Clonal hematopoiesis of indeterminate potential (CHIP) in cerebromicrovascular aging: implications for vascular contributions to cognitive impairment and dementia (VCID)

GeroScience, Journal Year: 2025, Volume and Issue: unknown

Published: April 11, 2025

Language: Английский

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Healthy ageing in older adults with cardiovascular disease

European Heart Journal, Journal Year: 2025, Volume and Issue: unknown

Published: April 29, 2025

Abstract As life expectancy continues to increase due advancements in medical technology, public health, nutrition, and socioeconomic progress, the population of older adults USA Europe is rapidly growing. By 2050, individuals aged 65 are projected constitute over 20% US 29% European population, leading a higher prevalence chronic diseases, including cardiovascular disease. Cardiovascular disease, cause death USA, poses significant challenges healthy ageing by contributing accelerated biological development geriatric syndromes. This state-of-the-art review aims (i) define for patients living with disease; (ii) compare chronological vs as it pertains (iii) describe impact syndromes provide an approach management prevention; (iv) address gaps knowledge future directions potential interventions that could promote ageing.

Language: Английский

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Comprehensive Geriatric Assessment to Optimize the Management of Older Patients With Transthyretin Cardiac Amyloidosis

JACC Advances, Journal Year: 2024, Volume and Issue: 3(9), P. 101123 - 101123

Published: July 22, 2024

Transthyretin cardiac amyloidosis (ATTR-CA) predominantly affects older adults with multiple chronic conditions, leading to significant physical, cognitive, and emotional challenges. New disease-modifying drugs are effective in early stages, prompting a shift toward comprehensive assessments, including functional capacity quality of life. However, these assessments may not fully capture the complexity ATTR-CA patients, especially regarding frailty mood disorders, which can influence symptom reporting. Thus, integrating geriatric assessment tools into routine clinical practice be crucial detect signs or impairment that could impact outcomes mitigate futility ageism decision-making process. This review highlights importance evaluating multimorbidity, disability, patients optimize management strategies.

Language: Английский

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Frailty and Cardiovascular Disease

Springer eBooks, Journal Year: 2024, Volume and Issue: unknown, P. 299 - 308

Published: Jan. 1, 2024

Language: Английский

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Bringing Geroscience into the Mainstream: From Education to Clinical Practice, What Will It Take?

The Journals of Gerontology Series A, Journal Year: 2024, Volume and Issue: 79(9)

Published: Aug. 10, 2024

Language: Английский

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Current and Prospective Biochemical Markers for the Identification of Acute Coronary Syndrome-A Review

Biomedical & Pharmacology Journal, Journal Year: 2024, Volume and Issue: 17(4), P. 2071 - 2085

Published: Dec. 30, 2024

Acute coronary syndrome (ACS) represents a spectrum of heart muscle oxygen deprivation (ischemia) which ranges from temporary tissue damage in angina to unstable with possible minor cell death and finally full-blown attack (myocardial infarction) extensive necrosis. Biochemical indicators the remain crucial comprehensive evaluation management individuals various forms ACS. Diagnosing ACS accurately is for optimal treatment. While existing biochemical markers play vital role, searching an ideal biomarker continues. myocardial injury are critical global assessment treatment these syndromes. The objective review, primarily evaluate current understanding biomarkers rather than specifically assess most promising. review emphasizes importance markers, ongoing search biomarker, how diagnosis This examines associated atherosclerosis, including matrixins, PAPP-A metalloproteinase, myeloperoxidase, microalbuminuria, cystatin, P-selectin, glycogen phosphorylase-BB, C-reactive protein marker, cluster differentiation 40 (CD40L) creatine kinase-myocardial band (CK-MB), ischemia-modified albumin. Traditional Tn levels may not rise immediately during ischemia, but MPO increase earlier, aiding early detection. MPO, produced inflammation, offers predictive data surpassing troponins. IMA also rises faster troponins, signaling ischemia before irreversible damage. hs-CRP provides insights into inflammation cardiovascular risk, complementing MicroRNAs serve as precise ACS, troponins detecting molecular changes linked disease. These enhance Clinically, have significantly risen at stage ischemia; however, other should be considered detection risk stratification. Elevated can indicate earlier additional systemic risk. provide detailed outperform identifying offering more sensitive diagnostic approach. Further monitoring adjustments based on advised. In conclusion, while diagnosing novel like IMA, hs-CRP, microRNAs offer better assessment. improving accuracy patient outcomes when used alongside traditional biomarkers.

