Prognostic Usefulness of Serum Uric Acid After Acute Myocardial Infarction (The Japanese Acute Coronary Syndrome Study)

The association between serum uric acid and ischemic heart disease remains controversial and it has been difficult to identify the specific role of elevated serum uric acid because of its association with established cardiovascular risk factors such as hypertension, diabetes mellitus, hyperlipidaemia and obesity. Our objective was to study the association of serum uric acid level with confirmed cases of Acute Coronary Syndrome i.e. Unstable Angina, Acute Myocardial Infarction(AMI). The study was conducted in Chittagong Medical College (CMC) & University of Science and Technology(USTC) and nearby diagnostic centre. The study was based on Patients with Acute Coronary Syndrome proved by ECG and/or raised serum Troponin I. The aim of the study was to determine the relationship between serum uric acid and Unstable angina or myocardial infacrtion. There were 35% males & 5% females. The mean age of respondent was 50 years and age ranges from 35 to 70 years. In this study 50 cases of diagnosed myocardial infarction were selected and subsequently investigated with ECG, Radiological and Echocardiographic investigations. Increased serum uric acid levels are a common finding in patients with high blood pressure, insulin resistance, obesity and Cardiovascular disease. The clinical findings, chest X-ray and ECG findings of patients with risk factors for myocardial infarction were extensively studied and the findings are consistent with findings stated in textbooks.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i2.21070

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Gambaran kadar asam urat pada pasien sindrom koroner akut di RSUP Prof. Dr. R. D. Kandou Manado periode Januari-Desember 2015

e-CliniC ◽

10.35790/ecl.4.2.2016.14462 ◽

2016 ◽

Vol 4 (2) ◽

Author(s):

Annisa Syahfitri ◽

Victor Joseph ◽

Starry H. Rampengan

Keyword(s):

Myocardial Infarction ◽

Acute Coronary Syndrome ◽

Uric Acid ◽

Angina Pectoris ◽

Serum Uric Acid ◽

Elevated Serum ◽

St Segment Elevation ◽

Coronary Syndrome ◽

Segment Elevation Myocardial Infarction ◽

St Segment

Abstract: Acute coronary syndrome (ACS) is the term for symptoms due to disorder of blood flow inside the coronary arteries. ACS consists of unstable angina pectoris (UAP), non–ST-segment elevation myocardial infarction (NSTEMI), and ST-segment elevation myocardial infarction (STEMI). One predisposition factor of ACS that is still debated is uric acid. Its role in cardiovascular diseases is assumed due to endothelial disruption caused by elevated serum uric acid. This study was aimed to obtain the profile of uric acid serum in ACS patients at Prof. Dr. R. D. Kandou hospital Manado from January to December 2015. This was a retrospective study with a descriptive observational method using medical record of Prof Dr. R. D. Kandou Hospital Manado. The results showed that there were 97 patients with ACS, including 43 (44.33%) patients with NSTEMI, 43 (44.33%) patients with UAP, and 11 (11.34%) patients with STEMI. Males were more common than females. Most patient were aged 55-65 years old. Elevated serum uric acid was found in 52% of patients, generally in males and NSTEMI cases. More than half of the patients had history of elevated serum uric acid. The most risk factor in the cases were hypertension and smoking.Keywords: description, uric acid, acute coronary syndrome Abstrak: Sindrom koroner akut (SKA) merupakan sekelompok gejala akibat gangguan aliran darah pada arteri koroner. SKA terdiri dari unstable angina pectoris (UAP), infark miokard tanpa elevasi ST (NSTEMI), dan infark miokard dengan elevasi ST (STEMI). Salah satu faktor predisposisi SKA yang hingga kini masih diperdebatkan ialah asam urat. Diduga peran asam urat terhadap penyakit kardiovaskular terletak pada gangguan endotel pembuluh darah yang ditimbulkannya. Penelitian ini bertujuan untuk mengetahui gambaran kadar asam urat pada pasien SKA di RSUP Prof. Dr. R. D. Kandou Manado selama periode Januari-Desember 2015. Jenis penelitian ialah retrospektif dengan metode observasional-deskriptif yang dilaksanakan di Bagian Rekam Medik RSUP Prof. Dr. R. D. Kandou Manado. Hasil penelitian mendapatkan 97 pasien SKA dengan data lengkap, diantaranya 43 kasus (44,33%) NSTEMI, 43 kasus (44,33%) UAP, dan 11 kasus (11,34%) STEMI. Pasien terbanyak terdapat pada laki-laki dan kelompok usia 55-65 tahun. Peningkatan kadar asam urat dijumpai pada 52% pasien, umumnya pada laki-laki dan kasus NSTEMI. Umumnya pasien juga memiliki riwayat asam urat. Faktor risiko terbanyak yang dimiliki ialah hipertensi dan merokok. Kata kunci: deskripsi, asam urat, sindrom koroner akut

