scholarly journals HIV indirectly accelerates coronary artery disease by promoting the effects of risk factors: longitudinal observational study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Márton Kolossváry ◽  
David Celentano ◽  
Gary Gerstenblith ◽  
David A. Bluemke ◽  
Raul N. Mandler ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Hiv Infection ◽  
Risk Scores ◽  
Atherosclerotic Cardiovascular Disease ◽  
Cocaine Use ◽  
Significant Difference ◽  
Ascvd Risk ◽  
Artery Disease

AbstractOur objective was to assess whether human immunodeficiency virus (HIV)-infection directly or indirectly promotes the progression of clinical characteristics of coronary artery disease (CAD). 300 African Americans with asymptomatic CAD (210 male; age: 48.0 ± 7.2 years; 226 HIV-infected) who underwent coronary CT angiography at two time points (mean follow-up: 4.0 ± 2.3 years) were randomly selected from 1429 participants of a prospective epidemiological study between May 2004 and August 2015. We calculated Agatston-scores, number of coronary plaques and segment stenosis score (SSS). Linear mixed models were used to assess the effects of HIV-infection, atherosclerotic cardiovascular disease (ASCVD) risk, years of cocaine use on CAD. There was no significant difference in annual progression rates between HIV-infected and—uninfected regarding Agatston-scores (10.8 ± 25.1/year vs. 7.2 ± 17.8/year, p = 0.17), the number of plaques (0.2 ± 0.3/year vs. 0.3 ± 0.5/year, p = 0.11) or SSS (0.5 ± 0.8/year vs. 0.5 ± 1.3/year, p = 0.96). Multivariately, HIV-infection was not associated with Agatston-scores (8.3, CI: [− 37.2–53.7], p = 0.72), the number of coronary plaques (− 0.1, CI: [− 0.5–0.4], p = 0.73) or SSS (− 0.1, CI: [− 1.0–0.8], p = 0.84). ASCVD risk scores and years of cocaine-use significantly increased all CAD outcomes among HIV-infected individuals, but not among HIV-uninfected. Importantly, none of the HIV-medications were associated with any of the CAD outcomes. HIV-infection is not directly associated with CAD and therefore HIV-infected are not destined to have worse CAD profiles. However, HIV-infection may indirectly promote CAD progression as risk factors may have a more prominent role in the acceleration of CAD in these patients.

Elevated level of circulatory sTLT1 induces inflammation through SYK/MEK/ERK signalling in coronary artery disease

2019 ◽  
Vol 133 (22) ◽  
pp. 2283-2299
Author(s):  
Apabrita Ayan Das ◽  
Devasmita Chakravarty ◽  
Debmalya Bhunia ◽  
Surajit Ghosh ◽  
Prakash C. Mandal ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Chronic Inflammation ◽  
Ex Vivo ◽  
Human Subjects ◽  
Critical Role ◽  
Atherosclerotic Cardiovascular Disease ◽  
Tnf Α ◽  
Artery Disease

Abstract The role of inflammation in all phases of atherosclerotic process is well established and soluble TREM-like transcript 1 (sTLT1) is reported to be associated with chronic inflammation. Yet, no information is available about the involvement of sTLT1 in atherosclerotic cardiovascular disease. Present study was undertaken to determine the pathophysiological significance of sTLT1 in atherosclerosis by employing an observational study on human subjects (n=117) followed by experiments in human macrophages and atherosclerotic apolipoprotein E (apoE)−/− mice. Plasma level of sTLT1 was found to be significantly (P<0.05) higher in clinical (2342 ± 184 pg/ml) and subclinical cases (1773 ± 118 pg/ml) than healthy controls (461 ± 57 pg/ml). Moreover, statistical analyses further indicated that sTLT1 was not only associated with common risk factors for Coronary Artery Disease (CAD) in both clinical and subclinical groups but also strongly correlated with disease severity. Ex vivo studies on macrophages showed that sTLT1 interacts with Fcɣ receptor I (FcɣRI) to activate spleen tyrosine kinase (SYK)-mediated downstream MAP kinase signalling cascade to activate nuclear factor-κ B (NF-kB). Activation of NF-kB induces secretion of tumour necrosis factor-α (TNF-α) from macrophage cells that plays pivotal role in governing the persistence of chronic inflammation. Atherosclerotic apoE−/− mice also showed high levels of sTLT1 and TNF-α in nearly occluded aortic stage indicating the contribution of sTLT1 in inflammation. Our results clearly demonstrate that sTLT1 is clinically related to the risk factors of CAD. We also showed that binding of sTLT1 with macrophage membrane receptor, FcɣR1 initiates inflammatory signals in macrophages suggesting its critical role in thrombus development and atherosclerosis.

