Genetic variability in the extracellular matrix as a determinant of cardiovascular risk: association of type III collagen COL3A1 polymorphisms with coronary artery disease

Blood ◽  
2002 ◽  
Vol 100 (4) ◽  
pp. 1220-1223 ◽  
Author(s):  
Clare Muckian ◽  
Anthony Fitzgerald ◽  
Anne O'Neill ◽  
Anna O'Byrne ◽  
Desmond J. Fitzgerald ◽  
...  

Although common genetic variants in platelet collagen receptors influence platelet activation and thrombosis, the impact of polymorphisms in collagen genes on cardiovascular disease is unknown. To evaluate this, we genotyped a highly polymorphic intronic tandem repeat of the COL3A1 gene, encoding collagen type III, alpha 1. This revealed 4 common alleles (COL3A1-1, -2, -3, and -4). The 2 populations studied were as follows: (1) a cross-sectional study of 703 acute coronary syndrome (ACS) patients with myocardial infarction (MI) and unstable angina, and (2) a prospective study of 924 Caucasian patients from the OPUS (Orbofiban in Patients with Unstable coronary Syndromes)-TIMI-16 trial of the oral GPIIb/IIIa antagonist orbofiban. In addition, we studied 306 control subjects and 224 patients with stable angina. In the case-control population, COL3A1-4 carriers were protected against ACS (odds ratio [OR] = 0.57, 95% CI = 0.35-0.91, P = .02) and stable angina (OR = 0.35, 95% CI = 0.16-0.74, P = .006). In the OPUS population, allele 4 again appeared protective against composite end points (death, MI, stroke, recurrent ischemia, and urgent rehospitalization) (relative risk [RR] = 0.41, 95% CI = 0.17-1.00). There were significant interactions between COL3A1-1 and -3 variants and treatment. Allele COL3A1-3 was associated with an increased risk of the composite end point (RR = 1.65, 95% CI = 1.07-2.55) in patients randomized to orbofiban, but appeared protective in placebo patients (RR = 0.53, 95% CI = 0.28-0.98). We conclude that variants in the COL3A1 gene, the product of which is a vessel-wall protein and platelet ligand, modulate the risk of coronary artery disease and could also modulate the response to antithrombotic therapy. This is the first reported association between polymorphisms of extracellular matrix components and cardiovascular risk.

2008 ◽  
Vol 31 (2) ◽  
pp. 85 ◽  
Author(s):  
Zhi-Yuan Liu ◽  
Jin-Ying Zhang ◽  
Tong-Wen Sun ◽  
Yan-Jun Zhang ◽  
Li Zhang ◽  
...  

Purpose: To investigate the levels of pregnancy-associated plasma protein A (PAPP-A) or insulin-like growth factor -1 (IGF-1) in patients with acute coronary syndrome. Methods: Serum PAPP-A and IGF-1 was measured with biotin–tyramide-amplified enzyme immunoassay and Enzyme Linked Immuoserbent Assay, respectively, in patients with ST elevation acute myocardial infarction (STEMI, n=12), unstable angina (UAP, n=15), and stable angina (n=15). PAPP-A and IGF-1 was also measured in 16 healthy subjects (control group). Results: The serum levels of PAPP-A in the STEMI (16.9±10.3 mIU/L) and UAP group (15.2±10.5 mIU/L) were higher than in the stable angina (8.5±3.1 mIU/L) or control group (8.4±2.0 mIU/L, P < 0.01). The serum levels of IGF-1 in the STEMI (132.3±40.9 µg/L) and UAP group (127.3±36.0 µg/L) were also higher than in the stable angina (44.9±18.5 µg/L) or control group (67.7±24.5µg/L, P < 0.01). There were no differences in serum levels of PAPP-A or IGF-1 among the single, double and three vessel lesion groups. The serum levels of PAPP-A (19.9±10.1 mIU/L) and IGF-1 (153.2±52.4 µg/L) after PCI were higher than those before PCI (15.1±10.0 mIU/L and 91.4±51.0 µg/L, respectively, P < 0.01). A positive correlation was found between PAPP-A and IGF-1 levels in the STEMI and UAP group before PCI (r=0.48?P < 0.01). Conclusion: PAPP-A and IGF-1 are elevated in patients with acute coronary syndrome. They may be used as biomarkers for vulnerable plaques in patients with coronary artery disease. Whether post-PCI elevation of IGF-1 can be used to predict restenosis of coronary arteries remains to be seen.


