scholarly journals Serum Procalcitonin as a Marker for Infection in Patients with Acute Myocardial Infarction

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S352-S352
Author(s):  
Itzhak Vitkon-Barkay ◽  
Tsilia Lazarovitch ◽  
Dror Marchaim ◽  
Hannah Segaloff ◽  
Ronit Zaidenstein ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Predictive Value ◽  
Bacterial Infections ◽  
Medical Center ◽  
White Blood Cells ◽  
Laboratory Data ◽  
Significant Proportion ◽  
Infection Diagnosis ◽  
Wbc Count

Abstract Background Significant proportion of patients with acute myocardial infarction (AMI) also present with systemic inflammatory response syndrome (SIRS). Thus it is difficult to determine in certain situations, whether empiric antibiotic treatment is warranted. Serum procalcitonin (PCT) is known to be elevated in bacterial infections, but its performances in predicting bacterial infection among patients with AMI, who might benefit from appropriate empiric management, is unknown. Methods A prospective observational study was conducted at Assaf Harofeh Medical Center, Israel. Serum PCT was collected within 48 hours from patients presenting with AMI. Demographic, clinical, and laboratory data, were collected prospectively. Two experienced Infectious Diseases (ID) specialists who were blinded to the PCT results, independently determined the gold standard for infection in every patient. By utilizing sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and the area under the ROC curve (AUC), the performance of PCT, fever, white-blood cells (WBC) count and C-reactive protein (CRP) for infection diagnosis was calculated. Results The analysis included 230 AMI patients (age 63.0 ± 13.0 years), of which 36 (15.6%) were determined to be infected. The best cutoff for PCT as a differentiating marker between infected and non-infected patients was achieved at 0.09ng/dl (sensitivity 94.4%, specificity 85.1%, AUC ROC 0.94). This test outperformed CRP, WBC, and fever, for infection diagnosis (figure). Conclusion PCT should be utilized for ruling out infection in AMI patients by utilizing serum PCT>0.09ng/dl (i.e., ≥0.1ng/dl) as a cutoff. Disclosures All authors: No reported disclosures.

P1004Atrial fibrillation during acute myocardial infarction : a prospective multicenter study

EP Europace ◽  
2020 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
S Grigoryan ◽  
L G Hazarapetyan ◽  
A A Ter-Markaryan ◽  
M F Drampyan
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Multivariate Analyses ◽  
Past History ◽  
Medical Center ◽  
Statistical Significance ◽  
Laboratory Data ◽  
Left Ventricular ◽  
Acute Mi

Abstract   New-onset atrial fibrillation (AF) frequently complicates acute myocardial infarction (AMI) and is associated with higher in-hospital and 1-year mortality, particularly in patients with ST-segment elevation AMI. In this clinical setting the occurrence of AF is of particular importance since irregular ventricular rates during AF may cause further impairment of the coronary circulation and left ventricular function in addition to the adverse consequences of neuro-hormonal activation. However, incidence and risk factors contributing to the occurrence of AF in AMI are still not well-known. The purpose of this study is to evaluate prospectively some risk factors contributing the incidence of AF in the setting of AMI. Methods This was a three-center prospective study, conducted in the coronary care unit of our medical center during the period of January 2017 to June 2018. This study included 976 patients with acute MI of different localization. AF was found in 82 patients of whom 68 experienced this arrhythmia anew. Onset, duration and mode of termination of AF, clinical and risk factors associated with its presentation and its relation with patient outcome were evaluated. Anamnesis, clinical and functional state of the heart (according to the results of instrumental and laboratory data) was studied in all patients. The data was analyzed for statistical significance using multivariate analyses by SPSS 16. Results   The obtained results showed that in acute MI AF was registered in 9.4% of patients, among which new episodes of AF have been identified in 82.9% of patients. All the patients who developed AF after AMI were more than 60 years of age. Moreover, 68% of patients with AF have arterial hypertension, 27% - diabetes mellitus and 67% patients have higher heart rate. There is a relationship between developed AF and other supraventricular arrhythmias in the past history.  In 62% of patients with AF, anterior MI was detected and accompanied by more severe hemodynamic disorders. Multivariate analyses showed that AF correlated weakly with age (r = 0.249) and strongly with left atrial diameter (r = 0.478) and left ventricular dysfunction (r = 0.419) especially with higher Killip class. Conclusions The results of the present study revealed that in the presence of identified certain risk factors in patients with acute MI, AF may develop. There is the link between identified risk factors and the occurrence of AF

scholarly journals Predictive value of stress hyperglycemia ratio for the occurrence of acute kidney injury in acute myocardial infarction patients with diabetes

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Side Gao ◽  
Qingbo Liu ◽  
Hui Chen ◽  
Mengyue Yu ◽  
Hongwei Li
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Acute Kidney Injury ◽  
Cardiogenic Shock ◽  
Predictive Value ◽  
Kidney Injury ◽  
Left Ventricular Ejection ◽  
Diabetic Patients ◽  
Stress Hyperglycemia ◽  
Patients With Diabetes

