scholarly journals Elevated Plasma IL-37, IL-18, and IL-18BP Concentrations in Patients with Acute Coronary Syndrome

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Qingwei Ji ◽  
Qiutang Zeng ◽  
Ying Huang ◽  
Ying Shi ◽  
Yingzhong Lin ◽  
...  

Objective.More recently, evidence showed that the novel anti-inflammatory cytokine interleukin- (IL-) 37 was expressed in the foam-like cells of atherosclerotic coronary and carotid artery plaques, suggesting that IL-37 is involved in atherosclerosis-related diseases. However, the plasma levels of IL-37 in patients with acute coronary syndrome (ACS, including unstable angina pectoris and acute myocardial infarction) have yet to be investigated.Methods.Plasma IL-37, IL-18, and IL-18BP levels were measured in 50 patients with stable angina pectoris (SAP), 75 patients with unstable angina pectoris (UAP), 67 patients with acute myocardial infarction (AMI), and 65 control patients.Results.The plasma IL-37, IL-18, and IL-18BP levels were significantly increased in ACS patients compared to SAP and control patients. A correlation analysis showed that the plasma biomarker levels were positively correlated with each other and with the levels of C-reactive protein (CRP),N-terminal probrain natriuretic peptide (NT-proBNP), and left ventricular end-diastolic dimension (LVEDD) but negatively correlated with left ventricular ejection fraction (LVEF). Furthermore, the plasma IL-37, IL-18, and IL-18BP had no correlation with the severity of the coronary artery stenosis.Conclusions.The results indicate that the plasma IL-37 levels are associated with the onset of ACS.

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Sudeb Mukherjee ◽  
Suhana Datta ◽  
S. C. Mandal

Background. The association between subclinical thyroid dysfunction (defined by no symptoms or clinical features of hypothyroidism but biochemically TSH level in the range of above 5 miu/ml but below 10 miu/ml with normal FT4 level) and Acute Coronary Syndrome (ACS) is not known so far. This study was done to calculate the prevalence of subclinical thyroid dysfunction in patients with ACS. Methods. A retrospective chart review of 1100 consecutive patients was done who presented to Emergency Department with symptoms suggestive of ACS and admitted. They were later classified in 3 categories that includes Acute ST Elevated Myocardial Infarction (STEMI), Unstable Angina (UA), and Acute Non-ST Elevated Myocardial Infarction (NSTEMI). Thyroid function test (FT4, TSH) and antithyroid peroxidase (TPO) were done and evaluated properly. Results. Of 1100 consecutive patients 168 (15.27%) patients had the biochemical features of subclinical thyroid dysfunction. These 168 patients include 60 STEMI, 66 NSTEMI, and 42 Unstable Angina patients. There were no statistically significant differences in terms of left ventricular ejection fraction (LVEF) and catheterisation results considering thyroid dysfunction. Conclusions. Subclinical thyroid dysfunction is quite prevalent in ACS patients. There are no significant associations between STEMI, Unstable Angina, or NSTEMI patients in terms of thyroid dysfunction neither in single vessel versus multivessel disease involvement. The causative role and outcomes of treatment are still uncertain and need further follow-up.


Author(s):  
Maryam Nabati ◽  
Zahra Dehghan ◽  
Bahareh Kalantari ◽  
Jamshid Yazdani

Background: The presence of different risk groups among patients with the non–ST-elevation acute coronary syndrome indicates the need for new tools to establish early diagnoses and prognostic stratifications. The role of prolonged corrected QT (QTc) intervals in myocardial ischemia has yet to be thoroughly assessed. The purpose of our study was to assess the significance of QTc prolongations during acute non–ST-segment elevation myocardial infarction (NSTEMI) or unstable angina. Methods: The QTc interval was measured in 205 patients admitted with NSTEMI or unstable angina to the Coronary Care Unit of Fatemeh Zahra Hospital between 2014 and 2015. On that basis, the patients were divided into those with normal (<440 ms) and the ones with prolonged (≥440 ms) QTc intervals. Echocardiography and coronary angiography were performed within 48 to 72 hours after hospitalization. A logistic regression model was applied to assess the predictors of left ventricular systolic dysfunction. Results: The mean age of the patients was 58.21±10.72 years, and men comprised 51% of the participants. Overall, a QTc interval prolongation of ≥440 ms was present in 45 subjects (21.95% of the patients), which was significantly associated with a previous myocardial infarction (MI) (P=0.024), a minimum ST depression of 1 mm in the inferior leads (P=0.006), and a maximum left ventricular ejection fraction of 35% (P=0.018). Furthermore, among the different electrocardiographic variables, only a prolonged QTc interval (OR=0.275, 95% CI=0.078–0.976; and P=0.046) was inversely associated with the left ventricular systolic function. Conclusion: Our study showed that prolonged QTc intervals can be used as a useful risk marker for identifying high-risk patients with the acute coronary syndrome.


