scholarly journals Renal Allograft-Related Inflammation and Accelerated Coronary-Artery Disease: A Case Report

2021 ◽  
Author(s):  
Rainer Ullrich Pliquett ◽  
Andrea Tannapfel ◽  
Sait Sebastian Daneschnejad
Keyword(s):  
Kidney Transplant ◽  
Systemic Inflammation ◽  
Renal Allograft ◽  
Active Role ◽  
Coronary Plaque ◽  
Plaque Instability ◽  
Reactive Protein ◽  
Coronary Syndrome ◽  
Coronary Syndromes ◽  
Artery Disease

Background: Although persistent systemic inflammation is considered to be predictive for future cardiovascular events, it remains unclear whether or not C-reactive protein (CrP) plays an active role in coronary-plaque instability. Here, we report a case of a patient with failed and super-infected renal allograft as a source for systemic inflammation presenting with repeat acute coronary syndromes. Case presentation: A 52-years-old male type-2 diabetic with a failed kidney transplant who was hospitalized for acute urinary-tract infection. In the presence of other, classic cardiovascular risk factors, peak values of CrP coincided with episodes of unstable angina treated by cardiologic interventions. Besides pyelonephritis, the histological examination of the kidney transplant revealed signs of chronic rejection and the presence of a renal cell carcinoma in situ. Once the renal allograft has been removed, systemic inflammation was attenuated, the patient was not rehospitalized for acute-coronary syndrome within the next 12 months. Conclusion: In this case, systemic inflammation was paralleled by instability of coronary plaques as documented by repeat coronary angiograms.

scholarly journals A case of renal allograft-related inflammation complicated by acute coronary syndromes

2021 ◽  
Author(s):  
Rainer Ullrich Pliquett ◽  
Andrea Tannapfel ◽  
Sait Sebastian Daneschnejad
Keyword(s):  
Kidney Transplant ◽  
Systemic Inflammation ◽  
Acute Coronary Syndromes ◽  
Renal Allograft ◽  
Percutaneous Coronary Interventions ◽  
Plaque Instability ◽  
Coronary Syndrome ◽  
Coronary Interventions ◽  
Percutaneous Coronary ◽  
Coronary Syndromes

Background: Although persistent systemic inflammation is considered to be predictive for future cardiovascular events, it remains unclear whether or not C-reactive protein (CrP) plays an active role in coronary-plaque instability. Here, we report a case of a patient with failed and super-infected renal allograft as a source for systemic inflammation presenting with repeat acute coronary syndromes. Case presentation: A 52-years-old male type-2 diabetic with a failed kidney transplant who was hospitalized for acute urinary-tract infection. In the presence of other, classic cardiovascular risk factors, peak values of CrP coincided with episodes of unstable angina treated by percutaneous coronary interventions. Besides pyelonephritis, the histological examination of the kidney transplant revealed signs of chronic rejection and the presence of a renal cell carcinoma in situ. Once the renal allograft has been removed, systemic inflammation was attenuated, the patient was not re-hospitalized for acute-coronary syndrome within the next 12 months. Conclusion: In this case, systemic inflammation was paralleled by instability of coronary plaques as documented by repeat percutaneous coronary interventions.

scholarly journals Correlation of Serum Uric Acid Levels with Nonculprit Plaque Instability in Patients with Acute Coronary Syndromes: A 3-Vessel Optical Coherence Tomography Study

2018 ◽  
Vol 2018 ◽  
pp. 1-7
Author(s):  
Donghui Zhang ◽  
Ruoxi Zhang ◽  
Ning Wang ◽  
Lin Lin ◽  
Bo Yu
Keyword(s):  
Optical Coherence Tomography ◽  
Uric Acid ◽  
Serum Uric Acid ◽  
Elevated Serum ◽  
Coronary Plaque ◽  
Optical Coherence ◽  
Plaque Instability ◽  
Coronary Syndrome ◽  
Fibrous Cap ◽  
Coronary Syndromes