2006 ◽  
Vol 152 (4) ◽  
pp. 693.e7-693.e12 ◽  
Author(s):  
Sang-Wook Kim ◽  
Gary S. Mintz ◽  
Esteban Escolar ◽  
Patrick Ohlmann ◽  
Jerzy Pregowski ◽  
...  

2017 ◽  
pp. 662-668 ◽  
Author(s):  
Katarzyna Widecka ◽  
Krzysztof Safranow ◽  
Maciej Lewandowski ◽  
Krzysztof Przybycień ◽  
Jarosław Gorący ◽  
...  

2020 ◽  
Vol 13 (3) ◽  
pp. 43-59
Author(s):  
Μaria Goudinoudi ◽  
Vasiliki Karra ◽  
Konstantinos Ekmetzoglou ◽  
Anna Korombeli ◽  
Evangelia Kouskouni

Introduction: Religious faith and spirituality often seem to affect physical and psychological functioning of patients with chronic diseases. Aim: To investigate the relationship between religiosity/spirituality of coronary patients with anxiety and depression which may be experienced during their hospitalization. Methods: A cross-sectional study was conducted involving 172 patients (23 female and 149 male) with coronary artery disease, who were hospitalized in a general hospital of Attica region with an acute coronary syndrome diagnosis. HADS scale was used for the investigation of hospital anxiety and depression and the Belief and Values Scale was used to evaluate the patients’ religious faith and spirituality. Results: Moderate levels of religiosity/spirituality and no to moderate levels of anxiety and depression were found in coronary patients. No statistically significant correlations were found between the HADS subscales and the Beliefs and Values Scale (p> 0.001), although individuals who have experienced strong spiritual experiences, experienced less anxiety and depression in hospital. There were found statistically significant correlations (p <0.001) with gender, religious beliefs, patients’ age with Belief and Values Scale. There were also statistically significant correlations (p<0.001) of HADS subscales with family status, age, smoking habits, stress and medication. Conclusion: Highly religious coronary patients are less likely to experience anxiety and depression during hospitalization, though confounders seem to interfere and make it difficult to interpret this relationship. Further research is required in order to explore the impact of religiosity on psychological distress of hospitalized coronary patients.


2017 ◽  
Vol 24 (01) ◽  
pp. 26-30
Author(s):  
Ahmed Zeeshan ◽  
Zaheer Ahmad ◽  
Ghulam Abbas Tahir ◽  
Yasir Yaqoob

Microalbuminuria is a strong and independent indicator of increased cardiovascularrisk among individuals with and without diabetes and hypertension. The pathophysiologicmechanism underlying the association between albumin excretion and cardiovascular disease(CVD) is that microalbuminuria can be a predictor of CVD risk as it reflects the vascular damagein kidneys. It also shows endothelial damage predicting CV disease risk. Based on this theory,periodic screening for microalbuminuria could allow early identification of vascular diseaseand help stratify overall cardiovascular risk, especially in patients with risk factors such ashypertension or diabetes. Therefore microalbuminuria can be used for stratification of risk forcardiovascular disease. Once microalbuminuria is present, cardiovascular risk factor reductionshould be aggressive. Objectives: The objective of the study was to determine the role ofmicroalbuminuria as an atherosclerotic risk factor and its association with coronary arterydisease. Study Design: Cross-sectional study. Duration of Study: Duration of study was6 months with first patient enrolled on 16-03-2007 and last patient enrolled on 15-09-2007.Setting: Medical Unit-III and CCU Allied Hospital, Faisalabad. Subjects: 300 patients withacute coronary syndrome, admitted in Allied hospital Faisalabad were enrolled. Methods: 300patients diagnosed as having acute coronary syndrome admitted in Allied hospital Faisalabad,were included in the study. Early morning urine as well as 24 hour urine had been collectedin sterilized urine bags and microalbuminuria was tested. Results: In this study 300 patientshaving acute coronary syndrome were enrolled. Microalbuminuria was positive in 66 (22%)patients and 234 (78%) patients had no microalbuminuria. There was significant associationbetween microalbuminuria and atherosclerotic coronary artery disease. Conclusion: It isconcluded that microalbuminuria is an atherosclerotic risk factor and it is strongly associatedwith coronary artery disease.


