Cardiovascular Diabetology最新文献

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Sex-difference of multifactorial intervention on cardiovascular and mortality risk in DKD: post-hoc analysis of a randomised clinical trial. 多因素干预对 DKD 患者心血管疾病和死亡风险的性别差异:随机临床试验的事后分析。
IF 8.5 1区 医学
Cardiovascular Diabetology Pub Date : 2024-08-05 DOI: 10.1186/s12933-024-02371-3
Roberto Minutolo, Vittorio Simeon, Luca De Nicola, Paolo Chiodini, Raffaele Galiero, Luca Rinaldi, Alfredo Caturano, Erica Vetrano, Celestino Sardu, Raffaele Marfella, Ferdinando Carlo Sasso, A Lampitella, A Lampitella, A Lanzilli, N Lascar, S Masi, P Mattei, V Mastrilli, P Memoli, R Minutolo, R Nasti, A Pagano, M Pentangelo, E Pisa, E Rossi, F C Sasso, S Sorrentino, R Torella, R Troise, P Trucillo, A A Turco, S Turco, F Zibella, L Zirpoli
{"title":"Sex-difference of multifactorial intervention on cardiovascular and mortality risk in DKD: post-hoc analysis of a randomised clinical trial.","authors":"Roberto Minutolo, Vittorio Simeon, Luca De Nicola, Paolo Chiodini, Raffaele Galiero, Luca Rinaldi, Alfredo Caturano, Erica Vetrano, Celestino Sardu, Raffaele Marfella, Ferdinando Carlo Sasso, A Lampitella, A Lampitella, A Lanzilli, N Lascar, S Masi, P Mattei, V Mastrilli, P Memoli, R Minutolo, R Nasti, A Pagano, M Pentangelo, E Pisa, E Rossi, F C Sasso, S Sorrentino, R Torella, R Troise, P Trucillo, A A Turco, S Turco, F Zibella, L Zirpoli","doi":"10.1186/s12933-024-02371-3","DOIUrl":"10.1186/s12933-024-02371-3","url":null,"abstract":"<p><strong>Objective: </strong>Women with type 2 diabetes experience higher cardiovascular and mortality risk than men possibly because of a sub-optimal cardio-protective treatment. We evaluated whether an intensive multifactorial therapy (MT) produces similar protective effect on development of adverse outcomes in women and men.</p><p><strong>Research design and methods: </strong>Nephropathy in Diabetes type 2 study is an open-label cluster randomized trial comparing the effect of Usual Care (UC) or MT of main cardiovascular risk factors (blood pressure < 130/80 mmHg, HbA1c < 7%, LDL < 100 mg/dL, and total cholesterol < 175 mg/dL) on cardiovascular and mortality risk in patients with type 2 diabetes. In this post-hoc analysis, we stratified patients by sex to compare the occurrence of MACEs (primary endpoint) and all-cause death (secondary endpoint) between women (104 MT and 105 UC) and men (103 MT and 83 UC).</p><p><strong>Results: </strong>Achievement of therapeutic goals was similar by sex, with 44% and 47% of women and men in MT achieving at least 3 targets vs. 16% and 20% of women and men in UC. During a median follow-up of 13.0 years, we recorded 262 MACE (48.5% in women) and 189 deaths (53.6% in women). Compared to the UC group, the risk of MACE in the MT group was reduced by 52% in women and by 44% in men (P = 0.11). Conversely, the reduction in mortality risk by MT was greater in women (44% versus 12%, P = 0.019).</p><p><strong>Conclusions: </strong>MT similarly reduces the risk of MACEs in either sex. This therapeutic approach is associated with a survival advantage in women as compared with men and it may represent an important rationale to motivate physicians in overcoming their therapeutic inertia often encountered in female patients as well as to encourage patients of both sexes at improving their adherence to multidrug therapy.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":null,"pages":null},"PeriodicalIF":8.5,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11299289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141892915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
N-terminal pro-B-type natriuretic peptide levels vary by ethnicity and are associated with insulin sensitivity after gestational diabetes mellitus N 端前 B 型钠尿肽水平因种族而异,并与妊娠糖尿病后的胰岛素敏感性有关
IF 9.3 1区 医学
Cardiovascular Diabetology Pub Date : 2024-08-03 DOI: 10.1186/s12933-024-02349-1
