Biomarkers for Cardiovascular Risk

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiovascular Medicine".

Deadline for manuscript submissions: closed (15 March 2023) | Viewed by 32869

Special Issue Editors

1. Department of Cardiology and Internal Medicine, Collegium Medicum Bydgoszcz, Nicolaus Copernicus University Torun, Torun, Poland
2. Division of Cardiovascular Medicine, University of California San Diego, La Jolla, CA, USA
Interests: coronary artery disease; heart failure; ventricular dysfunction; biomarkers; cardiovascular risk; echocardiography; cardiometabolic disease
Division of Cardiovascular Medicine, University of California San Diego, La Jolla, CA, USA
Interests: preventive cardiology; lipidology; biomarkers for cardiovascular risk stratification; cardiometabolic disease; women's cardiovascular health

Special Issue Information

Dear Colleagues,

Cardiovascular disease (CVD) is the main cause of morbidity and mortality despite significant advancements in preventive strategies, diagnostic methods, and therapeutic approaches over the last few decades. The burden of CVD continues to increase due to high prevalence of cardiometabolic risk factors such as obesity, elevated atherogenic lipids and blood pressure, metabolic syndrome, diabetes, and chronic stress. Despite guideline-based therapies, coronary artery disease is a leading cause of death, and heart failure is a common complication with adverse outcomes. The management of individuals at high cardiovascular risk is challenging and remains an unmet need of CVD care. Primary and secondary prevention strategies aim at addressing cardiometabolic risks, optimizing evidence-based therapies, and improving long-term outcome.

Biomarkers offer a strategy for improving cardiovascular risk stratification and clinical decision making for patient management. The progress in understanding the pathophysiological background of CVD has fostered the development of novel biomarkers representing various mechanisms underlying CVD. The biomarkers provide useful information for early diagnosis, prognosis, and prediction of treatment response, enhance the overall prognostic value of already well-known risk factors, and point to a need to develop new targeted therapies. Multi-marker approaches enhance risk discrimination and aid in a choice of individualized targeted therapies. The development of novel biomarkers and therapeutic targets has greatly accelerated progress toward personalized medicine.

It is our privilege to invite researchers and clinical practitioners to contribute to this Special Issue on Biomarkers for Cardiovascular Risk in the Journal of Clinical Medicine. We welcome the submission of original research, review articles, and innovative protocols which highlight recent advances in the use of biomarkers for improving the management of cardiovascular risk.

Prof. Dr. Iwona Świa̧tkiewicz
Prof. Dr. Pam R. Taub
Guest Editors

Manuscript Submission Information

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Keywords

  • biomarkers
  • cardiovascular disease
  • coronary artery disease
  • heart failure
  • cardiovascular risk factors
  • cardiometabolic risk
  • outcome

Published Papers (20 papers)

