165 results on '"Rui-Xia Xu"'
Search Results
2. A review of pre-implantation genetic testing technologies and applications
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Ren-Qian Du, Ding-Ding Zhao, Kai Kang, Fan Wang, Rui-Xia Xu, Chun-Li Chi, Ling-Yin Kong, and Bo Liang
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Reproductive Medicine ,Obstetrics and Gynecology - Published
- 2022
3. Sodium Ferulate Inhibits Rat Cardiomyocyte Hypertrophy Induced by Angiotensin II Through Enhancement of Endothelial Nitric Oxide Synthase/Nitric Oxide/Cyclic Guanosine Monophosphate Signaling Pathway
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Min, Luo, Hui-Cai, Lin, Zhao-Qin, Wen, Pan-Pan, Chen, Wan-Lan, Shi, Ying-Ying, Li, Yang, Gao, Shang-Fu, Xu, Rui-Xia, Xu, Qi-Hai, Gong, and Jiang, Deng
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Pharmacology ,Coumaric Acids ,Nitric Oxide Synthase Type III ,Angiotensin II ,Guanosine Monophosphate ,Cardiomegaly ,Esters ,Nitric Oxide ,Rats ,Rats, Sprague-Dawley ,Animals ,Myocytes, Cardiac ,Cardiology and Cardiovascular Medicine ,Cyclic GMP ,Signal Transduction - Abstract
Sodium ferulate (SF) is the sodium salt of ferulic acid, which is one of the effective components of Angelica sinensis and Lignsticum chuanxiong , and plays an important role in protecting the cardiovascular system. In this study, myocardial hypertrophy was induced by angiotensin II 0.1 μmol/L in neonatal Sprague-Dawley rat ventricular myocytes. Nine groups were designed, that is, normal, normal administration, model, L-arginine (L-arg 1000 μmol/L), SF (50, 100, 200 μmol/L) group, and N G -nitro-L-arg-methyl ester 1500 μmol/L combined with SF 200 μmol/L or L-arg 1000 μmol/L group, respectively. Cardiomyocyte hypertrophy was confirmed by observing histological changes and measurements of cell diameter, protein content and atrial natriuretic factor, and β-myosin heavy chain levels of the cells. Notably, SF could inhibit significantly myocardial hypertrophy of neonatal rat cardiomyocytes in a concentration-dependent manner without producing cytotoxicity, and the levels of nitric oxide, NO synthase (NOS), endothelial NOS, and cyclic guanosine monophosphate were increased, but the level of cyclic adenosine monophosphate was decreased in cardiomyocytes. Simultaneously, levels of protein kinase C beta, Raf-1, and extracellular regulated protein kinase 1/2 (ERK1/2) were downregulated, whereas levels of mitogen-activated protein kinase phosphatase-1 were significantly upregulated. All the beneficial effects of SF were blunted by N G -nitro-L-arg-methyl ester. Overall, these findings reveal that SF can inhibit angiotensin II-induced myocardial hypertrophy of neonatal rat cardiomyocytes, which is closely related to activation of endothelial NOS/NO/cyclic guanosine monophosphate, and inhibition of protein kinase C and mitogen-activated protein kinase signaling pathways.
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- 2022
4. NAFLD fibrosis score is correlated with PCSK9 and improves outcome prediction of PCSK9 in patients with chest pain: a cohort study
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Jia Peng, Ming-Ming Liu, Jing-Lu Jin, Ye-Xuan Cao, Yuan-Lin Guo, Na-Qiong Wu, Cheng-Gang Zhu, Qian Dong, Jing Sun, Rui-Xia Xu, and Jian-Jun Li
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Liver Cirrhosis ,Male ,Chest Pain ,Cardiovascular outcomes ,RC620-627 ,Endocrinology, Diabetes and Metabolism ,Research ,Biochemistry (medical) ,Clinical Biochemistry ,Patient Acuity ,Proprotein convertase subtilisin/kexin type 9 ,Middle Aged ,Prognosis ,Non-alcoholic fatty liver disease fibrosis score ,Endocrinology ,Cardiovascular Diseases ,Non-alcoholic Fatty Liver Disease ,Risk Factors ,Humans ,Female ,Proprotein Convertase 9 ,Nutritional diseases. Deficiency diseases - Abstract
Background The risk of liver fibrosis in non-alcoholic fatty liver disease (NAFLD) can be easily evaluated by noninvasive scoring systems, of which the NAFLD fibrosis score (NFS) is the most commonly used. Proprotein convertase subtilisin/kexin type 9 (PCSK9), a new predictor of cardiovascular events, has been reported to be associated with cardiovascular outcomes and NAFLD. However, the relationship of NFS with PCSK9 and their prognostic abilities in cardiovascular risks are unknown. Methods A total of 2008 hospitalized subjects who had chest pain without lipid-lowering therapy were consecutively included. Baseline clinical data were collected, and the NFS was calculated. The circulating PCSK9 concentration was determined by enzyme immunoassay. The major adverse cardiovascular event (MACE) occurrences were recorded in the follow-up period. Associations of PCSK9 concentration with NFS were examined. All of the participants were categorized into three groups according to NFS levels and were further stratified by PCSK9 tertiles to evaluate the MACEs. Results 158 (7.87%) MACEs were observed during a mean of 3.2 years of follow-up. NFS levels were independently related to higher PCSK9 levels according to multivariable linear regression analysis. Furthermore, elevated PCSK9 and NFS concentrations were respectively associated with increased MACE incidence in multivariable Cox regression models. When combining NFS status with PCSK9 tertiles as a stratifying factor, patients with intermediate-high NFS and high PCSK9 levels had higher risks of events than those with low NFS and low PCSK9 levels. Conclusions This study revealed for the first time that NFS is positively related to PCSK9 and that the combination of NFS and PCSK9 greatly increased the risk of MACEs in patients with chest pain, providing a potential link between NFS and PCSK9 for predicting cardiovascular events.
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- 2022
5. Systematic exploration of transcriptional responses of interspecies interaction between Karenia mikimotoi and Prorocentrum shikokuense
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Jian-Wei Zheng, Guo-Hui He, Rui-Xia Xu, Xiang Wang, Hong-Ye Li, and Wei-Dong Yang
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Plant Science ,Aquatic Science - Published
- 2023
6. Metabolic-associated fatty liver disease and major adverse cardiac events in patients with chronic coronary syndrome: a matched case–control study
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Ying Gao, Ye-Xuan Cao, Qian Dong, Jian-Jun Li, Rui-Xia Xu, Jing-Lu Jin, Cheng-Gang Zhu, Na-Qiong Wu, Ming-Hua Zheng, Yuan-Lin Guo, and Hui-Hui Liu
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medicine.medical_specialty ,Hepatology ,Proportional hazards model ,business.industry ,Fatty liver ,Case-control study ,medicine.disease ,Coronary artery disease ,Non-alcoholic Fatty Liver Disease ,Case-Control Studies ,Internal medicine ,Nonalcoholic fatty liver disease ,medicine ,Humans ,cardiovascular diseases ,Risk factor ,business ,Survival rate - Abstract
A consensus of experts suggests that nonalcoholic fatty liver disease (NAFLD) does not appropriately reflect current knowledge and metabolic-associated fatty liver disease (MAFLD) is supposed to be a more suitable overarching concept. However, the association of MAFLD with cardiovascular outcomes in patients with coronary artery disease has not been examined yet. Thus, this study aimed to assess the impact of MAFLD on major adverse cardiac events (MACEs) in patients with chronic coronary syndrome (CCS). This study included 3306 patients with CCS who were diagnosed with MAFLD. Controls without MAFLD were matched (1:1) to cases by age and gender. All participants were followed up for the occurrence of MACEs. Finally, the association between MAFLD and the risk of MACEs was assessed. During an average of 55.09 ± 19.92 months follow-up, 376 and 248 MACEs were observed in MAFLD and control groups, respectively. When compared with controls, Kaplan–Meier analysis showed that patients with MAFLD had significantly lower event-free survival rate and multivariate Cox regression analysis further revealed that MAFLD group had significantly increased MACEs risk (both p
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- 2021
7. Association between remnant cholesterol and verbal learning and memory function in the elderly in the US
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Ying-Yi, Xie, Liang, Zhao, Li-Jian, Gao, Rui-Xia, Xu, Ying, Gao, Ke-Fei, Dou, Yuan-Lin, Guo, and Yong-Ming, He
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Cognition ,Cholesterol ,Endocrinology ,Endocrinology, Diabetes and Metabolism ,Biochemistry (medical) ,Clinical Biochemistry ,Humans ,Cognitive Dysfunction ,Verbal Learning ,Nutrition Surveys ,Aged - Abstract
Background The relationship between remnant cholesterol (RC) and atherosclerotic cardiovascular risk has been given increasing attention in recent years. However, its association with verbal learning and memory performance has not been reported. Methods Data were extracted from the National Health and Nutrition Examination Survey (NHANES) 2011–2014 database. Participants aged ≥60 years with available fasting lipid data were included. Verbal learning and memory performance were evaluated using the Consortium to Establish a Registry for Alzheimer’s Disease Word List Memory Task (CERAD-WL) subtest. The CERAD total score was calculated as the mean of three immediate recalls and a delayed recall. RC was calculated as total cholesterol (TC) minus the sum of low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C). Multivariate ordinal logistic regression was performed to evaluate the association between RC, as well as its derived marker, the TC/RC ratio, and age-stratified quartiles of the CERAD total score. Results A total of 1377 participants were analysed. On a continuous scale, per 1 mmol/L increase in RC and per 1 unit increase in the TC/RC ratio were associated with multivariable adjusted odds ratios (95% CI) of 0.74 (0.58–0.94) and 1.45 (1.13–1.87), respectively, for having a CERAD total score in a higher quartile. On a categorical scale, higher RC quartiles were associated with a CERAD total score in a lower quartile; in contrast, the higher TC/RC quartile was associated with a CERAD total score in a higher quartile (all P for trend Conclusions The current study suggests that lower RC levels and a higher TC/RC ratio are associated with better verbal learning and memory function, which indicates that lowering RC levels could be beneficial for preventing cognitive impairment in elderly individuals. Further research is needed to validate the causal roles of RC and the TC/RC ratio in cognition.
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- 2022
8. Hypertension and clinical outcomes in patients with familial hypercholesterolemia
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Ming-Ming Liu, Jia Peng, Rui-Xia Xu, Yuan-Lin Guo, Cheng-Gang Zhu, Na-Qiong Wu, and Jian-Jun Li
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Hyperlipoproteinemia Type II ,Physiology ,Risk Factors ,Hypertension ,Internal Medicine ,Coronary Stenosis ,Humans ,Coronary Artery Disease ,Cardiology and Cardiovascular Medicine - Abstract
Hypertension is a known risk factor for cardiovascular disease; however, its impact on clinical outcomes in patients with heterozygous familial hypercholesterolemia (HeFH) is unclear. Hence, we aimed to investigate the effects of hypertension on severity of coronary artery atherosclerosis and cardiovascular outcomes in patients with HeFH.A total of 480 patients with clinical or molecular diagnosis of definite or probable familial hypercholesterolemia according to Dutch Lipid Clinic Network criteria (DLCN score ≥6) were included in the study. They were divided into the two groups according to their blood pressure status: hypertension group and normotension group. The severity of coronary stenosis was assessed by a number of diseased vessels, Gensini, Syntax, and Jeopardy scores. All individuals were followed up for cardiovascular events (CVEs) and cox proportion hazard models were used to evaluate the association of hypertension with cardiovascular outcomes.Patients with hypertension had more severe coronary stenosis and a higher incidence of CVEs compared with the ones with normotension (log-rank P 0.001). After multivariable adjustment, there was a 2.1-fold increased risk of CVEs among patients with hypertension compared with patients with normotension (adjusted hazard ratio 2.06, 95% confidential interval 1.17-3.65, P 0.01). Hypertension control status was also associated with CVEs even after adjustment of multiple variables. However, no combined effect on increased cardiovascular risks was detected in this HeFH cohort.In patients with HeFH, hypertension is an independent risk factor for cardiovascular events. Moreover, blood pressure control status in patients with hypertension is associated with the worse outcomes.
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- 2022
9. SORBS2 as a molecular target for atherosclerosis in patients with familial hypercholesterolemia
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Ming-Ming Liu, Jia Peng, Yuan-Lin Guo, Cheng-Gang Zhu, Na-Qiong Wu, Rui-Xia Xu, Qian Dong, Chuan-Jue Cui, and Jian-Jun Li
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Inflammation ,History ,Polymers and Plastics ,Inflammasomes ,Hypercholesterolemia ,RNA-Binding Proteins ,General Medicine ,Atherosclerosis ,Industrial and Manufacturing Engineering ,General Biochemistry, Genetics and Molecular Biology ,Hyperlipoproteinemia Type II ,Lipoproteins, LDL ,NLR Family, Pyrin Domain-Containing 3 Protein ,Humans ,lipids (amino acids, peptides, and proteins) ,Business and International Management ,Reactive Oxygen Species ,Adaptor Proteins, Signal Transducing - Abstract
Background Familial hypercholesterolemia (FH) is a metabolic disease in which patients are prone to develop premature atherosclerosis (AS). Sorbin and SH3 Domain Containing 2 (SORBS2) is known to play a role in coronary heart disease (CHD). However, the mechanism underlying SORBS2 involvement in the development of hypercholesterolemia remains unknown. Here, we investigated the effects of SORBS2 on inflammation and foam cell formation and its underlying mechanisms. Methods Using Bioinformatics analysis, we established that SORBS2 is upregulated in patients with FH. Circulating concentrations of SORBS2 were measured using ELISA kit (n = 30). The association between circulating SORBS2 levels and inflammatory factors or lipid indexes were conducted using Spearman correlation analysis. We further conducted in vitro experiments that the expression of SORBS2 were analyzed, and SORBS2 siRNA were transfected into oxidized LDL (OxLDL)-induced macrophages, followed by western blot and immunofluorescence. Results Circulating SORBS2 levels were positively associated with inflammatory factors and lipid indexes. We also observed that high in vitro expression of SORBS2 in OxLDL-induced macrophages. After SORBS2 silencing, Nod like receptor family pyrin domain-containing 3 protein(NLRP3)-Caspase1 activation and NF-κB activation were attenuated, and secretion of pro-inflammatory cytokines (IL-1β and IL-18) was decreased. Moreover, SORBS2 silencing blocked reactive oxygen species (ROS) production and lipid accumulation, and promoted cholesterol efflux through ABCG1-PPARγ pathway. Conclusions SORBS2 regulates lipid-induced inflammation and foam cell formation, and is a potential therapeutic target for hypercholesterolemia.
