Chronic Inflammatory Diseases and Coronary Heart Disease: Insights from Cardiovascular CT

2021 ◽  
Author(s):  
Nidhi Patel ◽  
Amit K. Dey ◽  
Alexander V. Sorokin ◽  
Meron Teklu ◽  
Rylee Petrole ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Inflammatory Diseases ◽  
Chronic Inflammatory Diseases ◽  
Cardiovascular Ct

scholarly journals Comparative Risk of Incident Coronary Heart Disease Across Chronic Inflammatory Diseases

2021 ◽  
Vol 8 ◽  
Author(s):  
Arjun Sinha ◽  
Adovich S. Rivera ◽  
Simran A. Chadha ◽  
Sameer Prasada ◽  
Anna E. Pawlowski ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Disease Severity ◽  
Lupus Erythematosus ◽  
Inflammatory Diseases ◽  
Coronary Revascularization ◽  
Cox Models ◽  
Chronic Inflammatory Diseases ◽  
Adjusted Risk ◽  
Chd Risk

Background: Chronic inflammatory diseases (CIDs) are considered risk enhancing factors for coronary heart disease (CHD). However, sparse data exist regarding relative CHD risks across CIDs.Objective: Determine relative differences in CHD risk across multiple CIDs: psoriasis, rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), human immunodeficiency virus (HIV), systemic sclerosis (SSc), and inflammatory bowel disease (IBD).Methods: The cohort included patients with CIDs and controls without CID in an urban medical system from 2000 to 2019. Patients with CIDs were frequency-matched with non-CID controls on demographics, hypertension, and diabetes. CHD was defined as myocardial infarction (MI), ischemic heart disease, and/or coronary revascularization based on validated administrative codes. Multivariable-adjusted Cox models were used to determine the risk of incident CHD and MI for each CID relative to non-CID controls. In secondary analyses, we compared CHD risk by disease severity within each CID.Results: Of 17,049 patients included for analysis, 619 had incident CHD (202 MI) over an average of 4.4 years of follow-up. The multivariable-adjusted risk of CHD was significantly higher for SLE [hazard ratio (HR) 1.9, 95% confidence interval (CI) 1.2, 3.2] and SSc (HR 2.1, 95% CI 1.2, 3.9). Patients with SLE also had a significantly higher risk of MI (HR 3.6, 95% CI 1.9, 6.8). When CIDs were categorized by markers of disease severity (C-reactive protein for all CIDs except HIV, for which CD4 T cell count was used), greater disease severity was associated with higher CHD risk across CIDs.Conclusions: Patients with SLE and SSc have a higher risk of CHD. CHD risk with HIV, RA, psoriasis, and IBD may only be elevated in those with greater disease severity. Clinicians should personalize CHD risk and treatment based on type and severity of CID.

Abstract 16122: Comparative Risk of Incident Coronary Heart Disease Across Multiple Chronic Inflammatory Diseases

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Arjun Sinha ◽  
Adovich Rivera ◽  
Simran Chadha ◽  
Sameer Prasada ◽  
Anna Pawlowski ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Lupus Erythematosus ◽  
Inflammatory Diseases ◽  
Coronary Revascularization ◽  
Immune Dysfunction ◽  
Chronic Inflammatory Diseases ◽  
Chd Risk ◽  
Chd Risk Factors

Introduction: Inflammation plays an important role in the pathogenesis of coronary heart disease (CHD). Chronic inflammatory diseases (CIDs) may serve as models to provide insights into the relationships between immune dysfunction, inflammation, and CHD. To investigate this further, we analyzed the risk of incident CHD across different CIDs. Methods: We created a cohort of individuals with CIDs and non-CID controls (frequency-matched on demographics and CHD risk factors), free of baseline CHD, receiving regular outpatient care in a large medical system from 2000 to 2019. CIDs included psoriasis, rheumatoid arthritis (RA), systemic sclerosis (SSc), systemic lupus erythematosus (SLE), human immunodeficiency virus (HIV), and inflammatory bowel disease (IBD). CHD was defined as myocardial infarction (MI), angina, or coronary revascularization. We used adjusted hazards models to determine incident CHD risk for each CID relative to controls. We also analyzed incident CHD risk by severity of inflammation (baseline C-reactive protein) or immune dysfunction (baseline CD4 T cell level in HIV). Results: Of 18,129 individuals with CIDs and 18,988 controls, there were 1,011 incident CHD events over a median of 3.5 years. After adjusting for demographics and CHD risk factors, CHD risk was significantly elevated in SLE [hazard ratio (HR) 2.85, 95% confidence interval (CI) 2.19-3.71, p<0.01], SSc (HR 2.14, 95% CI 1.54-2.99, p<0.01), HIV (HR 1.38, 95% CI 1.12-1.69, p<0.01), and RA (HR 1.22, 95% CI 1.00-1.49, p=0.05). Findings were similar with MI as the lone outcome. When CIDs were categorized by inflammation or immune dysfunction, there was a pattern of higher CHD risk with higher levels of inflammation/immune dysfunction across CIDs (Figure). Conclusions: Our results show that SLE, SSc, HIV, and RA were associated with significantly elevated risks of incident CHD and MI. Higher levels of inflammation or immune dysfunction were associated with heightened CHD risk within CIDs.