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14 pages, 259 KiB  
Article
Venous Thromboembolism in Patients Hospitalized for COVID-19 in a Non-Intensive Care Unit
by Magdalena Mackiewicz-Milewska, Małgorzata Cisowska-Adamiak, Jerzy Pyskir and Iwona Świątkiewicz
J. Clin. Med. 2024, 13(2), 528; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm13020528 - 17 Jan 2024
Viewed by 653
Abstract
Coronavirus Disease 2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) may contribute to venous thromboembolism (VTE) with adverse effects on the course of COVID-19. The purpose of this study was to investigate an incidence and risk factors for VTE in [...] Read more.
Coronavirus Disease 2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) may contribute to venous thromboembolism (VTE) with adverse effects on the course of COVID-19. The purpose of this study was to investigate an incidence and risk factors for VTE in patients hospitalized for COVID-19 in a non-intensive care unit (non-ICU). Consecutive adult patients with COVID-19 hospitalized from November 2021 to March 2022 in the isolation non-ICU at our center were included in the study. Incidence of VTE including pulmonary embolism (PE) and deep vein thrombosis (DVT), clinical characteristics, and D-dimer plasma levels during the hospitalization were retrospectively evaluated. Among the 181 patients (aged 68.8 ± 16.2 years, 44% females, 39% Delta SARS-CoV-2 variant, 61% Omicron SARS-CoV-2 variant), VTE occurred in 29 patients (VTE group, 16% of the entire cohort). Of them, PE and DVT were diagnosed in 15 (8.3% of the entire cohort) and 14 (7.7%) patients, respectively. No significant differences in clinical characteristics were observed between the VTE and non-VTE groups. On admission, median D-dimer was elevated in both groups, more for VTE group (1549 ng/mL in VTE vs. 1111 ng/mL in non-VTE, p = 0.09). Median maximum D-dimer was higher in the VTE than in the non-VTE group (5724 ng/mL vs. 2200 ng/mL, p < 0.005). In the univariate analysis, systemic arterial hypertension and the need for oxygen therapy were predictors of VTE during hospitalization for COVID-19 (odds ratio 2.59 and 2.43, respectively, p < 0.05). No significant associations were found between VTE risk and other analyzed factors; however, VTE was more likely to occur in patients with a history of VTE, neurological disorders, chronic pulmonary or kidney disease, atrial fibrillation, obesity, and Delta variant infection. Thromboprophylaxis (83.4% of the entire cohort) and anticoagulant treatment (16.6%) were not associated with a decreased VTE risk. The incidence of VTE in patients hospitalized in non-ICU for COVID-19 was high despite the common use of thromboprophylaxis or anticoagulant treatment. A diagnosis of arterial hypertension and the need for oxygen therapy were associated with an increased VTE risk. Continuous D-dimer monitoring is required for the early detection of VTE. Full article
(This article belongs to the Special Issue Biomarkers for Cardiovascular Risk)
9 pages, 719 KiB  
Article
Persistently High Levels of Coagulation Factor XI as a Risk Factor for Venous Thrombosis
by Luca Spiezia, Chiara Forestan, Elena Campello, Chiara Simion and Paolo Simioni
J. Clin. Med. 2023, 12(15), 4890; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm12154890 - 25 Jul 2023
Cited by 2 | Viewed by 894
Abstract
Coagulation factor XI (FXI) promotes fibrin formation and inhibits fibrinolysis. Elevated plasma FXI levels, limited to a single measurement, are associated with a higher thrombotic risk. Our case–control study aimed to identify the effect of persistently increased plasma FXI levels on the risk [...] Read more.
Coagulation factor XI (FXI) promotes fibrin formation and inhibits fibrinolysis. Elevated plasma FXI levels, limited to a single measurement, are associated with a higher thrombotic risk. Our case–control study aimed to identify the effect of persistently increased plasma FXI levels on the risk of deep vein thrombosis (DVT). All patients evaluated between January 2016 and January 2018 for a first episode of proximal DVT of the lower extremity were considered for enrolment. Plasma FXI levels were measured at least 1 month after the discontinuation of anticoagulant treatment (T1). The patients with increased plasma FXI levels (>90th percentile of controls) were tested again 3 months later (T2). Among the 200 enrolled patients (M/F 114/86, age range 26–87 years), 47 patients had increased plasma FXI levels at T1 and16 patients had persistently increased plasma FXI levels at T2. The adjusted odds ratio for DVT was 2.4 (95% CI, 1.3 to 5.5, p < 0.001) for patients with increased FXI levels at T1 and 5.2 (95% CI, 2.3 to 13.2, p < 0.001) for patients with persistently high FXI levels at T2. Elevated FXI levels constitute a risk factor for deep vein thrombosis, and this risk nearly doubled in patients with persistently increased plasma FXI levels. Larger prospective studies are needed to confirm our findings. Full article
(This article belongs to the Special Issue Biomarkers for Cardiovascular Risk)
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12 pages, 568 KiB  
Article
Soluble Urokinase-Type Plasminogen Activator Receptor (suPAR) Is a Biomarker Associated with Left Ventricular Hypertrophy in the Elderly, Specifically in Women
by Rafał Nikodem Wlazeł, Agnieszka Guligowska, Zuzanna Chrząstek, Tomasz Kostka, Anna Jegier and Iwona Szadkowska
J. Clin. Med. 2023, 12(9), 3290; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm12093290 - 05 May 2023
Cited by 1 | Viewed by 1268
Abstract
Left ventricular hypertrophy (LVH) may result in the development of heart failure, which is widespread among people of advanced age. The pathophysiology of LVH is complex and its biochemical pathways are not fully understood in this group. Elevated soluble urokinase-type plasminogen activator receptor [...] Read more.
Left ventricular hypertrophy (LVH) may result in the development of heart failure, which is widespread among people of advanced age. The pathophysiology of LVH is complex and its biochemical pathways are not fully understood in this group. Elevated soluble urokinase-type plasminogen activator receptor (suPAR), a biomarker of immune activation, including fibrosis, reflects subclinical organ damage in systematic diseases. The present study assesses the clinical role of suPAR measurement in determination of LVH-associated cardiac disorders in the elderly. The studied population consisted of 238 individuals aged 76–91 years; of these, 139 (58%) were diagnosed with LVH. Serum biomarkers measurement (suPAR, troponin T, NT-proBNP and CRP) and echocardiography were performed in all subjects. The suPAR level was significantly higher in the LVH group (4.01 vs. 3.82 ng/mL, p = 0.033) and correlated with the parameters of cardiac diastolic function. Stepwise logistic regression found suPAR level (OR = 1.55, p = 0.016), BMI (OR = 1.17, p = 0.0003) and hypertension (OR = 2.42, p = 0.046) to be independently associated with LVH in women. In men, the strongest predictors of LVH were hypertension (OR = 7.52, p = 0.014) and BMI (OR = 1.42, p = 0.032). The observations indicate suPAR as a promising marker reflecting LVH, especially in women at advanced age, independent of age-associated cardiac remodeling. Full article
(This article belongs to the Special Issue Biomarkers for Cardiovascular Risk)
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14 pages, 744 KiB  
