Genetic associations of the origin and predictive estimation of the acute non-ST segment elevation myocardial infarction in patients with metabolic syndrome

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
N Chumachenko ◽  
E.D Kosmacheva
Keyword(s):  
Myocardial Infarction ◽  
Metabolic Syndrome ◽  
Main Group ◽  
Control Group ◽  
Enos Gene ◽  
Funding Source ◽  
Genetic Associations ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment

Abstract Background and introduction Metabolic syndrome (MS) is a baseline condition that influencesthe management of patients with coronary heart disease (CHD). The assessment of genotyping characteristics in patients with MS with non-ST segment elevation myocardial infarction (nSTEMI) remains a challenge. Purpose To define characteristics of G Protein β3 subunit gene C825T polymorphism; T786C in the eNOS gene and G894T in the eNOS gene in patients with MS after nSTEMI, evaluate the prognostic specificity of genotypes in a study population. Methods The study included 150 patients with CHD and MS. The main group included 99 patients (69.7% males, a mean age of (67.4±0.7 y))with nSTEMI, preserved left ventricular systolic function who underwent urgent percutaneous coronary intervention. The control group included 51 patients with a mean age of (64.6±1.3 y) without the history of previous myocardial infarction and acute cerebrovascular disease. There was no statistically significant difference between gender and age in two groups (p>0.05). The predictive significance of the main group genotypes was estimated with odds ratio and risk ratio of “cumulative point of undesirable effects” (CPUE) and included: cardiovascular death, acute coronary syndrome, repeat revascularization, hospitalization for congestive heart failure. The accuracy of the genotype distribution corresponded to the Hardy-Weinberg equilibrium (p>0.05). The accuracy of the results was analyzed using Student, χ2, Fisher's criteria. Results We received high patient numbers with CC genotype of eNOS:786 gene in the main group (n=19 (19.2%)) as compared with the controls (n=3 (6.2%)) (p<0.05, φ=0.03), with GG genotype of eNOS:894 (p<0.01, χ2=8.0) in the main group (n=59 (59.6%)) as compared with the controls (n=18 (35.3%)), with CC genotype of eNOS:894 in the control group (n=40 (78.4%)) as compared with the main group (n=56 (56.6%)) (p<0.05; χ2=7.0). Patients who were heterozygous for eNOS:894 gene prevailed in the main group (n=30 (30.3%)) as compared with the controls (n=27 (52.9%)) (p<0.01, χ2=7.3). The statistically significant CPUE was more frequent diagnosed in patients with TT genotype of GNβ3:825 (OR=12.00, 95% confidence interval ((CI): 2.8–51.7, p<0.05), CC genotype of eNOS:786 (OR=5.1, 95% CI: 1.3–20.0, p<0.05) and TT genotype of eNOS:894 (OR=8.0, 95% CI: 1.8–35.2, p<0,05). Conclusions 4 practically applicable categories of reviewed genotypes were found: 1) nSTEMI - -protective: CC genotype for GNβ3:825 gene, GT – eNOS:894, 2) nSTEMI – unfavorable: CT–GNβ3:825, CC – eNOS:786 and GG – eNOS:894, 3) CPUE – unfavorable: TT – GNβ3:825, CC – eNOS:786, TT – eNOS:894, and 4) nSTEMI, CPUE-neutral: TT and TC – eNOs:786. CC – eNOS:786 genotype is separated as unfavorable for the development of both nSTEMI and CPUE. More studies are necessary for a personified approach, taken into account the obtained features of genetic associations. Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): Scientific Research Institute - S.V. Ochapovsky Clinic Regional Hospital #1, Krasnodar

Evolution of hospital discharge medication and 6 months outcomes of ST-Segment Elevation Myocardial Infarction patients in Portugal over the years

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J.P De Sousa Bispo ◽  
T.F Mota ◽  
R Fernandes ◽  
P Azevedo ◽  
D Carvalho ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Hospital Discharge ◽  
Public Institution ◽  
Categorical Variables ◽  
Funding Source ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
Segment Elevation Myocardial Infarction ◽  
Discharge Medication ◽  
St Segment

