Psychosocial stress and major cardiovascular events in patients with stable coronary heart disease

Hagström, Emil; Norlund, Fredrika; Stebbins, Amanda; Armstrong, Paul W.; Chiswell, Karen; Granger, Christopher B.; López‐Sendón, José; Pella, Daniel; Soffer, Joseph; Sy, Rody G.; Wallentin, Lars; White, Harvey D.; Stewart, Ralph; Held, Claes

doi:10.1111/joim.12692

Cited by 66 publications

(53 citation statements)

References 30 publications

(47 reference statements)

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“…Third, possible confounders cannot be ruled out despite adjustment. 48,49 Fourth, our results reflect an association. The role of hsa_circ_0001445 in the causal pathway of the disease cannot be inferred from our study design, although this knowledge is not a prerequisite for a biomarker.…”

supporting

confidence: 65%

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Plasma circular RNA hsa_circ_0001445 and coronary artery disease: Performance as a biomarker

et al. 2020

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The role of circular RNAs (circRNAs) as biomarkers remains poorly characterized. Here, we investigated the performance of the circRNA hsa_circ_0001445 as a biomarker of coronary artery disease (CAD) in a real‐world clinical practice setting. Plasma hsa_circ_0001445 was measured in a study population of 200 consecutive patients with suspected stable CAD who had undergone coronary computed tomographic angiography (CTA). Multivariable logistic models were constructed combining conventional risk factors with established biomarkers and hsa_circ_0001445. Model robustness was internally validated by the bootstrap technique. Biomarker accuracy was evaluated using the C‐index. The integrated discrimination improvement (IDI) and net reclassification improvement (NRI) were also calculated. Risk groups were developed via classification tree models. The stability of plasma hsa_circ_0001445 was evaluated under different clinical conditions. hsa_circ_0001445 levels were associated with higher coronary atherosclerosis extent and severity with a 2‐fold increase across tertiles (28.4%‐50.0%). Levels of hsa_circ_0001445 were proportional to coronary atherosclerotic burden, even after comprehensive adjustment for cardiovascular risk factors, medications, and established biomarkers (fully adjusted OR = 0.432 for hsa_circ_0001445 as a continuous variable and fully adjusted OR = 0.277 for hsa_circ_0001445 as a binary variable). The classification of patients was improved with the incorporation of hsa_circ_0001445 into a base clinical model (CM) composed of conventional cardiovascular risk factors, showing an IDI of 0.047 and NRI of 0.482 for hsa_circ_0001445 as a continuous variable and an IDI of 0.056 and NRI of 0.373 for hsa_circ_0001445 as a binary variable. A trend toward higher discrimination capacity was also observed (C‐indexCM = 0.833, C‐indexCM+continuous hsa_circ_0001445 = 0.856 and C‐indexCM+binary hsa_circ_0001445 = 0.855). Detailed analysis of stability showed that hsa_circ_0001445 was present in plasma in a remarkably stable form. In vitro, hsa_circ_0001445 was downregulated in extracellular vesicles secreted by human coronary smooth muscle cells upon exposure to atherogenic conditions. In patients with suspected stable CAD referred for coronary CTA, plasma hsa_circ_0001445 improves the identification of coronary artery atherosclerosis.

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supporting

confidence: 65%

“…Second, the incorporation of circRNAs in clinical laboratories is hampered by the fact that research technologies are required for circRNA quantification. Third, possible confounders cannot be ruled out despite adjustment . Fourth, our results reflect an association.…”

Section: Discussionmentioning

confidence: 69%

Plasma circular RNA hsa_circ_0001445 and coronary artery disease: Performance as a biomarker

et al. 2020

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“…Dear Editor, I read with great interest the article by Hagstr€ om et al [1] about the association between psychosocial stress, such as depressive symptoms, loss of interest, living alone and financial stress, and increased cardiovascular mortality amongst patients with stable coronary heart disease (CHD) despite optimal secondary medical prevention treatment. Although many other contemporary studies have also confirmed the positive correlation of depression with CHD [2,3], an early description of this association is found in the Deuterocanonical Book of the Christian Old Testament, called, according to the translation of the Seventy (Septuagint), Wisdom of Jesus the Son of Sirach (Codex Alexandrinus) or Wisdom of Sirach (Codex Baticanus), also known as the Book of Ecclesiasticus (Latin Church).…”

Section: Sorrow and Cardiovascular Eventsmentioning

confidence: 99%

Sorrow and cardiovascular events

Mazokopakis

2018

J Intern Med

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“…It is indeed fascinating that, already 2000 years ago, the link between sorrow (and perhaps depression) and disease had been observed. The past knowledge on the complex relation between low socio-economic status, depression/being sorrow and heart disease is still, 2000 years later, a growing contemporary problem [2]. Being sorrow could, besides being interpreted as part of a longer standing depression, also reflect a state of more acute emotional stress, such as after the death of a beloved one, sometimes observed causing Takotsubo cardiomyopathy [3].…”

mentioning

confidence: 99%