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- 2022
10. Current Guideline Risk Stratification and Cardiovascular Outcomes in Chinese Patients Suffered From Atherosclerotic Cardiovascular Disease
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Sha, Li, Hui-Hui, Liu, Yuan-Lin, Guo, Cheng-Gang, Zhu, Na-Qiong, Wu, Rui-Xia, Xu, Qian, Dong, Jie, Qian, Ke-Fei, Dou, and Jian-Jun, Li
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China ,Cardiovascular Diseases ,Risk Factors ,Endocrinology, Diabetes and Metabolism ,Humans ,Atherosclerosis ,Risk Assessment - Abstract
Background and AimsHeterogeneity exists among patients with atherosclerotic cardiovascular disease (ASCVD) with regard to the risk of recurrent events. Current guidelines have definitely refined the disease and we aimed to examine the practicability in Chinese population.MethodsA cohort of 9944 patients with ASCVD was recruited. Recurrent events occurred during an average of 38.5 months’ follow-up were collected. The respective and combinative roles of major ASCVD (mASCVD) events and high-risk conditions, being defined by 2018 AHA/ACC guideline, in coronary severity and outcome were studied.ResultsThe number of high-risk conditions was increased with increasing number of mASCVD events (1.95 ± 1.08 vs. 2.16 ± 1.10 vs. 2.42 ± 1.22). Trends toward the higher to the highest frequency of multi-vessel coronary lesions were found in patients with 1- (71.1%) or ≥2 mASCVD events (82.8%) when compared to those without (67.9%) and in patients with 2- (70.5%) or ≥3 high-risk conditions (77.4%) when compared to those with 0-1 high-risk condition (61.9%). The survival rate was decreased by 6.2% between none- and ≥2 mASCVD events or by 3.5% between 0-1 and ≥3 high-risk conditions. Interestingly, diabetes was independently associated with outcome in patients with 1- [1.54(1.06-2.24)] and ≥2 mASCVD events [1.71(1.03-2.84)]. The positive predictive values were increased among groups with number of mASCVD event increasing (1.10 vs. 1.54 vs. 1.71).ConclusionPropitious refinement of ASCVD might be reasonable to improve the survival. Concomitant diabetes was differently associated with the incremental risk among different ASCVD categories, suggesting the need of an appropriate estimate rather than a ‘blanket’ approach in risk stratification.
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- 2022
11. Liver fibrosis scores and coronary atherosclerosis: novel findings in patients with stable coronary artery disease
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Hui-Wen Zhang, Ye-Xuan Cao, Jian-Jun Li, Yan-Fang Li, Yuan-Lin Guo, Yan Zhang, Qian Dong, Jing Sun, Ying Gao, Rui-Xia Xu, Geng Liu, Cheng-Gang Zhu, Na-Qiong Wu, Jing-Lu Jin, Chuan-Jue Cui, Hui-Hui Liu, and Qi Hua
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Liver Cirrhosis ,medicine.medical_specialty ,Coronary Artery Disease ,Severity of Illness Index ,Cohort Studies ,Coronary artery disease ,03 medical and health sciences ,0302 clinical medicine ,Non-alcoholic Fatty Liver Disease ,Internal medicine ,Humans ,Medicine ,Risk factor ,Coronary atherosclerosis ,Hepatology ,business.industry ,Proportional hazards model ,Hazard ratio ,Fatty liver ,Atherosclerosis ,medicine.disease ,Confidence interval ,030220 oncology & carcinogenesis ,Cohort ,Cardiology ,030211 gastroenterology & hepatology ,business - Abstract
Although non-invasive liver fibrosis scores (LFSs) have already been considered as effective tools for estimating cardiovascular risk, their roles in predicting disease severity and cardiovascular event (CVEs) in patients with stable coronary artery disease (CAD) are not comprehensively evaluated. The aim of the present study was to investigate whether non-alcoholic fatty liver disease fibrosis score (NAFLD-FS) and fibrosis-4 (FIB-4) are associated with CVEs in a large cohort with long-term follow-up. A cohort of 5143 patients with angiography-proven stable CAD were consecutively enrolled and followed up for CVEs. The degree of coronary severity was assessed using the number of diseased vessels, Gensini, Syntax, and Jeopardy scores. The predictive values of NAFLD-FS and FIB-4 scores to coronary severity, coronary calcification (CAC), and CVEs were assessed, respectively. During a median follow-up of 7 years, 435 CVEs were recorded. Both NAFLD-FS and FIB-4 were predictors for the presence of CAC. The degree of coronary stenosis was significantly higher in high NAFLD-FS categories while FIB-4 was only positively associated with the number of diseased vessels and Gensini score. In Kaplan–Meier analysis, the patients with intermediate and high NAFLD-FS and FIB-4 had higher risk of CVEs and cardiovascular mortality. In multivariate Cox regression analysis, NAFLD-FS and FIB-4 were independently associated with CVEs [hazard ratio (95% confidence interval): 1.150 (1.063–1.244), p
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- 2021
12. Impact of liver fibrosis score on prognosis in patients with previous myocardial infarction: A prospective cohort study
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Na-Qiong Wu, Hui-Hui Liu, Jing-Lu Jin, Hui-Wen Zhang, Yan Zhang, Jian-Jun Li, Qian Dong, Jing Sun, Yuan-Lin Guo, Cheng-Gang Zhu, Rui-Xia Xu, Yexuan Cao, Ying Gao, and Meng Zhang
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Liver Cirrhosis ,medicine.medical_specialty ,Myocardial Infarction ,Liver fibrosis score ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Internal medicine ,Humans ,Medicine ,In patient ,Prospective Studies ,Myocardial infarction ,Prospective cohort study ,Hepatology ,business.industry ,Proportional hazards model ,Hazard ratio ,Fatty liver ,Prognosis ,medicine.disease ,Confidence interval ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,business - Abstract
Background & aims Liver fibrosis score (LFS) has been used for predicting the cardiovascular outcomes (CVOs) in diverse populations. However, the association of LFS with CVOs in patients with previous myocardial infarction (MI) remains undetermined. We aimed to examine the prognostic value of LFS in patients with prior MI in a prospective cohort. Methods A total of 3718 patients with previous MI were consecutively enrolled from March 2009 to January 2019. Five LFSs including the fibrosis-4 (FIB-4) score, non-alcohol fatty liver disease fibrosis score (NFS), Forns score, HUI score and BARD score were used. The CVOs covered major adverse cardiac event (MACEs), cardiovascular mortality and all-cause mortality. Cox proportional hazards model was used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs). Results During a mean follow-up of 47.4 ± 24.8 months, 431 (11.6%) MACEs occurred. Kaplan-Meier analysis demonstrated that higher LFSs resulted in a significantly higher probability of CVOs. Compared to the lowest score group, multivariable-adjusted HRs (95% CIs) of the highest group of FIB-4, NFS, Forns score, HUI score and BARD score were 1.75 (1.32-2.33), 2.37 (1.70-3.33), 2.44 (1.61-3.73), 1.58 (1.16-2.14) and 1.27 (1.03-1.57) respectively. These LFSs were also independent predictors of cardiovascular mortality and all-cause mortality. Similar results were observed across subgroups analysis. The addition of LFSs to a prediction model significantly increased the C-statistic for CVOs. Conclusions The present study firstly demonstrated that LFS could be used as a risk stratification tool for predicting CVOs in patients with previous MI, which should be evaluated further.
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- 2021
13. Diallyl disulfide improves lipid metabolism by inhibiting PCSK9 expression and increasing LDL uptake via PI3K/Akt-SREBP2 pathway in HepG2 cells
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Rui-Xia Xu, Yue Zhang, Liang Li, Jun Wang, Jian-Jun Li, Xian-Chang Sun, Chun-Yan Ma, Ya-Ru Wu, and Hui-Lin Qu
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Serine Proteinase Inhibitors ,Endocrinology, Diabetes and Metabolism ,Atorvastatin ,Medicine (miscellaneous) ,030209 endocrinology & metabolism ,030204 cardiovascular system & hematology ,Pharmacology ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Western blot ,medicine ,Humans ,Disulfides ,Protein kinase B ,PI3K/AKT/mTOR pathway ,Hypolipidemic Agents ,Nutrition and Dietetics ,medicine.diagnostic_test ,Diallyl disulfide ,PCSK9 Inhibitors ,Lipid metabolism ,Hep G2 Cells ,Allyl Compounds ,Lipoproteins, LDL ,Gene Expression Regulation ,chemistry ,LDL receptor ,Hepatocytes ,lipids (amino acids, peptides, and proteins) ,Phosphatidylinositol 3-Kinase ,Proprotein Convertase 9 ,Signal transduction ,Cardiology and Cardiovascular Medicine ,Proto-Oncogene Proteins c-akt ,Signal Transduction ,Sterol Regulatory Element Binding Protein 2 ,medicine.drug - Abstract
Background and aim Diallyl disulfide (DADS), a volatile sulfide extracted from garlic, has been suggested as a chemical of anti-atherosclerotic drugs, while its molecular mechanism for this benefit has not fully been understood. The aim of the present study was to investigate the effects of DADS on lipid metabolism and its potential mechanisms in HepG2 cells induced by lipopolysaccharides (LPS). Methods and results HepG2 cells were treated with LPS with or without different concentrations of DADS (0, 20, 40, 80, 160 μg/ml) for 24 h. The cell activity was detected by CCK8, and Dil-LDL uptake assay was used to examine the LDL uptake. Real-time PCR and Western blot were used to detect the expression of LDLR, PCSK9 SREBP2 and HMGCR. In addition, we examined the effect of the combination of DADS with atorvastatin on PCSK9 expression. The results showed that LPS significantly increased PCSK9 and SREBP2 expressions in a dose-dependent manner in HepG2 cells. DADS attenuated PCSK9, SREBP2 and HMGCR expressions and up-regulated the expression of LDLR. Moreover, DADS reversed the expressions of PCSK9, SREBP2, HMGCR and LDLR induced by LPS and DADS could promote the LDL uptake in HepG2 cells. Furthermore, DADS decreased the expression of PCSK9 by activating the PI3K/Akt-SREBP2 signal pathway. Notably, DADS could reduce PCSK9 expression induced by atorvastatin in HepG2 cells. Conclusion DADS could significantly attenuated PCSK9 expression in a dose-dependent manner induced by LPS and increased the LDLR expression in HepG2 cells, which was associated with the activation of PI3K/Akt-SREBP2 signaling pathway.
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- 2021
14. Synergistic effect of the commonest residual risk factors, remnant cholesterol, lipoprotein(a), and inflammation, on prognosis of statin-treated patients with chronic coronary syndrome
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Hui-Hui Liu, Yuan-Lin Guo, Cheng-Gang Zhu, Na-Qiong Wu, Ying Gao, Rui-Xia Xu, Qian Dong, Jie Qian, Ke-Fei Dou, and Jian-Jun Li
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Inflammation ,C-Reactive Protein ,Risk Factors ,Disease Progression ,Humans ,General Medicine ,Cholesterol, LDL ,Syndrome ,Hydroxymethylglutaryl-CoA Reductase Inhibitors ,Prognosis ,General Biochemistry, Genetics and Molecular Biology ,Lipoprotein(a) - Abstract
BackgroundCurrently, remnant cholesterol (RC), lipoprotein(a) [Lp(a)], and inflammation are considered the principal residual cardiovascular risk (RCVR) factors. This study sought to evaluate the combined impact of RC, Lp(a), and inflammation on prognosis of statin-treated patients with chronic coronary syndrome (CCS), which has not been investigated.MethodsA total of 6839 patients with CCS were consecutively enrolled. Baseline RC, Lp(a), and high-sensitivity C-reactive protein (hsCRP) concentrations were measured and their medians were used for categorizations. All patients were followed for the major adverse cardiovascular events (MACEs), including cardiovascular death, non-fatal myocardial infarction, and stroke. The individual and combined effects of RC, Lp(a), and hsCRP on MACEs were examined and stratification analysis according to low-density lipoprotein cholesterol (LDL-C) was performed.ResultsOver an average of 54.93 ± 18.59 months follow-up, 462 MACEs were recorded. Multivariate Cox analysis showed that elevated RC and Lp(a) levels were significantly associated with an increased risk of MACEs, while high hsCRP levels were related to a slightly but non-significantly increased MACEs risk. Moreover, when participants were subgrouped according to RC, Lp(a), and hsCRP levels together, only High RC-High Lp(a)-High hsCRP group had significantly higher risk of MACEs [hazard ratio (HR) 1.99, 95% confidence interval (CI) 1.15–3.47] compared with the reference group (Low RC-Low Lp(a)-Low hsCRP), especially in patients with LDL-C ConclusionsThe combination of elevated levels of RC, Lp(a), and hsCRP potentiated the adverse effect on MACEs among statin-treated patients with CCS, suggesting that multiple RCVR factors assessment may be a better strategy to improve stratification in very-high risk population.
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- 2022
15. Lipoprotein(a) and Cardiovascular Outcomes in Patients With Coronary Artery Disease and Different Metabolic Phenotypes
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Jing-Lu Jin, Hui-Wen Zhang, Hui-Hui Liu, Cheng-Gang Zhu, Yuan-Lin Guo, Na-Qiong Wu, Rui-Xia Xu, Qian Dong, and Jian-Jun Li
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Cardiology and Cardiovascular Medicine - Abstract
BackgroundThe positive relationship between metabolic healthy obesity (MHO) and cardiovascular risk has been under debate in recent years. Previously, strong evidence supported the causal role of increased plasma lipoprotein(a) [Lp(a)] levels in cardiovascular disease (CVD). The current study aimed to investigate the different associations of Lp(a) and cardiovascular events (CVEs) in patients with coronary artery disease (CAD) and different metabolic phenotypes.MethodsA total of 5,089 patients who were angiography-proven CAD were consecutively included and followed up for CVEs. Obesity was defined as a body mass index (BMI) ≥25 kg/m2 according to Asia-specific BMI criteria. Patients were divided into four groups according to metabolic phenotypes, namely metabolically healthy/unhealthy non-obese and metabolically healthy/unhealthy obese [metabolically healthy non-obese (MHN), MHO, metabolically unhealthy non-obese (MUN), and metabolically unhealthy obesity (MUO)]. Comparisons of CAD severity and outcomes were performed among four groups. Cox regression analyses and cubic spline models were used to examine the relationship between Lp(a) and CVEs in patients with different metabolic phenotypes.ResultsDuring a median of 7.5 years’ follow-up, 540 (10.6%) CVEs occurred. MUN and MUO populations had more severe coronary stenosis than MHN ones, while no significant difference in the Gensini score (GS) was observed between MHN and MHO. Patients with MUN and MUO presented a higher risk of CVEs than patients with MHN (hazard ratio [HR]: 1.414, 95% CI: 1.024–1.953–1.556 and HR: 1.747, 95% CI: 1.295–1.363, p < 0.05). In subgroup analysis, restricted cubic spline models showed that there was no association between Lp(a) and CVEs in patients in MHN and MHO, while the MUN and MUO groups presented increasing associations between Lp(a) and CVEs and such association was stronger in the MUO group. In Cox regression analysis, Lp(a) >50 mg/dl was associated with a 2.032- and 2.206-fold higher risk of subsequent CVEs in the MUO and MUN subgroups, respectively.ConclusionAmong patients with angiography-proven stable CAD, Lp(a) had a more significant prognostic value in both MUO and MUN individuals regardless of obesity, suggesting the importance of screening for cardiovascular risk with Lp(a) in metabolically unhealthy patients.
