Coronary Heart Disease Subjects Research Articles

Coronary atherosclerosis and periodontitis have similarities in their clinical presentation.

Periodontitis (PE) and coronary heart disease (CHD) possess multiple mechanisms for a putative association. This case-control study compared the periodontal status among CHD subjects to controls without CHD, while also investigating atheroma invasion by known periodontal pathogens. 161 subjects participated in this study were divided into three CHD groups: No CHD, chronic CHD, acute CHD. Additional analysis involved grouping subjects according to number of atheromas: no atheroma, 1-4 atheromas, 5-18 atheromas. Data were collected from medical records, periodontal examinations, and questionnaires that included demographic, behavioral, and oral health variables. Angiographic catheterizations were analyzed according to the number of atheroma lesions, lesion size, lesion location, and atheroma lesion stability. Lipoprotein profile, inflammatory markers and cells were analyzed. The microbiological branch added 30 individuals who had their atheroma lesion and subgingival plaque analyzed using polymerase chain reaction probes against the 16 s region, red complex and Aggregatibacter actinomycetemcomitans' DNA. Subjects with CHD had high levels of systemic inflammatory markers and low levels of high-density lipoproteins compared to subjects without CHD. Subjects without CHD and clear coronaries had a prevalence of mild CAL, while individuals with more atheroma lesions had advanced CAL and more active PE. Subjects with more advanced CAL were 4 times more likely to have CHD compared to subjects with less, which is comparable to smoking. Only 4 subjects had the screened pathogens detected in atheroma, although these subjects also have the screened pathogens in subgingival plaque. However, 80% of atheromas had bacteria. CHD and PE showed similarities in progression while active PE led to more atheroma lesions that also tended to be larger in size.

CYP4V2 rs56413992 C > T was associated with the risk of coronary heart disease in the Chinese Han population: a case–control study

PurposeThe research aimed to detect the association between single nucleotide polymorphisms (SNPs) in CYP4V2 gene and coronary heart disease (CHD) risk.MethodsThis case–control study included 487 CHD subjects and 487 healthy individuals. Logistic regression was performed to analyze the connection between five SNPs in CYP4V2 (rs1398007, rs13146272, rs3736455, rs1053094, and rs56413992) and CHD risk, and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated to evaluate the connection.ResultsAs a result, we found that rs56413992 T allele (OR = 1.36, 95% CI = 1.09–1.70, p = 0.007) and CT genotype (OR = 1.40, 95% CI = 1.06–1.83, p = 0.017) were significantly associated with an increased risk of CHD in the overall analysis. Precisely, rs56413992 was linked to an elevated risk of CHD in people aged > 60, males, smokers and drinkers. The study also indicated that rs1398007 was linked to an increased CHD risk in drinkers. In addition, rs1053094 was correlated with a decreased risk of CHD complicated with diabetes mellitus (DM), and rs1398007 was correlated with a decreased risk of CHD complicated with hypertension (HTN).ConclusionThis study was the first to experimentally demonstrate that CYP4V2 rs56413992 was associated with the risk of CHD, which will provide a certain reference for revealing the pathogenesis of CHD.

Endothelial Nitric Oxide Synthase T-786C and G-894T Gene Polymorphisms: A Risk Assessment of Coronary Heart Disease.

