Feeds:
Posts
Comments

Archive for the ‘Systemic Inflammatory Diseases as CVD Risk’ Category

Eight Subcellular Pathologies driving Chronic Metabolic Diseases – Methods for Mapping Bioelectronic Adjustable Measurements as potential new Therapeutics: Impact on Pharmaceuticals in Use

Posted in Acute Myocardial Infarction, Adaptive Immune Response to Biomaterials and Tissue Repair, Advanced Drug Manufacturing Technology, Amino acids, Apoptosis, Apoptosis, Artificial intelligence applications for cardiology, Artificial Intelligence in Medicine - Application for Diagnosis, Artificial Intelligence in Medicine - Applications in Therapeutics, Atherogenic Processes & Pathology, Autoimmune Inflammatory DIseases, Autologous Cell Therapy, Automated Cell Processing, Autophagosome, Autophagy, Autophagy-Modulating Proteins, “Antibody–enzyme conjugates”, Bio Instrumentation in Experimental Life Sciences Research, Biochemical pathways, Bioengineering & reverse engineering design, Biological Engineering, Biomarkers & Medical Diagnostics, Biomedical Measurement Science, Ca2+ triggered activation, Calcium Signaling, Calmodulin, Calmodulin Kinase and Contraction, Cancer - General, Cardiac muscle regeneration, Cardiovascular Pharmacogenomics, Cell Biology, Signaling & Cell Circuits, Cell death pathways, Cell Processing System in Cell Therapy Process Development, Cerebrovascular and Neurodegenerative Diseases, Chemical Biology and its relations to Metabolic Disease, children, Clinical & Translational, Clinical Genomics, Computational Histopathology, congestive heart failure, Cytokine Receptor Structure, Cytokines, Deep Learning in Pathology, Dehydrogenase, Developmental biology, Diabetes Mellitus, Diagnostic Immunology, Disease Biology, Disease Biology, Small Molecules in Development of Therapeutic Drugs, Drug Carrier Design, Drug Delivery Platform Technology, Drug Discovery Chemistry, drug repurposing, Endocrine Diseases, Endoplasmic reticulum, Enzyme Induction, Enzymes and isoenzymes, Epigenetics and Cardiovascular Risks, Epigenetics and Environmental Factors, Evolution of Biology Through Culture, Fatty acids, Frontiers in Cardiology and Cardiovascular Disorders, Gastroenterology, Gene Regulation, Genome Biology, Genomic Analysis of EKG Electrophysiology Genomics, Genomic Endocrinology, Genomics Pharmacy, Glycobiology: Biopharmaceutical Production, Glycobiology: Biopharmaceutical Production, Pharmacodynamics and Pharmacokinetics, Gut Microbiome and Obesity, HTN, HTN in Youth, Human Antibody Response, Human Circulating Antibody Repertoire, Human Immune System in Health and in Disease, Human Sensation and Cellular Transduction: Physiology and Therapeutics, Immuno-Oncology & Genomics, Immunodiagnostics, Immunology, Immunotherapy, Indigent Nutrition, inflammation independent of lipid levels, Inflammatory Pathophysiology, Innovation in Immunology Diagnostics, Inosine nucleotides, Intellectual Property, Innovations, Commercialization, Investment in technological breakthrough, Interviews with Scientific Leaders, Investment in Technological Breakthrough, ion-transporting enzyme, IP Development by LPBI Group Team, Kinase, Lipid metabolism, Lipidomics, Lipids, Liposome, Liver & Digestive Diseases Research, Machine learning in predicting type 2 diabetes, Materials Science & Engineering, Medical and Population Genetics, Meta-analysis of transcriptome data, Metabolism, Metabolomics, Methylation, Microbiologial genetics, microbiome, Microfuidics, Micronutrients, Microvesicle, Molecular Genetics & Pharmaceutical, Mutant Gene Expression, Myocardial adenine nucleotide metabolism, Myocardial Ischemia, Myocardial Metabolism, Myocardial metabolism, Myocardial ischemia, myocardial perfusion, Myocardial adenine nucleotide metabolism, Na-K transport, Na-K-ATPase, Nanotechnology for Drug Delivery, Neurodegenerative Diseases, Neurohumoral Transmission, Neurological Diseases, Nitric Oxide in Health and Disease, Nutrigenomics, Nutrition, Nutrition and Phytochemistry, Nutrition Disorders, Nutritional Supplements: Atherogenesis, Nutritional Supplements: Atherogenesis, lipid metabolism, Obesity, Organic BioElectronics, Origins of Cardiovascular Disease, Pancreatic adenocarcinoma classifier, Patient-centered Medicine, Perioperative Statins at Noncardiac Surgery, Personalized and Precision Medicine & Genomic Research, Phagophore, Pharmaceutical Analytics, Pharmaceutical Drug Discovery, Pharmacodynamics and Pharmacokinetics, Pharmacogenomics, Pharmacotherapy and Cell Activity, Pharmacotherapy of Cardiovascular Disease, Phosphatase, Phosphorylase, Phosphorylation, Population Health Management, Population Health Management, Genetics & Pharmaceutical, Population Health Management, Nutrition and Phytochemistry, Precision Cancer Medicine, Protection Against Autoimmune Disease, Protein-energy malnutrition, Proteins, Proteomics, Rare heart rhythm disorders and Long QT syndrome (LQTS), Regenerative Biology and Medicine, RNA Biology, S-nitrosylation, Sensors & Analytics, Signaling, Signaling & Cell Circuits, single cell sequencing, Skeletal muscle regeneration, Small Molecules in Development of Therapeutic Drugs, Statistical Methods for Research Evaluation, Stress Disorders, Stroke, Stroke, Systemic Inflammatory Diseases as CVD Risk, Systemic Inflammatory Response Related Disorders, Technology Transfer: Biotech and Pharmaceutical, therapeutics, Tissue Engineering and Regenerative Medicine, Tissue Microenvironment, Tolerance-inducing Autoimmune Disease Therapeutics, Transcriptomics, Transformative Technologies in Healthcare, Translational Research, tyrosine decarboxylases, Ubiquitin, Ubiquitinylation, Unfolded Protein Response (UPR), Universal Immune Cell Therapies (uICT), Variation in human protein-coding regions, Vascular Diseases, Water Transporters on August 19, 2023| Leave a Comment »

Eight Subcellular Pathologies driving Chronic Metabolic Diseases – Methods for Mapping Bioelectronic Adjustable Measurements as potential new Therapeutics: Impact on Pharmaceuticals in Use

Curators:

 

THE VOICE of Aviva Lev-Ari, PhD, RN

In this curation we wish to present two breaking through goals:

Goal 1:

Exposition of a new direction of research leading to a more comprehensive understanding of Metabolic Dysfunctional Diseases that are implicated in effecting the emergence of the two leading causes of human mortality in the World in 2023: (a) Cardiovascular Diseases, and (b) Cancer

Goal 2:

Development of Methods for Mapping Bioelectronic Adjustable Measurements as potential new Therapeutics for these eight subcellular causes of chronic metabolic diseases. It is anticipated that it will have a potential impact on the future of Pharmaceuticals to be used, a change from the present time current treatment protocols for Metabolic Dysfunctional Diseases.

According to Dr. Robert Lustig, M.D, an American pediatric endocrinologist. He is Professor emeritus of Pediatrics in the Division of Endocrinology at the University of California, San Francisco, where he specialized in neuroendocrinology and childhood obesity, there are eight subcellular pathologies that drive chronic metabolic diseases.

These eight subcellular pathologies can’t be measured at present time.

In this curation we will attempt to explore methods of measurement for each of these eight pathologies by harnessing the promise of the emerging field known as Bioelectronics.