HIV may indirectly accelerate coronary artery disease through enhancing the effects of conventional and non-conventional cardiovascular risk factors

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Kolossvary ◽  
E.K Fishman ◽  
G Gerstenblith ◽  
D.A Bluemke ◽  
R.N Mandler ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Hiv Infection ◽  
Cardiovascular Risk Factors ◽  
Agatston Score ◽  
Funding Source ◽  
Significant Difference ◽  
Ascvd Risk ◽  
Artery Disease

Abstract Background/Introduction Cross-sectional studies are inconsistent on the potential independent adverse effects of human immunodeficiency virus (HIV)-infection on coronary artery disease (CAD). Furthermore, there is no information on the potential effects of HIV-infection on plaque volumes. Also, only the independent effects of HIV-infection on CAD have been investigated. Purpose In a prospective longitudinal observational cohort, we wished to assess whether HIV-infection accelerates CAD independently, or by acting in synergistic fashion with conventional and nonconventional cardiovascular risk factors to accelerate disease progression as assessed by clinical and volumetric parameters of CAD on coronary CT angiography (CCTA). Methods Overall, 300 asymptomatic individuals without cardiovascular symptoms but with CCTA-confirmed coronary plaques (210 males, age: 48.0±7.2 years) with or without HIV (226 HIV-infected) prospectively underwent CCTA at two time points (mean follow-up: 4.0±2.3 years). Agatston-score, number of coronary plaques, segment stenosis score were calculated, and we also segmented the coronary plaques to enumerate total, noncalcified (−100–350HU) and calcified (≥351HU) plaque volumes. Linear mixed models were used to assess the effects of HIV-infection, atherosclerotic cardiovascular disease (ASCVD) risk, years of cocaine use and high-sensitivity C-reactive protein on CCTA markers of CAD. Results In univariate analysis, there was no significant difference in CAD characteristics between HIV-infected and -uninfected, neither at baseline nor at follow-up (p&gt;0.05 for all). Furthermore, there was no significant difference in annual progression rates between the two groups (p&gt;0.05 for all). By multivariate analysis, HIV was not associated with any CAD parameter (p&gt;0.05 for all). However, among HIV-infected individuals, each year of cocaine use significantly increased all CAD parameters (p&lt;0.05 for all), while ASCVD risk score was significantly associated with CAD parameters except for Agatston-score (p&lt;0.05). These associations were only present among HIV-infected individuals. Conclusion(s) Instead of directly worsening CAD, HIV may promote CAD through increased susceptibility to conventional and nonconventional cardiovascular risk factors. Therefore, aggressive management of both conventional and nonconventional cardiovascular risk factors is needed to reduce cardiovascular burden of HIV-infection. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): National Institutes of Health, National Institute on Drug Abuse

Prevalence and predictors of coronary artery disease in adults with Kawasaki disease

2014 ◽  
Vol 25 (6) ◽  
pp. 1124-1129 ◽  
Author(s):  
Jalaj Garg ◽  
Parasuram Krishnamoorthy ◽  
Chandrasekar Palaniswamy ◽  
Rajiv Paudel ◽  
Saurav Chatterjee ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Kawasaki Disease ◽  
Hospital Admissions ◽  
Artery Aneurysm ◽  
Adult Patients ◽  
Significant Difference ◽  
Traditional Risk Factors ◽  
Artery Disease

