scholarly journals MP11: COMORBID DEPRESSION OR ANXIETY IS ASSOCIATED WITH AORTIC VASCULAR INFLAMMATION AND CORONARY HEART DISEASE BEYOND TRADITIONAL CARDIOVASCULAR RISK FACTORS IN PSORIASIS

2016 ◽  
Vol 64 (3) ◽  
pp. 809.1-809
Author(s):  
T Aberra ◽  
A Joshi ◽  
J Lerman ◽  
J Rodante ◽  
J Silverman ◽  
...  
Keyword(s):  
Vascular Inflammation ◽  
Coronary Plaque ◽  
Plaque Burden ◽  
High Risk Population ◽  
Inflammatory Disorder ◽  
Comorbid Depression ◽  
18Fdg Pet ◽  
Increased Risk ◽  
Pet Ct ◽  
History Of

Purpose of StudyPsoriasis is a chronic inflammatory disorder associated with vascular inflammation (VI), measured by 18-fluorodeoxyglucose positron emission tomography/computed tomography (18-FDG PET/CT), and increased risk of MI. Patients with psoriasis are more likely to have comorbid depression and anxiety. Whether these comorbidities accelerate the development of CVD in psoriasis is unclear. We hypothesized that aortic VI and coronary plaque burden would be increased in patients with psoriasis who have depression and/or anxiety compared to those with psoriasis who do not.Methods UsedPatients were prospectively enrolled. Those who reported a history of depression and/or anxiety (n=40) on survey and age- and gender-matched patients who reported no history of psychiatric illness (n=40) were selected. Target-to-Background ratio from 18FDG PET/CT was used to assess aortic VI, and coronary CT angiography scans were analyzed for coronary plaque composition.Summary of ResultsBoth aortic VI and coronary plaque burden were higher in psoriasis patients with comorbid depression or anxiety compared to those without (table 1). After adjustment for Framingham Risk Score, body mass index, and statin use; VI (β=0.24, p=0.02), total plaque burden (β=0.13, p=0.04), and non-calcified burden (β=0.13, p=0.04) were associated with comorbid depression and/or anxiety.ConclusionsPatients with psoriasis who have comorbid depression or anxiety have increased aortic VI and coronary plaque burden, suggesting that identification of psychiatric diagnoses in psoriasis may be warranted for future CV risk reduction in this high risk population.Abstract MP11 Figure 1

scholarly journals Mental disorders and risk of suicide attempt in prisoners

2020 ◽  
Author(s):  
Louis Favril
Keyword(s):  
Suicidal Ideation ◽  
Mental Disorders ◽  
Suicide Attempt ◽  
Prison Population ◽  
Total Sample ◽  
Epidemiological Studies ◽  
High Risk Population ◽  
Increased Risk ◽  
History Of ◽  
Mere Presence

Background: Mental disorders are overrepresented in prisoners, placing them at an increased risk of suicide. Advancing our understanding of how different mental disorders relate to distinct stages of the suicidal process—the transition from ideation to action—would provide valuable information for clinical risk assessment in this high-risk population. Methods: Data were drawn from a representative sample of 1212 adults (1093 men) incarcerated across 13 New Zealand prisons, accounting for 14% of the national prison population. Guided by an ideation-to-action framework, three mutually exclusive groups of participants were compared on the presence of mental disorders assessed by validated DSM-IV diagnostic criteria: prisoners without any suicidal history (controls; n = 778), prisoners who thought about suicide but never made a suicide attempt (ideators; n = 187), and prisoners who experienced suicidal ideation and acted on such thoughts (attempters; n = 247). Results: One-third (34.6%) of participants reported a lifetime history of suicidal ideation, of whom 55.6% attempted suicide (19.2% of all prisoners). Suicidal outcomes in the absence of mental disorders were rare. Whilst each disorder increased the odds of suicidal ideation (OR range 1.73–4.13) and suicide attempt (OR range 1.82–4.05) in the total sample (n = 1212), only a select subset of disorders was associated with suicide attempt among those with suicidal ideation (n = 434). Drug dependence (OR = 1.65, 95% CI 1.10-2.48), alcohol dependence (OR = 1.89, 95% CI 1.26-2.85), and posttraumatic stress disorder (OR = 2.09, 95% CI 1.37-3.17) distinguished attempters from ideators. Conclusion: Consistent with many epidemiological studies in the general population, our data suggest that most mental disorders are best conceptualized as risk factors for suicidal ideation rather than for suicide attempt. Once prisoners consider suicide, other biopsychosocial factors beyond the mere presence of mental disorders may account for the progression from thoughts to acts of suicide.