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- 2022
16. Long-term prognostic utility of low-density lipoprotein (LDL) triglyceride in real-world patients with coronary artery disease and diabetes or prediabetes
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Raul D. Santos, Ying Gao, Cheng-Gang Zhu, Qi Hua, Hui-Wen Zhang, Xiao-Lin Li, Yan-Fang Li, Chuan-Jue Cui, Rui-Xia Xu, Jing-Lu Jin, Hui-Hui Liu, Qian Dong, Jing Sun, Ye-Xuan Cao, Geng Liu, Jian-Jun Li, Yuan-Lin Guo, Na-Qiong Wu, and Yan Zhang
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Male ,lcsh:Diseases of the circulatory (Cardiovascular) system ,Endocrinology, Diabetes and Metabolism ,Myocardial Infarction ,Coronary Artery Disease ,Coronary artery disease ,chemistry.chemical_compound ,Interquartile range ,Prediabetes ,Coronary Artery Bypass ,Prospective cohort study ,Original Investigation ,Hazard ratio ,Diabetes ,Middle Aged ,Prognosis ,Hospitalization ,Lipoproteins, LDL ,Cardiovascular Diseases ,Cardiology ,Female ,Pre-diabetes ,Cardiology and Cardiovascular Medicine ,LDL-TG ,medicine.medical_specialty ,Stable CAD ,Prediabetic State ,Percutaneous Coronary Intervention ,Internal medicine ,Diabetes mellitus ,medicine ,Diabetes Mellitus ,Humans ,Angina, Unstable ,MACEs ,Triglycerides ,Aged ,Glycated Hemoglobin ,Triglyceride ,business.industry ,Cholesterol, HDL ,Cholesterol, LDL ,medicine.disease ,Confidence interval ,chemistry ,Diabetes Mellitus, Type 2 ,lcsh:RC666-701 ,Case-Control Studies ,Thrombotic Stroke ,business - Abstract
Background Recent guidelines highlighted the association between atherosclerosis and triglyceride-enriched lipoproteins in patients with impaired glucose metabolism. However, evidence from prospective studies for long-term prognostic utility of low-density lipoprotein triglyceride (LDL-TG) in real-world patients with prediabetes (Pre-DM) or diabetes mellitus (DM) and coronary artery disease (CAD) is currently not available. The aim of the present study was to evaluate the impact of LDL-TG on major adverse cardiovascular events (MACEs) in patients with stable CAD under different glucose metabolism status. Methods A total of 4381 patients with CAD were consecutively enrolled and plasma LDL-TG level was measured by an automated homogeneous assay. They were categorized according to both status of glucose metabolism [DM, Pre-DM, normal glycaemia regulation (NGR)] and tertiles of LDL-TG. All subjects were followed up for the occurrence of MACEs. Results During a median of 5.1 (interquartile range 3.9 to 5.9) years’ follow-up, 507 (11.6%) MACEs occurred. Cubic spline models showed a significant association between LDL-TG and MACEs in DM and Pre-DM but not in NGR. When the combined effect of elevated LDL-TG and glucose disorders was considered for risk stratification, the medium tertile of LDL-TG plus DM, and the highest tertile of LDL-TG plus Pre-DM or plus DM subgroups were associated with significantly higher risk of MACEs after adjustment of confounders including triglyceride [hazard ratios (95% confidence intervals): 1.843 (1.149–2.955), 1.828 (1.165–2.867), 2.212 (1.396–3.507), all p Conclusions In this longitudinal cohort study on real-world practice, higher LDL-TG was associated with worse outcomes among Pre-DM and DM patients with stable CAD.
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- 2020
17. Prognostic utility of triglyceride-rich lipoprotein-related markers in patients with coronary artery disease
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Ying Gao, Raul D. Santos, Qi Hua, Yuan-Lin Guo, Na-Qiong Wu, Cheng-Gang Zhu, Hui-Wen Zhang, Ye-Xuan Cao, Yan-Fang Li, Yan Zhang, Rui-Xia Xu, Jian-Jun Li, Jing-Lu Jin, and Hui-Hui Liu
- Subjects
Male ,0301 basic medicine ,medicine.medical_specialty ,Triglyceride rich lipoprotein ,Lipoproteins ,apolipoprotein C-III ,triglyceride-rich lipoprotein-cholesterol ,Coronary Artery Disease ,QD415-436 ,030204 cardiovascular system & hematology ,Biochemistry ,Coronary artery disease ,03 medical and health sciences ,cardiovascular events ,0302 clinical medicine ,Endocrinology ,Unit increase ,Interquartile range ,Internal medicine ,medicine ,Humans ,In patient ,Triglycerides ,Research Articles ,Secondary prevention ,business.industry ,Cell Biology ,Middle Aged ,Prognosis ,medicine.disease ,030104 developmental biology ,Cardiology ,Female ,lipids (amino acids, peptides, and proteins) ,Statin therapy ,business ,Biomarkers ,remnant-like lipoprotein particle-cholesterol ,Lipoprotein - Abstract
TG-rich lipoprotein (TRL)-related biomarkers, including TRL-cholesterol (TRL-C), remnant-like lipoprotein particle-cholesterol (RLP-C), and apoC-III have been associated with atherosclerosis. However, their prognostic values have not been fully determined, especially in patients with previous CAD. This study aimed to examine the associations of TRL-C, RLP-C, and apoC-III with incident cardiovascular events (CVEs) in the setting of secondary prevention of CAD. Plasma TRL-C, RLP-C, and total apoC-III were directly measured. A total of 4,355 participants with angiographically confirmed CAD were followed up for the occurrence of CVEs. During a median follow-up period of 5.1 years (interquartile range: 3.9–6.4 years), 543 (12.5%) events occurred. Patients with incident CVEs had significantly higher levels of TRL-C, RLP-C, and apoC-III than those without events. Multivariable Cox analysis indicated that a log unit increase in TRL-C, RLP-C, and apoC-III increased the risk of CVEs by 49% (95% CI: 1.16–1.93), 21% (95% CI: 1.09–1.35), and 40% (95% CI: 1.11–1.77), respectively. High TRL-C, RLP-C, and apoC-III were also independent predictors of CVEs in individuals with LDL-C levels ≤1.8 mmol/l (n = 1,068). The addition of RLP-C level to a prediction model resulted in a significant increase in discrimination, and all three TRL biomarkers improved risk reclassification. Thus, TRL-C, RLP-C, and apoC-III levels were independently associated with incident CVEs in Chinese CAD patients undergoing statin therapy.
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- 2020
18. Association of lipoprotein(a) levels with recurrent events in patients with coronary artery disease
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Hui-Wen Zhang, Na-Qiong Wu, Jing-Lu Jin, Ying Gao, Cheng-Gang Zhu, Ye-Xuan Cao, Yuan-Lin Guo, Yan-Fang Li, Hui-Hui Liu, Jian-Jun Li, Li-Feng Hong, Rui-Xia Xu, and Qi Hua
- Subjects
Male ,Cardiovascular event ,China ,medicine.medical_specialty ,Time Factors ,Myocardial Infarction ,Coronary Artery Disease ,030204 cardiovascular system & hematology ,Coronary Angiography ,Risk Assessment ,Coronary artery disease ,03 medical and health sciences ,0302 clinical medicine ,Recurrence ,Risk Factors ,Internal medicine ,medicine ,Humans ,In patient ,Prospective Studies ,030212 general & internal medicine ,Myocardial infarction ,Prospective cohort study ,Stroke ,Aged ,biology ,business.industry ,Lipoprotein(a) ,Middle Aged ,Prognosis ,medicine.disease ,Up-Regulation ,biology.protein ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business ,Biomarkers ,Lipoprotein - Abstract
ObjectiveWhether lipoprotein(a) (Lp(a)) is a predictor for recurrent cardiovascular events (RCVEs) in patients with coronary artery disease (CAD) has not been established. This study, hence, aimed to examine the potential impact of Lp(a) on RCVEs in a real-world, large cohort of patients with the first cardiovascular event (CVE).MethodsIn this multicentre, prospective study, 7562 patients with angiography-diagnosed CAD who had experienced a first CVE were consecutively enrolled. Lp(a) concentrations of all subjects were measured at admission and the participants were categorised according to Lp(a) tertiles. All patients were followed-up for the occurrence of RCVEs including cardiovascular death, non-fatal myocardial infarction and stroke.ResultsDuring a mean follow-up of 61.45±19.57 months, 680 (9.0%) RCVEs occurred. The results showed that events group had significantly higher Lp(a) levels than non-events group (20.58 vs 14.95 mg/dL, pConclusionsCirculating Lp(a) concentration was indeed a useful predictor for the risk of RCVEs in real-world treated patients with CAD, providing additional information concerning the future clinical application of Lp(a).
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- 2020
19. Impact of free fatty acids on prognosis in coronary artery disease patients under different glucose metabolism status
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Yuan-Lin Guo, Hui-Wen Zhang, Na-Qiong Wu, Qian Dong, Jing Sun, Ye-Xuan Cao, Hui-Hui Liu, Jian-Jun Li, Cheng-Gang Zhu, Rui-Xia Xu, Jing-Lu Jin, and Ying Gao
- Subjects
Blood Glucose ,Male ,medicine.medical_specialty ,China ,lcsh:Diseases of the circulatory (Cardiovascular) system ,Time Factors ,Endocrinology, Diabetes and Metabolism ,Myocardial Infarction ,Comorbidity ,Coronary Artery Disease ,Carbohydrate metabolism ,Fatty Acids, Nonesterified ,Free fatty acids ,Gastroenterology ,Risk Assessment ,Coronary artery disease ,Prediabetic State ,Risk Factors ,Diabetes mellitus ,Internal medicine ,medicine ,Diabetes Mellitus ,Prevalence ,Humans ,Angiology ,Aged ,Original Investigation ,Proportional hazards model ,business.industry ,Hazard ratio ,Confounding ,Cardiovascular outcome ,Middle Aged ,medicine.disease ,Confidence interval ,Progression-Free Survival ,Stroke ,lcsh:RC666-701 ,Female ,lipids (amino acids, peptides, and proteins) ,Pre-diabetes ,Cardiology and Cardiovascular Medicine ,business ,Biomarkers - Abstract
BackgroundThe aim of the present study is to examine the effects of free fatty acids (FFAs) on major cardiovascular events (MACEs) in patients with stable coronary artery disease (CAD) and different glucose metabolism status.MethodsIn this study, we consecutively enrolled 5443 patients from March 2011 to May 2015. Patients were categorized according to both status of glucose metabolism status [diabetes mellitus (DM), pre-diabetes (Pre-DM), normal glycaemia regulation (NGR)] and FFAs levels. All subjects were followed up for the occurrence of the MACEs.ResultsDuring a median of 6.7 years’ follow-up, 608 MACEs occurred. A twofold higher FFAs level was independently associated with MACEs after adjusting for confounding factors [Hazard Ratio (HR): 1.242, 95% confidence interval (CI) 1.084–1.424,pvalue = 0.002]. Adding FFAs to the Cox model increased the C-statistic by 0.015 (0.005–0.027). No significant difference in MACEs was observed between NGR and Pre-DM groups (p > 0.05). When patients were categorized by both status of glucose metabolism and FFAs levels, medium and high FFAs were associated with significantly higher risk of MACEs in Pre-DM [1.736 (1.018–2.959) and 1.779 (1.012–3.126), all p-value ConclusionsThe present data indicated that baseline FFAs levels were associated with the prognosis in DM and Pre-DM patients with CAD, suggesting that FFAs may be a valuable predictor in patients with impaired glucose metabolism.
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- 2019
20. Improvement of evaluation in Chinese patients with atherosclerotic cardiovascular disease using the very-high-risk refinement: a population-based study
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Jian-Jun Li, Yuan-Lin Guo, Rui-Xia Xu, Na-Qiong Wu, Qian Dong, Cheng-Gang Zhu, Hui-Hui Liu, and Sha Li
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medicine.medical_specialty ,Coronary stenosis ,Health development ,Internal medicine ,Internal Medicine ,medicine ,Lipoprotein cholesterol ,Chinese ,Atherosclerotic cardiovascular disease ,business.industry ,Health Policy ,Hazard ratio ,Public Health, Environmental and Occupational Health ,Obstetrics and Gynecology ,atherosclerotic cardiovascular disease ,Guideline ,Population based study ,Psychiatry and Mental health ,Infectious Diseases ,Pediatrics, Perinatology and Child Health ,VHR-ASCVD in Chinese patients ,Very-high-risk ,Geriatrics and Gerontology ,Public aspects of medicine ,RA1-1270 ,business ,Very high risk - Abstract
Background: Continuous refinement of atherosclerotic cardiovascular disease (ASCVD) stratification has raised the definition of very-high-risk (VHR) recently, which has been underutilized in China. We aimed to identify patients at VHR and evaluate their performances in a Chinese population. Methods: A total of 9944 patients with ASCVD was continuously enrolled. Patients at VHR was identified according to 2018 AHA/ACC guideline. Median follow-up was 36.4 months. Clinical characteristics, low-density lipoprotein cholesterol (LDL-C) achievements, and the prognostic value of VHR mapping for cardiovascular events (CVEs) were evaluated. Findings: Overall, 26% (2542/9944) of patients were deemed as VHR, which were subsequently divided into two subgroups of VHR-1 [31% (779/2542)] and VHR-2 [69% (1763/2542)]. The rates of VHR were higher among patients of male (30%,2157/7268), young with age
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- 2021
21. Association of diabetes mellitus with clinical outcomes in patients with different coronary artery stenosis
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Na-Qiong Wu, Ye-Xuan Cao, Yuan-Lin Guo, Hui-Wen Zhang, Cheng-Gang Zhu, Jing-Lu Jin, Qian Dong, Jian-Jun Li, and Rui-Xia Xu
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Male ,medicine.medical_specialty ,Time Factors ,Computed Tomography Angiography ,Endocrinology, Diabetes and Metabolism ,Myocardial Infarction ,Comorbidity ,Coronary Angiography ,Chest pain ,Risk Assessment ,Severity of Illness Index ,Cardiovascular events ,Diabetes mellitus ,Risk Factors ,Internal medicine ,Myocardial Revascularization ,medicine ,Humans ,Diseases of the circulatory (Cardiovascular) system ,Prospective Studies ,Myocardial infarction ,Aged ,Ischemic Stroke ,Original Investigation ,Angiology ,business.industry ,Incidence ,Incidence (epidemiology) ,Hazard ratio ,Coronary Stenosis ,Coronary artery stenosis ,Middle Aged ,Prognosis ,medicine.disease ,Confidence interval ,Hospitalization ,Stenosis ,Diabetes Mellitus, Type 2 ,Beijing ,RC666-701 ,Disease Progression ,Female ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background It has been demonstrated that patients with type 2 diabetes mellitus (DM) is associated with increased cardiovascular risk. However, little is known regarding the long-term prognosis in diabetic patients who experience mild-to-intermediate coronary artery stenosis (CAS). This study was to assess the clinical outcomes of diabetic patients with different severity of CAS. Methods We consecutively enrolled 10,940 patients hospitalized due to angina-like chest pain and followed up for major adverse cardiovascular events (MACEs) covering cardiac death, myocardial infarction, ischemic stroke, unplanned coronary revascularization and angina-related hospitalization. According to coronary angiography, patients were divided into non-obstructive CAS (NOCAS, Results During a median follow-up of 40 months, 1,017 (11.1%) MACEs occurred. In patients with ICAS or SCAS, the incidence of events was higher when patients coexisted with DM (p Conclusions Diabetic patients with ICAS had the worse outcome, which was comparable to patients with SCAS alone.
