1,721,260 research outputs found
Routine assessment of on-clopidogrel platelet reactivity and gene polymorphisms in predicting clinical outcome following drug-eluting stent implantation in patients with stable coronary artery disease
No full textOBJECTIVES:
This study sought to assess the usefulness of clopidogrel-pathway genotyping and on-treatment platelet reactivity (OTR) testing in predicting major adverse cardiac events (MACE) in stable coronary artery disease (CAD) patients receiving drug-eluting stents (DES) under dual antiplatelet (clopidogrel plus aspirin) therapy.
BACKGROUND:
The role of pharmacogenetics and OTR in predicting MACE-death, myocardial infarction, or stent thrombosis-in stable CAD patients scheduled for DES implantation is still debated.
METHODS:
Patients with stable CAD treated by DES implantation (n = 1,432) were genotyped with a TaqMan OpenArray (Applied Biosystems, Carlsbad, California) and assessed for OTR with the VerifyNow P2Y12 test (Accumetrics Inc., San Diego, California). Genes tested were ABCB1, CYP1A2, CYP2B6*9, CYP2C8*3, CYP2C9*2, CYP2C19, CYP3A4, CYP3A5*3, P2RY12, and PON1CYP2C19. High OTR was defined as P2Y12 reaction units ≥230. The endpoint at 12-month follow-up was MACE occurring during antiplatelet therapy.
RESULTS:
All groups that were stratified for loss-of-function variants of the cytochrome P450 gene CYP2C19 had significant hazard ratios (HR) for MACE (genotypic HR: 1.41, 95% confidence interval [CI]: 1.06 to 1.89, p = 0.01; allelic HR: 1.56, 95% CI: 2.26 to 1.2, p = 0.01). Variants of other clopidogrel-pathway genes were not significantly associated with MACE. When OTR was assessed, clinical significance was found only in high-risk diabetic (HR: 2.11, 95% CI: 1.29 to 3.45, p < 0.001) and chronic kidney disease (HR: 2.03, 95% CI: 1.03 to 4.02, p = 0.04) patients.
CONCLUSIONS:
CYP2C19 metabolizer status is an independent predictor of MACE after DES implantation and can be used for prognostication in all stable CAD patients. High OTR, as assessed by the VerifyNow P2Y12 test, is an independent predictor of MACE only for high-risk subsets, that is, patients with diabetes or chronic kidney disease
MicroRNA-Dependent Control of the Cardiac Fibroblast Secretome
No full textComment on
Extracellular matrix secretion by cardiac fibroblasts: role of microRNA-29b and microRNA-30c. [Circ Res. 2013]
Abonnenc M, Nabeebaccus AA, Mayr U, Barallobre-Barreiro J, Dong X, Cuello F, Sur S, Drozdov I, Langley SR, Lu R, Stathopoulou K, Didangelos A, Yin X, Zimmermann WH, Shah AM, Zampetaki A, Mayr M
Long noncoding RNAs and microRNAs in cardiovascular pathophysiology
No full textRNAs not encoding proteins have gained prominence over the last couple of decades as fundamental regulators of cellular function. Not surprisingly, their dysregulation is increasingly being linked to pathology. Here, we review recent reports investigating the pathophysiological relevance of this species of RNA for the cardiovascular system, concentrating mainly on recent findings on long noncoding RNAs and microRNAs in cardiac hypertrophy and failure
HEXIM1 : a new player in myocardial hypertrophy?
No full textThis editorial refers to ‘Inducible re-expression of HEXIM1
causes physiological cardiac hypertrophy in the adult mouse’
by M.M. Montano et al., pp. 74–82, Cardiovascular Research (2013) 99
Therapeutic applications of noncoding RNAs
No full textPurpose of review In this review, we summarize the basic principles underlying the therapeutic use of nonprotein coding (nc)RNAs, such as microRNA (miRNA) and long noncoding RNA, in the cardiovascular field, focusing, where possible, on recent advances that may lead to translation to the clinic for heart failure. Recent findings The number of individual miRNAs associated with a given aspect of heart disease is increasing rapidly, as is the data on miRNA profiles in normal and diseased myocardium. Less is known on the role of long noncoding RNA, and to date only a few have been studied in the heart. Novel oligonucleotide-based therapies have started to trickle into the clinic, but strategies focusing on ncRNA are still in a clinical/preclinical trial phase. Summary The discovery of functional ncRNAs is leading to a better understanding of the mechanisms underlying cardiovascular physiology. Dysregulation of ncRNAs is being increasingly associated with many diseases affecting the heart and in certain instances may have a pathogenic role. Therapeutic intervention aimed at opposing ncRNA misexpression has been widely demonstrated to be effective in blunting disease in animal models, and may thus have potential in the clinical setting
Generation of Human Cardiomyocytes : a Differentiation Protocol from Feeder-free Human Induced Pluripotent Stem Cells
No full textIn order to investigate the events driving heart development and to determine the molecular mechanisms leading to myocardial diseases in humans, it is essential first to generate functional human cardiomyocytes (CMs). The use of these cells in drug discovery and toxicology studies would also be highly beneficial, allowing new pharmacological molecules for the treatment of cardiac disorders to be validated pre-clinically on cells of human origin. Of the possible sources of CMs, induced pluripotent stem (iPS) cells are among the most promising, as they can be derived directly from readily accessible patient tissue and possess an intrinsic capacity to give rise to all cell types of the body (1). Several methods have been proposed for differentiating iPS cells into CMs, ranging from the classical embryoid bodies (EBs) aggregation approach to chemically defined protocols (2,3). In this article we propose an EBs-based protocol and show how this method can be employed to efficiently generate functional CM-like cells from feeder-free iPS cells
ATP6V0A1 polymorphism and microRNA-637: A pathogenetic role for microRNAs in essential hypertension at last?
No full textEpigenetic modifications and noncoding RNAs in cardiac hypertrophy and failure
No full textThe regulatory networks governing gene expression in cardiomyocytes are under intense investigation, not least because dysregulation of the gene programme has a fundamental role in the development of a failing myocardium. Epigenetic modifications and functional non-protein-coding RNAs (ncRNAs) are important contributors to this process. The epigenetic modifications that regulate transcription comprise post-translational changes to histones - the proteins around which DNA is wound - as well as modifications to cytosine residues on DNA. The most studied of the histone changes are acetylation and methylation. Histone acetylation is known to be important in cardiac physiology and pathophysiology, but the roles of other histone modifications and of cytosine methylation are only starting to be investigated. Understanding of the role of microRNAs has also seen major advancements, but the function of long ncRNAs is less well defined. Moreover, the connection between ncRNAs and epigenetic modifications is poorly understood in the heart. In this Review, we summarize new insights into how these two layers of gene-expression regulation might be involved in the pathogenesis of cardiac hypertrophy and failure, and how we are only beginning to appreciate the complexity of the interactive network of which they are part
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