Unmeasurable eight subcellular pathologies that drive chronic metabolic diseases

  1. Glycation
  2. Oxidative Stress
  3. Mitochondrial dysfunction [beta-oxidation Ac CoA malonyl fatty acid]
  4. Insulin resistance/sensitive [more important than BMI], known as a driver to cancer development
  5. Membrane instability
  6. Inflammation in the gut [mucin layer and tight junctions]
  7. Epigenetics/Methylation
  8. Autophagy [AMPKbeta1 improvement in health span]

Diseases that are not Diseases: no drugs for them, only diet modification will help

Image source

Robert Lustig, M.D. on the Subcellular Processes That Belie Chronic Disease

https://www.youtube.com/watch?v=Ee_uoxuQo0I

 

Exercise will not undo Unhealthy Diet

Image source

Robert Lustig, M.D. on the Subcellular Processes That Belie Chronic Disease

https://www.youtube.com/watch?v=Ee_uoxuQo0I

 

These eight Subcellular Pathologies driving Chronic Metabolic Diseases are becoming our focus for exploration of the promise of Bioelectronics for two pursuits:

  1. Will Bioelectronics be deemed helpful in measurement of each of the eight pathological processes that underlie and that drive the chronic metabolic syndrome(s) and disease(s)?
  2. IF we will be able to suggest new measurements to currently unmeasurable health harming processes THEN we will attempt to conceptualize new therapeutic targets and new modalities for therapeutics delivery – WE ARE HOPEFUL

In the Bioelecronics domain we are inspired by the work of the following three research sources:

  1. Biological and Biomedical Electrical Engineering (B2E2) at Cornell University, School of Engineering https://www.engineering.cornell.edu/bio-electrical-engineering-0
  2. Bioelectronics Group at MIT https://bioelectronics.mit.edu/
  3. The work of Michael Levin @Tufts, The Levin Lab
Michael Levin is an American developmental and synthetic biologist at Tufts University, where he is the Vannevar Bush Distinguished Professor. Levin is a director of the Allen Discovery Center at Tufts University and Tufts Center for Regenerative and Developmental Biology. Wikipedia
Born: 1969 (age 54 years), Moscow, Russia
Education: Harvard University (1992–1996), Tufts University (1988–1992)
Affiliation: University of Cape Town
Research interests: Allergy, Immunology, Cross Cultural Communication
Awards: Cozzarelli prize (2020)
Doctoral advisor: Clifford Tabin
Fields: Developmental biology, synthetic biology
SOURCE
Most recent 20 Publications by Michael Levin, PhD
SOURCE
SCHOLARLY ARTICLE
The nonlinearity of regulation in biological networks
1 Dec 2023npj Systems Biology and Applications9(1)
Co-authorsManicka S, Johnson K, Levin M…
VIEW PDF10.1038/S41540-023-00273-W
3

3 total citations on Dimensions.

Article has an altmetric score of 20
SCHOLARLY ARTICLE
Toward an ethics of autopoietic technology: Stress, care, and intelligence
1 Sep 2023BioSystems231
Co-authorsWitkowski O, Doctor T, Solomonova E…
VIEW PDF10.1016/J.BIOSYSTEMS.2023.104964
Article has an altmetric score of 36
SCHOLARLY ARTICLE
Closing the Loop on Morphogenesis: A Mathematical Model of Morphogenesis by Closed-Loop Reaction-Diffusion
14 Aug 2023Frontiers in Cell and Developmental Biology11:1087650
Co-authorsGrodstein J, McMillen P, Levin M
VIEW PDF10.3389/FCELL.2023.1087650
Article has an altmetric score of 22
SCHOLARLY ARTICLE
Correcting instructive electric potential patterns in multicellular systems: External actions and endogenous processes.
30 Jul 2023Biochim Biophys Acta Gen Subj1867(10):130440
Co-authorsCervera J, Levin M, Mafe S
VIEW MORE INFO10.1016/J.BBAGEN.2023.130440
Article has an altmetric score of 20
SCHOLARLY ARTICLE
Regulative development as a model for origin of life and artificial life studies
1 Jul 2023BioSystems229
Co-authorsFields C, Levin M
10.1016/J.BIOSYSTEMS.2023.104927
1

1 citation on Dimensions.

Article has an altmetric score of 19
SCHOLARLY ARTICLE
The Yin and Yang of Breast Cancer: Ion Channels as Determinants of Left–Right Functional Differences
1 Jul 2023International Journal of Molecular Sciences24(13)
Co-authorsMasuelli S, Real S, McMillen P…
VIEW PDF10.3390/IJMS241311121
Article has an altmetric score of 7
SCHOLARLY ARTICLE
Bioelectricidad en agregados multicelulares de células no excitables- modelos biofísicos
Jun 2023Revista Española de Física32(2)
Co-authorsCervera J, Levin M, Mafé S
SCHOLARLY ARTICLE
Bioelectricity: A Multifaceted Discipline, and a Multifaceted Issue!
1 Jun 2023Bioelectricity5(2):75
Co-authorsDjamgoz MBA, Levin M
10.1089/BIOE.2023.0022.EDITORIAL
SCHOLARLY ARTICLE
Control Flow in Active Inference Systems – Part I: Classical and Quantum Formulations of Active Inference
1 Jun 2023IEEE Transactions on Molecular, Biological, and Multi-Scale Communications9(2):235-245
Co-authorsFields C, Fabrocini F, Friston K…
10.1109/TMBMC.2023.3272150
2

2 total citations on Dimensions.

Article has an altmetric score of 1
SCHOLARLY ARTICLE
Control Flow in Active Inference Systems – Part II: Tensor Networks as General Models of Control Flow
1 Jun 2023IEEE Transactions on Molecular, Biological, and Multi-Scale Communications9(2):246-256
Co-authorsFields C, Fabrocini F, Friston K…
10.1109/TMBMC.2023.3272158
2

2 total citations on Dimensions.

Article has an altmetric score of 1
SCHOLARLY ARTICLE
Darwin’s agential materials: evolutionary implications of multiscale competency in developmental biology
1 Jun 2023Cellular and Molecular Life Sciences80(6)
Co-authorsLevin M
VIEW PDF10.1007/S00018-023-04790-Z
1

1 citation on Dimensions.

Article has an altmetric score of 61
SCHOLARLY ARTICLE
Morphoceuticals: Perspectives for discovery of drugs targeting anatomical control mechanisms in regenerative medicine, cancer and aging
1 Jun 2023Drug Discovery Today28(6)
Co-authorsPio-Lopez L, Levin M
VIEW PDF10.1016/J.DRUDIS.2023.103585
1

1 citation on Dimensions.

Article has an altmetric score of 17
SCHOLARLY ARTICLE
Morphoceuticals: Perspectives for discovery of drugs targeting anatomical control mechanisms in regenerative medicine, cancer and aging
Jun 2023DRUG DISCOVERY TODAY28(6):1-13
Co-authorsPio-Lopez L, Levin M
VIEW MORE INFO10.1016/J.DRUDIS.2023.103585THIS
SCHOLARLY ARTICLE
Cellular signaling pathways as plastic, proto-cognitive systems: Implications for biomedicine
12 May 2023Patterns4(5)
Co-authorsMathews J, Chang A, Devlin L…
VIEW PDF10.1016/J.PATTER.2023.100737
3

3 total citations on Dimensions.

Article has an altmetric score of 18
SCHOLARLY ARTICLE
Making and breaking symmetries in mind and life
14 Apr 2023Interface Focus13(3)
Co-authorsSafron A, Sakthivadivel DAR, Sheikhbahaee Z…
VIEW PDF10.1098/RSFS.2023.0015
Article has an altmetric score of 7
SCHOLARLY ARTICLE
The scaling of goals from cellular to anatomical homeostasis: an evolutionary simulation, experiment and analysis
14 Apr 2023Interface Focus13(3)
Co-authorsPio-Lopez L, Bischof J, LaPalme JV…
VIEW PDF10.1098/RSFS.2022.0072
1

1 citation on Dimensions.

