for A. cantonensis, received only supportive treatment, and had the complete clinical course documented. Factors associated with duration of headache were executed by multivariate linear regression analysis. A total of 54 patients were used in the final analysis. Of those, 39 patients (79.2%) were male and the mean ± SD age of all patients was 33.7 ± 12.2. The mean ± SD duration of headache was 16.0 ± 12.4 days with the longest duration of 49 days. The only factor associated with duration of headache was gender (p = 0.036). The male gender had a coefficient of −8.4 (95% CI: −16.2, −0.6). The median duration of headache in male and female patients was 11 and 20 days, respectively. In conclusion, A. cantonensis eosinophilic meningitis can cause long lasting headache, and gender may be associated with duration of headache.
Collapse
Affiliation(s)
| | | | - Vichai Senthong
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Panita Limpawattana
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Pewpan M Intapan
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Wanchai Maleewong
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Thidarat Prasongdee
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Sureeporn Naonongwai
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Somsak Tiamkao
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Verajit Chotmongkol
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Sittichai Khamsai
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| |
Collapse
|
20
|
Jinchai J, Khamsai S, Chattakul P, Limpawattana P, Chindaprasirt J, Chotmongkol V, Silaruks S, Senthong V, Sawanyawisuth K. How common is obstructive sleep apnea in young hypertensive patients? Intern Emerg Med 2020; 15:1005-1010. [PMID: 31970622 DOI: 10.1007/s11739-019-02273-3] [Citation(s) in RCA: 4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Accepted: 12/30/2019] [Indexed: 11/26/2022]
Abstract
Obstructive sleep apnea (OSA) has been reported to be a cause of hypertension in 40-80% of hypertensive patients. However, there are limited data available on the prevalence and predictors of OSA in young hypertensive patients. This study was conducted between October 2017 and October 2018. The inclusion criteria were (1) age over 18 and under 35 years (2) diagnosis with hypertension and (3) available respiratory polysomnography results. Patients with other causes of secondary hypertension were excluded. Predictors for OSA were analyzed using multivariate logistic regression analysis. There were 593 consecutive young patients who were diagnosed with hypertension during the study period. Of those, 475 (80.10%) were excluded due to their hypertension having renal causes (429; 90.32%), endocrine-related causes (40; 8.42%), or cardiovascular causes (6; 1.26%). Of the remaining patients (118 patients) who were eligible for the study, 105 (88.98%) of whom were diagnosed with OSA. The median age of the patients with OSA did not differ from those without OSA (29 vs 23 years; p value 0.065). There were two independent predictors for OSA: age and body mass index with adjusted odds ratios (95% confidence interval) of 1.280 (1.049, 1.562) and 1.258 (1.083, 1.462), respectively. In conclusion, after excluding other possible causes of hypertension, we found OSA to be highly prevalent in hypertensive patients younger than 35 years old. Increasing age and high body mass index were predictors for OSA in young hypertensive patients.
Collapse
Affiliation(s)
- Jittirat Jinchai
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand
- Sleep Apnea Research Group, and Research Center in Back, Neck and Other Joint Pain and Human Performance, Khon Kaen University, Khon Kaen, Thailand
| | - Sittichai Khamsai
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Paiboon Chattakul
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Panita Limpawattana
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Jarin Chindaprasirt
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Verajit Chotmongkol
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Songkwan Silaruks
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Vichai Senthong
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Kittisak Sawanyawisuth
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand.
- Sleep Apnea Research Group, and Research Center in Back, Neck and Other Joint Pain and Human Performance, Khon Kaen University, Khon Kaen, Thailand.
| |
Collapse
|
21
|
Chaichan S, Asawalertsaeng T, Veerapongtongchai P, Chattakul P, Khamsai S, Pongkulkiat P, Chotmongkol V, Limpawattana P, Chindaprasirt J, Senthong V, Ngamjarus C, Sittichanbuncha Y, Kitkhuandee A, Sawanyawisuth K. Are full-face helmets the most effective in preventing head and neck injury in motorcycle accidents? A meta-analysis. Prev Med Rep 2020; 19:101118. [PMID: 32509508 PMCID: PMC7264075 DOI: 10.1016/j.pmedr.2020.101118] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 03/21/2020] [Accepted: 05/08/2020] [Indexed: 12/02/2022] Open
Abstract
Motorcycles are the most common type of vehicle involved in traffic deaths in developing countries. Although helmets can provide protection against injury, there is limited evidence available regarding which type of helmet best protects against head and neck injuries in this setting. This review was conducted based on articles in the PubMed, Scopus, and Web of Science databases. We compared full-face helmets with other types of helmet with regard to head and neck injury prevention in road accidents involving motorcyclists. Of 702 studies, six were eligible with a total of 6,529 participants. When compared with partial and open helmets, the odds ratio of full-face helmets was 0.356 (95% CI of 0.280, 0.453) and 0.636 (95% CI of 0.453, 0.894), respectively, for reduction of head and neck injuries. In conclusion, full-face helmets reduced head and neck injuries in motorcycle accidents to a greater extent than other types of helmet. Policy makers should recommend that motorcyclists use full-face helmets.
Collapse
Affiliation(s)
| | | | | | - Paiboon Chattakul
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Sittichai Khamsai
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Patnarin Pongkulkiat
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Verajit Chotmongkol
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Panita Limpawattana
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Jarin Chindaprasirt
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Vichai Senthong
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Chetta Ngamjarus
- Department of Epidemiology and Biostatistics, Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand
| | - Yuwares Sittichanbuncha
- Department of Emergency Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Amnat Kitkhuandee
- Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | | |
Collapse
|
22
|
Sawanyawisuth K, Chattakul P, Khamsai S, Boonsawat W, Ladla A, Chotmongkol V, Limpawattana P, Chindaprasirt J, Senthong V, Phitsanuwong C, Sawanyawisuth K. Role of Inhaled Corticosteroids for Asthma Exacerbation in Children: An Updated Meta-Analysis. J Emerg Trauma Shock 2020; 13:161-166. [PMID: 33013097 PMCID: PMC7472813 DOI: 10.4103/jets.jets_116_19] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 02/24/2020] [Accepted: 03/06/2020] [Indexed: 11/28/2022] Open
Abstract
Background: Several studies showed that inhaled corticosteroids (ICS) may be a potential treatment in acute asthma exacerbation in children. This study was an update meta-analysis on the roles of ICS in the management of acute asthma exacerbation in children presenting to the hospital. Materials and Methods: Published articles with key words of ICS for asthma exacerbation, asthma attacks, and acute asthma in children aged under 18 years in the hospital setting with outcome of hospital admission between 2009 and 2018 were enrolled. The databases used in this study were Medline, Scopus, and Web of Science. Odds ratio of comparison between ICS and other treatments on hospital admissions was calculated. Results: There were 311 eligible studies met the searching criteria; seven eligible studies for the analysis; comprised of three meta-analysis and four added studies. The ICS had a significant reduction in hospital admission compared with placebo in overall with odds ratio of 0.63 (95% confidence interval [CI]: 0.41–0.96) and in moderate-to-severe group with odds ratio of 0.17 (95% CI: 0.05–0.51). Comparing with systemic corticosteroid (SC), ICS had significantly lower hospital admissions overall and in mild-to-moderate group with odds ratios of 0.63 and 0.26, respectively. The combination of ICS and SC had odds ratio of 0.75 (95% CI: 0.57–0.99) over SC in moderate-to-severe asthma exacerbation. Conclusions: ICS significantly reduced hospital admission in asthma exacerbation in children. It may be used alone for mild-to-moderate asthma exacerbation and combination with SC for moderate-to-severe asthma exacerbation.