Ischaemic heart disease and pregnancy

Heart ◽  
2018 ◽  
Vol 105 (3) ◽  
pp. 189-195 ◽  
Author(s):  
Matthew Cauldwell ◽  
Lucia Baris ◽  
Jolien W Roos-Hesselink ◽  
Mark R Johnson
Keyword(s):  
Heart Disease ◽  
Ischaemic Heart Disease ◽  
Maternal Morbidity ◽  
Inflammatory Diseases ◽  
Later Life ◽  
Shock Delivery ◽  
Chronic Inflammatory Diseases ◽  
Prevalence Of Obesity ◽  
History Of ◽  
In Pregnancy

Although ischaemic heart disease is currently rarely encountered in pregnancy, occurring between 2.8 and 6.2 per 100 000 deliveries, it is becoming more common as women delay becoming pregnant until later life, when medical comorbidities are more common, and because of the higher prevalence of obesity in the pregnant population. In addition, chronic inflammatory diseases, which are more common in women, may contribute to greater rates of acute myocardial infarction (AMI). Pregnancy itself seems to be a risk factor for AMI, although the exact mechanisms are not clear. AMI in pregnancy should be investigated in the same manner as in the non-pregnant population, not allowing for delays, with investigations being conducted as they would outside of pregnancy. Maternal morbidity following AMI is high as a result of increased rates of heart failure, arrhythmia and cardiogenic shock. Delivery in women with history of AMI should be typically guided by obstetric indications not cardiac ones.

scholarly journals MicroRNA-21 Negatively Regulates Treg Cells Through a TGF-β1/Smad-Independent Pathway in Patients with Coronary Heart Disease

2015 ◽  
Vol 37 (3) ◽  
pp. 866-878 ◽  
Author(s):  
Sihui Li ◽  
Qian Fan ◽  
Shaolin He ◽  
Tingting Tang ◽  
Yuhua Liao ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Mononuclear Cells ◽  
Inflammatory Diseases ◽  
Pain Syndrome ◽  
Treg Cells ◽  
Protective Role ◽  
Negative Control ◽  
Peripheral Blood Mononuclear ◽  
Tgf Β1

Background: CD4+CD25+FoxP3+ regulatory T cells (Treg cells) play a protective role against the development and progression of the inflammatory disease atherosclerosis (AS). MicroRNA-21 (miR-21) is expressed in Treg cells and is up-regulated in the context of AS and other inflammatory diseases. Aims: This study aimed to determine the role of miR-21 in Treg cell regulation and gene expression during the development of AS in patients with coronary heart disease (CHD). Methods and Results: MiR-21 expression in peripheral blood mononuclear cells (PBMCs) was significantly up-regulated in patients with CHD (acute myocardial infarction (AMI) group, n=24; unstable angina (UA) group, n=21; stable angina (SA) group, n=24) compared with patients with chest pain syndrome (CPS, n=27), and miR-21 expression showed an increasing trend from SA to UA to AMI patients. Moreover, flow cytometry analysis indicated that the frequencies of circulating Treg cells decreased in a manner proportionate opposite with the level of miR-21. Quantitative real-time PCR (qRT-PCR) revealed a decrease in mRNA expression of forkhead box P3 (foxp3), transforming cell growth factor beta 1(TGF-β1) and smad7 (a known target gene of miR-21). ELISA analysis revealed a decrease in TGF-β1 secreted into the plasma. In addition, we transfected PBMCs with a miRNA negative control (NS-m), a miR-21 mimic (miR-21-m), a miRNA inhibitor negative control (NS-i), or a miR-21 inhibitor(miR-21-i). Up-regulation of miR-21 decreased the frequency of circulating Treg cells, decreased the expression levels of foxp3, TGF-β1 and smad7, and decreased the amount of TGF-β1 secreted into the plasma. Consistent with these observations, miR-21 down-regulation increased the frequency of circulating Treg cells, increased the expression of foxp3, TGF-β1 and smad7, and increased the amount of TGF-β1 secreted into the plasma. Conclusions: Because the smad7 expression pattern was similar to that of TGF-β, our study suggests that miR-21 can negatively regulate the frequency of circulating Treg cells through a TGF-β1/smad-independent signaling pathway in PBMCs.