2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Ramin Eskandari ◽  
Parisa Matini ◽  
Sepideh Emami ◽  
Yousef Rezaei

Abstract Background: Admission hyperglycemia has been associated with major adverse cardiovascular and cerebrovascular events (MACCEs) in patients with acute coronary syndrome. Methods: In this study we sought to determine the association between admission blood sugar (ABS) and the outcomes of non-diabetic patients with first-ever acute myocardial infarction (MI). Non-diabetic patients with MI were evaluated from March 2016 to March 2019. Baseline characteristics, laboratories, electrocardiogram, and baseline left ventricular ejection fraction (LVEF) were recorded. All patients were followed up and outcomes were obtained. Follow-up data comprised of repeating electrocardiogram and echocardiography at 1 year, and MACCE, including re-MI, stroke, and mortality. Results: A total of 312 patients with a mean age of 54.2 ± 11.9 years were evaluated. All patients were followed up for a median of 38 months. The frequencies of in-hospital mortality and MACCE at late follow-up were higher in third tertile of ABS compared with those in first and second tertiles (both p <0.05). Based on the Cox regression analysis, the independent predictors of MACCE included age (hazard ratio [HR] 1.068, 95% confidence interval [CI] 1.033 – 1.105, p <0.001), third tertile of ABS >172 mg/dL (HR 21.257, 95% CI 2.832 – 159.577, p=0.003), and baseline LVEF (HR 0.947, 95% CI 0.901 – 0.995, p=0.031). Conclusion: Admission stress hyperglycemia is associated with increased rates of in-hospital mortality and MACCE at late follow-up in non-diabetic patients with MI. Moreover, elevated ABS, older ages, and a decreased value of baseline LVEF predicted MACCE during follow-up.


2018 ◽  
Vol 26 (3) ◽  
pp. 283-292 ◽  
Author(s):  
Lorena Ciumărnean ◽  
Mihai Greavu ◽  
Ştefan C Vesa ◽  
Alina I Tanțău ◽  
Gabriela B Dogaru ◽  
...  

Abstract Introduction: Reduced serum levels of paraoxonase 1 (PON1) activities are associated with diseases involving increased oxidative stress, such as acute coronary syndrome. We aimed to determine whether serum PON1 activities are a prognostic factor for one-year survival following ST-elevation myocardial infarction (STEMI). Material and methods: We prospectively followed for one-year 75 patients diagnosed and treated for STEMI. Clinical, laboratory and imagistic data were gathered after coronary angiography. PON1 activities (paraoxonase, arylesterase, and lactonase) were assayed spectophotometrically on samples of heparinized plasma taken from the patients in a timeframe of maximum 20 minutes after coronary angiography. Results: Increased mortality was linked to age (patients over 68 years), permanent atrial fibrillation or left ventricular ejection fraction (LVEF) <40% (associated with global hypokinesia, apical or septal akinesia), trivascular disease atherosclerosis, reduced PON1 activities (paraoxonase <18.4 IU/mL, arylesterase <12.6 IU/mL, lactonase <27.6 IU/mL), and glomerular filtration rate levels <54 mL/min/1.73m2. Multivariate survival analysis showed the independent prognostic role of age (HR 3.92; 95%CI 1.08-14.16; p=0.03), LVEF (HR 9.93; 95%CI 2.20-44.86; p=0.003) and arylesterase (HR 4.25; 95%CI 0.94-19.18; p=0.05) for one-year mortality. Conclusion: Reduced arylesterase activity of PON1 is an independent predictor of one-year survival after acute myocardial infarction.


Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Muhammed K Elfaituri ◽  
Mohamed Abrahim Bin Zarti ◽  
Hazem Abdelkarem Faraj ◽  
Ahmed Khaled ◽  
Mohammed Abdulhameed Zendah ◽  
...  