The polymorphism of the endothelial nitric oxide synthase (eNOS) gene is thought to enhance the risk of coronary heart disease (CHD). The most protruding reason for endothelial dysfunction is the diminished production of NO. In the eNOS encoding gene, a number of mutations were associated with decreased NO effect promoting the presence of CHD. This study aims to look at the role of polymorphisms in the eNOS genes G-894T and T-786C in young South Indians. From January 2022 to May 2022, 91 angiographically proven CHD subjects attending the Department of Cardiology and Medicine and 91 controls from a master health checkup in the age group of 45 years participated in this observational cross-sectional study at SRM Medical College Hospital and Research Centre in Chennai, Tamil Nadu, India. Overnight fasting plasma samples were taken for analysis of the lipid profile as well as NO by Griess reaction utilizing an enzyme-linked immunosorbent assay (ELISA) technique. Polymerase chain reaction (PCR) and restricted fragment length polymorphism (RFLP) were used to amplify the T-786C and G-894T eNOS genes. When compared to controls, the mean level of serum NO in CHD patients was considerably lower. For eNOS T-786C polymorphism, the distribution of TC genotype (p = 0.017), odds (OD) ratio = 2.1, CC genotype (p = 0.011), OD ratio = 3.75, and minor C allele frequency (p = 0.001). And for eNOS G-894T polymorphism, the distribution of GT genotype (p = 0.01), TT genotype (p =0.02) with OD ratio and minor T allele frequency (p = 0.002) with OD ratio = 1.07 and 0.83. Our study concludes that the polymorphism of eNOS T-786C and G-894T genes may be the main causative association for the presence of CHD. How to cite this article: Jaishankar T, Shivasekar M, Vinodhini VM. Endothelial Nitric Oxide Synthase T-786C and G-894T Gene Polymorphisms: A Risk Assessment of Coronary Heart Disease. J Assoc Physicians India 2023;71(9):45-50.

Association of Circulating Matrix Metalloproteinase-9 and the Risk of Coronary Heart Disease in Young Smokers

Introduction: Smoking causes cardiovascular risk which may alter the stability between the production and degradation of the extracellular matrix. Matrix metalloproteinase-9 (MMP-9) is a zinc-containing endopeptidase that degrades the extracellular matrix and plays a vital role in tissue remodeling. As a result, elevated serum MMP-9 levels produced by smoking, particularly at young age, raise the risk of future CHD. So this study aims to find out the possible relationship between circulating MMP-9 and the risk of cardiovascular disease in young smokers. Methods: The study was conducted on smokers with CHD subjects attending cardiology and medicine OP of the SRM Medical College Hospital and research center Tamil Nadu, India. The study group was divided into three groups. Group 1 includes 120 healthy controls as nonsmokers, Group 2 includes 120 smokers with Coronary heart disease (CHD), and Group 3 includes 120 smokers with diabetes and CHD subjects in the age group of 20-55 years. Serum MMP-9, hs-CRP, and APO-E levels were measured using the ELISA method and the lipid level was measured enzymatically using AU480 automatic analyzer (back man coulter). Results: The mean serum MMP-9, hs-CRP, and APO-E levels were significantly higher in both groups (p<0.05) when compared to controls. The study also shows a significant positive association between MMP-9 with hs-CRP, APO-E, smoking burden, and smoking intensity. Conclusion: The study concludes a significant association exists between cigarette smoking with MMP-9 and also relative exposure to circulating inflammation markers plays a potential role in the pathogenesis of CHD.

Determinants of coronary heart disease among adults: a case-control study

BackgroundAccording to recent World Health Organization data, coronary heart disease (CHD) remains the leading cause of death worldwide. Although the risk factors of this disease are well known, the strength of these factors varies in different populations. The aim of the study was to assess the determinants of CHD in Indonesian adults aged 25 years and over. MethodsA case–control study was carried out involving 592 subjects aged 25 years and over (444 controls and 148 cases). Participants were interviewed using validated questionnaires. Physical examinations and supporting examinations were conducted. The Chi square test, Fisher’s exact test, and independent t test were used to analyze the data. To determine independent predictors of CHD, the odds ratio (OR) was determined via the multiple logistic regressions test. ResultsThe CHD subjects (case group) showed higher blood sugar and systolic pressure than non-CHD subjects (controls), with mean fasting blood sugar of 92.53±27.05 mg/dL vs 88.29 ±23.43 mg/dL (p=0.038), 2-hour postprandial blood sugar of 133.15±65.09 mg/dL vs 120.87±44.60 mg/dL (p=0.000), and systolic blood pressure of 89±27.62 mmHg vs 129.98±10.58 mmHg (p=0.002). The logistic regression analysis in the case group showed that higher education (college) had a 2.32-fold greater effect (95% CI. 1.01-5.35) on CHD incidence compared to the control group. ConclusionsThis study has demonstrated that the most frequent risk factor for CVD in adults aged 25 years and over is higher education. Control and prevention of CHD need to be done with regular control of blood sugar levels and blood pressure to stabilize them within normal limits.