Article
Cardiometabolic Effects of Cabergoline and Combined Oral Contraceptive Pills in Young Women with Hyperprolactinemia: A Pilot Study
by Robert Krysiak, Karolina Kowalcze and Bogusław Okopień
J. Clin. Med. 2023, 12(9), 3208; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm12093208 - 29 Apr 2023
Viewed by 1393
Abstract
Although dopaminergic agents are the drugs of choice in treatment of prolactin excess, women who cannot be treated with these agents are recommended to receive estrogen preparations. The aim of this study was to compare cardiometabolic effects of both treatment options. The study [...] Read more.
Although dopaminergic agents are the drugs of choice in treatment of prolactin excess, women who cannot be treated with these agents are recommended to receive estrogen preparations. The aim of this study was to compare cardiometabolic effects of both treatment options. The study population included three groups of young women. Subjects with mild-to-moderate hyperprolactinemia received either low-dose cabergoline or oral combined contraceptives (ethinyl estradiol plus desogestrel), while normoprolactinemic women were drug-naive. Plasma prolactin, glucose homeostasis markers, lipids, circulating levels of uric acid, high-sensitivity C-reactive protein (hsCRP), fibrinogen and homocysteine, and the urinary albumin-to-creatinine ratio (UACR) were assessed at entry and six months later. Hyperprolactinemic women differed from normoprolactinemic ones in glucose homeostasis markers, high-density lipoprotein (HDL)-cholesterol, triglycerides, uric acid, hsCRP, fibrinogen, homocysteine and UACR. Cabergoline decreased total and monomeric prolactin levels, which was accompanied by normalization of glucose, insulin sensitivity, glycated hemoglobin, HDL-cholesterol, triglycerides, uric acid, hsCRP, fibrinogen, homocysteine and UACR. Despite a neutral effect on prolactin levels, combined contraceptives worsened insulin sensitivity and increased triglycerides, hsCRP, fibrinogen and UACR. At follow-up, cabergoline-treated women were characterized by a better cardiometabolic profile than women receiving ethinyl estradiol plus desogestrel. Our findings suggest that only cabergoline reduces cardiometabolic risk in young women with hyperprolactinemia. Full article
(This article belongs to the Special Issue Biomarkers for Cardiovascular Risk)
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12 pages, 542 KiB  
Article
Elevated Soluble Suppressor of Tumorigenicity 2 Predict Hospital Admissions Due to Major Adverse Cardiovascular Events (MACE)
by Dongqing Chen, Rossana Untaru, Glykeria Stavropoulou, Bahador Assadi-Khansari, Conagh Kelly, Amanda J. Croft, Stuart Sugito, Nicholas J. Collins, Aaron L. Sverdlov and Doan T. M. Ngo
J. Clin. Med. 2023, 12(8), 2790; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm12082790 - 09 Apr 2023
Cited by 1 | Viewed by 1716
Abstract
The role of soluble suppression of tumorigenicity (sST2) as a biomarker in predicting clinical outcomes in patients with cardiovascular diseases (CVD) has not been fully elucidated. In this study, we sought to determine the relationship between sST2 levels and any unplanned hospital readmissions [...] Read more.
The role of soluble suppression of tumorigenicity (sST2) as a biomarker in predicting clinical outcomes in patients with cardiovascular diseases (CVD) has not been fully elucidated. In this study, we sought to determine the relationship between sST2 levels and any unplanned hospital readmissions due to a major adverse cardiovascular event (MACE) within 1 year of first admission. Patients (n = 250) admitted to the cardiology unit at John Hunter Hospital were recruited. Occurrences of MACE, defined as the composite of total death, myocardial infarction (MI), stroke, readmissions for heart failure (HF), or coronary revascularization, were recorded after 30, 90, 180, and 365 days of first admission. On univariate analysis, patients with atrial fibrillation (AF) and HF had significantly higher sST2 levels vs. those who did not. Increasing levels of sST2 by quartiles were significantly associated with AF, HF, older age, low hemoglobin, low eGFR, and high CRP levels. On multivariate analysis: high sST2 levels and diabetes remained as risk predictors of any MACE occurrence; an sST2 level in the highest quartile (Q4: >28.4 ng/mL) was independently associated with older age, use of beta-blockers, and number of MACE events within a 1 year period. In this patient cohort, elevated sST2 levels are associated with unplanned hospital admission due to MACE within 1 year, independent of the nature of the index cardiovascular admission. Full article
(This article belongs to the Special Issue Biomarkers for Cardiovascular Risk)
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14 pages, 2053 KiB  
Article
Implications of Inflammatory and Oxidative Stress Markers in the Attenuation of Nocturnal Blood Pressure Dipping
by Alvaro Hermida-Ameijeiras, Nestor Vazquez-Agra, Anton Cruces-Sande, Estefania Mendez-Alvarez, Ramon Soto-Otero, Jose-Enrique Lopez-Paz, Antonio Pose-Reino and Arturo Gonzalez-Quintela
J. Clin. Med. 2023, 12(4), 1643; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm12041643 - 18 Feb 2023
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Abstract
To date, no model has jointly encompassed clinical, inflammatory, and redox markers with the risk of a non-dipper blood pressure (BP) profile. We aimed to evaluate the correlation between these features and the main twenty-four-hour ambulatory blood pressure monitoring (24-h ABPM) indices, as [...] Read more.
To date, no model has jointly encompassed clinical, inflammatory, and redox markers with the risk of a non-dipper blood pressure (BP) profile. We aimed to evaluate the correlation between these features and the main twenty-four-hour ambulatory blood pressure monitoring (24-h ABPM) indices, as well as to establish a multivariate model including inflammatory, redox, and clinical markers for the prediction of a non-dipper BP profile. This was an observational study that included hypertensive patients older than 18 years. We enrolled 247 hypertensive patients (56% women) with a median age of 56 years. The results showed that higher levels of fibrinogen, tissue polypeptide-specific antigen, beta-2-microglobulin, thiobarbituric acid reactive substances, and copper/zinc ratio were associated with a higher risk of a non-dipper BP profile. Nocturnal systolic BP dipping showed a negative correlation with beta-globulin, beta-2-microglobulin, and gamma-globulin levels, whereas nocturnal diastolic BP dipping was positively correlated with alpha-2-globulin levels, and negatively correlated with gamma-globulin and copper levels. We found a correlation between nocturnal pulse pressure and beta-2-microglobulin and vitamin E levels, whereas the day-to-night pulse pressure gradient was correlated with zinc levels. Twenty-four-hour ABPM indices could exhibit singular inflammatory and redox patterns with implications that are still poorly understood. Some inflammatory and redox markers could be associated with the risk of a non-dipper BP profile. Full article
(This article belongs to the Special Issue Biomarkers for Cardiovascular Risk)
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12 pages, 1703 KiB  
Article
Initial In-Hospital Visit-to-Visit Heart Rate Variability Is Associated with Higher Risk of Atrial Fibrillation in Patients with Acute Ischemic Stroke
