Personalized medicine in cardiovascular disease: review of literature

Sheikhy, Ali; Fallahzadeh, Aida; Meybodi, Hamid Reza Aghaei; Hasanzad, Mandana; Tajdini, Masih; Hosseini, Kaveh

doi:10.1007/s40200-021-00840-0

Cited by 10 publications

(10 citation statements)

References 162 publications

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“…There are several conducted studies in this field, although none of them consider individuals genomic and epigenomic profiles composed. Future studies should identify the finest care for an individual based on a unique personal profile instead of the normal population [36].…”

Section: Discussionmentioning

confidence: 99%

Off-pump versus on-pump coronary artery bypass graft surgery outcomes in patients with severe left ventricle dysfunction: inverse probability weighted study

Sheikhy

Fallahzadeh

Forouzannia

et al. 2022

BMC Cardiovasc Disord

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Objective In this study we aimed to compare on-pump and off-pump coronary artery bypass grafting (CABG) outcomes in patients presented with low left ventricular ejection fraction (EF) as a high-risk group of patients. Methods In this registry-based study from 2014 and 2016, all patients with severe left ventricular dysfunction (EF less than 35%) were included and followed until 2020. The median follow-up period was 47.83 [38.41, 55.19] months. Off pump CABG (OPCABG) was compared with on-pump CABG (ONCABG) in terms of mid-term non-fatal cardiovascular events (CVEs) and all-cause mortality. Propensity score method (with inverse probability weighting technique) was used to compare these two groups. Results From 14,237 patients who underwent isolated CABG, 2055 patients with EF ≤ 35% were included; 1705 in ONCABG and 350 patients in OPCABG groups. Although OPCABG was associated with lower risk of 30-days mortality (Odds Ratio [OR]: 0.021; Confidence Interval [CI] 95% [0.01, 0.05], P < 0.001); there was no significant difference between OPCABG and ONCABG in term of mid-term mortality and non-fatal CVEs ((Hazard ratio [HR]: 0.822; 95%CI [0.605, 1.112], p = 0.208) and (HR: 1.246; 95%CI [0.805, 1.929], p = 0.324), respectively). Patients with more than three traditional coronary artery disease risk factors, had more favorable outcomes (in terms of mid-term mortality) if underwent OPCABG (HR: 0.420; 95%CI [0.178, 0.992], p = 0.048). Conclusion OPCABG was associated with lower risk of 30-days mortality; however, mid-term outcomes were comparable in both OPCABG and ONCABG techniques.

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Section: Discussionmentioning

confidence: 99%

Off-pump versus on-pump coronary artery bypass graft surgery outcomes in patients with severe left ventricle dysfunction: inverse probability weighted study

Sheikhy

Fallahzadeh

Forouzannia

et al. 2022

BMC Cardiovasc Disord

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“…Ultimately, these results highlighted the role of personalized medicine, suggesting that not the same HDL-C level might be necessarily beneficial to different individuals. In particular, various distinct genetic variants have been reported to affect HDL-C levels and function, as well as statin pharmacokinetics [ 48 ].…”

Section: Discussionmentioning

confidence: 99%

BMI modifies HDL-C effects on coronary artery bypass grafting outcomes

et al. 2022

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Background Despite the recognized implications of high-density lipoprotein cholesterol (HDL-C) in cardiovascular diseases, the role of body mass index (BMI) in HDL-C association with cardiovascular outcomes remains unclear. This study investigated the possible modifying implications of BMI on the correlation between HDL-C and coronary artery bypass grafting (CABG) outcomes. Methods The present cohort included isolated CABG patients (median follow-up: 76.58 [75.79–77.38] months). The participants were classified into three groups: 18.5 ≤ BMI < 25 (normal), 25 ≤ BMI < 30 (overweight), and 30 ≤ BMI < 35 (obese) kg/m2. Cox proportional hazard models (CPHs) and restricted cubic splines (RCSs) were applied to evaluate the relationship between HDL-C and all-cause mortality as well as major adverse cardio-cerebrovascular events (MACCEs) in different BMI categories. Results This study enrolled a total of 15,639 patients. Considering the final Cox analysis among the normal and overweight groups, HDL-C ≥ 60 was a significant protective factor compared to 40 < HDL-C < 60 for all-cause mortality (adjusted hazard ratio (aHR): 0.47, P: 0.027; and aHR: 0.64, P: 0.007, respectively). However, the protective effect of HDL-C ≥ 60 was no longer observed among patients with 30 ≤ BMI < 35 (aHR: 1.16, P = 0.668). RCS trend analyses recapitulated these findings; among 30 ≤ BMI < 35, no uniform inverse linear association was observed; after approximately HDL-C≈55, its increase was no longer associated with reduced mortality risk. RCS analyses on MACCE revealed a plateau effect followed by a modest rise in overweight and obese patients from HDL-C = 40 onward (nonlinear association). Conclusions Very high HDL-C (≥ 60 mg/dL) was not related to better outcomes among obese CABG patients. Furthermore, HDL-C was related to the post-CABG outcomes in a nonlinear manner, and the magnitude of its effects also differed across BMI subgroups.

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“…It is reasonable not to administer antiarrhythmic with similar structure in amiodarone lung injuries such as dronedarone, and a personalized approach for each patient is recommended especially in the elderly patient with underlying lung diseases such as previous severe COVID‐19 which lead to permanent lung injury 11–15 …”

Section: Discussionmentioning

confidence: 99%