scholarly journals Changes in gut microbiota are associated with coronary angiographic severity and prognosis in patients with acute coronary syndrome

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J Gao ◽  
J Wang ◽  
L.L Zhao ◽  
C.P Li ◽  
Z Cui ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Gut Microbiota ◽  
16S Rdna ◽  
Real Time Pcr ◽  
Syntax Score ◽  
Funding Source ◽  
16S Rdna Sequence ◽  
Coronary Syndrome ◽  
Long Term Prognosis

Abstract Background 1. Studies have found that gut microbiota is a new participant and potential therapeutic target for CVD and even MI. 2. No clinical study to date, however, has investigated whether the changes of gut microbiota associated with coronary lesion degree and prognosis in patients with acute coronary syndrome (ACS). Aim We prospectively investigated associations, of gut microbiota in their feces and coronary lesion degree, and long-term prognosis of patients with ACS. Methods 1. In prospective cohort study, a total 502 subjects including 402 ACS patients and 100 controls. Fecal specimens were used to extract bacterial genomic DNA 2. 16S rDNA sequence of bacteria were generated to analyse specific gut microbial taxa associated with ACS onset for 60 ACS patients and 30 healthy controls. 3. Specific primers were designed according to the 16S rDNA sequence of bacteria for real time PCR reaction to determine the number of different bacteria. 4. All ACS patients calculated SYNTAX score by coronary radiography results and followed up for one year. The correlation of gut microbiota with coronary angiographic severity and prognosis in the ACS patients was analyzed. Results 1. Compared with the control group,the number of bacteria in Escherichia coli, Streptococcus and Enterobacteriaceae increased significantly (P<0.05) and Lactobacillus decreased significantly (P<0.05) in patients with ACS. 2. Lactobacillus were independent predictors of coronary angiographic severity in patients with ACS (HR=0.953; 95% CI: 0.935–0.970, P<0.001). 3. Decreased Lactobacillus levels were independent protection factors with all-cause death (HR=0.954; 95% CI: 0.913–0.997, P=0.038) and risk of major adverse cardiac events (HR=0.952; 95% CI: 0.929–0.976, P<0.001),especially for heart failure in long-term prognosis(HR=0.960; 95% CI: 0.932–0.989, P=0.007). Conclusion 1. Number of Lactobacillus are significantly decreased in patients with ACS,and associated with SYNTAX score,suggesting that Lactobacillus is associated with severity of coronary artery disease, all-cause death and MACE. 2. It provides new ideas for the prevention and treatment of ACS. Real time PCR Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): Major Science and Technology Projects of Tianjin Science and Technology Commission in 2016

5-year outcomes in patients with acute coronary syndrome treated with biodegradable polymer sirolimus-eluting stents versus durable polymer everolimus-eluting stents

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J.F Iglesias ◽  
D Heg ◽  
M Roffi ◽  
D Tueller ◽  
O Muller ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Cardiac Death ◽  
Target Lesion ◽  
Funding Source ◽  
Target Vessel ◽  
Coronary Syndrome ◽  
Durable Polymer ◽  
Stable Cad

Abstract Background Newest generation drug-eluting stents (DES) combining ultrathin cobalt chromium platforms with biodegradable polymers may reduce target lesion failure (TLF) as compared to second generation DES among patients with acute coronary syndrome (ACS). While previous studies indicated a potential benefit within the first two years after percutaneous coronary intervention (PCI), it remains uncertain whether the clinical benefit persists after complete degradation of the polymer coating. Purpose To compare the long-term effects of ultrathin-strut biodegradable polymer sirolimus-eluting stents (BP-SES) versus thin-strut durable polymer everolimus-eluting stents (DP-EES) for PCI in patients with ACS. Methods We performed a subgroup analysis of ACS patients included into the BIOSCIENCE trial (NCT01443104), a randomized trial comparing BP-SES with DP-EES. The primary endpoint of the present post-hoc analysis was TLF, a composite of cardiac death, target vessel myocardial infarction (MI) and clinically indicated target lesion revascularization (TLR), at 5 years. Results Among 2,119 patients enrolled between March 2012 and May 2013, 1,131 (53%) presented with ACS (ST-segment elevation myocardial infarction, 36%). Compared to patients with stable CAD, ACS patients were younger, had a lower baseline cardiac risk profile, including a lower prevalence of hypertension, hypercholesterolaemia, diabetes mellitus, and peripheral artery disease, and had a greater incidence of previous revascularization procedures. At 5 years, TLF occurred similarly in 89 patients (cumulative incidence, 16.9%) treated with BP-SES and 85 patients (16.0%) treated with DP-EES (RR 1.04; 95% CI 0.78–1.41; p=0.78) in patients with ACS, and in 109 patients (24.1%) treated with BP-SES and 104 patients (21.8%) treated with DP-EES (RR 1.11; 95% CI 0.85–1.45; p=0.46) in stable CAD patients (p for interaction=0.77) (Figure 1, Panel A). Cumulative incidences of cardiac death (8% vs. 7%; p=0.66), target vessel MI (5.2% vs. 5.8%; p=0.66), clinically indicated TLR (8.9% vs. 8.3%; p=0.63) (Figure 1, Panel B-D), and definite thrombosis (1.4% vs. 1.0%; p=0.57) at 5 years were similar among ACS patients treated with ultrathin-strut BP-SES or thin-strut DP-EES. Overall, there was no interaction between clinical presentation and treatment effect of BP-SES versus DP-EES. Conclusion In a subgroup analysis of the BIOSCIENCE trial, we found no difference in long-term clinical outcomes between ACS patients treated with ultrathin-strut BP-SES or thin-strut DP-EES at five years. Funding Acknowledgement Type of funding source: Private company. Main funding source(s): Unrestricted research grant to the institution from Biotronik AG, Switzerland

scholarly journals 0363: Obstructive sleep apnea in acute coronary syndrome patients: prevalence and long-term prognosis