Article has an altmetric score of 30
SCHOLARLY ARTICLE
The collective intelligence of evolution and development
Apr 2023Collective Intelligence2(2):263391372311683SAGE Publications
Co-authorsWatson R, Levin M
VIEW PDF10.1177/26339137231168355
Article has an altmetric score of 65
SCHOLARLY ARTICLE
Bioelectricity of non-excitable cells and multicellular pattern memories: Biophysical modeling
13 Mar 2023Physics Reports1004:1-31
Co-authorsCervera J, Levin M, Mafe S
10.1016/J.PHYSREP.2022.12.003
2

2 total citations on Dimensions.

Article has an altmetric score of 25
SCHOLARLY ARTICLE
There’s Plenty of Room Right Here: Biological Systems as Evolved, Overloaded, Multi-Scale Machines
1 Mar 2023Biomimetics8(1)
Co-authorsBongard J, Levin M
VIEW PDF10.3390/BIOMIMETICS8010110
4

4 total citations on Dimensions.

Article has an altmetric score of 26
SCHOLARLY ARTICLE
Transplantation of fragments from different planaria: A bioelectrical model for head regeneration
7 Feb 2023Journal of Theoretical Biology558
Co-authorsCervera J, Manzanares JA, Levin M…
VIEW PDF10.1016/J.JTBI.2022.111356
SCHOLARLY ARTICLE
Bioelectric networks: the cognitive glue enabling evolutionary scaling from physiology to mind
1 Jan 2023Animal Cognition
Co-authorsLevin M
VIEW PDF10.1007/S10071-023-01780-3
2

2 total citations on Dimensions.

Article has an altmetric score of 62
SCHOLARLY ARTICLE
Biological Robots: Perspectives on an Emerging Interdisciplinary Field
1 Jan 2023Soft Robotics
Co-authorsBlackiston D, Kriegman S, Bongard J…
10.1089/SORO.2022.0142
1

1 citation on Dimensions.

Article has an altmetric score of 56
SCHOLARLY ARTICLE
Cellular Competency during Development Alters Evolutionary Dynamics in an Artificial Embryogeny Model
1 Jan 2023Entropy25(1)
Co-authorsShreesha L, Levin M
VIEW PDF10.3390/E25010131
5

5 total citations on Dimensions.

Article has an altmetric score of 16
SCHOLARLY ARTICLE
Endless forms most beautiful 2.0: teleonomy and the bioengineering of chimaeric and synthetic organisms (July, blac073, 2022)
1 Jan 2023BIOLOGICAL JOURNAL OF THE LINNEAN SOCIETY138(1):141
Co-authorsClawson WP, Levin M
VIEW PDFVIEW MORE INFO10.1093/BIOLINNEAN/BLAC116
SCHOLARLY ARTICLE
Future medicine: from molecular pathways to the collective intelligence of the body
1 Jan 2023Trends in Molecular Medicine
Co-authorsLagasse E, Levin M
10.1016/J.MOLMED.2023.06.007

THE VOICE of Dr. Justin D. Pearlman, MD, PhD, FACC

PENDING

THE VOICE of  Stephen J. Williams, PhD

Ten TakeAway Points of Dr. Lustig’s talk on role of diet on the incidence of Type II Diabetes

 

  1. 25% of US children have fatty liver
  2. Type II diabetes can be manifested from fatty live with 151 million  people worldwide affected moving up to 568 million in 7 years
  3. A common myth is diabetes due to overweight condition driving the metabolic disease
  4. There is a trend of ‘lean’ diabetes or diabetes in lean people, therefore body mass index not a reliable biomarker for risk for diabetes
  5. Thirty percent of ‘obese’ people just have high subcutaneous fat.  the visceral fat is more problematic
  6. there are people who are ‘fat’ but insulin sensitive while have growth hormone receptor defects.  Points to other issues related to metabolic state other than insulin and potentially the insulin like growth factors
  7. At any BMI some patients are insulin sensitive while some resistant
  8. Visceral fat accumulation may be more due to chronic stress condition
  9. Fructose can decrease liver mitochondrial function
  10. A methionine and choline deficient diet can lead to rapid NASH development

 

Read Full Post »

The Framingham Study: Across 6 Decades, Cardiovascular Disease Among Middle-Aged Adults – mean life expectancy increased and the RLR of ASCVD decreased. Effective primary prevention efforts and better screening increased.

Posted in Atherogenic Processes & Pathology, Electrophysiology, Frontiers in Cardiology and Cardiovascular Disorders, HTN, inflammation independent of lipid levels, Origins of Cardiovascular Disease, Pharmacotherapy of Cardiovascular Disease, Population Health Management, Population Health Management, Genetics & Pharmaceutical, Systemic Inflammatory Diseases as CVD Risk, Vascular Diseases on April 22, 2022| Leave a Comment »

The Framingham Study: Across 6 Decades, Cardiovascular Disease Among Middle-Aged Adults – mean life expectancy increased and the RLR of ASCVD decreased. Effective primary prevention efforts and better screening increased.

Reporter: Aviva Lev-Ari, PhD, RN

UPDATED on 8/27/2023

Cardiovascular disease & why we should change the way we assess risk | The Peter Attia Drive Podcast

https://www.youtube.com/watch?v=W1geXgNEG_0

Temporal Trends in the Remaining Lifetime Risk of Cardiovascular Disease Among Middle-Aged Adults Across 6 Decades: The Framingham Study

Ramachandran S. Vasan

Danielle M Enserro

Vanessa Xanthakis

Alexa S Beiser

 and 

Sudha Seshadri

Originally published 18 Apr 2022

https://doi.org/10.1161/CIRCULATIONAHA.121.057889 Circulation. 2022;0

Abstract

Background: The remaining lifetime risk (RLR) is the probability of developing an outcome over the remainder of one’s lifespan at any given age. The RLR for atherosclerotic cardiovascular disease (ASCVD) in three 20-year periods were assessed using data from a single community-based cohort study of predominantly White participants

Methods: Longitudinal data from the Framingham study in 3 epochs (epoch 1, 1960-1979; epoch 2, 1980-1999; epoch 3, 2000-2018) were evaluated. The RLR of a first ASCVD event (myocardial infarction, coronary heart disease death, or stroke) from 45 years of age (adjusting for competing risk of death) in the 3 epochs were compared overall, and according to the following strata: sex, body mass index, blood pressure and cholesterol categories, diabetes, smoking, and Framingham risk score groups.

Results: There were 317 849 person-years of observations during the 3 epochs (56% women; 94% White) and 4855 deaths occurred. Life expectancy rose by 10.1 years (men) to 11.9 years (women) across the 3 epochs. There were 1085 ASCVD events over the course of 91 330 person-years in epoch 1, 1330 ASCVD events over the course of 107 450 person years in epoch 2, and 775 ASCVD events over the course of 119 069 person-years in epoch 3. The mean age at onset of first ASCVD event was greater in the third epoch by 8.1 years (men) to 10.3 years (women) compared with the first epoch. The RLR of ASCVD from 45 years of age declined from 43.7% in epoch 1 to 28.1% in epoch 3 (P<0.0001), a finding that was consistent in both sexes (RLR [epoch 1 versus epoch 3], 36.3% versus 26.5% [women]; 52.5% versus 30.1% [men]; P<0.001 for both). The lower RLR of ASCVD in the last 2 epochs was observed consistently across body mass index, blood pressure, cholesterol, diabetes, smoking, and Framingham risk score strata (P<0.001 for all). The RLR of coronary heart disease events and stroke declined in both sexes (P<0.001).