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- 2021
22. Berberine attenuates atherosclerotic lesions and hepatic steatosis in ApoE(-/-) mice by down-regulating PCSK9 via ERK1/2 pathway
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Yuan-Lin Guo, Jian-Jun Li, Wei Zhang, Ya-Ru Wu, Hui-Lin Qu, Chun-Yan Ma, Yu-Hong Yao, Yue Zhang, Xiao-Yun Shi, and Rui-Xia Xu
- Subjects
medicine.medical_specialty ,biology ,Normal diet ,Cholesterol ,PCSK9 ,General Medicine ,chemistry.chemical_compound ,Endocrinology ,chemistry ,Internal medicine ,ABCA1 ,LDL receptor ,medicine ,biology.protein ,Oil Red O ,lipids (amino acids, peptides, and proteins) ,Original Article ,Scavenger receptor ,Lipoprotein - Abstract
BACKGROUND: It has been demonstrated that berberine (BBR), a kind of alkaloid derived from Chinese herbal medicine, has multiple pharmacological effects on human’s diseases including anti-atherosclerosis action. However, although the previous studies showed that the beneficial impact of BBR on atherosclerosis might be associated with proprotein convertase subtilisin/kexin type 9 (PCSK9), the exact underlying mechanism are not fully determined. The present study aimed to investigate potential mechanisms of anti-atherosclerosis by BBR using ApoE(-/-) mice. METHODS: The eight-week mice were divided into five groups: group 1 (wild type C57BL/6J mice with normal diet), group 2 (ApoE(-/-) mice with normal diet), group 3 [ApoE(-/-) mice with high-fat diet (HFD)], group 4 (ApoE(-/-) mice with HFD, and treatment with low dose BBR of 50 mg/kg/d), and group 5 (ApoE(-/-) mice with HFD, and treatment with high dose BBR of 100 mg/kg/d). After a 16-week treatment, the blood sample, aorta and liver were collected for lipid analysis, hematoxylin-eosin (HE) or oil red O staining, and Western blotting respectively. Besides, HepG2 Cells were cultured and treated with different concentrations of BBR (0, 5, 25 and 50 µg/mL) for 24 hours. Subsequently, cells were collected for real-time PCR or western blotting assays. Finally, the expression levels of PCSK9, LDL receptor (LDLR), ATP-binding cassette transporter A1 (ABCA1), ATP-binding cassette transporter G1 (ABCG1), and scavenger receptor class B type I (SR-BI) were examined. RESULTS: Fifty mg/kg/d and 100 mg/kg/d of BBR decreased total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL) cholesterol (LDL-C), and increased high-density lipoprotein cholesterol (HDL-C) level. Moreover, BBR reduced aorta atherosclerotic plaque, and ameliorated lipid deposition in ApoE(-/-) mice fed with HFD. Finally, in vitro study showed that BBR promoted intracellular cholesterol efflux, up-regulated LDLR and down-regulated PCSK9 expression via the ERK1/2 pathway in cultured HepG2 cells. CONCLUSIONS: Data indicated that BBR significantly attenuated lipid disorder, reduced aortic plaque formation, and alleviated hepatic lipid accumulation in ApoE(-/-) mice fed with HFD, which was associated with down-regulation of PCSK9 through ERK1/2 pathway.
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- 2021
23. Visit-to-visit variability of lipid and cardiovascular events in patients with familial hypercholesterolemia
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Na-Qiong Wu, Liang Li, Jing-Lu Jin, Rui-Xia Xu, Ye-Xuan Cao, Qian Dong, Cheng-Gang Zhu, Jing Sun, Yuan-Lin Guo, Hui-Hui Liu, Jian-Jun Li, and Hui-Wen Zhang
- Subjects
medicine.medical_specialty ,Triglyceride ,business.industry ,Coefficient of variation ,Hazard ratio ,General Medicine ,Familial hypercholesterolemia ,030204 cardiovascular system & hematology ,medicine.disease ,Confidence interval ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,chemistry ,Internal medicine ,medicine ,Original Article ,lipids (amino acids, peptides, and proteins) ,cardiovascular diseases ,030212 general & internal medicine ,Prospective cohort study ,business ,Mace ,Lipoprotein - Abstract
Background Visit-to-visit variability in lipid has been suggested as a predictor of major adverse cardiovascular events (MACEs). However, no evidence exists on the prognostic value of lipid variability in patients with familial hypercholesterolemia (FH). This prospective cohort study aimed to investigate whether lipid variability affects future MACEs in patients with FH receiving standard lipid-lowering therapy. Methods A total of 254 patients with FH were consecutively enrolled and followed for MACEs. Variability in the triglyceride, total cholesterol, high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C) and lipoprotein (a) [Lp(a)] were evaluated from 3 months after discharge using the standard deviation (SD), coefficient of variation (CV) and variability independent of the mean (VIM). Results During a mean follow-up of 49 months, 22 (8.7%) events occurred. Visit-to-visit variability in Lp(a) was significantly higher in the MACE group compared to the non-MACE group. In the multivariate Cox analysis, only Lp(a)-related parameters were independent predictors for MACEs. The hazard ratios and 95% confidence intervals of each 1-SD increase of SD, CV, and VIM of Lp(a) were 1.42 (1.12-1.80), 1.50 (1.11-2.02) and 1.60 (1.16-2.22), respectively. Kaplan-Meier analysis revealed that patients with higher Lp(a) variability presented lower event-free survival. The results were consistent in various subgroups. Conclusions Our study firstly suggested that Lp(a) variability was associated with MACEs in real-world patients with FH, which emphasized the importance of regular lipid monitoring in the patients with high risk.
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- 2021
24. Prognostic value of NT-proBNP in patients with chronic coronary syndrome and normal left ventricular systolic function according to glucose status: a prospective cohort study
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Ying Gao, Hui-Hui Liu, Yuan-Lin Guo, Na-Qiong Wu, Cheng-Gang Zhu, Jing-Lu Jin, Yan Zhang, Ye-Xuan Cao, Qian Dong, Rui-Xia Xu, and Jian-Jun Li
- Subjects
Blood Glucose ,Male ,Time Factors ,Endocrinology, Diabetes and Metabolism ,Coronary Artery Disease ,Ventricular Function, Left ,Coronary artery disease ,Diabetes mellitus ,Risk Factors ,Natriuretic Peptide, Brain ,Prospective Studies ,Myocardial infarction ,Prediabetes ,Prospective cohort study ,Original Investigation ,education.field_of_study ,Hazard ratio ,Syndrome ,Middle Aged ,Prognosis ,Disease Progression ,Female ,Cardiology and Cardiovascular Medicine ,hormones, hormone substitutes, and hormone antagonists ,Adult ,Cardiovascular outcomes ,medicine.medical_specialty ,Systole ,Population ,Chronic coronary syndrome ,Risk Assessment ,Prediabetic State ,Internal medicine ,medicine ,Diseases of the circulatory (Cardiovascular) system ,Humans ,cardiovascular diseases ,Risk factor ,education ,Aged ,business.industry ,Proportional hazards model ,medicine.disease ,Peptide Fragments ,RC666-701 ,Chronic Disease ,N-terminal pro‐brain natriuretic peptide ,business ,Biomarkers - Abstract
Background The prognostic value of N-terminal pro-brain natriuretic peptide (NT-proBNP) in patients with coronary artery disease (CAD) with different glucose status has not been established. This study sought to evaluate the significance of NT-proBNP in predicting major adverse cardiovascular events (MACEs) in patients with chronic coronary syndrome (CCS) and normal left-ventricular systolic function (LVSF) according to different glucose status, especially in those with abnormal glucose metabolism. Methods A total of 8062 patients with CCS and normal LVSF were consecutively enrolled in this prospective study. Baseline plasma NT-proBNP levels were measured. The follow-up data of all patients were collected. Kaplan-Meier and Cox regression analyses were used to assess the risk of MACEs according to NT-proBNP tertiles stratified by glucose status. Results Over an average follow-up of 59.13 ± 18.23 months, 569 patients (7.1 %) suffered from MACEs, including cardiovascular death, non-fatal myocardial infarction, and non-fatal stroke. Kaplan-Meier analysis showed that high NT-proBNP levels had a significant association with MACEs in subjects with prediabetes mellitus (pre-DM) or DM, but not in patients with normoglycemia. Multivariate Cox regression analysis revealed that NT-proBNP remained an independent predictor of MACEs in patients with pre-DM [hazard ratio (HR): 2.56, 95% confidence interval (CI): 1.34–4.91] or DM (HR: 2.34, 95% CI: 1.32–4.16). Moreover, adding NT-proBNP to the original Cox model including traditional risk factors significantly increased the C-statistic by 0.035 in pre-DM and DM, respectively. Conclusions The present study indicated that NT-proBNP could well predict worse outcomes in dysglycemic patients with CCS and normal LVSF, suggesting that NT-proBNP may help with risk stratification in this population.
- Published
- 2021
25. Meis2 represses the osteoblastic transdifferentiation of aortic valve interstitial cells through the Notch1/Twist1 pathway
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Kun Zhao, Zhe Zheng, Zhou Zhou, Yaru Wu, Hanning Liu, Rui-Xia Xu, Cheng Sun, and Ke Si
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Male ,0301 basic medicine ,Aortic valve ,Small interfering RNA ,Epithelial-Mesenchymal Transition ,Biophysics ,Biochemistry ,03 medical and health sciences ,0302 clinical medicine ,Valvular disease ,MEIS2 Gene ,Humans ,Medicine ,RNA, Small Interfering ,Receptor, Notch1 ,Molecular Biology ,Aged ,Homeodomain Proteins ,Osteoblasts ,business.industry ,Twist-Related Protein 1 ,Transdifferentiation ,Calcinosis ,Nuclear Proteins ,Neural crest ,Aortic Valve Stenosis ,Cell Biology ,Middle Aged ,Cell biology ,030104 developmental biology ,medicine.anatomical_structure ,Gene Expression Regulation ,Aortic Valve ,030220 oncology & carcinogenesis ,Cell Transdifferentiation ,cardiovascular system ,Female ,RNA Interference ,Signal transduction ,Aortic valve calcification ,business ,Signal Transduction ,Transcription Factors - Abstract
Aim Calcific aortic valve disease (CAVD) is the most common valvular disease worldwide. The osteoblastic transdifferentiation of aortic valve interstitial cells (VICs) is the essential process of CAVD, but the underlying mechanisms are poorly understood. Aortic VICs are generated from epithelial-to-mesenchymal transition (EMT) and migration of neural crest cells (NCCs).Meis2 has been associated with EMT and NCCs migration during development, but its role in CAVD is unknown. This study aims to elucidate the specific functions of Meis2 and its downstream targets in aortic valve calcification. Material and methods Levels of Meis2 were examined in calcified (n = 30) and normal (n = 30) human aortic valve tissues, respectively. Meis2 was inhibited in porcine aortic VICs in vitro, and the effect on osteoblastic transdifferentiation and its downstream pathway were studied. Results Meis2 gene and protein expression decreased significantly in calcified human aortic valve tissue compared with the normal ones. Inhibiting Meis2 by siRNAs reduced the gene and protein expression of Notch1 and Twist1, and induced the osteoblastic transdifferentiation of the porcine aortic VICs in vitro. Conclusions The present study indicated that Meis2 repress the osteoblastic transdifferentiation of aortic VICs through the Notch1/Twist1 signaling pathway. The Results identify Meis2 as a potential intervention target for the prevention of CAVD.
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- 2019
26. Comparison of statin plus ezetimibe with double-dose statin on lipid profiles and inflammation markers
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Di Sun, Cheng-Gang Zhu, Yuan-Lin Guo, Ying Gao, Jian-Jun Li, Qian Dong, Geng Liu, Jing Sun, Na-Qiong Wu, Xi Zhao, and Rui-Xia Xu
- Subjects
Male ,medicine.medical_specialty ,Statin ,medicine.drug_class ,Endocrinology, Diabetes and Metabolism ,Atorvastatin ,Clinical Biochemistry ,Clinical nutrition ,030204 cardiovascular system & hematology ,Gastroenterology ,law.invention ,Ox-LDL ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,Asian People ,Ezetimibe ,Randomized controlled trial ,law ,Internal medicine ,Statistical significance ,medicine ,Humans ,030212 general & internal medicine ,LDL-C ,lcsh:RC620-627 ,Aged ,Inflammation ,Chinese ,biology ,business.industry ,Research ,Biochemistry (medical) ,C-reactive protein ,Cholesterol, LDL ,Middle Aged ,lcsh:Nutritional diseases. Deficiency diseases ,C-Reactive Protein ,Combination ,biology.protein ,Female ,lipids (amino acids, peptides, and proteins) ,Hydroxymethylglutaryl-CoA Reductase Inhibitors ,business ,Biomarkers ,Lipidology ,medicine.drug - Abstract
Background Achievement of low-density lipoprotein cholesterol (LDL-C) goal is the most important for the patients with atherosclerotic cardiovascular diseases (ASCVD) who received lipid-lowering therapy. It is unclear that whether combination of ezetimibe with statin is superior to double-dose of statin regarding both of the lipid-lowering efficacy and improvement of inflammation in Chinese patients with ASCVD. Therefore, this study was performed to compare the effects of these two regimes on lipid profiles and inflammation markers. Methods In this randomized control study, ninety eight patients with ASCVD, who were naïve to statins or other lipid-lowering agents, were enrolled into the study, and randomly assigned into two groups, A40 group (atorvastatin 40 mg/d, n = 50), A20E10 group (atorvastatin 20 mg/d combined with ezetimibe 10 mg/d, n = 48).The patients were followed up at week 4 and week 12 after treatment. The lipid profiles and oxidative low-density lipoprotein cholesterol (ox-LDL) were measured at the end of study. Results There were no differences in clinical characteristics including lipid, ox-LDL and hypersensitive C reactive protein (Hs-CRP) among groups at baseline. However, the average level of LDL-C was lower in group A20E10 than that in group A40 significantly (1.59 ± 0.44 mmol/L vs 1.99 ± 0.56 mmol/L, p = 0.001) during follow-up at week 12 after treatment. Importantly, the higher rate of achievement of LDL-C goal was attained at group of combination statin with ezetimibe (79.2% in group A20E10 vs 50.0% in group A40, p = 0.016). The difference of the level of ox-LDL between both the groups after 12 weeks treatment had not statistical significance (3.63 ± 1.13 U/L in group A20E10 vs 4.14 ± 1.32 U/L in group A40, p = 0.077).Similarly, the level of Hs-CRP between both the groups after treatment was not significantly different (p > 0.05). Conclusions In this randomized study, the data showed that a combination of moderate statin and ezetimibe achieved more reduction of LDL-C compared to the double-dose statin but similar impact on inflammation markers.
