Pub Date : 2024-09-17DOI: 10.1016/j.atherosclerosis.2024.118599
Michael S Dodd, Lucy Ambrose, Vicky Ball, Kieran Clarke, Carolyn A Carr, Damian J Tyler
Background and aims: Peroxisome proliferator-activated receptor α (PPARα) is crucial for regulating cardiac β-oxidation in the heart, liver, and kidney. Ageing can induce cardiac metabolic alterations, but the role of PPARα has not been extensively characterised. The aim of this research was to investigate the role of PPARα in the aged heart.
Methods: Hyperpolarized [1-13C]pyruvate was used to evaluate in vivo cardiac carbohydrate metabolism in fed and fasted young (3 months) and old (20-22 months) PPARα knockout (KO) mice versus controls. Cine MRI assessed cardiac structural and functional changes. Cardiac tissue analysis included qRT-PCR and Western blotting for Pparα, medium chain acyl-CoA dehydrenase (MCAD), uncoupling protein (UCP) 3, glucose transporter (GLUT) 4 and PDH kinase (PDK) 1,2, and 4 expression.
Results: PPARα-KO hearts from both young and old mice showed significantly reduced Pparα mRNA and a 58-59 % decrease in MCAD protein levels compared to controls. Cardiac PDH flux was similar in young control and PPARα-KO mice but 96 % higher in old PPARα-KO mice. Differences between genotypes were consistent in fed and fasted states, with reduced PDH flux when fasted. Increased PDH flux was accompanied by a 179 % rise in myocardial GLUT4 protein. No differences in PDK 1, 2, or 4 protein levels were observed between fed groups, indicating the increased PDH flux in aged PPARα-KO mice was not due to changes in PDH phosphorylation.
Conclusions: Aged PPARα-KO mice demonstrated higher cardiac PDH flux compared to controls, facilitated by increased myocardial GLUT4 protein levels, leading to enhanced glucose uptake and glycolysis.
{"title":"The age-dependent development of abnormal cardiac metabolism in the peroxisome proliferator-activated receptor α-knockout mouse.","authors":"Michael S Dodd, Lucy Ambrose, Vicky Ball, Kieran Clarke, Carolyn A Carr, Damian J Tyler","doi":"10.1016/j.atherosclerosis.2024.118599","DOIUrl":"https://doi.org/10.1016/j.atherosclerosis.2024.118599","url":null,"abstract":"<p><strong>Background and aims: </strong>Peroxisome proliferator-activated receptor α (PPARα) is crucial for regulating cardiac β-oxidation in the heart, liver, and kidney. Ageing can induce cardiac metabolic alterations, but the role of PPARα has not been extensively characterised. The aim of this research was to investigate the role of PPARα in the aged heart.</p><p><strong>Methods: </strong>Hyperpolarized [1-<sup>13</sup>C]pyruvate was used to evaluate in vivo cardiac carbohydrate metabolism in fed and fasted young (3 months) and old (20-22 months) PPARα knockout (KO) mice versus controls. Cine MRI assessed cardiac structural and functional changes. Cardiac tissue analysis included qRT-PCR and Western blotting for Pparα, medium chain acyl-CoA dehydrenase (MCAD), uncoupling protein (UCP) 3, glucose transporter (GLUT) 4 and PDH kinase (PDK) 1,2, and 4 expression.</p><p><strong>Results: </strong>PPARα-KO hearts from both young and old mice showed significantly reduced Pparα mRNA and a 58-59 % decrease in MCAD protein levels compared to controls. Cardiac PDH flux was similar in young control and PPARα-KO mice but 96 % higher in old PPARα-KO mice. Differences between genotypes were consistent in fed and fasted states, with reduced PDH flux when fasted. Increased PDH flux was accompanied by a 179 % rise in myocardial GLUT4 protein. No differences in PDK 1, 2, or 4 protein levels were observed between fed groups, indicating the increased PDH flux in aged PPARα-KO mice was not due to changes in PDH phosphorylation.</p><p><strong>Conclusions: </strong>Aged PPARα-KO mice demonstrated higher cardiac PDH flux compared to controls, facilitated by increased myocardial GLUT4 protein levels, leading to enhanced glucose uptake and glycolysis.</p>","PeriodicalId":8623,"journal":{"name":"Atherosclerosis","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-15DOI: 10.1016/j.atherosclerosis.2024.118600
Anna Abramova, Jamie Bride, Camille Oger, Marie Demion, Jean-Marie Galano, Thierry Durand, Jérôme Roy
Oxidative stress plays a critical role in numerous pathological processes. Under these stress conditions, the free radical-catalyzed lipid peroxidation generates in vivo a large number of key products that are involved in many physiological and pathophysiological processes. Among these products are neuroprostanes, which arise from the peroxidation of docosahexaenoic acid (DHA), and isoprostanes, resulting from arachidonic acid (AA) and eicosapentaenoic acid (EPA) through the same peroxidation process. These non-enzymatic oxygenated metabolites newly appointed NEO-PUFAs have gained recognition as reliable markers of oxidative stress in neurogenerative and cardiovascular diseases. Moreover, some of them display a wide range of biological activities. The ability to detect and measure these metabolites offers precious insights into the mechanisms of oxidative damage and holds potential therapeutic implications for various health conditions, including neurodegenerative diseases. This review focuses on the role of neuroprostanes as biomarkers for oxidative stress and related diseases, highlighting their potential applications in medical research and treatment.