The Implications of Smoking on Lipid Peroxidation and Serum Antioxidant Status in Young Smokers with Coronary Heart Disease

Cigarette smoking is one of the leading causes of heart disease. Cigarette smoke contains oxidants playing a major role in oxidative stress by lowering antioxidant capacity and by increasing the level of lipid peroxidation. The study aims to estimate the total antioxidant capacity levels, lipid peroxidation and its relation to cardiovascular disease in young smokers. The study contains three groups. Group1 includes 120 healthy controls as nonsmokers, group2 includes 120 young active smokers with coronary heart disease (CHD) and group3 includes 120 young active smokers with diabetic CHD subjects who were attending the SRM Medical College Hospital in Tamil Nadu for cardiology and medicine. The Total Antioxidant Capacity and lipid peroxidation especially measured as malondialdehyde (MDA) was determined using a spectrophotometric technique. Enzyme-linked Immune Sorbent Assay was used to measure oxidized LDL (ox- LDL)" and "high-sensitivity CRP (hs-CRP). The total antioxidant capacity of smokers was found to be significantly lower than those of healthy controls p<0.0001. On the other hand, MDA, ox-LDL and hs-CRP concentrations were considerably higher in smokers than healthy controls p<0.0001. Interestingly smoking burden and smoking intensity also show a significant correlation with antioxidant capacity, lipid peroxidation (MDA) as well as with ox-LDL. The study concludes that cigarette smoking reduces the concentration of total antioxidant required for free radical scavenging which enhances the rate of lipid peroxidation and is one of the risk factors for CHD observed in smokers.

The Burden of Impaired Serum Albumin Antioxidant Properties and Glyco-Oxidation in Coronary Heart Disease Patients with and without Type 2 Diabetes Mellitus.

Human serum albumin (HSA) has an important antioxidant activity due to the presence of the reduced cysteine at position 34, which represents the most abundant free thiol in the plasma. In oxidative-based diseases, HSA undergoes S-thiolation (THIO-HSA) with changes in the antioxidant function of albumin that could contribute to the progression of the disease. The aim of this study was to verify, for the first time, the different burdens of THIO-HSA, glycated HSA (GLY-HSA), and advanced glycation end products (AGE) accumulation both in type 2 diabetes mellitus (T2DM) patients and in non-diabetic patients, with or without coronary heart disease (CHD). In this study, we assessed the presence of modified forms of HSA, THIO-HSA, and GLY-HSA by means of mass spectrometry in 33 patients with both T2DM and CHD, in 31 patients with T2DM and without CHD, in 30 patients without diabetes with a history of CHD, and 27 subjects without diabetes and CHD. All the patients’ anthropometric and clinical data were recorded including age, sex, duration of diabetes, body mass index (BMI), blood pressure, and history of CHD defined with anamnestic data. Metabolic parameters, such as fasting plasma glucose (FPG), glycated hemoglobin (HbA1c), lipids, pentosidine, AGE, receptor for advanced glycation end-products (RAGE) and its soluble form (sRAGE), were measured. AGE and pentosidine are significantly higher in T2DM patients with and without CHD with respect to non-diabetic patients with CHD and control subjects. RAGE levels are significantly higher in T2DM patients with respect to non-diabetic patients, and among T2DM patients, the group with CHD showed significantly higher RAGE levels than those without CHD (217 ± 171 pg/mL and 140 ± 61 pg/mL, respectively). Albumin isoforms discriminate between non-diabetic patients with CHD and T2DM patients with and without CHD and control subjects, with GLY-HSA levels higher in T2DM with and without CHD, and THIO-HSA higher in CHD patients without T2DM. Finally, we demonstrated that the oxidized forms of HSA can increase the expression of the inflammatory cytokine Tumor Necrosis Factor-alpha (TNFα) in monocytic cells. In patients with CHD, GLY-HSA and THIO-HSA have a different prevalent distribution, the first one prevailing in patients with T2DM and the second one in patients without T2DM. These findings suggest that albumin quality and homeostasis balance between glyco-oxidation and thiolation might have an impact on the antioxidant defense system in cardiovascular diseases.