by Jiann-Der Lee, Ya-Wen Kuo, Chuan-Pin Lee, Yen-Chu Huang, Meng Lee and Tsong-Hai Lee
J. Clin. Med. 2023, 12(3), 1050; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm12031050 - 29 Jan 2023
Viewed by 992
Abstract
Background: To evaluate the association between the visit-to-visit heart rate variability and the risk of atrial fibrillation (AF) in acute ischemic stroke (AIS). Methods: We analyzed the data of 8179 patients with AIS. Patients without AF on 12-lead electrocardiography underwent further 24 h [...] Read more.
Background: To evaluate the association between the visit-to-visit heart rate variability and the risk of atrial fibrillation (AF) in acute ischemic stroke (AIS). Methods: We analyzed the data of 8179 patients with AIS. Patients without AF on 12-lead electrocardiography underwent further 24 h Holter monitoring. They were categorized into four subgroups according to the visit-to-visit heart rate variability expressed as the coefficient of variation in heart rate (HR-CV). Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using the HR-CV < 0.08 subgroup as a reference. Results: The adjusted OR of paroxysmal AF was 1.866 (95% CI = 1.205–2.889) for the HR-CV ≥ 0.08 and <0.10 subgroup, 1.889 (95% CI = 1.174–3.038) for the HR-CV ≥ 0.10 and <0.12 subgroup, and 5.564 (95% CI = 3.847–8.047) for the HR-CV ≥ 0.12 subgroup. The adjusted OR of persistent AF was 2.425 (95% CI = 1.921–3.062) for the HR-CV ≥ 0.08 and <0.10 subgroup, 4.312 (95% CI = 3.415–5.446) for the HR-CV ≥ 0.10 and <0.12 subgroup, and 5.651 (95% CI = 4.586–6.964) for the HR-CV ≥ 0.12 subgroup. Conclusions: HR-CV can facilitate the identification of patients with AIS at a high risk of paroxysmal AF. Full article
(This article belongs to the Special Issue Biomarkers for Cardiovascular Risk)
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11 pages, 708 KiB  
Article
Soluble Vascular Cell Adhesion Molecule-1 as an Inflammation-Related Biomarker of Coronary Slow Flow
by Qing Zhu, Cuiting Zhao, Yonghuai Wang, Lixin Mu, Xinxin Li, Yiqiu Qi, Jun Yang and Chunyan Ma
J. Clin. Med. 2023, 12(2), 543; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm12020543 - 09 Jan 2023
Cited by 3 | Viewed by 1168
Abstract
Background: Coronary slow flow (CSF) is an angiographic entity characterized by delayed coronary opacification with no evident obstructive lesion in the epicardial coronary artery. Several studies have shown that the occurrence and development of CSF may be closely related to inflammation. Soluble vascular [...] Read more.
Background: Coronary slow flow (CSF) is an angiographic entity characterized by delayed coronary opacification with no evident obstructive lesion in the epicardial coronary artery. Several studies have shown that the occurrence and development of CSF may be closely related to inflammation. Soluble vascular cell adhesion molecule-1 (sVCAM-1) is a biomarker related to inflammation. The aim of this study was to evaluate the correlation between plasma soluble VCAM-1 level and CSF occurrence and thus the predictive value of VCAM-1 for CSF. Methods: Forty-six CSF patients and thirty control subjects were enrolled. Corrected thrombolysis in myocardial infarction frame count (cTFC) was used to diagnose CSF. Functional status and quality of life were determined by the Seattle Angina Questionnaire (SAQ). Echocardiography was used to evaluate the systolic and diastolic function of the left ventricle (LV) and right ventricle (RV). The plasma levels of sVCAM-1, IL-6, and TNF-α were quantified by enzyme-linked immunosorbent assay. Results: Compared with the control group, the physical limitation score by the SAQ, the LV global longitudinal strain (GLS), mitral E, and mitral E/A decreased in patients with CSF, while the plasma IL-6 and TNF-α levels increased. The plasma sVCAM-1 level in the CSF group was significantly higher than that in the control group (186.03 ± 83.21 vs. 82.43 ± 42.12 ng/mL, p < 0.001), positively correlated with mean cTFC (r = 0.57, p < 0.001), and negatively correlated with the physical limitation score (r = −0.32, p = 0.004). Logistic regression analyses confirmed that plasma sVCAM-1 level (OR = 1.07, 95%CI: 1.03–1.11) is an independent predictor of CSF, and the receiver operating characteristic curve analysis showed that plasma sVCAM-1 levels had statistical significance in predicting CSF (area under curve = 0.88, p < 0.001). When the sVCAM-1 level was higher than 111.57 ng/mL, the sensitivity for predicting CSF was 87% and the specificity was 73%. Conclusions: Plasma sVCAM-1 level can be used to predict CSF and was associated with the clinical symptoms of patients. It may serve as a potential biomarker for CSF in the future. Full article
(This article belongs to the Special Issue Biomarkers for Cardiovascular Risk)
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13 pages, 270 KiB  
Article
Hepatitis C Infection as a Risk Factor for Hypertension and Cardiovascular Diseases: An EpiTer Multicenter Study
by Paweł Rajewski, Dorota Zarębska-Michaluk, Ewa Janczewska, Andrzej Gietka, Włodzimierz Mazur, Magdalena Tudrujek-Zdunek, Krzysztof Tomasiewicz, Teresa Belica-Wdowik, Barbara Baka-Ćwierz, Dorota Dybowska, Waldemar Halota, Beata Lorenc, Marek Sitko, Aleksander Garlicki, Hanna Berak, Andrzej Horban, Iwona Orłowska, Krzysztof Simon, Łukasz Socha, Marta Wawrzynowicz-Syczewska, Jerzy Jaroszewicz, Zbigniew Deroń, Agnieszka Czauż-Andrzejuk, Jolanta Citko, Rafał Krygier, Anna Piekarska, Łukasz Laurans, Witold Dobracki, Jolanta Białkowska, Olga Tronina, Magdalena Wietlicka-Piszcz, Małgorzata Pawłowska and Robert Flisiakadd Show full author list remove Hide full author list
J. Clin. Med. 2022, 11(17), 5193; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11175193 - 01 Sep 2022
Cited by 3 | Viewed by 1742
Abstract
Hepatitis C infection is one of the main reasons for liver cirrhosis and hepatocellular carcinoma. In recent years, more and more is being heard about extrahepatic manifestations of the hepatitis C infection including its possible influence on the development of hypertension and cardiovascular [...] Read more.
Hepatitis C infection is one of the main reasons for liver cirrhosis and hepatocellular carcinoma. In recent years, more and more is being heard about extrahepatic manifestations of the hepatitis C infection including its possible influence on the development of hypertension and cardiovascular diseases. In the given work, the frequency analysis of the incidence of hypertension and cardiovascular diseases among 2898 HCV-infected patients treated in Poland and the assessment of their relevance to the HCV genotype and the progression of liver fibrosis can be found. The prevalence of hypertension in the group of analyzed patients was 39% and was significantly associated with old age (OR = 1.08 (1.07–1.08)) and female sex, as well as the progression of liver fibrosis (OR = 1.54 (1.29–1.85)). Hypertension was found in 47.6% of patients with F4 fibrosis, 42.1% of patients with F3 fibrosis, and 25% of patients with F1 fibrosis. The incidence of cardiovascular disease in the studied group of patients was as follows: all incidents, 131 (4.52%); including ischemic heart disease 104, (3.95%); stroke, 2 (0.07%); atherosclerosis, 21 (0.72%); and aneurysms, 4 (0.14%). The obtained results prove that the prevalence of cardiovascular diseases is significantly associated with the advanced age of patients and the progression of liver fibrosis. The relevance of sex and the HCV genotype to the prevalence frequency of cardiovascular diseases in the study group has not been proven. This being the case, no differences in the frequency of their incidence depending on the HCV genotype, including genotype 3, was found. Hepatitis C infection as a non-classical risk factor for cardiovascular disease and hypertension does require further studying. Full article
