scholarly journals Effective microRNAs in Ischemia/Reperfusion Before and After Bypass Graft Surgery in Coronary Artery Patients

2020 ◽  
Author(s):  
Erman Kandilli ◽  
Şenay Görücü Yılmaz ◽  
Murat Yardımcı ◽  
Necla Benlier ◽  
Muradiye Nacak

Abstract BackgroundCardiovascular diseases (CVD) are among the causes of morbidity and mortality in the world. Significant advances have been made in the diagnosis, treatment and prognosis of CVD. New biomarkers and therapeutic targets are needed to reduce the incidence of this disease. Recently, there is growing evidence that circulating microRNAs can be used as diagnostic biomarkers in this disease. Methods We compared five microRNA (hsa-miR-21-5p, hsa-mi181a-5p, hsa-miR-199a-5p, hsa-miR-199b-5p and hsa-miR-320a) expression levels associated with ischemia/reperfusion before and after bypass graft surgery in serum samples of patients (N=46) with coronary artery disease and healthy control subjects (N=48). Expression measurements were made for each miRNA preoperatively and postoperatively at 1. and 24. hours, and then compared with the control subjects. Troponin I, creatine phosphate kinase and creatine kinase myocardial band cardiac markers were measured before and 1 and 24 hours postoperatively and compared to miRNA expressions and controls. Quantitative real-time PCR was used for expression analysis. The data were analyzed by Mann-Whitney test, chi-squared test, Logistic Regression analysis, and Kruskal-Wallis test with the statistical package SPSS. Results The five miRNAs were down-regulated compared to controls. The expression level for miR-199a at 24 h postoperatively was significantly lower than at 1 h (p=0.001). Receiver operating characteristic analysis showed that the area under the curve of miR-199a-5p was 0.810 (sensitivity 87% and specificity 68.5%) in preoperative patients. Conclusions: miR-199a and miR-199b in serum are a novel non-invasive biomarker candidate for coronary artery disease.

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Heidi Cung ◽  
Joe Anderson ◽  
James Nawarskas ◽  
Matthew Campen

Introduction: Vascular disease is driven by systemic inflammation that can arise from sites distal to the affected coronary or cerebral vessels. The objective of this study is to characterize the inflammatory potential of serum from patients with coronary artery disease (CAD) using cultured endothelial cells as a biosensor of the circulating milieu. Methods: Serum samples from CAD patients (N=48) and healthy control subjects (N=50) were incubated with primary human coronary artery endothelial cells at a 1:10 dilution for 4h, following by isolation of the cellular RNA. Alteration of inflammation-responsive elements (adhesion molecules and cytokines) was assessed on a gene expression level. Specific indicators included intercellular adhesion molecule-1 (ICAM), vascular cell adhesion molecule-1 (VCAM), and interleukin-8 (IL-8). Additionally, the serum samples from the CAD patients and healthy individuals were quantitatively analyzed for IL-1β, IL-6, IL-8, and TNF-α using an electrochemical luminescence platform. Results: For the CAD subjects’ serum, the mean values of ICAM, VCAM, and IL-8 expression were all elevated compared to healthy control subjects (p<0.001 for each by Students T-test). Correlational analysis revealed the three indicators (ICAM, VCAM, and IL-8) to be independent of each other and also other inflammatory markers such as C-reactive protein. IL-8 expression was negatively correlated with serum HDL levels but positively correlated with body fat composition. Interestingly, serum levels of IL-1β, IL-6, IL-8, and TNF-α in CAD patients were not statistically different from healthy control subjects. Conclusions: As yet uncharacterized circulating factors in the serum of CAD patients appear to activate endothelial cells. This assay paradigm performed well in terms of discriminating patients with CAD compared to healthy subjects, with greater range and specificity than specific inflammatory markers.


2020 ◽  
Vol 18 (5) ◽  
pp. 523-530 ◽  
Author(s):  
Konstantinos Maniatis ◽  
Gerasimos Siasos ◽  
Evangelos Oikonomou ◽  
Manolis Vavuranakis ◽  
Marina Zaromytidou ◽  
...  

