Brain-derived neurotrophic factor is associated with coronary macrophage infiltrates in patients with acute coronary syndrome

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
R.A Montone ◽  
M Camilli ◽  
M Russo ◽  
M Del Buono ◽  
F Gurguglione ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Neurotrophic Factor ◽  
Serum Levels ◽  
Brain Derived Neurotrophic Factor ◽  
C Reactive Protein ◽  
St Segment Elevation ◽  
Protein Levels ◽  
Reactive Protein ◽  
Coronary Syndrome ◽  
St Segment

Abstract Background Brain-derived neurotrophic factor (BDNF) is a neurotrophine that plays a key role in the regulation of both central and peripheral nervous system. Moreover, BDNF is secreted in multiple tissues and exerts systemic, autocrine, and paracrine effects in the cardiovascular system. Of importance, BDNF expression was enhanced in macrophages and smooth muscle cells in atherosclerotic coronary arteries and may be involved in thrombus formation. Thus, BDNF has been suggested as an important link between inflammation and thrombosis, potentially involved in the pathogenesis of acute coronary syndrome (ACS). Purpose In our study we aimed at assessing serum levels of BDNF in patients with ACS, evaluating differences according to clinical presentation [ST-segment elevation myocardial infarction (STEMI) vs. Non-ST-segment elevation ACS (NSTE-ACS)]. Moreover, we assessed the presence of optical coherence (OCT)-defined macrophage infiltrates (MØI) in the culprit vessel of ACS patients and evaluated their relationship with BDNF levels. Methods ACS patients were prospectively selected. Blood samples were collected at admission and serum levels of BDNF were subsequently assessed. Presence of OCT-defined MØI along the culprit vessel was assessed. Results 166 ACS patients were enrolled [mean age 65.3±11.9 years, 125 (75.3%) male, 109 STEMI, 57 NSTE-ACS]. Serum levels of BDNF were higher among STEMI patients compared with NSTE-ACS [median (IQR) 2.48 pg/mL (1.54–3.34) vs. 2.12 pg/mL (1.34–2.47), p=0.007], while C-reactive protein levels did not differ between the two groups. OCT assessment was performed in 53 patients and MØI were detected in 27 patients. Of importance, patients with MØI in the culprit vessel had higher levels of BDNF compared with patients without MØI [median (IQR) 2.23 pg/mL (1.38–2.53) vs. 1.41 pg/mL (0.93–2.07), p=0.023], while C-reactive protein levels did not differ between the two groups. Of note, at multivariate regression analysis BDNF levels were independent predictor of MØI [OR: 2.20; 95% CI (1.02–4.74), p=0.043]. Conclusions Serum levels of BDNF may reliable identify the presence of local macrophage inflammatory infiltrates in patients with ACS. Moreover, BDNF levels are higher in patients with STEMI compared with NSTE-ACS. Taken together, these data suggest that BDNF may represent an interesting link between local inflammatory activation and enhanced thrombosis in ACS. BDNF serum levels Funding Acknowledgement Type of funding source: None

scholarly journals C-Reactive Protein in Patients with NSTEMI Acute Coronary Syndrome

2013 ◽  
Vol 1 (1) ◽  
pp. 10-14 ◽  
Author(s):  
RK Dubey ◽  
N Dhakal ◽  
BKL Das ◽  
NK Pandey ◽  
N Baral ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Serum Levels ◽  
C Reactive Protein ◽  
St Segment Elevation ◽  
Reactive Protein ◽  
Coronary Syndrome ◽  
Group I ◽  
St Segment ◽  
Group Ii ◽  
Serum Crp