2016 ◽  
Vol 8 (1) ◽  
pp. 19-20
Author(s):  
Silvia Leao ◽  
Pedro Magalhaes ◽  
Filipa Cordeiro ◽  
Bebiana Conde ◽  
Pedro Mateus ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Acute Coronary Syndrome ◽  
Sleep Apnea ◽  
Coronary Syndrome ◽  
Obstructive Sleep ◽  
Long Term Prognosis

scholarly journals Relation of Fibrinogen-to-Albumin Ratio to Severity of Coronary Artery Disease and Long-Term Prognosis in Patients with Non-ST Elevation Acute Coronary Syndrome

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Mingkang Li ◽  
Chengchun Tang ◽  
Erfei Luo ◽  
Yuhan Qin ◽  
Dong Wang ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Albumin Ratio ◽  
Coronary Syndrome ◽  
St Elevation ◽  
Elevation Acute Coronary Syndrome ◽  
Artery Disease ◽  
Long Term Prognosis

Previous studies showed that fibrinogen-to-albumin ratio (FAR) regarded as a novel inflammatory and thrombotic biomarker was the risk factor for coronary artery disease (CAD). In this study, we sought to evaluate the relationship between FAR and severity of CAD, long-term prognosis in non-ST elevation acute coronary syndrome (NSTE-ACS) patients firstly implanted with drug-eluting stent (DES). A total of 1138 consecutive NSTE-ACS patients firstly implanted with DES from January 2017 to December 2018 were recruited in this study. Patients were divided into tertiles according to FAR levels (Group 1: ≤8.715%; Group 2: 8.715%~10.481%; and Group 3: >10.481%). The severity of CAD was evaluated using the Gensini Score (GS). The endpoints were major adverse cardiovascular events (MACE), including all-cause mortality, myocardial reinfarction, and target vessel revascularization (TVR). Positive correlation was detected by Spearman’s rank correlation coefficient analysis between FAR and GS (r=0.170, P<0.001). On multivariate logistic analysis, FAR was an independent predictor of severe CAD (OR: 1.060; 95% CI: 1.005~1.118; P<0.05). Multivariate Cox regression analysis indicated that FAR was an independent prognostic factor for MACE at 30 days, 6 months, and 1 year after DES implantation (HR: 1.095; 95% CI: 1.011~1.186; P=0.025. HR: 1.076; 95% CI: 1.009~1.147; P=0.026. HR: 1.080; 95% CI: 1.022~1.141; P=0.006). Furthermore, adding FAR to the model of established risk factors, the C-statistic increased from 0.706 to 0.720, 0.650 to 0.668, and 0.611 to 0.632, respectively. And the models had incremental prognostic value for MACE, especially for 1-year MACE (NRI: 13.6% improvement, P=0.044; IDI: 0.6% improvement, P=0.042). In conclusion, FAR was associated independently with the severity of CAD and prognosis, helping to improve risk stratification in NSTE-ACS patients firstly implanted with DES.

Influence of Admission Glucose Level on Long-Term Prognosis in Patients With Acute Coronary Syndrome

2006 ◽  
Vol 59 (12) ◽  
pp. 1268-1275
Author(s):  
Stella M. Macín ◽  
Eduardo R. Perna ◽  
María L. Coronel ◽  
Jorge O. Kriskovich ◽  
Pablo A. Bayol ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Glucose Level ◽  
Coronary Syndrome ◽  
Long Term Prognosis ◽  
Admission Glucose

scholarly journals The correlation between traditional risk factors and the severity of acute coronary syndrome and long-term prognosis

2015 ◽  
Vol 6 (4) ◽  
pp. 6-10
Author(s):  
I. S Skopets ◽  
N. N Vezikova ◽  
I. M Marusenko ◽  
O. Yu Barysheva
Keyword(s):  
Risk Factors ◽  
Acute Coronary Syndrome ◽  
Family History ◽  
Coronary Syndrome ◽  
Increased Risk ◽  
Life Threatening ◽  
Traditional Risk Factors ◽  
Long Term Prognosis

A number of studies demonstrate that patients with traditional risk factors (TRF) have not only increases primary risk of atherothrombotic events, but are also associated with many complicates and poor prognosis.Purpose: assessment of TRF effect on the incidence of complications and outcomes in patients with acute coronary syndrome (ACS).Materials and methods: in 255 patients hospitalized with ACS were retrospective determined the TRF prevalence, frequency of the complications and correlation between the presence of TRF and the risk of complications and long-term prognosis (follow-up 1 year).Results: patients had TRF very often, 80% patients had more than 3 TRFs. The presence of some TRFs (smoking, abdominal obesity, family history) was associated with a significantly increased risk of complications in patients with ACS, including life-threatening. Effect of TRF on long-term prognosis was not determined.Conclusion: the findings suggest the need to evaluation TRF not only in primary preventive and also to improve the effectiveness of risk stratification in patients with ACS.

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