scholarly journals 2.5-fold increased risk of recurrent acute myocardial infarction with familial hypercholesterolemia

2020 ◽  
Author(s):  
Karianne Svendsen ◽  
Henriette W. Krogh ◽  
Jannicke Igland ◽  
Grethe S. Tell ◽  
Liv J. Mundal ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Familial Hypercholesterolemia ◽  
Increased Risk

scholarly journals Individuals with familial hypercholesterolemia have increased risk of re-hospitalization after acute myocardial infarction compared with controls

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
K Svendsen ◽  
H.W Krogh ◽  
J Igland ◽  
G.S Tell ◽  
L.J Mundal ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Familial Hypercholesterolemia ◽  
Cox Regression ◽  
Public Institution ◽  
University Hospital ◽  
Funding Source ◽  
Hazard Ratios ◽  
Increased Risk ◽  
University Of Oslo

Abstract Background and aim We have previously reported that individuals with familial hypercholesterolemia (FH) have a two-fold increased risk of acute myocardial infarction (AMI) compared with the general population. The consequences of having an AMI on re-hospitalization and mortality are however less known. The aim of the present study was to compare the risk of re-hospitalization with AMI and CHD and risk of mortality after incident (first) AMI-hospitalization between persons with and without FH (controls). Methods The original study population comprised 5691 persons diagnosed with FH during 1992–2014 and 119511 age and sex matched controls randomly selected from the general Norwegian population. We identified 221 individuals with FH and 1947 controls with an incident AMI registered in the Norwegian Patient Registry (NPR) or the Cardiovascular Disease in Norway Project during 2001–2017. Persons with incident AMI were followed until December 31st 2017 for re-hospitalization with AMI or coronary heart disease (CHD) registered in the NPR, and for mortality through linkage to the Norwegian Cause of Death Registry. Risk of re-hospitalization was compared with sub-hazard ratios (SHR) from competing risk regression with death as competing event, and mortality was compared using hazard ratios (HR) from Cox regression. All models were adjusted for age. Results Risk of re-hospitalization was 2-fold increased both for AMI [SHR=2.53 (95% CI: 1.88–3.41)] and CHD [SHR=1.82 (95% CI: 1.44–2.28)]. However, persons with FH did not have increased 28-day mortality following an incident AMI (HR=1.05 (95% CI: 0.62–1.78), but the longer-term (>28 days) mortality after first AMI was increased in FH [HR=1.45 (95% CI: 1.07–1.95]. Conclusion This study yields the important finding that persons with FH have increased risk of re-hospitalization of both AMI and CHD after incident AMI. These findings call for more intensive follow-up of individuals with FH after an AMI. Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): University of Oslo and Oslo University Hospital

scholarly journals MiR-126-3p and MiR-223-3p as Biomarkers for Prediction of Thrombotic Risk in Patients with Acute Myocardial Infarction and Primary Angioplasty

2021 ◽  
Vol 11 (6) ◽  
pp. 508
Author(s):  
Milan Hromadka ◽  
Zuzana Motovska ◽  
Ota Hlinomaz ◽  
Petr Kala ◽  
Frantisek Tousek ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Predictive Accuracy ◽  
Cardiovascular Death ◽  
Primary Angioplasty ◽  
Bleeding Complications ◽  
Clinical Predictors ◽  
Thrombotic Risk ◽  
Increased Risk ◽  
One Year

Aim. This study was designed to evaluate the relationship between microRNAs (miRNAs), miR-126-3p and miR-223-3p, as new biomarkers of platelet activation, and predicting recurrent thrombotic events after acute myocardial infarction (AMI). Methods and Results. The analysis included 598 patients randomized in the PRAGUE-18 study (ticagrelor vs. prasugrel in AMI). The measurements of miRNAs were performed by using a novel miRNA immunoassay method. The association of miRNAs with the occurrence of the ischemic endpoint (EP) (cardiovascular death, nonfatal MI, or stroke) and bleeding were analyzed. The miR-223-3p level was significantly related to an increased risk of occurrence of the ischemic EP within 30 days (odds ratio (OR) = 15.74, 95% confidence interval (CI): 2.07–119.93, p = 0.008) and one year (OR = 3.18, 95% CI: 1.40–7.19, p = 0.006), respectively. The miR-126-3p to miR-223-3p ratio was related to a decreased risk of occurrence of EP within 30 days (OR = 0.14, 95% CI: 0.03–0.61, p = 0.009) and one year (OR = 0.37, 95% CI: 0.17–0.82, p = 0.014), respectively. MiRNAs were identified as independent predictors of EP even after adjustment for confounding clinical predictors. Adding miR-223-3p and miR-126-3p to miR-223-3p ratios as predictors into the model calculating the ischemic risk significantly increased the predictive accuracy for combined ischemic EP within one year more than using only clinical ischemic risk parameters. No associations between miRNAs and bleeding complications were identified. Conclusion. The miR-223-3p and the miR-126-3p are promising independent predictors of thrombotic events and can be used for ischemic risk stratification after AMI.

scholarly journals Role of diuretics on long-term mortality may differ in volume status in patients with acute myocardial infarction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T Kawai ◽  
D Nakatani ◽  
T Yamada ◽  
T Watanabe ◽  
T Morita ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Propensity Score ◽  
Plasma Volume ◽  
Cox Regression ◽  
Volume Status ◽  
Increased Risk ◽  
Long Term Mortality

Abstract Background Diuretics has been reported to have a potential for an activation of the renin-angiotensin-aldosterone system and the sympathetic nervous system, leading to a possibility of poor clinical outcome in patients with cardiovascular disease. However, few data are available on clinical impact of diuretics on long-term outcome in patients with acute myocardial infarction (AMI) based on plasma volume status. Methods To address the issue, a total of 3,416 survived patients with AMI who were registered to a large database of the Osaka Acute Coronary Insufficiency Study (OACIS) were studied. Plasma volume status was assessed with the estimated plasma volume status (ePVS) that was calculated at discharge as follows: actual PV = (1 − hematocrit) × [a + (b × body weight)] (a=1530 in males and a=864 in females, b=41.0 in males and b=47.9 in females); ideal PV = c × body weight (c=39 in males and c=40 in females), and ePVS = [(actual PV − ideal PV)/ideal PV] × 100 (%). Multivariable Cox regression analysis and propensity score matching were performed to account for imbalances in covariates. The endpoint was all-cause of death (ACD) within 5 years. Results During a median follow-up period of 855±656 days, 193 patients had ACD. In whole population, there was no significant difference in long-term mortality risk between patients with and without diuretics in both multivariate cox regression model and propensity score matching population. When patients were divided into 2 groups according to ePVS with a median value of 4.2%, 46 and 147 patients had ACD in groups with low ePVS and high ePVS, respectively. Multivariate Cox analysis showed that use of diuretics was independently associated with an increased risk of ACD in low ePVS group, (HR: 2.63, 95% confidence interval [CI]: 1.22–5.63, p=0.01), but not in high ePVS group (HR: 0.70, 95% CI: 0.44–1.10, p=0.12). These observations were consistent in the propensity-score matched cohorts; the 5-year mortality rate was significantly higher in patients with diuretics than those without among low ePVS group (4.7% vs 1.7%, p=0.041), but not among high ePVS group (8.0% vs 10.3%, p=0.247). Conclusion Prescription of diuretics at discharge was associated with increased risk of 5-year mortality in patients with AMI without PV expansion, but not with PV expansion. The role of diuretics on long-term mortality may differ in plasma volume status. Therefore, prescription of diuretics after AMI may be considered based on plasma volume status. Funding Acknowledgement Type of funding source: None

The ratio of circulating endothelin-1 to endothelin-3 associated with TIMI risk and dynamic TIMI risk score in ST elevation acute myocardial infarction

