Advancements in Myocardial Infarction Management: Exploring Novel Approaches and Strategies

Cureus, Journal Year: 2023, Volume and Issue: unknown

Published: Sept. 19, 2023

In the landscape of healthcare, management myocardial infarction (MI) stands as a pivotal challenge and critical juncture where advancements are reshaping trajectory patient care. Myocardial infarction, commonly known heart attack, remains foremost contributor to global morbidity mortality. Conventional strategies have historically focused on rapid restoration blood flow through revascularization techniques. However, last decade has witnessed profound transformation, with burgeoning emphasis precision medicine innovative interventions. This contextual backdrop sets stage for deep dive into realm novel diagnostic modalities, spanning high-sensitivity biomarkers, advanced imaging techniques, data-driven algorithms. These innovations facilitate not only early detection but also stratification patients, paving way individualized treatment plans. By targeting underlying mechanisms damage, these interventions hold promise attenuating impact MI promoting cardiac regeneration. It examines integration telemedicine, wearable devices, remote monitoring platforms, bridging gap between patients caregivers while enabling timely Additionally, psychosocial aspects recovery explored, highlighting psychological support lifestyle enhance long-term well-being. exploring diagnostics, therapies, holistic patient-centered strategies, it underscores collaborative efforts medical practitioners, researchers, technological pioneers in As we stand at intersection advancement compassionate management, embracing approaches promises future can be mitigated, lives extended enriched.

Language: Английский

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DNA Methylation-derived biological age and long-term mortality risk in subjects with type 2 diabetes

Cardiovascular Diabetology, Journal Year: 2024, Volume and Issue: 23(1)

Published: July 13, 2024

Abstract Background Individuals with type 2 diabetes (T2D) face an increased mortality risk, not fully captured by canonical risk factors. Biological age estimation through DNA methylation (DNAm), i.e . the epigenetic clocks, is emerging as a possible tool to improve stratification for multiple outcomes. However, whether these tools predict independently of factors in subjects T2D unknown. Methods Among cohort 568 patients followed 16.8 years, we selected subgroup 50 subjects, 27 survived and 23 deceased at present, passing quality check balanced all after propensity score matching. We analyzed DNAm from peripheral blood leukocytes using Infinium Human MethylationEPIC BeadChip (Illumina) evaluate biological aging previously validated clocks assess DNAm-estimated levels inflammatory proteins cell counts. tested associations estimates two-stage residual-outcome regression analysis, creating reference model on data group patients. Results Deceased had higher median expressed DNAmPhenoAge algorithm (57.49 [54.72; 60.58] years. vs. 53.40 [49.73; 56.75] years; p = 0.012), accelerated DunedinPoAm pace (1.05 [1.02; 1.11] 1.02 [0.98; 1.06]; 0.012). PhenoAge (HR 1.16, 95% CI 1.05–1.28; 0.004) 3.65, 1.43–9.35; 0.007) showed association The predictors 3 chronic inflammation-related proteins, CXCL10, CXCL11 enRAGE, C-reactive protein DNAm-based exhausted CD8 + T counts were when compared survived. Conclusions These findings suggest that aging, estimated existing tools, associated individuals T2D, common DNAm-surrogates characterize Replication larger cohorts needed potential this approach refine T2D.

Language: Английский

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PCSK9 Expression in Vascular Smooth Muscle Cells: Role of Insulin Resistance and High Glucose

International Journal of Molecular Sciences, Journal Year: 2025, Volume and Issue: 26(3), P. 1003 - 1003

Published: Jan. 24, 2025

Beyond the regulation of cholesterol metabolism, a number extrahepatic functions proprotein convertase subtilisin/kexin type 9 (PCSK9) have been increasingly identified. The main purpose this study was to verify whether PCSK9 expression in vascular smooth muscle cells (VSMC) is influenced by insulin resistance and high glucose (HG). In cultured rat aortic VSMC from lean insulin-sensitive Zucker rats (LZRs) obese insulin-resistant (OZRs), classical animal model resistance, we evaluated with or without monoclonal antibodies against Alirocumab Evolocumab synthetic PCSK9-binding peptide PEP 2-8. Effects molecular mechanisms underlying altered were proliferation migration assay, reactive oxygen species (ROS) production, involvement PKC, NADPH-oxidase, MAPK/ERK-1/2 pathway activation. As result, found that, comparison LZR, OZR showed basal overexpression mitigated Alirocumab, Evolocumab, 2-8, inhibitors MAPK. finding upregulation paralleled increased ROS proliferation, migration. HG but not OZR, via oxidative stress effects reduced inhibitors. These findings suggest that dysregulation could be involved damage metabolic disorders, such as obesity diabetes.