Language: Английский

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Can statin preventative treatment inform geroscience‐guided therapeutics?

Aging Cell, Journal Year: 2023, Volume and Issue: 22(12)

Published: Oct. 13, 2023

Potential senotherapeutic effect of statins may lead to prevention and reduction frailty. People with HIV (PWH) develop cardiovascular disease (CVD) at a significantly younger age than the general population, in context multimorbid burden that is consistent an accelerated aging phenotype (Grinspoon et al., 2023). The Randomized Trial Prevent Vascular Events (REPRIEVE) study took center stage 2023 International AIDS Society (IAS) meeting Brisbane, Australia, sharing findings treatment pitavastatin reduced risk major adverse events (MACE) compared placebo PWH without pre-existing CVD Among 7769 persons (median 50 years) low-to-moderate atherosclerotic CVD, dose 4 mg daily was associated 35% lower MACE 21% and/or death over median follow-up 5.1 years on first among different subgroups, particularly ART duration >10 years, nadir CD4 cell count <200 cell/μL, current >500 cell/μL REPRIEVE builds data from previous notable primary-prevention involving statins, is, rosuvastatin landmark JUPITER (Ridker 2008), which evaluated 17,802 healthy 66 adults infection or dyslipidemia, but elevated high-sensitivity C-reactive protein (hs-CRP), inflammatory biomarker predicts vascular events. Over 1.9 there significant hs-CRP levels. Although levels have not yet been reported study, prior studies indicate biomarkers such as hs-CRP, IL-6 remain despite effective decline response statin therapy (Funderburg 2014). These trial results support growing appreciation for pleiotropic role beyond plasma low-density lipoprotein (LDL) Statins also prevent plaque formation cholesterol crystals directly activate NLRP3 inflammasome, key mediator inflammation (Koushki 2021) potentially neurocognitive (Ising 2019). Furthermore, given lipophilic are widely distributed across tissues, whereas hydrophilic appear be liver specific, carefully designed mechanistic differentiate function needed 2021). studies, considered together (pitavastatin JUPITER) inform geroprotective strategies—because tends comorbid condition (accelerated/accentuated by infection) advancing driven finite set common aging-related pathways, example, hallmarks (Burch 2014; López-Otín 2013; Toribio 2017; 2018). Whether observed LDL within antecedent molecular drivers will exciting next chapter these investigations. One attractive hallmark targeted senescence. Indeed, we propose agent, targeting senescence, either senolytics (promote clearance senescent cells) senomorphics (block proliferation senescence-associated secretory phenotype, SASP) (Coppé 2008; Matsubayashi Because cellular senescence underlies many age-related conditions, senotherapy represents promising approach mitigating conditions (e.g., metabolic disease, frailty, dementia). via inflammation, secondary lipid lowering, possibly through direct impact aging. several population suggest influence For improve endothelial alteration epigenetic pathways (Liuzzo & Pedicino, 2023) telomere attrition (Nose Interestingly, American College Cardiology has recently suggested consider geroscience therapeutic strategies older adult (Forman Notably, however, linked effects, including increased dysfunction (Abbasi 2021; Bai 2023; Centers Disease Control Pre- vention, n.d.; Mansi Sattar 2010), albeit only minimally increasing glucose study. other differ tissue effects. following infarct mitochondrial (Bland 2022). While myositis myopathy side effects outcomes tend rare. Nevertheless, their presence raises questions regarding holistic health benefit-to-burden, underscores gap our understanding mechanism action statins. HIV, recent clinical differences based biological sex statin-mediated protection loss muscle mass, strength, physical (Cárdenas Notably trial, related symptoms were marginally (2.3% vs. 1.4% arm) while no 2008). Collectively, benefits reducing cardiometabolic, biomarkers, SASP outweigh slight myopathy-related symptoms. This especially linkage between functional (Cesari 2004) frailty (Ferrucci Fabbri, Frailty, characterized critical exhaustion reserve resilience provide opportunity measure process (Afilalo Forman Frailty construct composite vulnerability stressors net result competing forces, some acting gero-protectors others gero-inducers. Ultimately, imbalance homeostatic reserves against stressors, expose individual higher negative outcomes, falls, disability, comorbidities, cognitive impairment, (Rockwood Mitnitski, 2007). Developing function-promoting interventions delay onset both healthspan lifespan critically relevant (Montano experience earlier greater prevalence people HIV-1 RNA (Desquilbet With initiation more less toxic antiretroviral therapy, demonstrated decrease aged 3-fold increase those 75 Modena Metabolic clinic, suggesting potential this specific contemporary (Guaraldi Importantly, consistently important factor multiple cohorts (Kelly 2019; Kuniholm decreasing added numerous “hallmarks”, ultimately slowing progression geriatric syndromes A substudy (PREPARE NCT04221295) collected objective measures function, area, density, subset participants (Umbleja 2020). relatively young cohort low baseline may; limit ability detect changes typically ascertained individuals 65 Finally, light findings, anticipate guidelines soon reflect PWH, dramatic change prescription rates (Jaschinski n.d.). area roll-out, end 2030 about 70% old 78% (Smit 2015). However, estimations might generalizable all geographical areas. REPRIEVE, authors noted CV factors had high income countries BMI, smoking, family history CVD) As risks expected changing epidemic obesity middle-income countries, weight modern comparison regimens, cardioprotective could even coming years. often early use conditions. represent breakthrough medicine, well broader field geroscience-guided therapeutics Giovanni Guaraldi Monty A. Montano conceptualized manuscript. Guaraldi, Kristine M. Erlandson, Jovana Milic, Alan L. Landay, wrote revised did supervision final version All contributed discussion would like thank Claudia Alonso Melissa Mendez help designing graphical abstract. received funding produce GG research grants speaker honoraria Gilead, ViiV, MERCK, Jansen. attended advisory boards ViiV MERCK. KME grant Gilead participated Merck. payments University Colorado. JM ViiV. AL receives Abbott Gilead. MM Editor Chief Aging Cell (John Wiley Sons). N/A

