Abstract 3578: Local Atherosclerotic Plaques Hide Information That Is Predictive For The Occurrence Of Adverse Cardiovascular Events And Will Help To Identify The Vulnerable Patient: A Prospective Cohort Study In 667 Patients.

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Gerard Pasterkamp ◽  
Willem E Hellings ◽  
Domique De kleijn ◽  
Jean-Paul de Vries ◽  
Cees A Seldenrijk ◽  
...  
Keyword(s):  
Smooth Muscle ◽  
Smooth Muscle Cell ◽  
Cardiovascular Events ◽  
Cardiovascular Death ◽  
Atherosclerotic Plaques ◽  
Atherosclerotic Lesions ◽  
Vascular Bed ◽  
Hide Information ◽  
Vulnerable Patient

Introduction Atherosclerosis is a systemic disease and the risk for ischemic events in any vascular bed increases when one arterial bed has been affected. It could be speculated that atherosclerotic lesions within the vascular bed share common denominators that destabilize multiple atherosclerotic lesions and increase risk for a subsequent cardiovascular event. We hypothesized that atherosclerotic plaques hide a cellular and molecular fingerprint that is shared by many plaques within the same individual, and that some of these characteristics would be predictive for the occurrence of clinical events due to progression of atherosclerotic disease. Methods Atherosclerotic specimens were collected after carotid endarterectomy and patients underwent clinical follow-up for the duration of 3 years. This first report summarizes the results of a study which investigated the predictive value of histological examination atherosclerotic plaques (macrophage and smooth muscle cell infiltration, collagen, calcifications, thrombus and lipid core) for the occurrence of future adverse cardiovascular events. Results A total of 164 (24.7%) of 667 patients reached the composite primary endpoint of myocardial infarction [n=11], PCI [n=14], CABG [n=6] cardiovascular death [n=12], stroke [n=24], cerebral bleeding [n=14], aneurysm surgery [n=8], peripheral artery surgery [n=64], non cardiovascular death [n=11]. The extent of macrophage or smooth muscle cell infiltration, collagen, calcification and lipid core size within the plaque did not predict systemic adverse cardiovascular events during follow up [p>0.20]. However, the presence of thrombus in the dissected plaque was strongly positively associated with reaching the primary endpoint [Cox Regression: Hazard ratio = 1.6; 95% Confidence interval = 1.1 – 2.5]. Conclusion This atherosclerotic biobank with a longitudinal study design allows identifying local plaque markers related with progression of atherosclerotic disease in the entire vascular system. For the first time we show proof of concept that local plaques hide information that may help to identify the vulnerable patient who is likely to suffer a cardiovascular event.

scholarly journals Smooth muscle-specific HuR knockout induces defective autophagy and atherosclerosis

2021 ◽  
Vol 12 (4) ◽  
Author(s):  
Shanshan Liu ◽  
Xiuxin Jiang ◽  
Xiuru Cui ◽  
Jingjing Wang ◽  
Shangming Liu ◽  
...  
Keyword(s):  
Smooth Muscle ◽  
Cardiovascular Events ◽  
Rna Binding ◽  
Rna Binding Protein ◽  
Plaque Burden ◽  
Atherosclerotic Plaques ◽  
Ampk Activation ◽  
Homeostatic Regulation ◽  
Human Antigen R

AbstractHuman antigen R (HuR) is a widespread RNA-binding protein involved in homeostatic regulation and pathological processes in many diseases. Atherosclerosis is the leading cause of cardiovascular disease and acute cardiovascular events. However, the role of HuR in atherosclerosis remains unknown. In this study, mice with smooth muscle-specific HuR knockout (HuRSMKO) were generated to investigate the role of HuR in atherosclerosis. HuR expression was reduced in atherosclerotic plaques. As compared with controls, HuRSMKO mice showed increased plaque burden in the atherosclerotic model. Mechanically, HuR could bind to the mRNAs of adenosine 5′-monophosphate-activated protein kinase (AMPK) α1 and AMPKα2, thus increasing their stability and translation. HuR deficiency reduced p-AMPK and LC3II levels and increased p62 level, thereby resulting in defective autophagy. Finally, pharmacological AMPK activation induced autophagy and suppressed atherosclerosis in HuRSMKO mice. Our findings suggest that smooth muscle HuR has a protective effect against atherosclerosis by increasing AMPK-mediated autophagy.

scholarly journals Cardiovascular family history increases the risk of disease recurrence after a first myocardial infarction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A Wahrenberg ◽  
P Magnusson ◽  
R Kuja-Halkola ◽  
H Habel ◽  
K Hambraeus ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Family History ◽  
Cardiovascular Events ◽  
Cardiovascular Death ◽  
Funding Source ◽  
History Of ◽  
First Time ◽  
Early Family