Archana Sharma, Kåre I. Birkeland, Ingrid Nermoen, Christine Sommer, Elisabeth Qvigstad, Sindre Lee-Ødegård, Kari A. Sveen, Naveed Sattar, Stina T. Sollid, Torbjørn Omland, Peder L. Myhre
{"title":"N-terminal pro-B-type natriuretic peptide levels vary by ethnicity and are associated with insulin sensitivity after gestational diabetes mellitus","authors":"Archana Sharma, Kåre I. Birkeland, Ingrid Nermoen, Christine Sommer, Elisabeth Qvigstad, Sindre Lee-Ødegård, Kari A. Sveen, Naveed Sattar, Stina T. Sollid, Torbjørn Omland, Peder L. Myhre","doi":"10.1186/s12933-024-02349-1","DOIUrl":"https://doi.org/10.1186/s12933-024-02349-1","url":null,"abstract":"Individuals of South Asian origin have a greater risk of cardiovascular disease after gestational diabetes mellitus (GDM) than European individuals. B-type natriuretic peptide (BNP) and the amino-terminal fragment of its prohormone (NT-proBNP) are commonly used for heart failure screening and diagnosis, but biologically BNP exerts several beneficial cardiovascular effects primarily by counteracting the renin-angiotensin-aldosterone-system. We asked whether ethnic differences in circulating NT-proBNP levels could be explained by the differences in cardiometabolic and inflammatory risk markers? We examined 162 South Asian and 107 Nordic women in Norway 1–3 years after GDM with a clinical examination, fasting blood samples and an oral glucose tolerance test. We measured the levels of NT-proBNP, high-sensitivity cardiac troponin T, high-sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6), leptin, adiponectin and markers of insulin sensitivity, such as the Matsuda insulin sensitivity index (ISI). Finally, we tried to identify which independent covariate best mediated the ethnic differences in NT-proBNP. The mean (SD) age was 35.3 (4.5) years, BMI 29.1 (6.0) kg/m2, waist-height ratio 0.60 (0.08) and 164 women (61%) had prediabetes/diabetes. Notably, South Asian women had lower levels of NT-proBNP than Nordic women in both the normoglycemic and prediabetes/diabetes groups (median (IQR) 26 (15–38) vs. 42 (22–66) ng/L, p < 0.001). Higher NT-proBNP levels were associated with greater insulin sensitivity in both South Asian and Nordic women (p = 0.005 and p < 0.001). South Asian women had higher levels of hsCRP (median (IQR) 2.2 (1.1–4.4) vs. 1.2 (0.3–4.2) mg/L), IL-6 (2.3 (1.5–3.2) vs. 1.5 (1.5–2.5) pg/mL), leptin (1647 (1176–2480) vs. 1223 (876–2313) pmol/L), and lower adiponectin levels (7.2 (5.3–9.3) vs. 10.0 (7.2–13.5) mg/L) and Matsuda ISI (2.4 (1.7–3.7) vs. 4.2 (2.9–6.1), pall<0.01) than Nordic women. Even after adjusting for these differences, higher NT-proBNP levels remained associated with insulin sensitivity (22% higher NT-proBNP per SD Matsuda ISI, p = 0.015). Insulin sensitivity and adiponectin mediated 53% and 41% of the ethnic difference in NT-proBNP. NT-proBNP levels are lower in South Asian than in Nordic women after GDM. Lower NT-proBNP levels correlate with impaired insulin sensitivity. Lower NT-proBNP levels in South Asian women could, therefore, be attributed to impaired insulin sensitivity rather than total body fat.","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":null,"pages":null},"PeriodicalIF":9.3,"publicationDate":"2024-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141884435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Epicardial adipose tissue volume and density are associated with heart failure with improved ejection fraction 心外膜脂肪组织的体积和密度与射血分数改善型心力衰竭有关
IF 9.3 1区 医学
Cardiovascular Diabetology Pub Date : 2024-08-03 DOI: 10.1186/s12933-024-02376-y
Chen Die Yang, Jin Wei Quan, Guan Poh Tay, Shuo Feng, He Yuan, Abulikemu Amuti, Si Yi Tang, Xin Rui Wu, Ruo Sen Yuan, Lin Lu, Rui Yan Zhang, Xiao Qun Wang