Abstract Objectives To assess the evolution of hospital discharge management, 6 months hospitalization and mortality over the years of all patients admitted with ST segment elevation myocardial infarction (STEMI) in Portugal. Methods A nationwide electronic prospective registry that included all patients admitted to Portuguese hospitals with a diagnosis of Acute Coronary Syndrome since 2002 until 2018 was used to collect all data relative to patients admitted with a STEMI diagnosis during that time frame. Data on demographic data, clinical status, revascularization strategy, discharge medication and 6 months hospitalization and mortality were obtained. We compared the data and its evolution over the years to assess for trends. For statistical analysis, Qui-square tests were used to assess trends in categorical variables, and Kruskal-Wallis tests were used to assess trends in numerical variables. A p-value <0.05 was considered statistically significant. Results During the study, a total of 23807 patients were admitted for STEMI in Portuguese hospitals, 74.3% were male and average age of 63.9±13.6 years. We report a progressive and significant increase the use of primary angioplasty versus fibrinolysis (24.3% to 98.4%, p<0.001), in coronary angioplasties (36.4% to 73.2%, p<0.001), in the use of drug-eluting stents (0% to 70.1%, p<0.001), and a decrease in the patients that underwent surgery (6.8% to 1.3%, p<0.001) and intra-aortic balloon pump (1.8% to 0%, p=0.009), resulting in a decrease in in-hospital mortality from 9.9% to 6.1% (p<0.001). At discharge, we report a progressive increase in the prescription of P2Y12 inhibitors (21.1% to 95.2%, p<0.001), beta-blockers (68.8% to 83.8%, p<0.001), RAAS inhibitors (69.5% to 86.7%, p<0.001) and statins (79.6% to 94.9%, p<0.001), while the prescription of aspirin (94.1% para 94.8%, p=0.428), calcium channel blockers (5.3% to 5.6%, p<0.684) stayed stable, and there was a decrease in the prescription of nitrates (52.9% to 5.8%, p<0.001). Hospital admissions at 6 months consistently and progressively reduced over time (18.6% to 8.5%, p<0.001) as well as mortality (6.7% para 4.3%, p<0.001). Conclusion Post discharge treatment of STEMI patients in Portuguese hospitals has evolved according to guidelines, with higher prescription of medication proven to reduce outcomes, resulting in lower hospitalization rates and mortality. 6 Month Outcomes over the years Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): Sociedade Portuguesa de Cardiologia

scholarly journals The effect of heparin after primary percutaneous coronary intervention on short-term clinical outcomes in patients with ST-segment elevation myocardial infarction

2020 ◽  
Vol 9 (11) ◽  
pp. 1636
Author(s):  
Mohammed Rouzbahani ◽  
Mohsen Rezaie ◽  
Nahid Salehi ◽  
Parisa Janjani ◽  
Reza Heidari Moghadam ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Intervention Group ◽  
Coronary Intervention ◽  
Control Group ◽  
Short Term ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
Timi Flow ◽  
St Segment ◽  
Percutaneous Coronary

Background: Doing percutaneous coronary intervention (PCI) in the first hours of myocardial infraction (MI) is effective in re-establishment of blood flow. Anticoagulation treatment should be prescribed in patients undergoing PCI to decrease the side effects of ischemia. The aim of this study is to determine the effect of heparin prescription after PCI on short-term clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI). Materials: This randomized clinical trial study was conducted at Imam Ali cardiovascular center at Kermanshah university of medical science (KUMS), Iran. Between April 2019 to October 2019, 400 patients with STEMI which candidate to PCI were enrolled. Patients randomly divided in two groups: intervention group (received 5,000 units of heparin after PCI until first 24 hours, every 6 hours) and control group (did not receive heparin). Data were collected using a checklist developed based on the study's aims. Differences between groups were assessed using independent t-tests and chi-square (or Fisher exact tests).Result: Observed that, mean prothrombin time (PT) (13.30±1.60 vs. 12.21±1.15, p<0.001) and partial thromboplastin time (PTT) (35.30±3.08 vs. 34.41±3.01, p=0.003) were significantly higher in intervention group compared to control group. Thrombolysis in myocardial infarction (TIMI) flow grade 0/1 after primary PCI was significantly more frequently in control group (5.5% vs. 1.0%, p=0.034). The mean of ejection fraction (EF) after PCI (47.58±7.12 vs. 45.15±6.98, p<0.001) was significantly higher in intervention group. Intervention group had a statistically significant shorter length of hospital stay (4.71±1.03 vs. 6.12±1.10, p<0.001). There was higher incidence of re-vascularization (0% vs. 3.0%; p=0.013) and re-MI (0% vs. 2.5%; p=0.024) in the control group.Conclusion: Performing primary PCI with receiving heparin led to improve TIMI flow and consequently better EF. Receiving heparin is associated with lower risk of re-MI and re-vascularization.

scholarly journals Associations between macrophage inhibitor factor, anxiety and depression in patients with ST-segment elevation myocardial infarction

2019 ◽  
Vol 26 (3) ◽  
pp. 45-52
Author(s):  
O. V. Petyunina ◽  
M. P. Kopytsya ◽  
О. V. Skrynnik
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Anxiety And Depression ◽  
Control Group ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Percutaneous Coronary ◽  
Anxiety Depression

