scholarly journals Platelets, atherothrombosis, and atherosclerosis

2016 ◽  
Author(s):  
Karl Egan ◽  
Fionnuala Ni Ainle ◽  
Dermot Kenny
Keyword(s):  
Cardiovascular Disease ◽  
Antiplatelet Agents ◽  
Vascular Lesions ◽  
Atherosclerotic Plaques ◽  
Arterial Circulation ◽  
Chronic Inflammatory Condition ◽  
Artery Disease ◽  
Ischemic Events ◽  
Progression Of Atherosclerosis

Cardiovascular disease is the leading cause of morbidity and mortality worldwide. In 2008 alone, 17.3 million deaths (representing 30% of all deaths) were attributable to the complications of cardiovascular disease. Of these deaths, 7.3 million were due to coronary artery disease while 6.2 million were attributable to stroke. Cardiovascular disease is expected to remain the leading cause of death globally, with the number of deaths expected to reach 23.6 million annually by 2030 (WHO statistics, 2012). Vascular disease arises through the complications of atherosclerosis, a complex chronic inflammatory condition affecting the arterial circulation. It leads to the development of vascular lesions or atherosclerotic plaques, which manifest as asymmetrical thickenings of the intima of medium to large sized elastic and muscular arteries. Arterial thrombosis on ruptured atherosclerotic plaques can lead to acute events, such as myocardial infarction (MI) and ischemic stroke. Platelets are the key cellular component of arterial thrombi with platelet adhesion under high shear conditions being central to atherothrombosis. In addition, platelets play a role in the progression of atherosclerosis. In this review, we will discuss the evidence for the role of platelets in atherothrombosis, notably the efficacy of antiplatelet agents in the prevention of ischemic events, and finally their role in the progression of atherosclerosis (atherogenesis).

scholarly journals Platelets, atherothrombosis, and atherosclerosis

2016 ◽  
Author(s):  
Karl Egan ◽  
Fionnuala Ni Ainle ◽  
Dermot Kenny
Keyword(s):  
Cardiovascular Disease ◽  
Antiplatelet Agents ◽  
Vascular Lesions ◽  
Atherosclerotic Plaques ◽  
Arterial Circulation ◽  
Chronic Inflammatory Condition ◽  
Artery Disease ◽  
Ischemic Events ◽  
Progression Of Atherosclerosis

Cardiovascular disease is the leading cause of morbidity and mortality worldwide. In 2008 alone, 17.3 million deaths (representing 30% of all deaths) were attributable to the complications of cardiovascular disease. Of these deaths, 7.3 million were due to coronary artery disease while 6.2 million were attributable to stroke. Cardiovascular disease is expected to remain the leading cause of death globally, with the number of deaths expected to reach 23.6 million annually by 2030 (WHO statistics, 2012). Vascular disease arises through the complications of atherosclerosis, a complex chronic inflammatory condition affecting the arterial circulation. It leads to the development of vascular lesions or atherosclerotic plaques, which manifest as asymmetrical thickenings of the intima of medium to large sized elastic and muscular arteries. Arterial thrombosis on ruptured atherosclerotic plaques can lead to acute events, such as myocardial infarction (MI) and ischemic stroke. Platelets are the key cellular component of arterial thrombi with platelet adhesion under high shear conditions being central to atherothrombosis. In addition, platelets play a role in the progression of atherosclerosis. In this review, we will discuss the evidence for the role of platelets in atherothrombosis, notably the efficacy of antiplatelet agents in the prevention of ischemic events, and finally their role in the progression of atherosclerosis (atherogenesis).

Platelets, inflammation and anti-inflammatory effects of antiplatelet drugs in ACS and CAD

2015 ◽  
Vol 114 (09) ◽  
pp. 498-518 ◽  
Author(s):  
Karin Müller ◽  
Madhumita Chatterjee ◽  
Dominik Rath ◽  
Tobias Geisler
Keyword(s):  
Cardiovascular Disease ◽  
Chronic Inflammation ◽  
Platelet Activation ◽  
Inflammatory Marker ◽  
Antiplatelet Agents ◽  
Prognostic Impact ◽  
Chronic Inflammatory Condition ◽  
Anti Inflammatory ◽  
Coronary Events

SummaryPlatelets play a pivotal role in chronic inflammation leading to progression of atherosclerosis and acute coronary events. Recent discoveries on novel mechanisms and platelet-dependent inflammatory targets underpin the role of platelets to maintain a chronic inflammatory condition in cardiovascular disease. There is strong and clinically relevant crosslink between chronic inflammation and platelet activation. Antiplatelet therapy is a cornerstone in the prevention and treatment of acute cardiovascular events. The benefit of antiplatelet agents has mainly been attributed to their direct anti-aggregatory impact. Some anti-inflammatory off-target effects have also been described. However, it is unclear whether these effects are secondary due to inhibition of platelet activation or are caused by direct distinct mechanisms interfering with inflammatory pathways. This article will highlight novel platelet associated targets that contribute to inflammation in cardiovascular disease and elucidate mechanisms by which currently available antiplatelet agents evolve anti-inflammatory capacities, in particular by carving out the differential mechanisms directly or indirectly affecting platelet mediated inflammation. It will further illustrate the prognostic impact of antiplatelet therapies by reducing inflammatory marker release in recent cardiovascular trials.

scholarly journals High Plasma Levels of Soluble Talin-1 in Patients with Coronary Artery Disease

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Masayuki Aoyama ◽  
Yoshimi Kishimoto ◽  
Emi Saita ◽  
Yukinori Ikegami ◽  
Reiko Ohmori ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Vessels ◽  
Focal Adhesions ◽  
High Plasma ◽  
Blood Levels ◽  
Atherosclerotic Plaques ◽  
Vessel Disease ◽  
Artery Disease

Aims. Talin-1 is a cytoskeletal protein that binds integrin, thereby leading to integrin activation and affecting focal adhesions. Recently, talin-1 expression was reported to be downregulated in human atherosclerotic plaques. However, blood levels of soluble talin-1 (sTalin-1) in patients with atherosclerotic disease, such as coronary artery disease (CAD), have not been elucidated. Methods. We measured plasma sTalin-1 levels in 349 patients undergoing elective coronary angiography. The severity of CAD was represented as the number of stenotic coronary vessels and segments. Results. Of the 349 study patients, CAD was found in 194 patients, of whom 88 had 1-vessel disease (1-VD), 60 had 2-vessel disease (2-VD), and 46 had 3-vessel disease (3-VD). Plasma sTalin-1 levels were higher in 194 patients with CAD than in 155 without CAD (CAD(-) group) (median 0.30 vs. 0.23 ng/mL, P<0.005). A stepwise increase in sTalin-1 levels was found depending on the number of >50% stenotic coronary vessels: 0.23 in CAD(-), 0.29 in 1-VD, 0.30 in 2-VD, and 0.32 ng/mL in 3-VD group, respectively, (P<0.05). High sTalin-1 level (>0.28 ng/mL) was found in 36% of CAD(-), 51% of 1-VD, 53% of 2-VD, and 59% of 3-VD group (P<0.025). sTalin-1 levels also correlated with the number of >50% stenotic segments (r=0.14, P<0.02). The multivariate analysis revealed that sTalin-1 levels were independently associated with CAD. The odds ratio for CAD was 1.83 (95%CI=1.14−2.93) for high sTalin-1 level (>0.28 ng/mL) (P<0.02). Conclusions. Plasma sTalin-1 levels in patients with CAD were found to be high and to be associated with the presence and severity of CAD, suggesting a role of sTalin-1 in the progression of coronary atherosclerosis.

scholarly journals Mast Cells in Cardiovascular Disease: From Bench to Bedside

2019 ◽  
Vol 20 (14) ◽  
pp. 3395 ◽  
Author(s):  
Hermans ◽  
Lennep ◽  
van Daele ◽  
Bot
Keyword(s):  
Cardiovascular Disease ◽  
Mast Cells ◽  
Animal Studies ◽  
Intraplaque Hemorrhage ◽  
Hematological Disease ◽  
Plaque Instability ◽  
Clonal Proliferation ◽  
Progression Of Atherosclerosis

Mast cells are pluripotent leukocytes that reside in the mucosa and connective tissue. Recent studies show an increased prevalence of cardiovascular disease among patients with mastocytosis, which is a hematological disease that is characterized by the accumulation of mast cells due to clonal proliferation. This association suggests an important role for mast cells in cardiovascular disease. Indeed, the evidence establishing the contribution of mast cells to the development and progression of atherosclerosis is continually increasing. Mast cells may contribute to plaque formation by stimulating the formation of foam cells and causing a pro-inflammatory micro-environment. In addition, these cells are able to promote plaque instability by neo-vessel formation and also by inducing intraplaque hemorrhage. Furthermore, mast cells appear to stimulate the formation of fibrosis after a cardiac infarction. In this review, the available data on the role of mast cells in cardiovascular disease are summarized, containing both in vitro research and animal studies, followed by a discussion of human data on the association between cardiovascular morbidity and diseases in which mast cells are important: Kounis syndrome, mastocytosis and allergy.

Continuous Ambulatory Peritoneal Dialysis in High-Risk Patients: Patients with Cardiovascular Diseases -Role of the Nurse

1999 ◽  
Vol 19 (2_suppl) ◽  
pp. 499-503
Author(s):  
Marie-Christine Z. Lambert ◽  
Holger Schilling
Keyword(s):  
Cardiovascular Disease ◽  
Peritoneal Dialysis ◽  
Ventricular Hypertrophy ◽  
Cardiovascular Complications ◽  
Left Ventricular ◽  
Therapeutic Success ◽  
Risk Patients ◽  
Continuous Peritoneal Dialysis ◽  
Artery Disease

Most patients receiving renal replacement therapy have cardiovascular disease. The most frequent conditions are left ventricular hypertrophy and coronary artery disease. Hemodialysis is associated with a characteristic spectrum of acute complications (such as hypotension, sudden death) that can be explained by typical dialysis -induced effects on the heart. With continuous peritoneal dialysis (CAPO) some of the cardiovascular complications are ameliorated owing to slow ultrafiltration and absence of an arteriovenous fistula. CAPO might be concluded to be the preferable option in patients with cardiovascular disease, but a few disadvantages, such as hyperlipidemia and hyperinsulinemia, also exist. Nurses also play an important role in the therapeutic success and outcomes of these patients.

scholarly journals Dual Antiplatelet Therapy in Secondary Prevention of Ischemic Stroke: A Ghost from the Past or a New Frontier?

2010 ◽  
Vol 2010 ◽  
pp. 1-8
Author(s):  
Clotilde Balucani ◽  
Kristian Barlinn ◽  
Zeljko Zivanovic ◽  
Lucilla Parnetti ◽  
Mauro Silvestrini ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Secondary Prevention ◽  
Extended Release ◽  
Standard Of Care ◽  
Antiplatelet Agents ◽  
Minor Stroke ◽  
Early Management ◽  
New Frontier ◽  
Ischemic Events

With majority of ischemic strokes attributable to atherothrombosis and many being predictable after transient ischemic attacks (TIA), the role of early secondary prevention with antiplatelet agents is under renewed investigation. Prior major clinical trials of various secondary stroke prevention regimens pointed to a greater efficacy of dual antiplatelet agents if initiated early from symptom onset. This paper examines data and rationale behind dual antiplatelet regimens across the completed clinical trials. The safety of dual antiplatelets approach is of concern, but it could be outweighed, at least in early management, by a greater reduction in recurrence of ischemic events since this risk is “front loaded” after minor stroke or TIA. Aspirin monotherapy, though considered standard of care, is compared to aspirin-extended release dipiridamole and its combination with clopidogrel in early-phase completed and efficacy-phase ongoing clinical trials.

scholarly journals The gut microbiome and cardiovascular disease: current knowledge and clinical potential

2019 ◽  
Vol 317 (5) ◽  
pp. H923-H938 ◽  
Author(s):  
Adilah F. Ahmad ◽  
Girish Dwivedi ◽  
Fergal O’Gara ◽  
Jose Caparros-Martin ◽  
Natalie C. Ward
Keyword(s):  
Heart Failure ◽  
Cardiovascular Disease ◽  
Gut Microbiota ◽  
Gut Microbiome ◽  
Current Knowledge ◽  
Diverse Community ◽  
Clinical Potential ◽  
Functional Components ◽  
Progression Of Atherosclerosis

Cardiovascular disease (CVD) is the leading cause of death worldwide. The human body is populated by a diverse community of microbes, dominated by bacteria, but also including viruses and fungi. The largest and most complex of these communities is located in the gastrointestinal system and, with its associated genome, is known as the gut microbiome. Gut microbiome perturbations and related dysbiosis have been implicated in the progression and pathogenesis of CVD, including atherosclerosis, hypertension, and heart failure. Although there have been advances in the characterization and analysis of the gut microbiota and associated bacterial metabolites, the exact mechanisms through which they exert their action are not well understood. This review will focus on the role of the gut microbiome and associated functional components in the development and progression of atherosclerosis. Potential treatments to alter the gut microbiome to prevent or treat atherosclerosis and CVD are also discussed.

scholarly journals Cohort profile: role of lipoproteins in cardiovascular disease—the LipidCardio study

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e030097 ◽  
Author(s):  
Maximilian König ◽  
Samita Joshi ◽  
David M Leistner ◽  
Ulf Landmesser ◽  
David Sinning ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Family History ◽  
Obstructive Coronary Artery Disease ◽  
Strong Association ◽  
Exclusion Criterion ◽  
Nucleotide Polymorphisms ◽  
Coronary Syndrome ◽  
Reasonable Evidence ◽  
Artery Disease

PurposeThe LipidCardio Study was established for in-depth analyses of cardiovascular risk factors, providing well-defined cardiovascular and metabolic phenotypes. In particular, the role of lipoproteins in the pathobiological process and treatment of cardiovascular disease (CVD) will be a main focus.Participants1005 individuals aged 21 years and older undergoing cardiac catheterisation during 17 months at a tertiary academic cardiology centre were enrolled (troponin-positive acute coronary syndrome was exclusion criterion). The baseline data not only contain detailed phenotyping, broad biochemical parameters, genetic data, but also standardised personal and family history, a screening test for cognitive impairment, pulse wave analysis and measurements of hand grip strength, among others. Blood samples were stored in a biobank for future analyses.Findings to dateThe mean age of the participants at enrolment was 70.9±11.1 years (70% male). Coronary angiography provided evidence of obstructive coronary artery disease (CAD) in 69.9% of participants. Those with evidence of CAD were significantly more likely to be male, inactive, diabetic and with a family history of CVD than participants without CAD.About 20% of patients had lipoprotein(a) (Lp(a)) concentrations above 106.9 nmol/L (fifth quintile). These patients had significantly increased odds of obstructive CAD compared with participants in quintiles 1–4 (crude OR 1.70, 95% CI 1.17 to 2.48, p=0.005). There was reasonable evidence that with increasing severity of CAD the odds of having elevated Lp(a) increased. We were able to replicate the established strong association between specified single nucleotide polymorphisms (SNPs) in theLPAgene (rs10455872, rs3798220 and rs186696265) and theAPOEgene (rs7412), and the concentration of Lp(a), validating our phenotype database and biobank.Future plansMortality information will be obtained in 2 year intervals. Follow-up phone interviews will be conducted at 3 and 6 years after enrolment. We seek to cooperate with other researchers, for example, by sharing data and biobank samples.

Cardiovascular disease in nonagenarians: Prevalence and utilization of preventive therapies

2018 ◽  
Vol 26 (4) ◽  
pp. 356-364 ◽  
Author(s):  
Jose M Mostaza ◽  
Carlos Lahoz ◽  
Miguel A Salinero-Fort ◽  
Juan Cardenas
Keyword(s):  
Cardiovascular Disease ◽  
Cardiovascular Diseases ◽  
Primary Prevention ◽  
Antiplatelet Agents ◽  
Population Based ◽  
Cross Sectional Study ◽  
Preventive Strategy ◽  
Cross Sectional ◽  
Artery Disease ◽  
Clinical Records

Aims Nonagenarians are a fast growing segment of industrialized countries' populations. Despite a greater risk of cardiovascular disease, there are limited data about their use of preventive therapies and factors guiding decisions regarding their prescription. The aim of this study was to evaluate the prevalence of cardiovascular diseases and the patterns of use of cardiovascular treatments in subjects ≥90 years old. Methods Population-based, cross-sectional study, in all nonagenarians residing in the Community of Madrid (Spain). Data were obtained from their electronic clinical records in primary care. Results Data were available from 59,423 subjects (mean age 93.3 years, 74.2% female, 13.5% with dementia). Prevalence of cardiovascular disease was 24.1% (10.9% with coronary artery disease (CAD), 13.1% with cerebrovascular disease (CVD) and 2.7% with peripheral artery disease(PAD)). In primary prevention, the use of statins and antiplatelet agents was 21.9% and 26.7%, respectively. Of subjects with vascular disease 27.7% were receiving a combined preventive strategy (use of antithrombotics, plus statins, plus blood pressure below 140/90 mmHg). Factors favourably associated with a combined preventive strategy were: female sex (odds ratio (OR) 1.29; 95% confidence interval (CI): 1.11–1.49), being independent versus totally dependent (OR 1.94; 95% CI: 1.43–2.65), diabetes (OR 1.42; 95% CI: 1.20–1.68), and negatively, age (OR 0.87; 95% CI: 0.85–0.90), CVD versus CAD (OR 0.41; 95% CI: 0.35–0.47), PAD versus CAD (OR 0.23; 95% CI: 0.18–0.30), dementia (OR 0.61; 95% CI: 0.49–0.76) and nursing home residency (OR 0.73; 95% CI: 0.57–0.93). Conclusion Nonagenarians have a great burden of cardiovascular diseases and receive a great number of preventive therapies, even in primary prevention, despite their unproven efficacy at these ages.

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