(This article belongs to the Special Issue Biomarkers for Cardiovascular Risk)
11 pages, 1445 KiB  
Article
Lipid Profile, Lp(a) Levels, and HDL Quality in Adolescents with Down Syndrome
by Aleksandra Krzesińska, Anna Kłosowska, Kornelia Sałaga-Zaleska, Agnieszka Ćwiklińska, Agnieszka Mickiewicz, Gabriela Chyła, Jolanta Wierzba, Maciej Jankowski and Agnieszka Kuchta
J. Clin. Med. 2022, 11(15), 4356; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11154356 - 27 Jul 2022
Cited by 1 | Viewed by 1624
Abstract
The improvement in the lifespan of individuals with Down syndrome (DS) has created interest in the context of the development of age-related diseases. Among them is atherosclerosis-based cardiovascular disease (CVD), which seems to be an especially urgent and important issue. The aim of [...] Read more.
The improvement in the lifespan of individuals with Down syndrome (DS) has created interest in the context of the development of age-related diseases. Among them is atherosclerosis-based cardiovascular disease (CVD), which seems to be an especially urgent and important issue. The aim of the present study was to evaluate the lipid markers that may clarify cardiovascular risk profiles in individuals with DS. To this end, we analyzed lipid profile parameters, including lipoprotein(a) (Lp(a)) levels, protein composition, and the antioxidative properties of high-density lipoprotein (HDL), in 47 adolescents with DS and 47 individuals without DS. Compared with the control group (C), subjects with DS had significantly increased concentrations of low-density lipoprotein cholesterol (105 ± 31 vs. 90 ± 24 mg/dL, p = 0.014), non-high-density lipoprotein cholesterol (120 ± 32 vs. 103 ± 26 mg/dL, p = 0.006), and triglycerides (72 [55–97] vs. 60 [50–77] mg/dL, p = 0.048). We found that patients with DS were characterized by significantly higher Lp(a) levels (31.9 [21.5–54.3] vs. 5.2 (2.4–16.1) mg/dL, p < 0.001). In fact, 57% of individuals with DS had Lp(a) levels above 30 mg/dL, which was approximately four times higher than those in the control group (DS 57% vs. C 15%). Apart from decreased high-density lipoprotein cholesterol levels in the subjects with DS (53 ± 11 vs. 63 ± 12 mg/dL, p < 0.001), differences in parameters showing the quality of HDL particles were observed. The concentrations of the main proteins characterizing the HDL fraction, apolipoprotein A-I and apolipoprotein A-II, were significantly lower in the DS group (144 ± 21 vs. 181 ± 33 mg/dL, p < 0.001; 33 ± 6 vs. 39 ± 6 mg/dL, p < 0.001, respectively). No significant differences between the groups were observed for the concentration of paraoxonase-1 (DS 779 ± 171 vs. C 657 ± 340 ng/mL, p = 0.063), enzyme activities toward paraoxon (DS 219 [129–286] vs. C 168 [114–272] IU/L, p = 0.949), or phenyl acetate (DS 101 ± 20 vs. C 93 ± 21 kIU/L, p = 0.068). There were no differences in myeloperoxidase activity between the study groups (DS 327 [300–534] vs. C 426 [358–533] ng/mL, p = 0.272). Our results are the first to demonstrate an unfavorable lipid profile combined with higher Lp(a) levels and quality changes in HDL particles in individuals with DS. This sheds new light on cardiovascular risk and traditional healthcare planning for adolescents with DS. Full article
(This article belongs to the Special Issue Biomarkers for Cardiovascular Risk)
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16 pages, 2408 KiB  
Article
Advanced Glycation End Product (AGE) and Soluble Receptor of AGE (sRAGE) Levels in Relation to Periodontitis Severity and as Putative 3-Year Outcome Predictors in Patients Undergoing Coronary Artery Bypass Grafting (CABG)
by Stefan Reichert, Britt Hofmann, Michael Kohnert, Alexander Navarrete Santos, Lisa Friebe, Julia Grollmitz, Hans-Günter Schaller and Susanne Schulz
J. Clin. Med. 2022, 11(14), 4105; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11144105 - 15 Jul 2022
Cited by 1 | Viewed by 1439
Abstract
Tissue concentrations of advanced glycation end product (AGE) and peripheral soluble receptor of AGE (sRAGE) levels may be associated with periodontitis severity. Both parameters and periodontitis might serve as outcome predictors for patients undergoing coronary artery bypass grafting (CABG). This study aimed to [...] Read more.
Tissue concentrations of advanced glycation end product (AGE) and peripheral soluble receptor of AGE (sRAGE) levels may be associated with periodontitis severity. Both parameters and periodontitis might serve as outcome predictors for patients undergoing coronary artery bypass grafting (CABG). This study aimed to investigate possible associations between periodontitis and AGE/sRAGE. Ultimately, we wanted to examine whether AGE, sRAGE, and severe periodontitis are associated with the incidence of new cardiovascular events within 3 years of follow-up after CABG. Ninety-five patients with coronary vascular disease (CVD) (age 69 years, 88.3% males) needing CABG surgery were included. Periodontal diagnosis was made according to the guidelines of the “Centers for Disease Control and Prevention (CDC)” (2007) and staged according to the new classification of periodontal diseases (2018). AGE tissue concentrations were assessed as skin autofluorescence (sAF). sRAGE levels were determined by using a commercially available enzyme-linked immunoabsorbance assay (ELISA) kit. Univariate and multivariate baseline and survival analyses were carried out with Mann–Whitney U test, Chi² test, Kaplan–Meier curves with Log-Rank test, and logistic and Cox regression. sAF was identified as an independent risk indicator for severe periodontitis with respect to the cofactors age, gender, plaque index, and diabetes (adjusted odds ratio [OR] = 2.9, p = 0.028). The degree of subgingival inflammation assessed as a percentage of sites with bleeding on probing (BOP) was inversely correlated with sRAGE concentration (r = −0.189, p = 0.034). Both sAF (Hazard Ratio [HR] = 2.4, p = 0.004) and sRAGE (HR = 1.9, p = 0.031) increased the crude risk for new adverse events after CABG. The occurrence of severe periodontitis trends towards a higher risk for new cardiovascular events (HR = 1.8, p = 0.115). Applying multivariate Cox regression, only peripheral arterial disease (adjusted HR = 2.7, p = 0.006) and history of myocardial infarction (adjusted HR = 2.8, p = 0.010) proved to be independent risk factors for cardiovascular outcome. We conclude that sAF may represent a new, independent risk indicator for severe periodontitis. In contrast, sAF, sRAGE, and severe periodontitis were not independent prognostic factors for postoperative outcome in patients undergoing CABG. Full article
(This article belongs to the Special Issue Biomarkers for Cardiovascular Risk)
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26 pages, 1837 KiB  
Article
Predictive Value of HAS-BLED Score Regarding Bleeding Events and Graft Survival following Renal Transplantation