{"title":"Metabolites derived from radical oxidation of PUFA: NEO-PUFAs, promising molecules for health?","authors":"Anna Abramova, Jamie Bride, Camille Oger, Marie Demion, Jean-Marie Galano, Thierry Durand, Jérôme Roy","doi":"10.1016/j.atherosclerosis.2024.118600","DOIUrl":"https://doi.org/10.1016/j.atherosclerosis.2024.118600","url":null,"abstract":"<p><p>Oxidative stress plays a critical role in numerous pathological processes. Under these stress conditions, the free radical-catalyzed lipid peroxidation generates in vivo a large number of key products that are involved in many physiological and pathophysiological processes. Among these products are neuroprostanes, which arise from the peroxidation of docosahexaenoic acid (DHA), and isoprostanes, resulting from arachidonic acid (AA) and eicosapentaenoic acid (EPA) through the same peroxidation process. These non-enzymatic oxygenated metabolites newly appointed NEO-PUFAs have gained recognition as reliable markers of oxidative stress in neurogenerative and cardiovascular diseases. Moreover, some of them display a wide range of biological activities. The ability to detect and measure these metabolites offers precious insights into the mechanisms of oxidative damage and holds potential therapeutic implications for various health conditions, including neurodegenerative diseases. This review focuses on the role of neuroprostanes as biomarkers for oxidative stress and related diseases, highlighting their potential applications in medical research and treatment.</p>","PeriodicalId":8623,"journal":{"name":"Atherosclerosis","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142340191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-13DOI: 10.1016/j.atherosclerosis.2024.118596
Background and aims
PCSK9 is a key regulator of LDL-cholesterol levels. PCSK9 gain of function variants (GOFVs) cause autosomal dominant hypercholesterolemia (ADH). The first described PCSK9-GOFV, p.Ser127Arg, almost exclusively reported in France, represents 67 % of the PCSK9 French GOFVs due to a founder effect. Few other carriers are reported in South Africa and Norway. This study aims to estimate when the common ancestor lived and to describe a cohort of p.Ser127Arg carriers.
Methods
Eight families and 14 p.Ser127Arg carriers were genotyped and phenotyped. Haplotypes were constructed using 11 microsatellites around PCSK9 and 6 intragenic single nucleotide polymorphisms (SNPs). To add to the biological analysis, eight additional p.Ser127Arg carriers, 12 carriers of other PCSK9-GOFVs, 93 LDLR loss of function variant (LOFV) carriers and 49 non-carriers subjects were phenotyped.
Results
The most common ancestor of p.Ser127Arg was estimated to have lived 775 years ago [95 % CI: 575-1075]. French Protestants exiled after the revocation of the Edict of Nantes in 1685 AD likely brought the variant to South Africa and Norway. As expected for ADH subjects, carriers of LDLR-LOFV, the p.Ser127Arg, or other PCSK9-GOFVs showed significantly higher LDL-C levels than that of the non-carriers. Interestingly, LDL-C levels are higher for LDLR-LOFVs and for the reduced secreted p.Ser127Arg than for secreted PCSK9-GOFVs, suggesting a greater effect of the p.Ser127Arg. Conversely, HDL-C was significantly lower for LDLR-LOFV and p.Ser127Arg carriers.
Conclusions
This first report from a large cohort of PCSK9-p.Ser127Arg carriers provides observations suggesting a stronger hypercholesterolemic potential of the mutated pro-PCSK9 compared with the secreted mature protein. This work also provides additional data to support the association between PCSK9 and HDL metabolism, and molecular evidence that this variant appeared in France around 1248 AD (Graphical Abstract = Fig. 1).
