Study the Value of Interleukin-6 As Diagnostic and Predictive marker of Cardiac Events in St Segment Elevation Myocardial Infarction

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Galal Adel Mohamed Abd El Rehem ◽  
Sameh Salem Hefny Taha ◽  
John Nader Naseef ◽  
Taghreed Mohamed Fareed Othman Mohamed
Keyword(s):  
Myocardial Infarction ◽  
Interleukin 6 ◽  
Troponin I ◽  
Myocardial Necrosis ◽  
Heart Association ◽  
Cardiac Events ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
History Of

Abstract Background Owing to major changes in the biomarkers available for diagnosis, criteria for acute myocardial infarction have been revised. The current international consensus definition states that the term acute myocardial infarction (AMI) should be used when there is evidence of myocardial necrosis in a clinical setting consistent with myocardial ischemia. The present guidelines pertain to patients presenting with ischemic symptoms and persistent ST-segment elevation on the electrocardiogram (ECG). Most of these patients will show a typical rise in biomarkers of myocardial necrosis and progress to Q wave myocardial infarction. Separate guidelines have recently been developed by another task force of the ESC (European Society of Cardiology) for patients presenting with ischemic symptoms but without persistent ST segment elevation and for patients undergoing myocardial revascularization in general. Aim of the work The aims of this work are: To assess the diagnostic value of interleukin-6 compared to troponin I in ST segment elevation myocardial infarction. To assess the predictive value of elevated interleukin-6 in ST segment elevation myocardial infarction. Patients This prospective study was included sixty adult patients of both sexes meeting the American Heart Association (AHA) recommendations for diagnosis of ST segment elevation myocardial infarction from those attending the Critical Care Units, Critical Care Medicine Department, Faculty of Medicine, Ain Shams University to be included in the current study. Inclusion Criteria :Patients were fulfilled the criteria of diagnosis of acute coronary syndrome (ACS) and diagnosed as ST segment elevation MI according to American Heart Association (AHA) criteria which include patient ranging between 30 to 70 years and presented with active chest pain. Exclusion Criteria Patients were excluded from the study if they have: (1) Recent myocardial infarction in the last three months. (2) Recent cardiological intervention in the last three months. (3) Recent ischemic cerebrovascular stroke in the last three months. (4) Non ST segment elevation myocardial infarction and unstable angina according to electrocardiographic changes, cardiac markers and clinical condition of the patients. (5) Acute infectious diseases that leads to elevation of troponin I and interleukin-6. (6) Active immunological diseases. (7) Renal impairment. Methods The following data were obtained from each patient: Personal data: name, age, sex, occupation and special habits e.g. smoking. History of present illness regarding to clinical condition: onset, nature, duration, course, progression, characteristic site and radiating areas of the chest pain, relieving and aggravating factors, associated symptoms (as diaphoresis, nausea, vomiting, dyspnea and palpitation) and medication received and their effects. Medical history of diabetes mellitus (DM), hypertension (HTN), and history of ischemic heart disease (IHD). Family history of IHD, DM and HTN. Conclusion From this current study we revealed that: STEMI patients have increased level of interleukin-6 compared to those normal persons. Interleukin-6 may be a potentially useful marker for diagnosis of STEMI. Interleukin-6 may be helpful prognostic value for future cardiac mortality in STEMI patients. The level of interleukin-6 is not affected by the extent of myocardial damage and necrosis. Interleukin-6 is an inflammatory cytokine. Recommendations From this study we recommend the use of interleukin-6 level as good diagnostic marker for diagnosis of ST segment elevation myocardial infarction, Also this study recommend the use of interleukin-6 as good prognostic inflammatory marker in future adverse cardiac events and mortality occur after myocardial infarction STEMI type. Study limitations The results are interpreted in consideration of the small population of patients and short term follow up.

scholarly journals High Sensitivity Troponin in Infarcted Patients with History of Myocardial In-farction

2019 ◽  
pp. 1-5
Author(s):  
Orlando Victorino de Moura Junior ◽  
Arthur Augusto Souza Bordin ◽  
Sibele Sauzem Milano ◽  
Gustavo Lenci Marques
Keyword(s):  
Myocardial Infarction ◽  
Troponin I ◽  
High Sensitivity ◽  
Serum Levels ◽  
Previous Myocardial Infarction ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
High Sensitivity Troponin ◽  
St Segment ◽  
History Of