Language: Английский

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Editor-in-Chief’s Top Picks From 2023

Journal of the American College of Cardiology, Journal Year: 2024, Volume and Issue: 83(10), P. 961 - 1026

Published: March 1, 2024

Language: Английский

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Role of the National Institute on Aging in Transforming Aging Research Through Geroscience and Gerotherapeutics—50 Years of Innovation

JAMA Internal Medicine, Journal Year: 2024, Volume and Issue: 184(10), P. 1146 - 1146

Published: Aug. 5, 2024

This Viewpoint discusses the role of National Institute on Aging (NIA) in fields geroscience and gerotherapeutics.

Language: Английский

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Impact of Frailty and Clonal Hematopoiesis on Cardiovascular Outcomes in Elderly Patients with Renal Artery Stenosis Undergoing Stenting

Research Square (Research Square), Journal Year: 2024, Volume and Issue: unknown

Published: Nov. 19, 2024

Background: Frailty and clonal hematopoiesis of indeterminate potential (CHIP) have emerged as crucial predictors adverse cardiovascular outcomes in older adults. However, their combined impact on major events (MACE) patients with severe atherosclerotic renal artery stenosis (ARAS) remains unclear. Methods: We conducted a prospective cohort study involving 175 aged 60 years ARAS (luminal ≥ 70%) who underwent stenting at Beijing Hospital between January 2019 December 2022. was assessed using the Fried phenotype, categorizing into robust, prefrail, frail subgroups. CHIP status determined through targeted gene sequencing peripheral blood, stratifying No (VAF < 2%), Small 2%-<10%), Large 10%) All were systematically followed up until June 30, 2024. The primary outcome incidence MACE, which composite function deterioration (RFD), initiation replacement therapy, revascularization, nonfatal myocardial infarction, hospitalization for heart failure, stroke, cardiorenovascular death. employed Cox proportional hazards models, Kaplan-Meier survival analysis, heatmaps to explore frailty MACE risk. Results: mean age 68.3 years. Of cohort, 64.6% had no CHIP, 26.8% 8.6% CHIP. Frail showed higher prevalence particularly (34.7%) (10.2%) categories. During median follow-up 32 months, 54 occurred. curve revealed that associated (35.7% vs. 29.5% prefrail 24.6% P = 0.045) RFD (16.3% 11.5% 7.7% 0.034). Patients experienced significantly rates (60.0% 36.2% 24.8% 0.004) (26.7% 14.9% 8.0% 0.019). Findings appeared be consistent those MACE. independent contribution overall greatest spread risk obtained models incorporated Conclusion: independently jointly, contribute elderly undergoing stenting. These findings highlight necessity integrated stratification management strategies this high-risk population.

Language: Английский

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