- Published
- 2018
27. The different relations of PCSK9 and Lp(a) to the presence and severity of atherosclerotic lesions in patients with familial hypercholesterolemia
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Di Sun, Ye-Xuan Cao, Hui-Hui Liu, Yan Zhang, Sha Li, Yuan-Lin Guo, Cheng-Gang Zhu, Na-Qiong Wu, Rui-Xia Xu, Jian-Jun Li, Jing-Lu Jin, and Jing Sun
- Subjects
Adult ,Carotid Artery Diseases ,Male ,Heterozygote ,medicine.medical_specialty ,Population ,Enzyme-Linked Immunosorbent Assay ,Coronary Artery Disease ,Familial hypercholesterolemia ,030204 cardiovascular system & hematology ,Coronary Angiography ,Carotid Intima-Media Thickness ,Risk Assessment ,Severity of Illness Index ,Hyperlipoproteinemia Type II ,Coronary artery disease ,Peripheral Arterial Disease ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Internal medicine ,medicine ,Humans ,Genetic Predisposition to Disease ,education ,education.field_of_study ,biology ,business.industry ,PCSK9 ,Carotid ultrasonography ,Lipoprotein(a) ,Middle Aged ,medicine.disease ,Plaque, Atherosclerotic ,Cross-Sectional Studies ,Phenotype ,medicine.anatomical_structure ,biology.protein ,Cardiology ,Female ,Proprotein Convertase 9 ,Cardiology and Cardiovascular Medicine ,business ,Biomarkers ,030217 neurology & neurosurgery ,Lipoprotein ,Artery - Abstract
Background and aims The relation of lipoprotein (a) [Lp(a)] and proprotein convertase substilisin/kexin type 9 (PCSK9) levels to coronary artery disease (CAD) has been well established in the general population, while little is known about the association between Lp(a) or PCSK9 and atherosclerotic lesions of different artery sites in patients with familial hypercholesterolemia (FH). Methods One hundred and fifty-one patients with verified genotyped heterozygous FH (HeFH) were enrolled. There were available data regarding coronary angiography and carotid ultrasonography in 151 patients and femoral ultrasonography in 55 patients. Coronary and carotid severity was evaluated by Gensini score and Crouse score. PCSK9 and Lp(a) concentrations were determined by ELISA and immunoturbidimetry, respectively. Finally, the correlation of PCSK9 and Lp(a) with the presence and severity of CAD and peripheral artery disease (PAD) was assessed. Results The distributions of PCSK9 and Lp(a) were skewed and a close correlation between them in HeFH patients was found. PCSK9 levels were significantly higher in patients with coronary and carotid atherosclerotic lesions compared to their non-atherosclerotic groups, while no difference was found in femoral atherosclerotic lesions groups. Lp(a) levels only differed between patients with or without coronary atherosclerotic lesions. Patients with highest PCSK9 and Lp(a) concentrations had the highest prevalence and severity of atherosclerotic lesions. Multivariate regression analysis showed that PCSK9 was independently associated with CAD and PAD, while Lp(a) was only associated with CAD. Conclusions Circulating PCSK9 concentrations were associated with an increased risk of CAD and PAD, while Lp(a) was only a marker for CAD in HeFH patients.
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- 2018
28. Atherogenic dyslipidaemia and cardiovascular events in patients with diabetes or pre-diabetes and stable coronary artery disease: a prospective, cohort study
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Ye-Xuan Cao, Xiang-Dong You, Hui-Hui Liu, Ying Gao, Li-Guo Wu, Rui-Xia Xu, Jian-Jun Li, Qian Dong, Na Guo, Jing Sun, Jing-Lu Jin, Cheng-Gang Zhu, Yuan-Lin Guo, and Na-Qiong Wu
- Subjects
Male ,medicine.medical_specialty ,Epidemiology ,lcsh:Medicine ,Coronary Artery Disease ,030204 cardiovascular system & hematology ,Cohort Studies ,Prediabetic State ,Coronary artery disease ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Risk Factors ,Internal medicine ,Diabetes mellitus ,lipid disorders ,Diabetes Mellitus ,Humans ,Medicine ,Prospective Studies ,030212 general & internal medicine ,Myocardial infarction ,coronary heart disease ,Prospective cohort study ,Stroke ,Dyslipidemias ,Triglyceride ,business.industry ,general diabetes ,lcsh:R ,General Medicine ,medicine.disease ,chemistry ,Female ,Blood sugar regulation ,business ,Cohort study - Abstract
ObjectiveThe aim of the study was to investigate the impacts of triglyceride (TG) and high-density lipoprotein cholesterol (HDL-C) dyslipidaemia on prognosis in coronary artery disease (CAD) patients with different glucose metabolism status.DesignAn observational cohort study.Setting/participantsA total of 3057 patients with stable CAD were consecutively enrolled and divided into three groups according to different glucose metabolism status. Atherogenic dyslipidaemia (AD) was defined as TG ≥1.7 mmol/L and HDL-C Primary outcome measuresThe primary endpoints were cardiovascular mortality, non-fatal myocardial infarction and non-fatal stroke.ResultsDuring a median follow-up of 6.1 years, 308 (10.1%) CVEs occurred. No significant difference in the occurrence of CVEs was observed between normal glucose regulation (NGR) and pre-diabetes (pre-DM) groups (HR: 1.25, 95% CI 0.89 to 1.76) while DM group presented 1.45-fold higher risk of CVEs (HR: 1.45, 95% CI 1.02 to 2.05). When the participants were categorised according to combined status of two parameters, the cardiovascular risk was significantly elevated in pre-DM or DM plus AD group compared with the NGR plus non-AD group (HR: 1.76, 95% CI 1.10 to 2.80 and HR: 1.87, 95% CI 1.17 to 2.98).ConclusionsThe present study suggested that the presence of AD might affect the prognosis in patients with DM or pre-DM and stable CAD.
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- 2021
29. Abstract 16263: Association Between Visit-to-Visit Lipid Variability and Cardiovascular Events in Patients With Familial Hypercholesterolemia
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Na-Qiong Wu, Yuan-Lin Guo, Yan Zhang, Chuan-Que Cui, Yexuan Cao, Jing Sun, Geng Liu, Ying Gao, Rui-Xia Xu, Jian-Jun Li, Cheng-Gang Zhu, Qian Dong, Huihui Liu, Jing-Lu Jin, and Hui-Wen Zhang
- Subjects
medicine.medical_specialty ,Cholesterol ,business.industry ,Familial hypercholesterolemia ,medicine.disease ,chemistry.chemical_compound ,chemistry ,Physiology (medical) ,Internal medicine ,medicine ,In patient ,Cardiology and Cardiovascular Medicine ,business ,Value (mathematics) - Abstract
Introduction: Visit-to-visit variability in lipid has been suggested as an predictor of major adverse cardiovascular events (MACEs). However, no evidence exists on the prognostic value of lipid variability in patients with familial hypercholesterolemia (FH). Hypothesis: This prospective cohort study aimed to investigate whether lipid variability affects future MACEs in patients with FH receiving standard lipid-lowering therapy. Methods: A total of 254 patients with FH were consecutively enrolled and followed for MACEs. Variability in triglyceride, total cholesterol, high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C) and lipoprotein (a) [Lp(a)] were evaluated from 3 months after discharge using the standard deviation (SD), coefficient of variation (CV) and variability independent of the mean (VIM). Results: During a mean follow-up of 49 months, 22 (8.7%) events occurred. Visit-to-visit variability in Lp(a) was significantly higher in the MACE group compared to the non-MACE group. In multivariate Cox analysis, only Lp(a) variability parameters were independent predictors for MACEs. The hazard ratios and 95% confidence intervals of each 1-SD increase of SD, CV and VIM of Lp(a) were 1.42 (1.12-1.80), 1.50 (1.11-2.02) and 1.60 (1.16-2.22), respectively. Kaplan-Meier analysis revealed that patients with higher Lp(a) variability presented lower event-free survival (Log-rank p Conclusions: This is the first report to evaluate the prognostic value of lipid variability in real-world patients with FH and showed that Lp(a), but not LDL-C variability, was associated with MACEs, which emphasized the importance of regular lipid monitoring in patients with high risk.
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- 2020
30. Abstract 15487: Combined Effects of Lipoprotein(a) and Hypertension in Predicting Cardiovascular Outcomes in Patients With Coronary Artery Disease
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Huihui Liu, Yexuan Cao, Jinglu Jin, Hui-Wen Zhang, Qi Hua, Yan-Fang Li, Yuan-Lin Guo, Cheng-Gang Zhu, Na-Qiong Wu, Ying Gao, Rui-Xia Xu, Jing Sun, and Jian-Jun Li
- Subjects
medicine.medical_specialty ,biology ,business.industry ,Lipoprotein(a) ,Disease ,medicine.disease ,Coronary artery disease ,Physiology (medical) ,Internal medicine ,biology.protein ,Cardiology ,medicine ,In patient ,Cardiology and Cardiovascular Medicine ,business ,Cardiovascular outcomes ,Lipoprotein - Abstract
Introduction: Although emerging data have suggested that circulating lipoprotein(a) [Lp(a)] could predict cardiovascular events (CVEs) in patients with cardiovascular disease, no study is currently available regarding the prognostic significance of Lp(a) in patients with hypertension. Hypothesis: We assessed the hypothesis that there is a prognostic linkage between hypertension and Lp(a) concentrations in patients with coronary artery disease (CAD). Methods: A total of 8668 patients with stable CAD were consecutively enrolled. Baseline Lp(a) concentrations of them were measured. All subjects were categorized according to Lp(a) levels of Results: Over an average of 54.81±18.60 months follow-up, 584 (6.7%) CVEs occurred. Kaplan-Meier and multivariate Cox regression analyses showed that elevated Lp(a) levels had a significant association with CVEs in hypertensive patients, regardless of the control status of blood pressure, but not in normotensive subjects. Moreover, when subgrouping according to both Lp(a) categories and hypertension status, the risk for CVEs was only significantly elevated in high Lp(a) plus hypertension group compared with the reference group with low Lp(a) levels and normotension (hazard ratio: 1.85, 95% confidence interval: 1.19-2.85). Conclusions: In conclusion, elevated Lp(a) was associated with higher risk for CVEs in CAD patients with hypertension and the coexistence of high Lp(a) concentrations and hypertension greatly worsened the clinical prognosis. Our findings may present a prognostic linkage between hypertension and Lp(a) concentrations in patients with CAD.
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- 2020
31. Abstract 16276: Lipoprotein (a) Predicts Recurrent Worse Outcomes in Type 2 Diabetes Mellitus Patients With Prior Cardiovascular Events: A Prospective, Observational Cohort Study
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Hui-Wen Zhang, Ying Gao, Na-Qiong Wu, Cheng-Gang Zhu, Yuan-Lin Guo, Jing-Lu Jin, Yexuan Cao, Qi Hua, Jian-Jun Li, Rui-Xia Xu, Yan Zhang, and Yan-Fang Li
- Subjects
medicine.medical_specialty ,biology ,business.industry ,Type 2 Diabetes Mellitus ,Lipoprotein(a) ,medicine.disease ,Coronary artery disease ,Physiology (medical) ,Diabetes mellitus ,Internal medicine ,medicine ,biology.protein ,In patient ,Cardiology and Cardiovascular Medicine ,business ,Cohort study ,Lipoprotein - Abstract
Introduction: Merging studies have reported the association of lipoprotein(a) [Lp(a)] with poor outcomes of coronary artery disease (CAD) in patients with type 2 diabetes mellitus (T2DM). However, the prognostic importance of Lp(a) for recurrent cardiovascular events (CVEs) is currently undetermined in patients with T2DM and prior CVEs. Methods: From April 2011 to March 2017, we consecutively recruited 2,284 T2DM patients with prior CVEs. Patients were categorized into low, medium, and high groups by Lp(a) levels and followed up for hard, recurrent CVEs, including nonfatal acute myocardial infarction, stroke, and cardiovascular mortality. Caplan-Meier, Cox regression and C-statistic analyses were performed. Results: During 7,613 patient-years’ follow-up, 153 recurrent CVEs occurred. Lp(a) levels were significantly higher in patients with recurrent CVEs than counterparts (20.44 vs. 14.71 mg/dL, p=0.002). Kaplan-Meier analysis revealed that the event-free survival rate was dramatically lower in high and medium Lp(a) groups than that in low group irrespective of HBA1c status ( Conclusions: Our data, for the first time, confirmed that Lp(a) was an independent predictor for recurrent CVEs in T2DM patients with prior CVEs, suggesting that Lp(a) measurement may help to further risk stratification for T2DM patients after they suffered a first CVE.