Design of the Study: Historical Cohort. Objectives: This study aimed to verify which risk factors contribute to increase hs-cTnI in patients with Myocardial Infarcion with ST segment elevation, to ana-lyze which prognostic impacts it may have and to evaluate troponin levels in pa-tients that had previous acute myocardial infarction and assess how this com-pared to patients without previous history of an acute event. Methodology: It was assessed medical records of patients admitted in the Cor-onary Unit of the Hospital de Clínicas (HC-UFPR) in Curitiba, South of Brazil, diagnosed with ST segment elevation Myocardial Infarction and whose serum levels of high sensitivity troponin I (hs-cTnI) were collected at admission moment. The select data were: gender, age, high blood pressure, smoking, diabetes, previous myocardial infarction, dyslipidemia and serum levels of high sensitivity troponin I. For prognostic proposes, it was analysed intra-hospital death and ventricular function, based on left ventricular ejection fraction. Findings: Patients admitted with previous myocardial infarction had lower levels of hs-TnI. Gender, age, presence of high blood pressure, tabagism, diabetes and dyslipidemia didn’t reveal correlation with troponin values, allowing the in-ference that high sensitivity troponin values at first presentation of these patients have no direct relation to these variables. Regarding prognosis, levels of high sensitivity troponin could not be associated to mortality or ventricular malfunction. Conclusions: At admission, high-sensitivity troponin I levels were lower in pa-tients with prior myocardial infarction. Relevance: This work correlates the values of the high-sensitivity troponin of    patients with ST segment Elevation Myocardial Infarction to cardiovascular risks factors and to the prognosis of these patients. This approach is not found in cur-rent medical literature, whose works mainly relates to acute events.

scholarly journals Loeffler’s endocarditis and possible coronary spasm secondary to eosinophilic coronary periarteritis with ECG change mimicking acute non-ST-segment elevation myocardial infarction: A case report

2020 ◽  
Author(s):  
Fan-xin Kong ◽  
Meng Li ◽  
Chun-Yan Ma ◽  
Ping-ping Meng ◽  
Yong-huai Wang ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Differential Diagnosis ◽  
Coronary Artery ◽  
Troponin I ◽  
Hypereosinophilic Syndrome ◽  
Coronary Spasm ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment

Abstract Background Loeffler’s endocarditis is an inflammatory cardiac condition of hypereosinophilic syndrome which rarely involves coronary artery. When coronary artery is involved, known as eosinophilic coronary periarteritis, the clinical presentation, electrocardiographic changes and troponin level are extremely nonspecific and may mimic acute coronary syndrome. It is very important to make differential diagnosis for ECPA in order to avoid the unnecessary further invasive coronary angiography. Case presentation We report a case with chest pain, ST-segment depression in electrocardiogram and increased troponin-I mimicking acute non-ST-segment elevation myocardial infarction. However, quick echocardiography showed endomyocardial thickening with normal regional wall motion, which corresponded to the characteristics of Loeffler’s endocarditis. Emergent blood analysis showed marked increase in eosinophils and computed tomography angiography found no significant stenosis of coronary artery. Manifestations of magnetic resonance imaging consisted with findings of echocardiography. Finally, the patient was diagnosed as Loeffler’s endocarditis and possible coronary spasm secondary to eosinophilic coronary periarteritis. Conclusion This case exhibits the crucial use of quick transthoracic echocardiography and the emergent hematological examination for differential diagnosis in such scenarios as often if electrocardiogram change mimicking myocardial infarction.

P3127Optimal revascularization strategy in non-ST-segment elevation myocardial infarction with multivessel coronary artery disease: staged vs. one-time vs. culprit-only revascularization

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Kim ◽  
Y Ahn ◽  
M H Jeong ◽  
D S Sim ◽  
Y J Hong ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Multivessel Coronary Artery Disease ◽  
Cardiac Events ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Adverse Cardiac Events ◽  
Artery Disease

