scholarly journals Associations of Arachidonic Acid Synthesis with Cardiovascular Risk Factors and Relation to Ischemic Heart Disease and Stroke: A Univariable and Multivariable Mendelian Randomization Study

Nutrients ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1489
Author(s):  
Ting Zhang ◽  
Shiu-Lun Au Yeung ◽  
C. Mary Schooling
Keyword(s):  
Risk Factors ◽  
Arachidonic Acid ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Mendelian Randomization ◽  
Density Lipoprotein ◽  
Plasma Phospholipid ◽  
Ischemic Heart ◽  
Cvd Risk ◽  
Markers Of Inflammation

Arachidonic acid (AA), a major long-chain omega-6 polyunsaturated fatty acid, is associated with ischemic heart disease (IHD) and stroke. We assessed bi-directional associations of AA synthesis reflected by plasma phospholipid AA with CVD risk factors, and identified mediators of associations of AA with IHD and stroke using Mendelian randomization (MR). We used two-sample MR to assess bi-directional associations of AA synthesis with lipids, blood pressure, adiposity, and markers of inflammation and coagulation. We used multivariable MR to assess mediators of associations of AA with IHD and stroke. Genetically predicted AA (% of total fatty acids increase) was positively associated with apolipoprotein B (ApoB, 0.022 standard deviations (SD), 95% confidence interval (CI) 0.010, 0.034), high-density (0.030 SD, 95% CI 0.012, 0.049) and low-density lipoprotein cholesterol (LDL-C, 0.016 SD, 95% CI 0.004, 0.027) and lower triglycerides (−0.031 SD, 95% CI −0.049, −0.012) but not with other traits. Genetically predicted these traits gave no association with AA. The association of AA with IHD was attenuated adjusting for ApoB or LDL-C. Genetically predicted AA was associated with lipids but not other traits. Given ApoB is thought to be the key lipid in IHD, the association of AA with IHD is likely mediated by ApoB.

scholarly journals Investigating Effects of Plasma Apolipoprotein E on Ischemic Heart Disease Using Mendelian Randomization Study

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2215
Author(s):  
Meng-Yu Li ◽  
Man-Ki Kwok ◽  
Catherine Mary Schooling
Keyword(s):  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Apolipoprotein E ◽  
Ldl Cholesterol ◽  
Mendelian Randomization ◽  
Density Lipoprotein ◽  
Ischemic Heart ◽  
Direct Effects ◽  
Apoe Isoforms ◽  
Plasma Apolipoprotein

Background: Observationally plasma apolipoprotein E (apoE) is positively associated with ischemic heart disease (IHD). A Mendelian randomization (MR) study suggesting apoE is unrelated to cardiovascular mortality did not consider specific isoforms. We used MR to obtain estimates of plasma apoE2, apoE3 and apoE4 on IHD, low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol, triglycerides and apolipoprotein B (apoB). Methods: We obtained independent genetic instruments from proteome genome-wide association studies (GWAS) and applied them to large outcome GWAS. We used univariable MR to assess the role of each isoform and multivariable MR to assess direct effects. Results: In univariable MR, apoE4 was positively associated with IHD (odds ratio (OR) 1.05, 95% confidence interval (CI) 1.01 to 1.09), but apoE2 and apoE3 were less clearly associated. Using multivariable MR an association of apoE2 with IHD (OR 1.16, 95% CI 0.98 to 1.38) could not be excluded, and associations of apoE3 and apoE4 with IHD were not obvious. In univariable MR, apoE2 and apoE4 were positively associated with apoB, and a positive association of apoE2 with LDL cholesterol could not be excluded. Using multivariable MR apoE2 was positively associated with LDL cholesterol, and associations with apoB could not be excluded. After adjusting for apoB, no direct effects of apoE isoforms on IHD were evident. Conclusions: Plasma apoE2 and apoE4 may play a role in lipid modulation and IHD. Whether apoE could be a potential therapeutic target requires further clarification when larger genetic studies of apoE isoforms are available.

scholarly journals ST segment elevation and depression, and T-wave changes as electrophysiological signs of metabolic disorders with lipid and non-lipid risk factors for ischemic heart disease in the 25–44-year-old population

2021 ◽  
Vol 10 (4) ◽  
pp. 29-38
Author(s):  
N. A. Kuzminykh ◽  
L. V. Shcherbakova ◽  
V. S. Shramko ◽  
D. V. Denisova ◽  
Yu. I. Ragino
Keyword(s):  
Risk Factors ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Metabolic Disorders ◽  
Density Lipoprotein ◽  
Ischemic Heart ◽  
St Segment Elevation ◽  
T Wave ◽  
St Segment ◽  
St Elevation

