HOMOCYSTEINE AMELIORATES PROTECTIVE EFFECT OF APOLIPOPROTEINE A1 ON CARDIOVASCULAR RISK

Background Studies have suggested that sodium glucose co‐transporter 2 inhibitors exert anti‐inflammatory effects. We examined the association of baseline growth differentiation factor‐15 (GDF‐15), a marker of inflammation and cellular injury, with cardiovascular events, hospitalization for heart failure (HF), and kidney outcomes in patients with type 2 diabetes in the CANVAS (Canagliflozin Cardiovascular Assessment Study) and determined the effect of the sodium glucose co‐transporter 2 inhibitor canagliflozin on circulating GDF‐15. Methods and Results The CANVAS trial randomized 4330 people with type 2 diabetes at high cardiovascular risk to canagliflozin or placebo. The association between baseline GDF‐15 and cardiovascular (non‐fatal myocardial infarction, non‐fatal stroke, cardiovascular death), HF, and kidney (40% estimated glomerular filtration rate decline, end‐stage kidney disease, renal death) outcomes was assessed using multivariable adjusted Cox regression models. During median follow‐up of 6.1 years (N=3549 participants with available samples), 555 cardiovascular, 129 HF, and 137 kidney outcomes occurred. Each doubling in baseline GDF‐15 was significantly associated with a higher risk of cardiovascular (hazard ratio [HR], 1.2; 95% CI, 1.0‒1.3), HF (HR, 1.5; 95% CI, 1.2‒2.0) and kidney (HR, 1.5; 95% CI, 1.2‒2.0) outcomes. Baseline GDF‐15 did not modify canagliflozin’s effect on cardiovascular, HF, and kidney outcomes. Canaglifozin treatment modestly lowered GDF‐15 compared with placebo; however, GDF‐15 did not mediate the protective effect of canagliflozin on cardiovascular, HF, or kidney outcomes. Conclusions In patients with type 2 diabetes at high cardiovascular risk, higher GDF‐15 levels were associated with a higher risk of cardiovascular, HF, and kidney outcomes. Canagliflozin modestly lowered GDF‐15, but GDF‐15 reduction did not mediate the protective effect of canagliflozin.

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P824 Impact of cardiovascular risk factors and treatment strategies on the presence of intramyocardial hemorrhage visualized by magnetic resonance in patients with reperfused infarction

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jez319.475 ◽

2020 ◽

Vol 21 (Supplement_1) ◽

Author(s):

B Igual Munoz ◽

E S L C Elena Sanchez Lacuesta ◽

J L D G Jose Luis Diez Gil ◽

M F V Maria Ferre Valverdu ◽

F T M Francisco Ten Morro ◽

...

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Risk Factor ◽

Cardiovascular Risk ◽

Magnetic Resonance ◽

Protective Effect ◽

Cardiovascular Risk Factors ◽

Independent Risk Factor ◽

Treatment Strategies ◽

Lv Mass

Abstract Intramyocardial hemorrhage (IMH) is considered a marker of tissue damage severity in patients with reperfused ST-segment elevation myocardial infarction (STEMI) and has been associated with a poor prognosis despite successful revascularization of the culprit artery . We aim to study the impact of cardiovascular risk factors and treatment strategies on the presence of IMH studied with T2* -w cardiovascular magnetic resonance (CMR) in this clinical setting METHODS A prospective observational study including patients with repefused STEMI who underwent an MRI during the first week post-revascularization were conducted . The presence of IMH was analyzed in ECG triggered T2 * w sequences as presence of hipointensity area . Clinical data including cardiovascular risk factors and treatment strategies at cath lab were studied. RESULTS 94 patients with reperfused STEMI were included. Demographic data are shown at the the table. No significant association was observed between the presence of IMH and the different treatment strategies used. All data were introduced in a multivariate model including presence of thrombus, total ischemia time and culprit coronary artery. The analysis showed previous infarction as an independent risk factor (OR: 6 p = 0.03, CI: 1.1-29) while history of hypertension (OR: 0.9, p = 0.04, CI: 0.1- 0.9) and systolic blood pressure showed independent protective effect (OR: 0.3 p = 0.02 IC: 0.9-0.99.) CONCLUSIONS. 1. Previous infarction was shown to be an independent risk factor for IMH . 2. Arterial hypertension and systolic blood pressure showed a protective effect. Age (years) 62 ±13 Male sex 72 (77) Diabetes mellitus 32 (34) Hypertension 53 (56) Hyperlipidaemia 52 (55) Current or prior smoking 55 (58) Time to reperfusion 203 (142-300) Infarct-related artery LAD 38 (41) RCA 49 (52) Cx 7 (7) Infarct size (% LV mass) 18 ± 11 MO (% LV mass) 3.15 (1.44-5.48) Abstract P824 Figure. Intramyocardial hemorraghe T2* sequences

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The Protective Effect of the Mediterranean Diet: Focus on Cancer and Cardiovascular Risk

Medical Principles and Practice ◽

10.1159/000321197 ◽

2011 ◽

Vol 20 (2) ◽

pp. 103-111 ◽

Cited By ~ 72

Author(s):

Ernest K.J. Pauwels

Keyword(s):

Cardiovascular Risk ◽

Protective Effect ◽

Mediterranean Diet ◽

The Mediterranean

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Antibodies against HDL Components in Ischaemic Stroke and Coronary Artery Disease

Thrombosis and Haemostasis ◽

10.1055/s-0038-1645857 ◽

2018 ◽

Vol 118 (06) ◽

pp. 1088-1100 ◽

Cited By ~ 7

Author(s):

Joana Batuca ◽

Marta Amaral ◽

Catarina Favas ◽

Gonçalo Justino ◽

Ana Papoila ◽

...