Conclusions: Over the past 6 decades, mean life expectancy increased and the RLR of ASCVD decreased in the community based, predominantly White Framingham study. The residual burden of ASCVD underscores the importance of continued and effective primary prevention efforts with better screening for risk factors and their effective treatment.

SOURCE

https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.057889#.Yl6sSKaYNF4.linkedin

Read Full Post »

Precision Cardiology to Benefit from New Atlas of Cells of the Adult Human Heart

Posted in Cardiovascular Research, Frontiers in Cardiology and Cardiovascular Disorders, Origins of Cardiovascular Disease, Resident-cell-based, Single Cell Genomics, Single-cell sequencing, Systemic Inflammatory Diseases as CVD Risk, Variation in human protein-coding regions on September 29, 2020| Leave a Comment »

Precision Cardiology to Benefit from New Atlas of Cells of the Adult Human Heart

Reporters: Justin D. Pearlman, MD, PhD, FACC and Aviva Lev-Ari, PhD, RN

 

The Voice of Dr. Pearlman on potential clinical implications of the New Atlas:

 

Published on 9/24/2020 in Nature

Litviňuková, M., Talavera-López, C., Maatz, H. et al. Cells of the adult human heart. Nature (2020). https://doi.org/10.1038/s41586-020-2797-4

 

Abstract

Cardiovascular disease is the leading cause of death worldwide. Advanced insights into disease mechanisms and therapeutic strategies require deeper understanding of the healthy heart’s molecular processes. Knowledge of the full repertoire of cardiac cells and their gene expression profiles is a fundamental first step in this endeavor. Here, using state-of-the-art analyses of large-scale single-cell and nuclei transcriptomes, we characterise six anatomical adult heart regions. Our results highlight the cellular heterogeneity of cardiomyocytes, pericytes, and fibroblasts, revealing distinct atrial and ventricular subsets with diverse developmental origins and specialized properties. We define the complexity of the cardiac vasculature and its changes along the arterio-venous axis. In the immune compartment we identify cardiac resident macrophages with inflammatory and protective transcriptional signatures. Further, inference of cell-cell interactions highlight different macrophage-fibroblast-cardiomyocyte networks between atria and ventricles that are distinct from skeletal muscle. Our human cardiac cell atlas improves our understanding of the human heart and provides a healthy reference for future studies.

Author information

Author notes

  1. These authors contributed equally: Monika Litviňuková, Carlos Talavera-López, Henrike Maatz, Daniel Reichart
  2. These authors jointly supervised this work: J. G. Seidman, Christine E. Seidman, Michela Noseda, Norbert Hubner, Sarah A. Teichmann

Affiliations

  1. Cellular Genetics Programme, Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge, CB10 1SA, United Kingdom

    Monika Litviňuková, Carlos Talavera-López, Krzysztof Polanski, Kenny Roberts, Liz Tuck, Eirini S. Fasouli, Hongbo Zhang, Omer Bayraktar & Sarah A. Teichmann

  2. Cardiovascular and Metabolic Sciences, Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany

    Monika Litviňuková, Henrike Maatz, Catherine L. Worth, Eric L. Lindberg, Masatoshi Kanda, Giannino Patone & Norbert Hubner

  3. EMBL – EBI, Wellcome Genome Campus, Hinxton, Cambridge, CB10 1SA, United Kingdom

    Carlos Talavera-López

  4. Department of Genetics, Harvard Medical School, Boston, MA, United States

    Daniel Reichart, Emily R. Nadelmann, Daniel M. DeLaughter, Hiroko Wakimoto, Joshua M. Gorham, J. G. Seidman & Christine E. Seidman

  5. Dept Physics/Cavendish Laboratory, University of Cambridge, JJ Thompson Ave, Cambridge, CB3 0EH, United Kingdom

    Sarah A. Teichmann

  6. Department of Cardiology, University Heart & Vascular Center, University of Hamburg, Hamburg, Germany

    Daniel Reichart

  7. National Heart and Lung Institute, Imperial College London, London, United Kingdom

    Michael Lee, Sara Samari, Joseph J. Boyle & Michela Noseda

  8. British Heart Foundation Centre of Research Excellence and Centre of Regenerative Medicine, Imperial College London, London, United Kingdom

    Michela Noseda

  9. Department of Surgery, University of Cambridge, NIHR Cambridge Biomedical Centre, and Cambridge Biorepository for Translational Medicine, Cambridge, United Kingdom

    Krishnaa T. Mahbubani & Kourosh Saeb-Parsy

  10. Charité-Universitätsmedizin, Berlin, Germany

    Norbert Hubner

  11. Berlin Institute of Health (BIH), Berlin, Germany

    Norbert Hubner

  12. DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany

    Barbara McDonough & Norbert Hubner

  13. Cardiovascular Division, Brigham and Women’s Hospital, Boston, MA, United States

    Barbara McDonough & Christine E. Seidman

  14. Howard Hughes Medical Institute, Chevy Chase, MD, United States

    Christine E. Seidman

  15. Institute of Computational Biology (ICB), HMGU, Neuherberg, Germany

    Matthias Heinig

  16. Department of Informatics, Technische Universitaet Muenchen (TUM), Munich, Germany

    Matthias Heinig

  17. Division of Cardiology, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada

    Hao Zhang, Anissa Viveiros & Gavin Y. Oudit

  18. Mazankowski Alberta Heart Institute, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada

    Hao Zhang, Anissa Viveiros & Gavin Y. Oudit

  19. Department of Histology and Embryology of Zhongshan School of Medicine, Sun-Yat Sen University, Guangzhou, China

    Hongbo Zhang

  20. Department of Rheumatology and Clinical Immunology, Sapporo Medical University, Sapporo, Japan

    Masatoshi Kanda

Corresponding authors

Correspondence to J. G. Seidman or Christine E. Seidman or Michela Noseda or Norbert Hubner or Sarah A. Teichmann.

Read Full Post »

COVID concern in Cardiology: Asymptomatic patients who have been previously infected demonstrating evidence on MRI of scarring or myocarditis

Posted in Atherogenic Processes & Pathology, Biomarkers: Inflammation, Cardio-Oncology, COVID-19, COVID-19 effects on Human Heart, Frontiers in Cardiology and Cardiovascular Disorders, inflammation independent of lipid levels, Medical Imaging Technology, Image Processing/Computing, MRI, CT, Nuclear Medicine, Ultra Sound, Origins of Cardiovascular Disease, Population Health Management, Genetics & Pharmaceutical, SAR-Cov-2 a vasculotropic (blood vessels) RNA Virus, Systemic Inflammatory Diseases as CVD Risk, Treatment Protocols for COVID-19, Virus Infective Acute Respiratory Syndrome: SARS-CoV on September 21, 2020| Leave a Comment »

COVID concern in Cardiology: Asymptomatic patients who have been previously infected demonstrating evidence on MRI of scarring or myocarditis

Reporters: Justin D. Pearlman, MD, PhD, FACC and Aviva Lev-Ari, PhD, RN

 

The Voice of Dr. Justin D. Pearlman, MD, PhD, FACC

Indeed, many viruses can cause inflammation and weakening of the heart.

