Dataset Information

Cerebral microbleeds and acute myocardial infarction: Screening and disease progression.

ABSTRACT: Introduction:Cerebral microbleeds (CMB) are associated with intracerebral haemorrhage. Therefore they may represent a concern if anticoagulant and/or antiplatelet therapy is needed. The aim of this study was to determine the prevalence of CMB in patients with acute myocardial infarction (AMI), and to follow their progression at 3 months under dual antiplatelet therapy (DAPT). Methods:This prospective study included patients aged over 60 hospitalized in intensive cardiac care unit in our city for AMI. These patients underwent a first brain Magnetic resonance imaging (MRI) within 72 h of admission, that was repeated 3 months. Results:108 patients were included between November 2016 and December 2018. The prevalence of CMB was 21.3%, with a female predominance of 65.2% vs 32.1% (p = 0.004). Diabetes is significantly associated with the presence of CMB, 45.5% vs 21.2% (p = 0.021). Patients with at least one acute CMB had higher haemorrhagic risk as evaluated with CRUSADE score (40.5 ± 13.6 vs 31.2 ± 14.8 (p = 0.004).Multivariate analysis showed that only female sex was associated with the presence of a CMB on the initial MRI. On repeated MRI, an increase in CMB was observed in 6% of patients.Our results suggest that discharge treatment with anticoagulant in combination with antiplatelet therapy may be an independent predictor of early progression of CMB. Conclusion:Our study confirms the high prevalence of CMB in patients over 60 years with AMI. The association of anticoagulant with DAPT, 3 months after stenting, may be an independent factor of CMB progression.

SUBMITTER: Alaa El Din A

PROVIDER: S-EPMC7262454 | biostudies-literature | 2020 Jun

REPOSITORIES: biostudies-literature

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Cerebral microbleeds and acute myocardial infarction: Screening and disease progression.

Alaa El Din Abbass A Debeaumarche Hugo H Thouant Pierre P Maza Maud M Ricolfi Frédéric F Zeller Marianne M Bichat Florence F Baudouin Nathalie N Bejot Yannick Y Cottin Yves Y

International journal of cardiology. Heart & vasculature 20200529

<h4>Introduction</h4>Cerebral microbleeds (CMB) are associated with intracerebral haemorrhage. Therefore they may represent a concern if anticoagulant and/or antiplatelet therapy is needed. The aim of this study was to determine the prevalence of CMB in patients with acute myocardial infarction (AMI), and to follow their progression at 3 months under dual antiplatelet therapy (DAPT).<h4>Methods</h4>This prospective study included patients aged over 60 hospitalized in intensive cardiac care unit ...[more]

PMID: 32490144

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Project description:BackgroundPreclinical data suggest that an acute inflammatory response following myocardial infarction (MI) accelerates systemic atherosclerosis. Using combined positron emission and computed tomography, we investigated whether this phenomenon occurs in humans.Methods and resultsOverall, 40 patients with MI and 40 with stable angina underwent thoracic 18F-fluorodeoxyglucose combined positron emission and computed tomography scan. Radiotracer uptake was measured in aortic atheroma and nonvascular tissue (paraspinal muscle). In 1003 patients enrolled in the Global Registry of Acute Coronary Events, we assessed whether infarct size predicted early (≤30 days) and late (>30 days) recurrent coronary events. Compared with patients with stable angina, patients with MI had higher aortic 18F-fluorodeoxyglucose uptake (tissue-to-background ratio 2.15±0.30 versus 1.84±0.18, P<0.0001) and plasma C-reactive protein concentrations (6.50 [2.00 to 12.75] versus 2.00 [0.50 to 4.00] mg/dL, P=0.0005) despite having similar aortic (P=0.12) and less coronary (P=0.006) atherosclerotic burden and similar paraspinal muscular 18F-fluorodeoxyglucose uptake (P=0.52). Patients with ST-segment elevation MI had larger infarcts (peak plasma troponin 32 300 [10 200 to >50 000] versus 3800 [1000 to 9200] ng/L, P<0.0001) and greater aortic 18F-fluorodeoxyglucose uptake (2.24±0.32 versus 2.02±0.21, P=0.03) than those with non-ST-segment elevation MI. Peak plasma troponin concentrations correlated with aortic 18F-fluorodeoxyglucose uptake (r=0.43, P=0.01) and, on multivariate analysis, independently predicted early (tertile 3 versus tertile 1: relative risk 4.40 [95% CI 1.90 to 10.19], P=0.001), but not late, recurrent MI.ConclusionsThe presence and extent of MI is associated with increased aortic atherosclerotic inflammation and early recurrent MI. This finding supports the hypothesis that acute MI exacerbates systemic atherosclerotic inflammation and remote plaque destabilization: MI begets MI.Clinical trial registrationURL: https://www.clinicaltrials.gov. Unique identifier: NCT01749254.