AbstractBackground: Accelerated coronary atherosclerosis in patients with Kawasaki disease, in conjunction with coronary artery aneurysm and stenosis that characterise this disease, are potential risk factors for developing coronary artery disease in young adults. We aimed to determine the prevalence and predictors of coronary artery disease in adult patients with Kawasaki disease. Methods: All patients aged 18−55 years of age diagnosed with Kawasaki disease were sampled from Nationwide Inpatient Sample database using International Classification of Diseases 9th revision (ICD 9 code 446.1) from 2009 to 2010. Demographics, prevalence of coronary artery disease, and other traditional risk factors in adult patients with Kawasaki disease were analysed using ICD 9 codes. Results: The prevalence of Kawasaki disease among adults was 0.0005% (n=215) of all in-hospital admissions in United States. The mean age was 27.3 years with women (27.6 years) older than men (27.1 years). Traditional risk factors were hypertension (21%), hyperlipidaemia (15.6%), diabetes (11.5%), tobacco use (8.8%), and obesity (8.8%), with no significant difference between men and women. Coronary artery disease (32.4%), however, was more prevalent in men (44.7%) than in women (12.1%; p=0.03). In multivariate regression analysis, after adjusting for demographics and traditional risk factors, hypertension (OR=13.2, p=0.03) was an independent risk factor of coronary artery disease. Conclusion: There was increased preponderance of coronary artery disease in men with Kawasaki disease. On multivariate analysis, hypertension was found to be the only independent predictor of coronary artery disease in this population after adjusting for other risk factors.

scholarly journals Ankle-brachial Index and associated factors in individuals with coronary artery disease

2020 ◽  
Vol 66 (4) ◽  
pp. 407-413
Author(s):  
Saulo Henrique Salgueiro de Aquino ◽  
Isabelle Tenório Melo ◽  
Carlos Dornels Freire de Souza ◽  
Francisco de Assis Costa
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Family History ◽  
Ankle Brachial Index ◽  
Chi Square ◽  
Significant Difference ◽  
History Of ◽  
Artery Disease

SUMMARY OBJECTIVE Analyzing the association between ABI and the main risk factors for coronary artery disease in coronary patients. METHODS Were selected 156 adult patients from a hospital in Maceió, Alagoas. Were evaluated with risk factors age, obesity, hypertension, diabetes mellitus, smoking, and dyslipidemia. PAOD screening was performed by the ankle-brachial index (ABI). The Mann-Whitney, chi-square, and Fisher’s exact tests were used. Confidence Interval of 95% and a significance of 5%. RESULTS 67.3% (n=105) males, 52.6% (n=82) elderly, 23.1% (n = 34) obese, 72.4% 6% (n=113) hypertensive, 34.6% (n=54) diabetics, 53.2% (n=83) smokers, 34.6% (n=54) dyslipidemic and 70.5% (n=110) with a family history of CAD. 16.7% (n=26) of the individuals presented PAOD. Three factors were associated with PAOD: age group ≥ 60 years (OR:3.656; p=0.005), diabetes mellitus (OR:2.625; p=0.024) and hypertension (OR:5.528; p=0.008). No significant difference was observed in the variables smoking, dyslipidemia, family history of CAD, and obesity. CONCLUSION The independent risk factors for PAOD were age, diabetes mellitus, and systemic arterial hypertension.

Abstract 12678: Clinical Utility of Echocardiographic Epicardial Adipose Tissue Thickness Measured Using a High-frequency Linear Probe in Patients With Coronary Artery Disease

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Yukia Hirata ◽  
Hirotsugu Yamada ◽  
Kenya Kusunose ◽  
Susumu Nishio ◽  
Mika Bando ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Adipose Tissue ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
High Frequency ◽  
Epicardial Adipose Tissue ◽  
Linear Probe ◽  
Significant Difference ◽  
Artery Disease