So far there is no established action to take for prevention, and management is based on clinical manifestations of heart failure: shortness of breath, particularly if worse laying flat or worse with exertion, leg swelling (edema), blood tests showing elevated brain natriuretic peptide (BNP or proBNP, a marker of heart muscle strain), and a basic metabolic panel that may show “pre-renal azotemia” (elevation of BUN and Creatinine, typically in a ratio >20:1) and/or hyponatremia (sodium concentration below 135 mEq/dL). If any of the above are suspected, it is reasonable to get transthoracic echocardiography for systolic and diastolic function. If either systolic or diastolic function by ultrasound show significant impairment not improved by usual therapy (diuretic, ACEI/ARB/ARNI, blocker, aldosterone inhibitor e.g. spironolactone) then an MRI scar map may be considered (MRI scar maps show retention of gadolinium contrast agent by injured heart muscle, first demonstrated by Dr. Justin Pearlman during angiogenesis research MRI studies).

There is no controversy in the above, the controversy is a rush to expanded referral for cardiac MRI without clear clinical evidence of heart impairment, at a stage when there is no established therapy for possible detection of myocarditis (cardiac inflammation). General unproven measures for inflammation may include taking ginger and tumeric supplements if well tolerated by the stomach, drinking 2 cups/day of Rooibos Tea if well tolerated by the liver.

Canakinumab was recommended by one research group to treat inflammation and risk to the heart if the blood test hsCRP is elevated (in addition to potential weakening of muscle, inflammation activates complement, makes atherosclerosis lesions unstable, and thus may elevate risk of heart attack, stroke, renal failure or limb loss from blocked blood delivery). The canakinumab studies were published in NEJM and LANCET with claims of significant improvement in outcomes, but that was not approved by FDA or confirmed by other groups, even though it has biologic plausibility. https://www.thelancet.com/journals/lancet/article/PIIS0140-67361732247-X/fulltext

 

Some Heart Societies Agree on Cautions for COVID-Myocarditis Screening

— Official response has been modest, though

by Crystal Phend, Senior Editor, MedPage Today September 18, 2020

Such evidence of myocardial injury and inflammation on CMR turned up in a German study among people who recovered from largely mild or moderate cases of COVID-19 compared with healthy controls and risk factor-matched controls.

Then an Ohio State University study showed CMR findings suggestive of myocarditis in 15% of collegiate athletes after asymptomatic or mild SARS-CoV-2 infection.

But an open letter from some 50 medical professionals across disciplines emphasized that “prevalence, clinical significance and long-term implications” of such findings aren’t known. The letter called on the 18 professional societies to which it was sent on Tuesday to release clear guidance against CMR screening in the general population to look for post-COVID heart damage in the absence of symptoms.

The Society for Cardiac Magnetic Resonance quickly responded with a brief statement from its chief executive officer, Chiara Bucciarelli-Ducci, MD, PhD, agreeing that routine CMR in asymptomatic patients after COVID-19 “is currently not justified… and it should not be encouraged.”

She referred clinicians to the multisociety guidelines on clinical indications of CMR when deciding whether to scan COVID-19 patients. “While CMR is an excellent imaging tool for diagnosing myocarditis in patients with suspected disease, we do not recommend its use in patients without symptoms,” she added.

The American Heart Association didn’t put out any written statement but offered spokesperson Manesh Patel, MD, chair of its Diagnostic and Interventional Cath Committee.

“The American Heart Association’s position on this is that in general we agree that routine cardiac MRI should not be conducted unless in the course of a study” for COVID-19 patients, he said. “There’s a lot of evolving information around people with COVID, and certainly asymptomatic status, whether it’s recent or prior, it’s not clearly known what the MRI findings will mean or what the long-term implications are without both a control group and an understanding around population.”

The ACC opted against taking a stand. It provided MedPage Today with the following statement from ACC President Athena Poppas, MD:

“We appreciate the authors’ concerns about the potential mischaracterization of the long-term impact of myocarditis after a COVID-19 diagnosis and the need for well-designed clinical trials and careful, long term follow-up. The pandemic is requiring everyone make real-time decisions on how to best care for heart disease patients who may be impacted by COVID-19. The ACC is committed to helping synthesize and provide the most up-to-date, high quality information possible to the cardiovascular care team. We will continue to review and assess the scientific data surrounding cardiac health and COVID-19 and issue guidance to help our care team.”

While the open letter noted that some post-COVID patients have been asking for CMR, Walsh noted that primary care would likely see the brunt of any such influx. She personally has not had any patients ask to be screened.

SOURCE

https://www.medpagetoday.com/infectiousdisease/covid19/88704?xid=nl_covidupdate_2020-09-21

Effect of interleukin-1β inhibition with canakinumab on incident lung cancer in patients with atherosclerosis: exploratory results from a randomised, double-blind, placebo-controlled trial

Published:August 27, 2017DOI:https://doi.org/10.1016/S0140-6736(17)32247-X

Summary

Background

Inflammation in the tumour microenvironment mediated by interleukin 1β is hypothesised to have a major role in cancer invasiveness, progression, and metastases. We did an additional analysis in the Canakinumab Anti-inflammatory Thrombosis Outcomes Study (CANTOS), a randomised trial of the role of interleukin-1β inhibition in atherosclerosis, with the aim of establishing whether inhibition of a major product of the Nod-like receptor protein 3 (NLRP3) inflammasome with canakinumab might alter cancer incidence.

Methods

We did a randomised, double-blind, placebo-controlled trial of canakinumab in 10 061 patients with atherosclerosis who had had a myocardial infarction, were free of previously diagnosed cancer, and had concentrations of high-sensitivity C-reactive protein (hsCRP) of 2 mg/L or greater. To assess dose–response effects, patients were randomly assigned by computer-generated codes to three canakinumab doses (50 mg, 150 mg, and 300 mg, subcutaneously every 3 months) or placebo. Participants were followed up for incident cancer diagnoses, which were adjudicated by an oncology endpoint committee masked to drug or dose allocation. Analysis was by intention to treat. The trial is registered with ClinicalTrials.gov, NCT01327846. The trial is closed (the last patient visit was in June, 2017).

Findings

Baseline concentrations of hsCRP (median 6·0 mg/L vs 4·2 mg/L; p<0·0001) and interleukin 6 (3·2 vs 2·6 ng/L; p<0·0001) were significantly higher among participants subsequently diagnosed with lung cancer than among those not diagnosed with cancer. During median follow-up of 3·7 years, compared with placebo, canakinumab was associated with dose-dependent reductions in concentrations of hsCRP of 26–41% and of interleukin 6 of 25–43% (p<0·0001 for all comparisons). Total cancer mortality (n=196) was significantly lower in the pooled canakinumab group than in the placebo group (p=0·0007 for trend across groups), but was significantly lower than placebo only in the 300 mg group individually (hazard ratio [HR] 0·49 [95% CI 0·31–0·75]; p=0·0009). Incident lung cancer (n=129) was significantly less frequent in the 150 mg (HR 0·61 [95% CI 0·39–0·97]; p=0·034) and 300 mg groups (HR 0·33 [95% CI 0·18–0·59]; p<0·0001; p<0·0001 for trend across groups). Lung cancer mortality was significantly less common in the canakinumab 300 mg group than in the placebo group (HR 0·23 [95% CI 0·10–0·54]; p=0·0002) and in the pooled canakinumab population than in the placebo group (p=0·0002 for trend across groups). Fatal infections or sepsis were significantly more common in the canakinumab groups than in the placebo group. All-cause mortality did not differ significantly between the canakinumab and placebo groups (HR 0·94 [95% CI 0·83–1·06]; p=0·31).

Interpretation

Our hypothesis-generating data suggest the possibility that anti-inflammatory therapy with canakinumab targeting the interleukin-1β innate immunity pathway could significantly reduce incident lung cancer and lung cancer mortality. Replication of these data in formal settings of cancer screening and treatment is required.

Funding

Novartis Pharmaceuticals.