The aim – to investigate associations between macrophage inhibitory factor (MIF) and anxiety, depression and stress in patients with ST-segment elevation myocardial infarction (STEMI). Materials and methods. 73 patients with STEMI with TIMI-III aged 58.37±10.34 were enrolled in the study. Revascularization tactics distribution was the following: 43 (58.9 %) patients underwent primary percutaneous coronary intervention using bare-metal coronary stent, 30 (41.1 %) – pre-hospital thrombolysis with subsequent percutaneous coronary intervention within12 hours. Echocardiography was done during the period of hospitalization. Serum MIF was studied using the enzyme linked immunoassay method. Anxiety, depression and stress were determined with DASS-21 questionnaire. Results and discussion. When comparing the median values of the MIF level in STEMI patients, a statistically significant increase in the MIF concentration relative to control group (2582.80 [1308.40–4122.20] and 573.75 [397.80–1016.75] ng/ml, p<0.001). It evidences the activation of the formation of MIF after the index event. Positive correlation was determined between the level of MIF, the level of troponin I (r=0.33; р=0.045) and blood leukocytes (r=0.36; р=0.039) that confirms its involvement into inflammation and necrosis processes. The univariant and multivariate analysis revealed the effect of the degree of depression and anxiety growth on the DASS-21 questionnaire (p=0.0138 and p=0.0050, respectively) on the increasing of the MIF. Conclusions. The data obtained confirm the relationship between the MIF and anxiety and depression prior the onset of myocardial infarction, indicating their influence on the processes of inflammation.

scholarly journals Features of percutaneous therapy in non-ST-segment elevation myocardial infarction patients who were admitted to hospital at different times since the onset of symptoms

2020 ◽  
Vol 26 (6) ◽  
pp. 11-26
Author(s):  
M. Yu. Sokolov ◽  
Yu. M. Sokolov ◽  
Yu .V. Kashuba
Keyword(s):  
Myocardial Infarction ◽  
Coronary Revascularization ◽  
Control Group ◽  
Cumulative Survival ◽  
St Segment Elevation ◽  
Percutaneous Therapy ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Number Of Patients ◽  
Diagnosed Diabetes

The aim – to evaluate the effect of coronary revascularization (coronary stenting, CS) on the survival of non-ST-segment elevation myocardial infarction (NSTEMI) patients during interventions at different times since the onset of the disease. Materials and methods. The study involved 101 patients with NSTEMI. 29 patients were examined urgently (from 0 to 72 h since the onset of the disease). The remaining 72 patients were hospitalized as scheduled and NSTEMI diagnosis was made between 4 and 180 days before coronary ventriculography or CS. Results and discussion. Patients after CS better tolerated physical activity, they less frequently experienced relapse of angina pectoris and myocardial infarction in comparison with the control group, in which revascularization was not performed. The overall survival of patients with NSTEMI over the 48-month observation period was statistically significantly (p<0.0048) higher in patients who underwent CS than in the control group: 95 % and 80 %, respectively. The cumulative survival without MACE of urgent and planned patients significantly (р=0.002) increased during 48 months of observation in patients who underwent CS and amounted to 78 % compared to 50 % in the control group. Also in the period from 4 to 180 days, the cumulative survival without MACE of NSTEMI patients who underwent SC in a planned manner was significantly higher compared with the control group (p<0.0036): 81 % and 50 %, respectively. In patients after percutaneous interventions, the function of the left ventricle significantly increased and after 48 months of follow-up, the number of patients without disturbances of segmental contractility increased from 82.4 % to 92.4 %. Patients with NSTEMI, who were first diagnosed with dysglycaemia (without diagnosed diabetes mellitus), were more likely to have severe multivessel coronary disease compared with patients who had normal carbohydrate metabolism. Conclusions. Carrying out CS in NSTEMI patients at different times since the onset of the disease statistically significantly increased both overall and cumulative survival of patients. At the same time, the positive effect of CS on cumulative survival without MACE was noted not only in the group of urgent patients, but also in patients who underwent NSTEMI in the period from 4 to 180 days before hospitalization.

Analysis of Serum Endothelial Cell-Specific Molecule 1 (Endocan) Level in Type 2 Diabetes Mellitus With Acute ST-Segment Elevation Myocardial Infarction and its Correlation

Angiology ◽  
2016 ◽  
Vol 68 (1) ◽  
pp. 74-78 ◽  
Author(s):  
Chong-Rong Qiu ◽  
Qiang Fu ◽  
Jian Sui ◽  
Qian Zhang ◽  
Peng Wei ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Myocardial Infarction ◽  
Vascular Disease ◽  
Control Group ◽  
Diabetic Patients ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Significant Difference