Aim. To study the associations of electrophysiological signs of metabolic disorders with lipid and non-lipid risk factors in the urban 25–44-year-old population.Methods. A population survey (random sample) of Novosibirsk residents aged 25–44 years (656 men, 783 women) was conducted. The concentrations of total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol, and triglycerides were determined. Systolic / diastolic blood pressure, body mass index, presence of arterial hypertension, and smoking status were evaluated. The following electrocardiographic markers of metabolic disturbances were analyzed: baseline non-ischemic ST elevation depression >0.5 mm, baseline ST elevation >0.5 mm, and T-wave changes (flattening, amplitude reduction, inversion).Results. ST segment depression was detected in 4.2% of subjects (5.8% women, 2.4% men (p = 0.001)). ST segment elevation was detected in 28.5% of subjects (17.5% women, 41.6% men (p<0.001)). T-wave changes were detected in 18.9% of subjects (14.2% women, 24.5% men (p<0.001)). It was noted that men with elevated LDL-C levels and hypertension were more likely to have ST segment depression (1.4 and 1.9 times, respectively) than men without these abnormalities. In the general population, people with elevated LDL-C levels were 1.2 times more likely to have ST segment depression. Among men with ST segment elevation the concentration of LDL-C in the blood was 1.06 times higher than in men without ST segment elevation. People with a higher body mass index were 1.15 and 1.3 times more likely to have a T-wave change (in the general and female population, respectively). In the general population with T-wave changes, waist circumference and systolic blood pressure level were 1.02 and 1.02 times higher, respectively.Conclusion. ST segment elevation and depression, and T-wave changes are associated with lipid and non-lipid risk factors for ischemic heart disease. The data obtained indicate a potentiating effect of metabolic disorders in the body on the development of risk factors for ischemic heart disease and metabolic cardiomyopathy.

Abstract 16831: Effect of a Virtual Cardiac Rehabilitation Program on Functional Capacity and Risk Factor Modification in Veterans With Ischemic Heart Disease

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Arash Harzand ◽  
Alexander A Vakili ◽  
Michelle Davis-Watts ◽  
Rene Nazar ◽  
Phyllis Wright ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Cardiac Rehabilitation ◽  
Functional Capacity ◽  
Ischemic Heart ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Home Based

Background: Cardiac rehabilitation (CR) is a comprehensive lifestyle change program proven to reduce cardiovascular disease (CVD) risk and improve quality of life in patients with ischemic heart disease but remains highly underutilized (<20% of eligible patients) due to the inconvenience and cost of attending a facility-based program. We evaluated the efficacy of a home-based, virtual CR program using mobile health (mHealth) in veterans with coronary artery disease (CAD) on improving functional capacity, CVD risk factors, and depressive symptoms. Methods: We enrolled 196 Veterans with a qualifying CR diagnosis between May 2016 and April 2020. All participants underwent baseline functional evaluation with a 6-minute walk test (6MWT), followed by a 12-week home-based, virtual CR program delivered via the Movn smartphone app (Movn by Moving Analytics). The Movn app featured daily alerts to exercise, a digital diary to record activity and vital signs, and connectivity with a health coach who remotely monitored participants through an integrated dashboard and scheduled weekly phone visits. We compared the risk factor profile pre-intervention versus post-intervention with paired t-tests. Results: Among enrolled Veterans, the mean (SD) age was 61 (9) years, 95% were male, and 50% were black. A majority (63%) completed the full 12-week virtual CR program including an exit visit. Participants completed an average of 10.4 ± 1.9 (range 3–13) phone visits with the coach. There were concurrent improvements in 6MWT distance (443.9 vs. 481.9 meters; mean difference [MD], 38 meters; 95% CI, 26.6 – 50.8, P<0.001), low-density lipoprotein cholesterol (80 vs. 69 mg/dL, MD, -10.9; 95% CI, -17.9 to -3.9, P=0.003), body mass index (31.1 vs 30.8; MD, -0.33; 95% CI, -0.60 to -0.06; P=0.001), and PHQ-9 depression scores (7.4 vs. 6; MD, -1.4, 95% CI, -2.4 to -0.44; P=0.005) among program completers. Conclusions: Among veterans with ischemic heart disease, a virtual CR program results in moderate improvements in functional capacity, CVD risk factors, and mood. The durability of these effects and whether virtual CR improves longer-term outcomes such as readmissions, survival, and cost remain to be determined.