Elevated serum uric acid (SUA) level is known to be a prognostic factor in patients with acute coronary syndrome (ACS). However, the correlation between SUA level and coronary plaque instability has not been fully evaluated. The aim of this study was to investigate the association between SUA level and plaque instability of nonculprit lesions in patients with ACS using optical coherence tomography. A total of 150 patients with ACS who underwent 3-vessel optical coherence tomography were selected. Patients were classified into 3 groups according to tertiles of SUA level. There was a trend towards a thinner fibrous cap (0.15 ± 0.06 versus 0.07 ± 0.01 versus 0.04 ± 0.01 mm2, p<0.001) and a wider mean lipid arc (169.41 ± 33.16 versus 177.22 ± 37.76 versus 222.43 ± 47.65°, p<0.001) with increasing SUA tertile. The plaques of the high and intermediate tertile groups had a smaller minimum lumen area than the low tertile group (6.02 ± 1.11 versus 5.38 ± 1.28 mm2, p<0.001). In addition, thin-cap fibroatheromas, microvessels, macrophages, and cholesterol crystals were more frequent in the high tertile group than the low and intermediate groups. Multivariate analysis showed SUA level to be a predictor of plaque instability.

Coronary plaque instability is associated with inflammatory activity of visceral adipose tissue and carotid artery: a prospective pilot F-18 FDG PET/CT study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
K Pahk ◽  
H.W Kwon ◽  
J.S Eo ◽  
H.S Seo ◽  
S Kim
Keyword(s):  
Adipose Tissue ◽  
Carotid Artery ◽  
Systemic Inflammation ◽  
Fdg Pet ◽  
Coronary Plaque ◽  
Inflammatory Activity ◽  
Plaque Instability ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
Visceral Adipose

Abstract Background Dysfunctional Visceral adipose tissue (VAT) secretes pro-inflammatory cytokines and promotes inflammatory cell infiltration into VAT thereby boosting insulin resistance and systemic inflammation which eventually lead to increased risk of cardiovascular disease (CVD). F-18 FDG PET/CT is well known to reflect the inflammatory activity of classically activated (M1) macrophage. Purpose We hypothesized that F-18 FDG PET/CT could reflect the inflammatory activity of dysfunctional VAT and carotid artery which were associated with coronary plaque instability. Methods A total of 90 participants were enrolled in this prospective study. F-18 FDG PET/CT was performed in 32 participants with acute myocardial infarction (AMI) within a week of disease onset, 33 participants with stable coronary artery disease (CAD), and 25 control subjects. Maximum standardized uptake value (SUVmax) was calculated in VAT, subcutaneous adipose tissue (SAT), spleen, and bone marrow (BM). Target-to-background ratio (TBR) was calculated in right carotid artery and right jugular vein. Results The SUVmax of VAT and the TBR of right carotid artery were highest in patients with AMI, intermediate in patient with stable CAD, and lowest in control subjects. Systemic inflammation surrogate markers such as high-sensitivity C-reactive protein, spleen SUVmax were also showed similar pattern like the SUVmax of VAT and the TBR of right carotid artery. Furthermore, multiple linear regression analysis showed that the SUVmax of VAT and spleen SUVmax were independently associated with the TBR of right carotid artery. Conclusions F-18 FDG PET/CT could reflect the synchronized systemic inflammation in VAT and carotid artery which could affect the coronary artery instability. Furthermore, our findings offer clinical insights into risk stratification, monitoring of therapy, and physiological changes in the development of CAD. Funding Acknowledgement Type of funding source: None

C-Reactive protein and coronary artery disease: Additional evidence of the implication of an inflammatory process in acute coronary syndromes

1999 ◽  
Vol 137 (2) ◽  
pp. 346-351 ◽  
Author(s):  
Idrissia Abdelmouttaleb ◽  
Nicolas Danchin ◽  
Claudio Ilardo ◽  
Isabelle Aimone-Gastin ◽  
Michael Angioï ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Acute Coronary Syndromes ◽  
Inflammatory Process ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Coronary Syndromes ◽  
Artery Disease

Relationship between Baseline White Blood Cell count and C-reactive protein with Angiographic severity of Coronary Artery Disease in Patients with Acute Coronary Syndrome

2012 ◽  
Vol 5 (1) ◽  
pp. 23-29
Author(s):  
M Ahmed ◽  
NA Chowdhury ◽  
SK Chakrovortty ◽  
S Gafur ◽  
M Aziz ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Blood Cell ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Coronary Syndrome ◽  
Artery Disease ◽  
Wbc Count