ENOS Gene Variants and Their Genetic Susceptibility Associated with Coronary Heart Disease

Objective: Gene variations in the gene encoding endothelial nitric oxide synthase (eNOS) may impact the initiation of coronary heart disease (CHD). Insufficient production of nitric oxide (NO) is the most obvious cause of endothelial dysfunction. The aim of this study was to investigate polymorphisms in the eNOS genes G894T and T786C that influence the development of CHD.Material and Methods: A total of 91 angiographically proven CHD subjects at the Department of Cardiology and Medicine and 91 controls at master health check, in the age group of 30-45 years were evaluated in this cross-sectional study. After overnight fasting blood samples were collected for evaluation of lipid profile by using Auto analyzer AU 480 and NO by Griess reaction, using Enzyme linked Immunosorbent assay. Polymerase Chain Reaction and Restriction Fragment Length Polymerization were used to amplify the eNOS gene, T786C, and G894T, respectively.Results: A significant decrease in the serum level of NO was observed in CHD subjects compared to controls. In eNOS T786C polymorphism, the distribution of TC genotype (p-value=0.017) odds ratio (OR)=2.1 and minor C allele frequency (p-value=0.001). Additionally, for eNOS G894T polymorphism, the distribution of GT genotype (p-value=0.014) OR=2.03 and minor T allele frequency (p-value=0.001).Conclusion: This study concludes that polymorphisms of the eNOS genes G894T and T786C could increase the risk of CHD.

Effects of serum branched-chain amino acids on nonalcoholic fatty liver disease and subsequent cardiovascular disease.

To reveal the role of branched-chain amino acids (BCAAs) in the development and progression of nonalcoholic fatty liver disease (NAFLD) and the effect on the incidence of subsequent cardiovascular disease. A total of 1302 subjects in the cohort study of the Huai'an Diabetes Prevention Program were divided into two groups according to whether NAFLD was present at baseline. The group without NAFLD at baseline was only followed up, and the group with NAFLD at baseline received diet and exercise interventions. Anthropometric and biochemical examinations were performed at baseline and at the end of 4years for all subjects. Serum BCAA (leucine, isoleucine, and valine) levels were measured by hydrophilic interaction chromatography-tandem mass spectrometry. The associations of baseline serum BCAA levels with the risk for NAFLD, coronary heart disease (CHD), and cardiovascular events (CVEs) after 4years were further evaluated. (1) At baseline and after the 4-year follow-up, baseline serum leucine, valine, and total BCAAs in the NAFLD group were significantly higher than those in the non-NAFLD group (p < 0.05). (2) According to whether NAFLD was present at baseline and after follow-up, all subjects were divided into four groups, including the control group, new case group, improvement group, and unchanged group. There was no significant difference in baseline BCAAs levels between the new case group and the improvement group (p > 0.05). (3) Risk factors for the occurrence and development of NAFLD were analysed by a multiple logistic regression model according to whether NAFLD existed at baseline. Serum leucine (OR = 1.058, 95% CI 1.005-1.114, p = 0.033) and total BCAAs (OR = 1.023, 95% CI 1.001-1.046, p = 0.045) were independent risk factors for new-onset NAFLD. Serum valine (OR = 1.131, 95% CI 1.043-1.226, p = 0.003), and total BCAAs (OR = 1.040, 95% CI 1.003-1.078, p = 0.035) were independent risk factors showing that NAFLD could not be reversed. (4) The cross-table Chi-square test showed that the incidence of both CHD and CVEs was significantly highest in the new case group (p < 0.05). (5) After adjusting for confounding factors, baseline isoleucine, valine, and BCAA levels were independently associated with new-onset CHD in subjects with or without NAFLD at baseline (p < 0.05). High BCAA levels exacerbate the risk of CHD and CVEs by influencing the occurrence and progression of NAFLD. However, lifestyle interventions could reverse the risk of NAFLD, CHD and CVEs associated with BCAAs.