Background: C- reactive protein (CRP) is an acute phase inflammatory mediator that has been implicated as a risk factor for cardiovascular disease (CVD). The clinical presentation of acute coronary syndrome (ACS) ranges from unstable angina (UA) to non ST- segment elevation myocardial infarction (NSTEMI) and ST- segment elevation myocardial infarction (STEMI). Although, elevated levels of serum CRP have been reported in patients with CVD, the serum levels of CRP in patients with NSTEMI ACS is unknown. The purpose of the study was to determine whether the serum levels of CRP are higher in patients with NSTEMI ACS as compared to healthy controls. Methods: The study subjects consisted of two groups. Group I: (controls) twenty- five age-matched healthy men and Group II: Forty- five NSTEMI ACS patients. Fasting blood samples were collected and serum levels of CRP were measured by using highly sensitivity immunoassay rate method technology. Results: The serum levels of CRP in Group I and Group II were 3.2 ± 0.25 and 11.32 ± 2.1 mg/L, respectively and these values were significantly different from each other (p< 0.05). Group II showed a 253% higher level of CRP as compared to Group I subjects. Conclusion: The results demonstrate that the serum levels of CRP are higher in patients with NSTEMI ACS as compared to controls. Serum CRP levels are elevated in patients with NSTEMI ACS and may contribute to the inflammation and thrombosis associated with acute coronary syndrome. DOI: http://dx.doi.org/10.3126/jucms.v1i1.8416   Journal of Universal College of Medical Sciences Vol.1(1) 2013:  10-14

scholarly journals THE FEATURES OF ATHEROSCLEROTIC PROCESS DEVELOPMENT AND ACUTE CORONARY SYNDROME COURSE IN PATIENTS WITHOUT DYSLIPIDEMIA

2017 ◽  
Vol 1 ◽  
pp. 17-24
Author(s):  
Valeriia Vataha
Keyword(s):  
Acute Coronary Syndrome ◽  
Blood Serum ◽  
Atherosclerotic Plaque ◽  
Ankle Brachial Index ◽  
C Reactive Protein ◽  
St Segment Elevation ◽  
Reactive Protein ◽  
Coronary Syndrome ◽  
St Segment ◽  
Atherosclerotic Process

The aim is to study the conditions of appearance and the features of course of the acute coronary syndrome (ACS) in patients with normal rates of lipid metabolism and to assess the influence of additional risk factors (uinary acid, C-reactive protein, fibrinogen) on the development of atherosclerotic process by assessment of surrogate markers of atherosclerosis the thickness of intima-media complex (TIMC) of carotid arteries (СА), the presence of atherosclerotic plaque (AP) in CA, the value of ankle-brachial index (ABI)) in patients with ACS without dyslipidemia (DLP). Materials and methods. The study included 66 patients without DLP (50 men and 16 women, the mean age - 53,7±10,6 years) with ACS, divided in groups depending on its forms: 1 group – patients with instable angina (IA), 2 group – patients with myocardium infraction (MI) without ST segment elevation and 3 group – patients with MI with ST segment elevation. The level of serum acid, C-reactive protein, fibrinogen in blood serum were detected and ultrasound examination of СА with detection of CA TIMC, presence of atherosclerotic plaque and measuring of arterial pressure on upper and low extremities with ABI calculation was carried out. Results. Among examined patients MI with ST segment elevation was diagnosed in 33 persons (50,0%); MI without ST segment elevation – in 18 (27,3%) and IA – in 15 (22,7%). The complicated ACS was observed in 20 (30,30%) persons. The value of CA TIMC among patients with MI with ST segment elevation was reliably higher than in patients with MI without ST segment elevation (р<0,001), and ABI was reliably lower in persons with MI and ST segment elevation (р<0,05) and IA (р<0,05) than in patients with MI without ST segment elevation. Correlative analysis demonstrated the interconnection between the levels of inflammation indicators (C-reactive protein, fibrinogen) in the blood serum and the value of CA TIMC and ABI. Conclusions. The persons without DLP need additional examination (detection of C-reactive protein, fibrinogen levels in blood serum, ultrasound of CA and detection of ABI) for more precise evaluation of ACS risk.

scholarly journals Evolutionary and prognostic implications in patient with acute coronary syndrome and dysthyroidism