{"title":"Epicardial adipose tissue volume and density are associated with heart failure with improved ejection fraction","authors":"Chen Die Yang, Jin Wei Quan, Guan Poh Tay, Shuo Feng, He Yuan, Abulikemu Amuti, Si Yi Tang, Xin Rui Wu, Ruo Sen Yuan, Lin Lu, Rui Yan Zhang, Xiao Qun Wang","doi":"10.1186/s12933-024-02376-y","DOIUrl":"https://doi.org/10.1186/s12933-024-02376-y","url":null,"abstract":"Heart failure (HF) with improved ejection fraction (EF, HFimpEF) is a distinct HF subtype, characterized by left ventricular (LV) reverse remodeling and myocardial functional recovery. Multiple cardiometabolic factors are implicated in this process. Epicardial adipose tissue (EAT), emerging as an endocrine and paracrine organ, contributes to the onset and progression of HF. However, the relation between EAT and the incidence of HFimpEF is still unclear. A total of 203 hospitalized HF patients with reduced EF (HFrEF, LVEF ≤ 40%) who underwent coronary CT angiography (CCTA) during index hospitalization were consecutively enrolled between November 2011 and December 2022. Routine follow-up and repeat echocardiograms were performed. The incidence of HFimpEF was defined as (1) an absolute LVEF improvement ≥ 10% and (2) a second LVEF > 40% (at least 3 months apart). EAT volume and density were semiautomatically quantified on non-enhanced series of CCTA scans. During a median follow-up of 8.6 (4.9 ~ 13.3) months, 104 (51.2%) patients developed HFimpEF. Compared with HFrEF patients, HFimpEF patients had lower EAT volume (115.36 [IQR 87.08 ~ 154.78] mL vs. 169.67 [IQR 137.22 ~ 218.89] mL, P < 0.001) and higher EAT density (-74.92 ± 6.84 HU vs. -78.76 ± 6.28 HU, P < 0.001). Multivariate analysis showed lower EAT volume (OR: 0.885 [95%CI 0.822 ~ 0.947]) and higher density (OR: 1.845 [95%CI 1.023 ~ 3.437]) were both independently associated with the incidence of HFimpEF. Subgroup analysis revealed that the association between EAT properties and HFimpEF was not modified by HF etiology. This study reveals that lower EAT volume and higher EAT density are associated with development of HFimpEF. Therapies targeted at reducing EAT quantity and improving its quality might provide favorable effects on myocardial recovery in HF patients. ","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":null,"pages":null},"PeriodicalIF":9.3,"publicationDate":"2024-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141887163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Association of triglyceride-glucose index with the risk of incident aortic dissection and aneurysm: a large-scale prospective cohort study in UK Biobank. 甘油三酯-葡萄糖指数与主动脉夹层和动脉瘤发病风险的关系:英国生物库大规模前瞻性队列研究。
IF 8.5 1区 医学
Cardiovascular Diabetology Pub Date : 2024-08-02 DOI: 10.1186/s12933-024-02385-x
Cuihong Tian, Yequn Chen, Binyi Xu, Xuerui Tan, Zhaowei Zhu
{"title":"Association of triglyceride-glucose index with the risk of incident aortic dissection and aneurysm: a large-scale prospective cohort study in UK Biobank.","authors":"Cuihong Tian, Yequn Chen, Binyi Xu, Xuerui Tan, Zhaowei Zhu","doi":"10.1186/s12933-024-02385-x","DOIUrl":"10.1186/s12933-024-02385-x","url":null,"abstract":"<p><strong>Background: </strong>Triglyceride-glucose (TyG) index is an emerging surrogate indicator of insulin resistance, which has been demonstrated as a risk factor for various cardiovascular diseases including coronary syndrome, in-stent restenosis, and heart failure. However, association of TyG index with incident aortic dissection (AD) and aortic aneurysm (AA) remains to be investigated.</p><p><strong>Methods: </strong>This study included 420,292 participants without baseline AD/AA from the large-scale prospective UK Biobank cohort. The primary outcome was incident AD/AA, comprising AD and AA. Multivariable-adjusted Cox proportional hazards regression models and restricted cubic spline (RCS) analyses were applied to assess the relationship between TyG index and the onset of AD/AA. In addition, the association between TyG index and incident AD/AA was examined within subgroups defined by age, gender, smoking status, drinking status, diabetes, hypertension, and BMI.