{"title":"The singular French PCSK9-p.Ser127Arg gain-of-function variant: A significant player in cholesterol levels from a 775-year-old common ancestor","authors":"","doi":"10.1016/j.atherosclerosis.2024.118596","DOIUrl":"10.1016/j.atherosclerosis.2024.118596","url":null,"abstract":"<div><h3>Background and aims</h3><div>PCSK9 is a key regulator of LDL-cholesterol levels. PCSK9 gain of function variants (GOFVs) cause autosomal dominant hypercholesterolemia (ADH). The first described PCSK9-GOFV, p.Ser127Arg, almost exclusively reported in France, represents 67 % of the PCSK9 French GOFVs due to a founder effect. Few other carriers are reported in South Africa and Norway. This study aims to estimate when the common ancestor lived and to describe a cohort of p.Ser127Arg carriers.</div></div><div><h3>Methods</h3><div>Eight families and 14 p.Ser127Arg carriers were genotyped and phenotyped. Haplotypes were constructed using 11 microsatellites around <em>PCSK9</em> and 6 intragenic single nucleotide polymorphisms (SNPs). To add to the biological analysis, eight additional p.Ser127Arg carriers, 12 carriers of other PCSK9-GOFVs, 93 LDLR loss of function variant (LOFV) carriers and 49 non-carriers subjects were phenotyped.</div></div><div><h3>Results</h3><div>The most common ancestor of p.Ser127Arg was estimated to have lived 775 years ago [95 % CI: 575-1075]. French Protestants exiled after the revocation of the Edict of Nantes in 1685 AD likely brought the variant to South Africa and Norway. As expected for ADH subjects, carriers of LDLR-LOFV, the p.Ser127Arg, or other PCSK9-GOFVs showed significantly higher LDL-C levels than that of the non-carriers. Interestingly, LDL-C levels are higher for LDLR-LOFVs and for the reduced secreted p.Ser127Arg than for secreted PCSK9-GOFVs, suggesting a greater effect of the p.Ser127Arg. Conversely, HDL-C was significantly lower for LDLR-LOFV and p.Ser127Arg carriers.</div></div><div><h3>Conclusions</h3><div>This first report from a large cohort of PCSK9-p.Ser127Arg carriers provides observations suggesting a stronger hypercholesterolemic potential of the mutated pro-PCSK9 compared with the secreted mature protein. This work also provides additional data to support the association between PCSK9 and HDL metabolism, and molecular evidence that this variant appeared in France around 1248 <span>AD (Graphical Abstract = Fig. 1)</span>.</div></div>","PeriodicalId":8623,"journal":{"name":"Atherosclerosis","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142578096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-12DOI: 10.1016/j.atherosclerosis.2024.118597
Background and aims
Coronary microvascular dysfunction (CMD) is common after ST-elevation myocardial infarction (STEMI), leading to adverse clinical outcomes. However, its diagnosis remains difficult, and mechanisms elusive. This study explores the role of Trimethylamine N-oxide (TMAO), a gut microbiota metabolite, as a potential biomarker for diagnosing CMD in STEMI patients.
Methods
This prospective, observational study enrolled 210 STEMI patients with multivessel coronary artery disease who underwent primary percutaneous coronary intervention (PCI). TMAO levels were measured at baseline, 3 months, and 12 months post-PCI, whilst coronary physiology was assessed at 3 months. The primary endpoint was the incidence of CMD at 3 months, with the secondary endpoint being major adverse cardiovascular and cerebrovascular events (MACCE) at 12 months. An additional 59 consecutive patients were enrolled for validation.
Results
TMAO levels varied from baseline to 3 months, then stabilised. The areas under the ROC curve for baseline TMAO and TMAO at 3-month were 0.55 (95 % CI 0.46–0.64; p = 0.426), and 0.80 (95 % CI 0.73–0.87; p < 0.001), respectively. The optimal cut-off for TMAO at 3-month to diagnose CMD was 3.91, with similar sensitivity and specificity in the derivation and validation cohort. The incidence of MACCE was higher in patients with TMAO≥3.91 (41.4 % vs 10.7 %; p < 0.001). The addition of 3-month TMAO improved the diagnostic performance of traditional risk factors.
Conclusion
TMAO is a robust biomarker for CMD and is significantly associated with the incidence of MACCE. TMAO has the potential in guiding clinical decision-making and suggests an interplay between gut microbiota and CMD.