Endothelial cell-specific molecule 1 (ESM-1; endocan) is expressed by endothelial cells, and it can be overexpressed in diabetic patients. However, little is known concerning diabetic patients with acute ST-segment elevation myocardial infarction (STEMI). Therefore, we assessed serum ESM-1 level in patients having type 2 diabetes mellitus (T2DM) STEMI; 72 patients with DM (38 with and 34 without vascular disease) and 33 individuals as a control group were included. There was a significant difference in serum ESM-1 level between the T2DM group and the control group ( P = .03). There was also a significant difference in serum ESM-1 level between the T2DM with STEMI group and newly diagnosed T2DM group without vascular disease ( P = .01). In patients with T2DM, serum ESM-1 levels correlated positively with high-sensitivity C-reactive protein levels and the neutrophil to lymphocyte ratio ( r = .321, P = .006 and r = .320, P = .006). Our findings suggest that serum ESM-1 level may be a novel endothelial dysfunction biomarker and it may be related to vascular disease in T2DM.

scholarly journals Elevated Plasma IL-38 Concentrations in Patients with Acute ST-Segment Elevation Myocardial Infarction and Their Dynamics after Reperfusion Treatment

2015 ◽  
Vol 2015 ◽  
pp. 1-10 ◽  
Author(s):  
Yucheng Zhong ◽  
Kunwu Yu ◽  
Xiang Wang ◽  
Xiaoya Wang ◽  
Qingwei Ji ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Troponin I ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Control Group ◽  
Atheromatous Plaque ◽  
Ventricular Ejection Fraction ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment

Objective.Recent studies suggest that IL-38 is associated with autoimmune diseases. Furthermore, IL-38 is expressed in human atheromatous plaque. However, the plasma levels of IL-38 in patients with ST-segment elevation myocardial infarction (STEMI) have not yet to be investigated.Methods.On admission, at 24 h, at 48 h, and at 7 days, plasma IL-38, C-reactive protein (CRP), cardiac troponin I (cTNI), and N-terminal of the prohormone brain natriuretic peptide (NT-proBNP) levels were measured and IL-38 gene in peripheral blood mononuclear cells (PBMCs) was detected in STEMI patients.Results.The results showed that plasma IL-38 levels and IL-38 gene expression in PBMCs were significantly increased in STEMI patients compared with control group and were time dependent, peaked at 24 h. In addition, plasma IL-38 levels were dramatically reduced in patients with reperfusion treatment compared with control group. Similar results were also demonstrated with CRP, cTNI, and NT-proBNP levels. Furthermore, IL-38 levels were found to be positively correlated with CRP, cTNI, and NT-proBNP and be weakly negatively correlated with left ventricular ejection fraction (LVEF) in STEMI patients.Conclusions.The results indicate that circulating IL-38 is a potentially novel biomarker for patients with STEMI and IL-38 might be a new target for MI study.

Coronary plaque characteristics associated with reduced thrombolysis in myocardial infarction flow in st-segment elevation myocardial infarction patients with plaque erosion

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J Wang ◽  
J Dai ◽  
C Fang ◽  
B Yu
Keyword(s):  
Myocardial Infarction ◽  
Local Treatment ◽  
Funding Source ◽  
Timi Flow Grade ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
Timi Flow ◽  
Plaque Erosion ◽  
St Segment ◽  
Significant Difference

Abstract Background It has been reported that the lumen factors of the culprit lesions are related to Thrombolysis in Myocardial Infarction (TIMI) flow grade in ST-Segment–Elevation Myocardial Infarction (STEMI) patients, but the factors of reduced TIMI flow in plaque erosion have not been studied. Methods 329 STEMI patients with plaque erosion who underwent pre-intervention optical coherence tomography after thrombectomy were included and divided into 2 groups according to preprocedural TIMI flow grade [TIMI 0–1 (n=219) and TIMI 2–3 (n=110)]. Results The patients with older age (55.7±11.1yrs vs. 51.8±10.6yrs, P=0.003) and diabetes patients (18.3% vs. 8.2%, P=0.015) had poorer TIMI flow, and the patients with reduced TIMI flow grade have lower initial cTnI (1.2ng/mL vs. 2.1ng/mL, P=0.023). The lesion in the LAD had better blood flow than the lesion in RCA (P=0.003), and the patients in TIMI 0–1 grade had more lipid plaques (53.9% vs. 41.8%, P=0.039), more macrophage (59.8% vs. 41.8%, P=0.002), and more calcification (34.2% vs. 21.8%, P=0.020). There was no statistically significant difference in the descriptive indicators of lipid or lumen between the two groups. And In a multivariate logistic regression model, the independent correlation factors of reduced TIMI flow grade in erosion patients were age, diabetes mellitus, lesion vessel, and macrophage. Conclusions In STEMI patients with plaque erosion non-lumen factors greatly affect flow, which suggests that systemic treatment is as important as local treatment for plaque erosion. Flow Chart Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): National Natural Science Foundation of China (81827806, 81801861), National Key R&D Program of China (2016YFC1301100)

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