Renin-angiotensin-aldosterone system polymorphisms: a role or a hole in occurrence and long-term prognosis of acute myocardial infarction at young age

<p>Abstract</p> <p>Background</p> <p>The renin-angiotensin-aldosterone system (RAAS) is involved in the cardiovascular homeostasis as shown by previous studies reporting a positive association between specific RAAS genotypes and an increased risk of myocardial infarction. Anyhow the prognostic role in a long-term follow-up has not been yet investigated.</p> <p>Aim of the study was to evaluate the influence of the most studied RAAS genetic Single Nucleotide Polymorphisms (SNPs) on the occurrence and the long-term prognosis of acute myocardial infarction (AMI) at young age in an Italian population.</p> <p>Methods</p> <p>The study population consisted of 201 patients and 201 controls, matched for age and sex (mean age 40 ± 4 years; 90.5% males). The most frequent conventional risk factors were smoke (p < 0.001), family history for coronary artery diseases (p < 0.001), hypercholesterolemia (p = 0.001) and hypertension (p = 0.002). The tested genetic polymorphisms were angiotensin converting enzyme insertion/deletion (ACE I/D), angiotensin II type 1 receptor (AGTR1) A1166C and aldosterone synthase (CYP11B2) C-344T. Considering a long-term follow-up (9 ± 4 years) we compared genetic polymorphisms of patients with and without events (cardiac death, myocardial infarction, revascularization procedures).</p> <p>Results</p> <p>We found a borderline significant association of occurrence of AMI with the ACE D/I polymorphism (DD genotype, 42% in cases vs 31% in controls; p = 0.056). DD genotype remained statistically involved in the incidence of AMI also after adjustment for clinical confounders.</p> <p>On the other hand, during the 9-year follow-up (65 events, including 13 deaths) we found a role concerning the AGTR1: the AC heterozygous resulted more represented in the event group (p = 0.016) even if not independent from clinical confounders. Anyhow the Kaplan-Meier event free curves seem to confirm the unfavourable role of this polymorphism.</p> <p>Conclusion</p> <p>Polymorphisms in RAAS genes can be important in the onset of a first AMI in young patients (ACE, CYP11B2 polymorphisms), but not in the disease progression after a long follow-up period. Larger collaborative studies are needed to confirm these results.</p

Leaders Matter Morally: The Role of Ethical Leadership in Shaping Employee Moral Cognition and Misconduct

There has long been interest in how leaders influence the unethical behavior of those who they lead. However, research in this area has tended to focus on leaders’ direct influence over subordinate behavior,such as through role modeling or eliciting positive social exchange. We extend this research by examining how ethical leaders affect how employees construe morally problematic decisions, ultimately influencing their behavior. Across four studies, diverse in methods (lab and field) and national context (the United States and China), we find that ethical leadership decreases employees’ propensity to morally disengage, with ultimate effects on employees’ unethical decisions and deviant behavior. Further, employee moral identity moderates this mediated effect. However, the form of this moderation is not consistent. In Studies 2 and 4, we find that ethical leaders have the largest positive influence over individuals with a weak moral identity (providing a “saving grace”), whereas in Study 3, we find that ethical leaders have the largest positive influence over individuals with a strong moral identity (catalyzing a “virtuous synergy”). We use these findings to speculate about when ethical leaders might function as a “saving grace” versus a “virtuous synergy.” Together, our results suggest that employee misconduct stems from a complex interaction between employees, their leaders, and the context in which this relationship takes place, specifically via leaders’ influence over employees’ moral cognition

100 hours of astronomy at the Mexican northern border

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