背景和目的冠状动脉微血管功能障碍(CMD)是ST段抬高型心肌梗死(STEMI)后的常见病,会导致不良的临床结局。然而,其诊断仍很困难,其机制也难以捉摸。本研究探讨了肠道微生物群代谢物三甲胺N-氧化物(TMAO)作为诊断STEMI患者CMD的潜在生物标记物的作用。方法这项前瞻性观察性研究共纳入了210名接受初级经皮冠状动脉介入治疗(PCI)的STEMI多支血管冠状动脉疾病患者。在PCI术后基线、3个月和12个月时测量TMAO水平,在3个月时评估冠状动脉生理功能。主要终点是3个月时的CMD发生率,次要终点是12个月时的主要不良心脑血管事件(MACCE)。结果TMAO水平从基线到3个月期间有所变化,随后趋于稳定。基线 TMAO 和 3 个月时 TMAO 的 ROC 曲线下面积分别为 0.55 (95 % CI 0.46-0.64; p = 0.426) 和 0.80 (95 % CI 0.73-0.87; p < 0.001)。3个月时TMAO诊断CMD的最佳临界值为3.91,在推导队列和验证队列中具有相似的敏感性和特异性。TMAO≥3.91的患者MACCE发生率更高(41.4% vs 10.7%;p < 0.001)。结论TMAO是一种可靠的CMD生物标记物,与MACCE的发病率显著相关。TMAO具有指导临床决策的潜力,并表明肠道微生物群与CMD之间存在相互作用。
{"title":"The association between trimethylamine N-oxide levels and coronary microvascular dysfunction and prognosis in patients with ST-elevation myocardial infarction","authors":"","doi":"10.1016/j.atherosclerosis.2024.118597","DOIUrl":"10.1016/j.atherosclerosis.2024.118597","url":null,"abstract":"<div><h3>Background and aims</h3><div>Coronary microvascular dysfunction (CMD) is common after ST-elevation myocardial infarction (STEMI), leading to adverse clinical outcomes. However, its diagnosis remains difficult, and mechanisms elusive. This study explores the role of Trimethylamine N-oxide (TMAO), a gut microbiota metabolite, as a potential biomarker for diagnosing CMD in STEMI patients.</div></div><div><h3>Methods</h3><div>This prospective, observational study enrolled 210 STEMI patients with multivessel coronary artery disease who underwent primary percutaneous coronary intervention (PCI). TMAO levels were measured at baseline, 3 months, and 12 months post-PCI, whilst coronary physiology was assessed at 3 months. The primary endpoint was the incidence of CMD at 3 months, with the secondary endpoint being major adverse cardiovascular and cerebrovascular events (MACCE) at 12 months. An additional 59 consecutive patients were enrolled for validation.</div></div><div><h3>Results</h3><div>TMAO levels varied from baseline to 3 months, then stabilised. The areas under the ROC curve for baseline TMAO and TMAO at 3-month were 0.55 (95 % CI 0.46–0.64; <em>p</em> = 0.426), and 0.80 (95 % CI 0.73–0.87; <em>p</em> < 0.001), respectively. The optimal cut-off for TMAO at 3-month to diagnose CMD was 3.91, with similar sensitivity and specificity in the derivation and validation cohort. The incidence of MACCE was higher in patients with TMAO≥3.91 (41.4 % vs 10.7 %; <em>p</em> < 0.001). The addition of 3-month TMAO improved the diagnostic performance of traditional risk factors.</div></div><div><h3>Conclusion</h3><div>TMAO is a robust biomarker for CMD and is significantly associated with the incidence of MACCE. TMAO has the potential in guiding clinical decision-making and suggests an interplay between gut microbiota and CMD.</div></div>","PeriodicalId":8623,"journal":{"name":"Atherosclerosis","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142311560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-11DOI: 10.1016/j.atherosclerosis.2024.118583
Tyler Artner, Smriti Sharma, Irene M Lang
Cardiovascular disease (CVD) is the leading cause of death worldwide, and despite treatment efforts, cardiovascular function cannot always be restored, and progression of disease be prevented. Critical insights are oftentimes based on tissue samples. Current knowledge of tissue pathology typically relies on invasive biopsies or postmortem samples. Liquid biopsies, which assess circulating mediators to deduce the histology and pathology of distant tissues, have been advancing rapidly in cancer research and offer a promising approach to be translated to the understanding and treatment of CVD. The widely understood elevations in cell-free DNA during acute and chronic cardiovascular conditions, associate with disease, severity, and offer prognostic value. The role of neutrophil extracellular traps (NETs) and circulating nucleases in thrombosis provide a solid rationale for liquid biopsies in CVD. cfDNA originates from various tissue types and cellular sources, including mitochondria and nuclei, and can be used to trace cell and tissue type lineage, as well as to gain insight into the activation status of cells. This article discusses the origin, structure, and potential utility of cfDNA, offering a deeper and less invasive approach for the understanding of the complexities of CVD.
