53 research outputs found
New Opportunities for Determining the Terms of Carrying out the Control Coronarangiography after Percutaneous Coronary Intervention
No full textBackground. Coronary heart disease is the leading cause of death in the Russian Federation, causing social and economic damage to the state. Previously published studies showed the association of rs1800470 polymorphism of the gene of the transforming growth factor-β1 (TGF-β1) with the risk of developing coronary artery disease due to more severe atherosclerotic lesions of the coronary arteries. Aim of the research. To study the association of single-nucleotide polymorphism rs1800470 of the TGF-β1 gene with the rate of progression of atherosclerotic coronary artery lesion. Material and methods. The study included 89 men with myocardial infarction, a Caucasian race under the age of 65 years (51 ± 7.9). Genomic DNA was isolated from venous blood by the phenol-chloroform method. The rs1800470 polymorphism of the TGF-β1 gene was tested using real-time polymerase chain reaction (PCR) (TaqMan probes, AB 7900HT). Assessment of the severity of coronary lesion was carried out initially according to the standard polyprojection coronary angiography protocol with the Gensini score calculated, as well as in dynamics after 40.7 ± 29.7 months (from 5 to 103 months). Results. Carrier of the rs1800470 allele A of the TGF-β1 gene is an independent risk factor for coronary heart disease and is associated with a more aggressive course of coronary atherosclerosis in men: a 20 % worsening of the Gensini score was observed after 7 months (p = 0.013), and by 30 % after 5 months (p = 0.003) from the initial coronary angiography. In addition, the homozygous genotype AA rs1800470 of the TGF-β1 gene is associated with the development of late stent restenoses in this group of patients after 12 months of observation (p = 0.002). Conclusion. Identification of carriers of the rs1800470 allele A of the TGF-β1 gene can help identify patients at risk for more rapid progression of coronary artery atherosclerosis in order to conduct angiographic control in the early period – 6 months from the initial percutaneous coronary intervention
Angiographic dynamics of coronary flow state after percutaneous coronary intervention in carriers of polymorphic RS1800470 variants of the TGF-β1 gene
No full textAim. To study the relationship between the angiographic dynamics of the state of the coronary bed in patients undergoing percutaneous coronary intervention (PCI) due to myocardial infarction (MI) and the carriage of polymorphic rs1800470 variants of the transforming growth factor beta-1 gene (TGF-β1).Material and methods. The study included 89 men with MI of the Caucasian race aged 32 to 65 years (52 [45,0-58,0]). Genomic deoxyribonucleic acid (DNA) was extracted from venous blood by phenol-chloroform technique. The rs1800470 polymorphism of the TGF-β1 gene was tested using real-time polymerase chain reaction (PCR) (TaqMan probes, AB 7900HT). Assessment of the severity of coronary lesions was carried out initially according to the standard coronary angiography (CAG) protocol with the calculation of the Gensini score. CAG was also conducted in the dynamics after 5-103 months (42,3±29,5 months) of the study beginning.Results. In male carriers of the rs1800470 A allele of the TGF-β1 gene, the mean values of the Gensini score statistically significantly increased (47,5±34,1 (CAG-1) and 64,5±35,5 (CAG-2), p <0,001) in comparison with carriers of the homozygous GG rs1800470 variant of the TGF-β1 gene (43,5±21,1 (CAG-1) and 46,2±23,2 (CAG2), p=0,066). In patients who had rs1800470 A allele of the TGF-β1 gene, a 20%decrease in the Gensini score was observed after 7 months (p=0,013), and 30% — after 5 months (p=0,003) of the initial CAG. The development of late stent restenoses in carriers of the rs1800470 A allele and the homozygous risk genotype AA of the TGF-β1 gene was noted at an earlier date — 8 (p=0,047) and 12 months (p=0,002), respectively.Conclusion. Currently, the conduct of CAG in dynamics in patients undergoing PCI is recommended as clinically indicated. The exception is the group of patients who underwent endoprosthesis replacement of the left coronary artery or have uncorrected stenosis of a different location from 3 to 12 months after PCI. The presented data show a possible predictor role of rG1800470 polymorphism of the TGF-β1 gene in relation to the progression of coronary atherosclerosis and the development of late stent restenoses