2020 ◽  
Vol 98 (9) ◽  
pp. 637-643 ◽  
Author(s):  
Anggoro Budi Hartopo ◽  
Ira Puspitawati ◽  
Hasanah Mumpuni
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Risk Score ◽  
Multivariable Analysis ◽  
Primary Objective ◽  
St Segment Elevation ◽  
Timi Score ◽  
Increased Risk ◽  
Timi Risk Score ◽  
Elevation Acute Myocardial Infarction

In ST segment elevation acute myocardial infarction (STEMI), the endothelin (ET) system imbalance, reflected by the circulating ET-1:ET-3 ratio has not been investigated. This study’s primary objective was to measure the circulating ET-1:ET-3 ratio and correlate it with the risk stratification for 1 year mortality of STEMI based on TIMI score. On admission, the TIMI risk score and at discharge, the dynamic TIMI risk score were calculated in 68 consecutive subjects with STEMI. Subjects with high TIMI risk score were associated with higher mean ET-1 level and ET-1:ET-3 ratio. The ET-1:ET-3 ratio more accurately predicted the high on admission TIMI risk score than the ET-1 level. Subjects with high dynamic TIMI risk score were associated with higher mean ET-1 level and ET-1:ET-3 ratio. The ET-1:ET-3 ratio more accurately predicted the high at discharge dynamic TIMI risk score than ET-1 level. From multivariable analysis, the ET-1:ET-3 ratio was not independently associated with high on admission TIMI risk score but independently predicted high at discharge dynamic TIMI risk score (odds ratio = 9.186, p = 0.018). In conclusion, combining the ET-1 and ET-3 levels into the ET-1:ET-3 ratio provided a prognostic value by independently predicting the increased risk to 1 year mortality as indicated by at discharge dynamic TIMI risk score in patients with STEMI.

Abstract P208: Functional Status, Rehospitalization, and Mortality Outcomes Among Acute Myocardial Infarction Patients with Prior and New-Onset Atrial Fibrillation

2011 ◽  
Vol 4 (suppl_2) ◽  
Author(s):  
Kyle P Hornsby ◽  
Kensey Gosch ◽  
Amy L Miller ◽  
Jonathan P Piccini ◽  
Renato D Lopes ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Atrial Fibrillation ◽  
Acute Myocardial Infarction ◽  
Health Status ◽  
Functional Status ◽  
Physical Function ◽  
Adverse Outcomes ◽  
Increased Risk ◽  
New Onset

Background: Little data are available regarding differences in prognosis and health status between new-onset and prior atrial fibrillation (AF) among patients with acute myocardial infarction (AMI). Methods: The TRIUMPH study enrolled 4340 AMI patients who received longitudinal follow-up including SF-12 health status assessments through 1 year post-AMI. We compared 1-year mortality, rehospitalization, and functional status according to AF type (none, prior, new) after adjusting for differences in baseline characteristics. Results: A total of 212 AMI patients (4.9%) had prior AF and 254 (5.9%) had new-onset AF. Compared with no AF, new AF was associated with older age, male sex, first MI, worse baseline physical function, home atrioventricular nodal blocker use, and worse ventricular function (c-index 0.77). Rates of 1-year mortality were 6.2%, 14.5%, and 13.0%, and 1-year rehospitalization rates were 29.1%, 44.2%, and 36.8% for no, prior, and new AF, respectively. After multivariable adjustment, neither prior nor new AF was associated with increased 1-year mortality, and only prior AF was associated with increased risk of 1-year rehospitalization (Figure). After adjusting for baseline SF-12 physical function scores, patients with prior AF had lower 1-year scores than those with no AF (40.6 vs. 43.7, p <0.003), whereas patients with new AF had similar scores (42.9 vs. 43.7, p=0.36). Conclusion: New-onset AF during AMI is associated with a number of comorbidities but, unlike prior AF, is not associated with adverse outcomes. These results raise the question of whether AF is itself a cause of or simply a marker of comorbidities leading to downstream adverse outcomes after AMI.