</p><p><strong>Results: </strong>Over a median follow-up period of 14.8 (14.1, 15.5) years, 3,481 AD/AA cases occurred. The incidence of AD/AA rose along with elevated TyG index. RCS curves showed a linear trend of TyG index with risk of incident AD/AA. TyG index was positively associated with risk of incident AD/AA after adjusting for age, gender, smoking status, drinking status, BMI, hypertension, LDL-c, and HbA1c, with adjusted HRs of 1.0 (reference), 1.20 (95% CI 1.08-1.35), 1.21 (95% CI 1.08-1.35), and 1.30 (95% CI 1.16-1.45) for TyG index quartiles 2, 3, and 4, respectively. Especially, participants in the highest TyG index quartile had highest risk of developing AA, with an adjusted HR of 1.35 (95% CI 1.20-1.52).</p><p><strong>Conclusions: </strong>TyG index is independently associated with a higher risk of incident AD/AA, indicating the importance of using TyG index for risk assessment of AD/AA, especially for AA.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":null,"pages":null},"PeriodicalIF":8.5,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11297767/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141878428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Relationship between NT-proBNP, echocardiographic abnormalities and functional status in patients with subclinical siabetic cardiomyopathy. 亚临床糖尿病心肌病患者的 NT-proBNP、超声心动图异常和功能状态之间的关系。
IF 8.5 1区 医学
Cardiovascular Diabetology Pub Date : 2024-08-02 DOI: 10.1186/s12933-024-02378-w
Pishoy Gouda, Yuxi Liu, Javed Butler, Stefano Del Prato, Nasrien E Ibrahim, Carolyn S P Lam, Thomas Marwick, Julio Rosenstock, Wilson Tang, Faiez Zannad, James Januzzi, Justin Ezekowitz
{"title":"Relationship between NT-proBNP, echocardiographic abnormalities and functional status in patients with subclinical siabetic cardiomyopathy.","authors":"Pishoy Gouda, Yuxi Liu, Javed Butler, Stefano Del Prato, Nasrien E Ibrahim, Carolyn S P Lam, Thomas Marwick, Julio Rosenstock, Wilson Tang, Faiez Zannad, James Januzzi, Justin Ezekowitz","doi":"10.1186/s12933-024-02378-w","DOIUrl":"10.1186/s12933-024-02378-w","url":null,"abstract":"<p><strong>Introduction: </strong>Persons with diabetes are at risk for developing a cardiomyopathy through several pathophysiological mechanisms independent of traditional risk factors for heart failure. Among those with diabetic cardiomyopathy (DbCM), the relationship between natriuretic peptides, cardiac structural abnormalities and functional capacity is largely unknown.</p><p><strong>Methods: </strong>In this prespecified subgroup analysis of the Aldose Reductase Inhibition for Stabilization of Exercise Capacity in Heart Failure (ARISE-HF) trial, 685 participants with asymptomatic DbCM underwent baseline echocardiography data, laboratory investigations, and functional assessments. Participants were stratified by N-terminal pro-B type natriuretic peptide (NT-proBNP) quartiles, and correlation with echocardiographic and functional parameters were assessed using Spearman correlation test.</p><p><strong>Results: </strong>The median NT-proBNP was 71 (Q1, Q3: 33, 135) ng/L. No association was observed between NT-proBNP concentrations and echocardiographic parameters of either diastolic or systolic dysfunction including global longitudinal strain, left ventricular ejection fraction, left ventricular mass index, left atrial volume index, E/E', or right ventricular systolic pressure. In contrast, NT-proBNP was significantly correlated with overall Kansas City Cardiomyopathy Questionnaire score (rho = - 0.10; p = 0.007), the Physical Activity Scale in the Elderly (rho = - 0.12; p = 0.004), duration of cardiopulmonary exercise testing (rho = - 0.28; p < 0.001), peak VO<sup>2</sup> (rho = - 0.26; p < 0.001), and ratio of minute ventilation/carbon dioxide production (rho = 0.12; p = 0.002). After adjustment for known confounders, the correlation with Physical Activity Scale in the Elderly and overall Kansas City Cardiomyopathy Questionnaire score was no longer significant.