Cardiovascular Disease

The thromboxane A2 pathway and its components are implicated in the progression of atherosclerosis and cardiovascular diseases. (CAD) Thromboxane A2 is clearly involved in CAD due to its acute and chronic role in promotion of vasoconstriction and platelet aggregation. The success of low-dose aspirin in prevention of CAD is explained by platelet COX-1 inhibiting thromboxane A2 biosynthesis. Levels of urinary 11-dehydrothromboxane B2 reflect activity of components of the thromboxane A2 pathway that regulate thromboxane A2 generation.

The improvement of walking abilities and endothelial function after the supervised training treadmill program

"In this prospective study we evaluated the relationship between thromboxane B2 (TXB2), prostacyclin (PGI2) and lactate concentrations, and the improvement of walking abilities and endothelial function in patients with peripheral artery disease (PAD) undergoing a supervised treadmill training program (STTP)."

The Maximal Walking Time (MWT) improved significantly after STTP by 91% (p<0.0001) and PFWT by 97% (P<0.0001).  Also ankle/brachial index (ABI) values improved significantly after STTP in all patient groups and was more pronounced in those with longer MWT at baseline.  FMD values increased by 45% (p<0.0001) after STTP.  Urinary 11-dehydro-thromboxane B2 and 2, 3-dinor-6-keto-PGF1a concentration tend to decrease after STTP and their ratio remained unchanged.  Lactate levels did not change after the treadmill training program.  Hs-CRP and fibrinogen concentration decreased signficantly after STTP only in patients with longer MWT at baseline - fourth quartile".

"STTP in patients with PAD showed signficantly improved walking abilities and endothelialial function."

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Oxidative stress reflected by increased F2-isoprostanes is associated with increasing urinary 11-dehydro thromboxane B2 levels in patients with coronary artery disease.2016

"Oxidative stress is a potential mechanism of incomplete inhibition of COX-1.

"8-isoPGF2a was found to be independently and positively associated with 11 dhTxB2."

"Elevated 11dhTxB2 was found to increase the risk of adverse events in patients with stable CAD [12] and myocardial infarction."

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11-Dehydro thromboxane B2 levels after percutaneous transluminal angioplasty in patients with peripheral arterial occlusive disease during a one year follow-up period.

"Overall the mean TXB2 values immediately after PTA were significantly higher than either before the procedure (1524.4 pg/mg ± 1411.1 vs. 2098.1 pg/mg creatinine ± 1661.8; P=0.00002), the day after PTA, or at any other point during the study.”

"Moreover, preoperative TXB2 levels correlated well with the composite endpoints of death, myocardial infarction and stroke during the follow-up period"

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Age-related increase of thromboxane B2 and risk of cardiovascular disease in atrial fibrillation

"Cardiovascular events (CVEs) represent the main cause of morbidity and mortality in the elderly population.  Several mechanisms have been proposed so far to explain the age-related incidence of CVs.  Thus, the prevalence of cardiovascular risk factors, such as smoking, hypertension and diabetes increases in elderly people.  Of note is that despite increasingly effective cardiovascular preventive strategies a portion of patients still experience cardiovascular complications."

"Urinary excretion of 11-dehydro-txb2 increases by advancing age, peaking after 70 years."

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Risk factors for nonplatelet thromboxane generation after coronary artery bypass graft surgery.

"A significant finding of our analysis was that U8-iso-PGF2a correlated directly with the incidence of early vein graft thrombosis. This suggests that therapies aimed at reducing oxidative stress might be a viable strategy to reduce nonplatelet TXA2 generation and improve outcomes after cardiac surgery."

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A Japanese cross-sectional multicenter study of biomarkers associated with cardiovascular disease in smokers and non-smokers

“The mean hs-CRP concentration was not significantly different between the two groups of subjects.”

“We found that the 11-DTXB2 concentration was about 24% greater in smokers than in non-smokers, supporting the use of 11-DTXB2 as a potential biomarker for smoking and CVD.”

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The cardiovascular benefits of dark chocolate

"Dark chocolate contains many biologically active components, such as catechins, procyanidins, and theobromine from cocoa, together with added sucrose and lipids.  All of these can directly or indirectly affect the cardiovascular system by multiple mechanisms."

"The effect of chocolate is more convoluted since the sucrose and lipid may transiently and negatively impact on endothelial function, partly through insulin signaling and nitric oxide bioavailability."

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Mediterranean diet reduces thromboxane A2 production in atrial fibrillation patients

"Platelet activation plays a major role in cardiovascular events.  Mediterranean diet reduces the incidence of stroke and myocardial infarction but it is still unclear if it affects platelet activation.  Aim of the study was to evaluate the effect of Mediterranean diet on the urinary excretion of 11-dehydro-thromboxane (TX) B2, a marker in vivo platelet activation, in patients with atrial fibillation."

"Med diet adherence is inversely associated to urinary excretion of 11-dehydro-TXB2, suggesting that Med-Diet may favorably affect platelet function in AF patients."

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Relation of fish oil supplementation to markers of atherothrombotic risk in patients with cardiovascular disease not receiving lipid-lowering therapy.

"Fish oil supplementation (FOS) is known to have cardiovascular benefits.  However, the effects of FOS on thrombosis are incompletely understood.  We sought to determine if the use of FOS is associated with lower indices of atherothrombotic risk in patients with suspected coronary artery disease."

"Fish oil supplementation (FOS) is known to have cardiovascular benefits. Patients on FOS had lower urinary 11-dehydrothromboxane B2 levels regardless of lipid-lowering therapy."

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The influence of low-grade inflammation on platelets in patients with stable coronary artery disease.

"Inflammation is likely to be involved in all stages of atherosclerosis.  Numerous inflammatory biomarkers are currently being studied, and even subtle increases in inflammatory biomarkers have been associated with increased risk of cardiovascular events in patients with coronary artery disease (CAD).  Low-grade inflammation may influence both platelet production and platelet activation potentially leading to enhanced platelet aggregation."

"Increased levels of hsCRP and IL-6 were independently associated with increased platelet aggregation and urine-11-dehydrothromboxane B2 levels (110). This association may be explained by aspirin-insensitive thromboxane generation derived from cyclooxygenase-2 in non-platelet cells."

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