OR20. Correlation between diabetes mellitus and significant in-stent restenosis in patient underwent coronary angiography evaluation

Abstract Aims Percutaneous Coronary Intervention (PCI) is a non-surgical invasive intervention with or without stenting performed on coronary heart disease (CHD) patient to improve blood flow of narrowed coronary arteries. One of the complication after PCI is in-stent restenosis (ISR), which is the narrowing of stented segment of coronary artery. Diabetes Mellitus (DM), is characterized by hyperglycemia, has long been known to increase the risk of CHD by 2-4 fold. Condition of hyperglycemia in diabetes has affects on the progression of neointimal hyperplasia (NIH) that progress to ISR. As the number of CHD patients with diabetes mellitus (DM) is expected to increase, so is the risk of ISR incidence in CHD patients with diabetes mellitus (DM) who undergo PCI. Method and Results A retrospective cross-sectional study was conducted using medical records of CHD patients who underwent coronary angiography evaluation between January 2018 and March 2020 at Catheterization Laboratory, Regional General Hospital of West Nusa Tenggara. Significant ISR was defined as diameter of stenosis ≥50% at coronary angiography evaluation. Total subjects were 66 subjects, with 33 DM subjects and 33 non-DM subjects, and ISR was found in 12 and 10 subjects respectively. There was no significant difference on the incidence of ISR between the DM and non-DM groups. Conclusion There was no correlation between DM and ISR, and there was no significant difference in the incidence of ISR between the DM and non-DM group in CHD subjects underwent coronary angiography evaluation.

Hair Lead, Aluminum, and Other Toxic Metals in Normal-Weight and Obese Patients with Coronary Heart Disease.

The objective of the present study was to evaluate hair toxic metal levels in patients with obesity and/or coronary heart disease (CHD). Following a 2 × 2 factorial design, subjects without CHD were grouped into normal weight control (n = 123) and obese groups (n = 140). Patients suffering from CHD were divided into normal weight (n = 180) and obese CHD subjects (n = 240). Hair Al, As, Cd, Hg, Ni, and Pb levels were evaluated using inductively-coupled plasma mass-spectrometry. The data demonstrate that hair Al and Hg levels were higher in obese subjects as compared to normal weight controls. Normal weight CHD patients were characterized by significantly higher hair Al, As, Cd, and Pb levels when compared to healthy subjects. The highest hair Al, As, and Pb levels were observed in obese CHD patients, significantly exceeding the respective values in other groups. Factorial analysis revealed significant influence of factorial interaction (CHD*obesity) only for hair Pb content. Given the role of obesity as a risk factor for CHD, it is proposed that increased toxic metal accumulation in obesity may promote further development of cardiovascular diseases.

Genetic Polymorphisms of NLRP3 (rs4612666) and CARD8 (rs2043211) in Periodontitis and Cardiovascular Diseases.

Simple SummaryResearchers have been studying the relationship between gum disease and cardiac health for decades. Gum disease develops when a sticky bacterial biofilm known as plaque forms around the teeth. The bacterial plaque and its toxic byproducts sometimes migrate inside the blood vessels and get lodged in the arterial wall known as atheroma which is found to be a leading cause for heart disease. Various host products are seen to be elevated in the human body as the result of the inflammation. We focused on the relationship between the two biomolecules namely NLRP3 (rs4612666) and CARD8 (rs2043211) with gum and heart disease. Seventy patients were selected for the study and were divided into two groups. Group I consisted of patients with gum diseases only and Group 2 consisted of patients with both gum and heart disease. On analysis, certain factors such as age, cholesterol levels and poor oral health were observed to be higher in patients with both gum and heart disease. The dental plaque from the teeth and the blood drawn from these patients were collected for the testing of the above biomolecules. These were found to be higher in patients with both gum and the heart diseases. Thus, the higher levels of the above biomolecules indicated that patients with severe gum disease and poor oral health may develop a risk to develop heart problems in the future. Thus, early prevention of the oral diseases and gum ailments might reduce the risk of the future heart diseases.Background: The existing data show that inflammasomes play a role in periodontal disease pathogenesis. However, their role in the pathogenesis of periodontitis and coronary heart disease remains unclear. This study had the objective of assessing NLRP3 (rs4612666) and CARD8 (rs2043211) gene polymorphisms in dental plaque and blood of generalized chronic periodontitis (CP) patients in the presence and absence of coronary heart disease (CHD). Methods: A total of 70 subjects were divided into two groups, including CP and CP + CHD subjects. Demographic variables, periodontal, and cardiac parameters were recorded from both groups. Subgingival plaque and blood samples were obtained from both groups and were subjected to further molecular analysis for NLRP3 (rs4612666) and CARD8 (rs2043211) expression and allele change using conventional polymerase chain reaction (PCR) and gene sequencing (Sanger’s method). Results: Amongst the demographic variables, age, and monthly income were statistically significant between the two groups. Plaque index (PI), clinical attachment level (CAL), high-density lipoprotein (HDL), and low density-lipoprotein (LDL) exhibited statistically significant levels between the two groups. NLRP3 (rs4612666) and CARD8 (rs2043211) genes showed a statistically significant association of allele change (frequency) among the groups. In general, when all of the parameters were compared to the allele change of the genes, statistically significant relationships were found between the two groups. Conclusions: The present study expressed an allele change of the investigated genes which could profoundly affect the pathobiology of the two diseases under investigation.