心血管疾病(CVD)是导致全球死亡的主要原因,尽管已经进行了治疗,但心血管功能并不总能恢复,疾病的恶化也无法预防。关键的见解往往基于组织样本。目前的组织病理学知识通常依赖于侵入性活检或死后样本。液体活检通过评估循环介质来推断远处组织的组织学和病理学,在癌症研究领域进展迅速,为了解和治疗心血管疾病提供了一种前景广阔的方法。众所周知,在急性和慢性心血管疾病期间,游离细胞 DNA 的升高与疾病、严重程度有关,并具有预后价值。中性粒细胞胞外捕获物(NET)和循环核酸酶在血栓形成中的作用为在心血管疾病中进行液体活检提供了可靠的依据。cfDNA 来源于不同的组织类型和细胞来源,包括线粒体和细胞核,可用于追踪细胞和组织类型的血统,并深入了解细胞的活化状态。本文讨论了 cfDNA 的起源、结构和潜在用途,为了解心血管疾病的复杂性提供了一种更深入、创伤更小的方法。
{"title":"Nucleic acid liquid biopsies in cardiovascular disease: Cell-free DNA liquid biopsies in cardiovascular disease.","authors":"Tyler Artner, Smriti Sharma, Irene M Lang","doi":"10.1016/j.atherosclerosis.2024.118583","DOIUrl":"https://doi.org/10.1016/j.atherosclerosis.2024.118583","url":null,"abstract":"<p><p>Cardiovascular disease (CVD) is the leading cause of death worldwide, and despite treatment efforts, cardiovascular function cannot always be restored, and progression of disease be prevented. Critical insights are oftentimes based on tissue samples. Current knowledge of tissue pathology typically relies on invasive biopsies or postmortem samples. Liquid biopsies, which assess circulating mediators to deduce the histology and pathology of distant tissues, have been advancing rapidly in cancer research and offer a promising approach to be translated to the understanding and treatment of CVD. The widely understood elevations in cell-free DNA during acute and chronic cardiovascular conditions, associate with disease, severity, and offer prognostic value. The role of neutrophil extracellular traps (NETs) and circulating nucleases in thrombosis provide a solid rationale for liquid biopsies in CVD. cfDNA originates from various tissue types and cellular sources, including mitochondria and nuclei, and can be used to trace cell and tissue type lineage, as well as to gain insight into the activation status of cells. This article discusses the origin, structure, and potential utility of cfDNA, offering a deeper and less invasive approach for the understanding of the complexities of CVD.</p>","PeriodicalId":8623,"journal":{"name":"Atherosclerosis","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-08DOI: 10.1016/j.atherosclerosis.2024.118590
Konsta Teppo, Elin Karlsson, Tuomas Kiviniemi, Olli Halminen, Ossi Lehtonen, Elis Kouki, Jari Haukka, Pirjo Mustonen, Jukka Putaala, Miika Linna, Juha Hartikainen, K E Juhani Airaksinen, Mika Lehto
Background and aims: We examined temporal trends and age-related differences in the prevalence of vascular diseases and in their association with ischemic stroke (IS) risk in patients with atrial fibrillation (AF).
Methods: The registry-based FinACAF study covered all patients with AF in Finland during 2007-2018. Incidence rate ratios (IRRs) of IS were computed with Poisson regression, and the interaction of vascular diseases with age and calendar year period was assessed.
Results: We identified 229,565 patients (50.0 % female; mean age 72.7 years) with incident AF. The overall prevalence of any vascular disease was 28.6 %, and the prevalence increased from 2007 to 2018, primarily among patients over 75 years. Overall, 5909 (2.6 %) patients experienced IS within the first year after AF diagnosis. Crude IS rate decreased continuously during the study period in both patients with and without vascular diseases, with the rates remaining consistently higher in patients with vascular diseases. Vascular diseases were independently associated with higher IS incidence among patients under 65 years (adjusted IRR with 95 % confidence interval 1.35 (1.10-1.66)), while among older patients, only peripheral artery disease was associated with IS, and other vascular conditions had no association with IS. No interactions between the calendar year period and vascular diseases with IS rate were observed.
Conclusions: The association between vascular diseases and IS has remained stable over time and vascular diseases were independently associated with higher incidence of IS particularly in patients with AF under the age of 65.