scholarly journals 0721 Coronary Atherosclerotic Plaque Burden and Composition in Patients with Obstructive Sleep Apnea by Coronary CT Angiography

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A274-A274
Author(s):  
M Lu ◽  
Y Wei ◽  
Z Wang ◽  
F Fang ◽  
S E John ◽  
...  
Keyword(s):  
Risk Factors ◽  
Regression Analysis ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Linear Regression Analysis ◽  
Coronary Plaque ◽  
Plaque Burden ◽  
Obstructive Sleep ◽  
Increased Risk ◽  
Calcified Plaque

Abstract Introduction OSA is closely associated with increased risk of coronary artery disease. Although previous small studies have investigated coronary plaque in OSA patients, limited data are available regarding the association of OSA with plaque morphology and composition. Therefore, we aimed to quantitatively characterize and compare coronary plaque burden and composition between patients with no or mild obstructive sleep apnea (OSA) and moderate-severe OSA using coronary computed tomography angiography (CTA) in a large-scale study. Methods We retrospectively analyzed consecutive patients who underwent sleep monitoring and coronary CTA. Metrics reflecting coronary plaque characteristics were compared between patients with no or mild OSA with apnea hypoxic index (AHI) ≤15 and moderate-severe OSA (AHI>15). The associations of OSA with coronary plaque components were determined by logistic and linear regression analysis. Results A total of 854 patients were enrolled in the study. Of these, 162 did not meet the inclusion criteria and of the remaining 692 patients 400 (57.8%) had moderate-severe OSA and 292 had no or mild OSA. Patients with moderate-severe OSA had a significantly higher total plaque volume, total non-calcified plaque (NCP) volume and total low density non-calcified plaque (LD-NCP) volume, and corresponding burden than those with no or mild OSA (all with p<0.05). Multivariate logistic regression analysis revealed that moderate-severe OSA patients are more likely to have any plaque, NCP and LD-NCP than those without no or mild OSA (p<0.05). In addition, stepwise multivariate linear regression analysis further revealed an independent relationship between moderate OSA (15<AHI≤30) and more so between severe OSA (AHI>30) and, NCP volume, LD-NCP volume, NCP composition, and LD-NCP composition, following adjustment for traditional cardiovascular risk factors, compared to no or mild OSA (AHI<15) (all with a p<0.05). Moderate-severe OSA conferred a similar odds ratio for LD-NCPs (a high-risk plaque) as the usual cardiovascular risk factors. Conclusion In this large cross-sectional study, OSA severity was associated with high-risk plaque features independent of traditional cardiovascular risk factors, suggesting an increased risk for cardiovascular events. Support This study was supported by NSFC (Project 81870335), International Science & Technology Cooperation Program of China (No.2015DFA30160), Beijing Municipal Science & Technology Commission (No. Z141100006014057)

scholarly journals Circulating Neutrophils Do Not Predict Subclinical Coronary Artery Disease in Women with Former Preeclampsia

Cells ◽  
2020 ◽  
Vol 9 (2) ◽  
pp. 468
Author(s):  
John A.L. Meeuwsen ◽  
Judith de Vries ◽  
Gerbrand A. Zoet ◽  
Arie Franx ◽  
Bart C. J. M. Fauser ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Flow Cytometry ◽  
Coronary Artery ◽  
Chemokine Receptors ◽  
Secondary Outcome ◽  
High Risk Population ◽  
Increased Risk ◽  
Luminal Stenosis ◽  
History Of ◽  
Artery Disease