Abstract Background/Introduction Although optimal revascularization strategy in patients with ST-segment elevation myocardial infarction with multivessel coronary artery disease (MVD) was well established, there are few studies which investigated optimal revascularization strategy in non-ST-segment elevation myocardial infarction (NSTEM) with MVD. Purpose We investigated 2-year clinical outcomes according to strategy of revascularization in patients with NSTEMI and MVD. Methods Between November 2011 and October 2015, a total of 2474 patients with NSTEMI and MVD who underwent successful percutaneous coronary intervention were analyzed from the Korea Acute Myocardial Infarction Registry-National Institute of Health (staged 308, one-time 1043 and culprit-only 1123 patients). We did not include patients with left main disease and cardiogenic shock. Primary endpoint was major adverse cardiac events (MACE: the composite of cardiac death, myocardial infarction [MI] or target-vessel revascularization [TVR]) during 2-year follow-up (median 737 days [interquartile range 705–764]). We also analyzed the of all-cause mortality, stroke and non-TVR. Results Baseline characteristics such as age, gender, and prevalence of atherosclerotic risk factors between multivessel revascularization (MVR; staged or one-time revascularization) and CVR were similar. There was also no difference in symptom to balloon time in 2 groups. MACE occurred in 305 patients (12.3%) during 2-year follow-up. MVR could reduce incidence of MACE (10.2% vs. 14.9%; adjusted hazard ratio [HR] 1.50 for CVR, 95% confidence interval [CI] 1.20–1.88, p<0.001), all-cause death (8.4% vs. 12.1%; adjusted HR 1.45 for CVR, 95% CI 1.13–1.87, p=0.003) and non-TVR (1,9% vs. 7.0%; adjusted HR 3.99 for CVR, 95% CI 2.55–6.27, p<0.001). There was no difference in incidence of stroke between MVR and CVR. We also analyzed same analysis between staged and one-time revascularization. Complete revascularization was more achieved in one-time revascularization group compared to staged revascularization group (62.0% vs. 76.1%, p<0.001). In multivariate Cox-regression analysis, staged revascularization was not associated with improved clinical outcomes in terms of MACE (HR 0.74, 95% CI 0.50–1.09, p=0.126), all-cause death (HR 1.07, 95% CI 0.69–1.68, p=0.759), stroke (HR 1.75, 95% CI 0.68–4.52, p=0.245) and non-TVR (HR 2.56, 95% CI 0.75–8.68, p=0.132). Analysis by propensity score matching and inverse probability of treatment weighting did not significantly affect the results. Conclusions MVR reduced 2-year adverse cardiac events in patients with NSTEMI and MVD compared to CVR. However, staged revascularization was not superior to one-time revascularization for reducing MACE among NSTEMI patients with MVD who received MVR.

scholarly journals Impact of hyperglycemia on the results of percutaneous coronary interventions in patients with acute ST-segment elevation myocardial infarction

2017 ◽  
Vol 89 (9) ◽  
pp. 25-29 ◽  
Author(s):  
I S Bessonov ◽  
V A Kuznetsov ◽  
Yu V Potolinskaya ◽  
I P Zyrianov ◽  
S S Sapozhnikov
Keyword(s):  
Myocardial Infarction ◽  
Independent Predictor ◽  
Mortality Rates ◽  
Percutaneous Coronary Interventions ◽  
Cardiac Events ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Adverse Cardiac Events ◽  
Percutaneous Coronary

Aim. To investigate the impact of hyperglycemia on the results of percutaneous coronary interventions (PCIs) in patients with acute ST-segment elevation myocardial infarction (ASTEMI). Subjects and methods. A study group consisted of 511 patients with hyperglycemia (blood glucose level (BGL) ≥7.77 mmol/L) who underwent primary PCIs in the period from 2005 to 2015. A comparison group included 579 patients (BGL ≥7.77 mmol/L). Results. Assessment of the results of hospital interventions revealed that the mortality rates in patients with hyperglycemia proved to be higher than in those with normal BGL (6.5 and 2.6%, respectively; p=0.002). No differences were found in the rates of stent thrombosis (1 and 1.4%; p=0.541) and recurrent myocardial infarction (1.2 and 1.6%; p=0.591). Major adverse cardiac events, including death, recurrent infarction, and stent thrombosis, were more frequently determined in the hyperglycemic patients (7.6 and 4.3%; p=0.020). No-reflow phenomenon statistically significantly more frequently developed in the patients with hyperglycemia (6.8 and 3.3%; p=0.007). Binary logistic regression analysis showed that the presence of hyperglycemia served as an independent predictor of hospital mortality (odds ratio (OR) 2.6; 95% confidence interval (CI), 1.4 to 4.8; p=0.002). The application of a random probability sampling technique revealed that mortality remained statistically significantly higher in the hyperglycemic patients than in the normoglycemic individuals at admission (6.7 and 2.6%; р=0.011). Conclusion. PCIs in patients with ASTEMI and hyperglycemia are characterized by higher mortality rates and the risk of major adverse cardiac events. Admission hyperglycemia is an independent predictor of hospital mortality.

Sign in / Sign up

Export Citation Format

Share Document