Abstract Background Acute hyperglycemia has been recognized as a robust predictor for occurrence of acute kidney injury (AKI) in nondiabetic patients with acute myocardial infarction (AMI), however, its discriminatory ability for AKI is unclear in diabetic patients after an AMI. Here, we investigated whether stress hyperglycemia ratio (SHR), a novel index with the combined evaluation of acute and chronic glycemic levels, may have a better predictive value of AKI as compared with admission glycemia alone in diabetic patients following AMI. Methods SHR was calculated with admission blood glucose (ABG) divided by the glycated hemoglobin-derived estimated average glucose. A total of 1215 diabetic patients with AMI were enrolled and divided according to SHR tertiles. Baseline characteristics and outcomes were compared. The primary endpoint was AKI and secondary endpoints included all-cause death and cardiogenic shock during hospitalization. The logistic regression analysis was performed to identify potential risk factors. Accuracy was defined with area under the curve (AUC) by a receiver-operating characteristic (ROC) curve analysis. Results In AMI patients with diabetes, the incidence of AKI (4.4%, 7.8%, 13.0%; p < 0.001), all-cause death (2.7%, 3.6%, 6.4%; p = 0.027) and cardiogenic shock (4.9%, 7.6%, 11.6%; p = 0.002) all increased with the rising tertile levels of SHR. After multivariate adjustment, elevated SHR was significantly associated with an increased risk of AKI (odds ratio 3.18, 95% confidence interval: 1.99–5.09, p < 0.001) while ABG was no longer a risk factor of AKI. The SHR was also strongly related to the AKI risk in subgroups of patients. At ROC analysis, SHR accurately predicted AKI in overall (AUC 0.64) and a risk model consisted of SHR, left ventricular ejection fraction, N-terminal B-type natriuretic peptide, and estimated glomerular filtration rate (eGFR) yielded a superior predictive value (AUC 0.83) for AKI. Conclusion The novel index SHR is a better predictor of AKI and in-hospital mortality and morbidity than admission glycemia in AMI patients with diabetes.

Predictive Value of Two-Dimensional Echocardiographic and Hemodynamic Measurements on Admission With Acute Myocardial Infarction

1988 ◽  
Vol 1 (3) ◽  
pp. 187-193 ◽  
Author(s):  
Wybren Jaarsma ◽  
Cees A. Visser ◽  
Machiel J. Eenige van ◽  
Freek W.A. Verheugt ◽  
Albert J. Funke Kupper ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Predictive Value ◽  
Two Dimensional ◽  
Hemodynamic Measurements

Creatine kinase radioimmunoassay and isoenzyme electrophoresis compared in the diagnosis of acute myocardial infarction.

1980 ◽  
Vol 26 (7) ◽  
pp. 861-866 ◽  
Author(s):  
H A Homburger ◽  
G L Jacob
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Creatine Kinase ◽  
Chest Pain ◽  
Predictive Value ◽  
Positive Test ◽  
Test Results ◽  
Diagnostic Specificity ◽  
B Subunit ◽  
Creatine Kinase B

Abstract We compared, in 116 patients, the relative usefulness of results of tests for creatine kinase B isoenzymes, as measured by radioimmunoassay, and the MB isoenzyme, as measured by electrophoresis, in diagnosis of acute myocardial infarction. The radioimmunoassay was specific for isoenzymes of creatine kinase containing the B subunit. All patients with acute transmural infarcts had positive test results by both techniques, but concentrations of B-isoenzymes were more frequently above normal than were MB bands in the case of patients with acute subendocardial infarcts and in the case of all patients with acute myocardial infarcts from whom sera were collected more than 24 h after onset of chest pain. Concentrations of B-isoenzymes also were increased, even when MB bands were not electrophoretically detectable, in specimens from several patients without documented actue myocardial infarcts. These abnormal results presumably were caused by increased concentrations of the BB isoenzyme in serum. Accordingly, an increased concentration of B-isoenzymes had less diagnostic specificity and predictive value for acute myocardial infarction than did a detectable MB band. Results of isoenzyme electrophoresis were more reliable for establishing this diagnosis, but the results of radioimmunoassay were more reliable for excluding it in patients with chest pain as the primary symptom.

Effect of thrombolytic therapy on the predictive value of signal-averaged electrocardiography after acute myocardial infarction

1992 ◽  
Vol 70 (1) ◽  
pp. 21-25 ◽  
Author(s):  
Marek Malik ◽  
Piotr Kulakowski ◽  
Olusola Odemuyiwa ◽  
Jan Poloniecki ◽  
Anne Staunton ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Thrombolytic Therapy ◽  
Predictive Value
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