</p><p><strong>Conclusion: </strong>Among patients with subclinical DbCM, elevated NT-proBNP concentrations are associated with worse health status, lower activity levels, and reduced functional capacity, but not with cardiac structural abnormalities. These findings suggest that regardless of cardiac structural abnormalities, biomarker concentrations reflect important deterioration in functional capacity in affected individuals.</p><p><strong>Trial registration: </strong>ARISE-HF, NCT04083339 Date Registered August 23, 2019.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":null,"pages":null},"PeriodicalIF":8.5,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11297788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141878429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Sex differences in the diagnostic algorithm of screening for heart failure by symptoms and NT-proBNP in patients with type 2 diabetes. 2型糖尿病患者通过症状和NT-proBNP筛查心衰的诊断算法中的性别差异。
IF 8.5 1区 医学
Cardiovascular Diabetology Pub Date : 2024-08-01 DOI: 10.1186/s12933-024-02360-6
Sarah Hofer-Zeni, Michael Leutner, Peter Klimek, Luise Bellach, Noemi Pavo, Suriya Prausmüller, Martin Hülsmann, Alexandra Kautzky-Willer
{"title":"Sex differences in the diagnostic algorithm of screening for heart failure by symptoms and NT-proBNP in patients with type 2 diabetes.","authors":"Sarah Hofer-Zeni, Michael Leutner, Peter Klimek, Luise Bellach, Noemi Pavo, Suriya Prausmüller, Martin Hülsmann, Alexandra Kautzky-Willer","doi":"10.1186/s12933-024-02360-6","DOIUrl":"10.1186/s12933-024-02360-6","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to assess the guideline recommended diagnostic tools NT-proBNP and NYHA classification, with a focus on sex-specific differences.</p><p><strong>Background: </strong>Patients with Type 2 Diabetes (T2D) face a heart failure (HF) risk up to four times higher than those without T2D, particularly affecting women more than twice as much as men. Despite distinct pathophysiological differences between men and women, there are currently no sex-specific recommendations for the diagnostic algorithm of HF in diabetic patients.</p><p><strong>Methods: </strong>A total of 2083 patients with T2D were enrolled, and the primary endpoint was heart failure during hospitalization within a 5-year timeframe. The secondary endpoint was all-cause death.</p><p><strong>Results: </strong>In female patients, frequency of HF diagnosis prior to or during hospitalization and mortality did not differ significantly between NYHA II and III, in contrast to male patients. Additionally, there was no notable difference in mean NT-proBNP levels between NYHA stage II and III only in female patients. The multivariable regression analysis highlighted NYHA classification not to be a predictor of NT-proBNP levels in female but solely in male patients. On multivariable Cox regression NYHA score was also no significant risk factor for occurence of HF in female patients. Furthermore, there was no significant disparity in mortality between men with NT-proBNP levels between 125 and 400 pg/ml and those below 125 pg/ml, whereas in women mortality was significantly higher in the group with NT-proBNP levels between 125 and 400 pg/ml than below 125 pg/ml.</p><p><strong>Conclusion: </strong>These findings suggest that NYHA classification may not be the most suitable tool for assessing the diagnosis of HF in female patients with T2D. Moreover, the need for consideration of a more symptom-independent screening for HF in female patients with T2D and re-evaluation of current guidelines especially regarding sex-specific aspects is highlighted.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":null,"pages":null},"PeriodicalIF":8.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11295336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141874254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Lessons from PROMINENT and prospects for pemafibrate. PROMINENT 的经验教训和培马贝特的前景。
IF 8.5 1区 医学
Cardiovascular Diabetology Pub Date : 2024-07-29 DOI: 10.1186/s12933-024-02305-z
Jean-Charles Fruchart, Jamila Fruchart-Najib, Shizuya Yamashita, Peter Libby, Koutaro Yokote, Tatsuhiko Kodama, Yohei Tomita, Paul M Ridker, Michel P Hermans, Alberto Zambon