2021 ◽  
Vol 16 (2) ◽  
pp. 225-233
Author(s):  
Eleonora DRĂGAN ◽  
◽  
Maria Suzana GUBERNA ◽  
Cătălina Liliana ANDREI ◽  
Crina-Julieta SINESCU ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Blood Pressure ◽  
Acute Coronary Syndrome ◽  
Heart Disease ◽  
C Reactive Protein ◽  
St Segment Elevation ◽  
Reactive Protein ◽  
Coronary Syndrome ◽  
St Segment

Purpose. The study aims to determine the impact of dysthyroidism on the severity and type of coronary lesion, on vascular function, as well as on the morbidity and mortality of patients with acute coronary syndrome, by finding predictive markers that can be translated into preventive measures that contribute substantially to reduce the number of newly diagnosed patients with coronary heart disease. Methods. We introduced in the study 100 patients recently diagnosed with acute coronary syndrome, without history of ischemic heart disease or thyroid disease, hospitalized in the Cardiology Clinic of the “Bagdasar-Arseni“ Emergency Clinical Hospital Bucharest, for the interventional treatment of acute coronary syndrome. The studied patients were hospitalized between November 2014 and April 2015, with regular follow-up of up to 5 years (telephone or direct interview, conducted at 6 months, 12 months, 24 months, 36 months, 48 months, 60 months), with an average period follow-up of 1006 days, evaluated clinically, bio-humorally, by echocardiography, explored with coronary angiography with the calculation of the SYNTAX score and with the performance of electrocardiogram and pulse wave. The obtained data were integrated in Excel sheets and statistically processed with the Python program. Results. The mortality rate in the patient group was 7% (7 deaths). Descriptively, of the deceased, 6 patients (86%) were male, and as thyroid status 1 hyperthyroid patient (14%), 3 hypothyroid patients (43%) and 3 patients (43%) normothyroid. There were 4 deaths (8%) in the group of patients with unstable angina and 3 deaths (8%) in the group of patients with myocardial infarction without ST-segment elevation. There were no deaths in the group of patients with acute myocardial infarction with ST-segment elevation. At follow-up, 41 patients (41%) were readmitted. Re-hospitalization was influenced by elevated values of mean blood pressure, diastolic blood pressure and C-reactive protein, unicoronary atherosclerotic disease and unstable angina at admission. At follow-up, the development of noncardiac events was noted in the evolution of patients, diabetes mellitus occurring in the majority, in almost a quarter of patients (22 patients, respectively 24% developed diabetes over time), 34% (19 patients) in euthyroidism and 8% (3 patients) dysthyroidism. Discussions. Predictive factors for the readmission of the patient with acute coronary syndrome are highlighted the following: increased level of C-reactive protein (p = 0.017), tricoronary vascular damage (p = 0.01), diastolic blood pressure greater than 80 mmHg (p = 0.025), and euthyroid status (p = 0.04). The probability of death for the patient with acute coronary syndrome rises to 66% in the presence of severe systolic dysfunction of the left ventricle (p = 0.006), and to 61% in the case of elevated values of hs troponin I (p = 0.008). In our study, the presence of dysthyroidism in the patient with acute coronary syndrome has a protective role in the development of diabetes in the first 5 years (p = 0.025). Conclusion. Dysthyroidism is associated with increased morbidity and mortality from cardiovascular disease.

scholarly journals Relationship Between C-Reactive Protein to Albumin Ratio and Thrombus Burden in Patients With Acute Coronary Syndrome

2019 ◽  
Vol 25 ◽  
pp. 107602961882441 ◽  
Author(s):  
Hakan Duman ◽  
Göksel Çinier ◽  
Eftal Murat Bakırcı ◽  
Handan Duman ◽  
Ziya Şimşek ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
C Reactive Protein ◽  
Albumin Ratio ◽  
St Segment Elevation ◽  
Reactive Protein ◽  
Coronary Syndrome ◽  
Segment Elevation Myocardial Infarction ◽  
Coronary Thrombus ◽  
St Segment

