Factor XIII Val34Leu polymorphism and the risk of myocardial infarction under the age of 36 years

2008 ◽  
Vol 99 (06) ◽  
pp. 1085-1089 ◽  
Author(s):  
Marianna Politou ◽  
Christoforos Komporozos ◽  
Demosthenes Panagiotakos ◽  
Chrisoula Belessi ◽  
Anthi Travlou ◽  
...  

SummaryThere are limited and controversial data regarding the impact of factor XIII (FXIII) Val34Leu polymorphism in the pathogenesis of premature myocardial infarction (MI). We examined whether FXIII Val34Leu polymorphism is associated with the development of early MI.We recruited 159 consecutive patients who had survived their first acute MI under the age of 36 years (mean age=32.1 ± 3.6 years, 138 were men). The control group consisted of 121 healthy individuals matched with cases for age and sex, without a family history of premature coronary heart disease (CHD). FXIII Val34Leu polymorphism was tested with polymerase chain reaction and reverse hybridization. There was a lower prevalence of carriers of the Leu34 allele in patients than in controls (30.2 vs. 47.1%, p=0.006). FXIII Val34Leu polymorphism was associated with lower risk for acute MI after adjusting for major cardiovascular risk factors (odds ratio [OR] = 0.51, 95% confidence interval [CI] 0.27–0.95, p=0.03). Subgroup analysis according to angiographic findings (“normal” coronary arteries [n=29] or significant CHD [n=130]) showed that only patients with MI and significant CHD had lower prevalence of carriers of the Leu34 allele compared to controls after adjusting for major cardiovascular risk factors (OR = 0.42, 95% CI 0.22–0.83, p=0.01). Our data indicate that FXIII Val34Leu polymorphism has a protective effect against the development of MI under the age of 36 years, particularly in the setting of significant CHD.

2021 ◽  
Author(s):  
Bartosz Krzowski ◽  
Michał Peller ◽  
Maria Boszko ◽  
Paulina Hoffman ◽  
Natalia Żurawska ◽  
...  

Abstract Background: Treatment of acute myocardial infarction has been studied and improved over the past years. However, the initial months after myocardial infarction are crucial from the perspective of the patient's prognosis. It is extremely important to take care of all cardiovascular risk factors.Mobile application ‘afterAMI’ supported by a web system is a novel telemedical tool developed to support patients and physicians during cardiac rehabilitation. The application has an educational model with a focus on cardiovascular risk factors and lifestyle after myocardial infarction. Moreover, it offers a module that controls vital signs like blood pressure, heart rate, weight, and many others. Additionally, the application will send reminders for better drug adherence.Methods: A group of 100 patients with myocardial infarction on admission at the 1st Chair and Department and of Cardiology, Medical University of Warsaw, will be recruited into the study. The project aims to assess the impact of the application-supported model of care in comparison with standard rehabilitation. At the end of the study, cardiovascular risk factors will be analysed, along with issues like rehospitalizations, patients' knowledge of risk factors, returning to work, and quality of life. In this prospective, open-label, randomized, single-center study, all 100 patients will be observed for 6 months after discharge from the hospital. Endpoints will be assessed during control visits 1- and 6-months after inclusion into the study.Discussion: This project is an example of a telemedical solution application embracing everyday clinical practices, conforming with multiple international cardiac societies’ guidelines. Cardiac rehabilitation process enhancements are required to improve patients’ prognosis. The evidence regarding the use of the mobile application in the described group of patients is limited and usually covers a small number of participants. The described study aims to discuss whether telemedicine use in this context is beneficial for the patients.Trial registration: ClinicalTrials.gov, NCT04793425, registered 11 March 2021.


Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Lars Lind ◽  
Erik Ingelsson ◽  
Johan Sundström ◽  
Johan ärnlöv

Objective: The aim of this study was to investigate how the length of the follow-up period influences the strength of the associations between major cardiovascular risk factors and different cardiovascular outcomes (myocardial infarction [MI], stroke and heart failure). Methods: We examined 1826 men aged 50 regarding cardiovascular risk factors in 1970-74. The follow-up time was 33 years. The hazard ratio (HR) was calculated yearly for each risk factor and outcome. During follow-up, 571 cases of MI, 381 cases of stroke and 384 cases of heart failure occurred. Results: Two major patterns were found regarding influence of the follow-up time on the associations between risk factors and the different cardiovascular outcomes. First, a gradual decline in the HR over time was seen for blood pressure in relation to all three outcomes, with the most rapid decline for heart failure and stroke. This pattern was also seen for BMI in relation to MI and heart failure, and for smoking regarding MI and stroke. Second, we observed a gradual increase in HRs to a maximum at 20-25 years, and thereafter a slight decline. This pattern was seen for the apoB/A1 ratio, HDL, and triglycerides, mainly in relation to MI and heart failure. Conclusion: The length of follow-up influenced the associations between traditional risk factors and cardiovascular outcomes in different ways. The collective influence of the risk factors did however show a substantial decline in discrimination over time for the outcomes stroke and heart failure, but not regarding myocardial infarction.