by Hans Michael Hau, Markus Eckert, Sven Laudi, Maria Theresa Völker, Sebastian Stehr, Sebastian Rademacher, Daniel Seehofer, Robert Sucher, Tobias Piegeler and Nora Jahn
J. Clin. Med. 2022, 11(14), 4025; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11144025 - 12 Jul 2022
Cited by 1 | Viewed by 1632
Abstract
Objective: Due to the high prevalence and incidence of cardio- and cerebrovascular diseases among dialysis-dependent patients with end-stage renal disease (ERSD) scheduled for kidney transplantation (KT), the use of antiplatelet therapy (APT) and/or anticoagulant drugs in this patient population is common. However, these [...] Read more.
Objective: Due to the high prevalence and incidence of cardio- and cerebrovascular diseases among dialysis-dependent patients with end-stage renal disease (ERSD) scheduled for kidney transplantation (KT), the use of antiplatelet therapy (APT) and/or anticoagulant drugs in this patient population is common. However, these patients share a high risk of complications, either due to thromboembolic or bleeding events, which makes adequate peri- and post-transplant anticoagulation management challenging. Predictive clinical models, such as the HAS-BLED score developed for predicting major bleeding events in patients under anticoagulation therapy, could be helpful tools for the optimization of antithrombotic management and could reduce peri- and postoperative morbidity and mortality. Methods: Data from 204 patients undergoing kidney transplantation (KT) between 2011 and 2018 at the University Hospital Leipzig were retrospectively analyzed. Patients were stratified and categorized postoperatively into the prophylaxis group (group A)—patients without pretransplant anticoagulation/antiplatelet therapy and receiving postoperative heparin in prophylactic doses—and into the (sub)therapeutic group (group B)—patients with postoperative continued use of pretransplant antithrombotic medication used (sub)therapeutically. The primary outcome was the incidence of postoperative bleeding events, which was evaluated for a possible association with the use of antithrombotic therapy. Secondary analyses were conducted for the associations of other potential risk factors, specifically the HAS-BLED score, with allograft outcome. Univariate and multivariate logistic regression as well as a Cox proportional hazard model were used to identify risk factors for long-term allograft function, outcome and survival. The calibration and prognostic accuracy of the risk models were evaluated using the Hosmer–Lemshow test (HLT) and the area under the receiver operating characteristic curve (AUC) model. Results: In total, 94 of 204 (47%) patients received (sub)therapeutic antithrombotic therapy after transplantation and 108 (53%) patients received prophylactic antithrombotic therapy. A total of 61 (29%) patients showed signs of postoperative bleeding. The incidence (p < 0.01) and timepoint of bleeding (p < 0.01) varied significantly between the different antithrombotic treatment groups. After applying multivariate analyses, pre-existing cardiovascular disease (CVD) (OR 2.89 (95% CI: 1.02–8.21); p = 0.04), procedure-specific complications (blood loss (OR 1.03 (95% CI: 1.0–1.05); p = 0.014), Clavien–Dindo classification > grade II (OR 1.03 (95% CI: 1.0–1.05); p = 0.018)), HAS-BLED score (OR 1.49 (95% CI: 1.08–2.07); p = 0.018), vit K antagonists (VKA) (OR 5.89 (95% CI: 1.10–31.28); p = 0.037), the combination of APT and therapeutic heparin (OR 5.44 (95% CI: 1.33–22.31); p = 0.018) as well as postoperative therapeutic heparin (OR 3.37 (95% CI: 1.37–8.26); p < 0.01) were independently associated with an increased risk for bleeding. The intraoperative use of heparin, prior antiplatelet therapy and APT in combination with prophylactic heparin was not associated with increased bleeding risk. Higher recipient body mass index (BMI) (OR 0.32 per 10 kg/m2 increase in BMI (95% CI: 0.12–0.91); p = 0.023) as well as living donor KT (OR 0.43 (95% CI: 0.18–0.94); p = 0.036) were associated with a decreased risk for bleeding. Regarding bleeding events and graft failure, the HAS-BLED risk model demonstrated good calibration (bleeding and graft failure: HLT: chi-square: 4.572, p = 0.802, versus chi-square: 6.52, p = 0.18, respectively) and moderate predictive performance (bleeding AUC: 0.72 (0.63–0.79); graft failure: AUC: 0.7 (0.6–0.78)). Conclusions: In our current study, we could demonstrate the HAS-BLED risk score as a helpful tool with acceptable predictive accuracy regarding bleeding events and graft failure following KT. The intensified monitoring and precise stratification/assessment of bleeding risk factors may be helpful in identifying patients at higher risks of bleeding, improved individualized anticoagulation decisions and choices of antithrombotic therapy in order to optimize outcome after kidney transplantation. Full article
(This article belongs to the Special Issue Biomarkers for Cardiovascular Risk)
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10 pages, 1165 KiB  
Article
TMAO and Gut Microbial-Derived Metabolites TML and γBB Are Not Associated with Thrombotic Risk in Patients with Venous Thromboembolism
by Marina Canyelles, Melania Plaza, Noemí Rotllan, Dolors Llobet, Josep Julve, Sergi Mojal, Maribel Diaz-Ricart, José Manuel Soria, Joan Carles Escolà-Gil, Mireia Tondo, Francisco Blanco-Vaca and Joan Carles Souto
J. Clin. Med. 2022, 11(5), 1425; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11051425 - 04 Mar 2022
Cited by 2 | Viewed by 1809
Abstract
Background: The present work evaluates the association between circulating concentrations of Trimethylamine-N-oxide (TMAO), gamma butyrobetaine (γBB), and trimetyllisine (TML) in controls and patients with venous thromboembolism (VTE) with coagulation parameters. Methods: The study involved 54 VTE patients and 57 controls. Platelet function, platelet [...] Read more.
Background: The present work evaluates the association between circulating concentrations of Trimethylamine-N-oxide (TMAO), gamma butyrobetaine (γBB), and trimetyllisine (TML) in controls and patients with venous thromboembolism (VTE) with coagulation parameters. Methods: The study involved 54 VTE patients and 57 controls. Platelet function, platelet hyperreactivity, platelet adhesiveness, thrombosis-associated parameters, and thrombin generation parameters were studied. Plasma TMAO, γBB, and TML determination was performed using an ultra-high-performance liquid chromatography system coupled with mass spectrometry. Results: No differences were found for TMAO, γBB, or TML concentrations between controls and VTE patients. In thrombin generation tests, TMAO, γBB, and TML showed a positive correlation with lag time and time to peak. TMAO, γBB, and TML negatively correlated with peak height. No significant differences were observed regarding TMAO, γBB, and TML concentrations between the two blood withdrawals, nor when the control and VTE patients were analyzed separately. No correlation was observed between these gut metabolites and platelet function parameters. Conclusions: No differences were found regarding TMAO, γBB, and TML concentrations between the control and VTE groups. Some correlations were found; however, they were mild or went in the opposite direction of what would be expected if TMAO and its derivatives were related to VTE risk. Full article
(This article belongs to the Special Issue Biomarkers for Cardiovascular Risk)
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Review