Association of RS1800470 polymorphic variants of the transforming growth factor β1 (TGF-β1) gene with the severity of coronary atherosclerosis
No full textAim. To study the relationship of rs1800470 polymorphic variants of the transforming growth factor p1 (TGF-β1) gene with the severity of coronary arteries (CA) atherosclerosis.Material and methods. The study included 256 patients with myocardial infarction (MI) (216 males and 40 females) of a Caucasoid race aged <65 years (52,1 ±8,4). Phenol-chloroform extraction was used for separating DNA from venous blood. The rs1800470 polymorphism of TGF-β1gene was tested using real-time polymerase chain reaction (PCR) (TaqMan probes, AB 7900HT). The assessment of coronary bed lesion severity was made according to the protocol of standard polyprojection coronary angiography with using of Gensini scores.Results. For the first time in the Siberian population, the relationship of the A rs1800470 allele of the TGF-β1gene and severity of coronary atherosclerosis has been proved in men. The carriers of the rs1800470 allele A of the TGF-β1 gene had a odds ratio (OR) of the multivessel CA lesion (OR =2,84 (95% CI 1,37-5,87), p=0,004) and proximal type coronary atherosclerosis (OR =2,66 (95% CI 1,29-5,47), p=0,007). In general, the Gensini score was significantly higher in carriers of the risk A rs1800470 allele of the TGF-β1 gene: AA genotype — 57,33±41,89; AG genotype — 52,86±40,74; GG genotype — 43±28,83 (p>0,05), however, the differences were statistically significant in the upper quartile (p=0,028). OR of severe damage to CA (Gensini score >80 points) in carriers of the A rs1800470 allele of the TGF-β1 gene was 3,64 (95% CI 1,06-12,49). In women, no statistically significant correlation of the rs1800470 genotype of the TGF-β1 gene with the severity of CA lesions was identified.Conclusion. A rs1800470 allele of TGF-β1 gene is associated with the severity of coronary atherosclerosis in men
New horizons in the use of biological agents during pregnancy in patients with rheumatic disease
No full textPregnancy in the presence of rheumatic diseases (RD) and adequate therapy before planned conception, during gestation, and after delivery during lactation is challenging. Advances in the treatment of RD are largely due to the clinical introduction of a new class of biological agents (BAs). There are less than two decades of experience in using BAs in rheumatology and to date there are no unified standards and accepted rules governing their use during pregnancy. According to the current requirements, information on a medicine should be given in three sections: 1) pregnancy; 2) lactation, and 3) use in men and women who are planning concept (the latter section has appeared for the first time). The present article summarizes data on the possible use of BAs in patients with RD during pregnancy planning, pregnancy, and breastfeeding.</jats:p
Dissociation of clinical symptoms and magnetic resonance imaging data in axial psoriatic arthritis
No full textCurrently, there is no generally accepted definition of axial lesions in psoriatic arthritis (axPsA), and the diagnostic criteria are extrapolated from the recommendations for ankylosing spondylitis and axial spondyloarthritis.Objective: To evaluate data of magnetic resonance imaging (MRI) of spine and sacroiliac joints (SIJ) in patients with psoriasis complaining of chronic back pain of any cause.Material and methods. 143 patients were enrolled to the study, including 57 (39.9%) men and 86 (60.1%) women, median age – 47 [36; 57] years, mean duration of psoriasis was 17.4±13.4 years. In all patients, the agreement of the existing symptoms with the inflammatory back pain (IBP) criteria of A. Calin et al., M. Rudwaleit et al. and ASAS was checked. All patients underwent MRI of the spine and SIJ, determination of ESR, CRP levels, HLA-B27 and consultations with a dermatologist and a rheumatologist.Results and discussion. An association of bone marrow edema (BME) in the spine and SIJ with nail involvement (odds ratio, OR 2.32; 95% confidence interval, CI 1.12–4.81; p=0.035), palmoplantar psoriasis (OR 3.85; 95% CI 1.43–10.41; p=0.054) and a weak correlation with PASI (r=0.329, p=0.034) was found. There were no statistically significant differences in PASI between patients with BME and without BME. In patients with IBP who fulfilled the criteria of A. Calin et al., osteitis in the SIJ was present in 19 (34.5%; OR 2.79; 95% CI 1.26–6.19; p=0.01); Berlin