Collapse
Affiliation(s)
- Kanlayanee Sawanyawisuth
- Department of Biochemistry, Faculty of Medicine, Khon Kaen, Thailand.,Sleep Apnea Research Group, Research Center in Back, Neck and Other Joint Pain and Human Performance, Khon Kaen University, Khon Kaen, Thailand
| | - Paiboon Chattakul
- Sleep Apnea Research Group, Research Center in Back, Neck and Other Joint Pain and Human Performance, Khon Kaen University, Khon Kaen, Thailand.,Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Sittichai Khamsai
- Sleep Apnea Research Group, Research Center in Back, Neck and Other Joint Pain and Human Performance, Khon Kaen University, Khon Kaen, Thailand.,Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Watchara Boonsawat
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Arinrada Ladla
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Verajit Chotmongkol
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Panita Limpawattana
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Jarin Chindaprasirt
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Vichai Senthong
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | | | - Kittisak Sawanyawisuth
- Sleep Apnea Research Group, Research Center in Back, Neck and Other Joint Pain and Human Performance, Khon Kaen University, Khon Kaen, Thailand.,Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| |
Collapse
|
23
|
Chattakul P, Napinkul P, Khamsai S, Limpawattana P, Chindaprasirt J, Chotmongkol V, Silaruks S, Senthong V, Yuenyaow L, Wansutha S, Timinkul A, Phitsanuwong C, Sawanyawisuth K. Additional risk factors associated with symptomatic hydrochlorothiazide-induced hyponatremia in hypertensive patients. Arterial Hypertension 2020. [DOI: 10.5603/ah.a2020.0003] [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: 11/25/2022] Open
|
24
|
Silaruks S, Khamsai, Chootrakul A, Chindaprasirt J, Chotmongkol V, Senthong V, Sittichanbuncha Y, Sawanyawisuth K. 052 Factors associated With Hypertensive Crisis Occurrence in Obstructive Sleep Apnea Induced Hypertension Patients. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.059] [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: 11/28/2022]
|
25
|
Abstract
PURPOSE OF REVIEW Trimethylamine N-oxide (TMAO) is a gut microbiota-dependent metabolite produced from choline and phosphatidylcholine. Trimethylamine N-oxide was found associated with enhanced atherosclerosis and thrombosis in vitro and in vivo. We summarized available clinical studies which investigated TMAO's role in predicting prognostic outcomes, including mortality, in patients with cardiovascular diseases. RECENT FINDINGS In chronic kidney disease cohorts, higher TMAO levels were significantly associated with higher mortality from 1.18 to 4.32 folds. Higher TMAO levels were not significantly associated with mortality in patient undergoing dialysis. In patients with peripheral artery disease, higher TMAO levels were associated with higher overall mortality from 1.38 to 2.06 folds. In patients with type 2 diabetes, higher TMAO levels were significantly associated with higher overall mortality 2.07 to 2.7 folds. In patients with heart failure, higher TMAO levels were associated with higher mortality or cardiac transplantation 1.18 to 1.79 folds. TMAO levels could potentially be integrated to existed risk stratification tools and could lead to novel prevention and treatment approaches to cardiovascular disease. Nonetheless, more studies would be needed to clarify predictive value of TMAO to specific groups of patients. Mechanisms how TMAO affect atherosclerosis and confounding effects of TMAO with traditional cardiovascular parameters should also be further investigated.
Collapse
Affiliation(s)
| | | | - Suranut Charoensri
- Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Vichai Senthong
- Cardiovascular Unit, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand.
| |
Collapse
|
26
|
Decharatchakul N, Settasatian C, Settasatian N, Komanasin N, Kukongviriyapan U, Intharaphet P, Senthong V. Association of genetic polymorphisms in SOD2, SOD3, GPX3, and GSTT1 with hypertriglyceridemia and low HDL-C level in subjects with high risk of coronary artery disease. PeerJ 2019; 7:e7407. [PMID: 31396447 PMCID: PMC6679910 DOI: 10.7717/peerj.7407] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Accepted: 07/04/2019] [Indexed: 12/11/2022] Open
Abstract
Background Oxidative stress modulates insulin resistant-related atherogenic dyslipidemia: hypertriglyceridemia (HTG) and low high-density lipoprotein cholesterol (HDL-C) level. Gene polymorphisms in superoxide dismutase (SOD2 and SOD3), glutathione peroxidase-3 (GPX3), and glutathione S-transferase theta-1 (GSTT1) may enable oxidative stress-related lipid abnormalities and severity of coronary atherosclerosis. The present study investigated the associations of antioxidant-related gene polymorphisms with atherogenic dyslipidemia and atherosclerotic severity in subjects with high risk of coronary artery disease (CAD). Methods Study population comprises of 396 subjects with high risk of CAD. Gene polymorphisms: SOD2 rs4880, SOD3 rs2536512 and rs2855262, GPX rs3828599, and GSTT1 (deletion) were evaluated the associations with HTG, low HDL-C, high TG/HDL-C ratio, and severity of coronary atherosclerosis. Results SOD2 rs4880-CC, SOD3 rs2536512-AA, rs2855262-CC, and GPX3 rs3828599-AA, but not GSTT1-/- individually increased risk of HTG combined with low HDL-C level. With a combination of five risk-genotypes as a genetic risk score (GRS), GRS ≥ 6 increased risks of low HDL-C, high TG/HDL-C ratio, and HTG combined with low HDL-C, comparing with GRS 0–2 [respective adjusted ORs (95% CI) = 2.70 (1.24–5.85), 3.11 (1.55–6.23), and 5.73 (2.22–14.77)]. Gene polymorphisms, though, were not directly associated with severity of coronary atherosclerosis; high TG/HDL-C ratio was associated with coronary atherosclerotic severity [OR = 2.26 (95% CI [1.17–4.34])]. Conclusion Combined polymorphisms in antioxidant-related genes increased the risk of dyslipidemia related to atherosclerotic severity, suggesting the combined antioxidant-related gene polymorphisms as predictor of atherogenic dyslipidemia.