Knockdown of lncRNA ENST00000609755.1 Confers Protection Against Early oxLDL-Induced Coronary Heart Disease.

Background: This study investigated the association between long non-coding RNAs (lncRNAs) and coronary heart disease (CHD) and further elucidated the potential biological roles of lncRNAs in CHD pathogenesis.Methods: A case-control study (590 patients and 590 controls) was conducted from February 2017 and March 2019 in Fuzhou, China. Environmental factors were investigated using questionnaires and physical examinations. Five representative lncRNAs were screened using lncRNA microarray (peripheral blood in 5 cases and 5 controls) and further verified by quantitative real-time polymerase chain reaction (peripheral blood leukocyte in 100 cases and 100 controls). Oxidized low-density lipoprotein (oxLDL) was used to induce a human coronary artery endothelial cell (HCAECs) injury model, and loss of function was used to elucidate the role of lncRNA ENST00000609755.1 (lnc-MICALL2-2) in oxLDL-induced HCAECs injury.Results: A total of 320 lncRNAs were found dysregulated in CHD patients (fold change> 2, p < 0.05). The results of a discovery microarray, population verification and HCAEC experiments suggested the lnc-MICALL2-2 is upregulated in CHD subjects and in an oxLDL-induced HCAECs injury model. Conversely, lnc-MICALL2-2 inhibition in vitro attenuated the effects of oxLDL on HCAECs morphology, proliferation, and apoptosis.Conclusion: Elevated expression of lnc-MICALL2-2 is an independent risk factor for CHD, and knockdown subsequently confers protection against early pathological processes of oxLDL-induced CHD.

Serum Galectin-3 and Subsequent Risk of Coronary Heart Disease in Subjects With Childhood-Onset Type 1 Diabetes: A Cohort Study.

OBJECTIVETo study whether serum galectin-3 and other biomarkers of inflammation predict coronary heart disease (CHD) in subjects with long-standing childhood-onset type 1 diabetes.RESEARCH DESIGN AND METHODSA population-based nationwide cohort of 299 subjects with type 1 diabetes diagnosed in Norway at <15 years of age during 1973–1982 was examined in 2002–2003 at a mean age of 33 years (range 21–44), with mean diabetes duration of 24 years (range 19–30). Subjects were followed through 31 December 2017 for their first CHD event registered by a hospitalization or cause of death using nationwide registries. Stored serum samples were available for 296 subjects and analyzed for interleukin-6 (IL-6), IL-6 receptor, IL-18, hs-CRP, matrix metalloproteinase-9, tissue inhibitor of metalloproteinase-1 (TIMP-1), galectin-3, and high-sensitivity troponin T. Adjusted hazard ratios (aHRs) for CHD per SD increase in biomarker were estimated using Cox regression.RESULTSOf 295 subjects, 40 (13.6%) had a documented CHD event during a mean follow-up of 14.4 years (range 0.5–16). IL-6 (aHR 1.32 [95% CI 1.07–1.63]), galectin-3 (aHR 1.44 [95% CI 1.09–1.80]), and TIMP-1 (aHR 1.37 [95% CI 1.04–1.81]) were significant predictors of CHD after adjustment for conventional risk factors.CONCLUSIONSGalectin-3 was significantly associated with future CHD in subjects with type 1 diabetes, and if the results are replicated in larger studies, it may aid in prediction together with conventional risk factors for CHD.