2021 ◽  
Vol 40 (2) ◽  
pp. 49-54
Author(s):  
Al’farabi S. Izmuhanov ◽  
Aleksandr V. Gordienko

AIM: Myocardial rupture currently remains in most cases a fatal complication of myocardial infarction. OBJECTIVE: To study the features of the structure of cardiovascular risk factors in men under 60 years old with complicated myocardial infarction to improve prevention. MATERIALS AND METHODS: The study included men 1960 years old with type I myocardial infarction. The patients were divided into two groups age-comparable: I studied, with myocardial rupture seven patients; II control, without breaks 558 patients. A comparative analysis of the frequency of observation of the main and additional factors of cardiovascular risk in the selected groups was performed. RESULTS OF THE STUDY: In the patients of the study group, frequent (four or more times a year) colds were observed more often than in the control group (42.9 and 14.8%, respectively; p = 0.04), the internal organs foci of infections (85.7 and 40.3%; p = 0.049), bypass surgery (57.1 and 10.2%; p 0.0001) and continuous cardiac pacing (28.6 and 0.5%; p 0.0001) in medical history. The presence of arterial hypertension (28.5 and 67.6%; p = 0.03) and foci of oral cavity infections (0 and 20.3%; p = 0.049) reduced the risk of myocardial rupture. In the study group, the levels of total cholesterol (4.3 0.3 and 5.8 1.2 mmol/l); p = 0.02), low-density lipoproteins (2.7 0.1 and 4.2 1.2 mmol/l); p = 0.04) and triglycerides (0.7 0.1 and 2.6 1.8 mmol/l); p = 0.008) were lower than in the control. CONCLUSION: Combinations of these cardiovascular risk factors indicate an increased risk of myocardial rupture. It is advisable to use them for predictive modeling of this event and the formation of risk groups for the purpose of timely prevention, (bibliography: 18 refs.).


Author(s):  
Gordienko A.V. ◽  
Balabanov A.S. ◽  
Biyaliev E.K.

Relevance. Mortality in cardiogenic shock remains high. Aim. To evaluate the structure of cardiovascular risk factors features in men under 50 years old with myocardial infarction complicated by cardiogenic shock, in order to improve the prevention of this complication. Material and methods. The study included men 19-50 years old with type I myocardial infarction. The patients were divided into two age-comparable groups: I - the study group, with cardiogenic shock - seven patients; II - control, without it - 202 patients. A comparative analysis of the of cardiovascular risk factors structure in the selected groups and a risk analysis (ANOVA) of the development of cardiogenic shock were performed. Results. In the study group, the predominance of renal dysfunction (100 and 10.3%, respectively; p=0.004), alcohol abuse (71.4 and 35.2%; p=0.049), the presence of atrial fibrillation (57.1 and 5,0%; p˂0.0001), urolithiasis 28.6 and 6.4%; p=0.001), cholelithiasis 14.3 and 5.5%; p=0.001 and gout 14.3 and 0.5%; p=0.001) in history. In the control group, a history of unstable angina pectoris was more often recorded (0 and 38.1%; p=0.04). When assessing the risks, in addition to those listed, smoking 20 cigarettes per day, a decrease in lipid metabolism indicators (very low density lipoproteins 0.36 mmol/l, low density 2.7 mmol/l, cholesterol˂3,8 mmol/l, triglycerides 1.2 mmol/l, cholesterol/high density lipoproteins˂4.63), creatinine≥140 μmol/l in combination with overweight (≥96.0 kg and Quetelet index ≥31,0 kg/m2) and age (≥48 years). Conclusions. The listed factors can be used in the formation of high-risk groups for observation and timely implementation of the necessary treatment as well as for prognostic modeling of cardiogenic shock.


2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
I Lechner ◽  
M Reindl ◽  
C Tiller ◽  
M Holzknecht ◽  
A Mayr ◽  
...  