Infectious-inflammatory diseases and vascular stiffness in capable patients with coronary heart disease

2020 ◽  
Vol 315 ◽  
pp. e120
Author(s):  
M. Evsevyeva ◽  
M. Eremin ◽  
E. Italjantseva ◽  
M. Rostovtseva ◽  
V. Koshel
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Inflammatory Diseases ◽  
Vascular Stiffness

Features of treatment and rehabilitation of patients suffering from stable coronary heart disease with comorbid background at the outpatient stage

2021 ◽  
Vol 3 ◽  
Author(s):  
D.Yu. Gamayunov ◽  
◽  
V.A. Khaptanova ◽  
A.N. Kalyagin ◽  
N.M. Balabina ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Oral Cavity ◽  
Inflammatory Diseases ◽  
Beta Blockers ◽  
Cardiovascular Complications ◽  
Angle Closure ◽  
Deficiency Anemia ◽  
Stable Coronary Heart Disease ◽  
Coronavirus Infection

This literature review highlights the relevance of both cardiovascular diseases in general and coronary heart disease in particular. The features of the therapy of coronary heart disease and some comorbid conditions are considered: atrial fibrillation, arterial hypertension, diabetes mellitus, chronic kidney disease, gastrointestinal tract diseases, bronchial patency disorders, iron deficiency anemia, inflammatory diseases of the oral cavity, angle-closure glaucoma, new coronavirus infection COVID-19. Attention is drawn to the paradoxical relationship between cholesterol levels and the risk of cardiovascular complications and death in patients with end – stage CKD. The effect of omeprazole on reflux-induced myocardial ischemia is described. The possibility of using cardioselective beta -blockers in patients with COPD is emphasized. The choice of the form of nitrate release in inflammatory diseases of the oral cavity requires special attention. An urgent problem is the interaction of antiviral drugs and drugs of basic therapy of coronary heart disease in patients with a new coronavirus infection COVID – 19. Thus, patients taking CYP3A4 inhibitors are recommended to use prasugrel. The article examines the effect of comorbidity on the severity of persistent loss of body functions. Attention is drawn to the existing problems of rehabilitation of patients with coronary heart disease at the outpatient stage: patients ignoring non – drug rehabilitation methods, insufficiently attentive attitude to the issue of full – fledged secondary prevention. It is necessary to further improve the algorithms for the tactics of management of comorbid patients with coronary heart disease at the outpatient stage and a more detailed solution to the issue of medical and labor expertise and rehabilitation of this category of patients.

Abstract P013: Association Between Serum Chemerin Levels and Coronary Heart Disease: A Meta Analysis

Circulation ◽  
2016 ◽  
Vol 133 (suppl_1) ◽  
Author(s):  
Pradyumna Agasthi ◽  
Sivakanth Aloor ◽  
Avantika Chenna ◽  
Vivek Menon ◽  
Rachel Harris
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Inflammatory Diseases ◽  
Meta Analysis ◽  
Elevated Serum ◽  
Control Group ◽  
Median Percentage ◽  
Cross Sectional ◽  
Female Population ◽  
And Control

Background: Chemerin is a novel adipokine linked with obesity, metabolic syndrome and chronic inflammatory diseases. It plays a pivotal role in modulating adipocyte differentiation, activation of macrophages and production of proinflammatory cytokines. It is hypothesized that chemerin promotes vascular remodeling and endothelial dysfunction leading to the development of coronary atherosclerosis. We conducted a meta-analysis to evaluate the relationship between serum chemerin levels and coronary heart disease (CHD). Methods: We searched MEDLINE, CINAHL and COCHRANE databases for studies reporting serum chemerin levels in the patients with CHD and healthy controls. We included case controls, cohort and cross-sectional studies. We calculated the weighted standardized mean difference (SMD) in serum chemerin levels between the CHD and control groups.We performed residual maximum likelihood meta-regression analysis on covariates age, BMI and female sex. Results: Our search strategy yielded 43 articles and we included 10 studies enrolling 2225 participants. The median age and body mass index(BMI) of the CHD group was 62 yrs (IQR 60-63) and 26 kg/m 2 (IQR 26-28) vs 61 yrs (IQR 58-62) and 26 kg/m 2 (IQR 24-27) in the control group. The median percentage of female population was lower in the CHD group at 39% (IQR 22-52) vs 49% (IQR 31-53) in the control group. The unweighted median serum chemerin levels in the CHD group were 33.3 ng/ml (IQR 25.4-63.2) compared to 29.8 ng/ml (IQR 15.2-38.2) in the control group. The SMD of serum chemerin level was 0.78 (95% CI 0.39 - 1.17) P <0.001 comparing those in the CHD group and control group. This association was not explained by age, BMI or sex. Conclusion: An elevated serum chemerin level is significantly associated with presence of CHD. Chemerin can potentially used as a novel biomarker and to risk stratify patients with CHD.

Sign in / Sign up

Export Citation Format

Share Document