Language: Английский

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The relationship between oxLDL, sLOX-1, PCSK9 and carotid intima-media thickness in patients with prediabetes and type 2 diabetes

Scientific Reports, Journal Year: 2025, Volume and Issue: 15(1)

Published: Feb. 7, 2025

Affection of vascular structures is a known complication in diabetes and prediabetes. Subclinical atherosclerosis begins to develop years before both cardiovascular cerebrovascular diseases become symptomatic. The aim this study was evaluate the relationship between circulating oxidized LDL (oxLDL), soluble lectin-like (sLOX)-1 proprotein convertase subtilisin/kexin type 9 (PCSK9) levels carotid intima-media thickness (CIMT) patients with prediabetes T2DM. We recruited 50 T2DM macrovascular complications, uncomplicated, patients, healthy participants. common arteries were visualized by high-resolution B-mode artery ultrasonography. Measurement serum oxLDL, sLOX-1 PCSK9 assessed using commercially available human enzyme-linked immunosorbent assay (ELISA) method. Homeostasis model assessment for insulin resistance (HOMA-IR) also calculated. Circulating LDL-C, significantly higher complications compared control group, uncomplicated diabetes. There significant difference, especially controls complications. CIMT increased progressively from through Both right left showed differences groups versus at p < 0.001 showing progressive increase involvement progression disease. positive correlation sLOX-1, CIMT. ROC curve analyses that PCSK9, as well oxLDL LOX-1, strong predictor high sensitivity specificity. In study, we found associated thickness. Our findings suggest these biomarkers may be used potential markers risk 2

Language: Английский

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Metabolic surgery in improving arterial health in obese individuals

Current Problems in Cardiology, Journal Year: 2023, Volume and Issue: 49(3), P. 102359 - 102359

Published: Dec. 20, 2023

Language: Английский

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PCSK9 and Coronary Artery Plaque—New Opportunity or Red Herring?

Current Atherosclerosis Reports, Journal Year: 2024, Volume and Issue: 26(10), P. 589 - 602

Published: Aug. 16, 2024

Abstract Purpose of Review Although the clinical benefit reducing low-density lipoprotein cholesterol (LDLc) in patients with coronary artery disease (CAD) is well-established, impact on plaque composition and stability less clear. Our narrative review aimed to assess effects proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors characteristics specifically focusing from atheroma progression regression stabilization. Recent Findings The combination statin therapy PCSK9 (evolocumab alirocumab) promotes following an acute syndrome. GLAGOV study highlighted relationship between achieved LDLc levels changes percentage volume. Similarly, PACMAN-AMI concluded that qualitative quantitative were associated LDLc. Summary Assessing severity stenosis extent atherosclerotic burden by means imaging techniques (e.g., IVUS, OCT near-infrared spectroscopic) have significantly advanced our understanding benefits promoting achieving features stabilization through increasingly intensive lipid-lowering strategies.

Language: Английский

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LDL Cholesterol Variability Impacts the Prognosis of Patients with Chronic Ischemic Heart Disease: A Real-World Italian Experience

Journal of Clinical Medicine, Journal Year: 2023, Volume and Issue: 12(19), P. 6231 - 6231

Published: Sept. 27, 2023

Epidemiologic, genetic, and clinical intervention studies have indisputably shown that low-density lipoprotein cholesterol (LDL-C) is causal in the development of atherosclerotic cardiovascular disease (ASCVD). However, LDL-C variability could be related to increased ASCVD risk patients already treated with statins. The aim present retrospective real-life study was assess prognostic impact on all-cause mortality hospitalizations stable artery disease. A total 3398 were enrolled followed up for a median 56 months. Considering < 70 mg/dL as therapeutical target, during follow-up, percentage who achieved this goal raised from 20.7% 31.9%. In total, 1988 events recorded, which 428 deaths 1560 hospitalizations. At last medical examination, each increase levels 20 corresponded 6% raise any event (HR 1.06; 95%CI, 1.03 1.09). conclusion, our real-world supports hypothesis continuous progressive downward trend needed achieve maintain benefit, at least secondary prevention.

Language: Английский

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Association between systemic immune-inflammation index and diabetes mellitus in the NHANES 2003–2018 population

Journal of the Endocrine Society, Journal Year: 2024, Volume and Issue: 8(8)

Published: June 26, 2024

This study aimed to explore the association between Systemic Immune-Inflammation Index (SII) and diabetes mellitus (DM) assess its influence on prognosis of DM no-DM groups.

Language: Английский

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Novel insights into the association between genetically proxied inhibition of proprotein convertase subtilisin/kexin type 9 and risk of sarcopenia

Journal of Cachexia Sarcopenia and Muscle, Journal Year: 2024, Volume and Issue: unknown

Published: Sept. 10, 2024

Language: Английский

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Maternal Obesity Modulates Cord Blood Concentrations of Proprotein Convertase Subtilisin/Kexin-type 9 Levels

Journal of the Endocrine Society, Journal Year: 2024, Volume and Issue: 8(4)

Published: Feb. 19, 2024

Abstract Context In utero exposure to maternal obesity or diabetes is considered a pro-inflammatory state. Objective To evaluate whether cord blood proprotein convertase subtilisin/kexin-type 9 (PCSK9), which regulated by inflammation and metabolic derangements, elevated in neonates born overweight, obese, diabetic mothers. Methods A retrospective study full-term between 2010 2023, at Brigham Women's Hospital. There were 116 included our study, of 74 (64%) overweight/obese mothers 42 (36%) nonoverweight/nonobese Results Neonates had significantly higher concentrations PCSK9 compared with group (323 [253-442] ng/mL 270 [244-382] ng/mL, P = .041). We found no significant difference nondiabetic multivariate linear regression analysis, plasma concentration was associated overweight/obesity status (b 50.12; 95% CI, 4.02-96.22; .033), after adjusting for gestational age, birth weight, male sex, intrauterine growth restriction. Conclusion have the group, status, perinatal factors. Larger longitudinal studies are needed examine role development syndrome high-risk

Language: Английский

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