Background: Inflammation has been shown to play a role in atherosclerosis and acute coronary syndrome. This study was carried out to evaluate the relationship between baseline white blood cell (WBC) count and C-reactive protein (CRP) with angiographic severity of coronary artery disease in patients with acute coronary syndrome and to identify those subsets of patients with acute coronary syndrome who may need to undergo invasive or conservative strategies.Method: A total of 100 patients with acute coronary syndrome including unstable angina, non-ST elevated myocardial infarction & ST elevated myocardial infarction were evaluated in National Institute of Cardiovascular Disease (NICVD), Dhaka with a view to correlate angiographic findings, C-reactive protein and WBC count. Results: This study observed that either raised WBC count or raised CRP independently and combination of both WBC count and CRP elevation were significantly associated with more severe coronary artery disease. Either raised WBC count or raised CRP or combination of raised WBC    count and CRP were significant predictor of multivessel disease and high stenosis score. Conclusion: Elevation of WBC count and CRP in patients with acute coronary syndrome are associated with severe coronary disease. WBC count and CRP can be used as a new and even simpler tool for risk stratification in acute coronary syndrome. DOI: http://dx.doi.org/10.3329/cardio.v5i1.12209 Cardiovasc. j. 2012; 5(1): 23-29

scholarly journals Myeloperoxidase: A New Biomarker of Inflammation in Ischemic Heart Disease and Acute Coronary Syndromes

2008 ◽  
Vol 2008 ◽  
pp. 1-4 ◽  
Author(s):  
Valentina Loria ◽  
Ilaria Dato ◽  
Francesca Graziani ◽  
Luigi M. Biasucci
Keyword(s):  
Heart Disease ◽  
Acute Coronary Syndromes ◽  
Clinical Characteristics ◽  
Extracellular Fluid ◽  
Polymorphonuclear Neutrophils ◽  
Clinical Tool ◽  
Plaque Instability ◽  
Coronary Syndrome ◽  
Coronary Syndromes ◽  
State Of Art

Myeloperoxidase (MPO) is an enzyme stored in azurophilic granules of polymorphonuclear neutrophils and macrophages and released into extracellular fluid in the setting of inflammatory process. The observation that myeloperoxidase is involved in oxidative stress and inflammation has been a leading factor to study myeloperoxidase as a possible marker of plaque instability and a useful clinical tool in the evaluation of patients with coronary heart disease. The purpose of this review is to provide an overview of the pathophysiological, analytical, and clinical characteristics of MPO and to summarize the state of art about the possible clinical use of MPO as a marker for diagnosis and risk stratification of patients with acute coronary syndrome (ACS).

scholarly journals Current Knowledge of MicroRNAs (miRNAs) in Acute Coronary Syndrome (ACS): ST-Elevation Myocardial Infarction (STEMI)

Life ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 1057
Author(s):  
Daniela Maria Tanase ◽  
Evelina Maria Gosav ◽  
Anca Ouatu ◽  
Minerva Codruta Badescu ◽  
Nicoleta Dima ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Development ◽  
Current Knowledge ◽  
St Elevation Myocardial Infarction ◽  
Cardiac Damage ◽  
Coronary Syndrome ◽  
Coronary Syndromes ◽  
St Elevation ◽  
Artery Disease ◽  
Potential Use

Regardless of the newly diagnostic and therapeutic advances, coronary artery disease (CAD) and more explicitly, ST-elevation myocardial infarction (STEMI), remains one of the leading causes of morbidity and mortality worldwide. Thus, early and prompt diagnosis of cardiac dysfunction is pivotal in STEMI patients for a better prognosis and outcome. In recent years, microRNAs (miRNAs) gained attention as potential biomarkers in myocardial infarction (MI) and acute coronary syndromes (ACS), as they have key roles in heart development, various cardiac processes, and act as indicators of cardiac damage. In this review, we describe the current available knowledge about cardiac miRNAs and their functions, and focus mainly on their potential use as novel circulating diagnostic and prognostic biomarkers in STEMI.

scholarly journals Predictor value of neurohumoral disorders in patients with chronic coronary syndrome with concomitant non-alcoholic fat disease

2021 ◽  
Vol 25 (3) ◽  
pp. 438-442
Author(s):  
N. S. Mykhailovska ◽  
L. E. Miniailenko ◽  
O. O. Lisova ◽  
T. O. Kulynych ◽  
H. V. Grytsay ◽  
...  
Keyword(s):  
Endothelial Dysfunction ◽  
Sensitivity And Specificity ◽  
Systemic Inflammation ◽  
Roc Analysis ◽  
Asymmetric Dimethylarginine ◽  
Homa Index ◽  
Liver Pathology ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Coronary Syndrome

