CYSTATIN C IS AN INDEPENDENT RISK PREDICTOR FOR DEATH OR MYOCARDIAL INFARCTION IN PATIENTS WITH ST-ELEVATION MYOCARDIAL INFARCTION (STEMI) AS WELL AS IN NON-ST-ELEVATION ACUTE CORONARY SYNDROME (NSTE-ACS)

Vascular calcification contributes to the pathogenesis of coronary artery disease while matrix Gla protein (MGP) was recently identified as a potent inhibitor of vascular calcification. MGP fractions, such as dephosphorylated-uncarboxylated MGP (dp-ucMGP), lack post-translational modifications and are less efficient in vascular calcification inhibition. We sought to compare dp-ucMGP levels between patients with acute coronary syndrome (ACS), stratified by ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI) status. Physical examination and clinical data, along with plasma dp-ucMGP levels, were obtained from 90 consecutive ACS patients. We observed that levels of dp-ucMGP were significantly higher in patients with NSTEMI compared to STEMI patients (1063.4 ± 518.6 vs. 742.7 ± 166.6 pmol/L, p < 0.001). NSTEMI status and positive family history of cardiovascular diseases were only independent predictors of the highest tertile of dp-ucMGP levels. Among those with NSTEMI, patients at a high risk of in-hospital mortality (adjudicated by GRACE score) had significantly higher levels of dp-ucMGP compared to non-high-risk patients (1417.8 ± 956.8 vs. 984.6 ± 335.0 pmol/L, p = 0.030). Altogether, our findings suggest that higher dp-ucMGP levels likely reflect higher calcification burden in ACS patients and might aid in the identification of NSTEMI patients at increased risk of in-hospital mortality. Furthermore, observed dp-ucMGP levels might reflect differences in atherosclerotic plaque pathobiology between patients with STEMI and NSTEMI.

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Aspiration Thrombectomy in Patients With ST Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention (from the Acute Coronary Syndrome Israeli Survey 2010)

The American Journal of Cardiology ◽

10.1016/j.amjcard.2013.11.032 ◽

2014 ◽

Vol 113 (5) ◽

pp. 809-814 ◽

Cited By ~ 2

Author(s):

Mady Moriel ◽

Shlomi Matetzky ◽

Amit Segev ◽

Aaron Medina ◽

Ran Kornowski ◽

...

Keyword(s):

Myocardial Infarction ◽

Percutaneous Coronary Intervention ◽

Acute Coronary Syndrome ◽

Primary Percutaneous Coronary Intervention ◽

Coronary Intervention ◽

St Elevation Myocardial Infarction ◽

Aspiration Thrombectomy ◽

Coronary Syndrome ◽

Percutaneous Coronary ◽

St Elevation

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The Study of Serum Calcium to Magnesium Ratio in Patients with Acute Coronary Syndrome in a Tertiary Hospital, Hubli, Karnataka

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/644 ◽

2021 ◽

Vol 8 (41) ◽

pp. 3553-3558

Author(s):

Uday Subhash Bande ◽

Kalinga Bommanakatte Eranaik ◽

Manjunath Shivalingappa Hiremani ◽

Basawantrao Kailash Patil ◽

Sushma Shankaragouda Biradar

Keyword(s):

Myocardial Infarction ◽

Acute Coronary Syndrome ◽

Roc Analysis ◽

St Elevation Myocardial Infarction ◽

P Value ◽

Operating Characteristics ◽

Coronary Syndrome ◽

Function Tests ◽

Creatine Kinase Mb ◽

St Elevation

BACKGROUND Cardiovascular diseases are one of the leading causes of morbidity and mortality worldwide. High Ca levels and low Mg levels are associated with increased cardiovascular risk in the general population.1 The balance between Ca and Mg seems to play an important role in homeostasis since Mg is considered as physiologic antagonist of Ca.2 Hence Ca/Mg ratio was considered to study its association with acute coronary syndrome (ACS). METHODS This is a case control study conducted in Karnataka Institute of Medical Sciences, Hubli over a period of 2 years, February 2019 to December 2020. 200 cases and 150 controls were included in the study. The biochemical measurements including complete blood count (CBC), cardiac biomarkers, liver function tests, renal function tests (RFT), serum electrolytes and lipid profile were measured using standard laboratory methods. Student ‘t’ test was used to compare the data. Optimum cut-offs for diagnosis of acute myocardial infarction was calculated using receiver operating characteristics (ROC) analysis. The association among markers was established by calculating Pearson’s correlation. RESULTS Serum Ca/Mg ratio was significantly higher (p value < 0.001) in ACS when compared to control groups. It was also found that Ca/Mg ratio was significantly lower (p value < 0.001) in non-ST elevation myocardial infarction (NSTEMI) when compared to STEMI group. Serum Mg was significantly lower (p value < 0.001) in ACS group when compared to control group. Significant correlation (p value < 0.05) was found between serum Ca/Mg ratio and cardiac markers (CKMB, Troponin-I). ROC analysis of Ca/Mg (4.19) ratios showed optimum cut-offs in diagnosis of AMI. CONCLUSIONS Serum Ca/Mg could be useful adjuvant marker in diagnosis of AMI. The ratio is higher in ST-segment elevation myocardial infarction when compared to non-STsegment myocardial infarction, which could be due to greater decrease in Mg levels when compared Ca in ACS. KEYWORDS ST Elevation Myocardial Infarction (STEMI), Non ST Elevation Myocardial Infarction (NSTEMI), Calcium (Ca), Magnesium (Mg), Acute Coronary Syndrome (ACS), Creatine Kinase-MB (CK-MB).

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