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  • 1
    In: Nature, Springer Science and Business Media LLC, Vol. 612, No. 7938 ( 2022-12-01), p. E7-E7
    Materialart: Online-Ressource
    ISSN: 0028-0836 , 1476-4687
    RVK:
    RVK:
    RVK:
    Sprache: Englisch
    Verlag: Springer Science and Business Media LLC
    Publikationsdatum: 2022
    ZDB Id: 120714-3
    ZDB Id: 1413423-8
    SSG: 11
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 2
    In: Nature, Springer Science and Business Media LLC, Vol. 611, No. 7934 ( 2022-11-03), p. 115-123
    Kurzfassung: Previous genome-wide association studies (GWASs) of stroke — the second leading cause of death worldwide — were conducted predominantly in populations of European ancestry 1,2 . Here, in cross-ancestry GWAS meta-analyses of 110,182 patients who have had a stroke (five ancestries, 33% non-European) and 1,503,898 control individuals, we identify association signals for stroke and its subtypes at 89 (61 new) independent loci: 60 in primary inverse-variance-weighted analyses and 29 in secondary meta-regression and multitrait analyses. On the basis of internal cross-ancestry validation and an independent follow-up in 89,084 additional cases of stroke (30% non-European) and 1,013,843 control individuals, 87% of the primary stroke risk loci and 60% of the secondary stroke risk loci were replicated ( P   〈  0.05). Effect sizes were highly correlated across ancestries. Cross-ancestry fine-mapping, in silico mutagenesis analysis 3 , and transcriptome-wide and proteome-wide association analyses revealed putative causal genes (such as SH3PXD2A and FURIN ) and variants (such as at GRK5 and NOS3 ). Using a three-pronged approach 4 , we provide genetic evidence for putative drug effects, highlighting F11, KLKB1, PROC, GP1BA, LAMC2 and VCAM1 as possible targets, with drugs already under investigation for stroke for F11 and PROC. A polygenic score integrating cross-ancestry and ancestry-specific stroke GWASs with vascular-risk factor GWASs (integrative polygenic scores) strongly predicted ischaemic stroke in populations of European, East Asian and African ancestry 5 . Stroke genetic risk scores were predictive of ischaemic stroke independent of clinical risk factors in 52,600 clinical-trial participants with cardiometabolic disease. Our results provide insights to inform biology, reveal potential drug targets and derive genetic risk prediction tools across ancestries.
    Materialart: Online-Ressource
    ISSN: 0028-0836 , 1476-4687
    RVK:
    RVK:
    RVK:
    Sprache: Englisch
    Verlag: Springer Science and Business Media LLC
    Publikationsdatum: 2022
    ZDB Id: 120714-3
    ZDB Id: 1413423-8
    SSG: 11
    Standort Signatur Einschränkungen Verfügbarkeit
    BibTip Andere fanden auch interessant ...
  • 3
    In: Annals of the Rheumatic Diseases, BMJ, Vol. 81, No. Suppl 1 ( 2022-06), p. 1423-1424
    Kurzfassung: Ultrasound (US) is a valid imaging tool to detect signs of giant cell arteritis (GCA). Although the halo sign has always been considered the most useful finding for GCA diagnosis, modern high frequency transducers are able to precisely measure the intima-media thickness (IMT) of cranial and extracranial arteries. However, data on optimal cut-off values for IMT to differentiate patients and controls in clinical practice are limited. Objectives To determine the optimal cut-off value for IMT of cranial and extracranial arteries in patients with suspected GCA. Methods This is a retrospective observational study of patients referred to our US fast-track clinic with suspected GCA. All patients underwent bilateral US examination of the cranial and extracranial (carotid, subclavian and axillary) arteries within 24 hours per protocol. The exam was performed using an EsaoteMyLab8 with a 12-18 MHz frequency transducer for cranial arteries and an 8-14 frequency transducer for extracranial arteries. The IMT was measured in gray scale mode and the presence of a non-compressible halo sign was checked in all arteries. The gold standard for GCA diagnosis was clinical confirmation by the referring rheumatologist after 6 months follow-up. Mean IMT values of each artery were compared between patients with and without GCA by independent samples T-test. Receiver operating characteristics analysis was performed and the Youden index was used to determine the optimal cut-off value for IMT of each artery. Results Of the 157 patients with suspected GCA (67.5% female, mean age 73.7 years) referred to the fast-track clinic, 47 (29.9%) had GCA clinical confirmation after 6 months. 41 (87.2%) patients with GCA had positive US findings (61.7% had cranial involvement, 44.7% extracranial involvement and 19.1% a mixed pattern of cranial and extracranial arteries). The following IMT cut-off values showed the highest diagnostic accuracy: 0.44mm for the common superficial temporal artery; 0.34 mm for the frontal branch; 0.36 mm for the parietal branch; 1.1 mm for the carotid artery: 1 mm for the subclavian and axillary arteries. The area under the ROC curve of the IMT for a clinical diagnosis of GCA was 0.984 (95% CI 0.959 - 1) for common superficial temporal artery, 0.989 (95% CI 0.976 -1) for frontal branch, 0.991 (95% CI 0.980 - 1) for parietal branch, 0.977 (95% CI 0.961 – 0.993) for carotid, 0.99 (95% CI 0.979 - 1) for subclavian and 0.996 (95% CI 0.991 -1) for axillary arteries (Table 1). Table 1. Optimal IMT cut-off values for cranial and extracranial arteries Artery Side Patients without GCA Patients with GCA Cut-off (mm) AUC (CI 95%) Sensitivity (%) Specificity (%) Common superficialtemporal artery mm, mean (SD) Right 0.33 (0.06) 0.68 (0.28) 0.43 0.997 (0.988 -1) 100 97.1 Left 0.35 (0.11) 0.57 (0.21) 0.45 0.966 (0.905 -1) 100 92.3 Both 0.34 (0.08) 0.63 (0.25) 0.44 0.984 (0.959 -1) 94.7 95.1 Frontal branch mm, mean (SD) Right 0.26 (0.05) 0.4 (0.18) 0.34 0.994 (0.983 -1) 100 97.1 Left 0.27 (0.05) 0.4 (0.18) 0.34 0.985 (0.962 -1) 100 96.1 Both 0.26 (0.05) 0.4 (0.18) 0.34 0.989 (0.976 -1) 100 96.6 Parietal branch mm, mean (SD) Right 0.27 (0.05) 0.43 (0.18) 0.36 0.994 (0.981 -1) 100 98.9 Left 0.27 (0.05) 0.41 (0.16) 0.36 0.987 (0.967 -1) 100 97.6 Both 0.27 (0.05) 0.42 (0.17) 0.36 0.991 (0.980 -1) 100 98.3 Carotid mm, mean (SD) Right 0.8 (0.17) 0.88 (0.29) 1 0.974 (0.949 – 0.999) 100 92.6 Left 0.82 (0.15) 1 (0.42) 1.2 0.982 (0.961 - 1) 90.9 96.2 Both 0.81 (0.16) 0.96 (0.36) 1.1 0.977 (0.961 – 0.993) 90 94 Subclavian mm, mean (SD) Right 0.74 (0.18) 0.99 (0.44) 1 0.987 (0.97 - 1) 100 93.4 Left 0.67 (0.17) 0.9 (0.35) 1.1 0.991 (0.975 - 1) 100 98.3 Both 0.7 (0.18) 0.94 (0.4) 1 0.99 (0.979 - 1) 100 96 Axillary mm, mean (SD) Right 0.69 (0.16) 0.99 (0.5) 1 0.992 (0.982 - 1) 100 96 Left 0.67 (0.17) 0.99(0.49) 1 0.998 (0.995 -1) 100 98.3 Both 0.68 (0.17) 0.99 (0.49) 1 0.996 (0.991 -1) 100 97.1 Conclusion Different IMT cut-off values for each artery are necessary to establish a correct US diagnosis of GCA. These proposed IMT cut-off values may help to improve the diagnostic accuracy of US in clinical practice. Disclosure of Interests None declared
    Materialart: Online-Ressource
    ISSN: 0003-4967 , 1468-2060
    RVK:
    Sprache: Englisch
    Verlag: BMJ
    Publikationsdatum: 2022
    ZDB Id: 1481557-6
    Standort Signatur Einschränkungen Verfügbarkeit
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