Jump to: Research, Other

17 pages, 1118 KiB  
Review
Mitochondrial Cardiomyopathy: The Roles of mt-tRNA Mutations
by Yu Ding, Beibei Gao and Jinyu Huang
J. Clin. Med. 2022, 11(21), 6431; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11216431 - 30 Oct 2022
Cited by 5 | Viewed by 1968
Abstract
Mitochondria are important organelles whose primary role is generating energy through the oxidative phosphorylation (OXPHOS) system. Cardiomyopathy, a common clinical disorder, is frequently associated with pathogenic mutations in nuclear and mitochondrial genes. To date, a growing number of nuclear gene mutations have been [...] Read more.
Mitochondria are important organelles whose primary role is generating energy through the oxidative phosphorylation (OXPHOS) system. Cardiomyopathy, a common clinical disorder, is frequently associated with pathogenic mutations in nuclear and mitochondrial genes. To date, a growing number of nuclear gene mutations have been linked with cardiomyopathy; however, knowledge about mitochondrial tRNAs (mt-tRNAs) mutations in this disease remain inadequately understood. In fact, defects in mt-tRNA metabolism caused by pathogenic mutations may influence the functioning of the OXPHOS complexes, thereby impairing mitochondrial translation, which plays a critical role in the predisposition of this disease. In this review, we summarize some basic knowledge about tRNA biology, including its structure and function relations, modification, CCA-addition, and tRNA import into mitochondria. Furthermore, a variety of molecular mechanisms underlying tRNA mutations that cause mitochondrial dysfunctions are also discussed in this article. Full article
(This article belongs to the Special Issue Biomarkers for Cardiovascular Risk)
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19 pages, 1828 KiB  
Review
11β-Hydroxysteroid Dehydrogenase Type 1 as a Potential Treatment Target in Cardiovascular Diseases
by Daria Kupczyk, Renata Studzińska, Renata Kołodziejska, Szymon Baumgart, Martyna Modrzejewska and Alina Woźniak
J. Clin. Med. 2022, 11(20), 6190; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11206190 - 20 Oct 2022
Cited by 2 | Viewed by 2023
Abstract
Glucocorticoids (GCs) belong to the group of steroid hormones. Their representative in humans is cortisol. GCs are involved in most physiological processes of the body and play a significant role in important biological processes, including reproduction, growth, immune responses, metabolism, maintenance of water [...] Read more.
Glucocorticoids (GCs) belong to the group of steroid hormones. Their representative in humans is cortisol. GCs are involved in most physiological processes of the body and play a significant role in important biological processes, including reproduction, growth, immune responses, metabolism, maintenance of water and electrolyte balance, functioning of the central nervous system and the cardiovascular system. The availability of cortisol to the glucocorticoid receptor is locally controlled by the enzyme 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1). Evidence of changes in intracellular GC metabolism in the pathogenesis of obesity, metabolic syndrome (MetS) and cardiovascular complications highlights the role of selective 11β-HSD1 inhibition in the pharmacotherapy of these diseases. This paper discusses the role of 11β-HSD1 in MetS and its cardiovascular complications and the importance of selective inhibition of 11β-HSD1. Full article
(This article belongs to the Special Issue Biomarkers for Cardiovascular Risk)
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17 pages, 910 KiB  
Review
The Impact of Exercise on Redox Equilibrium in Cardiovascular Diseases
by Paweł Sutkowy, Joanna Wróblewska, Marcin Wróblewski, Jarosław Nuszkiewicz, Martyna Modrzejewska and Alina Woźniak
J. Clin. Med. 2022, 11(16), 4833; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11164833 - 18 Aug 2022
Cited by 2 | Viewed by 1378
Abstract
Cardiovascular diseases constitute the most important public health problem in the world. They are characterized by inflammation and oxidative stress in the heart and blood. Physical activity is recognized as one of the best ways to prevent these diseases, and it has already [...] Read more.
Cardiovascular diseases constitute the most important public health problem in the world. They are characterized by inflammation and oxidative stress in the heart and blood. Physical activity is recognized as one of the best ways to prevent these diseases, and it has already been applied in treatment. Physical exercise, both aerobic and anaerobic and single and multiple, is linked to the oxidant–antioxidant imbalance; however, this leads to positive adaptive changes in, among others, the increase in antioxidant capacity. The goal of the paper was to discuss the issue of redox equilibrium in the human organism in the course of cardiovascular diseases to systemize updated knowledge in the context of exercise impacts on the organism. Antioxidant supplementation is also an important issue since antioxidant supplements still have great potential regarding their use as drugs in these diseases. Full article
(This article belongs to the Special Issue Biomarkers for Cardiovascular Risk)
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9 pages, 1536 KiB  
Review
The Role and Implications of Epicardial Fat in Coronary Atherosclerotic Disease
by Laurentiu Braescu, Marinica Gaspar, Darius Buriman, Oana Maria Aburel, Adrian-Petru Merce, Felix Bratosin, Klokov Sergei Aleksandrovich, Satish Alambaram and Cristian Mornos
J. Clin. Med. 2022, 11(16), 4718; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11164718 - 12 Aug 2022
Cited by 8 | Viewed by 2117
Abstract
The current minireview aims to assess the implications of epicardial fat secretory function in the development of coronary artery disease. The epicardial adipose tissue (EAT) is a visceral fat depot that has been described as a cardiovascular risk factor. In addition to its [...] Read more.
The current minireview aims to assess the implications of epicardial fat secretory function in the development of coronary artery disease. The epicardial adipose tissue (EAT) is a visceral fat depot that has been described as a cardiovascular risk factor. In addition to its mechanical protection role and physiological secretory function, it seems that various secretion products of the epicardial fat are responsible for metabolic disturbances at the level of the cardiac muscle when in association with pre-existing pathological conditions, such as metabolic syndrome. There is a pathological reduction in sarcomere shortening, abnormal cytosolic Ca2+ fluxes, reduced expression of sarcoplasmic endoplasmic reticulum ATPase 2a and decreased insulin-mediated Akt-Ser473-phosphorylation in association with abnormal levels of epicardial fat tissue. Activin A, angiopoietin-2, and CD14-positive monocytes selectively accumulate in the diseased myocardium, resulting in reduced cardiomyocyte contractile function. At the same time, it is believed that these alterations in secretory products directly decrease the myocyte function via molecular changes, thus contributing to the development of coronary disease when certain comorbidities are associated. Full article
(This article belongs to the Special Issue Biomarkers for Cardiovascular Risk)
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12 pages, 1712 KiB  
Review
Circulating and Platelet MicroRNAs in Cardiovascular Risk Assessment and Antiplatelet Therapy Monitoring
by Grzegorz Procyk, Dominika Klimczak-Tomaniak, Grażyna Sygitowicz and Mariusz Tomaniak
J. Clin. Med. 2022, 11(7), 1763; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11071763 - 22 Mar 2022
Cited by 9 | Viewed by 2631
Abstract
Micro-ribonucleic acids (microRNAs) are small molecules that take part in the regulation of gene expression. Their function has been extensively investigated in cardiovascular diseases (CVD). Most recently, miRNA expression levels have been suggested as potential biomarkers of platelet reactivity or response to antiplatelet [...] Read more.
Micro-ribonucleic acids (microRNAs) are small molecules that take part in the regulation of gene expression. Their function has been extensively investigated in cardiovascular diseases (CVD). Most recently, miRNA expression levels have been suggested as potential biomarkers of platelet reactivity or response to antiplatelet therapy and tools for risk stratification for recurrence of ischemic evens. Among these, miR-126 and miR-223 have been found to be of particular interest. Despite numerous studies aimed at understanding the prognostic value of miRNA levels, no final conclusions have been drawn thus far regarding their utility in clinical practice. The aim of this review is to critically appraise the evidence on the association between miRNA expression, cardiovascular risk and on-treatment platelet reactivity as well as provide insights on future developments in the field. Full article
(This article belongs to the Special Issue Biomarkers for Cardiovascular Risk)
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20 pages, 1095 KiB  
Review
Flow-Responsive Noncoding RNAs in the Vascular System: Basic Mechanisms for the Clinician
by Salvatore De Rosa, Claudio Iaconetti, Ceren Eyileten, Masakazu Yasuda, Michele Albanese, Alberto Polimeni, Jolanda Sabatino, Sabato Sorrentino, Marek Postula and Ciro Indolfi
J. Clin. Med. 2022, 11(2), 459; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11020459 - 17 Jan 2022
Cited by 5 | Viewed by 2141
Abstract
The vascular system is largely exposed to the effect of changing flow conditions. Vascular cells can sense flow and its changes. Flow sensing is of pivotal importance for vascular remodeling. In fact, it influences the development and progression of atherosclerosis, controls its location [...] Read more.
The vascular system is largely exposed to the effect of changing flow conditions. Vascular cells can sense flow and its changes. Flow sensing is of pivotal importance for vascular remodeling. In fact, it influences the development and progression of atherosclerosis, controls its location and has a major influx on the development of local complications. Despite its importance, the research community has traditionally paid scarce attention to studying the association between different flow conditions and vascular biology. More recently, a growing body of evidence has been accumulating, revealing that ncRNAs play a key role in the modulation of several biological processes linking flow-sensing to vascular pathophysiology. This review summarizes the most relevant evidence on ncRNAs that are directly or indirectly responsive to flow conditions to the benefit of the clinician, with a focus on the underpinning mechanisms and their potential application as disease biomarkers. Full article
(This article belongs to the Special Issue Biomarkers for Cardiovascular Risk)
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Other