Collapse
Affiliation(s)
- Nisa Decharatchakul
- Biomedical Sciences Program, Graduate School, Khon Kaen University, Khon Kaen, Thailand.,Cardiovascular Research Group, Khon Kaen University, Khon Kaen, Thailand
| | - Chatri Settasatian
- Cardiovascular Research Group, Khon Kaen University, Khon Kaen, Thailand.,Department of Pathology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Nongnuch Settasatian
- Cardiovascular Research Group, Khon Kaen University, Khon Kaen, Thailand.,School of Medical Technology, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
| | - Nantarat Komanasin
- Cardiovascular Research Group, Khon Kaen University, Khon Kaen, Thailand.,School of Medical Technology, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
| | - Upa Kukongviriyapan
- Cardiovascular Research Group, Khon Kaen University, Khon Kaen, Thailand.,Department of Physiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Phongsak Intharaphet
- Cardiovascular Research Group, Khon Kaen University, Khon Kaen, Thailand.,Queen Sirikit Heart Center of the Northeast, Khon Kaen University, Khon Kaen, Thailand
| | - Vichai Senthong
- Cardiovascular Research Group, Khon Kaen University, Khon Kaen, Thailand.,Queen Sirikit Heart Center of the Northeast, Khon Kaen University, Khon Kaen, Thailand.,Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| |
Collapse
|
27
|
Saeseow S, Chattakul P, Khamsai S, Limpawattana P, Chindaprasirt J, Chotmongkol V, Silaruks S, Senthong V, Sawanyawisuth K. Predictors for Obesity Hypoventilation Syndrome in Thai Population. Sleep Med Res 2019. [DOI: 10.17241/smr.2019.00318] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
28
|
Aekphachaisawat N, Sawanyawisuth K, Khamsai S, Chattakul P, Takahashi K, Chotmongkol V, Tiamkao S, Limpawattana P, Senthong V, Chindaprasirt J, Theeranut A, Ngamjarus C. An ecological study of eosinophilic meningitis caused by the nematode, Angiostrongylus cantonensis (Chen, 1935) (Nematoda: Metastrongylidae). Parasitol Int 2019; 72:101944. [PMID: 31220635 DOI: 10.1016/j.parint.2019.101944] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 03/27/2019] [Revised: 05/28/2019] [Accepted: 06/17/2019] [Indexed: 11/30/2022]
Abstract
Climate change and other weather factors are associated with several infectious diseases, but are rarely reported as being associated with nematode infection. Eosinophilic meningitis (EOM) is an emerging disease worldwide caused by the nematode, Angiostrongylus cantonensis. It is transmitted through various agents such as snails and slugs. Temperature and rainfall are associated with snail population. There have been no previous studies on the relationship between weather and EOM. This was an ecological study. Numbers of EOM patients and weather data in Thailand's Loei province from 2006 to 2017 were obtained using a national database. A Spearman correlation was used to explore the relationship between EOM and weather variables. We developed a Poisson time series model combined with a distributed lag model (DLM) for estimating the effects of weather on EOM. We also created an autoregressive integrated moving average with exogeneous variable (ARIMAX) model for predicting future EOM cases over the following 12 months. There were 1126 EOM patients in the study. Among several weather factors, wind was significantly negatively correlated with the number of EOM patients (rs: -0.204, 95% CI: -0.361 to -0.058; p value: 0.014). The ARIMAX(3, 0, 0) model with wind speed as a variable was appropriate for predicting the number of EOM patients. The predicted and actual numbers of EOM patients in 2018 were highly concordant. In conclusion, wind speed is significantly negatively correlated with the number of EOM patients.
Collapse
Affiliation(s)
- Noppadol Aekphachaisawat
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; Sleep Apnea Research Group, Research Center in Back, Neck and Other Joint Pain and Human Performance, Research and Training Center for Enhancing Quality of Life of Working Age People, Research and Diagnostic Center for Emerging Infectious Diseases (RCEID), Khon Kaen University, Khon Kaen, Thailand
| | - Kittisak Sawanyawisuth
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; Sleep Apnea Research Group, Research Center in Back, Neck and Other Joint Pain and Human Performance, Research and Training Center for Enhancing Quality of Life of Working Age People, Research and Diagnostic Center for Emerging Infectious Diseases (RCEID), Khon Kaen University, Khon Kaen, Thailand
| | - Sittichai Khamsai
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Paiboon Chattakul
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Ken Takahashi
- Asbestos Diseases Research Institute, Sydney, Australia
| | - Verajit Chotmongkol
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Somsak Tiamkao
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Panita Limpawattana
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Vichai Senthong
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Jarin Chindaprasirt
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Ampornpan Theeranut
- Department of Adult Nursing, Faculty of Nursing, Khon Kaen University, Khon Kaen, Thailand
| | - Chetta Ngamjarus
- Department of Epidemiology and Biostatistics, Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand; Sleep Apnea Research Group, Research Center in Back, Neck and Other Joint Pain and Human Performance, Research and Training Center for Enhancing Quality of Life of Working Age People, Research and Diagnostic Center for Emerging Infectious Diseases (RCEID), Khon Kaen University, Khon Kaen, Thailand.
| |
Collapse
|
29
|
Rattanawan C, Komanasin N, Settasatian N, Settasatian C, Kukongviriyapan U, Intharapetch P, Senthong V. Association of TAFI gene polymorphisms with severity of coronary stenosis in stable coronary artery disease. Thromb Res 2018; 171:171-176. [PMID: 30321704 DOI: 10.1016/j.thromres.2018.10.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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: 06/04/2018] [Revised: 09/26/2018] [Accepted: 10/01/2018] [Indexed: 01/29/2023]
Abstract
INTRODUCTION Coronary stenosis is a consequence of atherosclerotic plaque progression that is associated with impaired fibrinolysis. Thrombin-activatable fibrinolysis inhibitor (TAFI) and plasminogen activator inhibitor 1 (PAI-1) are fibrinolysis inhibitors whose levels are influenced by acquired conditions and by polymorphisms. This study therefore aimed to investigate the association of TAFI and PAI-1 gene polymorphisms with severity of coronary stenosis in subjects with stable coronary artery disease (CAD). MATERIALS AND METHODS A total of 327 subjects suspected with CAD who underwent a coronary angiogram were recruited. Gensini score was applied to stratify the severity of coronary stenosis. Based on the Gensini score, the subjects were categorized into low-medium (<20) or high (≥20) groups. The study polymorphisms included TAFI Ala147Thr (505G/A), Thr325Ile (1040C/T), +1542C/G, +1583T/A and PAI-1 -675 4G/5G. Most polymorphisms were genotyped by allele-specific polymerase chain reaction, except for TAFI Thr325Ile that was genotyped by polymerase chain reaction-restriction fragment length polymorphism. RESULTS A significant increase in the Gensini score was found in TAFI 505A and +1583A allele carriers. Binary regression analysis revealed the independent association of the TAFI 505G/A and +1583T/A polymorphisms with a high Gensini score [adjusted OR = 1.67 (95% CI: 1.03, 2.73) and 1.69 (95% CI: 1.04, 2.76), respectively]. Neither the homozygous PAI-1 -675 4G/4G nor the heterozygous 4G/5G was associated with a high Gensini score. CONCLUSIONS The results indicated the contribution of TAFI polymorphisms to atherosclerosis progression and severity of coronary stenosis in stable CAD.