criteria of 4 signs – 25 (28.7%; OR 2.42; 95% CI 1.00–5.84; p=0.045); Berlin criteria of 3 signs – in 18 (24.0%; OR 1.12; 95% CI 0.51–2.44; p=0.783); ASAS criteria – in 17 (34.0%; OR 2.48; 95% CI 1.12–5.49; p=0.023). In almost half of the patients with BME in the spine or SIJ, the symptoms did not fulfil the criteria for IBP. Signs such as the presence and duration of morning stiffness had a high prognostic value. Isolated spondylitis (presence of BME in vertebrae and absence of BME in SIJ) was rarely found in patients with IBP fulfilling various criteria (in 4.0–8.1% of cases).Conclusion. Considering the existing discrepancy between symptoms and MRI results, it is necessary to develop independent tools for screening and early diagnosis of axPsA
ASSOCIATION BETWEEN ANXIETY-DEPRESSIVE SPECTRUM DISORDERS AND JOINT DISEASE IN WOMEN
No full textThe frequency of anxiety-depressive spectrum disorders (ADSDs) in patients with rheumatic diseases (RDs) is much higher than that in the general population. ADSDs are known to be associated with pain intensity, disease activity, and functional limitations. However, the majority of available papers are limited by the framework of a certain disease. Objective: to investigate the association of ADSDs with the characteristics of joint damage beyond the nosological approach. Subjects and methods. The investigation enrolled 38 women aged 18 years and older who had different RDs and preserved reproductive function, were treated at round-the-clock hospitals, and had no clinically significant comorbid diseases. All the patients were divided into two subgroups: 1) those with predominant hand joint injury and 2) those with joint involvement at other sites. All the patients were evaluated for disease activity (DAS-28-ESR, ASDAS-ESR), pain (visual analogue scale), and functional status (HAQ). The Hospital Anxiety and Depression Scale (HADS) was used to detect ADSDs and the Hamilton Anxiety Rating Scale (HAM-A) and the Hamilton Depression Rating Scale were employed to rate the severity of anxiety and depression, respectively. Results and discussion. The frequency of anxiety disorders evaluated through the HADS and the HAM-A was 44.7 and 34.2%, that of depressions was 34.2 and 60.5% respectively. The clinically evident level of HADS anxiety (11+) in Subgroup 1 was detected 5 times more frequently (30.0%) than in Subgroup 2 (5.5%); and that of HAM-A anxiety (18+) was twice as often: 45.0 and 22.2%, respectively. The frequency of clinically significant depression according to HADS (11+) and HAM-D (14+) in Subgroup 1 was 30.0 and 40.0%, and that in Group 2 was 11.1 and 16.7% respectively. The probability of severe depressions (HAM-D 19+) in hand joint injury was twice higher (odds ratio, 2.2; 95% confidence interval, 1.51–3.19) than in arthritis at various sites. Thus, this investigation provides evidence for the high frequency of ADSDS in patients with RDs. Reproductive-aged women with hand joint injury are one of the most vulnerable groups
GENETIC ASPECTS OF MYOCARDIAL INFARCTION: PROBLEMS AND PERSPECTIVES
No full textThe role of hereditary factors in the development of coronary heart disease and myocardial infarction is known, but the underlying pathogenetic mechanisms remain understudied. Multiple studies of candidate genes (those coding protein synthesis, participating in atherosclerosis pathogenesis, or regulating hemostasis and inflammation) have not been particularly successful. The main problem of these studies has been a very low level of reproducibility of the results obtained. By contrast, whole-genome association studies have provided new perspectives in this research area. This review discusses the modern relevant evidence and new directions for future research
GIANT CELL MYOCARDITIS IN HIV INFECTION: A FATAL TANDEM
No full textGiant cell myocarditis (GCM) is a rare autoimmune disease with the leading role of T-cell disorder in its pathogenesis. The associations are known of this disease with various autoimmunities, tumors, drug hypersensitivity. In the literary data there are just single cases of HCM development in HIV infected patients. The article presents clinical case and provides some discussion on the pathogenesis of HCM, making to think of HIV infection as one of possible causes of its development
IMPACT OF LOCUS 9P21.3 SINGLE NUCLEOTIDE POLYMORPHISMS ON CORONARY ATHEROSCLEROSIS SEVERITY AND LONG-TERM OUTCOMES AFTER PERCUTANEOUS CORONARY INTERVENTION IN PATIENT WITH MYOCARDIAL INFARCTION