Graves’-induced prothrombotic state and the risk of early-onset myocardial infarction

2021 ◽  
Vol 14 (6) ◽  
pp. e243446
Author(s):  
Meilyr Dixey ◽  
Alice Barnes ◽  
Fiqry Fadhlillah
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Ventricular Fibrillation ◽  
Cardiopulmonary Resuscitation ◽  
Plaque Rupture ◽  
Graves Disease ◽  
Thyroid Function Tests ◽  
Prothrombotic State ◽  
Thrombotic Occlusion ◽  
Increased Risk

Hyperthyroidism represents a state of hypercoagulability and hypofibrinolysis, which predisposes an individual to the increased risk of thromboembolism. We present a case of a 25-year-old patient presenting with an acute myocardial infarction secondary to plaque rupture with thrombotic occlusion of proximal left anterior descending artery, in a patient known to have Graves’ disease. She had a sudden ventricular fibrillation arrest and a precordial thump given and cardiopulmonary resuscitation started. She successfully underwent cardiac catheterisation. Subsequent thyroid function tests showed she was in active thyrotoxicosis.

Acute-Phase Plasma PCSK9 Levels and Recurrent Cardiovascular Events in a Chinese Acute Myocardial Infarction Cohort

Cardiology ◽  
2018 ◽  
Vol 141 (2) ◽  
pp. 88-97 ◽  
Author(s):  
Yan Gao ◽  
Yan Qiu ◽  
Jihua Wu ◽  
Wei Diao ◽  
Haibo Zhang ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Acute Phase ◽  
Recurrent Events ◽  
Density Lipoprotein ◽  
High Sensitivity ◽  
Female Gender ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Increased Risk

Background: Proprotein convertase subtilisin/kexin type 9 (PCSK9) is a promising target for lowering plasma low-density lipoprotein cholesterol and preventing cardiovascular (CV) disease. Whether plasma PCSK9 measured during the acute phase predicts recurrent CV events in patients with acute myocardial infarction (AMI) remains unresolved. Methods and Results: Plasma PCSK9 levels were measured in 1,646 patients with AMI from the China PEACE-Prospective AMI Study at the acute phase. Additionally, 248 patients were resampled and measured at 1 month post-AMI. Associations of acute-phase PCSK9 tertiles with clinical characteristics and recurrent CV events within 1 year were assessed. Female gender (OR 1.94, 95% CI 1.24–3.03), premature coronary heart disease (CHD; OR 2.12, 95% CI 1.37–3.26), higher high-sensitivity C-reactive protein (OR 1.67, 95% CI 1.44–1.95), and higher triglycerides (OR 1.46, 95% CI 1.03–2.09) were associated with higher baseline PCSK9. Plasma PCSK9 levels in the highest tertile (versus lowest) did not have an increased risk of 1-year recurrent CV events in the AMI cohort (HR 0.78, 95% CI 0.52–1.16) or any subgroup. There was also no association between percentage changes in PCSK9 over the first month and 1-year recurrent events, although there was a trend of differences between patients in the upper versus lower tertiles. Conclusion: Plasma PCSK9 levels measured during the acute phase were associated with high-sensitivity C-reactive protein, triglycerides, premature CHD, and gender in patients with AMI but did not predict recurrent CV events within 1 year. Dynamic changes in PCSK9 suggested a trend yet no significance value in predicting recurrent CV events.

scholarly journals Identification of Patients at Increased Risk of First Unheralded Acute Myocardial Infarction by Electron-Beam Computed Tomography

Circulation ◽  
2000 ◽  
Vol 101 (8) ◽  
pp. 850-855 ◽  
Author(s):  
Paolo Raggi ◽  
Tracy Q. Callister ◽  
Bruce Cooil ◽  
Zuo-Xiang He ◽  
Nicholas J. Lippolis ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Computed Tomography ◽  
Acute Myocardial Infarction ◽  
Electron Beam ◽  
Electron Beam Computed Tomography ◽  
Increased Risk

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

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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