Read Full Post »

The Role of Cholesterol Crystals in increase of NLRP3 Inflammasome affecting Coronary Artery Disease & Carotid Atherosclerosis

Posted in Atherogenic Processes & Pathology, Frontiers in Cardiology and Cardiovascular Disorders, Origins of Cardiovascular Disease, Systemic Inflammatory Diseases as CVD Risk, Vascular Diseases on September 15, 2020| Leave a Comment »

The Role of Cholesterol Crystals in increase of NLRP3 Inflammasome affecting Coronary Artery Disease & Carotid Atherosclerosis

Reporters: Justin D. Pearlman, MD, PhD, FACC and Aviva Lev-Ari, PhD, RN

The Voice of Dr. Justin D. Pearlman, MD, PhD, FACC

Justin D. Pearlman, MD, PhD, FACC – Scientific Expert & Key Opinion Leader on Cardiovascular Diseases, Cardiac Imaging & Complex Diagnosis in Cardiology: Senior Editor & Author

The study published in Lancet https://www.thelancet.com/journals/ebiom/article/PIIS2352-3964(20)30361-3/fulltext

shows plausible evidence for a sequence of events following atheroma crystal formation in blood vessel walls leading to inflammation and consequential injuries from atherosclerosis. The liquid crystal behavior of atheroma was first demonstrated in original PhD dissertation by JDPearlman MD PhD who demonstrated that 0.5 C temperature shift at body temperature converts the physical state of atheroma lipids to crystalline, known as liquid-crystal behavior, and studies he performed with NMR (nuclear magnetic resonance) and EPR (electron paramagnetic resonance) demonstrated that triglyceride levels impact the transition temperature. The current study shows a cascade of responses to the atheroma crystallization that leads to damaging inflammation and risk of acute obstruction. In particular, the current study demonstrates accumulation of blood complement factor complexes C1q and C5b-9, along with increases in complement receptors C5aR1, C5aR2 and C3aR1.  Priming human carotid plaques with C5a followed by cholesterol crystal incubation resulted in pronounced release of interleukins IL-1β, IL-18 and IL-1α. Further understanding of the dominant pathways linking atheroma crystallization to unstable plaque with clinical consequences (heart attack, stroke) points to additional opportunities for medication or gene therapy to mitigate the harm.

Cholesterol crystals use complement to increase NLRP3 signaling pathways in coronary and carotid atherosclerosis

Open AccessPublished:September 11, 2020 DOI:https://doi.org/10.1016/j.ebiom.2020.102985

Abstract

Background

During atherogenesis, cholesterol precipitates into cholesterol crystals (CC) in the vessel wall, which trigger plaque inflammation by activating the NACHT, LRR and PYD domains-containing protein 3 (NLRP3) inflammasome. We investigated the relationship between CC, complement and NLRP3 in patients with cardiovascular disease.

Methods

We analysed plasma, peripheral blood mononuclear cells (PBMC) and carotid plaques from patients with advanced atherosclerosis applying ELISAs, multiplex cytokine assay, qPCR, immunohistochemistry, and gene profiling.

Findings

Transcripts of interleukin (IL)-1beta(β) and NLRP3 were increased and correlated in PBMC from patients with acute coronary syndrome (ACS). Priming of these cells with complement factor 5a (C5a) and tumour necrosis factor (TNF) before incubation with CC resulted in increased IL-1β protein when compared to healthy controls. As opposed to healthy controls, systemic complement was significantly increased in patients with stable angina pectoris or ACS. In carotid plaques, complement C1q and C5b-9 complex accumulated around CC-clefts, and complement receptors C5aR1, C5aR2 and C3aR1 were higher in carotid plaques compared to control arteries. Priming human carotid plaques with C5a followed by CC incubation resulted in pronounced release of IL-1β, IL-18 and IL-1α. Additionally, mRNA profiling demonstrated that C5a and TNF priming followed by CC incubation upregulated plaque expression of NLRP3 inflammasome components.

Interpretation

We demonstrate that CC are important local- and systemic complement activators, and we reveal that the interaction between CC and complement could exert its effect by activating the NLRP3 inflammasome, thus promoting the progression of atherosclerosis.

Keywords

Read Full Post »

Dr. Giordano Featured in Forbes Article on COVID-19 Antibody Tests in Italy and USA

Posted in Biomarkers: Inflammation, Cancer Researchers Fighting COVID-19, Coronavirus Gene Expression, COVID-19, COVID-19, COVID-19 effects on Human Heart, COVID-19: Pandemic Surgery Guidance, Diagnostic Immunology, Diagnostics and Lab Tests, Economic Impact of Coronavirus Pandemic, Evolution of Biology Through Culture, Frontiers in Cardiology and Cardiovascular Disorders, Immune-Mediation (independent immunopathology: lung and reticuloendothelial system), Interviews with Key Opinion Leaders (KOLs), number of asymptomatic infections, Population Health Management, Population Health Management, Genetics & Pharmaceutical, SAR-Cov-2 a vasculotropic (blood vessels) RNA Virus, Scientific Publishing, Systemic Inflammatory Diseases as CVD Risk, tagged , , , , , , , , , , on May 10, 2020| Leave a Comment »

Dr. Giordano Featured in Forbes Article on COVID-19 Antibody Tests in Italy and USA

Reporter: Stephen J. Williams, PhD

via Dr. Giordano Featured in Forbes Article on COVID-19 Antibody Tests in Italy and USA

Read Full Post »

The role of PET/CT in diagnosing giant cell arteritis (GCA) and assessing the risk of ischemic events

Posted in Frontiers in Cardiology and Cardiovascular Disorders, inflammation independent of lipid levels, Medical Imaging Technology, Medical Imaging Technology, Image Processing/Computing, MRI, CT, Nuclear Medicine, Ultra Sound, Systemic Inflammatory Diseases as CVD Risk, Vascular Diseases on May 22, 2019| Leave a Comment »

The role of PET/CT in diagnosing giant cell arteritis (GCA) and assessing the risk of ischemic events

 

Reporter: Aviva Lev-Ari, PhD, RN

 

 

May 20, 2019 — PET/CT images are offering evidence of a link between vascular patterns at the time of diagnosis for giant cell arteritis (GCA) and a patient’s risk of an ischemic event, Spanish researchers explained in a study published online on 12 May in the European Journal of Nuclear Medicine and Molecular Imaging.

The group found that patients with inflammation in vertebral arteries, which causes blood vessels to narrow, were five times more likely to develop ischemic symptoms. The information may be particularly helpful because GCA is difficult to diagnose in its early stages.

“Bearing in mind these results and our findings, we consider that the vertebral arteries should be carefully studied in patients with suspected GCA, not only to support the diagnosis but also to assess the risk of development of ischemic events,” wrote lead author Dr. Jaume Mestre-Torres and colleagues from Hospital Vall d’Hebron in Barcelona.

GCA’s challenges

Giant cell arteritis is an inflammatory disease that causes the large blood vessels to narrow and restrict blood flow. The affliction is typically seen in the temporal arteries and the aorta in adults older than 50. Currently, there is little information on how the disease develops, although there are indications that it may be linked to genetics.

The challenge for clinicians is that there are “no specific clinical symptoms that lead to the diagnosis of GCA, but headache and ischemic symptoms such as jaw claudication and transient visual loss or permanent visual loss may raise suspicion [of the disease],” the authors noted.

Results

In assessing visual loss, the team found no significant differences between patients with vertebral artery involvement and permanent visual loss (61.5%) and patients with vertebral artery issues and no permanent visual loss (58.8%) (p = 0.88). Interestingly, the presence of intrathoracic large-vessel vasculitis tended to protect against a patient’s likelihood of permanent visual loss.

In addition, “all patients with vertebral involvement but no aortic involvement showed ischemic manifestations at disease onset,” the researchers noted. “In contrast, none of the patients with aortic involvement but no vertebral hypermetabolism showed ischemic symptoms.”