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Long-Term Prognostic Value of Cognitive Impairment on Top of Frailty in Older Adults after Acute Coronary Syndrome

Journal of Clinical Medicine ◽

10.3390/jcm10030444 ◽

2021 ◽

Vol 10 (3) ◽

pp. 444

Author(s):

Juan Sanchis ◽

Clara Bonanad ◽

Sergio García-Blas ◽

Vicent Ruiz ◽

Agustín Fernández-Cisnal ◽

...

Keyword(s):

Myocardial Infarction ◽

Older Adults ◽

Acute Myocardial Infarction ◽

Acute Coronary Syndrome ◽

Cognitive Impairment ◽

Cognitive Function ◽

Prognostic Value ◽

Adult Survivors ◽

Prognostic Information ◽

Coronary Syndrome

Frailty is a marker of poor prognosis in older adults after acute coronary syndrome. We investigated whether cognitive impairment provides additional prognostic information. The study population consisted of a prospective cohort of 342 older (>65 years) adult survivors after acute coronary syndrome. Frailty (Fried score) and cognitive function (Pfeiffer’s Short Portable Mental Status Questionnaire—SPMSQ) were assessed at discharge. The endpoints were mortality or acute myocardial infarction at 8.7-year median follow-up. Patient distribution according to SPMSQ results was: no cognitive impairment (SPMSQ = 0 errors; n = 248, 73%), mild impairment (SPMSQ = 1–2 errors; n = 52, 15%), and moderate to severe impairment (SPMSQ ≥3 errors; n = 42, 12%). A total of 245 (72%) patients died or had an acute myocardial infarction, and 216 (63%) patients died. After adjustment for clinical data, comorbidities, and Fried score, the SPMSQ added prognostic value for death or myocardial infarction (per number of errors; HR = 1.11, 95%, CI 1.04–1.19, p = 0.002) and death (HR = 1.11, 95% 1.03–1.20, p = 0.007). An SPMSQ with ≥3 errors identified the highest risk subgroup. Geriatric conditions (SPSMQ and Fried score) explained 19% and 43% of the overall chi-square of the models for predicting death or myocardial infarction and death, respectively. Geriatric assessment after acute coronary syndrome should include both frailty and cognitive function. This is particularly important given that cognitive impairment without dementia can be subclinical and thus remain undetected.

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Impact of Morning Onset on the Incidence of Recurrent Acute Coronary Syndrome and Progression of Coronary Atherosclerosis in Acute Myocardial Infarction

Circulation Journal ◽

10.1253/circj.cj-16-0817 ◽

2017 ◽

Vol 81 (3) ◽

pp. 361-367 ◽

Cited By ~ 8

Author(s):

Hiroshi Nakashima ◽

Yuka Mashimo ◽

Masaya Kurobe ◽

Shigenori Muto ◽

Shinnosuke Furudono ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Acute Coronary Syndrome ◽

Coronary Atherosclerosis ◽

Coronary Syndrome

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Acute Myocardial Infarction In Systemic Mastocytosis: Case Report With Literature Review Of The Role Of Inflammatory Process In Acute Coronary Syndrome

Current Cardiology Reviews ◽

10.2174/1573403x16666200331123242 ◽

2020 ◽

Vol 16 ◽

Author(s):

Ayman Battisha ◽

Khalid Sawalha ◽

Bader Madoukh ◽

Omar Sheikh ◽

Karim Doughem ◽

...

Keyword(s):

Risk Factors ◽

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Acute Coronary Syndrome ◽

Plasma Lipids ◽

Plaque Rupture ◽

Systemic Mastocytosis ◽

Cardiac Risk ◽

Control Group ◽

Coronary Syndrome

: Systemic Mastocytosis (SM) is a disorder of excessive mast cell infiltration in multiple organ tissues. Atherosclerosis is a major risk factor for developing acute coronary syndrome [1]. In addition to lipid accumulation in the arterial wall, inflammation plays an important role in the pathogenesis of plaque rupture and activating the thrombosis cascade [2]. The Mast cells contribution to plaque destabilization has been well established in multiple animal and human studies [3]. In a recent study, SM has been proven to be associated with a higher incidence of acute coronary syndrome even with lower plasma lipids level [4]. The study showed that 20% of patients with SM had cardiovascular events compared to only 6% in the control group with adjustment to all cardiac risk factors. Here, we present a case of acute myocardial infarction in a patient with SM with limited risk factors other than age.

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Serum Uric Acid as a Prognostic Factor of Acute Myocardial Infarction in Hospitalized Patients

TAJ Journal of Teachers Association ◽

10.3329/taj.v34i1.54902 ◽

2021 ◽

Vol 34 (1) ◽

pp. 26-32

Author(s):

Md Amzad Hossain Sardar ◽

Md Khalilur Rahman ◽

Md Mahidul Alam ◽

Md Aminul Hasan ◽

Ashoke Sarker ◽

...

Keyword(s):

Risk Factors ◽

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Uric Acid ◽

Family History ◽

Serum Uric Acid ◽

Acid Level ◽

Serum Uric Acid Level ◽

High Serum ◽

History Of

Background: Among non-communicable diseases, acute myocardial infarction (AMI) is a common killer of people in the world. The management of AMI patients is one of the major challenges in the field of cardiology. Uric acid has several effects of potential interest in cardiovascular disease. There are some markers indicating an unfavorable prognosis in AMI patients. Uric acid is one of the markers that have been evaluated in research. Objective: The aim of this study was to assess the association between serum uric acid level and in-hospital outcomes of AMI patients. Patients and methods: This longitudinal descriptive study was conducted over 115 AMI patients in the Cardiology Unit of Rajshahi Medical College Hospital during the period of January 2015 to December 2016. Baseline characteristics such as age, sex, BMI, BP, RBS, risk factors (hypertension, DM, smoking, family history of IHD, dyslipidemia), and outcomes of AMI patients (acute LVF, arrhythmia, conduction block, cardiogenic shock, death) were recorded. We measured the serum uric acid of this patient at admission. Results: The mean age of patients was 52.83±10.71 years. Out of 115 patients, 83.5% were male, and 16.5% were female. Among the risk factors, 65.2% of patients had HTN, 20.9% DM, 64.3% smoking, 16.5% family history of IHD, and 47.8% dyslipidemia. Out of 115, 35.7% of patients demonstrated high serum uric acid. In outcomes of AMI patients, acute LVF 24.4% (p=0.031) and death 12.2% (p=0.041) were significantly higher in patients with high serum uric acid levels. Conclusion: Significant association was found between high serum uric acid level and in-hospital outcomes of AMI patients. So, estimation of serum uric acid may offer an inexpensive, quick, and non-invasive method for identifying such high-risk patients. TAJ 2021; 34: No-1: 26-32

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Evaluating serum uric acid levels in patients with acute myocardial infarction

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20203124 ◽

2020 ◽

Vol 7 (8) ◽

pp. 1256

Author(s):

Piyush Gosar ◽

Ajay Pal Singh ◽

Pravi Gosar ◽

Bhawana Rani

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Uric Acid ◽

Serum Uric Acid ◽

Uric Acid Level ◽

Acid Level ◽

Serum Uric Acid Level ◽

Control Group ◽

Cardiovascular Morbidity And Mortality ◽

History Of

Background: Elevated levels of serum uric acid are associated with increased cardiovascular morbidity and mortality. However, this association with cardiovascular diseases is still unclear, and perhaps controversial. The objective of study was to assess the serum uric acid level in patients with Acute Myocardial Infarction (AMI).Methods: Sixty patients with AMI were studied in Department of Medicine/ Department of Cardiology, J.A. Group of Hospitals between 2016 -2018.Details of age, sex, smoking, alcohol consumption and history of ischemic heart disease (IHD) was obtained and recorded. Serum uric acid level was estimated and compared with control group (healthy subjects).Results: Serum uric acid level was significantly higher among AMI patients (6.43±2.60) as compared to control group (4.05±0.95) (p<0.001). Majority (46.7%) of the AMI patients had uric acid level of >7.1 followed by 20% patients who had uric acid level between 4.5-5.9 (p<0.001). Uric acid level was comparable between smoker and non-smokers (p=0.803), alcoholic and non-alcoholic (p=0.086), hypertensive and non-hypertensive (p=0.668), patients with and without diabetes (p=0.278) and patients with a history of IHD and without history of IHD (p=0.403).Conclusions: Serum uric acid may be useful for prognostication among those with pre-existing AMI.

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The process of collecting data for the Acute Myocardial Infarction / Acute Coronary Syndrome Register for the City of Zagreb

Cardiometry ◽

10.12710/cardiometry.2014.4.123125 ◽

2014 ◽

Author(s):

Inge Heim ◽

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Acute Coronary Syndrome ◽

Coronary Syndrome ◽

The City

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Clinical and Anamnestic Characteristics of Acute Coronary Syndrome after Suffering COVID-19

Annals of the Russian academy of medical sciences ◽

10.15690/vramn1612 ◽

2021 ◽

Vol 76 (5S) ◽

pp. 533-538

Author(s):

Natalia V. Orlova ◽

Valerij V. Lomajchikov ◽

Tatyana I. Bonkalo ◽

Grigorij A. Chuvarayan ◽

Yana G. Spiryakina ◽

...

Keyword(s):

Diabetes Mellitus ◽

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Acute Coronary Syndrome ◽

Coronary Vessels ◽

Thrombin Time ◽

Laboratory Parameters ◽

Coronary Syndrome ◽

Increased Risk

Background. COVID-19 increases the risk of developing thromboembolic complications, including acute myocardial infarction, in the acute period of the disease. The long-term consequences of COVID-19 are poorly understood. At the same time, the available data on an increased risk of acute coronary syndrome after infectious diseases allow us to make an assumption about a similar risk in COVID-19. The aim of the study was to study the anamnestic and laboratory diagnostic data in patients with acute coronary syndrome after COVID-19. Methods. The study included 185 patients with acute coronary syndrome who were admitted to the State Clinical Hospital No. 13 in Moscow in the period from May to December 2020. 2 groups were identified: group 1 109 patients with ACS who had previously suffered COVID-19, group 2 76 patients with ACS without COVID-19 in the past. The patients were collected anamnesis, including: the fact of smoking and alcohol consumption, heredity, previous diseases, including diabetes mellitus, acute myocardial infarction, previously performed PCI. Information about the COVID-19 infection has been collected (the duration of the disease, the course of the disease). A clinical and laboratory examination was conducted, including the determination of body mass index (BMI), examination for antibodies to COVID-19, determination of the lipid profile level (total cholesterol, LDL, HDL, triglycerides), blood glucose level, C-RB. The analysis was performed on automatic biochemical analyzers Hitachi-902, 912 (Roche Diagnostics, Japan). All patients underwent coronary angiography. Results. In patients with ACS with previously transferred COVID-19, the development of the disease occurred at a younger age compared to patients without transferred COVID-19. Among the patients with COVID-19, body weight was significantly lower, there were fewer smokers, concomitant type 2 diabetes mellitus and transferred ONMC were less common. In laboratory parameters, lower triglyceride levels were observed in patients with ACS with COVID-19 compared with those of patients without COVID-19. In the laboratory parameters of blood clotting in patients with ACS with COVID-19, higher APTT, thrombin time, fibrinogen level, D-dimer were noted. The indicated laboratory parameters in the groups had statistically significant differences. In ACS patients with a previous COVID-19, compared with patients without COVID-19, the lesion of 2 or more coronary vessels was more common in the anamnesis. Conclusion. According to the results of our study, it was revealed that multivessel coronary artery damage in patients after COVID-19 in comparison with patients without COVID-19 develops significantly more often, while these patients are significantly less likely to have DM and previously suffered ONMC, the level of TG is significantly lower.

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