Introduction: Preeclampsia (PE) represents a hypertensive pregnancy disorder that is associated with increased cardiovascular disease (CVD) risk. This increased risk has been attributed to accelerated atherosclerosis, with inflammation being a major contributor. Neutrophils play an important role in the onset and progression of atherosclerosis and have been associated with vascular damage in the placenta as well as the chronic inflammatory state in women with PE. We therefore investigated whether circulating neutrophil numbers or reactivity were associated with the presence and severity of subclinical atherosclerosis in women with a history of PE. Methods: Women aged 45–60 years with a 10 to 20 years earlier history of early onset preeclampsia (delivery <34 weeks of gestation) (n = 90), but without symptomatic CVD burden were screened for the presence of subclinical coronary artery disease (CAD) using both contrast-enhanced and non-contrast coronary CT angiography. Subclinical CAD was defined as a coronary artery calcium (CAC) score ≥100 Agatston Units and/or ≥50% coronary luminal stenosis. We assessed whether the numbers and activity of circulating neutrophils were associated with the presence of subclinical CAD and as secondary outcome measurements, with the presence of any calcium (CAC score > 0 AU) or stenosis, categorized as absent (0%), minimal to mild (>0 and <50%), and moderate to severe (≥50%) narrowing of the coronary artery. Blood was drawn just before CT and neutrophil numbers were assessed by flow cytometry. In addition, the presence of the chemokine receptors CXCR2 and CXCR4, which are known to be instrumental in neutrophil recruitment, and neutrophil activity upon stimulation with the bacterial peptide N-Formylmethionyl-leucyl-phenylalanine (fMLF) was assessed by flow cytometry. Results: Of the participating women, with an average age of 49 years, 13% (12 out of 90) presented with subclinical signs of CAD (CAC score ≥100 AU and/or ≥50% luminal stenosis), and 37% (33 out of 90) had a positive CAC score (>0). Total white blood cell count and neutrophil counts were not associated with the presence of subclinical CAD or with a positive CAC score. When assessing the presence of the chemokine receptors CXCR4 and CXCR2, we observed a slight decrease of neutrophil CXCR2 expression in women with CAC (median MFI 22.0 [interquartile range (IQR) 20.2–23.8]) compared to women without CAC (23.8 [IQR 21.6–25.6], p = 0.02). We observed no differences regarding neutrophil CXCR4 expression. In addition, expression of the early activity marker CD35 was slightly lower on neutrophils of women with subclinical CAD (median MFI 1.6 [IQR 1.5–1.9] compared to 1.9 [IQR 1.7–2.1] in women without CAD, p = 0.02). However, for all findings, statistical significance disappeared after adjustment for multiple testing. Conclusion: Our findings indicate that neutrophil counts and (re)activity are not directly associated with silent CAD disease burden and as such are not suitable as biomarkers to predict the presence of subclinical CAD in a high-risk population of women with a history of preeclampsia.

Abstract 16756: Quantitative Coronary CT Angiography Demonstrates Increased Total Burden and Non-Calcified Plaque in Psoriasis

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Nehal N Mehta ◽  
Karen Rodriguez ◽  
Amir Jahanshad ◽  
Balaji Natarajan ◽  
Parasuram Krishnamoorthy ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Coronary Plaque ◽  
Plaque Burden ◽  
Model Assessment ◽  
Metabolic Derangement ◽  
Coronary Ct ◽  
Increased Risk ◽  
Calcified Plaque ◽  
Total Burden ◽  
Chd Risk Factors

Introduction: Coronary computed tomography angiography (CCTA) directly characterizes composition of plaque in coronary heart disease (CHD). Although the use of CCTA has been established in clinical CHD, no study to date has ever examined how psoriasis (PSO), a chronic inflammatory skin disease associated with increased risk for myocardial infarction (MI), affects CHD by CCTA. Therefore, our goal was to understand whether psoriasis increases CHD detected by CCTA and establishes CHD plaque characteristics compared to subjects with clinical coronary disease and healthy volunteers. Methods: Subjects with PSO (N=54), CHD (N=75) and healthy controls (N=5) underwent quantitative coronary CCTA imaging (Toshiba MDCT). Total coronary plaque was assessed using QAngioCT (Medis, Netherlands) as the total coronary artery wall volume. Furthermore, to better understand the determinants of CHD [total burden (TB) and non-calcified plaque burden (NCB)], we performed deep phenotyping for lipid markers including lipid particle size and numbers, HDL efflux, and metabolic parameters of insulin resistance such as Homeostasis Model Assessment-Insulin Resistance (HOMA-IR) in psoriasis. Results: Our study showed that PSO was associated with higher TB and NCB of CHD when compared to both CHD and control groups (See Table 1). These findings were robust to adjustment for CHD risk factors (Framingham risk score) and luminal density (TB β=7.6, p<0.001 & NCB β=5.1, p=0.001). NCB was strongly associated with BMI (β=0.38, p<0.01), HDL efflux capacity (β=-10.9, p<0.05) and insulin resistance estimated by HOMA-IR (β=0.53, p<0.05) in psoriasis. Conclusions: This is the first study to show that psoriasis increases total burden of CHD which is non-calcified providing compelling evidence for the association between psoriasis and MI. Determinants of this NCB suggest focusing therapies on lipid and metabolic derangement in psoriasis may reduce this risk of future events.