背景与目的我们研究了心房颤动(房颤)患者血管疾病患病率及其与缺血性中风(IS)风险相关性的时间趋势和年龄差异:以登记为基础的 FinACAF 研究涵盖了 2007-2018 年间芬兰的所有房颤患者。采用泊松回归法计算了IS的发病率比(IRR),并评估了血管疾病与年龄和日历年期间的交互作用:我们发现了 229,565 名房颤患者(50.0% 为女性;平均年龄 72.7 岁)。任何血管疾病的总患病率为 28.6%,2007 年至 2018 年患病率有所上升,主要是 75 岁以上的患者。总体而言,5909 名患者(2.6%)在确诊房颤后的第一年内经历了 IS。在研究期间,有血管疾病和无血管疾病患者的粗IS率均持续下降,有血管疾病患者的IS率始终较高。在 65 岁以下的患者中,血管疾病与较高的 IS 发生率独立相关(调整后 IRR,95% 置信区间为 1.35 (1.10-1.66)),而在老年患者中,只有外周动脉疾病与 IS 相关,其他血管疾病与 IS 无关。在日历年期间和血管疾病与IS率之间没有观察到相互作用:随着时间的推移,血管疾病与IS之间的关系保持稳定,血管疾病与较高的IS发病率独立相关,尤其是在65岁以下的房颤患者中。
{"title":"Vascular disease and ischemic stroke in patients with atrial fibrillation: Temporal trends and age-related differences.","authors":"Konsta Teppo, Elin Karlsson, Tuomas Kiviniemi, Olli Halminen, Ossi Lehtonen, Elis Kouki, Jari Haukka, Pirjo Mustonen, Jukka Putaala, Miika Linna, Juha Hartikainen, K E Juhani Airaksinen, Mika Lehto","doi":"10.1016/j.atherosclerosis.2024.118590","DOIUrl":"https://doi.org/10.1016/j.atherosclerosis.2024.118590","url":null,"abstract":"<p><strong>Background and aims: </strong>We examined temporal trends and age-related differences in the prevalence of vascular diseases and in their association with ischemic stroke (IS) risk in patients with atrial fibrillation (AF).</p><p><strong>Methods: </strong>The registry-based FinACAF study covered all patients with AF in Finland during 2007-2018. Incidence rate ratios (IRRs) of IS were computed with Poisson regression, and the interaction of vascular diseases with age and calendar year period was assessed.</p><p><strong>Results: </strong>We identified 229,565 patients (50.0 % female; mean age 72.7 years) with incident AF. The overall prevalence of any vascular disease was 28.6 %, and the prevalence increased from 2007 to 2018, primarily among patients over 75 years. Overall, 5909 (2.6 %) patients experienced IS within the first year after AF diagnosis. Crude IS rate decreased continuously during the study period in both patients with and without vascular diseases, with the rates remaining consistently higher in patients with vascular diseases. Vascular diseases were independently associated with higher IS incidence among patients under 65 years (adjusted IRR with 95 % confidence interval 1.35 (1.10-1.66)), while among older patients, only peripheral artery disease was associated with IS, and other vascular conditions had no association with IS. No interactions between the calendar year period and vascular diseases with IS rate were observed.</p><p><strong>Conclusions: </strong>The association between vascular diseases and IS has remained stable over time and vascular diseases were independently associated with higher incidence of IS particularly in patients with AF under the age of 65.</p>","PeriodicalId":8623,"journal":{"name":"Atherosclerosis","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-07DOI: 10.1016/j.atherosclerosis.2024.118595
Background and aims
Immune checkpoint inhibitors (ICIs) revolutionized cancer treatment. However, ICIs may increase the immune response to non-tumor cells, possibly resulting in increased arterial inflammation, raising the risk of atherosclerotic events. Nevertheless, malignancies may induce a pro-inflammatory state and the association between ICIs and arterial inflammation remains to be clarified. This study aims to assess differences in increase in arterial inflammation between patients with advanced melanoma treated with ICIs compared to a control group without ICIs.
Methods
Patients with advanced melanoma who underwent [18F]FDG PET/CT scans at baseline, 6 months (T1) and 18 months (T2) were included in this retrospective observational study. Arterial inflammation was evaluated in eight segments by calculating the target-to-background ratio (TBR). The primary study outcome was the difference in increase in mean TBRmax between patients treated with and without ICIs.
Results
We included 132 patients of whom 72.7 % were treated with ICIs. After exclusion for the use of anti-inflammatory medication, patients treated with ICIs showed a significant increase in mean TBRmax between baseline and T1 from 1.29 ± 0.12 to 1.33 ± 0.13 (p = 0.017), while in the control group, no change in mean TBRmax (1.30 ± 0.12 to 1.28 ± 0.10, p = 0.22) was observed (p = 0.027). During longer follow-up, mean TBRmax remained stable in both groups. Arterial inflammation increased significantly after ICI therapy in patients without active inflammation (p < 0.001) and in patients without calcifications (p = 0.013).
Conclusions
A significant increase in arterial inflammation as measured on [18F]FDG PET/CT was observed in patients with advanced melanoma treated with ICIs only in the first six months after initiation of therapy, whereas no changes were observed in the control group. Moreover, arterial inflammation was mainly increased in patients without pre-existing inflammatory activity and with non-calcified lesions.