{"title":"Lessons from PROMINENT and prospects for pemafibrate.","authors":"Jean-Charles Fruchart, Jamila Fruchart-Najib, Shizuya Yamashita, Peter Libby, Koutaro Yokote, Tatsuhiko Kodama, Yohei Tomita, Paul M Ridker, Michel P Hermans, Alberto Zambon","doi":"10.1186/s12933-024-02305-z","DOIUrl":"10.1186/s12933-024-02305-z","url":null,"abstract":"<p><p>The neutral result of the PROMINENT trial has led to questions about the future for pemafibrate. This commentary discusses possible reasons for the lack of benefit observed in the trial. There were, however, indicators suggesting therapeutic potential in microvascular ischaemic complications associated with peripheral artery disease, with subsequent analysis showing reduction in the incidence of lower extremity ischaemic ulceration or gangrene. Reassurance about the safety of pemafibrate, together with emerging data from PROMINENT and experimental studies, also suggest benefit with pemafibrate in non-alcoholic fatty liver disease (alternatively referred to as metabolic dysfunction-associated steatotic liver disease) and microangiopathy associated with diabetes, which merit further study.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":null,"pages":null},"PeriodicalIF":8.5,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11288121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141854898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Mortality and cardiovascular events in diabetes mellitus patients at dialysis initiation treated with glucagon-like peptide-1 receptor agonists. 开始透析时接受胰高血糖素样肽-1 受体激动剂治疗的糖尿病患者的死亡率和心血管事件。
IF 8.5 1区 医学
Cardiovascular Diabetology Pub Date : 2024-07-29 DOI: 10.1186/s12933-024-02364-2
Hsuan-Wen Lai, Chun Yin See, Jui-Yi Chen, Vin-Cent Wu
{"title":"Mortality and cardiovascular events in diabetes mellitus patients at dialysis initiation treated with glucagon-like peptide-1 receptor agonists.","authors":"Hsuan-Wen Lai, Chun Yin See, Jui-Yi Chen, Vin-Cent Wu","doi":"10.1186/s12933-024-02364-2","DOIUrl":"10.1186/s12933-024-02364-2","url":null,"abstract":"<p><strong>Background: </strong>Glucagon-like Peptide-1 Receptor Agonists (GLP-1RAs) have demonstrated efficacy in improving mortality and cardiovascular (CV) outcomes. However, the impact of GLP-1RAs therapy on cardiorenal outcomes of diabetic patients at the commencement of dialysis remains unexplored.</p><p><strong>Purpose: </strong>This study aimed to investigate the long-term benefits of GLP-1RAs in type 2 diabetic patients at dialysis commencement.</p><p><strong>Methods: </strong>A cohort of type 2 diabetic patients initializing dialysis was identified from the TriNetX global database. Patients treated with GLP-1RAs and those treated with long-acting insulin (LAI) were matched by propensity score. We focused on all-cause mortality, four-point major adverse cardiovascular events (4p-MACE), and major adverse kidney events (MAKE).</p><p><strong>Results: </strong>Among 82,041 type 2 diabetic patients initializing dialysis, 2.1% (n = 1685) patients were GLP-1RAs users (mean ages 59.3 years; 55.4% male). 1682 patients were included in the propensity-matched group, treated either with GLP-1RAs or LAI. The main causes of acute dialysis in this study were ischemic heart disease (17.2%), followed by heart failure (13.6%) and sepsis (6.5%). Following a median follow-up of 1.4 years, GLP-1RAs uses at dialysis commencement was associated with a reduced risk of mortality (hazard ratio [HR] = 0.63, p < 0.001), 4p-MACE (HR = 0.65, p < 0.001), and MAKE (HR = 0.75, p < 0.001). This association was particularly notable in long-acting GLP-1RAs users, with higher BMI, lower HbA1c, and those with eGFR > 15 ml/min/1.73m<sup>2</sup>. GLP-1RAs' new use at dialysis commencement was significantly associated with a lower risk of MACE (p = 0.047) and MAKE (p = 0.004). Additionally, GLP-1RAs use among those who could discontinue from acute dialysis or long-term RAs users was associated with a lower risk of mortality, 4p-MACE, and MAKE.