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- 2020
32. Abstract 15533: Long-term Prognostic Utility of Low-density Lipoprotein (ldl) Triglyceride in Real-world Patients With Coronary Artery Disease and Diabetes or Prediabetes
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Qian Dong, Rui-Xia Xu, Huihui Liu, Jing-Lu Jin, Chuan-Jue Cui, Hui-Wen Zhang, Jing Sun, Yuan-Lin Guo, Na-Qiong Wu, Jian-Jun Li, Yexuan Cao, Ying Gao, Cheng-Gang Zhu, Geng Liu, and Yan Zhang
- Subjects
medicine.medical_specialty ,Triglyceride ,business.industry ,Carbohydrate metabolism ,medicine.disease ,Coronary artery disease ,chemistry.chemical_compound ,chemistry ,Physiology (medical) ,Internal medicine ,Diabetes mellitus ,Low-density lipoprotein ,medicine ,Cardiology ,In patient ,Prediabetes ,Cardiology and Cardiovascular Medicine ,business - Abstract
Introduction: Recent guidelines highlighted the association between atherosclerosis and triglyceride-enriched lipoproteins in patients with impaired glucose metabolism. However, evidence from prospective studies for long-term prognostic utility of low-density lipoprotein triglyceride (LDL-TG) in real-world patients with prediabetes (Pre-DM) or diabetes mellitus (DM) and coronary artery disease (CAD) is currently not available. Hypothesis: LDL-TG had impact on major adverse cardiovascular events (MACEs) in patients with stable CAD under different glucose metabolism status. Methods: A total of 4381 patients with CAD were consecutively enrolled and categorized according to both status of glucose metabolism [DM, Pre-DM, normal glycaemia regulation (NGR)] and tertiles of LDL-TG. Plasma LDL-TG level was measured by an automated homogeneous assay. All subjects were followed up for the occurrence of MACEs. Results: During a median 5.1 (interquartile range 3.9 to 5.9) year follow-up, 507 (11.6%) MACEs occurred. Cubic spline models showed a significant association between LDL-TG and MACEs in DM and Pre-DM but not in NGR. When the combined effect of elevated LDL-TG and glucose disorders was considered for risk stratification, the medium tertile of LDL-TG plus DM, the highest tertile of LDL-TG plus Pre-DM or plus DM subgroups were associated with significantly higher risk of MACEs after adjustment of confounders including triglyceride[hazard ratios (95% confidence intervals): 1.843(1.149-2.955), 1.828(1.165-2.867), 2.212(1.396-3.507), all p Conclusions: In this longitudinal cohort study on real-world practice, higher LDL-TG was associated with worse outcomes among Pre-DM and DM patients with stable CAD.
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- 2020
33. Abstract 15135: Liver Fibrosis Scores Predict Cardiovascular Outcomes in Patients With Previous Myocardial Infarction
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Yan Zhang, Cheng-Gang Zhu, Rui-Xia Xu, Hui-Wen Zhang, Yexuan Cao, Yuan-Lin Guo, Qian Dong, Huihui Liu, Jing-Lu Jin, Meng Zhang, Jian-Jun Li, and Na-Qiong Wu
- Subjects
medicine.medical_specialty ,business.industry ,Physiology (medical) ,Internal medicine ,Liver fibrosis ,medicine ,Cardiology ,In patient ,Myocardial infarction ,Cardiology and Cardiovascular Medicine ,medicine.disease ,business ,Cardiovascular outcomes - Abstract
Introduction: Liver fibrosis score (LFS) has been used for predicting the cardiovascular outcomes (CVOs) in diverse populations. However, the association of LFS with CVOs in patients with previous myocardial infarction (MI) remains undetermined. Hypothesis: The aim of the present study was to examine the prognostic value of LFS in patients with prior MI in a prospective cohort. Methods: A total of 3718 patients with previous MI were consecutively enrolled from March 2009 to January 2019. Five LFSs were used including the fibrosis-4 (FIB-4) score, non-alcohol fatty liver disease fibrosis score (NFS), Forns score, HUI score and BARD score in the current study. The CVOs covered major adverse cardiac event (MACE), hard endpoint, cardiovascular mortality and all-cause mortality. Cox proportional hazards model was used to calculate hazard ratios (HR) with 95% confidence intervals (CI). Results: During a mean follow-up of 47.4±24.8 months, 431 (11.6%) MACE occurred. Kaplan-Meier analysis demonstrated that higher LFSs resulted in a significantly higher probability of CVOs. Compared to the lowest score group, multivariable-adjusted HRs (95% CI) for the highest group of FIB-4, NFS, Forns score, HUI score and BARD score were 1.76 (1.33-2.34), 2.39 (1.71-3.34), 2.46 (1.62-3.74), 1.60 (1.18-2.17) and 1.28 (1.03-1.58), respectively. These LFSs were also independent predictors of hard endpoint, cardiovascular mortality and all-cause mortality. Similar results were observed across subgroups analysis. The addition of LFSs to a prediction model significantly increased the C-statistic for CVOs. Conclusions: The present study firstly demonstrated that LF scores might affect the prognosis in patients with previous MI, suggesting that LF scores may be helpful to further risk stratification and supporting LF scores screening in patients with previous MI.
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- 2020
34. Abstract 15567: Residual Cholesterol and Cardiovascular Events in Patients With Coronary Artery Disease Under Different Glucose Metabolism Status
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Na-Qiong Wu, Yan Zhang, Yexuan Cao, Hui-Wen Zhang, Rui-Xia Xu, Jing-Lu Jin, Yuan-Lin Guo, Cheng-Gang Zhu, and Jian-Jun Li
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medicine.medical_specialty ,business.industry ,Cholesterol ,Carbohydrate metabolism ,medicine.disease ,Coronary artery disease ,chemistry.chemical_compound ,chemistry ,Physiology (medical) ,Internal medicine ,Diabetes mellitus ,medicine ,Cardiology ,In patient ,Prediabetes ,Cardiology and Cardiovascular Medicine ,business - Abstract
Introduction: The atherogenicity of residual cholesterol (RC) has been underlined by recent guidelines, which was linked to coronary artery disease (CAD), especially for patients with diabetes mellitus (DM). Hypothesis: This study aimed to examine the prognostic value of plasma RC, clinically presented as triglyceride-rich lipoprotein-cholesterol (TRL-C) or remnant-like lipoprotein particles-cholesterol (RLP-C), in CAD patients with different glucose metabolism status. Methods: Fasting plasma TRL-C and RLP-C levels were directly calculated or measured in 4331 patients with CAD. Patients were followed for incident MACEs for up to 8.6 years and categorized according to both glucose metabolism status [DM, pre-DM, normal glycaemia regulation (NGR)] and RC levels. Cox proportional hazards model was used to calculate hazard ratios (HRs) with 95% confidence intervals. Results: During a mean follow-up of 5.1 years, 541 (12.5%) MACEs occurred. The risk for MACEs was significantly higher in patients with elevated RC levels after adjustment for potential confounders. No significant difference in MACEs was observed between pre-DM and NGR groups (p>0.05). When stratified by status of glucose metabolism and RC levels, highest levels of RLP-C, calculated and measured TRL-C were significant and independent predictors of developing MACEs in pre-DM (HR: 2.10, 1.98, 1.92, respectively; all p Conclusions: In this large cohort study with long-term follow-up, data firstly demonstrated that higher RC levels were significantly associated with the worse prognosis in DM and pre-DM patients with CAD, suggesting RC might be a target for patients with impaired glucose metabolism.
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- 2020
35. Association of small dense LDL-cholesterol with disease severity, hypertension status and clinical outcome in patients with coronary artery disease
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Ying Gao, Rui-Xia Xu, Hui-Hui Liu, Ye-Xuan Cao, Na-Qiong Wu, Jing-Lu Jin, Cheng-Gang Zhu, Yan Zhang, Qi Hua, Chuan-Jue Cui, Yuan-Lin Guo, Jian-Jun Li, Qian Dong, Jing Sun, Hui-Wen Zhang, and Yan-Fang Li
- Subjects
medicine.medical_specialty ,Physiology ,Coronary Artery Disease ,030204 cardiovascular system & hematology ,Severity of Illness Index ,Lesion ,Coronary artery disease ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Risk Factors ,Internal medicine ,Internal Medicine ,medicine ,Humans ,030212 general & internal medicine ,Proportional hazards model ,business.industry ,Cholesterol ,Hazard ratio ,Cholesterol, LDL ,medicine.disease ,Confidence interval ,Blood pressure ,medicine.anatomical_structure ,chemistry ,Hypertension ,Cardiology ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Artery - Abstract
OBJECTIVE Previous studies have demonstrated that small dense LDL-cholesterol (sdLDL-C) is related to the pathogenesis of coronary artery disease (CAD). However, its prognostic role in hypertensive patients with CAD has been undetermined. The aim of the study was to investigate the association between sdLDL-C with disease severity, hypertensive status and clinical outcome in patients with CAD. METHODS A total of 4594 patients with angiography-proven CAD were consecutively enrolled and categorized into subgroups according to blood pressure status. Serum sdLDL-C levels were measured by direct quantitative measurement using automated chemistry analyzers. The severity of coronary artery lesions were determined by Gensini score, Syntax score and the number of lesion vessels. The associations of sdLDL-C with disease severity, hypertensive status and cardiovascular events (CVEs) were evaluated. RESULTS Patients with hypertension had higher sdLDL-C levels than ones without (P = 0.010). In hypertensive patients, sdLDL-C was positively associated with the severity of CAD (P
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- 2020
36. The prevalence and natural progress of myocardial fibrosis in Duchenne muscular dystrophy patients
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Yingqiang Guo, Hong Xu, Huirong Liu, and Rui-Xia Xu
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medicine.medical_specialty ,biology ,medicine.diagnostic_test ,business.industry ,Duchenne muscular dystrophy ,Ischemia ,Duchenne's Muscular Dystrophy ,medicine.disease ,Linear gingival erythema ,Internal medicine ,Biopsy ,medicine ,biology.protein ,Myocardial fibrosis ,Cardiology and Cardiovascular Medicine ,Dystrophin ,business - Abstract
Purpose The cardiac disease is now as the leading cause of morbidity and mortality in DMD patients. The early detection of cardiac involvement is challenging and the frequency and presence of the cardiac involvement in the first decade is uncertain. The aim of the current study was to characterize the frequency, pattern and extent of LGE in the first decade in DMD patients, and identify a set of prognosis factors that portend the presence and extent of LGE in those patients. Methods There are 93 DMD patients (mean age: 8.31±2.30 years, rang: 3–13 years) with a biopsy showing absent dystrophin and/or DNA analysis demonstrating a characteristic dystrophin mutation enrolled. All patients underwent a complete cine imaging and LGE imaging. The left ventricular function and tissue characteristic were analyzed and statistic. Results There were 42% patients presented LGE-positive. Six years old was the youngest age onset myocardial fibrosis, and after 7 years old, the frequency of LGE positive rising fast. Moreover, all LGE positive patients showed complex patterns with non-ischaemic pattern, including septum, papillary muscle and right ventricular involvement. The free wall, inferior, apical and septum were the most common position. The papillary and right ventricular were rarely common. And all patients presented right ventricular involvement associated with septum involvement. Moreover, compared with younger patients ( Conclusion The myocardial fibrosis could onset in DMD patients in the first decade with a rapid rising and presented with complex patterns. The early CMR examination is necessary for the assessment of cardiac involvement and should consider to complete in younger age in DMD patients. Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): The National Natural Science Foundation
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- 2020
37. Heart-type fatty acid binding protein predicts cardiovascular events in patients with stable coronary artery disease: a prospective cohort study
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Jian-Jun Li, Yan Zhang, Yuan-Lin Guo, Hui-Hui Liu, Ying Gao, Na-Qiong Wu, Geng Liu, Qian Dong, Yan-Fang Li, Rui-Xia Xu, Hui-Wen Zhang, Ye-Xuan Cao, Jing Sun, Qi Hua, Chuan-Jue Cui, Cheng-Gang Zhu, and Jing-Lu Jin
- Subjects
medicine.medical_specialty ,Acute coronary syndrome ,business.industry ,Proportional hazards model ,Hazard ratio ,General Medicine ,030204 cardiovascular system & hematology ,medicine.disease ,Coronary artery disease ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Heart-type fatty acid binding protein ,Cohort ,medicine ,Cardiology ,Original Article ,030212 general & internal medicine ,Myocardial infarction ,business ,Prospective cohort study - Abstract
BACKGROUND: Heart-type fatty acid binding protein (H-FABP) has been reported to be a prognostic predictor for cardiovascular outcome in acute coronary syndrome (ACS). However, its prognostic utility in patients with stable coronary artery disease (CAD) has not been well established. The aim of this study was to assess the association between H-FABP with the severity of coronary disease and cardiovascular events (CVEs) in patients with stable CAD. METHODS: A total of 4,370 angiography-proven CAD patients were consecutively enrolled. The severity of CAD was assessed by Gensini Score (GS) and the numbers of diseased vessels. The CVEs included cardiovascular death, myocardial infarction, stroke and coronary revascularization. Cox regression analysis with adjusted hazard ratios (HRs) and Kaplan-Meier analysis were used to evaluate the relation of H-FABP to CVEs in this cohort. RESULTS: During a median follow-up of 51 months, 353 CVEs occurred. Overall, patients in the highest levels of H-FABP group had increased rate of multi-vessel stenosis and higher GS compared with those in the lowest group (P
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- 2020
38. Association of circulating PCSK9 concentration with cardiovascular metabolic markers and outcomes in stable coronary artery disease patients with or without diabetes: a prospective, observational cohort study
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Na-Qiong Wu, Rui-Xia Xu, Ming-Ming Liu, Yuan-Lin Guo, Jian-Jun Li, Qian Dong, Jing Sun, Jia Peng, Jing-Lu Jin, Ye-Xuan Cao, and Cheng-Gang Zhu
- Subjects
Male ,lcsh:Diseases of the circulatory (Cardiovascular) system ,medicine.medical_specialty ,Time Factors ,Endocrinology, Diabetes and Metabolism ,030209 endocrinology & metabolism ,Coronary Artery Disease ,030204 cardiovascular system & hematology ,Risk Assessment ,PCSK9 ,Coronary artery disease ,03 medical and health sciences ,0302 clinical medicine ,Predictive Value of Tests ,Risk Factors ,Internal medicine ,Diabetes mellitus ,Diabetes Mellitus ,DM ,medicine ,Humans ,CAD ,Prospective Studies ,Original Investigation ,Aged ,Dyslipidemias ,Angiology ,business.industry ,Proportional hazards model ,Hazard ratio ,Middle Aged ,Maces ,medicine.disease ,Progression-Free Survival ,Confidence interval ,Up-Regulation ,Cardiovascular metabolic markers ,lcsh:RC666-701 ,Female ,Proprotein Convertase 9 ,Cardiology and Cardiovascular Medicine ,business ,Biomarkers ,Cohort study - Abstract
Background Whether plasma proprotein convertase subtilisin/kexin type 9 (PCSK9) levels is a predictor for cardiovascular outcomes has currently been controversial. No data is currently available regarding the relation of PCSK9 to cardiovascular metabolic markers (CVMMs) and major adverse cardiovascular events (MACEs) in stable coronary artery disease (CAD) patients with diabetes or without diabetes. Methods A total 1225 untreated patients with stable CAD were consecutively enrolled and their baseline plasma PCSK9 levels were determined by ELISA. Patients were divided into high and low PCSK9 groups according to PCSK9 median. All patients followed up for the occurrence of MACEs and received standard therapy after admission. The associations of PCSK9 with CVMMs and MACEs were evaluated. Results PCSK9 levels were positively correlated with multiple CVMMs including total cholesterol, low-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol and hemoglobin A1c at baseline (all p p p p p Conclusions The present study firstly showed that elevated PCSK9 levels were related to multiple CVMMs and MACEs in stable CAD with diabetes, suggesting that plasma PCSK9 measurement could help to identify diabetic patients with CAD at higher cardiovascular risk. More studies may be needed to confirm our findings.