{"title":"Arterial inflammation on [18F]FDG PET/CT in melanoma patients treated with and without immune checkpoint inhibitors: CHECK-FLAME I","authors":"","doi":"10.1016/j.atherosclerosis.2024.118595","DOIUrl":"10.1016/j.atherosclerosis.2024.118595","url":null,"abstract":"<div><h3>Background and aims</h3><p>Immune checkpoint inhibitors (ICIs) revolutionized cancer treatment. However, ICIs may increase the immune response to non-tumor cells, possibly resulting in increased arterial inflammation, raising the risk of atherosclerotic events. Nevertheless, malignancies may induce a pro-inflammatory state and the association between ICIs and arterial inflammation remains to be clarified. This study aims to assess differences in increase in arterial inflammation between patients with advanced melanoma treated with ICIs compared to a control group without ICIs.</p></div><div><h3>Methods</h3><p>Patients with advanced melanoma who underwent [<sup>18</sup>F]FDG PET/CT scans at baseline, 6 months (T1) and 18 months (T2) were included in this retrospective observational study. Arterial inflammation was evaluated in eight segments by calculating the target-to-background ratio (TBR). The primary study outcome was the difference in increase in mean TBR<sub>max</sub> between patients treated with and without ICIs.</p></div><div><h3>Results</h3><p>We included 132 patients of whom 72.7 % were treated with ICIs. After exclusion for the use of anti-inflammatory medication, patients treated with ICIs showed a significant increase in mean TBR<sub>max</sub> between baseline and T1 from 1.29 ± 0.12 to 1.33 ± 0.13 (<em>p =</em> 0.017), while in the control group, no change in mean TBR<sub>max</sub> (1.30 ± 0.12 to 1.28 ± 0.10, <em>p =</em> 0.22) was observed (<em>p =</em> 0.027). During longer follow-up, mean TBR<sub>max</sub> remained stable in both groups. Arterial inflammation increased significantly after ICI therapy in patients without active inflammation (<em>p</em> < 0.001) and in patients without calcifications (<em>p =</em> 0.013).</p></div><div><h3>Conclusions</h3><p>A significant increase in arterial inflammation as measured on [<sup>18</sup>F]FDG PET/CT was observed in patients with advanced melanoma treated with ICIs only in the first six months after initiation of therapy, whereas no changes were observed in the control group. Moreover, arterial inflammation was mainly increased in patients without pre-existing inflammatory activity and with non-calcified lesions.</p></div>","PeriodicalId":8623,"journal":{"name":"Atherosclerosis","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0021915024011675/pdfft?md5=21ad258d1059bd9674acf07956182932&pid=1-s2.0-S0021915024011675-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142272941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-06DOI: 10.1016/j.atherosclerosis.2024.118593
Qingchao Meng, Li Zhao, Na Zhao, Yunqiang An, Bin Lu, Yang Gao
Background and aims: We aimed to investigate the relationship between coronary artery calcium (CAC) density progression and major adverse cardiovascular events (MACE), and the prognostic value of CAC density progression.
Methods: Patients with serial CAC scans were enrolled in this study. CAC density was directly measured in calcified lesions. Change and rate of progression of CAC density were calculated. Cox proportional hazard regression was utilized to estimate hazard ratios (HRs) for time to MACE regarding CAC density. The incremental prognostic value and the reclassification ability of CAC density progression were evaluated using the C-index and continuous net reclassification index (NRI).
Results: 304 patients (57.86 ± 9.47 years, 69.4 % male) were included. There were 47 MACE over a follow-up period of 76.00 (56.00-95.00) months. After adjustment for risk factors and CAC volume, the change of CAC density was inversely associated with MACE (per 10HU: HR: 0.956, 95 % confidence interval: 0.920-0.992, p = 0.018). Adding the change of CAC density to risk factors and baseline CAC density improved the C-index (0.694 vs. 0.678, p = 0.026). Adding the change of CAC density improved reclassification of MACE compared with risk factors and baseline CAC density [NRI = 0.432 (0.016-0.789)].
Conclusions: CAC density progression is inversely associated with MACE. The addition of the change of CAC density improves prognostic value compared to baseline risk factors and CAC density and optimizes risk reclassification.