Jump to: Research, Review

14 pages, 5393 KiB  
Systematic Review
Serum Concentrations of Ischaemia-Modified Albumin in Acute Coronary Syndrome: A Systematic Review and Meta-Analysis
by Arduino A. Mangoni and Angelo Zinellu
J. Clin. Med. 2022, 11(14), 4205; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11144205 - 20 Jul 2022
Cited by 2 | Viewed by 1154
Abstract
The identification of novel circulating biomarkers of acute coronary syndrome (ACS) may improve diagnosis and management. We conducted a systematic review and meta-analysis of ischaemia-modified albumin (IMA), an emerging biomarker of ischaemia and oxidative stress, in ACS. We searched PubMed, Web of Science, [...] Read more.
The identification of novel circulating biomarkers of acute coronary syndrome (ACS) may improve diagnosis and management. We conducted a systematic review and meta-analysis of ischaemia-modified albumin (IMA), an emerging biomarker of ischaemia and oxidative stress, in ACS. We searched PubMed, Web of Science, and Scopus from inception to March 2022, and assessed the risk of bias and certainty of evidence with the Joanna Briggs Institute Critical Appraisal Checklist and GRADE, respectively. In 18 studies (1654 ACS patients and 1023 healthy controls), IMA concentrations were significantly higher in ACS (standard mean difference, SMD = 2.38, 95% CI 1.88 to 2.88; p < 0.001; low certainty of evidence). The effect size was not associated with pre-defined study or patient characteristics, barring the country where the study was conducted. There were no significant differences in effect size between acute myocardial infarction (MI) and unstable angina (UA), and between ST-elevation (STEMI) and non-ST-elevation MI (NSTEMI). However, the effect size was progressively larger in UA (SMD = 1.63), NSTEMI (SMD = 1.91), and STEMI (3.26). Our meta-analysis suggests that IMA might be useful to diagnose ACS. Further studies are warranted to compare the diagnostic performance of IMA vs. established markers, e.g., troponin, and to determine its potential utility in discriminating between UA, NSTEMI, and STEMI (PROSPERO registration number: CRD42021324603). Full article
(This article belongs to the Special Issue Biomarkers for Cardiovascular Risk)
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