Introduction: Epicardial adipose tissue(EAT), which is thought to be an ectopic adipose tissue, has been paid attention in association with coronary artery disease (CAD). Hypothesis: We hypothesized that EAT in anterior interventricular groove (AIG) obtained by echocardiography can be an additional marker over classical risk factors for prediction of CAD. Methods: We enrolled 311 patients (mean age 67±11 yrs, 208 men) who underwent coronary angiography between December 2011 and December 2013 at our hospital. We measured EAT thickness on the AIG and right ventricular free wall (EAT-RV) using high-frequency linear probe. Subjects were divided into 2 groups with and without significant coronary stenosis (≧75%) from coronary angiography. The performance of clinical risk factors (including age, male gender, body mass index (BMI), diabetes mellitus, hypertension, dyslipidemia, and smoking) plus various combinations of EAT thickness measurements for predicting CAD was assessed using the area under the curve (AUC) in ROC analysis. Results: The EAT-AIG thickness was significantly greater in the CAD group than that in the non-CAD group (8.3±3.0 vs. 6.3±2.5 mm, p<0.001), and there as also significant difference in the EAT-RV between the two groups (5.0±2.1 vs. 4.4±2.3 mm, p=0.009). Adding the EAT-AIG thickness over classical risk factors improved prediction of presence CAD (AUC 0.692 vs. 0.788, p<0.001), while the EAT-RV did not (AUC 0.692 vs. 0.704, p=0.343). Conclusions: Echocardiographic EAT-AIG thickness was greater in the CAD group than the non-CAD group. This non-invasive index may have clinical potential as a maker for predicting coronary atherosclerosis.

Association of high mobility group box 1 protein with coronary artery disease

2019 ◽  
Vol 27 (4) ◽  
pp. 251-255 ◽  
Author(s):  
Necla Benlier ◽  
Mustafa Bilge Erdoğan ◽  
Serdar Keçioğlu ◽  
Nuri Orhan ◽  
Hülya Çiçek
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Healthy Subjects ◽  
High Mobility ◽  
High Mobility Group ◽  
Control Group ◽  
Protein Levels ◽  
Significant Difference ◽  
Artery Disease

Background Recently, the role of inflammation in coronary artery disease and the association of inflammatory biomarkers with adverse outcomes have been investigated in many studies. We investigated the relationship between high serum mobility group box 1 protein levels and established risk factors for coronary artery disease. Methods Fifty-five patients who presented to our Cardiovascular Surgery Clinic and subsequently underwent coronary artery bypass surgery for coronary artery disease and 50 healthy subjects presenting to the cardiology outpatient clinic without any cardiovascular problem were included in the study. The mean age was 61.47 ± 9.38 years for patients and 58.20 ± 10.15 years for controls. Results There was no statistically significant difference between groups with respect to age or sex. Family history of coronary artery disease, aspirin use, hypertension, and type 2 diabetes were significantly more prevalent in the patient group versus the control group. A significant difference was found between patients and healthy controls with respect to high mobility group box 1 protein levels ( p = 0.001). Conclusions Serum high mobility group box 1 protein was significantly increased in patients with coronary artery disease in comparison to healthy subjects. No associations were found between high mobility group box 1 protein level and certain risk factors for coronary artery disease.

scholarly journals Polygenic Scores to Assess Atherosclerotic Cardiovascular Disease Risk

2020 ◽  
Vol 126 (9) ◽  
pp. 1159-1177 ◽  
Author(s):  
Krishna G. Aragam ◽  
Pradeep Natarajan
Keyword(s):  
Cardiovascular Disease ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Clinical Utility ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Risk Scores ◽  
Atherosclerotic Cardiovascular Disease ◽  
Artery Disease ◽  
Atherosclerotic Cardiovascular Disease Risk