{"title":"Progression of coronary artery calcium density and major adverse cardiovascular events.","authors":"Qingchao Meng, Li Zhao, Na Zhao, Yunqiang An, Bin Lu, Yang Gao","doi":"10.1016/j.atherosclerosis.2024.118593","DOIUrl":"https://doi.org/10.1016/j.atherosclerosis.2024.118593","url":null,"abstract":"<p><strong>Background and aims: </strong>We aimed to investigate the relationship between coronary artery calcium (CAC) density progression and major adverse cardiovascular events (MACE), and the prognostic value of CAC density progression.</p><p><strong>Methods: </strong>Patients with serial CAC scans were enrolled in this study. CAC density was directly measured in calcified lesions. Change and rate of progression of CAC density were calculated. Cox proportional hazard regression was utilized to estimate hazard ratios (HRs) for time to MACE regarding CAC density. The incremental prognostic value and the reclassification ability of CAC density progression were evaluated using the C-index and continuous net reclassification index (NRI).</p><p><strong>Results: </strong>304 patients (57.86 ± 9.47 years, 69.4 % male) were included. There were 47 MACE over a follow-up period of 76.00 (56.00-95.00) months. After adjustment for risk factors and CAC volume, the change of CAC density was inversely associated with MACE (per 10HU: HR: 0.956, 95 % confidence interval: 0.920-0.992, p = 0.018). Adding the change of CAC density to risk factors and baseline CAC density improved the C-index (0.694 vs. 0.678, p = 0.026). Adding the change of CAC density improved reclassification of MACE compared with risk factors and baseline CAC density [NRI = 0.432 (0.016-0.789)].</p><p><strong>Conclusions: </strong>CAC density progression is inversely associated with MACE. The addition of the change of CAC density improves prognostic value compared to baseline risk factors and CAC density and optimizes risk reclassification.</p>","PeriodicalId":8623,"journal":{"name":"Atherosclerosis","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142379997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-05DOI: 10.1016/j.atherosclerosis.2024.118584
Smriti Sharma, Tyler Artner, Klaus T Preissner, Irene M Lang
Cardiovascular diseases (CVD) and their complications continue to be the leading cause of mortality globally. With recent advancements in molecular analytics, individualized treatments are gradually applied to the diagnosis and treatment of CVD. In the field of diagnostics, liquid biopsy combined with modern analytical technologies is the most popular natural source to identify disease biomarkers, as has been successfully demonstrated in the cancer field. While it is not easy to obtain any diseased tissue for different types of CVD such as atherosclerosis, deep vein thrombosis or stroke, liquid biopsies provide a simple and non-invasive alternative to surgical tissue specimens to obtain dynamic molecular information reflecting disease states. The release of cell-free ribonucleic acids (cfRNA) from stressed/damaged/dying and/or necrotic cells is a common physiological phenomenon. CfRNAs are a heterogeneous population of various types of extracellular RNA found in body fluids (blood, urine, saliva, cerebrospinal fluid) or in association with vascular/atherosclerotic tissue, offering insights into disease pathology on a diagnostic front. In particular, cf-ribosomal RNA has been shown to act as a damaging molecule in several cardio-vascular disease conditions. Moreover, such pathophysiological functions of cfRNA in CVD have been successfully antagonized by the administration of RNases. In this review, we discuss the origin, structure, types, and potential utilization of cfRNA in the diagnosis of CVD. Together with the analysis of established CVD biomarkers, the profiling of cfRNA in body fluids may thereby provide a promising approach for early disease detection and monitoring.
{"title":"Nucleic acid liquid biopsies in cardiovascular disease: Cell-free RNA liquid biopsies in cardiovascular disease.","authors":"Smriti Sharma, Tyler Artner, Klaus T Preissner, Irene M Lang","doi":"10.1016/j.atherosclerosis.2024.118584","DOIUrl":"https://doi.org/10.1016/j.atherosclerosis.2024.118584","url":null,"abstract":"<p><p>Cardiovascular diseases (CVD) and their complications continue to be the leading cause of mortality globally. With recent advancements in molecular analytics, individualized treatments are gradually applied to the diagnosis and treatment of CVD. In the field of diagnostics, liquid biopsy combined with modern analytical technologies is the most popular natural source to identify disease biomarkers, as has been successfully demonstrated in the cancer field. While it is not easy to obtain any diseased tissue for different types of CVD such as atherosclerosis, deep vein thrombosis or stroke, liquid biopsies provide a simple and non-invasive alternative to surgical tissue specimens to obtain dynamic molecular information reflecting disease states. The release of cell-free ribonucleic acids (cfRNA) from stressed/damaged/dying and/or necrotic cells is a common physiological phenomenon. CfRNAs are a heterogeneous population of various types of extracellular RNA found in body fluids (blood, urine, saliva, cerebrospinal fluid) or in association with vascular/atherosclerotic tissue, offering insights into disease pathology on a diagnostic front. In particular, cf-ribosomal RNA has been shown to act as a damaging molecule in several cardio-vascular disease conditions. Moreover, such pathophysiological functions of cfRNA in CVD have been successfully antagonized by the administration of RNases. In this review, we discuss the origin, structure, types, and potential utilization of cfRNA in the diagnosis of CVD. Together with the analysis of established CVD biomarkers, the profiling of cfRNA in body fluids may thereby provide a promising approach for early disease detection and monitoring.</p>","PeriodicalId":8623,"journal":{"name":"Atherosclerosis","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}