Annotation. Today it is important to study the clinical and prognostic role of neurohumoral disorders in patients with stable forms of chronic coronary syndrome (CCS) and concomitant liver pathology. The aim of the study: to investigate the levels of markers of insulin, adipokine balance, systemic inflammation and endothelial dysfunction and their predictor value for the presence of non-alcoholic fatty liver disease (NAFLD) in patients with CCS. The prospective monocenter double open study in parallel groups involved 120 patients with CCS: stable angina pectoris II-III functional class aged 60.0 (55.0; 64.0) years, of whom 67 (55%) men and 53 (45 %) women. The control selected group included 30 healthy individuals aged 59.0 (58.0; 66.0) years, including 14 (46%) men and 16 (54%) women. Determination of the serum concentration of biomarkers (adiponectin, resistin, insulin, asymmetric dimethylarginine (ADMA), C-reactive protein) was performed using enzyme-linked immunosorbent assay. Statistical data processing was performed using the license program package “Statistica 13.0” (StatSoftInc, USA, № JPZ8041382130ARCN10-J). The hypothesis about the normality of the distribution of the studied indicators was tested using the Shapiro-Wilk test. Quantitative traits were presented as M ± m or Me (Q25; Q75), depending on the type of distribution. Significance of differences was assessed using Student's t-test (for normal distribution) or Mann-Whitney U-test for independent samples (for distribution other than normal). In order to establish the threshold values of biomarkers for predicting the presence of NAFLD ROC analysis was used. It was found that in patients with CCS with concomitant NAFLD, compared with patients with CCS without liver pathology, there is a significant (p <0,05) increase in insulin levels, HOMA index, resistin, ADMA, RF-C-reactive protein and a decrease in adiponectin concentration. According to the results of ROC analysis, it was found that ADMA (Se = 80.0; Sp = 82.9; AUC = 0.91) had a high sensitivity, the optimal ratio of sensitivity and specificity for the diagnosis of NAFLD among all studied biomarkers. Other biomarkers (HOMA index, adiponectin, resistin, adiponectin/resistin ratio) also had an AUC greater than 0.8, but smaller sensitivity/specificity ratio. Thus, in patients with CCS associated with NAFLD, compared with patients without NAFLD, an imbalance of adipocytokines on the background of insulin resistance, systemic inflammation and endothelial dysfunction is observed. Asymmetric dimethylarginine has the highest sensitivity, the optimal ratio of sensitivity and specificity for the diagnosis of NAFLD in patients with coronary artery disease.

scholarly journals Free Thiol β2-GPI (β-2-Glycoprotein-I) Provides a Link Between Inflammation and Oxidative Stress in Atherosclerotic Coronary Artery Disease

2020 ◽  
Vol 40 (11) ◽  
pp. 2794-2804
Author(s):  
James C. Weaver ◽  
Inaam Ullah ◽  
Miao Qi ◽  
Bill Giannakopoulos ◽  
Kerry Anne Rye ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Stable Coronary Artery Disease ◽  
High Sensitivity ◽  
St Segment Elevation ◽  
Reactive Protein ◽  
Coronary Syndrome ◽  
Free Thiol ◽  
St Segment ◽  
Artery Disease

Objective: Atherosclerotic coronary artery disease is well recognised as an inflammatory disorder that is also influenced by oxidative stress. β2-GPI (β-2-glycoprotein-I) is a circulating plasma protein that undergoes post-translational modification and exists in free thiol as well as oxidized forms. The aim of this study was to assess the association between these 2 post-translational redox forms of β2-GPI and atherosclerotic coronary artery disease. Approach and Results: Stable patients presenting for elective coronary angiography or CT coronary angiography were prospectively recruited. A separate group of patients after reperfused ST-segment–elevation myocardial infarction formed an acute coronary syndrome subgroup. All patients had collection of fasting serum and plasma for quantification of total and free thiol β2-GPI. Coronary artery disease extent was quantified by the Syntax and Gensini scores. A total of 552 patients with stable disease and 44 with acute coronary syndrome were recruited. While total β2-GPI was not associated with stable coronary artery disease, a higher free thiol β2-GPI was associated with its presence and extent. This finding remained significant after correcting for confounding variables, and free thiol β2-GPI was a better predictor of stable coronary artery disease than hs-CRP (high-sensitivity C-reactive protein). Paradoxically, there were lower levels of free thiol β2-GPI after ST-segment–elevation myocardial infarction. Conclusions: Free thiol β2-GPI is a predictor of coronary artery disease presence and extent in stable patients. Free thiol β2-GPI was a better predictor than high-sensitivity C-reactive protein.

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