Collapse
Affiliation(s)
- Chutima Rattanawan
- Biomedical Sciences Program, Graduate School, Khon Kaen University, Khon Kaen, Thailand; Cardiovascular Research Group, Khon Kaen University, Khon Kaen, Thailand
| | - Nantarat Komanasin
- Cardiovascular Research Group, Khon Kaen University, Khon Kaen, Thailand; Department of Clinical Microscopy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand.
| | - Nongnuch Settasatian
- Cardiovascular Research Group, Khon Kaen University, Khon Kaen, Thailand; Department of Clinical Chemistry, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
| | - Chatri Settasatian
- Cardiovascular Research Group, Khon Kaen University, Khon Kaen, Thailand; Department of Pathology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Upa Kukongviriyapan
- Cardiovascular Research Group, Khon Kaen University, Khon Kaen, Thailand; Department of Physiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Pongsak Intharapetch
- Cardiovascular Research Group, Khon Kaen University, Khon Kaen, Thailand; Queen Sirikit Heart Center of the Northeast, Khon Kaen University, Khon Kaen, Thailand
| | - Vichai Senthong
- Cardiovascular Research Group, Khon Kaen University, Khon Kaen, Thailand; Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| |
Collapse
|
30
|
Senthong V, Kukongviriyapan U, Settasatian N, Settasatian C, Komanasin N. Low diastolic blood pressure is associated with a high atherosclerotic burden in patients with obstructive coronary artery disease. Cardiol J 2018; 25:345-352. [DOI: 10.5603/cj.a2017.0109] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 08/15/2017] [Accepted: 08/31/2017] [Indexed: 11/25/2022] Open
|
31
|
Abstract
INTRODUCTION Heart failure (HF) is a complex clinical syndrome with diverse risk factors and etiologies, differing underlying pathophysiology, and large phenotypic heterogeneity. RECENT FINDINGS Advances in imaging techniques coupled with clinical trials that targeted only in those with impaired left ventricular ejection fraction (LVEF) have largely shaped the current management strategy for HF that focuses predominantly in patients with systolic HF. In contrast, there are no effective treatments for HF with preserved ejection fraction (HFpEF). Instead of this "one-size-fits-all" approach to treatment, better precision to define HF phenotypic classifications may lead to more efficient and effective HF disease management. CONCLUSION Integrating variables-including clinical variables, HF biomarkers, imaging, genotypes, metabolomics, and proteomics-can identify different pathophysiologies, lead to more precise phenotypic classification, and warrant investigation in future clinical trials.
Collapse
Affiliation(s)
- Vichai Senthong
- Department of Cardiovascular Medicine, Heart and Vascular Institute, 9500 Euclid Avenue, Desk J3-4, Cleveland, OH, 44915, USA.,Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Jennifer L Kirsop
- Department of Cellular and Molecular Medicine, Lerner Research Institute, Cleveland, OH, USA
| | - W H Wilson Tang
- Department of Cardiovascular Medicine, Heart and Vascular Institute, 9500 Euclid Avenue, Desk J3-4, Cleveland, OH, 44915, USA. .,Department of Cellular and Molecular Medicine, Lerner Research Institute, Cleveland, OH, USA. .,Center for Clinical Genomics, Cleveland Clinic, Cleveland, OH, USA.
| |
Collapse
|
32
|
Senthong V, Li XS, Hudec T, Coughlin J, Wu Y, Levison B, Wang Z, Hazen SL, Tang WHW. Plasma Trimethylamine N-Oxide, a Gut Microbe-Generated Phosphatidylcholine Metabolite, Is Associated With Atherosclerotic Burden. J Am Coll Cardiol 2017; 67:2620-8. [PMID: 27256833 DOI: 10.1016/j.jacc.2016.03.546] [Citation(s) in RCA: 161] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 03/13/2016] [Accepted: 03/22/2016] [Indexed: 12/31/2022]
Abstract
BACKGROUND Trimethylamine N-oxide (TMAO), a gut microbiota metabolite from dietary phosphatidylcholine, has mechanistic links to atherosclerotic coronary artery disease (CAD) pathogenesis and is associated with adverse outcomes. OBJECTIVES This study sought to examine the relationship between plasma TMAO levels and the complexity and burden of CAD and degree of subclinical myonecrosis. METHODS We studied 353 consecutive stable patients with evidence of atherosclerotic CAD detected by elective coronary angiography between 2012 and 2014. Their high-sensitivity cardiac troponin T (hs-cTnT) levels were measured. SYNTAX (Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery) scores and lesion characteristics were used to quantify atherosclerotic burden. Fasting plasma TMAO was measured by mass spectrometry. RESULTS In this prospective cohort study, the median TMAO level was 5.5 μM (interquartile range [IQR]: 3.4 to 9.8 μM), the median SYNTAX score was 11.0 (IQR: 4.0 to 18.5), and 289 (81.9%), 40 (11.3%), and 24 (6.8%) patients had low (0 to 22), intermediate (23 to 32), and high (≥33) SYNTAX scores, respectively. Plasma TMAO levels correlated (all p < 0.0001) with the SYNTAX score (r = 0.61), SYNTAX score II (r = 0.62), and hs-cTnT (r = 0.29). Adjusting for traditional risk factors, body mass index, medications, lesion characteristic, renal function, and high-sensitivity C-reactive protein, elevated TMAO levels remained independently associated with a higher SYNTAX score (odds ratio [OR]: 4.82; p < 0.0001), SYNTAX score II (OR: 1.88; p = 0.0001), but were not associated with subclinical myonecrosis (OR: 1.14; p = 0.3147). Elevated TMAO level was an independent predictor of the presence of diffuse lesions, even after adjustments for traditional risk factors and for hs-cTnT (OR: 2.05; 95% confidence interval: 1.45 to 2.90; p = 0.0001). CONCLUSIONS Fasting plasma TMAO levels are an independent predictor of a high atherosclerotic burden in patients with CAD.