2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Mehrab Sayadi ◽  
Reza Elmafshar ◽  
Iman Razeghian-Jahromi ◽  
Mohammad Javad Zibaeenezhad

Background. Erectile dysfunction (ED) has been become an important health challenge in recent years affecting the quality of life significantly. In addition to imposed social problems, it may warn the existence of cardiovascular diseases especially that of ischemic heart disease (IHD). We aimed to investigate the association between ED and coronary artery disease (CAD) in a population of patients with stable angina based on angiographic findings. Methods. In this cross-sectional study, among patients who are diagnosed with stable angina referring for coronary angiography (excluding those with acute coronary syndrome), 200 patients were selected. They were divided equally into two groups of case and control. The former were positively CAD patients and the latter were normal peers, with respect to angiographic results. International index of erectile function (IIEF) questionnaire was used in order to evaluate erectile function during recent four weeks. Statistical analyses of the t-test and logistic regression were performed. The significance level was considered as a P value less than 5%. Results. The age range of the patients was 40–65 years old. The case group was significantly older ( P = 0.001 ). There was a remarkable relation between the low score from IIEF (ED) and existence of CAD. Also, the severity of ED was in a close relationship with severity of CAD. In addition, dyslipidemia in terms of high LDL and low HDL was associated with both ED and severity of CAD. Conclusion. Other than CAD, ED could be considered as one of the manifestations of atherosclerosis. Accordingly, the IIEF questionnaire is a useful tool to early diagnosis of CAD. Also, IIEF-derived scores estimate CAD severity. We suggest subjects with low score of IIEF examine their cardiovascular health with special attention to possible existence of IHD.


2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Kamel Mohammedi ◽  
Nathalie Préaubert ◽  
Tanguy Cariou ◽  
Vincent Rigalleau ◽  
Ninon Foussard ◽  
...  

Abstract Background Screening for coronary artery disease (CAD) remains broadly performed in patients with type 2 diabetes (T2DM), although the lack of evidence. We conduct a real-world evidence (RWE) study to assess the risk of major clinical outcomes and economic impact of routine CAD screening in T2DM individuals at a very high cardiovascular risk. Methods SCADIAB is a comparative nationwide cohort study using data from the French National Health Data System. The main inclusion criteria are: age ≥ 40 years, DT2 diagnosed for ≥ 7 years, with ≥ 2 additional cardiovascular risk factors plus a history of microvascular or macrovascular disease, except CAD. We estimated ≥ 90,000 eligible participants for our study. Data will be extracted from 01/01/2008 to 31/12/2019. Eligible participants will be identified during a first 7-year selection period (2008–2015). Each participant will be assigned either in experimental (CAD screening procedure during the selection period) or control group (no CAD screening) on 01/01/2015, and followed for 5 years. The primary endpoint is the incremental cost per life year saved over 5 years in CAD screening group versus no CAD screening. The main secondary endpoints are: total 5-year direct costs of each strategy; incidence of major cardiovascular (acute coronary syndrome, hospitalization for heart failure, coronary revascularization or all-cause death), cerebrovascular (hospitalization for transient ischemic attack, stroke, or carotid revascularization) and lower-limb events (peripheral artery disease, ischemic diabetic foot, lower-limb revascularization or amputation); and the budget impact for the French Insurance system to promote the cost-effective strategy. Analyses will be adjusted for a high-dimension propensity score taking into account known and unknown confounders. SCADIAB has been funded by the French Ministry of Health and the protocol has been approved by the French ethic authorities. Data management and analyses will start in the second half of 2021. Discussion SCADIAB is a large and contemporary RWE study that will assess the economic and clinical impacts of routine CAD screening in T2DM people at a very high cardiovascular risk. It will also evaluate the clinical practice regarding CAD screening and help to make future recommendations and optimize the use of health care resources. Trial registration ClinicalTrials.gov Identifier: NCT04534530 (https://clinicaltrials.gov/ct2/show/NCT04534530)


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