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- 2020
39. Lipoprotein (a)-mediated vascular calcification: population-based and in vitro studies
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Jia, Peng, Ming-Ming, Liu, Hui-Hui, Liu, Rui-Xia, Xu, Cheng-Gang, Zhu, Yuan-Lin, Guo, Na-Qiong, Wu, Qian, Dong, Chuan-Jue, Cui, and Jian-Jun, Li
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Adult ,Male ,China ,Endocrinology, Diabetes and Metabolism ,Myocytes, Smooth Muscle ,Patient Acuity ,Bone Morphogenetic Protein 2 ,Middle Aged ,Muscle, Smooth, Vascular ,Endocrinology ,Case-Control Studies ,Humans ,Female ,Osteopontin ,Receptor, Notch1 ,Vascular Calcification ,Cells, Cultured ,Aged ,Lipoprotein(a) - Abstract
Lipoprotein (a) [Lp(a)] is a causal risk factor for cardiovascular diseases, while its role in vascular calcification has not been well-established. Here, we investigated an association of Lp(a) with vascular calcification using population-based and in vitro study designs.A total of 2806 patients who received coronary computed tomography were enrolled to assess the correlation of Lp(a) with the severity of coronary artery calcification (CAC). Human aortic smooth muscle cells (HASMCs) were used to explore mechanisms of Lp(a)-induced vascular calcification.In the population study, Lp(a) was independently correlated with the presence and severity of CAC (all p 0.05). In vitro study showed that cell calcific depositions and alkaline phosphatase (ALP) activity were increased and the expression of pro-calcific proteins, including bone morphogenetic protein-2 (BMP2) and osteopontin (OPN), were up-regulated by Lp(a) stimulation. Interestingly, Lp(a) activated Notch1 signaling, resulting in cell calcification, which was inhibited by the Notch1 signaling inhibitor, DAPT. Lp(a)-induced Notch1 activation up-regulated BMP2-Smad1/5/9 pathway. In contrast, Noggin, an inhibitor of BMP2-Smad1/5/9 pathway, significantly blocked Lp(a)-induced HASMC calcification. Notch1 activation also induced translocation of nuclear factor-κB (NF-κB) accompanied by OPN overexpression and elevated inflammatory cytokines production, while NF-κB silencing alleviated Lp(a)-induced vascular calcification.Elevated Lp(a) concentrations are independently associated with the presence and severity of CAC and the impact of Lp(a) on vascular calcification is involved in the activation of Notch1-NF-κB and Notch1-BMP2-Smad1/5/9 pathways, thus implicating Lp(a) as a potential novel therapeutic target for vascular calcification.
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- 2022
40. The longitudinal association of remnant cholesterol with cardiovascular outcomes in patients with diabetes and pre-diabetes
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Na-Qiong Wu, Chuan-Jue Cui, Hui-Wen Zhang, Yan-Fang Li, Hui-Hui Liu, Ying Gao, Cheng-Gang Zhu, Qian Dong, Jing Sun, Yuan-Lin Guo, Yan Zhang, Xiao-Lin Li, Ye-Xuan Cao, Jing-Lu Jin, Rui-Xia Xu, Qi Hua, Jian-Jun Li, and Geng Liu
- Subjects
Blood Glucose ,Male ,China ,lcsh:Diseases of the circulatory (Cardiovascular) system ,medicine.medical_specialty ,Time Factors ,Endocrinology, Diabetes and Metabolism ,Chylomicron Remnants ,Coronary Artery Disease ,Risk Assessment ,Prediabetic State ,Cardiovascular events ,Coronary artery disease ,Risk Factors ,Diabetes mellitus ,Internal medicine ,Diabetes Mellitus ,medicine ,Humans ,Longitudinal Studies ,Prospective Studies ,cardiovascular diseases ,Pre-diabetes mellitus ,Original Investigation ,Aged ,Angiology ,Remnant cholesterol ,business.industry ,Proportional hazards model ,Confounding ,Hazard ratio ,Middle Aged ,Prognosis ,medicine.disease ,Confidence interval ,Cholesterol ,lcsh:RC666-701 ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business ,Biomarkers ,Cohort study - Abstract
Background The atherogenicity of remnant cholesterol (RC) has been underlined by recent guidelines, which was linked to coronary artery disease (CAD), especially for patients with diabetes mellitus (DM). This study aimed to examine the prognostic value of plasma RC in the patients with CAD under different glucose metabolism status. Methods Fasting plasma RC were directly calculated or measured in 4331 patients with CAD. Patients were followed for the occurrence of major adverse cardiovascular events (MACEs) and categorized according to both glucose metabolism status [DM, pre-DM, normoglycemia (NG)] and RC levels. Cox proportional hazards model was used to calculate hazard ratios (HRs) with 95% confidence intervals. Results During a mean follow-up of 5.1 years, 541 (12.5%) MACEs occurred. The risk for MACEs was significantly higher in patients with elevated RC levels after adjustment for potential confounders. No significant difference in MACEs was observed between pre-DM and NG groups (p > 0.05). When stratified by combined status of glucose metabolism and RC, highest levels of calculated and measured RC were significant and independent predictors of developing MACEs in pre-DM (HR: 1.64 and 1.98; both p Conclusions In this large-scale and long-term follow-up cohort study, data firstly demonstrated that higher RC levels were significantly associated with the worse prognosis in DM and pre-DM patients with CAD, suggesting that RC may be a target for patients with impaired glucose metabolism.
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- 2020
41. Lipoprotein (a) Predicts Recurrent Worse Outcomes in Type 2 Diabetes Mellitus Patients with Prior Cardiovascular Events: A Prospective, Observational Cohort Study
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Yan-Fang Li, Ye-Xuan Cao, Yuan-Lin Guo, Hui-Wen Zhang, Na-Qiong Wu, Jian-Jun Li, Yan Zhang, Jing-Lu Jin, Cheng-Gang Zhu, Ying Gao, Qi Hua, and Rui-Xia Xu
- Subjects
Male ,lcsh:Diseases of the circulatory (Cardiovascular) system ,medicine.medical_specialty ,Time Factors ,Endocrinology, Diabetes and Metabolism ,T2DM ,Risk Assessment ,Coronary artery disease ,Lp(a) ,Recurrence ,Risk Factors ,Cause of Death ,Diabetes mellitus ,Internal medicine ,medicine ,Humans ,CAD ,Prospective Studies ,Myocardial infarction ,Survival rate ,Stroke ,Original Investigation ,Aged ,biology ,Proportional hazards model ,business.industry ,Recurrent CVEs ,Lipoprotein(a) ,Middle Aged ,medicine.disease ,Progression-Free Survival ,Diabetes Mellitus, Type 2 ,HBA1c ,Cardiovascular Diseases ,lcsh:RC666-701 ,Beijing ,biology.protein ,Female ,Cardiology and Cardiovascular Medicine ,business ,Biomarkers ,Cohort study - Abstract
Background Merging studies have reported the association of lipoprotein(a) [Lp(a)] with poor outcomes of coronary artery disease (CAD) in patients with type 2 diabetes mellitus (T2DM). However, the prognostic importance of Lp(a) for recurrent cardiovascular events (CVEs) is currently undetermined in patients with T2DM and prior CVEs. Methods From April 2011 to March 2017, we consecutively recruited 2284 T2DM patients with prior CVEs. Patients were categorized into low, medium, and high groups by Lp(a) levels and followed up for recurrent CVEs, including nonfatal acute myocardial infarction, stroke, and cardiovascular mortality. Kaplan–Meier, Cox regression and C-statistic analyses were performed. Results During 7613 patient-years’ follow-up, 153 recurrent CVEs occurred. Lp(a) levels were significantly higher in patients with recurrent CVEs than counterparts (20.44 vs. 14.71 mg/dL, p = 0.002). Kaplan–Meier analysis revealed that the event-free survival rate was dramatically lower in high and medium Lp(a) groups than that in low group irrespective of HBA1c status ( Conclusions Our data, for the first time, confirmed that Lp(a) was an independent predictor for recurrent CVEs in T2DM patients with prior CVEs, suggesting that Lp(a) measurement may help to further risk stratification for T2DM patients after they suffered a first CVE.
- Published
- 2020
42. Allelopathy of Alexandrium pacificum on Thalassiosira pseudonana in laboratory cultures
- Author
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Yu Gao, Rui-Xia Xu, Wei-Dong Yang, Jie-Sheng Liu, Hong-Ye Li, and Xiao-Tong Mao
- Subjects
Health, Toxicology and Mutagenesis ,Thalassiosira pseudonana ,0211 other engineering and technologies ,02 engineering and technology ,Oxidative phosphorylation ,010501 environmental sciences ,Photosynthetic efficiency ,Photosynthesis ,01 natural sciences ,Environmental pollution ,Superoxide dismutase ,Botany ,GE1-350 ,Allelopathy ,Antioxidant system ,0105 earth and related environmental sciences ,Diatoms ,021110 strategic, defence & security studies ,biology ,Chemistry ,Alexandrium pacificum ,Public Health, Environmental and Occupational Health ,Dinoflagellate ,General Medicine ,biology.organism_classification ,Pollution ,Environmental sciences ,Nutrient absorption ,Oxidative Stress ,Diatom ,TD172-193.5 ,biology.protein ,Dinoflagellida ,Laboratories - Abstract
Alexandrium pacificum is a toxin-producing dinoflagellate with allelopathic effects. The elucidation of allelopathic mechanism of A. pacificum is of great significance for understanding A. pacificum blooms. To this end, using the model diatom Thalassiosira pseudonana as a target species, we observed changes in physiological, biochemical and gene transcription of T. pseudonana upon being co-cultured with A. pacificum. We found reciprocal effects between A. pacificum and T. pseudonana, and corroborated A. pacificum's allelopathy on T. pseudonana by observing inhibitory effects of filtrate from A. pacificum culture on the growth of T. pseudonana. We also found that co-culturing with A. pacificum, the expression of T. pseudonana genes related to photosynthesis, oxidative phosphorylation, antioxidant system, nutrient absorption and energy metabolism were drastically influenced. Coupled with the alterations in Fv/Fm (the variable/maximum fluorescence ratio), activity of superoxide dismutase, contents of malondialdehyde, neutral lipid and total protein in T. pseudonana co-cultured with A. pacificum, we propose that A. pacificum allelopathy could reduce the efficiency of photosynthesis and energy metabolism of T. pseudonana and caused the oxidative stress, while the nutrient absorption was also affected by allelopathic effects. The resultant data potentially uncovered the allelopathic molecular mechanism of A. pacificum to model alga T. pseudonana. The changes in nutrient uptake and even energy metabolism in T. pseudonana, as an adaptation to environmental conditions, may prevent it from stress-related injuries. Our finding might advance the understanding of allelopathic mechanism of A. pacificum.
- Published
- 2020
43. Lipid-Modifying Drugs: Pharmacology and Perspectives
- Author
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Rui-Xia, Xu and Yong-Jian, Wu
- Subjects
Humans ,Cholesterol, LDL ,Coronary Artery Disease ,Hydroxymethylglutaryl-CoA Reductase Inhibitors ,Atherosclerosis ,Lipids ,Dyslipidemias ,Hypolipidemic Agents - Abstract
Coronary artery disease (CAD) is one of the leading causes of death worldwide. It is well known that dyslipidemia is a major pathogenic risk factor for atherosclerosis and CAD, which results in cardiac ischemic injury and myocardial infarction. Lipid-modifying drugs can effectively improve lipid abnormalities including reducing low-density lipoprotein cholesterol (LDL-C) and triglycerides (TG) or increasing high-density lipoprotein cholesterol (HDL-C), and eventually decrease the incidence of cardiovascular events. This chapter will review basic principles of lipid metabolism and focus on the therapeutic strategies of lipids modifying drugs (statins, proprotein convertase subtilisin/kexin type 9 inhibitors, ezetimibe, niacin, polyunsaturated fatty acids, and so on) in patients with arteriosclerotic cardiovascular disease. Meanwhile, the challenges and perspectives of the lipid-lowering agents currently in clinical practice as well as their limitations will be outlined.
- Published
- 2020
44. Prognostic utility of heart-type fatty acid-binding protein in patients with stable coronary artery disease and impaired glucose metabolism: a cohort study
- Author
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Ying Gao, Na-Qiong Wu, Qian Dong, Jing Sun, Jian-Jun Li, Hui-Wen Zhang, Geng Liu, Qi Hua, Chuan-Jue Cui, Yuan-Lin Guo, Yan-Fang Li, Rui-Xia Xu, Jing-Lu Jin, Hui-Hui Liu, Ye-Xuan Cao, and Yan Zhang
- Subjects
Blood Glucose ,Male ,lcsh:Diseases of the circulatory (Cardiovascular) system ,medicine.medical_specialty ,Time Factors ,Endocrinology, Diabetes and Metabolism ,Coronary Angiography ,Coronary artery disease ,Gastroenterology ,Heart-type fatty acid-binding protein ,Impaired glucose metabolism ,Internal medicine ,Diabetes mellitus ,medicine ,Humans ,Prospective Studies ,Myocardial infarction ,Stroke ,Original Investigation ,Aged ,Glucose Metabolism Disorders ,business.industry ,Proportional hazards model ,Hazard ratio ,Middle Aged ,Prognosis ,medicine.disease ,Up-Regulation ,lcsh:RC666-701 ,Beijing ,Heart-type fatty acid binding protein ,Female ,lipids (amino acids, peptides, and proteins) ,Blood sugar regulation ,Cardiology and Cardiovascular Medicine ,business ,Fatty Acid Binding Protein 3 ,Biomarkers - Abstract
Background Heart-type fatty acid-binding protein (H-FABP) is a novel marker of myocardial injury and has been reported to be associated with cardiovascular diseases (CVD) including patients with diabetes mellitus (DM). Unfortunately, its prognostic value in patients with CVD and impaired glucose metabolism (IGM) is unclear. The objective of this study was to investigate the prognostic value of H-FABP in CVD patients with IGM. Methods A total of 4594 patients with angiography-proven coronary artery disease (CAD) were enrolled and divided into subgroup according to glucose metabolism status (normal glucose regulation [NGR], pre-DM, and DM). Baseline levels of H-FABP were measured using latex immunoturbidimetric method. The cardiovascular events (CVE) were defined as cardiovascular death, myocardial infarction, stroke and coronary revascularization. Cox regression and Kaplan–Meier analysis were used to evaluate the relations of H-FABP and glucose metabolism status to CVEs. Results During the follow-up period with up to 7.1 years, 380 CVEs occurred. Patients with CVE had higher levels of H-FABP compared to those without CVE (p Conclusions Our data firstly showed that elevated H-FABP levels were associated with worse outcomes in CAD patients with pre-DM and DM, which provided the novel information that H-FABP might be a prognostic marker for clinical outcomes among patients with CAD and IGM.