Abstract Background The association between aortic stiffness, cardiovascular risk factors and prognosis in patients with recent ST-elevation myocardial infarction (STEMI) is poorly understood. We analyzed the relationship between cardiovascular risk factors and arterial stiffening and assessed its prognostic significance in patients with recent STEMI. Methods We prospectively enrolled 408 consecutive patients who sustained a first STEMI and underwent primary percutaneous coronary intervention (PPCI). Aortic pulse wave velocity (PWV), a direct measure of aortic stiffness, was determined by the transit-time method using velocity-encoded, phase-contrast cardiac magnetic resonance imaging. Patient characteristics were acquired at baseline and major adverse cardiac and cerebrovascular events (MACCE) were assessed at 13 (interquartile range [IQR] 12–31) months. Cox regressionand logistic regression analysis were performed to explore predictors of PWV and MACCE. Results Median aortic PWV was 6.6 m/s (IQR 5.6–8.3m/s). In multivariable analysis, age (odds ratio [OR] 1.10, 95% confidence interval [CI], 1.08–1.14, p<0.001) and hypertension (OR 2.45, 95% CI, 1.53–3.91, p<0.001) were independently associated with increased PWV. Sex, diabetes, smoking status, dyslipidemia, and obesity were not significantly associated with PWV in adjusted analysis (all p>0.05). High PWV significantly and independently predicted occurrence of MACCE in adjusted analysis (hazard ratio [HR] 2.45, 95% CI 1.19–5.04, p=0.014). Conclusion In patients with recent STEMI, the impact of classical cardiovascular risk factors on aortic stiffness is mainly dependent on age and increased blood pressure. Increased aortic stiffness is associated with adverse clinical outcome post-STEMI, suggesting it as a relevant therapeutic target in this population. FUNDunding Acknowledgement Type of funding sources: Public grant(s) – EU funding. Main funding source(s): Austrian Science Fund (FWF)Austrian Society of Cardiology Figure 1. Biorender.com


2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
I Lechner ◽  
M Reindl ◽  
C Tiller ◽  
M Holzknecht ◽  
A Mayr ◽  
...  

Abstract Funding Acknowledgements Type of funding sources: None. Background The association between aortic stiffness, cardiovascular risk factors and prognosis in patients with recent ST-elevation myocardial infarction (STEMI) is poorly understood. Purpose We analyzed the relationship between cardiovascular risk factors and arterial stiffening and assessed its prognostic significance in patients with recent STEMI. Methods We prospectively enrolled 408 consecutive patients who sustained a first STEMI and underwent primary percutaneous coronary intervention (pPCI). Aortic pulse wave velocity (PWV), a direct measure of aortic stiffness, was determined by the transit-time method using velocity-encoded, phase-contrast cardiac magnetic resonance imaging. Patient characteristics were acquired at baseline and major adverse cardiac and cerebrovascular events (MACCE) were assessed at 13 (interquartile range [IQR] 12–31) months. Cox regression- and logistic regression analysis were performed to explore predictors of PWV and MACCE. Results Median aortic PWV was 6.6 m/s (IQR 5.6–8.3m/s). In multivariable analysis, age (odds ratio [OR] 1.10, 95% confidence interval [CI], 1.08–1.14, p < 0.001) and hypertension (OR 2.45, 95% CI, 1.53–3.91, p < 0.001) were independently associated with higher PWV. Gender, diabetes, smoking status, dyslipidemia, and obesity were not significantly associated with PWV in adjusted analysis (all p > 0.05). High PWV significantly and independently predicted occurrence of MACCE in adjusted analysis (hazard ratio [HR] 2.45, 95% CI 1.19–5.04, p = 0.014). Conclusion In patients with recent STEMI, the impact of classical cardiovascular risk factors on aortic stiffness is mainly dependent on age and increased blood pressure. Increased aortic stiffness is associated with adverse clinical outcome, suggesting it as a relevant therapeutic target in this population.


2021 ◽  
Author(s):  
Bartosz Krzowski ◽  
Michał Peller ◽  
Maria Boszko ◽  
Paulina Hoffman ◽  
Natalia Żurawska ◽  
...  