Effect of Glucagon on Ischemic Heart Disease and Its Risk Factors: A Mendelian Randomization Study

2020 ◽  
Vol 105 (8) ◽  
pp. e2778-e2788
Author(s):  
Jack C M Ng ◽  
C Mary Schooling
Keyword(s):  
Risk Factors ◽  
Heart Disease ◽  
Confidence Interval ◽  
Ischemic Heart Disease ◽  
Odds Ratio ◽  
Mendelian Randomization ◽  
Ischemic Heart ◽  
Fasting Insulin ◽  
Inverse Variance

Abstract Context Glucagon acts reciprocally with insulin to regular blood glucose. However, the effect of glucagon on cardiovascular disease has not been widely studied. It has been suggested that insulin may increase the risk of ischemic heart disease. Objective To investigate whether glucagon, the main counteracting hormone of insulin, plays a role in development of ischemic heart disease. Design, Setting, and Participants In this 2-sample Mendelian randomization study, we estimated the causal effect of glucagon on ischemic heart disease and its risk factors using the inverse-variance weighted method with multiplicative random effects and multiple sensitivity analyses. Genetic associations with glucagon and ischemic heart disease and its risk factors, including type 2 diabetes and fasting insulin, were obtained from publicly available genome-wide association studies. Main Outcome Measure Odds ratio for ischemic heart disease and its risk factors per 1 standard deviation change in genetically predicted glucagon. Results Twenty-four single-nucleotide polymorphisms strongly (P &lt; 5 × 10−6) and independently (r2 &lt; 0.05) predicting glucagon were obtained. Genetically predicted higher glucagon was associated with an increased risk of ischemic heart disease (inverse-variance weighted odds ratio, 1.03; 95% confidence interval, 1.0003-1.05) but not with type 2 diabetes (inverse-variance weighted odds ratio, 0.998, 95% confidence interval, 0.97-1.03), log-transformed fasting insulin (inverse-variance weighted beta, 0.002, 95% confidence interval, -0.01 to 0.01), other glycemic traits, blood pressure, reticulocyte, or lipids. Conclusion Glucagon might have an adverse impact on ischemic heart disease. Relevance of the underlying pathway to existing and potential interventions should be investigated.

scholarly journals Cardiovascular disease after renal transplantation.

1996 ◽  
Vol 7 (1) ◽  
pp. 158-165 ◽  
Author(s):  
B L Kasiske ◽  
C Guijarro ◽  
Z A Massy ◽  
M R Wiederkehr ◽  
J Z Ma
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Heart Disease ◽  
Renal Transplantation ◽  
Ischemic Heart Disease ◽  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Density Lipoprotein ◽  
Ischemic Heart ◽  
Peripheral Vascular

Although cardiovascular disease is a major cause of morbidity and mortality after renal transplantation, its pathogenesis and treatment are poorly understood. We conducted separate analyses of risk factors for ischemic heart disease, cerebral, and peripheral vascular disease after 706 renal transplants, all of which functioned for at least 6 months. We used Cox proportional hazards analysis to examine the effects of multiple pretransplant and posttransplant risk factors and included time-dependent variables measured at 3, 6, and 12 months, and annually to last follow-up at 7.0 +/- 4.2 yr. The independent relative risk (RR) of diabetes was 3.25 for ischemic heart disease, 3.21 for cerebral vascular disease, and 28.18 peripheral vascular disease (P < 0.05). The RR of each acute rejection episode was 1.40 for ischemic heart disease and 1.24 for cerebral vascular disease. Among serum lipid levels, high-density lipoprotein cholesterol was the best predictor of ischemic heart disease (RR = 0.80 for each 10 mg/dL). Posttransplant ischemic heart disease was strongly predictive of cerebral (5.80) and peripheral vascular disease (5.22), whereas ischemic heart disease was predicted by posttransplant cerebral (8.25) and peripheral vascular disease (4.58). Other risk factors for vascular disease included age, gender, cigarette smoking, pretransplant splenectomy, and serum albumin. Hypertension and low-density lipoprotein cholesterol had no effect, perhaps because of aggressive pharmacologic treatment. Thus, the incidence of cardiovascular disease continues to be high after renal transplantation, and multiple risk factors suggest a number of possible strategies for more effective treatment and prevention.

IMPACT OF RISK FACTORS OF ISCHEMIC HEART DISEASE ON THE DEVELOPMENT OF ACUTE CORONARY SYNDROME, PLATELET ULTRASTRUCTURE, AND ASPIRIN RESISTANCE

2019 ◽  
Vol 72 (11) ◽  
Author(s):  
Yulian H. Kyyak ◽  
Olga Yu. Barnett ◽  
Marta P. Halkevych ◽  
Olha Ye. Labinska ◽  
Hryhoriy Yu. Kyyak ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Coronary Syndrome ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Aspirin Resistance ◽  
Ischemic Heart ◽  
Coronary Syndrome
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