Association of Apolipoprotein E Gene Polymorphism with Ischemic Stroke in Coronary Heart Disease Patients Treated with Medium-intensity Statins.

ObjectiveTo study the association of apolipoprotein E(APOE) gene polymorphism with ischemic stroke (IS) in coronary heart disease (CHD) patients treated with medium-intensity statins.MethodsThe retrospective study was performed on 662 samples including 169 CHD subjects complicated with IS, 296 subjects with CHD, and 197 control subjects. The APOE gene was obtained from case files. Univariable and multivariable logistic regression analyses were utilized to recognize the possible risks of CHD and IS.ResultsThe frequency of ε3-ε4 genotype was increased in the CHD group (p=0.013) and CHD-IS group (p=0.001), the frequency of ε4 allele was also increased in the CHD group (p=0.047) and the CHD-IS group (p=0.009) compared with control group. ε3-ε4 genotype was the independent risk for CHD and CHD-IS after adjusting for traditional risk factors with adjusted odds ratio (AOR) 2.210, 95%CI: 1.263–3.867, p=0.005) and (AOR 2.794, 95%CI: 1.539–5.072, p=0.002). The ε4 allele was also significantly associated with CHD (AOR 2.126, 95%CI: 1.265–3.575,=0.004) and CHD-IS (AOR 2.740, 95%CI: 1.569–4.784, p=0.001).ConclusionThese results demonstrated that ε4 allele influenced the development of CHD with or without IS, especially for the genotype of ε3-ε4. CHD patients carrying the ε3-ε4 genotype and the ε4 allele were significantly associated with the incidence of IS, even if medium-intensity statins had been used.

The Association of Small Dense Low-Density Lipoprotein Cholesterol and Coronary Heart Disease in Subjects at High Cardiovascular Risk.

Aim: The present study aims to investigate the association between serum small dense low-density lipoprotein (sdLDL) cholesterol level and the development of coronary heart disease (CHD) in subjects at high cardiovascular risk.Methods: A total of 3,080 participants without prior cardiovascular disease (CVD), aged ≥ 40 years, were followed up for a median of 8.3 years, which were divided into two groups, those with serum sdLDL cholesterol levels of < 35 mg/dL or ≥ 35 mg/dL. Then, subjects were stratified by the status of diabetes, CVD-related comorbidities (defined as the presence of diabetes, chronic kidney disease, or peripheral artery disease), and the CVD risk assessment according to the Japan Atherosclerosis Society Guidelines. The hazard ratios (HRs) and 95% confidence intervals (CIs) were computed using a Cox proportional hazards model.Results: During the follow-up, 79 subjects developed CHD. The risk for incident CHD was higher in subjects with serum sdLDL cholesterol of ≥ 35 mg/dL than those with sdLDL cholesterol of < 35 mg/dL (HR 2.09, 95%CI 1.26–3.45) after adjusting for traditional risk factors. In the subgroup analyses, the multivariable-adjusted HR for incident CHD increased significantly in those with serum sdLDL cholesterol of ≥ 35 mg/dL among subjects with diabetes (HR 2.76, 95%CI 1.09–7.01), subjects with CVD-related comorbidities (HR 2.60, 95%CI 1.21–5.58), and high-risk category defined as the presence of CVD-related comorbidities or a Suita score of ≥ 56 points (HR 1.93, 95%CI 1.02–3.65).Conclusions: Elevated serum sdLDL cholesterol was associated with the development of CHD even in subjects at high cardiovascular risk.

Possible Use of Blood Tryptophan Metabolites as Biomarkers for Coronary Heart Disease in Sudden Unexpected Death.

Coronary heart disease (CHD) is the major cause of death in sudden unexpected death (SUD) cases. Tryptophan (TRP) and its metabolites are correlated with the CHD patient but less studies in the SUD. The aim of this study was to evaluate the relationship of TRP and its metabolites with the CHD in the SUD cases. Blood samples and heart tissues were collected from CHD subjects (n = 31) and the control group (n = 72). Levels of kynurenine (KYN), kynurenic acid (KYA), xanthurenic acid (XAN), 3-hydroxyanthranillic acid (HAA), quinolinic acid (QA), picolinic acid (PA) and 5-hydroxyindoleacetic acid (HIAA) were determined by HPLC-DAD. A severity of heart occlusion was categorized into four groups, and the relationship was measured with the TRP metabolites. The HIAA and The KYN levels significantly differed (p < 0.01) between the CHD group and the control group. Lower levels of QA/XAN, PA/KA, HAA/XAN, KYN/XAN and KYN/TRP were found in the CHD group. However, PA/HAA, PA/HIAA, PA/KYN and XAN/KA values in the CHD group were higher than the control group (p < 0.05). This study revealed that the values of PA/KA and PA/HAA provided better choices for a CHD biomarker in postmortem bodies.