Collapse
Affiliation(s)
- Vichai Senthong
- Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio; Queen Sirikit Heart Center of the Northeast, Department of Medicine, Faculty of Medicine, Khon Kaen University, Thailand
| | - Xinmin S Li
- Department of Cellular and Molecular Medicine, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
| | - Timothy Hudec
- Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio
| | - John Coughlin
- Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio
| | - Yuping Wu
- Department of Mathematics, Cleveland State University, Cleveland, Ohio
| | - Bruce Levison
- Department of Cellular and Molecular Medicine, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
| | - Zeneng Wang
- Department of Cellular and Molecular Medicine, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
| | - Stanley L Hazen
- Department of Cellular and Molecular Medicine, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
| | - W H Wilson Tang
- Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio; Department of Cellular and Molecular Medicine, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio.
| |
Collapse
|
33
|
Senthong V, Hudec T, Neale S, Wu Y, Hazen SL, Tang WHW. Relation of Red Cell Distribution Width to Left Ventricular End-Diastolic Pressure and Mortality in Patients With and Without Heart Failure. Am J Cardiol 2017; 119:1421-1427. [PMID: 28285713 DOI: 10.1016/j.amjcard.2017.01.036] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Revised: 01/05/2017] [Accepted: 01/05/2017] [Indexed: 01/06/2023]
Abstract
Higher red cell distribution width (RDW) has been associated with poor prognosis in patients with heart failure (HF). RDW is also closely associated with iron deficiency. However, the mechanism underlying this association is unclear. The relation between left ventricular end-diastolic pressure (LVEDP) and RDW has not been studied, especially in those without HF. We examined the relation between LVEDP and RDW in 1,084 consecutive stable patients who underwent elective coronary angiography. We observed that 38% had high LVEDP (>16 mm Hg) and 29% had history of HF. The median RDW was 13.4%, which was higher with increasing LVEDP (p <0.0001) and significantly higher in patients with HF (p <0.0001). Baseline RDW were independently associated with high LVEDP even after multivariable logistic regression analysis (adjusted odds ratio [OR] per unit change 1.14, 95% confidence interval [CI] 1.0 to 1.29, p = 0.044). Interestingly, result were stronger in non-HF cohort (adjusted OR per unit change 1.37, 95% CI 1.13 to 1.67, p = 0.001). In addition, elevated (third vs first tertiles) RDW levels were independently a predictor of high LVEDP and were associated with a 4.8-fold increased 5-year mortality risk (adjusted hazard ratio 4.11, 95% CI 2.12 to 7.96, p <0.0001), even with the addition of B-type natriuretic peptide to the model (adjusted OR for LVEDP 2.25, 95% CI 1.0 to 5.05, p = 0.05; adjusted hazard ratio for mortality 3.79, 95% CI 1.033 to 13.89, p = 0.044, respectively). In conclusion, high RDW levels were observed in patients with or without HF and independently associated with high LVEDP and with mortality.
Collapse
Affiliation(s)
- Vichai Senthong
- Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Ohio; Queen Sirikit Heart Center of the Northeast, Department of Medicine, Faculty of Medicine, Khon Kaen University, Thailand
| | - Timothy Hudec
- Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Ohio
| | - Sarah Neale
- Department of Cellular and Molecular Medicine, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
| | - Yuping Wu
- Department of Mathematics, Cleveland State University, Cleveland, Ohio
| | - Stanley L Hazen
- Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Ohio; Department of Cellular and Molecular Medicine, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
| | - W H Wilson Tang
- Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Ohio; Department of Cellular and Molecular Medicine, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio.
| |
Collapse
|
34
|
Senthong V, Wu Y, Hazen SL, Tang WHW. Predicting long-term prognosis in stable peripheral artery disease with baseline functional capacity estimated by the Duke Activity Status Index. Am Heart J 2017; 184:17-25. [PMID: 27892883 DOI: 10.1016/j.ahj.2016.10.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Accepted: 10/16/2016] [Indexed: 12/27/2022]
Abstract
BACKGROUND The ability of a simple self-assessment tool for estimated functional capacity to predict long-term prognosis in patients with established peripheral artery disease (PAD) is unknown. We investigate whether subjective measurement of functional capacity estimated by using the Duke Activity Status Index (DASI) questionnaire predicts long-term prognosis in patients with established PAD. METHODS We administered the DASI questionnaire to 771 stable patients with established PAD who underwent elective diagnostic coronary angiography with 5-year follow-up all-cause mortality. RESULTS Two hundred ten patients (27%) died over a 5-year follow-up. The lowest DASI score was associated with a 3.2-fold increased risk of 5-year all-cause mortality (unadjusted hazard ratio 3.23, 95% CI 2.19-4.75, P<.001). After adjustments for traditional risk factors, estimated glomerular filtration rate, high-sensitivity C-reactive protein, and lowest DASI score remained predictive of 5-year all-cause mortality (adjusted hazard ratio 2.09, 95% CI 1.36-3.23, P<.001). Interestingly, the lowest DASI score remained to predict 5-year all-cause mortality regardless of each PAD diagnosis subtype (including lower extremity, non-lower extremity, or carotid artery PAD), although the mortality risk was attenuated when incorporating heart disease severity in the non-lower extremity group. CONCLUSIONS A simple self-assessment tool of functional capacity provides an independent and incremental prognosis value for long-term adverse clinical events in stable patients with established PAD beyond each PAD diagnostic subtype.
Collapse
|
35
|
Abstract
BACKGROUND Production of the proatherogenic metabolite, trimethylamine N-oxide (TMAO), from dietary nutrients by intestinal microbiota enhances atherosclerosis development in animal models and is associated with atherosclerotic coronary artery disease in humans. The utility of studying plasma levels of TMAO to risk stratify in patients with peripheral artery disease (PAD) has not been reported. METHODS AND RESULTS We examined the relationship between fasting plasma TMAO and all-cause mortality (5-year), stratified by subtypes of PAD and presence of coronary artery disease in 935 patients with PAD who underwent elective angiography for cardiac evaluation at a tertiary care hospital. Median plasma TMAO was 4.8 μmol/L (interquartile range, 2.9-8.0 μmol/L). Elevated TMAO levels were associated with 2.7-fold increased mortality risk (fourth versus first quartiles, hazard ratio 2.86, 95% CI 1.82-3.97, P<0.001). Following adjustments for traditional risk factors, inflammatory biomarkers, and history of coronary artery disease, the highest TMAO quartile remained predictive of 5-year mortality (adjusted hazard ratio 2.06, 95% CI 1.36-3.11, P<0.001). Similar prognostic value for elevated TMAO was seen for subjects with carotid artery, non-carotid artery, or lower extremity PAD. TMAO provided incremental prognostic value for all-cause mortality (net reclassification index, 40.22%; P<0.001) and improvement in area under receiver operator characteristic curve (65.7% versus 69.4%; P=0.013). CONCLUSIONS TMAO, a pro-atherogenic metabolite formed by gut microbes, predicts long-term adverse event risk and incremental prognostic value in patients with PAD. These findings point to the potential for TMAO to help improve selection of high-risk PAD patients with or without significant coronary artery disease, who likely need more aggressive and specific dietary and pharmacologic therapy.