No full textAim. To investigate association between 9p21.3 locus single nucleotide polymorphisms (SNPs) and coronary atherosclerosis severity and long-term outcomes after percutaneous coronary intervention (PCI) in patients with myocardial infarction (MI).Material and methods. A total of 255 Caucasian patients (211 male, 44 female; aged up to 65 years, on the average 52.56±7.98 years) with MI were recruited into the study from 01.01.2009 to 30.06.2010. All participants were included into the study after written informed consent. Genome DNA was extracted from leukocytes of venous blood by the phenol-chloroform extraction method. Two SNPs rs10757278 and rs1333049 (locus 9p21.3) were tested by real-time polymerase chain reaction (PCR) according to protocol (probes TaqMan, Applied Biosystems, 7900HT). The coronary angiograms were reviewed by independent angiographers who were blinded to the results of the genotyp- ing (Philips Allura Xper FD10). The total number of lesions, Gensini score and SYNTAX score were derived. Follow-up lasted two years.Results. Locus 9р21.3 genotypes CC rs1333049 and GG rs10757278 demonstrated a direct strong association with severity of coronary atheromatous burden (left main coro- nary artery stenosis, total number of lesions, Gensini score). There are not influence of locus 9p21.3 on mortality, recurrent MI, hospitalization due to unstable angina, repeated PCI, stroke during follow-up period (6, 12, 24 months). Frequency of the genotype СС rs1333049 among patients with recurrent MI was 20% (without recurrent MI — 27.4%; р=0.54); with hospitalization due to unstable angina — 27.5% (without hospitalization — 26.4%; р=0.82); with repeated PCI — 24.0% (without repeated PCI — 27.2%; р=0.97); among died patients — 29.8% (among survived ones — 26.4%; р=0.76). Frequencies of the genotype GG rs10757278 were similar: recurrent MI (yes — 18.8%; no — 26.4%; р=0.49); hospitalization due to unstable angina (yes — 28%; no — 25.3%; р=0.42); repeated PCI (yes — 23.7%; no — 26.3%; р=0.98); death (yes — 28.6%; no — 25%; р=0.51). Conclusion. Locus 9р21.3 genotypes CC rs1333049 and GG rs10757278 revealed significant association with severity of coronary atheromatous burden in patients with MI. There was no relationship between these genotypes of locus 9р21.3 SNPs and long-term PCI outcomes
PREDICTIVE ROLE OF CHROMOSOME 9P21.3 POLYMORPHISMS AND THEIR ASSOCIATION WITH FAMILY HISTORY OF CORONARY HEART DISEASE IN PATIENTS WITH MYOCARDIAL INFARCTION
No full textAim. To investigate the association between single-nucleotide polymorphisms (SNPs) rs10757278 and rs1333049 of the 9p21.3 locus and family history of coronary heart disease (CHD) in myocardial infarction (MI) patients. Material and methods. The MI group (n=243) and the control group (n=280) were comparable by such parameters as age, gender, arterial hypertension, diabetes mellitus, hypercholesterolemia, overweight and obesity, abdominal obesity, and smoking history. However, the groups were significantly different in terms of family history of CHD (p=0,004). Genome DNA was extracted from venous blood using the phenol-chloroform extraction method. The SNPs rs10757278 (9p21.3) and rs1333049 (9Sр21.3) were tested using real-time polymerase chain reaction (PCR) and the AB 7900HT device, according to the producer’s protocol (TaqMan probes, Applied Biosystems, USA). Results. A statistically significant association between MI and the CC rs1333049 genotype or the GG rs10757278 genotype was observed in the whole study sample and separately in men and women. The MI odds ratio (OR) for carriers of the CC rs1333049 genotype was 2,02 (95% confidence interval, CI, 1,32–3,08) in the whole sample, 1,91 (1,11–2,95) in men, and 2,91 (1,22–6,91) in women. For carriers of the GG rs10757278 genotype, respective OR values were 1,98 (1,30– 3,02), 1,77 (1,08–2,87), and 2,94 (1,26–6,87). Among participants without CHD in family history, OR for the CC rs1333049 genotype (1,92, 95% CI 1,16–3,16) and the GG rs10757278 genotype (1,82, 95% CI 1,10–3,00) were comparable for those among MI patients with CHD in family history (respective OR 2,19 (1,28–3,75) and 2,23 (1,31–3,81)). Conclusion. For the first time in Russia, the association between MI-related polymorphisms of the 9p21.3 chromosome and family history of CHD was analysed. Two SNPs (rs1333049 and rs10757278) of the 9p21.3 locus predicted MI risk independently from either conventional risk factors or CHD in family history
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