Background: Osteoprotegerin and osteopontin have recently emerged as key factors in both vascular remodelling and atherosclerosis progression. Interleukin-6 (IL-6) is an inflammatory cytokine with a key role in atherosclerosis. The relationship of osteoprotegerin, osteopontin, and IL-6 serum levels with endothelial function and arterial stiffness was evaluated in patients with coronary artery disease (CAD). Methods: We enrolled 219 patients with stable CAD and 112 control subjects. Osteoprotegerin, osteopontin and IL-6 serum levels were measured using an ELISA assay. Endothelial function was evaluated by flow-mediated dilation (FMD) in the brachial artery and carotid-femoral pulse wave velocity (PWV) was measured as an index of aortic stiffness. Results: There was no significant difference between control subjects and CAD patients according to age and sex. Compared with control subjects, CAD patients had significantly impaired FMD (p<0.001) and increased PWV (p=0.009). CAD patients also had significantly higher levels of osteoprotegerin (p<0.001), osteopontin (p<0.001) and IL-6 (p=0.03), compared with control subjects. Moreover, IL-6 levels were correlated with osteoprotegerin (r=0.17, p=0.01) and osteopontin (r=0.30, p<0.001) levels. FMD was correlated with osteoprotegerin levels independent of possible confounders [b coefficient= - 0.79, 95% CI (-1.54, -0.05), p=0.04]. Conclusion: CAD patients have increased osteoprotegerin, osteopontin and IL-6 levels. Moreover, there is a consistent association between osteoprotegerin and osteopontin serum levels, vascular function and inflammation in CAD patients. These findings suggest another possible mechanism linking osteoprotegerin and osteopontin serum levels with CAD progression through arterial wall stiffening and inflammation.


2013 ◽  
Vol 6 ◽  
pp. CCRep.S11542
Author(s):  
Antoine Kossaify ◽  
Gilles Grollier

We report on an octogenarian patient presenting with an acute coronary syndrome due to significant left main coronary artery disease and severe ostial stenosis of the left anterior descending artery disease. Emergent bypass graft performed with “beating heart” consisted of left internal mammary graft to the mid left anterior descending artery with an “over-stent” anastomosis. The immediate post-operative phase was simple, however the patient presented on post-operative day 8 with extensive anterior myocardial infarction and cardiogenic shock. Emergent coronary angiogram showed subocclusive anastomotic stenosis. Percutaneous coronary intervention was performed on left main, proximal left anterior descending, and proximal circumflex arteries. Subsequently, the patient restored a satisfactory hemodynamic condition. A focus on the importance of decision for management of left main disease especially in octogenarian is presented, along with a review of the pertinent literature.


2021 ◽  
Vol 10 (10) ◽  
pp. 2210
Author(s):  
Georgios Sofidis ◽  
Nikolaos Otountzidis ◽  
Nikolaos Stalikas ◽  
Efstratios Karagiannidis ◽  
Andreas S. Papazoglou ◽  
...  

The GRACE score constitutes a useful tool for risk stratification in patients with acute coronary syndrome (ACS), while the SYNTAX score determines the complexity of coronary artery disease (CAD). This study sought to correlate these scores and assess the accuracy of the GRACE score in predicting the extent of CAD. A total of 539 patients with ACS undergoing coronary angiography were included in this analysis. The patients were classified into those with a SYNTAX score < 33 and a SYNTAX score ≥ 33. Spearman’s correlation and receiver operator characteristic analysis were conducted to investigate the role of the GRACE score as a predictor of the SYNTAX score. There was a significantly positive correlation between the SYNTAX and the GRACE scores (r = 0.32, p < 0.001). The GRACE score predicted severe CAD (SYNTAX ≥ 33) moderately well (the area under the curve was 0.595 (0.522–0.667)). A GRACE score of 126 was documented as the optimal cut-off for the prediction of a SYNTAX score ≥ 33 (sensitivity = 53.5% and specificity = 66%). Therefore, our study reports a significantly positive correlation between the GRACE and the SYNTAX score in patients with ACS. Notably, NSTEMI patients with a high-risk coronary anatomy have higher calculated GRACE scores. A multidisciplinary approach by a heart team could possibly alter the therapeutic approach and management in patients presenting with ACS and a high calculated GRACE score.


2021 ◽  
Vol 32 (4) ◽  
pp. 439-446
Author(s):  
Widya Handayani ◽  
Suharjono ◽  
Mohammad Yogiarto