Mean ferritin level comparison in patients with coronary heart disease and control subjects.

To determine and compare Mean ferritin level in stable diagnosed coronary heart disease and healthy control groups. Study Design: Analytic (case control study). Setting: Department of Hematology, Sheikhs Zayed Hospital, Lahore. Period: Six months (10th October, 2015 to 11th April, 2016). Material &amp; Methods: Serum iron, total iron binding capacity (TIBC), transferrin saturation (TSAT) and serum ferritin level were measured in 75 cases with coronary heart disease(CHD) and 75 controls (health individuals). All collected information was entered into SPSS version 20. Quantitative variables like age and serum ferritin were presented in the form of Mean ± SD for both cases and control. Qualitative variables like gender was presented in the form of frequency and percentages. T-test was used to compare the mean serum ferritin level between cases and controls. p≤ 0.05 was considered statistically significant. Results: Out of 75 patients, 62(82.7%) were males and 13 (17.3%) females .Serum ferritin levels were substantially raised in patient with CHD versus control subjects {1119±272 ng/l versus 82±139 ng/l (p&lt;.001)}. Total iron binding capacity (TIBC) was lower in patient with CHD {274±102µl versus 355±95 µmol/l (p&lt;.000)} compared to healthy subjects. Conclusion: The mean ferritin level in both groups showed statistically significant difference of serum ferritin level in patient with chronic heart disease and control group and serum ferritin level was considerably higher in patients.

Circulating miR-30c as a predictive biomarker of type 2 diabetes mellitus with coronary heart disease by regulating PAI-1/VN interactions

AimsType 2 diabetes mellitus (DM2) is associated with coronary heart disease (CHD) and is characterized by high levels of plasminogen activator inhibitor (PAI)-1. Circulating microRNAs have been reported as potential diagnostic biomarkers for DM2 and CHD. However, the underlying mechanisms have largely remained unclear. Main methodsThe changes of circulating miR-30c, PAI-1 and vitronetin (VN) in plasma from CHD, noncomplicated (NC) + DM2, CHD + DM2 subjects and control individuals were assessed by quantitative reverse transcription PCR (qRT-PCR) and ELISA assays, respectively. The effects of miR-30c on VN expression by targeting PAI-1 were assessed in vitro SMC and in ex vivo plasma, using bioinformatic analysis, miRNA transfection, luciferase assays, qRT-PCR and western blot, respectively. Key findingsWe found that decreased circulating miR-30c was negatively correlated with the severity of coronary lesions and the resulting elevated PAI-1 and VN levels. Circulating miR-30c significantly distinguished between patients with CHD + DM2, NC + DM2, CHD and control subjects, and that were significantly associated with certain risk factors for progression from a normal individual to one with CHD + DM2. Furthermore, we also showed that miR-30c plays a previously unrecognized role in regulating the expression of VN levels via regulating PAI-1 levels in vitro SMC and in ex vivo plasma. SignificanceThese findings provide a novel regulatory mechanism of miR-30c in regulating PAI-1/VN interactions and that may serve as a diagnostic biomarker of DM2 that is complicated with CHD.

Efficacy And Safety Of P2Y12 Inhibitors In Subjects With Coronary Heart Disease Treated With Dual Anti-Platelet Therapy - A Sex-Specific Systematic Review And Meta-Analysis

Background and Aims: A general consensus towards sex-specific differences in the clinical treatment of coronary heart disease (CHD) with dual antiplatelet therapy (DAPT) remains uncertain. The objective of this study was to investigate the efficacy and safety of DAPT in CHD subjects with systematic review and a sex-specific meta-analysis.