- Published
- 2020
45. Association of small dense low-density lipoprotein with cardiovascular outcome in patients with coronary artery disease and diabetes: a prospective, observational cohort study
- Author
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Ye-Xuan Cao, Qian Dong, Jing Sun, Na-Qiong Wu, Ying Gao, Jing-Lu Jin, Yan-Fang Li, Rui-Xia Xu, Chuan-Jue Cui, Hui-Wen Zhang, Cheng-Gang Zhu, Yan Zhang, Yuan-Lin Guo, Qi Hua, Geng Liu, Hui-Hui Liu, Xiao-Lin Li, and Jian-Jun Li
- Subjects
Blood Glucose ,Male ,lcsh:Diseases of the circulatory (Cardiovascular) system ,medicine.medical_specialty ,Time Factors ,Endocrinology, Diabetes and Metabolism ,Coronary Artery Disease ,030204 cardiovascular system & hematology ,sdLDL ,Risk Assessment ,Coronary artery disease ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Internal medicine ,Diabetes mellitus ,Diabetes Mellitus ,Medicine ,Humans ,cardiovascular diseases ,Prospective Studies ,Particle Size ,MACEs ,030304 developmental biology ,Angiology ,Aged ,Dyslipidemias ,Original Investigation ,0303 health sciences ,business.industry ,Proportional hazards model ,Confounding ,Hazard ratio ,Cholesterol, LDL ,Middle Aged ,CAD, DM ,medicine.disease ,Prognosis ,Up-Regulation ,Quartile ,lcsh:RC666-701 ,Beijing ,Female ,Cardiology and Cardiovascular Medicine ,business ,Biomarkers ,Cohort study ,Follow-Up Studies - Abstract
Background Elevation in small dense low-density lipoprotein (sdLDL) is common in patients with diabetes mellitus (DM), which has already been reported to be associated with incidence of coronary artery disease (CAD). The aim of the present study was to investigate the prognostic value of plasma sdLDL level in patients with stable CAD and DM. Methods A total of 4148 consecutive patients with stable CAD were prospectively enrolled into the study and followed up for major cardiovascular events (MACEs) up to 8.5 years. Plasma sdLDL level was measured in each patient by a direct method using automated chemistry analyzer. The patients were subsequently divided into four groups by the quartiles of sdLDL and the association of sdLDL level with MACEs in different status of glucose metabolism [DM, Pre-DM, normal glycaemia regulation (NGR)] was evaluated. Results A total of 464 MACEs were documented. Both Kaplan–Meier analysis and Cox regression analysis indicated that the patients in quartile 4 but not quartile 2 or 3 of sdLDL level had significantly higher rate of MACEs than that in lowest quartile. When the prognostic value of high sdLDL was assessed in different glucose metabolism status, the results showed that the high sdLDL plus DM was associated with worse outcome after adjustment of confounding risk factors (hazard ratio: 1.83, 95% confident interval: 1.24–2.70, p Conclusions The present study firstly indicated that elevated levels of plasma sdLDL were associated with increased risk of MACEs among DM patients with proven CAD, suggesting that sdLDL may be useful for CAD risk stratification in DM.
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- 2020
46. Prognostic utility of lipoprotein(a) combined with fibrinogen in patients with stable coronary artery disease: a prospective, large cohort study
- Author
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Rui-Xia Xu, Yan Zhang, Hui-Wen Zhang, Qi Hua, Na-Qiong Wu, Chuan-Jue Cui, Ye-Xuan Cao, Yan-Fang Li, Qian Dong, Hui-Hui Liu, Jing Sun, Yuan-Lin Guo, Jian-Jun Li, Jing-Lu Jin, Geng Liu, and Ying Gao
- Subjects
0301 basic medicine ,medicine.medical_specialty ,Antifibrinolytic ,medicine.drug_class ,lcsh:Medicine ,Coronary Artery Disease ,030204 cardiovascular system & hematology ,Fibrinogen ,General Biochemistry, Genetics and Molecular Biology ,Cohort Studies ,Coronary artery disease ,03 medical and health sciences ,0302 clinical medicine ,Lp(a) ,Risk Factors ,Internal medicine ,medicine ,Humans ,CAD ,Prospective Studies ,Myocardial infarction ,Prospective cohort study ,Stroke ,biology ,Proportional hazards model ,business.industry ,lcsh:R ,General Medicine ,Lipoprotein(a) ,Prognosis ,medicine.disease ,030104 developmental biology ,biology.protein ,Cardiology ,CVEs ,business ,Biomarkers ,medicine.drug - Abstract
Background Elevated lipoprotein(a) [Lp(a)] and fibrinogen (Fib) are both associated with coronary artery disease (CAD). The atherogenicity of Lp(a) can be partly due to the potentially antifibrinolytic categories. We hypothesize that patients with higher Lp(a) and Fib may have worse outcomes. Methods In this prospective study, we consecutively enrolled 8,417 Chinese patients with stable CAD from March 2011 to March 2017. All subjects were divided into 9 groups according to Lp(a) (Lp(a)-Low, Lp(a)-Medium, Lp(a)-High) and Fib levels (Fib-Low, Fib-Medium, Fib-High) and followed up for CVEs, including nonfatal acute myocardial infarction, stroke, and cardiovascular mortality. Kaplan–Meier, Cox regression and C-statistic analyses were performed. Results During a median of 37.1 months’ follow-up, 395 (4.7%) CVEs occurred. The occurrence of CVEs increased by Lp(a) (3.5 vs. 5.3 vs. 5.6%, p = 0.001) and Fib (4.0 vs. 4.4 vs. 6.1%, p p th group (HRadjusted 2.656, 95% CI 1.628–4.333, p adjusted 1.786, 95% CI 1.315–2.426, p adjusted 1.558, 95% CI 1.162–2.089, p = 0.003) group. Moreover, adding the combined Lp(a) and Fib increased the C-statistic by 0.013. Conclusion Combining Fib and Lp(a) enhance the prognostic value for incident CVEs beyond Lp(a) or Fib alone.
- Published
- 2020
47. Prognostic Value of NT-proBNP in Pre-Diabetic Patients With Stable Coronary Artery Disease and Normal Left Ventricular Systolic Function
- Author
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Yuan-Lin Guo, Na-Qiong Wu, Cheng-Gang Zhu, Jian-Jun Li, Hui-Hui Liu, Qian Dong, Rui-Xia Xu, Ye-Xuan Cao, and Jing-Lu Jin
- Subjects
medicine.medical_specialty ,Proportional hazards model ,business.industry ,Hazard ratio ,medicine.disease ,Confidence interval ,Coronary artery disease ,Internal medicine ,medicine ,cardiovascular diseases ,Myocardial infarction ,Prediabetes ,Risk factor ,Prospective cohort study ,business - Abstract
Background: Currently, no data is available regarding the predictive role of N-terminal pro-brain natriuretic peptide (NT-proBNP) in patients with prediabetes mellitus (pre-DM) and coronary artery disease (CAD). We aimed to evaluate the significance of NT-proBNP in predicting major adverse cardiovascular events (MACEs) in patients with stable CAD (SCAD) and normal left-ventricular systolic function (LVSF) according to different glucose status, especially in ones with pre-DM. Methods: In this prospective study, a total of 8062 patients with SCAD and normal LVSF were consecutively enrolled. They were categorized according to glucose status and further stratified by NT-proBNP tertiles. The follow-up data of all patients were collected. Findings: Over an average follow-up of 59·13±18·23 months, 569 patients suffered from MACEs, including cardiovascular death, non-fatal myocardial infarction, and stroke. Kaplan-Meier analysis showed that high NT-proBNP levels had a significant association with MACEs in subjects with pre-DM or DM (both p 0·05). Multivariate Cox regression analysis suggested that NT-proBNP remained an independent predictor for MACEs in patients with pre-DM [hazard ratio (HR): 2·68, 95% confidence interval (CI): 1·72-4·19] or DM (HR: 2·32, 95% CI: 1·55-3·51). Moreover, adding NT-proBNP to the original model increased the C-statistic by 0·024 and 0·036 in pre-DM and DM respectively (both p
- Published
- 2020
48. Lipid-Modifying Drugs: Pharmacology and Perspectives
- Author
-
Rui-Xia Xu and Yong-Jian Wu
- Subjects
chemistry.chemical_classification ,business.industry ,Lipid metabolism ,Pharmacology ,medicine.disease ,Arteriosclerotic Cardiovascular Disease ,Coronary artery disease ,03 medical and health sciences ,0302 clinical medicine ,chemistry ,Ezetimibe ,Medicine ,lipids (amino acids, peptides, and proteins) ,030212 general & internal medicine ,Myocardial infarction ,business ,Niacin ,Dyslipidemia ,Polyunsaturated fatty acid ,medicine.drug - Abstract
Coronary artery disease (CAD) is one of the leading causes of death worldwide. It is well known that dyslipidemia is a major pathogenic risk factor for atherosclerosis and CAD, which results in cardiac ischemic injury and myocardial infarction. Lipid-modifying drugs can effectively improve lipid abnormalities including reducing low-density lipoprotein cholesterol (LDL-C) and triglycerides (TG) or increasing high-density lipoprotein cholesterol (HDL-C), and eventually decrease the incidence of cardiovascular events. This chapter will review basic principles of lipid metabolism and focus on the therapeutic strategies of lipids modifying drugs (statins, proprotein convertase subtilisin/kexin type 9 inhibitors, ezetimibe, niacin, polyunsaturated fatty acids, and so on) in patients with arteriosclerotic cardiovascular disease. Meanwhile, the challenges and perspectives of the lipid-lowering agents currently in clinical practice as well as their limitations will be outlined.
- Published
- 2020
49. Predicting Cardiovascular Outcomes by Baseline Lipoprotein(a) Concentrations: A Large Cohort and Long‐Term Follow‐up Study on Real‐World Patients Receiving Percutaneous Coronary Intervention
- Author
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Ye-Xuan Cao, Yuan-Lin Guo, Jing-Lu Jin, Yan-Fang Li, Na-Qiong Wu, Xie-Hui Chen, Jian-Jun Li, Qi Hua, Hui-Hui Liu, Rui-Xia Xu, Hui-Wen Zhang, and Cheng-Gang Zhu
- Subjects
Male ,medicine.medical_specialty ,China ,Time Factors ,Long term follow up ,medicine.medical_treatment ,Coronary Artery Disease ,030204 cardiovascular system & hematology ,Risk Assessment ,Coronary artery disease ,03 medical and health sciences ,cardiovascular events ,0302 clinical medicine ,Percutaneous Coronary Intervention ,lipoprotein(a) ,Predictive Value of Tests ,Risk Factors ,Internal medicine ,Cardiovascular Disease ,Clinical Studies ,medicine ,Humans ,030212 general & internal medicine ,Prospective Studies ,Preventive Cardiology ,Baseline (configuration management) ,Original Research ,Aged ,biology ,Lipids and Cholesterol ,business.industry ,Percutaneous coronary intervention ,Lipoprotein(a) ,Middle Aged ,medicine.disease ,Treatment Outcome ,Conventional PCI ,biology.protein ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business ,Cardiovascular outcomes ,Biomarkers ,Lipoprotein ,Follow-Up Studies - Abstract
Background Although several studies have indicated that lipoprotein(a) is a useful prognostic predictor for patients following percutaneous coronary intervention ( PCI ), previous observations have somewhat been limited by either small sample size or short‐term follow‐up. Hence, this study aimed to evaluate the impact of lipoprotein(a) on long‐term outcomes in a large cohort of stable coronary artery disease patients after PCI . Methods and Results In this multicenter and prospective study, we consecutively enrolled 4078 stable coronary artery disease patients undergoing PCI from March 2011 to March 2016. They were categorized according to both the median of lipoprotein(a) levels and lipoprotein(a) values of dL (high). All patients were followed up for occurrence of cardiovascular events, including cardiovascular death, nonfatal myocardial infarction, and stroke. During an average of 4.9 years of follow‐up, 315 (7.7%) cardiovascular events occurred. The events group had significantly higher lipoprotein(a) levels than the nonevents group. Compared with the low lipoprotein(a) group, Kaplan–Meier analysis showed that the high lipoprotein(a) group had a significantly lower cumulative event‐free survival rate, and multivariate Cox regression analysis further revealed that the high lipoprotein(a) group had significantly increased cardiovascular events risk. Moreover, adding continuous or categorical lipoprotein(a) to the Cox model led to a significant improvement in C‐statistic, net reclassification, and integrated discrimination. Conclusions With a large sample size and long‐term follow‐up, our data confirmed that high lipoprotein(a) levels could be associated with a poor prognosis after PCI in stable coronary artery disease patients, suggesting that lipoprotein(a) measurements may be useful for patient risk stratification before selective PCI .
- Published
- 2020
50. Differences in phenotype, genotype and cardiovascular events between patients with probable and definite heterozygous familial hypercholesterolemia
- Author
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Na-Qiong Wu, Bing-Yang Zhou, Di Sun, Rui-Xia Xu, Sha Li, Yuan-Lin Guo, Ying Gao, Geng Liu, Qian Dong, Jian-Jun Li, Cheng-Gang Zhu, and Ye-Xuan Cao
- Subjects
Adult ,Male ,medicine.medical_specialty ,Heterozygote ,Genotype ,Hypercholesterolemia ,Familial hypercholesterolemia ,Kaplan-Meier Estimate ,030204 cardiovascular system & hematology ,Gene mutation ,Gastroenterology ,Hyperlipoproteinemia Type II ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Internal medicine ,Prevalence ,Medicine ,Humans ,030212 general & internal medicine ,Lipid clinic ,Tendon xanthomas ,Aged ,Pharmacology ,medicine.diagnostic_test ,business.industry ,Incidence (epidemiology) ,Coronary Stenosis ,General Medicine ,Cholesterol, LDL ,Middle Aged ,medicine.disease ,Phenotype ,Cardiovascular Diseases ,Mutation ,Phenotype genotype ,Molecular Medicine ,Female ,business ,Lipid profile - Abstract
Aim: To investigated the potential differences between probable and definite heterozygous familial hypercholesterolemia (HeFH) patients diagnosed by Dutch Lipid Clinic Network criteria. Methods: Clinical characteristics, lipid profile, severity of coronary artery stenosis and gene mutations were compared. Kaplan–Meier curve was performed to evaluate the cardiovascular events. Results: Overall, 325 participants were included and divided into two groups: probable (n = 233) and definite HeFH (n = 92). Definite HeFH patients had higher low-density lipoprotein cholesterol (LDL-C), oxidized-LDL and proprotein convertase subtilisin/kexin 9 levels, and higher prevalence of tendon xanthomas. The incidence of genetic mutations was statistically higher in definite HeFH than probable HeFH patients. The coronary stenosis calculated by Gensini score was statistically severer in definite HeFH patients. The best LDL-C threshold for predicting mutations was 5.14 mmol/l. Definite HeFH had lower event-free survival rates. Conclusion: Definite HeFH patients had higher severity of phenotype and genotype, and higher risk of cardiovascular events.
- Published
- 2019
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