Collapse
Affiliation(s)
- Vichai Senthong
- Cleveland Clinic, Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland, OH Faculty of Medicine, Department of Medicine, Queen Sirikit Heart Center of the Northeast, Khon Kaen University, Khon Kaen, Thailand
| | - Zeneng Wang
- Cleveland Clinic, Department of Cellular and Molecular Medicine, Lerner Research Institute, Cleveland, OH
| | - Yiying Fan
- Department of Mathematics, Cleveland State University, Cleveland, OH
| | - Yuping Wu
- Department of Mathematics, Cleveland State University, Cleveland, OH
| | - Stanley L Hazen
- Cleveland Clinic, Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland, OH Cleveland Clinic, Department of Cellular and Molecular Medicine, Lerner Research Institute, Cleveland, OH
| | - W H Wilson Tang
- Cleveland Clinic, Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland, OH Cleveland Clinic, Department of Cellular and Molecular Medicine, Lerner Research Institute, Cleveland, OH
| |
Collapse
|
36
|
Senthong V, Wang Z, Li XS, Fan Y, Wu Y, Tang WHW, Hazen SL. Intestinal Microbiota-Generated Metabolite Trimethylamine-N-Oxide and 5-Year Mortality Risk in Stable Coronary Artery Disease: The Contributory Role of Intestinal Microbiota in a COURAGE-Like Patient Cohort. J Am Heart Assoc 2016; 5:JAHA.115.002816. [PMID: 27287696 PMCID: PMC4937244 DOI: 10.1161/jaha.115.002816] [Citation(s) in RCA: 176] [Impact Index Per Article: 22.0] [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] [Indexed: 12/27/2022]
Abstract
Background Trimethylamine‐N‐oxide (TMAO), a metabolite derived from gut microbes and dietary phosphatidylcholine, is linked to both coronary artery disease pathogenesis and increased cardiovascular risks. The ability of plasma TMAO to predict 5‐year mortality risk in patients with stable coronary artery disease has not been reported. This study examined the clinical prognostic value of TMAO in patients with stable coronary artery disease who met eligibility criteria for a patient cohort similar to that of the Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation (COURAGE) trial. Methods and Results We examined the relationship between fasting plasma TMAO and all‐cause mortality over 5‐year follow‐up in sequential patients with stable coronary artery disease (n=2235) who underwent elective coronary angiography. We identified the COURAGE‐like patient cohort as patients who had evidence of significant coronary artery stenosis and who were managed with optimal medical treatment. Higher plasma TMAO levels were associated with a 4‐fold increased mortality risk. Following adjustments for traditional risk factors, high‐sensitivity C‐reactive protein, and estimated glomerular filtration rate, elevated TMAO levels remained predictive of 5‐year all‐cause mortality risk (quartile 4 versus 1, adjusted hazard ratio 1.95, 95% CI 1.33–2.86; P=0.003). TMAO remained predictive of incident mortality risk following cardiorenal and inflammatory biomarker adjustments to the model (adjusted hazard ratio 1.71, 95% CI 1.11–2.61; P=0.0138) and provided significant incremental prognostic value for all‐cause mortality (net reclassification index 42.37%, P<0.001; improvement in area under receiver operator characteristic curve 70.6–73.76%, P<0.001). Conclusions Elevated plasma TMAO levels portended higher long‐term mortality risk among patients with stable coronary artery disease managed with optimal medical treatment.
Collapse
Affiliation(s)
- Vichai Senthong
- Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH Queen Sirikit Heart Center of the Northeast, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Zeneng Wang
- Department of Cellular and Molecular Medicine, Lerner Research Institute, Cleveland Clinic, Cleveland, OH
| | - Xinmin S Li
- Department of Cellular and Molecular Medicine, Lerner Research Institute, Cleveland Clinic, Cleveland, OH
| | - Yiying Fan
- Department of Mathematics, Cleveland State University, Cleveland, OH
| | - Yuping Wu
- Department of Mathematics, Cleveland State University, Cleveland, OH
| | - W H Wilson Tang
- Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH Department of Cellular and Molecular Medicine, Lerner Research Institute, Cleveland Clinic, Cleveland, OH
| | - Stanley L Hazen
- Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH Department of Cellular and Molecular Medicine, Lerner Research Institute, Cleveland Clinic, Cleveland, OH
| |
Collapse
|
37
|
Yongsakulchai P, Settasatian C, Settasatian N, Komanasin N, Kukongwiriyapan U, Cote ML, Intharapetch P, Senthong V. Association of combined genetic variations in PPARγ , PGC-1α , and LXRα with coronary artery disease and severity in Thai population. Atherosclerosis 2016; 248:140-8. [DOI: 10.1016/j.atherosclerosis.2016.03.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 02/10/2016] [Accepted: 03/03/2016] [Indexed: 12/11/2022]
|
38
|
Sarutipaiboon I, Settasatian C, Settasatian N, Komanasin N, Kukongwiriyapan U, Intharapetch P, Senthong V. Association of MT1A gene polymorphism, rs8052394, with risk factors and coronary stenosis in THAI subject with CAD. Atherosclerosis 2015. [DOI: 10.1016/j.atherosclerosis.2015.04.459] [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: 11/30/2022]
|
39
|
Limpawattana P, Siriussawakul A, Chandavimol M, Sawanyawisuth K, Chindaprasirt J, Senthong V, Thepsuthammarat K. National Data of CPR Procedures Performed on Hospitalized Thai Older Population Patients. INT J GERONTOL 2015. [DOI: 10.1016/j.ijge.2015.05.004] [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: 10/23/2022] Open
|
40
|
Senthong V, Li X, Coughlin J, Hudec T, Neale S, Li L, Wu Y, Wang Z, Hazen S, Tang WH. HIGHER PLASMA TRIMETHYLAMINE-N-OXIDE IS ASSOCIATED WITH GREATER ATHEROSCLEROTIC BURDEN QUANTIFIED BY THE SYNTAX SCORE. J Am Coll Cardiol 2015. [DOI: 10.1016/s0735-1097(15)61676-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
41
|
Sawanyawisuth K, Waranon W, Pongtipakorn K, Kongbunkiat K, Limpawattana P, Senthong V, Chindaprasirt J, Chotmongkol V, Kanpittaya J, Intapan PM, Maleewong W, Kitkhuandee A. EHMTI-0025. Clinical manifestations of subarachnoid hemorrhage from gnathostoma spinigerum in srinagarind hospital. J Headache Pain 2014. [PMCID: PMC4182045 DOI: 10.1186/1129-2377-15-s1-d55] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
|
42
|
Kongmalai P, Karunasumetta C, Kuptarnond C, Prathanee S, Taksinachanekij S, Intanoo W, Wongbuddha C, Senthong V. The posterior pericardiotomy. Does it reduce the incidence of postoperative atrial fibrillation after coronary artery bypass grafting? J Med Assoc Thai 2014; 97 Suppl 10:S97-S104. [PMID: 25816544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Atrial fibrillation (AF) is the most common arrhythmia after coronary artery bypass graft surgery (CABG). Posterior pericardiotomy (PP) has been reported toreduce pericardial effusion, AF triggel; and reduce the length of hospital stay and hospital costs without significant complications. A total of 20 patients, diagnosed with coronary artery diseases to be treated by an elective or urgent CABG between August and December 2013, were randomly divided into two groups; 10 patients received PP (PP group) and 10 patients did not receive PP (control group). The incidence ofAF was equal (40% in both groups). Early pericardial effusion was slightly higher in the PP group (PP 70%, control 60%; p = 1.00). The incidence of left pleural effusion and pneumonia were higher in the PP group than in the control. Moreover, one patient in the PP group developed perioperative myocardial infarction (MI) that required intensive care with medication. The duration of ICU stay of the PP group was significantly longer than that of the control group. In conclusion, PP did not reduce the incidence of postoperative AF nor did early pericardial effusion. Rather, PP increased post-operative complications such asperioperative MI, left pleural effusion, and pneumonia resulting in the prolonged ICU stay.
