scholarly journals Uveitis as a potential predictor of acute myocardial infarction in patients with Behcet’s disease: a population-based cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e042201
Author(s):  
Yu-Yen Chen ◽  
Yun-Ju Lai ◽  
Yung-Feng Yen ◽  
Hsin-Hua Chen ◽  
Pesus Chou
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Cohort Study ◽  
Behcet’S Disease ◽  
Cox Regression ◽  
Behçet's Disease ◽  
Skin Lesions ◽  
Cumulative Hazard ◽  
Potential Predictor ◽  
Kaplan Meier

ObjectivesTo investigate whether uveitis is a predictor of acute myocardial infarction (AMI) among patients with Behcet’s disease (BD).DesignRetrospective cohort study.SettingPatients with BD were retrieved from the whole population of the Taiwan National Health Insurance Research Database from 1 January 2001 to 31 December 2013.ParticipantsAmong the 6508 patients with BD, 2517 (38.7%) were in the uveitis group and 3991 were in the non-uveitis group.Primary and secondary outcome measuresKaplan-Meier curves were generated to compare the cumulative hazard of AMI in the uveitis and non-uveitis groups. Multivariate Cox regression analysis was used to estimate the adjusted HRs and 95% CI of AMI, and was adjusted for age, gender, systemic comorbidities (eg, hypertension, diabetes, hyperlipidaemia, smoking) and clinical manifestation of BD (eg, oral ulcers, genital ulcers, skin lesions, arthritis and gastrointestinal involvement).ResultsThe mean age of the BD cohort was 38.1±15.1 years. Compared with non-uveitis patients, uveitis patients were significantly younger and male predominant. There was no significant difference between the two groups for most proportions of systemic comorbidities and clinical manifestations. The Kaplan-Meier method with the log-rank test showed that the uveitis group had a significantly higher cumulative hazard for patients with AMI compared with the non-uveitis group (p<0.0001). In the multivariable Cox regression after adjustment for confounding factors, patients with uveitis had a significantly higher risk of AMI (adjusted HR 1.87; 95% CI 1.52 to 2.29). Other significant risk factors for AMI were age, hypertension, smoking, and skin lesions.ConclusionsStatistical analyses from the nationwide database demonstrated that uveitis is a potential predictor of AMI in patients with BD.

scholarly journals The association between plasma furin and cardiovascular events after acute myocardial infarction

2020 ◽  
Author(s):  
Zhi-wei Liu ◽  
Qiang Ma ◽  
Jie Liu ◽  
Jing-Wei Li ◽  
Yun-Dai Chen
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Regression Analysis ◽  
Cox Regression ◽  
Critical Role ◽  
Cardiac Events ◽  
Cox Regression Analysis ◽  
Kaplan Meier ◽  
Atheromatous Plaques ◽  
Key Enzyme

Abstract Background: Furin is the key enzyme to cleave pro-BNP and plays a critical role in the cardiovascular system through its involvement in the lipid metabolism, blood pressure and formation of atheromatous plaques. NT-proBNP and recently corin, which is also a key enzyme to cleave pro-BNP, have been approved as predictors of prognosis after acute myocardial infarction (AMI). We here conducted this cohort study to investigate the relationship between plasma furin and the prognosis outcome in patients after AMI. Methods: We enrolled 1100 AMI patients and measured their plasma furin concentration. The primary endpoint was the major adverse cardiac events (MACE), a composite of cardiovascular (CV) death, non-fatal myocardial infarction or non-fatal stroke. The association of plasma furin concentration with AMI outcomes was explored by using Kaplan–Meier curve and multivariate Cox regression analysis. Results: Our results showed that slight increase of mean cTNT in patients with higher furin concentration (P=0.016). Over a median follow-up of 31 months, multivariate Cox regression analysis suggested that plasma furin was not associated with MACE (HR: 1.01; 95% CI: 0.93-1.06; P=0.807) after adjustment for potential conventional risk factors. However, plasma furin was associated with non-fatal MI (HR: 1.09; 95% CI: 1.01-1.17; P=0.022) after fully adjustment. Subgroup analysis indicated no relationship between plasma furin and MACE in different subgroup populations.Conclusions: Our study demonstrated that plasma furin was not associated with risk of MACE and may not be used as a predictor of poor prognosis after AMI. But higher levels of plasma furin may be associated with higher risk of non-fatal MI.

scholarly journals The association between plasma furin and cardiovascular events after acute myocardial infarction

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhi-Wei Liu ◽  
Qiang Ma ◽  
Jie Liu ◽  
Jing-Wei Li ◽  
Yun-Dai Chen
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Regression Analysis ◽  
Cox Regression ◽  
Critical Role ◽  
Cardiac Events ◽  
Cox Regression Analysis ◽  
Kaplan Meier ◽  
Atheromatous Plaques ◽  
Key Enzyme

Abstract Background Furin is the key enzyme involved in the cleavage of pro-BNP and plays a critical role in the cardiovascular system through its involvement in lipid metabolism, blood pressure regulation and the formation of atheromatous plaques. NT-proBNP and recently, corin, also a key enzyme in the cleavage of pro-BNP, have been accepted as predictors of prognosis after acute myocardial infarction (AMI). This cohort study was conducted to investigate the relationship between plasma furin and the prognostic outcomes of AMI patients. Methods In total, 1100 AMI patients were enrolled in the study and their plasma furin concentrations were measured. The primary endpoint was major adverse cardiac events (MACE), a composite of cardiovascular (CV) death, non-fatal myocardial infarction (MI) and non-fatal stroke. The associations between plasma furin concentration and AMI outcomes were explored using Kaplan–Meier curves and multivariate Cox regression analysis. Results The results showed a slight increase in mean cTNT in patients with higher furin concentrations (P = 0.016). Over a median follow-up of 31 months, multivariate Cox regression analysis indicated that plasma furin was not significantly associated with MACE (HR 1.01; 95% CI 0.93–1.06; P = 0.807) after adjustment for potential conventional risk factors. However, plasma furin was associated with non-fatal MI (HR 1.09; 95% CI 1.01–1.17; P = 0.022) in the fully adjusted model. Subgroup analyses indicated no relationship between plasma furin and MACE in different subgroups. Conclusions This study found no association between plasma furin and risk of MACE. Thus, plasma furin may not be a useful predictor of poor prognosis after AMI. However, higher levels of plasma furin may be associated with a higher risk of recurrent non-fatal MI.

scholarly journals Incidence, predictors, and prognostic impact of recurrent acute myocardial infarction in China

Heart ◽  
2020 ◽  
pp. heartjnl-2020-317165
Author(s):  
Jiali Song ◽  
Karthik Murugiah ◽  
Shuang Hu ◽  
Yan Gao ◽  
Xi Li ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Cox Regression ◽  
Early Period ◽  
Coronary Intervention ◽  
Rank Test ◽  
Prognostic Impact ◽  
Cardiac Events ◽  
Kaplan Meier ◽  
Multivariable Modelling

BackgroundIncidence, predictors, and prognostic impact of recurrent acute myocardial infarction (AMI) after initial AMI remain poorly understood. Data on recurrent AMI in China is unknown.MethodsUsing the China Patient-centred Evaluative Assessment of Cardiac Events (PEACE)-Prospective AMI Study, we studied 3387 patients admitted to 53 hospitals for AMI and discharged alive. The association of recurrent AMI with 1-year mortality was evaluated using time-dependent Cox regression. Recurrent AMI events were classified as early (1–30 days), late (31–180 days), and very late (181–365 days). Their impacts on 1-year mortality were estimated by Kaplan-Meier methodology and compared by the log-rank test. Multivariable modelling was used to identify factors associated with recurrent AMI.ResultsThe mean (SD) age was 60.7 (11.9) years and 783 (23.1%) were women. The observed 1-year recurrent AMI rate was 2.5% (95% CI 2.00 to 3.07) with 35.7% events occurring within the first 30 days. Recurrent AMI was associated with 1-year mortality with an adjusted HR of 25.42 (95% CI 15.27 to 42.34). Early recurrent AMI was associated with the highest 1-year mortality rate of 53.3% (log-rank p<0.001). Predictors of recurrent AMI included age 75–84, in-hospital percutaneous coronary intervention, heart rate >90 min/beats at initial admission, renal dysfunction, and not being prescribed any of guideline-based medications at discharge.ConclusionsOne-third of recurrent AMI events occurred early. Recurrent AMI is strongly associated with 1-year mortality, particularly if early. Heightened surveillance during this early period and improving prescription of recommended discharge medications may reduce recurrent AMI in China.

scholarly journals Hs-CRP to albumin ratio predicts mortality of acute myocardial infarction patients with chronic kidney disease undergoing coronary angiography

2021 ◽  
Author(s):  
Bo Zuo ◽  
Jiayu Li ◽  
Hui Chen
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Coronary Angiography ◽  
Cox Regression ◽  
Roc Curve Analysis ◽  
Albumin Ratio ◽  
Kaplan Meier ◽  
Hs Crp

Abstract Background The diagnosis and treatment of acute myocardial infarction (AMI) patients with chronic kidney disease (CKD) is still a challenging problem. The high sensitivity C-reactive protein (hs-CRP) to albumin ratio (HCAR) was proved to be a sensitive biomarker in predicting the prognosis of many diseases. The purpose of this study was to investigate the prognostic value of HCAR in postoperative 2-year mortality of AMI patients with CKD undergoing coronary angiography(CAG). Methods A total of 11933 patients underging CAG were collected in this retrospective study. Finally, 466 AMI patients with CKD undergoing CAG were enrolled. HCAR was calculated by dividing hs-CRP by albumin obtained from blood biochemical examination. Patients were divided into two groups according to the HCAR cutoff value in predicting 2-year mortality by Receiver operating characteristic (ROC) curve analysis. The primary endpoint was all-cause mortality at a 2-year follow-up. The Kaplan-Meier method and Cox regression analyses were used to analyze the survival of patients. Results A significant correlation was found between HCAR and NT-proBNP, LVEF, CK-MB, TnI and eGFR (P < 0.05). A cut-off value of 0.24 of HCAR predicted 2-year mortality, with a sensitivity of 66.18% and specificity of 52.21% (ROC area under the curve: 0.60, 95% CI: 0.53–0.68, P < 0.001). A higher HCAR was significantly associated with a higher 2-year mortality rate (45/236 (19%) vs. 23/230 (10%), P = 0.006). The Kaplan-Meier curve showed that the group with a higher HCAR had a worse prognosis (log-rank P < 0.001). HCAR was an independent risk factor for 2-year mortality (OR: 1.779, 95% CI: 1.017–3.112, P = 0.043). Conclusion HCAR might be a potential prognostic indicator of AMI patients with CKD undergoing CAG.

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