Keyword(s):

Risk Factors ◽

Coronary Artery Disease ◽

Cardiovascular Risk ◽

Coronary Artery ◽

Protective Effect ◽

Ischaemic Stroke ◽

Cardiovascular Risk Factors ◽

Healthy Controls ◽

Artery Disease

AbstractQuantitative and qualitative defects of high-density lipoprotein (HDL) are important in atherogenesis. In this study, we investigated whether antibodies against HDL components had additional value to conventional cardiovascular risk factors for the diagnosis of ischaemic stroke (IS) and coronary artery disease (CAD). Cross-sectional study was conducted on 53 patients with IS, 51 with CAD and 55 healthy controls, and in vitro studies to validate findings of the clinical study. We determined serum immunoglobulin G (IgG) antibodies against HDL (aHDL), apolipoproteins (aApoA-I, aApoA-II and aApoC-I) and paraoxonase-1 (aPON1) as well as PON1 activity (PON1a), total antioxidant capacity and biomarkers of endothelial activation (serum nitric oxide metabolites, 3-nitrotyrosine, VCAM-1 and ICAM-1); in vitro assays tested the capacity of IgG aHDL purified from high titer patients to inhibit PON1a and to reverse protective effect of HDL on endothelial cells. IgG aHDL, aApoA-I and aPON1 were higher in IS and CAD than controls (p < 0.001), predicted negatively PON1a and positively VCAM-1 and ICAM-1. By adding IgG aHDL and aApoA-I to a traditional cardiovascular risk factors model for IS and by adding IgG aHDL in a similar model for CAD, we obtained better discrimination of IS and CAD from healthy controls. IgG aHDL purified from IS and CAD inhibited PON1a by 38% (p < 0.01) and abrogated the protective effect of HDL on VCAM-1 expression by 126% compared with non-specific human IgG (p < 0.001). IgG against HDL components interfere with the antioxidant and anti-inflammatory properties of HDL and may represent novel biomarkers for vascular disease that need to be investigated in prospective studies.

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POS0587 EFFECT OF RHEUMATOID ARTHRITIS TREATMENTS ON THE INTIMA-MEDIA THICKNESS OF SUPRA-AORTIC TRUNKS AND ON CARDIOVASCULAR RISK

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.4120 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 526.2-526

Author(s):

L. Nacef ◽

H. Ferjani ◽

K. Maatallah ◽

Y. Mabrouk ◽

H. Riahi ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Cardiovascular Risk ◽

Protective Effect ◽

Disease Activity ◽

Carotid Arteries ◽

Internal Carotid ◽

Intima Media Thickness ◽

Media Thickness ◽

The Impact ◽

Internal Carotid Arteries

Background:Patients with rheumatoid arthritis (RA) are exposed to a multifactorial cardiovascular risk: chronic inflammation, endogenous and exogenous factors, and treatment.Objectives:The aim of this study was to investigate the impact of RA treatments on cardiovascular risk and the influence of supra aortic trunks.Methods:This is a prospective study conducted on RA patients followed-up between March and December 2020 at the rheumatology department of the Mohamed Kassab Institute of Orthopedics and Traumatology. Socio-demographic data of patients and characteristics of the disease were collected. The disease activity was evaluated by the Disease Activity Score 28. Prescribed treatments were specified. Ultrasonography of the supra aortic trunks was performed by measuring, in centimeters, the Intima-media Thickness (IMT) at the level of the left (LCC) and right (RCC) common carotid arteries, the left (LIC) and right (RIC) internal carotid arteries and the left (LEC) and right (REC) internal carotid arteries.Results:Of the 47 patients surveyed, 78.7% were female. The mean age was 52.5 ±11.06 [32-76]. The average RA progressed from 86.25 ±63 [5-288] and was erosive in 81.6% of cases. The rheumatoid factor (RF) was positive in 57.8% of patients, and citrullinated antipeptide antibodies (ACPA) were present in 62.2%. The treatments taken were: Methotrexate (MTX) (54.5%), Sulfasalazine (SLZ) (1.8%), Leflunomide (LFN) (3.6%), a combination of cs-DMARDs (5.5%), and biotherapy (10.9%). The prescribed biotherapies were: Etanercept (3.6%), Adalimumab (1.8%), Certolizumab (1.8%), Infliximab (3.6%). Corticosteroids (CT) were prescribed in 38.2% of patients, non-steroidal anti-inflammatory drugs (NSAIDs) (3.6%), and analgesics (41.8%).CT had a protective effect on IMT in LIC (p=0.031) and RIC (p=0.016). MTX had a significant protective effect on IMT in RIC (p=0.002) and LEC (p=0.033).SLZ was associated with an increase in IMT at the RIC level (p=0.05). There was no association between NSAID use and IMT. MTX and CT were significantly associated with a decrease in SCORE (p=0.02; p=0.05, respectively). There was a non-significant association between SLZ or LFN and decreased SCORE (p=0.140, p=0,970).Conclusion:In our series, patients taking MTX and CT had a lower IMT than those not taking these drugs. SLZ was associated with an increase in IMT. NSAIDs did not affect IMT in our study.References:[1]Pasquale Ambrosino and al, Subclinical atherosclerosis in patients with rheumatoid arthritis A meta-analysis of literature studies. Thrombosis and Haemostasis 113.5/2015[2]Hyun-Je Kim and al, Effects of Methotrexate on Carotid Intima-media Thickness in Patients with Rheumatoid Arthritis. The Korean Academy of Medical Sciences 2015.Disclosure of Interests:None declared

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