Collapse
|
43
|
Sittichanbuncha Y, Chairat C, Sawanyawisuth K, Senthong V. Cost differences between complete and incomplete post-exposure courses of rabies vaccination. Southeast Asian J Trop Med Public Health 2014; 45:1048-1052. [PMID: 25417505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Courses of post-exposure rabies vaccination in clinical practice are often not administered completely. If suspected animals are still alive after 10 days of observation, full post-exposure vaccination will usually be withheld from bite victims. In this study, we compared the cost differences between complete and incomplete courses of post-exposure rabies vaccination. The cost calculations were based on the principle that all patients will have at least one more animal bite in the future. Costs were compared between patients who received post-exposure rabies vaccination and if they completed or did not complete the vaccine regimen. In this study, 46.7% of 372 patients completed the full course of five doses of the rabies vaccine. Based on the study rationale, complete vaccination would save nation budget 224,700 Baht for WHO wound category 2, 801,474 Baht for WHO wound category 3 with equine rabies immunoglobulin treatment, and 2,618,916 Baht for WHO wound category 3 with human rabies immunoglobulin treatment. Physicians should encourage complete courses of post-exposure rabies vaccination to save further costs from animal bites in the future.
Collapse
|
44
|
Rattanatham R, Settasatian N, Settasatian C, Komanasin N, Kukongwiriyapan U, Intharapetch P, Senthong V. Association of mt2a gene polymorphism -209 a/g, rs1610216, with diabetes mellitus related to smoking status in thai subject with cad. Atherosclerosis 2014. [DOI: 10.1016/j.atherosclerosis.2014.05.216] [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: 11/27/2022]
|
45
|
Settasatian C, Decharatchakul N, Settasatian N, Komanasin N, Kukongwiriyapan U, Intharapetch P, Senthong V. The association of PON1 and SOD3 gene polymorphisms with smoking related CAD risk in Thai subjects. Atherosclerosis 2014. [DOI: 10.1016/j.atherosclerosis.2014.05.851] [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: 11/27/2022]
|
46
|
Sawanyawisuth K, Chindaprasirt J, Senthong V, Limpawattana P, Auvichayapat N, Tassniyom S, Chotmongkol V, Maleewong W, Intapan PM. Clinical manifestations of Eosinophilic meningitis due to infection with Angiostrongylus cantonensis in children. Korean J Parasitol 2013; 51:735-8. [PMID: 24516281 PMCID: PMC3916465 DOI: 10.3347/kjp.2013.51.6.735] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2013] [Revised: 07/28/2013] [Accepted: 10/11/2013] [Indexed: 11/29/2022]
Abstract
Eosinophilic meningitis, caused by the nematode Angiostrongylus cantonensis, is prevalent in northeastern Thailand, most commonly in adults. Data regarding clinical manifestations of this condition in children is limited and may be different those in adults. A chart review was done on 19 eosinophilic meningitis patients aged less than 15 years in Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Thailand. Clinical manifestations and outcomes were reported using descriptive statistics. All patients had presented with severe headache. Most patients were males, had fever, nausea or vomiting, stiffness of the neck, and a history of snail ingestion. Six patients had papilledema or cranial nerve palsies. It was shown that the clinical manifestations of eosinophilic meningitis due to A. cantonensis in children are different from those in adult patients. Fever, nausea, vomiting, hepatomegaly, neck stiffness, and cranial nerve palsies were all more common in children than in adults.
Collapse
Affiliation(s)
- Kittisak Sawanyawisuth
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand. ; Researches and Diagnostic Center for Emerging Infectious Diseases, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Jarin Chindaprasirt
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Vichai Senthong
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Panita Limpawattana
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Narong Auvichayapat
- Department of Paediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Sompon Tassniyom
- Department of Paediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Verajit Chotmongkol
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Wanchai Maleewong
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand. ; Researches and Diagnostic Center for Emerging Infectious Diseases, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Pewpan M Intapan
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand. ; Researches and Diagnostic Center for Emerging Infectious Diseases, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| |
Collapse
|
47
|
Senthong V, Chindaprasirt J, Sawanyawisuth K, Aekphachaisawat N, Chaowattanapanit S, Limpawattana P, Choonhakarn C, Sookprasert A. Group versus modified individual standard-setting on multiple-choice questions with the Angoff method for fourth-year medical students in the internal medicine clerkship. Adv Med Educ Pract 2013; 4:195-200. [PMID: 24101890 PMCID: PMC3791546 DOI: 10.2147/amep.s46705] [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] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND The Angoff method is one of the preferred methods for setting a passing level in an exam. Normally, group meetings are required, which may be a problem for busy medical educators. Here, we compared a modified Angoff individual method to the conventional group method. METHODS SIX CLINICAL INSTRUCTORS WERE DIVIDED INTO TWO GROUPS MATCHED BY TEACHING EXPERIENCE: modified Angoff individual method (three persons) and conventional group method (three persons). The passing scores were set by using the Angoff theory. The groups set the scores individually and then met to determine the passing score. In the modified Angoff individual method, passing scores were judged by each instructor and the final passing score was adjusted by the concordance method and reliability index. RESULTS There were 94 fourth-year medical students who took the test. The mean (standard deviation) test score was 65.35 (8.38), with a median of 64 (range 46-82). The three individual instructors took 45, 60, and 60 minutes to finish the task, while the group spent 90 minutes in discussion. The final passing score in the modified Angoff individual method was 52.18 (56.75 minus 4.57) or 52 versus 51 from the standard group method. There was not much difference in numbers of failed students by either method (four versus three). CONCLUSION The modified Angoff individual method may be a feasible way to set a standard passing score with less time consumed and more independent rather than group work by instructors.