Abstract Background Despite recent advances in secondary prevention, recurrent cardiovascular events are common after a myocardial infarction (MI). It has been reported that genetic risk scores may predict the risk of recurrent cardiovascular events. Although patient-derived family history is a composite of both genetic and environmental heritability of atherosclerotic cardiovascular disease (ASCVD), it is an easily accessible information compared to genetically based risk models but the association with recurrent events is unknown. Purpose To evaluate whether a register-verified family history of ASCVD is associated with recurrent cardiovascular events (rASCVD) in patients after a first-time MI. Methods We included patients with a first-time MI during 2005 – 2014, registered in the SWEDEHEART SEPHIA registry and without prior ASCVD. Follow-up was available until Dec 31st, 2018. Data on relatives, diagnoses and prescriptions were extracted from national registers. A family history of ASCVD was defined as a register-verified hospitalisation due to MI, angina with coronary revascularization procedures, stroke or cardiovascular death in any parent. Early history was defined as such an event before the age of 55 years in fathers and 65 years in mothers. The association between family history and a composite outcome including recurrent MI, angina requiring acute revascularization, ischaemic stroke and cardiovascular death during follow-up was studied with Cox proportional hazard regression with time from SEPHIA registry completion as underlying time-scale, adjusted for age with splines, gender and year of SEPHIA registry. Regression models were then further adjusted for hypertension, diabetes, smoking and for a subset of patients, LDL-cholesterol (LDL_C) at time of first event. Results Of 25,615 patients, 2.5% and 32.1% had an early and ever-occurring family history of ASCVD, respectively. Patients with early family history were significantly younger than other patients and were more likely to be current smokers and have a higher LDL-C (Median (IQR) 3.5 (1.1) vs 3.3 (1.1) mmol/L). In total, 3,971 (15.5%) patients experienced the outcome. Early family history of ASCVD was significantly associated with rASCVD (Hazard ratio (HR) 1.52, 95% confidence interval (CI) 1.23–1.87), and the effect was sustained when adjusted for cardiovascular risk factors (HR 1.48, 95% CI 1.20–1.83) and LDL-C (HR 1.35, 95% CI 1.04–1.74). Ever-occurring family history was weakly associated with ASCVD (HR 1.09, 95% CI 1.02 – 1.17) and the association remained unchanged with adjustments for risk factors. Conclusions Early family history of cardiovascular disease is a potent risk factor for recurrent cardiovascular events in a secondary prevention setting, independent of traditional risk factors including LDL-C. This is a novel finding and these patients may potentially benefit from intensified secondary preventive measures after a first-time MI. Funding Acknowledgement Type of funding source: Private grant(s) and/or Sponsorship. Main funding source(s): This work was funded by grants from The Swedish Heart and Lung Association

Regression of atherosclecrotic lesions: medicinal and alimentary factors

2016 ◽  
Vol 94 (9) ◽  
pp. 668-671
Author(s):  
S. V. Magaeva ◽  
A. A. Kubatiev ◽  
E. A. Shirokov ◽  
V. B. Simonenko
Keyword(s):  
Smooth Muscle ◽  
Clinical Studies ◽  
Cerebral Arteries ◽  
Foam Cells ◽  
Atherosclerotic Plaques ◽  
Long Period ◽  
Atherosclerotic Lesions

The article reports results of clinical studies aimed to elucidate the influence of medicines on the size and density of atherosclerotic plaques in the walls of coronary and cerebral arteries. The phenomenon of regression of atherosclerotic lesions in the survivors of Leningrad siege during a long period of starvation is analyzed. The influence of inhibitors of angiotensinconverting enzyme on apoptosis of smooth muscle and foam cells of atherosclerotic plaques in the sanological mechanisms of atherosclerosis is discussed. The concept of natural regression of atherosclerosis is formulated and the necessity of development of the methods for is pharmacological activation are formulated.

scholarly journals Predictive Value of the Cardio‐Ankle Vascular Index for Cardiovascular Events in Patients at Cardiovascular Risk

2021 ◽  
Author(s):  
Toru Miyoshi ◽  
Hiroshi Ito ◽  
Kohji Shirai ◽  
Shigeo Horinaka ◽  
Jitsuo Higaki ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cardiovascular Disease ◽  
Cohort Study ◽  
Arterial Stiffness ◽  
Prospective Cohort ◽  
Cardiovascular Events ◽  
Primary Outcome ◽  
Cardiovascular Death ◽  
Disease Risks

Background Arterial stiffness is an important predictor of cardiovascular events; however, indexes for measuring arterial stiffness have not been widely incorporated into routine clinical practice. This study aimed to determine whether the cardio‐ankle vascular index (CAVI), based on the blood pressure–independent stiffness parameter β and reflecting arterial stiffness from the origin of the ascending aorta, is a good predictor of cardiovascular events in patients with cardiovascular disease risk factors in a large prospective cohort. Methods and Results This multicenter prospective cohort study, commencing in May 2013, with a 5‐year follow‐up period, included patients (aged 40‒74 years) with cardiovascular disease risks. The primary outcome was the composite of cardiovascular death, nonfatal stroke, or nonfatal myocardial infarction. Among 2932 included patients, 2001 (68.3%) were men; the mean (SD) age at diagnosis was 63 (8) years. During the median follow‐up of 4.9 years, 82 participants experienced primary outcomes. The CAVI predicted the primary outcome (hazard ratio, 1.38; 95% CI, 1.16‒1.65; P <0.001). In terms of event subtypes, the CAVI was associated with cardiovascular death and stroke but not with myocardial infarction. When the CAVI was incorporated into a model with known cardiovascular disease risks for predicting cardiovascular events, the global χ 2 value increased from 33.8 to 45.2 ( P <0.001), and the net reclassification index was 0.254 ( P =0.024). Conclusions This large cohort study demonstrated that the CAVI predicted cardiovascular events. Registration URL: https://www.clinicaltrials.gov ; Unique identifier: NCT01859897.

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