Project description:Despite their different appearance on imaging, hemorrhagic and ischemic vascular lesions frequently co-occur in the brain and are hypothesized to progress concurrently. Although silent hemorrhagic and ischemic vascular brain lesions are highly prevalent in the general population, the concomitant progression of these lesions has only been studied to a limited extent in this population. We therefore aimed to investigate whether pre-existing and incident cerebral microbleeds (CMBs) are related to the progression of ischemic lesions in the general population.In the prospective population-based Rotterdam Scan Study, 803 individuals aged ?60 years underwent magnetic resonance imaging at baseline and after an average interval of 3.4 years. The presence of microbleeds and lacunes was visually rated by trained research physicians, and white matter lesions (WMLs) were automatically segmented at both time points. Logistic regression was used to investigate the association of microbleeds with incident lacunes, and linear regression was used to investigate the relation between microbleeds and progression of WML volume. All analyses were adjusted for age, sex and the time interval between baseline and follow-up scanning. The analyses were repeated after additional adjustments for cardiovascular risk factors: blood pressures; total and high-density lipoprotein cholesterol; smoking; diabetes mellitus; lipid lowering, antihypertensive and antiplatelet medications, and apolipoprotein E ?4. The analyses involving WMLs were also adjusted for intracranial volume.We found that pre-existing microbleeds in any location of the brain were related to a higher incidence of lacunes (odds ratio [OR] adjusted for age, sex and scan interval: 4.67; 95% confidence interval [CI]: 1.84-11.85). Pre-existing microbleeds were not related to progression of WML volume (mean difference in WML volume increase: -0.03; 95% CI: -0.15 to 0.09). Additional adjustments for cardiovascular risk factors did not change the results considerably. Incident microbleeds in any location of the brain were associated with a higher incidence of lacunes (OR: 9.18; 95% CI: 3.61-23.35), whereas only incident microbleeds located in cortico-subcortical regions were related to progression of WML volume (mean difference in WML volume increase: 0.41; 95% CI: 0.21-0.62). Again, adjustments for cardiovascular risk factors did not change the results significantly.Our findings suggest that in the general population, CMBs serve as a predictor of ischemic brain lesions and may represent an imaging marker of active vasculopathy. These results support the hypothesis of a common underlying pathway in the development of ischemic and hemorrhagic brain lesions.

Project description:Acute myocardial infarction (AMI) is a common disease that induced by sudden occlusion of a coronary artery and myocardial necrosis, which causes a great medical burden worldwide. Noncoding RNAs, such as circRNA, lncRNA and miRNA, play crucial roles in the progression of cardiovascular diseases. However, the circRNA-miRNA-mRNA network in the occurrence and development of AMI needs further investigation. In this study, we downloaded three AMI datasets, including circRNA (GSE160717), miRNA (GSE24591), and mRNA (GSE66360) from GEO database. The differentially expressed candidates, and GO and KEGG functions were analyzed by RStudio, and subsequently import to PPI and Cytoscape to obtain the hub genes. By using the starbase target prediction database, we further screen the ceRNA network of circRNA-miRNA-mRNA based on the selected differentially expressed candidates. We found 46 differential expressed mRNAs, 65 miRNAs, and five circRNAs. GO functions and KEGG enrichment of the 46 mRNAs focused on immune response and functions, involving IL-17 signaling pathway, Toll-like receptor signaling pathway, cytokine-cytokine receptor interaction, TNF signaling pathway, chemokine signaling pathway, and NF-kappaB signaling pathway, which may aggravate the pathologies of AMI. PPI and Cytoscape analysis showed 10 hub genes, including TLR2, IL1B, CCL4, CCL3, CCR5, TREM1, CXCL2, NLRP3, CSF3, and CCL20. By using starbase and circinteractome databases, ceRNA network construction showed that circRNA_023461 and circRNA_400027 regulate several miRNA-mRNA axes in AMI. In summary, this study uncovered the circRNA-miRNA-mRNA network based on three AMI datasets. The differentially expressed genes, including CCL20, CCL4, CSF3, and IL1B, focus on immune functions and pathways. Furthermore, circRNA_023461 and circRNA_400027 regulate several miRNA-mRNA axes, exerting important roles in AMI progression. Our founding provides new insights into AMI and improve the therapeutic strategies for AMI.

Dataset Information

Cerebral microbleeds and acute myocardial infarction: Screening and disease progression.

Publications

Cerebral microbleeds and acute myocardial infarction: Screening and disease progression.

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