Collapse
Affiliation(s)
- Vichai Senthong
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Jarin Chindaprasirt
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | | | | | | | - Panita Limpawattana
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Charoen Choonhakarn
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Aumkhae Sookprasert
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| |
Collapse
|
48
|
Phababpha S, Kukongviriyapan U, Pakdeechote P, Senggunprai L, Kukongviriyapan V, Settasatian C, Tatsanavivat P, Intharaphet P, Senthong V, Komanasin N, Settasatian N, Greenwald SE. Association of arterial stiffness with single nucleotide polymorphism rs1333049 and metabolic risk factors. Cardiovasc Diabetol 2013; 12:93. [PMID: 23787071 PMCID: PMC3699419 DOI: 10.1186/1475-2840-12-93] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2013] [Accepted: 06/18/2013] [Indexed: 01/28/2023] Open
Abstract
Background Increased arterial stiffness is a cardiovascular outcome of metabolic syndrome (MetS). The chromosome 9p21 locus has been identified as a major locus for risk of coronary artery disease (CAD). The single nucleotide polymorphism (SNP), rs1333049 on chromosome 9p21.3 has been strongly associated with CAD and myocardial infarction. Increased arterial stiffness could be the link between the 9p21 polymorphism and increased cardiovascular risk. Since the impact of a genetic polymorphism on arterial stiffness especially in Asian populations has not been well defined, we aimed to investigate the association of arterial stiffness with rs 1333049 variant on chromosome 9p21.3 in Thai subjects with and without MetS risk factors. Methods A total of 208 Thai subjects, aged 35–75 years, 135 with and 73 without MetS, according to IDF and NCEP-ATPIII criteria, were included in this study. Aortic-femoral pulse wave velocity (afPWV), brachial-ankle pulse wave velocity (baPWV) and aortic ankle pulse wave velocity (aaPWV) were measured and used as markers of arterial stiffness. The chromosome 9p21.3 locus, represented by the rs 1333049 variant and blood biochemistry were evaluated. Results Arterial stiffness was elevated in subjects with MetS when compared with nonMetS subjects. PWV, especially afPWV increased progressively with increasing number of MetS risk factors (r = 0.322, P <0.001). We also found that the frequency distribution of the rs1333049 genotypes is significantly associated with the afPWV (P <0.05). In multivariate analyses, there was an association between homozygous C allele and afPWV (Odds ratio (OR), 8.16; 95% confidence interval (CI), 1.91 to 34.90; P = 0.005), while the GC genotype was not related to afPWV (OR, 1.79; 95% CI, 0.84 to 3.77; P = 0.129) when compared with the GG genotype. Conclusions Our findings demonstrate for the first time that arterial stiffness is associated with genetic polymorphism in 9p21 and metabolic risk factors in a Thai population.
Collapse
Affiliation(s)
- Suphawadee Phababpha
- Department of Physiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
49
|
Senthong V, Chindaprasirt J, Sawanyawisuth K. Differential diagnosis of CNS angiostrongyliasis: a short review. Hawaii J Med Public Health 2013; 72:52-54. [PMID: 23901385 PMCID: PMC3689497] [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] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The diagnostic criterion for eosinophilic meningitis (EOM) is the identification of an absolute count of 10 eosinophils per ml or more than 10% of the total white blood cells in the cerebrospinal fluid (CSF) in the proper clinical context. The most common cause of EOM is Angiostrongylus cantonensis infection, termed meningitic angiostrongyliasis (MA). Neurognathostomiasis (NG) is the main parasitic disease in the differential diagnosis of meningitic angiostrongyliasis. This short review is based on articles published on Medline between 2000 and 2012 related to EOM. There are three main approaches that can be used to differentiate between MA and NG, involving clinical factors, history of larval exposure, and serological tests. MA patients presented with acute severe headache but without neurological deficit, combined with a history of eating uncooked snails or slugs. NG patients always presented with motor weakness, migratory swelling, radicular pain and had history of eating uncooked poultry or fish. Specific antigenic bands in immunoblot tests are helpful tools to differentiate the two diseases. Other causes of eosinophilic meningitis are neurocysticercosis, cerebral paragonimiasis, Toxoplasma canis, Baylisascaris, tuberculous meningitis, and cryptococcal meningitis.
Collapse
Affiliation(s)
- Vichai Senthong
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | | | | |
Collapse
|
50
|
Sawanyawisuth K, Chindaprasirt J, Senthong V, Makarawate P, Limpawattana P, Domthong A, Silaruks S, Chumjan S. Lower BMI is a predictor of obstructive sleep apnea in elderly Thai hypertensive patients. Sleep Breath 2013; 17:1215-9. [PMID: 23443912 DOI: 10.1007/s11325-013-0826-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2012] [Revised: 01/21/2013] [Accepted: 02/14/2013] [Indexed: 01/13/2023]
Abstract
PURPOSE The prevalence of both hypertension and obstructive sleep apnea (OSA) are increased in patients with age greater than 60 years. We studied the clinical differences of OSA in hypertensive patients with age greater or less than 60 years. In addition, rate of OSA-induced hypertension in Thai population is limited. METHODS We retrospectively reviewed medical records of patients treated at the hypertension/sleep clinic at Srinagarind Hospital, Khon Kaen University, between 2010 and 2011. The inclusion criteria used were hypertensive patients who had at least one symptom of OSA and had been tested for the sleep study. Rate and clinical features of OSA were studied and categorized by age of 69 years. Factors associated with likelihood of having OSA in hypertensive patients age over 60 years were identified by multiple logistic regression analysis. RESULTS During the study period, 49 patients met the criteria. Of those, 42 patients (85.71 %) had an apnea-hypopnea index (AHI) of more than 5/h. The average AHI was 22.22 ± 13.86 times/h. The common symptoms of OSA were snoring (100 %), daytime sleepiness (28.57 %), unexplained nocturia (28.57 %), and gastroesophageal reflux disease (28.57 %). The numbers of patients with age less than 60 years and more than 60 years were 20 and 22 cases, respectively. Most patients (88.10 %) had well-controlled blood pressure level. Only BMI was significantly associated with OSA-induced hypertension in patients aged over or equal to 60 years. The adjusted odds ratio was 0.743 (0.560, 0.985). CONCLUSIONS OSA is very common in Thai hypertensive patients aged 40-70 years who have at least one symptom of OSA. Lower BMI is a predictor of obstructive sleep apnea in elderly Thai hypertensive patients.
Collapse
Affiliation(s)
- Kittisak Sawanyawisuth
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand,
| | | | | | | | | | | | | | | |
Collapse
|