SOURCE

https://www.auntminnieeurope.com/index.aspx?sec=sup&sub=mol&pag=dis&ItemID=617395

Read Full Post »

@Cleveland Clinic – Serial measurements of high-sensitivity C-reactive protein (hsCRP) post acute coronary syndrome (ACS) may help identify patients at higher risk for morbidity and mortality

Posted in Acute coronary syndrome, Acute Myocardial Infarction, Atherogenic Processes & Pathology, Cardiovascular Research, Frontiers in Cardiology and Cardiovascular Disorders, HTN, inflammation independent of lipid levels, Origins of Cardiovascular Disease, Pharmacotherapy of Cardiovascular Disease, Systemic Inflammatory Diseases as CVD Risk on May 5, 2019| Leave a Comment »

@Cleveland Clinic – Serial measurements of high-sensitivity C-reactive protein (hsCRP) post acute coronary syndrome (ACS) may help identify patients at higher risk for morbidity and mortality

 

Reporter: Aviva Lev-Ari, PhD, RN

 

Original Investigation
March 6, 2019

Association of Initial and Serial C-Reactive Protein Levels With Adverse Cardiovascular Events and Death After Acute Coronary Syndrome, A Secondary Analysis of the VISTA-16 Trial

Preethi Mani, MD1; Rishi Puri, MBBS, PhD1,2; Gregory G. Schwartz, MD, PhD3; et alSteven E. Nissen, MD1,2; Mingyuan Shao, MS2; John J. P. Kastelein, MD, PhD4; Venu Menon, MD1,2; A. Michael Lincoff, MD1,2; Stephen J. Nicholls, MBBS, PhD5
Author Affiliations Article Information
JAMA Cardiol. 2019;4(4):314-320. doi:10.1001/jamacardio.2019.0179

Key Points

Question  Are initial and serial increases in high-sensitivity C-reactive protein levels after acute coronary syndrome in medically optimized patients associated with increased risk of a major cardiac event, cardiovascular death, and all-cause death?

Findings  In this secondary analysis of the VISTA-16 randomized clinical trial that included 5145 patients, baseline and longitudinal high-sensitivity C-reactive protein levels were independently associated with increased risk of a major adverse cardiac event, cardiovascular death, and all-cause death during the 16-week follow-up.

Meaning  Monitoring high-sensitivity C-reactive protein levels in patients after acute coronary syndrome may help better identify patients at greater risk for recurrent cardiovascular events or death.

Abstract

Importance  Higher baseline high-sensitivity C-reactive protein (hsCRP) levels after an acute coronary syndrome (ACS) are associated with adverse cardiovascular outcomes. The usefulness of serial hsCRP measurements for risk stratifying patients after ACS is not well characterized.

Objective  To assess whether longitudinal increases in hsCRP measurements during the 16 weeks after ACS are independently associated with a greater risk of a major adverse cardiac event (MACE), all-cause death, and cardiovascular death.

Results  Among 4257 patients in this study, 3141 (73.8%) were men and the mean age was 60.3 years (interquartile range [IQR], 53.5-67.8 years). The median 16-week low-density lipoprotein cholesterol level was 64.9 mg/dL (IQR, 50.3-82.3 mg/dL), and the median hsCRP level was 2.4 mg/L (IQR, 1.1-5.2 mg/L). On multivariable analysis, higher baseline hsCRP level (hazard ratio [HR], 1.36 [95% CI, 1.13-1.63]; P = .001) and higher longitudinal hsCRP level (HR, 1.15 [95% CI, 1.09-1.21]; P < .001) were independently associated with MACE. Similar significant and independent associations were shown between baseline and longitudinal hsCRP levels and cardiovascular death (baseline: HR, 1.61 per SD [95% CI, 1.07-2.41], P = .02; longitudinal: HR, 1.26 per SD [95% CI, 1.19-1.34], P < .001) and between baseline and longitudinal hsCRP levels and all-cause death (baseline: HR, 1.58 per SD [95% CI, 1.07-2.35], P = .02; longitudinal: HR, 1.25 per SD [95% CI, 1.18-1.32], P < .001).

Conclusions and Relevance  Initial and subsequent increases in hsCRP levels during 16 weeks after ACS were associated with a greater risk of the combined MACE end point, cardiovascular death, and all-cause death despite established background therapies. Serial measurements of hsCRP during clinical follow-up after ACS may help to identify patients at higher risk for mortality and morbidity.

SOURCE

https://jamanetwork.com/journals/jamacardiology/fullarticle/2725734

 

Inflammation’s role in residual risk

Residual risk of cardiovascular events or death remains high following ACS, despite coronary revascularization and optimal guideline-directed treatment with antiplatelet and LDL cholesterol-lowering agents. Inflammation is thought to drive this risk, but no effective treatment for such inflammation is commercially available. The secretory phospholipase A2 inhibitor varespladib was developed to meet this need, and it was evaluated in VISTA-16.

VISTA-16 was an international, multicenter clinical trial that randomized 5,145 patients in a double-blind manner to varespladib or placebo on a background of atorvastatin treatment within 96 hours of presentation with ACS. The trial was terminated early due to futility and likely harm from the drug, which was subsequently pulled from development.

Implications for practice

The association of increasing CRP levels with residual cardiovascular risk may prompt more intensive treatment to lower this risk. In particular, a secondary analysis showed that use of antiplatelet agents (clopidogrel, ticlopidine and prasugrel) was associated with stable or decreasing hsCRP levels.

“Monitoring not only lipids but also hsCRP after ACS may help us better identify patients at increased risk for recurrent cardiovascular events or death,” notes Dr. Puri. “High or increasing CRP levels could be an indication to optimize dual antiplatelet therapy post-ACS, along with high-intensity statin therapy (and possibly PCSK9 inhibitors) and antihypertensive therapy, in addition to instituting measures that are globally beneficial, such as dietary modifications and cardiac rehabilitation/exercise.”

SOURCE

https://consultqd.clevelandclinic.org/increasing-inflammation-correlates-with-residual-risk-after-acute-coronary-syndrome/amp/?__twitter_impression=true

 

Other related articles published in this Open Access Online Scientific Journal, include the following:

 

Biomarkers and risk factors for cardiovascular events, endothelial dysfunction, and thromboembolic complications

Larry H Bernstein, MD, FCAP, Curator

https://pharmaceuticalintelligence.com/2014/09/09/biomarkers-and-risk-factors-for-cardiovascular-events-endothelial-dysfunction-and-thromboembolic-complications/

 

A Concise Review of Cardiovascular Biomarkers of Hypertension

Curator: Larry H. Bernstein, MD, FCAP

https://pharmaceuticalintelligence.com/2016/04/25/a-concise-review-of-cardiovascular-biomarkers-of-hypertension/

 

Acute Coronary Syndrome (ACS): Strategies in Anticoagulant Selection: Diagnostics Approaches – Genetic Testing Aids vs. Biomarkers (Troponin types and BNP)

Curator: Aviva Lev-Ari, PhD, RN

https://pharmaceuticalintelligence.com/2018/03/13/acute-coronary-syndrome-acs-strategies-in-anticoagulant-selection-diagnostics-approaches-genetic-testing-aids-vs-biomarkers-troponin-types-and-bnp/

 

In Europe, BigData@Heart aim to improve patient outcomes and reduce societal burden of atrial fibrillation (AF), heart failure (HF) and acute coronary syndrome (ACS).