Abstract Background: Treatment of acute myocardial infarction has been studied and improved over the past years. However, the initial months after myocardial infarction are crucial from the perspective of the patient's prognosis. It is extremely important to take care of all cardiovascular risk factors.Mobile application ‘afterAMI’ supported by a web system is a novel telemedical tool developed to support patients and physicians during cardiac rehabilitation. The application has an educational model with a focus on cardiovascular risk factors and lifestyle after myocardial infarction. Moreover, it offers a module that controls vital signs like blood pressure, heart rate, weight, and many others. Additionally, the application will send reminders for better drug adherence.Methods: A group of 100 patients with myocardial infarction on admission at the 1st Chair and Department and of Cardiology, Medical University of Warsaw, will be recruited into the study. The project aims to assess the impact of the application-supported model of care in comparison with standard rehabilitation. At the end of the study, cardiovascular risk factors will be analysed, along with issues like rehospitalizations, patients' knowledge of risk factors, returning to work, and quality of life. In this prospective, open-label, randomized, single-center study, all 100 patients will be observed for 6 months after discharge from the hospital. Endpoints will be assessed during control visits 1- and 6-months after inclusion into the study.Discussion: This project is an example of a telemedical solution application embracing everyday clinical practices, conforming with multiple international cardiac societies’ guidelines. Cardiac rehabilitation process enhancements are required to improve patients’ prognosis. The evidence regarding the use of the mobile application in the described group of patients is limited and usually covers a small number of participants. The described study aims to discuss whether telemedicine use in this context is beneficial for the patients.Trial registration: ClinicalTrials.gov, NCT04793425, registered 11 March 2022.


Author(s):  
Ivan Lechner ◽  
Martin Reindl ◽  
Christina Tiller ◽  
Magdalena Holzknecht ◽  
Sarah Niederreiter ◽  
...  

AbstractThe association between aortic stiffness, cardiovascular risk factors and prognosis in patients with recent ST-elevation myocardial infarction (STEMI) is poorly understood. We analyzed the relationship between cardiovascular risk factors and arterial stiffening and assessed its prognostic significance in patients with recent STEMI. We prospectively enrolled 408 consecutive patients who sustained a first STEMI and underwent primary percutaneous coronary intervention (PPCI). Aortic pulse wave velocity (PWV), the most widely used measure of aortic stiffness, was determined by the transit-time method using velocity-encoded, phase-contrast cardiac magnetic resonance imaging. Patient characteristics were acquired at baseline and major adverse cardiac and cerebrovascular events (MACCE) were assessed at 13 [interquartile range (IQR) 12–31] months. Cox regression- and logistic regression analysis were performed to explore predictors of aortic stiffness and MACCE. Median aortic PWV was 6.6 m/s (IQR 5.6–8.3 m/s). In multivariable analysis, age [odds ratio (OR) 1.10, 95% confidence interval (CI), 1.08–1.14, p < 0.001] and hypertension (OR 2.45, 95% CI, 1.53–3.91, p < 0.001) were independently associated with increased PWV. Sex, diabetes, smoking status, dyslipidemia, and obesity were not significantly associated with PWV in adjusted analysis (all p > 0.05). High PWV significantly and independently predicted occurrence of MACCE in adjusted analysis [hazard ratio (HR) 2.45, 95% CI 1.19–5.04, p = 0.014]. In patients with recent STEMI, the impact of classical cardiovascular risk factors on aortic stiffness is mainly dependent on age and increased blood pressure. Increased aortic stiffness is associated with adverse clinical outcome post-STEMI, suggesting it as a relevant therapeutic target in this population. Trial (NCT04113356).


Author(s):  
Gordienko A.V. ◽  
Davletova A.K.

Relevance. Myocardial infarction and its complications in young and middle-aged men with arterial hypertension remains an important problem of modern cardiology. Aim. To evaluate the cardiovascular risk factors structure features in men under 50 years old with arterial hypertension to improve prevention and outcomes. Material and methods. The study included 209 men aged 19-50 years old with type I myocardial infarction, who underwent a standard diagnostic algorithm in the first 48 hours and at the end of the third week of the disease. The patients were divided into two age-matched groups: with arterial hypertension (121 patients, 88 patients without arterial hypertension). A comparative analysis of the frequency of identifying the main and additional cardiovascular risk factors and their parameters were performed in the selected groups. Results. The study group showed more pronounced glycemia (5.6±1.4 mmol/l) than in the control group (5.2±1.3 mmol/l; p=0.04) at the end of the third week of myocardial infarction. In this group, there was a high incidence of obesity (42.1 and 25.0%, respectively; p=0.01), changes in peripheral arteries (86.0 and 3.5%; p<0.0001) and target organ damage , meteorological dependence (31.4 and 9.1%; p=0.0001), impaired peripheral hemodynamics, as well as hereditary burden of vascular pathology (100 and 56.8%; p=0.03). Conclusions. The data obtained suggest a worse long-term prognosis and a greater degree of resistance to treatment in men with arterial hypertension, which must be considered when implementing preventive programs.


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