Abstract Objectives Coronary artery disease (CAD) is one of the main causes of death from cardiovascular disease, because heart attacks result in atherosclerosis which causes narrowing of the arteries. Atorvastatin has a pleiotropic effect as anti-inflammatory through one of the target levels of High Mobility Group Box-1 (HMGB-1). This prospective observational study aimed to analyze the effect of atorvastatin on serum HMGB-1 levels in CAD. Methods Samples were collected from prospective observation pre–post study in May–July 2018 with consecutive sampling method. Serum HMGB-1 levels were measured in patients with CAD who were given atorvastatin for CAD with type-2 diabetes mellitus compared without type-2 diabetes mellitus in a patient ward. Blood was collected on admission day and before the patient left the hospital. After centrifugation, serum samples were stored at −80 °C before measurement. We used an ELISA kit (IBL International) to determine HMGB-1 concentrations. This research protocol has been approved by the Ethical Committee of Dr. Soetomo General Hospital, Surabaya. Results We enrolled 38 patients and divided them into two groups which 19 patients on CAD with type-2 diabetes mellitus and 19 patients without diabetes mellitus. Serum HMGB-1 levels in CAD with type-2 diabetes mellitus were increased significantly (p = 0.049) and not significantly decreased in CAD without type-2 diabetes mellitus (p = 0.480). The HMGB-1 level was not significantly different between the two groups (p = 0.210). Conclusions HMGB-1 levels after providing atorvastatin in CAD with type-2 diabetes mellitus increased significantly, meanwhile, in CAD without type-2 diabetes mellitus did not decrease significantly. The HMGB-1 level was not significantly different between the two groups. Longer time and more point for the collected sample needed for further research.


Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Kyung Il Jo ◽  
Jong Soo Kim ◽  
Seung-Chyul Hong ◽  
Je Young Yeon

Background and Purpose: Coronary artery disease in moyamoya disease (MMD) have been described sporadically in several case reports. The purpose of this study is to determine the prevalence and characteristics of coronary artery disease in patients with MMD. Methods: From August 1991 to December 2012, 446 patients diagnosed with adult MMD at our hospital. Baseline characteristics and prevalence of coronary artery disease were reviewed based on medical records and laboratory findings. The findings of conventional coronary angiography and/or coronary computed tomography were also reviewed for the presence and appearance of coronary artery lesion. Results: - Of 446 patients with adult MMD, 21 patients were found to have coronary artery disease. Ten patients were treated with coronary artery bypass graft (n=4) or percutaneous coronary intervention (n=6) for unstable angina or myocardial infarction. Eleven were treated with medication for stable angina (n=6) and variant angina with mild degree of stenosis (n=5). Median age at diagnosed with coronary artery disease of these patients were 44 (range, 27-59). Two patients showed calcification on coronary artery lesion. Comorbid stroke risk factor rate were 19%, 38%, 9.5% and 19 % in diabetes, hypertension, dyslipidemia and smoking. Six of 21 patients had more than 2 risk factor. Conclusion: - Twenty one (4.7%) of our adult MMD registry patients showed coronary artery disease. And only 2 (9.5%) showed calcification which might means that atherosclerosis burden is low in coronary artery disease with MMD. Coronary artery disease might be a clinically relevant systemic manifestation in patients with MMD, considering early onset coronary diseaes and low prevalence of stroke risk factor.


2009 ◽  
Vol 55 (1) ◽  
pp. 85-92 ◽  
Author(s):  
Kai M Eggers ◽  
Allan S Jaffe ◽  
Lars Lind ◽  
Per Venge ◽  
Bertil Lindahl

Abstract Background: The aim of this study was to evaluate factors influencing the 99th percentile for cardiac troponin I (cTnI) when this cutoff value is established on a highly sensitive assay, and to compare the value of this cutoff to that of lower cutoffs in the prognostic assessment of patients with coronary artery disease. Methods: We used the recently refined Access AccuTnI assay (Beckman-Coulter) to assess the distribution of cTnI results in a community population of elderly individuals [PIVUS (Prospective Study of the Vasculature in Uppsala Seniors) study; n = 1005]. The utility of predefined cTnI cutoffs for risk stratification was then evaluated in 952 patients from the FRISC II (FRagmin and Fast Revascularization during InStability in Coronary artery disease) study at 6 months after these patients had suffered acute coronary syndrome. Results: Selection of assay results from a subcohort of PIVUS participants without cardiovascular disease resulted in a decrease of the 99th percentile from 0.044 μg/L to 0.028 μg/L. Men had higher rates of cTnI elevation with respect to the tested thresholds. Whereas the 99th percentile cutoff was not found to be a useful prognostic indicator for 5-year mortality, both the 90th percentile (hazard ratio 3.1; 95% CI 1.9–5.1) and the 75th percentile (hazard ratio 2.8; 95% CI 1.7–4.7) provided useful prognostic information. Sex-specific cutoffs did not improve risk prediction. Conclusions: The 99th percentile of cTnI depends highly on the characteristics of the reference population from which it is determined. This dependence on the reference population may affect the appropriateness of clinical conclusions based on this threshold. However, cTnI cutoffs below the 99th percentile seem to provide better prognostic discrimination in stabilized acute coronary syndrome patients and therefore may be preferable for risk stratification.


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