Reporter: Aviva Lev-Ari, PhD, RN

https://pharmaceuticalintelligence.com/2017/07/10/in-europe-bigdataheart-aim-to-improve-patient-outcomes-and-reduce-societal-burden-of-atrial-fibrillation-af-heart-failure-hf-and-acute-coronary-syndrome-acs/

 

Cardiovascular Diseases and Pharmacological Therapy: Curations by Aviva Lev-Ari, PhD, RN, 2006 – 4/2018

https://pharmaceuticalintelligence.com/2014/04/17/cardiovascular-diseases-and-pharmacological-therapy-curations-by-aviva-lev-ari-phd-rn/

 

 

Read Full Post »

The HFE H63D variant confers an increased risk for hypertension, no increased risk for adverse cardiovascular events or substantial left ventricular remodeling

Posted in Frontiers in Cardiology and Cardiovascular Disorders, Gene Regulation, Genetic Mutations in Congenital Heart Disease, Genetics & Innovations in Treatment, Genetics & Pharmaceutical, Genome Biology, HTN, Origins of Cardiovascular Disease, Systemic Inflammatory Diseases as CVD Risk on November 12, 2018| Leave a Comment »

The HFE H63D variant confers an increased risk for hypertension, no increased risk for adverse cardiovascular events or substantial left ventricular remodeling

Reporter: Aviva Lev-Ari, PhD, RN

Conclusion:

The HFE H63D variant confers an increased risk for hypertension per allele and, given its frequency, accounts for a significant number of cases of hypertension. However, there was no increased risk for adverse cardiovascular events or substantial left ventricular remodeling.

 

HFE H63D Polymorphism and the Risk for Systemic Hypertension, Myocardial Remodeling, and Adverse Cardiovascular Events in the ARIC Study

Originally published12 Nov 2018Hypertension. 2018;0:HYPERTENSIONAHA.118.11730

Abstract

H63D has been identified as a novel locus associated with the development of hypertension. The quantitative risks for hypertension, cardiac remodeling, and adverse events are not well studied. We analyzed white participants from the ARIC study (Atherosclerosis Risk in Communities) with H63D genotyping (N=10 902). We related genotype status to prevalence of hypertension at each of 5 study visits and risk for adverse cardiovascular events. Among visit 5 participants (N=4507), we related genotype status to echocardiographic features. Frequencies of wild type (WT)/WT, H63D/WT, and H63D/H63D were 73%, 24.6%, and 2.4%. The average age at baseline was 54.9±5.7 years and 47% were men. Participants carrying the H63D variant had higher systolic blood pressure (P=0.004), diastolic blood pressure (0.012), and more frequently had hypertension (P<0.001). Compared with WT/WT, H63D/WT and H63D/H63D participants had a 2% to 4% and 4% to 7% absolute increase in hypertension risk at each visit, respectively. The population attributable risk of H63D for hypertension among individuals aged 45 to 64 was 3.2% (95% CI, 1.3–5.1%) and 1.3% (95% CI, 0.0–2.4%) among individuals >65 years. After 25 years of follow-up, there was no relationship between genotype status and any outcome (P>0.05). H63D/WT and H63D/H63D genotypes were associated with small differences in cardiac remodeling. In conclusion, the HFE H63D variant confers an increased risk for hypertension per allele and, given its frequency, accounts for a significant number of cases of hypertension. However, there was no increased risk for adverse cardiovascular events or substantial left ventricular remodeling.

Footnotes

The online-only Data Supplement is available with this article at https://www.ahajournals.org/doi/suppl/10.1161/HYPERTENSIONAHA.118.11730.

Correspondence to Scott D. Solomon, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115. Email 
SOURCE

Read Full Post »

Cholesterol Lowering Novel PCSK9 drugs: Praluent [Sanofi and Regeneron] vs Repatha [Amgen] – which drug cuts CV risks enough to make it cost-effective?

Posted in Atherogenic Processes & Pathology, Epigenetics and Cardiovascular Risks, Fatty acids, Frontiers in Cardiology and Cardiovascular Disorders, inflammation independent of lipid levels, Lipid metabolism, Lipidomics, Lipids, Origins of Cardiovascular Disease, PCSK9 Inhibitor Therapy, Pharmaceutical R&D Informatics, Pharmacogenomics, Pharmacotherapy of Cardiovascular Disease, Systemic Inflammatory Diseases as CVD Risk, Value-based Drug Pricing on March 12, 2018| Leave a Comment »

 Cholesterol Lowering Novel PCSK9 drugs: Praluent [Sanofi and Regeneron] vs Repatha [Amgen] – which drug cuts CV risks enough to make it cost-effective?

Reporter: Aviva Lev-Ari, PhD, RN

 

UPDATED on 4/5/2022

Early PCSK9 Inhibition in AMI Yields Plaque Regression

Ted Bosworth

April 05, 2022

https://www.medscape.com/viewarticle/971582?spon=2&uac=93761AJ&impID=4140595&sso=true&faf=1&src=WNL_mdpls_220405_mscpedit_card

https://www.mdedge.com/cardiology/article/253443/lipid-disorders/early-pcsk9-inhibition-ami-yields-plaque-regression

 

UPDATED on 1/15/2019

In the patent fight over PCSK9 inhibitors, the Supreme Court refused to hear Amgen’s appeal of a 2017 court decision allowing Sanofi and Regeneron to continue selling alirocumab (Praluent). Amgen still has a new patent trial starting in Delaware federal court next month, FiercePharma reports.

Amgen’s Repatha hits wall at SCOTUS but presses ahead—new price breaks included

by Arlene Weintraub |

Amgen has been trying since 2015 to protect its PCSK9 cholesterol drug Repatha by keeping Sanofi and Regeneron’s rival Praluent off the market, even going as far as to ask the U.S. Supreme Court to review an ongoing patent fight.

But that attempt fell short this week as SCOTUS refused to hear the company’s appeal of a 2017 court decision allowing Sanofi and Regeneron to continue selling its head-to-head rival.

Amgen isn’t giving up the fight, though. The company is prepping for a new patent trial starting in Delaware federal court next month. And it’s responding to long-standing criticism of the high cost of PCSK9 drugs, which hit the market in 2015 at list prices of about $14,000 a year.

Amgen had already brought the price of the biweekly version of Repatha down to $5,850 per year before discounts and rebates, and late Monday it said it would lower cost of the monthly injectable dose to that same level.

SOURCE

UPDATED on 11/13/2018

ODYSSEY OUTCOMES: Alirocumab Cost-effective at $6000 a Year

Marlene Busko

November 11, 2018

CHICAGO — Treatment with the proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor alirocumab (Praluent, Sanofi/Regeneron) is cost-effective at $6319 a year when the willingness-to-pay threshold is the generally accepted $100,000 per quality-adjusted life-year (QALY), new research reports.

Deepak L. Bhatt, MD, MPH, Brigham and Women’s Hospital Heart and Vascular Center, Harvard Medical School, Boston, Massachusetts, presented these cost-effectiveness findings for alirocumab, based on data from the ODYSSEY OUTCOMES trial, here at the American Heart Association (AHA) 2018 Scientific Sessions

As previously reported, results from ODYSSEY OUTCOMES were presented at American College of Cardiology (ACC) 2018 Annual Scientific Session in March and the study was published November 7 in the New England Journal of Medicine.

Strengths of the current cost analysis include that it used actual trial data as opposed to modeling estimates, Bhatt pointed out to theheart.org | Medscape Cardiology.

SOURCE

https://www.medscape.com/viewarticle/904744?nlid=126063_3866&src=WNL_mdplsfeat_181113_mscpedit_card&uac=93761AJ&spon=2&impID=1799507&faf=1

 

Did Amgen’s Repatha cut CV risks enough to make it cost-effective? Analysts say no

Sanofi, Regeneron’s Praluent pulls off PCSK9 coup with 29% cut to death risks in most vulnerable patients
SEE our curations on PCSK9 drugs:

Read Full Post »

Older Posts »

%d bloggers like this: