Is there a consistent association between coronary heart disease and ischemic stroke caused by intracranial atherosclerosis?

Conforto, Adriana Bastos; Leite, Cláudia da Costa; Nomura, César Higa; Bor-Seng-Shu, Edson; Santos, Raul D.

doi:10.1590/0004-282x20130028

Cited by 16 publications

(13 citation statements)

References 48 publications

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“…[2] Although much of work has identified the significant association between RAGE gene polymorphisms and diabetic atherosclerosis, [34,35] it is difficult to draw a causal link between RAGE gene polymorphisms and the risk of CAD and IS. Sustained hyperglycemia could lead to the formation and accumulation of AGEs, and RAGE mediates most of the adverse effects of AGEs.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…[1,2] Both CAD and IS are manifestations of atherosclerosis. [2] Epidemiological studies have revealed that individuals with diabetes mellitus are more likely to suffer from atherosclerotic diseases. [3,4] Meanwhile, evidence has indicated that sustained hyperglycemia could result in the formation and accumulation of advanced glycosylation end products (AGEs), accelerating vascular dysfunction and atherogenesis.…”

Section: Introductionmentioning

confidence: 99%

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Association of RAGE gene Gly82Ser polymorphism with coronary artery disease and ischemic stroke

Ma¹,

Qu²,

Zhao

et al. 2016

Medicine

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Background:The receptor for advanced glycosylation end products (RAGE) has been widely linked to diabetic atherosclerosis, but its effects on coronary artery disease (CAD) and ischemic stroke (IS) remain controversial. The Gly82Ser polymorphism is located in the ligand-binding V domain of RAGE, suggesting a possible influence of this variant on RAGE function. The aim of the present study is to clarify the association between the RAGE Gly82Ser polymorphism and susceptibility to CAD and IS.Methods:Eligible studies were identified through a comprehensive literature search. Odds ratios (ORs) and 95% confidence intervals (CIs) were used to evaluate the association of Gly82Ser polymorphism with CAD and IS risk. Fixed- or random-effects model was used depending on the heterogeneity between studies. A funnel plot and Egger linear regression test were applied to assess publication bias. We also performed subgroup analyses to investigate potential sources of heterogeneity.Results:A total of 16 eligible articles containing 18 studies were analyzed. The pooled analysis indicated that the Gly82Ser polymorphism significantly increased CAD risk in recessive and homozygous genetic models (SS vs GS + GG: OR = 1.34, 95% CI = 1.09–1.64; SS vs GG: OR = 1.38, 95% CI = 1.12–1.71). A significant association between the Gly82Ser polymorphism and IS risk was observed in all tested models except the heterozygous genetic model (GS + SS vs GG: OR = 1.20, 95% CI = 1.04–1.38; SS vs GS + GG: OR = 2.20, 95% CI = 1.74–2.78; SS vs GG: OR = 2.23, 95% CI = 1.72–2.91; S vs G: OR = 1.32, 95% CI = 1.05–1.65). Subgroup analysis suggested an association between CAD and IS risk and the Gly82Ser polymorphism in the Chinese population, but not in the non-Chinese population.Conclusions:The current meta-analysis suggests that the RAGE Gly82Ser polymorphism is associated with an increased risk of CAD and IS, especially in the Chinese population. However, better-designed studies with larger sample sizes are needed to validate the results.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Association of RAGE gene Gly82Ser polymorphism with coronary artery disease and ischemic stroke

Ma¹,

Qu²,

Zhao

et al. 2016

Medicine

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“…Tuo tarpu informacijos apie KŠL ir intrakranijinių arterijų stenozės ryšį labai trūksta. Intrakranijinių arterijų sklerozė susijusi su padidėjusia išeminio galvos smegenų insulto (GSI) bei mirties rizika [3]. Išsamesni klinikiniai tyrimai padėtų nustatyti šių patologijų ryšį bei tuo pasinaudojant pritaikyti savailaikį gydymą.…”

Section: įVadasunclassified

Koronarine Širdies Liga Sergančiųjų Smegenų Pokyčių Įvertinimas

et al. 2017

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Raktažodžiai: intrakranijinių arterijų stenozė, išeminis galvos smegenų insultas, koronarinė širdies liga, miokardo infarktas. SantraukaŠiame darbe, analizuodami sergančiųjų koronarine širdies liga galvos smegenų magnetinio rezonanso tomografijos tyrimų vaizdus, siekėme nustatyti galvos smegenų kraujagyslinius pakitimus, susijusius su koronarine širdies liga, bei įvertinti gautus rezultatus. Retrospektyvinis tyrimas atliktas Vilniaus universiteto ligoninėje Santaros klinikose. Tyrimui atrinkti 33 50-80 m. amžiaus koronarine širdies liga sergantys ir turintys nustatytą širdies nepakankamumo NYHA 3 funkcinę klasę pacientai, kuriems atliktas galvos smegenų magnetinio rezonanso tomografijos tyrimas. Galvos smegenų intrakranijinių kraujagyslių ateroskleroziniai pažeidimai, galvos smegenų involiuciniai pakitimai bei koronarinės širdies ligos pažeidimai buvo nustatyti visiems tirtiems ligoniams, išskiriant dažniausiai pažeidžiamas kraujagysles bei palyginant gautus rezultatus su kitų šalių tyrimų rezultatais. Nustatyta, kad 63,6 proc. tirtų pacientų turi galvos smegenų kraujagyslių pažeidimų, 45,5 proc. iš jų pažeistos 2 ir daugiau kraujagyslių. Dažniau-siai pažeistos a. carotis interna dextra (39,4 proc.) ir a. carotis interna sinistra (30,3 proc.) kraujagyslės. Atsižvelgiant į koronarine širdies liga sergančiųjų intrakranijinių kraujagyslių pažeidimų dažnį, svarbu įvertinti ne tik dažniau europiečių populiacijoje pasitaikančius ekstrakranijinius pažeidimus, tačiau ir intrakranijinių kraujagyslių aterosklerozinius, okliuzinius pokyčius, kuriuos sąlygoja kompleksiškai pasireiškiantys kardiovaskuliniai reiškiniai. ĮvadasKoronarinė širdies liga (KŠL) -tai būklė, kurios metu pažeidžiamos širdies vainikinės arterijos, vystosi ateroskleroziniai pokyčiai ir miokardo išeminiai pakenkimai. Pastaruoju metu vis didesnį gydytojų bendruomenės susirūpinimą kelia širdies ir kraujagyslių ligų, pirmaujančių pasaulyje pagal mirtingumo rodiklius, ankstyvos diagnostikos ir gydymo sprendimų paieškos [1]. Daugumai pacientų, kuriems nustatomi ateroskleroziniai kraujagyslių pakitimai, pirmieji ligos simptomai pasireiškia vėlai, nes mažos plokštelės nesutrikdo kraujotakos, susidaro kolateralės. Negydoma KŠL gali komplikuotis krūtinės angina bei ūminiu koronariniu sindromu ir mirtimi, todėl itin svarbi ankstyva ligos diagnozė, užkertanti kelią tolimesniems kraujagyslių pažeidimams [2]. Ekstrakranijinių arterijų pažeidimai KŠL sergantiems pacientams vertinami jau seniai. Tuo tarpu informacijos apie KŠL ir intrakranijinių arterijų stenozės ryšį labai trūksta. Intrakranijinių arterijų sklerozė susijusi su padidėjusia išeminio galvos smegenų insulto (GSI) bei mirties rizika [3]. Išsamesni klinikiniai tyrimai padėtų nustatyti šių patologijų ryšį bei tuo pasinaudojant pritaikyti savailaikį gydymą.Tyrimo tikslas -analizuojant sergančiųjų KŠL galvos smegenų magnetinio rezonanso tomografijos (MRT) tyrimų vaizdus, nustatyti galvos smegenų kraujagyslinius pakitimus, susijusius su KŠL, išskirti dažniausiai pažeidžiamas krauja-

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“…It was concluded that the − 174 SNP was associated with atherosclerosis in the different study groups included in the study. Furthermore, a recent review by Conforto et al was focused on a potential link between coronary heart disease (CHD) and IS [8] . This review highlights that CHD and IS may co-exist and that these conditions could share some risk factors; however there are some unanswered questions regarding these.…”

Section: To the Editormentioning

confidence: 99%

Reply to: The risk of macrovascular complications in subjects genotyped for common IL-6 gene and TNF-α gene variants

Liaquat

Javed

2015

Clinical Chemistry and Laboratory Medicine (CCLM)

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We have read the comments by Dr. Sand on our recent article [1] , in which the putative effects of TNF-α and IL-6 gene variants on the idiopathic dilated cardiomyopathy (IDCM) in a Pakistani population was reported. In this paper we also conducted a meta-analysis by pooling our data with the previously published studies in this area. Dr. Sand has raised some issues regarding sample information, studies inclusion criteria and other concerns. We appreciate him for reading and critically analyzing our article, however, we do not agree with all the issues raised by him. We have tried to address the reported concerns; therefore, we believe that the cardiovascular and the cerebrovascular diseases may be studied in combination for genotype profiling.Dr. Sand has reported that the studies included in the current meta-analysis does not correspond to the inclusion criteria as two of the studies were on cerebrovascular pathologies (CP) [2,3] . It is a valid point, however, in the materials and methods section, we have categorically mentioned the " ischemic stroke " (IS) studies along with the other five cardiovascular disease (CVD) conditions. Although the risk factor profiles of both the conditions (CP and CVD) may differ in certain scenarios, however, it is widely accepted that inflammation is the underlying cause in the development of atherosclerotic pathologies of the vascular tissue [4,5] . The reference quoted by Dr. Sand also concludes that although the risk factors ' profiles of myocardial infarction and stroke are not similar but they still share a high risk of thrombotic events [6] .Yin and colleagues have conducted a meta-analysis on the influence of IL-6 − 174G/C polymorphism on atherosclerosis; this analysis also included CP along with other CVD conditions [7] . It was concluded that the − 174 SNP was associated with atherosclerosis in the different study groups included in the study. Furthermore, a recent review by Conforto et al. was focused on a potential link between coronary heart disease (CHD) and IS [8] . This review highlights that CHD and IS may co-exist and that these conditions could share some risk factors; however there are some unanswered questions regarding these. Nonetheless, further in-depth studies are required to have a better understanding of molecular basis leading to CHD and intracranial stenosis.With regards to the issue of missed publications; we have clearly stated in the materials and methods section that the electronic data base used in the current metaanalysis was PubMed; the articles [9 -12] are not present in PubMed, and therefore, they were not included in our study. Moreover, the time period for the studies included was from 2001 to 2013; the two studies notified [13,14] did not come in that time scale so they were excluded. In a paper by Maitra et al. [15] , according to the rs number, the addressed SNP was − 597, therefore, to avoid discrepancy that study was also excluded. Similarly, a study by Fan et al. included periodontitis [16] , therefore it was not in our inclusion cri...

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Is there a consistent association between coronary heart disease and ischemic stroke caused by intracranial atherosclerosis?

Cited by 16 publications

References 48 publications

Association of RAGE gene Gly82Ser polymorphism with coronary artery disease and ischemic stroke

Association of RAGE gene Gly82Ser polymorphism with coronary artery disease and ischemic stroke

Koronarine Širdies Liga Sergančiųjų Smegenų Pokyčių Įvertinimas

Reply to: The risk of macrovascular complications in subjects genotyped for common IL-6 gene and TNF-α gene variants

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