scholarly journals SAT-157 Diagnostic Performance of 18F-fluorodeoxyglucose Positron Emission Tomography in Indeterminate Adrenal Tumors

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Daria Ladygina ◽  
Dmitry Beltsevich ◽  
Michael Dolgushin ◽  
Akgul Odzharova ◽  
Alexander Martinovich ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
High Risk ◽  
Diagnostic Performance ◽  
Emission Tomography ◽  
High Risk Population ◽  
Benign Lesions ◽  
18Fdg Pet ◽  
Positron Emission ◽  
Pet Ct ◽  
Malignant Lesions

Abstract Evidence on the diagnostic performance of 18F-fluorodeoxyglucose(18FDG) positron emission tomography(PET)/CT imaging of adrenal lesions is limited. We aimed to assess the diagnostic performance of this diagnostic modality in a high risk population for adrenal malignancy using an optimal reference standard. We included 21 patients operated in our clinic during 2019 for whom 8FDG PET was performed before adrenalectomy. 3 patients with pheochromocytoma were later excluded from statistical analysis, they were sent to PET before increased urine metanephrines were received. Unenhanced abdominal CT was performed in all the patients; median size was 4,5 (2.3-10) cm and median radiodensity was 32 (-7 to 43) Hounsfield units (HU). All patients with adrenocortical carcinoma and metastasis to adrenals from other organs had radiodensity of &gt;10 HU. Maximum standardized uptake (SUV max) was higher in malignant lesions when compared to benign lesions (median = 10,9 [5.4-29.6] vs 4.1 [2.6-7.22], respectively, P=.003). Similarly, median SUV max lesion to SUV max liver ratio (ALR) in malignant lesions was higher than in benign lesions (median = 2,18 [1.41-5.53] vs. 1.29 [0.67-2.13], respectively, P=.017).18FDG- PET/CT SUV max lesion &gt; 6.7 diagnosed malignancy with a sensitivity of 83,3%, specificity of 91,7%. Conclusion: Noncontract CT radiodensity of ≤10 HU excludes malignancy even in a high risk population. For indeterminate adrenal lesions, given a superior specificity, 18FDG PET/CT could be considered as a second stage imaging.

scholarly journals Contemporary rationale for non-invasive imaging of adverse coronary plaque features to identify the vulnerable patient: a Position Paper from the European Society of Cardiology Working Group on Atherosclerosis and Vascular Biology and the European Association of Cardiovascular Imaging

2020 ◽  
Vol 21 (11) ◽  
pp. 1177-1183
Author(s):  
Marc R Dweck ◽  
Pál Maurovich-Horvat ◽  
Tim Leiner ◽  
Bernard Cosyns ◽  
Zahi A Fayad ◽  
...  
Keyword(s):  
Imaging Techniques ◽  
Invasive Coronary Angiography ◽  
Coronary Plaque ◽  
Position Paper ◽  
Plaque Burden ◽  
Atherosclerotic Plaques ◽  
Invasive Treatment ◽  
Non Invasive ◽  
Fibrous Cap ◽  
Increased Risk

Abstract Atherosclerotic plaques prone to rupture may cause acute myocardial infarction (MI) but can also heal without causing an event. Certain common histopathological features, including inflammation, a thin fibrous cap, positive remodelling, a large necrotic core, microcalcification, and plaque haemorrhage are commonly found in plaques causing an acute event. Recent advances in imaging techniques have made it possible to detect not only luminal stenosis and overall coronary atherosclerosis burden but also to identify such adverse plaque characteristics. However, the predictive value of identifying individual adverse atherosclerotic plaques for future events has remained poor. In this Position Paper, the relationship between vulnerable plaque imaging and MI is addressed, mainly for non-invasive assessments but also for invasive imaging of adverse plaques in patients undergoing invasive coronary angiography. Dynamic changes in atherosclerotic plaque development and composition may indicate that an adverse plaque phenotype should be considered at the patient level rather than for individual plaques. Imaging of adverse plaque burden throughout the coronary vascular tree, in combination with biomarkers and biomechanical parameters, therefore holds promise for identifying subjects at increased risk of MI and for guiding medical and invasive treatment.