</p><p><strong>Conclusion: </strong>Given to the limitations of this observational study, use of GLP-1RAs at the onset of dialysis was associated with a decreased risk of MACE, MAKE, and all-cause mortality. These findings show the lack of harm associated with the use of GLP-1RAs in diabetic patients at the initiation of acute dialysis.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":null,"pages":null},"PeriodicalIF":8.5,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11287940/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141854899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Identification of plasma miR-4505, miR-4743-5p and miR-4750-3p as novel diagnostic biomarkers for coronary artery disease in patients with type 2 diabetes mellitus: a case-control study. 将血浆 miR-4505、miR-4743-5p 和 miR-4750-3p 鉴定为 2 型糖尿病患者冠状动脉疾病的新型诊断生物标记物:一项病例对照研究。
IF 8.5 1区 医学
Cardiovascular Diabetology Pub Date : 2024-07-29 DOI: 10.1186/s12933-024-02374-0
Joanna Szydełko, Marcin Czop, Alicja Petniak, Monika Lenart-Lipińska, Janusz Kocki, Tomasz Zapolski, Beata Matyjaszek-Matuszek
{"title":"Identification of plasma miR-4505, miR-4743-5p and miR-4750-3p as novel diagnostic biomarkers for coronary artery disease in patients with type 2 diabetes mellitus: a case-control study.","authors":"Joanna Szydełko, Marcin Czop, Alicja Petniak, Monika Lenart-Lipińska, Janusz Kocki, Tomasz Zapolski, Beata Matyjaszek-Matuszek","doi":"10.1186/s12933-024-02374-0","DOIUrl":"10.1186/s12933-024-02374-0","url":null,"abstract":"<p><strong>Background: </strong>Type 2 diabetes mellitus (T2DM) and coronary artery disease (CAD) are commonly coexisting clinical entities with still growing incidence worldwide. Recently, circulating microRNAs (miRNAs) have emerged as novel molecular players in cardiometabolic diseases. This study aimed to identify a specific miRNA signature as a candidate biomarker for CAD in T2DM and to delineate potential miRNA-dependent mechanisms contributing to diabetic atherosclerosis.</p><p><strong>Methods: </strong>A total of 38 plasma samples from T2DM patients with and without CAD, CAD patients and healthy controls were collected for expression profiling of 2,578 miRNAs using microarrays. To investigate the regulatory role of differentially expressed (DE)-miRNA target genes, functional annotation and pathway enrichment analyses were performed utilizing multiple bioinformatics tools. Then, protein-protein interaction networks were established leveraging the STRING database in Cytoscape software, followed by cluster analysis and hub gene identification. Reverse transcription quantitative real-time polymerase chain reaction (RT-qPCR) was carried out for microarray data validation in the larger replication cohort of 94 participants. Receiver operating characteristic analysis was applied to evaluate the diagnostic values of miRNAs. Multivariate logistic regression analysis was used to develop miRNA-based diagnostic models.</p><p><strong>Results: </strong>In the discovery stage, overexpression of hsa-miR-4505, hsa-miR-4743-5p, hsa-miR-6846-5p, and down-regulation of hsa-miR-3613-3p, hsa-miR-4668-5p, hsa-miR-4706, hsa-miR-6511b-5p, hsa-miR-6750-5p, hsa-miR-4750-3p, hsa-miR-320e, hsa-miR-4717-3p, hsa-miR-7850-5p were detected in T2DM-CAD patients. The DE-miRNA target genes were significantly enriched in calcium ion binding, regulation of actin cytoskeleton, and gene expression. hsa-miR-4505, hsa-miR-4743-5p, and hsa-miR-4750-3p were found to be involved in fatty acid metabolism, leukocyte transendothelial migration, and neurotrophin signaling pathway. Dysregulation of hsa-miR-4505, hsa-miR-4743-5p, and hsa-miR-4750-3p in T2DM-CAD patients compared with T2DM subjects and controls (all p < 0.001) was further confirmed by RT-qPCR. All validated miRNAs demonstrated good discriminatory values for T2DM-CAD (AUC = 0.833-0.876). The best performance in detecting CAD in T2DM was achieved for a combination of three miRNAs (AUC = 0.959, 100% sensitivity, 86.67% specificity).