Increased coronary thrombus burden is known to be a strong predictor of adverse cardiovascular (CV) outcomes. C-reactive protein to albumin ratio (CAR) can be used as a surrogate marker of pro-inflammation which is closely related to prothrombotic state. We aimed to evaluate the association between CAR and coronary thrombus burden in patients who presented with acute coronary syndrome (ACS). Patients who presented with ACS and treated with primary percutaneous coronary intervention were included in the study. Patients were divided into 2 groups as high thrombus burden and low thrombus burden. The study population included 347 patients with non-ST-segment elevation myocardial infarction (169 [48.7%]) and ST-segment elevation myocardial infarction (178 [51.3%]). The CAR was significantly higher in patients with higher thrombus burden (24.4 [1.2-30.2] vs 31.9 [2.2-31.3], P < .001). Independent predictors for increased thrombus burden were higher CRP level (odds ratio [OR]: 0.047; 95% confidence interval [CI]: 0.004-0.486; P = .010), lower serum albumin level (OR: 0.057; 95% CI: 0.033-0.990; P = .049), higher CAR (OR: 1.13; 95% CI: 1.03-1.23; P = .008), higher neutrophil–lymphocyte ratio (OR: 1.18; 95% CI: 1.05-1.31; P = .004), and baseline troponin I level (OR: 1.06; 95% CI: 1.01-1.13; P = .017). Novel CAR can be used as a reliable marker for increased coronary thrombus burden that is associated with adverse CV outcomes.

scholarly journals Aspirin resistance in patients with acute coronary syndrome. Part 2

2011 ◽  
Vol 10 (2) ◽  
pp. 47-52 ◽  
Author(s):  
N. S. Frolova ◽  
R. M. Shakhnovich ◽  
E. M. Kaznacheeva ◽  
O. V. Sirotkina ◽  
A. B. Dobrovolskyi
Keyword(s):  
Acute Coronary Syndrome ◽  
Genetic Polymorphisms ◽  
Standard Dose ◽  
Aspirin Resistance ◽  
Aspirin Therapy ◽  
C Reactive Protein ◽  
St Segment Elevation ◽  
Reactive Protein ◽  
Coronary Syndrome ◽  
St Segment

Aim. In patients with acute coronary syndrome (ACS), to investigate the prevalence of aspirin resistance, its clinical features, prognostic effects, and potential correction. Material and methods. The study included 100 ACS patients receiving aspirin. Aspirin resistance was diagnosed if at Day 7 of aspirin therapy, the level of platelet aggregation (PLA) with arachidonic acid was ≥20%. In addition, a thromboxane A2 (ТхА2) metabolite – 11-dehydro-thromboxane B2 (11DHTxB2), as well as inflammation markers and genetic polymorphisms (sub-unit IIIa – Leu33Pro and cyclooxygenase-2 (COG) genes) were studied. Results. Aspirin resistance was diagnosed in 11% of ACS patients, receiving aspirin in a standard dose of 100 mg/d. The majority of aspirin-resistant patients had ACS with ST segment elevation (STE-ACS). In all aspirin-resistant ndividuals, the resistance was pharmacokinetic. The level of 11DHTxB2, increased at baseline in ACS patients and especially in those with STE-ACS, was reduced during aspirin therapy. The combination of high PLA and high 11DHTxB2 levels was typically associated with true aspirin resistance. In patients with metabolite levels >438 ng/ mmol creatinine, prognosis was significantly worse than in those with lower levels of this parameter. In aspirinresistant patients, the levels of interleukin-6 (IL-6), IL-10, and C-reactive protein (CRP) at baseline and throughout the study were significantly higher than in aspirin-sensitive subjects. There was no significant association between aspirin resistance and Leu33Pro or А842G polymorphisms, while А842G polymorphism was more common in aspirin-resistant patients. Conclusion. In aspirin-resistant patients, the level of ТхА2 metabolite is increased (true resistance). In ACS individuals with high levels of 11DHTxB2, the prognosis was worse. Aspirin resistance could be linked to inflammation activation. There was no consistent association between aspirin resistance and studied genetic polymorphisms.

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