Prevalence and association of mycoplasma infection in the development of coronary artery disease

Coronary heart disease (CHD) has been associated with significant morbidity and mortality worldwide. Although remain controversial, several studies have demonstrated the association of M. pneumoniae infections with atherosclerosis. We evaluated the possible association of mycoplasma infections in patients diagnosed with atherosclerosis by ELISA and PCR methods. Atherosclerotic tissue samples and blood samples were collected for the detection of mycoplasma antibodies (IgA) by ELISA from the 97 patients with coronary artery disease (CAD). M. pneumoniae specific IgA, IgG and IgM were measured by using the Anti-M. pneumoniae IgA/IgG/IgM ELISA. Detection of M. pneumoniae targeting the P1 adhesion gene was performed by PCR Acute infection of M. pneumoniae was diagnosed in 43.3% (42) of patients by PCR. The M. pneumoniae specific antibodies were detected in 36.1% (35) of patients. Twenty-five (25.8%) cases had IgG antibodies, 15 (15.5%) cases had IgM antibodies, 3 (3.1%) cases had IgA antibodies, 10 (10.3%) cases had both IgM + IgG antibodies and 1 (1%) case of each had IgM + IgA and IgG + IgA antibodies. None of the cases was positive for all three antibodies. A Pearson correlation coefficient analysis revealed an excellent correlation between the PCR and the serological results (r=0.921, p<0.001). A majority (17, 40.5%) of the M. pneumoniae positive patients are within the 41-50 years of age group, followed by 10 (23.8%) patients in the age group of 61-70 years and 2 (4.8%) patients were >70 years of age. Our study reported an unusually higher prevalence of M. pneumoniae by serological tests (36.1%) and PCR (43.3%). Although the hypothesis of the association of M. pneumoniae and CAD is yet to be proven, the unusually high prevalence of M. pneumoniae in CAD patients indicates an association, if not, in the development of atherosclerosis.

Coronary Artery Disease and Cancer: Treatment and Prognosis Regarding Gender Differences

Cardiovascular disease and cancer remain the leading causes of hospitalization and mortality in high-income countries. Survival after myocardial infarction has improved but there is still a difference in clinical outcome, mortality, and developing heart failure to the disadvantage of women with myocardial infarction. Most major cardiology trials and registries have excluded patients with cancer. As a result, there is only very limited information on the effects of coronary artery disease in cancer patients. In particular, the outcomes in women with cancer and coronary artery disease and its management remain empiric. We reviewed studies of over 27 million patients with coronary artery disease and cancer. Our review focused on the most important types of cancer (breast, colon, lung, prostate) and hematological malignancies with particular attention to sex-specific differences in treatment and prognosis.

INDICATIONS OF PRESCRIPTION OF STATINS IN TERTIARY CARE CENTRE OF NORTH INDIA

Background: To determine the indications for which statins are being prescribed Methods: Study was conducted on Patients with indications for statins presenting to cardiology OPD,Medicine OPD and Endocrinology OPD and started on statins at PGIMER, Chandigarh, within a period of 9 months. Results: In our study, out of 243 prescriptions, 55.1%(n=134) were prescribed statins for secondary prevention and 44.9%(n=109) had statins prescribed for primary prevention. Overall coronary artery disease (37.03%) was the leading indication followed by Diabetes mellitus without ASCVD(70.64%).Other indications of secondary preventionincluded newly diagnosed statin naïve patients diagnosed with stable coronary artery disease ,unstable coronary artery disease /acute coronary artery disease , ischemic cardiovascular accidentsand peripheral arterial disease .64.22 percent patients in primary prevention group were diabetics in our study . Concluded: We concluded that secondary prevention was found to the more common indication of statin prescription than primary prevention (ratio 1.22:1). Keywords: Statin, CAD, Prevention

Association of LpPLA2 with coronary artery disease a hospital-based case control study

Coronary artery disease (CAD) in Asian-Indians is characterised by an earlier onset and more severe disease when compared to Western populations. It is estimated that about 20% of patients presenting with an acute coronary syndrome do not have any of the conventional risk factors for CAD. To assess the risk posed by each of the newer risk factors; alongside conventional risk factors namely diabetes, hypertension, dyslipidaemia for coronary artery disease and to compare the relative risk in a case-control design. Department of Cardiology, XXX Institute of Medical sciences (XXX). Case control study design. Cases are as any individual with coronary artery disease and controls included patients with non-coronary conditions. Dependant variable: coronary artery disease (CAD); Independent variables: Lp PLA2, Lp(a), Apo(a), Apo(b), Ratio (Apo B/Apo A); Other predictors- diabetes mellitus, hypertension, dyslipidaemia, tobacco use Categorical variables were presented as frequencies and percentages. Chi-square test and binary logistic regression analysis was used to study the comparison and association of the categorical risk factors with the disease status, respectively. Software used was SPSS version 20.0. A total of 253 participants aged between 19 and 90 years; 140 cases and 113 controls were enrolled in this study. Except for the hs-CRP level, alcohol consumption and LDL, all the other risk factors were seen significantly associated with the coronary artery disease; dyslipidaemia (10.8, 95% CI 3.29-35.37), gender- male (4.68, 95% CI 2.12-10.30), diabetes mellitus (3.3, 95% CI 1.6 -6.77), lipoprotein(a) more than 30mg% (2.34, 95% CI 1.06-5.15) and hypertension (2.48, 95% CI 1.14-5.39). Conventional risk factors namely diabetes, hypertension and dyslipdaemia showed a statistically significant association with CAD while from among the biochemical markers the association was statistically significant only for Lp(a) when compared both between cases and controls and also in cases &#60; age 50 years. The other biochemical risk factors namely Lp-PLA2, Apo(A1) and Apo(b) showed a weak degree of association with CAD. In the present study we analyse the role of inflammatory mediators of CAD (hs-CRP, Lp-PLA2), pro-thrombotic markers [Lp(a)] alongside the lipid fractions apoB, apo A and their ratio to assess which of these biochemical markers predisposed one to CAD through assessment of the relative risk.

Association of Angio-LncRNAs MIAT rs1061540/MALAT1 rs3200401 Molecular Variants with Gensini Score in Coronary Artery Disease Patients Undergoing Angiography

Long non-coding RNAs (lncRNAs) have emerged as essential biomolecules with variable diagnostic and/or prognostic utility in several diseases, including coronary artery disease (CAD). We aimed for the first time to investigate the potential association of five angiogenesis-related lncRNAs (PUNISHER, SENCR, MIAT, MALAT1, and GATA6-AS) variants with CAD susceptibility and/or severity. TaqMan Real-Time genotyping for PUNISHER rs12318065A/C, SENCR rs12420823C/T, MIAT rs1061540C/T, MALAT1 rs3200401T/C, and GATA6-AS1 rs73390820A/G were run on the extracted genomic DNA from 100 unrelated patients with stable CAD undergoing diagnostic coronary angiography and from 100 controls. After adjusting covariates, the studied variants showed no association with disease susceptibility; however, MIAT*T/T genotype was associated with a more severe Gensini score. In contrast, MALAT1*T/C heterozygosity was associated with a lower score. The lipid profile, and to a lesser extent smoking status, male sex, weight, hypertension, and MALAT1 (T > C) (negative correlation), explained the variance between patients/control groups via a principal component analysis. Incorporating the principal components into a logistic regression model to predict CAD yielded a 0.92 AUC. In conclusion: MIAT rs1061540 and MALAT1 rs3200401 variants were associated with CAD severity and Gensini score in the present sample of the Egyptian population. Further large multi-center and functional analyses are needed to confirm the results and identify the underlying molecular mechanisms.

Estimating body fat distribution - a driver of cardiometabolic health - from silhouette images

Background: Inter-individual variation in fat distribution is increasingly recognized as clinically important but is not routinely assessed in clinical practice because quantification requires medical imaging. Objectives: We hypothesized that a deep learning model trained on an individual's body shape outline - or silhouette - would enable accurate estimation of specific fat depots, including visceral (VAT), abdominal subcutaneous (ASAT), and gluteofemoral (GFAT) adipose tissue volumes, and VAT/ASAT ratio. We additionally set out to study whether silhouette-estimated VAT/ASAT ratio may stratify risk of cardiometabolic diseases independent of body mass index (BMI) and waist circumference. Methods: Two-dimensional coronal and sagittal silhouettes were constructed from whole-body magnetic resonance images in 40,032 participants of the UK Biobank and used to train a convolutional neural network to predict VAT, ASAT, and GFAT volumes, and VAT/ASAT ratio. Logistic and Cox regressions were used to determine the independent association of silhouette-predicted VAT/ASAT ratio with type 2 diabetes and coronary artery disease. Results: Mean age of the study participants was 65 years and 51% were female. A deep learning model trained on silhouettes enabled accurate estimation of VAT, ASAT, and GFAT volumes (R2: 0.88, 0.93, and 0.93, respectively), outperforming a comparator model combining anthropometric and bioimpedance measures (ΔR2 = 0.05-0.13). Next, we studied VAT/ASAT ratio, a nearly BMI- and waist circumference-independent marker of unhealthy fat distribution. While the comparator model poorly predicted VAT/ASAT ratio (R2: 0.17-0.26), a silhouette-based model enabled significant improvement (R2: 0.50-0.55). Silhouette-predicted VAT/ASAT ratio was associated with increased prevalence of type 2 diabetes and coronary artery disease. Conclusions: Body silhouette images can estimate important measures of fat distribution, laying the scientific foundation for population-based assessment.

10 -Years Coronary Artery Disease Incidence and its Predictors in Overweight and Obese Adults Using A Competing Risk Model: A Longitudinal Study of Yazd Healthy Heart Cohort (YHHC)

We applied competing risk model to identify the predictors for Coronary Artery Disease (CAD) among 866 overweight and obese participants aged 20-74 years using their registered medical records in the first and second phase of Healthy Heart Cohort (YHHC) conducted in Yazd. These participants were free of coronary heart disease in the first phase of study. CAD was considered as the primary event and all other noncardiac deaths were considered as a competing event. The cumulative incidence of any CAD at the 5-year and 10-year follow-ups was approximately 6.8% and 10.6%, respectively, and approximately 4.6% and 8.5%, respectively, for all other noncardiac deaths. In both cause-specific and Fine-Gray models of risk factor diabetes type II, hypertriglyceridemia, university level of education (reversely), uric acid, age, systolic blood pressure and female gender (reversely) were associated with the increase risk of CAD. In addition to other traditional cardio metabolic risk factor we found that uric acid increased the risk of CAD in overweight and obese adults. It seems that lifestyle modification can reduce the risk of CAD. Also, high level of education had a protective effect on the risk of CAD. Both cause-specific and fine-gray models predicted similarly 10-years of CAD. The use of competing risk models in the presence of competing events is emphasized when interpreting survival studies.