</p><p><strong>Conclusions: </strong>Our study revealed a unique profile of plasma-derived miRNAs in T2DM patients with CAD. Potential miRNA-regulated pathways were also identified, exploring the underlying pathogenesis of CAD in T2DM. We developed a specific three-miRNA panel of hsa-miR-4505, hsa-miR-4743-5p and hsa-miR-4750-3p, that could serve as a novel non-invasive biomarker for CAD in patients with T2DM.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":null,"pages":null},"PeriodicalIF":8.5,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11287982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141854897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Association between atherogenic index of plasma and all-cause mortality and specific-mortality: a nationwide population‑based cohort study 血浆致动脉粥样硬化指数与全因死亡率和特定死亡率之间的关系:一项基于全国人口的队列研究
IF 9.3 1区 医学
Cardiovascular Diabetology Pub Date : 2024-07-27 DOI: 10.1186/s12933-024-02370-4
Fang-Fei You, Jian Gao, Yi-Ning Gao, Zhi-Hao Li, Dong Shen, Wen-Fang Zhong, Jin Yang, Xiao-Meng Wang, Wei-Qi Song, Hao Yan, Hao-Yu Yan, Jia-Hao Xie, Huan Chen, Chen Mao
{"title":"Association between atherogenic index of plasma and all-cause mortality and specific-mortality: a nationwide population‑based cohort study","authors":"Fang-Fei You, Jian Gao, Yi-Ning Gao, Zhi-Hao Li, Dong Shen, Wen-Fang Zhong, Jin Yang, Xiao-Meng Wang, Wei-Qi Song, Hao Yan, Hao-Yu Yan, Jia-Hao Xie, Huan Chen, Chen Mao","doi":"10.1186/s12933-024-02370-4","DOIUrl":"https://doi.org/10.1186/s12933-024-02370-4","url":null,"abstract":"Atherogenic index of plasma (AIP), a marker of atherosclerosis and cardiovascular disease (CVD). However, few studies have investigated association between AIP and all-cause mortality and specific-mortality in the general population. This study included data from 14,063 American adults. The exposure variable was the AIP, which was defined as log10 (triglycerides/high-density lipoprotein cholesterol). The outcome variables included all-cause mortality and specific-mortality. Survey-weighted cox regressions were performed to evaluate the relation between AIP and all-cause mortality and specific-mortality. Weighted restricted cubic spline was conducted to examin the non-linear relationship. During 10 years of follow-up, we documented 2,077, 262, 854, and 476 cases of all-cause mortality, diabetes mortality, CVD mortality and cancer mortality, respectively. After adjustment for potential confounders, we found that atherogenic index of plasma (AIP) was significantly associated with an increased risk of diabetes mortality when comparing the highest to the lowest quantile of AIP in female (p for trend = 0.001) or participants older than 65 years (p for trend = 0.002). AIP was not significantly associated with all-cause mortality, CVD mortality and cancer mortality (p > 0.05). Moreover, a non-linear association was observed between AIP and all-cause mortality in a U-shape (p for non-linear = 0.0011), while a linear relationship was observed with diabetes mortality and non-diabetes mortality (p for linear < 0.0001). In this study, there is a no significant association between high AIP levels and a high risk of all-cause and cardiovascular mortality. Besides, a higher AIP was significantly associated with an increased risk of diabetes mortality, which only found in women older than 65 years. AIP was associated with all-cause mortality in a U-shape. This association could be explained by the finding that higher AIP predicted a higher risk of death from diabetes, and that lower AIP predicted a higher risk of death from non-diabetes causes. ","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":null,"pages":null},"PeriodicalIF":9.3,"publicationDate":"2024-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141774845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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