An individual’s susceptibility to atherosclerotic cardiovascular disease is influenced by numerous clinical and lifestyle factors, motivating the multifaceted approaches currently endorsed for primary and secondary cardiovascular disease prevention. With growing knowledge of the genetic basis of atherosclerotic cardiovascular disease—in particular, coronary artery disease—and its contribution to disease pathogenesis, there is increased interest in understanding the potential clinical utility of a genetic predictor that might further refine the assessment and management of atherosclerotic cardiovascular disease risk. Rapid scientific and technological advances have enabled widespread genotyping efforts and dynamic research in the field of coronary artery disease genetic risk prediction. In this review, we describe how genomic analyses of coronary artery disease have been leveraged to create polygenic risk scores. We then discuss evaluations of the clinical utility of these scores, pertinent mechanistic insights gleaned, and practical considerations relevant to the implementation of polygenic risk scores in the health care setting.

scholarly journals Is serum Fibroblast Growth Factor 21 associated with the severity or presence of coronary artery disease?

2021 ◽  
Author(s):  
Gokay Nar ◽  
Sara Cetin Sanlialp ◽  
Rukiye Nar ◽  
Oguz Kilic ◽  
Mehmet Furkan Ozen ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Growth Factor ◽  
Fibroblast Growth Factor ◽  
Negative Relationship ◽  
Risk Scores ◽  
Fibroblast Growth Factor 21 ◽  
Fibroblast Growth ◽  
Significant Difference ◽  
Artery Disease

Aim: Recent studies have shown that increased circulating concentrations of fibroblast growth factor 21 (FGF21) are associated with obesity, metabolic disorder, and atherosclerosis. However, the studies which investigate the relationship between serum FGF21 levels and coronary artery disease (CAD) include conflicting data. In this study, we planned to investigate the role of FGF21 in CAD development and CAD severity. Method: Seventy-eight patients with stable angina pectoris (SA) (lesion positive) and 40   control patients (lesion negative) with similar cardiovascular risk factors who underwent coronary angiography were included in the study. Serum FGF21 levels were measured by ELISA method. CAD severity was evaluated by using SYNTAX and GENSINI risk scores. Results:  Although there was a statistically significant difference between serum FGF21 levels in the SA and the control groups [101.18 ± 141.62 vs. 47.93 ± 58.74 pg/mL; p = 0.03], no correlation was found between the SYNTAX (r = 0.146 and p = 0.134) and GENSINI (r = 0.211 and p = 0.084) scores with serum FGF21 levels. The SA group had lower serum HDL-C levels (41.57 ± 11.40 vs. 54.90 ± 34.47; p = 0.02). There was a significant and negative relationship between serum FGF21 and serum HDL-C levels in correlation analysis (r = - 0.272; p = 0.026). Conclusion: The serum FGF21 levels are different between SA diagnosed and control patients. FGF21 may be a marker for CAD diagnosis, but not for the evaluation of CAD severity. To the best of our knowledge, this is the first study to evaluate coronary artery disease severity together with a lipid profile.

scholarly journals Study of risk factors associated with adverse outcome in a severe coronary artery disease (syntax score >22) with different therapeutic strategies

2019 ◽  
Vol 6 (4) ◽  
pp. 1021
Author(s):  
Vidur G. Karnik ◽  
Yogesh B. Patil ◽  
N. Pai ◽  
M. N. Bhat ◽  
R. L. Kamath ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Care Center ◽  
Tertiary Care ◽  
Therapeutic Strategies ◽  
Syntax Score ◽  
Significant Difference ◽  
Therapeutic Procedures ◽  
Artery Disease

Background: The specific question of whether PCI or surgical treatment offers any advantage over MT in patients with stable angina and multivessel disease remains unanswered. Objective of our research was to study various risk factors which interferes the outcome of various therapeutic procedures in coronary artery disease.Methods: This was prospective observational study carried out in a tertiary care center from July 2014 to July 2016. A total of 98 subjects undergoing different therapeutic strategies were followed up. Risk factors which interferes the outcome of various therapeutic procedures in coronary artery disease (CAD) were studied.Results: There was a significant difference in mean SYNTAX score (P = 0.003), urine micro albumin levels (P=0.006), and body mass index (0.046) between those who had MACE and who did not have MACE.Conclusions: The urine micro albumin >30 mg/l and highest SYNTAX score were significantly associated with MACE at 1 year in subject with severe CAD.

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