PS9 - 2. Plasma trimethylamine N-oxide (TMAO) levels are associated with 18FDG-PET/CT determined vascular inflammation

2013 ◽  
Vol 11 (4) ◽  
pp. 157-158
Author(s):  
Ruud S. Kootte ◽  
Fleur M. van der Valk ◽  
Geesje M. Dallinga-Thie ◽  
Zeneng Wang ◽  
Stanley L. Hazen ◽  
...  
Keyword(s):  
Vascular Inflammation ◽  
18Fdg Pet ◽  
Pet Ct

scholarly journals Jejunojejunal Intussusception due to Metastatic Melanoma Seven Years after the Primer

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Alexander Giakoustidis ◽  
Thomas Goulopoulos ◽  
Anastasios Boutis ◽  
George Kavvadias ◽  
Aristidis Kainantidis ◽  
...  
Keyword(s):  
Small Intestine ◽  
Metastatic Melanoma ◽  
Medical Condition ◽  
Hashimoto Thyroiditis ◽  
Initial Manifestation ◽  
Intestinal Intussusception ◽  
18Fdg Pet ◽  
Loss Of Weight ◽  
Pet Ct ◽  
History Of

Intestinal intussusception in adults is a rare medical condition accounting for less than 5% of all intussusceptions. Herein we present a 45-year-old patient with a history of abdominal pain and loss of weight. CT scan revealed jejunojejunal intussusceptions. The patient was subjected to exploratory operation and small intestine resection due to a mass causing intestinal intussusception. Pathology confirmed suspected diagnosis of metastatic melanoma to small intestine secondary to melanoma, 7 years after the initial manifestation. Postoperative evaluation with 18FDG-PET/CT revealed increased uptake in the thyroid gland. Subsequent total thyroidectomy revealed severe Hashimoto thyroiditis and no signs of metastasis. The patient received adjuvant immunotherapy and is healthy with no signs of recurrence 3 years after the initial diagnosis and treatment.

scholarly journals Preventing Recurrent Preeclampsia by Tailored Treatment of Nonphysiologic Hemodynamic Adjustments to Pregnancy

Hypertension ◽  
2021 ◽  
Author(s):  
Eva G. Mulder ◽  
Chahinda Ghossein-Doha ◽  
Ella Cauffman ◽  
Veronica A. Lopes van Balen ◽  
Veronique M.M.M. Schiffer ◽  
...  
Keyword(s):  
Calcium Supplementation ◽  
Treatment Algorithm ◽  
High Risk Population ◽  
Hemodynamic Changes ◽  
Unique Identifier ◽  
Hemodynamic Variables ◽  
Increased Risk ◽  
Low Dose Aspirin ◽  
Gestational Age At Delivery ◽  
History Of

Preeclampsia is often preceded by abnormal hemodynamic changes with heterogeneous patterns in the first half of pregnancy. We assessed the effect of timely tailored correction of nonphysiological hemodynamic changes on preventing preeclampsia in a high-risk population. Primiparous women with a history of preeclampsia were invited to participate in a longitudinal program in their next pregnancy, including repeated hemodynamic assessments at 12-, 16-, 20- and 30-week gestation additional to regular pregnancy checkups. When at least 2 of the hemodynamic variables were not within physiological reference values, the hemodynamic imbalance between cardiac output and peripheral vascular resistance was counteracted with either labetalol, methyldopa, or nifedipine using a simple treatment algorithm. Normogram-guided women (n=157) were matched to 157 women receiving care as usual (power, 80%; α=0.05). Risk of recurrent preeclampsia was analyzed with logistic regression adjusted for daily low-dose aspirin or calcium supplementation. Hemodynamic changes were considered nonphysiological in 90% of women in the normogram-guided group. Twelve percent of these women developed recurrent preeclampsia compared with 22% in the care-as-usual group (adjusted odds ratio, 0.47 [95% CI, 0.25–0.88]). There were no differences between groups in gestational age at delivery (38 1 and 38 2 weeks in the normogram-guided and care-as-usual groups, respectively) and neonatal birth weight (3148 and 3180 g in the normogram-guided and care-as-usual groups, respectively). Tailored circulatory normalization of nonphysiological hemodynamic changes during pregnancy halves the risk of recurrent preeclampsia, without disadvantageous effects on offspring outcome. This simple and innovative treatment strategy may also be beneficial to other women at increased risk for preeclampsia in pregnancy. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT04216706.

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