Predictive value of N-terminal pro-B-type natriuretic peptide (NT-pro BNP) combined with D-dimer for no-reflow phenomenon in patients with acute coronary syndrome after emergency of percutaneous coronary intervention

Background: Profound reduction in antegrade epicardial coronary flow withconcomitant ischemia is seen occasionally during percutaneous coronary intervention despitethe absence of evident vessel dissection, obstruction, or distal vessel embolic cutoff. StudyDesign: Descriptive study. Setting: Khatum-un-Nabyeen Heart Center for percutaneouscoronary intervention. Period: January 2016 and December 2016. Methods and Results: Bothmales and females with age 30 years or more, presented. Patients with coronary angiogramssuggestive of percutaneous coronary intervention were included in the study by using nonprobability,purposive sampling technique. Following ethical and research approval from thehospital administration, clinical profile of the patients was documented. Patients presentedwith acute coronary syndrome as well as patients with stable coronary artery disease requiringcoronary intervention based on clinical, ECG, non-invasive test or coronary angiogram wereenrolled in the study. Patients with previous history of PCI or CABG were also included in thestudy. Pregnant patients were excluded from the study. The objective of this study is to find outthe incidence of no reflow phenomenon during PCI in our population. The TIMI flow grade wasdetermined for each treated vessel. The criteria for no-reflow was development of substantialflow reduction (less than TIMI 3 flow) in the absence of apparent dissection, thrombosis, ordistal vessel cutoff suggestive of macroembolization. SPSS version 16.0 was used for analyzingthe data. Frequency and percentages were used for categorical variables. Mean±SD was usedfor numerical variables. Data were presented in the form of tables. Conclusions: The no-reflowphenomenon, reduction in distal flow without apparent dissection or distal embolization - occursin 2.25% of coronary interventions.

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Plasma Trimethylamine-N-Oxide Is an Independent Predictor of Long-Term Cardiovascular Mortality in Patients Undergoing Percutaneous Coronary Intervention for Acute Coronary Syndrome

Frontiers in Cardiovascular Medicine ◽

10.3389/fcvm.2021.728724 ◽

2021 ◽

Vol 8 ◽

Author(s):

Ceren Eyileten ◽

Joanna Jarosz-Popek ◽

Daniel Jakubik ◽

Aleksandra Gasecka ◽

Marta Wolska ◽

...

Keyword(s):

Percutaneous Coronary Intervention ◽

Acute Coronary Syndrome ◽

Predictive Value ◽

Cox Regression ◽

Independent Predictor ◽

Coronary Intervention ◽

Coronary Syndrome ◽

Percutaneous Coronary ◽

All Cause Mortality

To investigate the association of liver metabolite trimethylamine N-oxide (TMAO) with cardiovascular disease (CV)-related and all-cause mortality in patients with acute coronary syndrome (ACS) who underwent percutaneous coronary intervention. Our prospective observational study enrolled 292 patients with ACS. Plasma concentrations of TMAO were measured during the hospitalization for ACS. Observation period lasted seven yr in median. Adjusted Cox-regression analysis was used for prediction of mortality. ROC curve analysis revealed that increasing concentrations of TMAO levels assessed at the time point of ACS significantly predicted the risk of CV mortality (c-index=0.78, p < 0.001). The cut-off value of >4 μmol/L, labeled as high TMAO level (23% of study population), provided the greatest sum of sensitivity (85%) and specificity (80%) for the prediction of CV mortality and was associated with a positive predictive value of 16% and a negative predictive value of 99%. A multivariate Cox regression model revealed that high TMAO level was a strong and independent predictor of CV death (HR = 11.62, 95% CI: 2.26–59.67; p = 0.003). High TMAO levels as compared with low TMAO levels were associated with the highest risk of CV death in a subpopulation of patients with diabetes mellitus (27.3 vs. 2.6%; p = 0.004). Although increasing TMAO levels were also significantly associated with all-cause mortality, their estimates for diagnostic accuracy were low. High TMAO level is a strong and independent predictor of long-term CV mortality among patients presenting with ACS.

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