Introduction: Acute coronary syndrome (ACS) encompasses a variety of coronary artery disorders involving myocardial infarction with ST-segment-elevation (STEMI), unstable angina (UA), and myocardial infarction with non-ST elevation (NSTEMI). Hypothesis: To gain insight into the epidemiology, evaluation, in-hospital treatment, and commitment to current management guidance of ACS for patients admitted to a tertiary care hospital in a developing country. Methods: We performed a retrospective observational study of 50 consecutive patients presenting with ACS between October 2019 and December 2019, and followed for in-hospital mortality at a tertiary care general medical unit. We collected and analysed patient reports on presentation, treatment, in-hospital mortality, and major adverse cardiovascular events (MACE). Results: Patients diagnosed with ACS had a mean (SD) age of 59.3 (13.1) years, and were predominantly men (58%). Alcohol and drug consumption, smoking, and morbid obesity were significantly associated with STEMI (P < 0.05). Discharge diagnoses included STEMI (40%), NSTEMI, and unstable angina. Mean (SD) duration of hospital stay was 5.5 (5.8) days. Left ventricular ejection fraction (LVEF) was below 40% in 28% of patients, with a mean (SD) LVEF of 46.0 (15.3) ml. Median time (interquartile range) from the onset of pain to hospital admission was 80 (423) minutes for STEMI and 138 (480) minutes for NSTEMI (P > 0.05). About 72% of patients were admitted to the cardiac intensive care unit, and 34% of STEMI patients received a fibrinolytic. All patients received anti-platelet drugs. MACE were identified in 16.3% of STEMI patients and 10.6% of NSTEMI patients. Body mass index, history of cardiac disease, longer hospital duration, diabetes, and hypertension were significant predictors of in-hospital MACE. All patients were discharged and alive at the study end. All patients received standard of care treatment after discharge. Conclusions: Delays in the delivery and application of thrombolytic are coronary therapy require attention in developing countries to improve the care of patients with ACS.


Kardiologiia ◽  
2021 ◽  
Vol 61 (11) ◽  
pp. 104-107
Author(s):  
Yu. A. Schneider ◽  
V. G. Tsoi ◽  
M. S. Fomenko ◽  
P. A. Shilenko ◽  
I. I. Dimitrova ◽  
...  

The conditions of the pandemic caused by the novel coronavirus infection (COVID-19) are associated with overloading intensive care units, conversion of hospitals, and changes in routing of patients with acute cardiovascular pathology. At the same time, medical practice is still challenged to provide medical care to patients with acute coronary syndrome (ACS). Patients with COVID-19 and acute myocardial infarction (AMI) are at a higher risk of death while the incidence of this combination of diseases will be growing. This article describes a case of diagnosis and treatment of COVID-19 in a 69-year-old patient who was urgently hospitalized with cardiogenic shock associated with ACS, electrocardiographic signs of complete left bundle branch block, and left ventricular ejection fraction of 19 %. Coronary angiography with stenting was successfully performed in the conditions of extracorporeal membrane oxygenation. The patient received long-term intensive therapy in the intensive care unit followed by symptomatic treatment in the cardiac surgery unit. The patient’s condition gradually improved and he was discharged from the hospital on the 56th day. The strategy of intensive care and active follow-up helped saving life of the patient with COVID-19 and AMI.


2021 ◽  
Vol 8 (8) ◽  
pp. 682-688
Author(s):  
Enna Berkah Sari ◽  
Nizam Zikri Akbar ◽  
Herman Hariman

Background: Acute Coronary Syndrome (ACS) is a major cardiovascular problem because it causes high hospital admissions and mortality rates. Acute Coronary Syndrome is divided into 3 (three), namely: unstable angina pectoris (UAP), myocardial infarction without ST segment elevation (NSTEMI), and myocardial infarction with ST segment elevation (STEMI). In addition to changes in biomarkers of heart injury, the platelet index (IPF = immature platelet fraction) will also change the level difference between STEMI with NSTEMI/UAP. Objective: To determine the differences in IPF levels of ACS patients with STEMI and NSTEMI/UAP Method: Observational analytic with cross sectional approach. The subjects of this study were 80 patients who came to the emergency installation of integrated heart center Emergency Room Haji Adam Malik Hospital Medan from May 2019 to September 2019 and was diagnosed with ACS (STEMI or NSTEMI/UAP). The sample in the study was the patient's venous blood and put it in an EDTA tube, then immediately checked the IPF value/level using the automatic hematology analyzer. Patients with heart failure or patients with thrombocytopenia were not included in this study. Results: In this study, the demographic characteristics of the ACS patients based on gender were male 77.5% STEMI and 87.5% NSTEMI/UAP while women 22.5% STEMI and 12.5% ​​NSTEMI/UAP. The results of the STEMI patient's IPF levels Compared with NSTEMI/UAP, the median is 6.2 (3.5-16.8) VS 2.9 (0.7-12) with a p-value of 0.0001. Conclusion: The characteristics of ACS patients based on the results of sex were that there were more men with NSTEMI/UAP than those with STEMI. There was a significant difference in the IPF levels of STEMI with NSTEMI/UAP. Keywords: Immature Platelet Fraction (IPF), Acute Coronary Syndrome (ACS), ST-Segment Elevation Myocardial Infarction (STEMI), Non ST-Segment Elevation Myocardial Infarction (NSTEMI), Unstable Angina Pectoris (UAP).


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