Abstract 2601: Increased TLR-4+ Monocytes in Thrombi from the Site of Coronary Occlusion in Acute Coronary Syndromes - a Role for Innate Immunity in Acute Coronary Syndrome

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Michel Neidhart ◽  
Christophe Wyss ◽  
Lukas Altwegg ◽  
Keiko Yonekawa ◽  
Franz Eberli ◽  
...  
Keyword(s):  
Innate Immunity ◽  
Acute Coronary Syndrome ◽  
Peripheral Blood ◽  
Coronary Occlusion ◽  
Adherent Cells ◽  
Healthy Controls ◽  
Coronary Syndrome ◽  
Coronary Syndromes ◽  
The Mean ◽  
Shock Proteins

Objective: To evaluate and compare the expression of Toll-like receptors 2 and 4 (TLR-2 and -4) in thrombi obtained at the site of coronary occlusion of patients with acute coronary syndrome (ACS) with their expression in peripheral blood (PBL) of the same patients and healthy controls. Methods: Thrombi were mechanically disrupted, treated with actilyse for 12 hours in RPMI + 10% FCS. The amount of erythrocytes was reduced by isotonic lysis. Peripheral blood from the same patients (n = 14) and from age- and sex-matched healthy controls (n = 10) were treated in the same manner. Adherent cells were detached by Accutase and mixed with the non-adhering cells. CD14+ and CD66b+ (FITC) cells were stained for TLR-2 and TLR-4 (PE) and analysed by flow cytometry. Results: TLR-4 was detected in the thrombi by immunohistochemistry. The proportion of TLR-4+ cells was markedly increased in the monocyte gate of cells isolated from the thrombus, in comparison to peripheral blood cells from the same patient or healthy controls. Most importantly, the expression of TLR-4, measured as the mean fluorescence intensity, was significantly elevated on CD14+ monocytes of the thrombus, compared to peripheral blood CD14+ cells from the same patient or healthy controls (Figure 1 ). No such differences could be found for expression of TLR 2, TLR 3 or TLR 9. Conclusion: Thrombi of patients with ACS contain an increased proportion of TLR-4+ monocytes. Thus, our results suggest that activation of innate immunity through TLR-4 is involved in ACS. This may be a part of a link between induction of heat shock proteins and thrombosis.

scholarly journals Serum Lipoprotein (a) levels in acute coronary syndrome; Comparison of younger and elderly patients with healthy controls

2019 ◽  
Vol 35 (6) ◽  
Author(s):  
Sadaf Hanif ◽  
Bilqees Akhtar ◽  
Muhammad Naeem Afzal
Keyword(s):  
Acute Coronary Syndrome ◽  
Elderly Patients ◽  
Vascular Disease ◽  
Serum Lipoprotein ◽  
P Value ◽  
Healthy Controls ◽  
Lipoprotein A ◽  
Coronary Syndrome ◽  
Coronary Vascular Disease ◽  
The Mean

Objective: To compare and see the association of serum Lipoprotein (a) levels in younger and older patients suffering from acute coronary syndrome compared to healthy controls Methods: This case control study was conducted in department of cardiology, King Edward Medical University, Lahore from January to December 2015. Total 180 subjects (90 cases and 90 healthy controls, subdivided in 45 young and old in each group ≤/>45 years of age) were included in the study by non-probability purposive sampling. Patients presenting with acute coronary event and angiographically proven coronary vascular disease were considered cases while those with normal coronaries served as controls. Lp(a) was measured after ten hours fasting. Lp(a) >30 nmol/l) were considered as high. Data were entered and analyzed in SPSS 17. Independent sample t-test was used to compare the mean lipoprotein (a) in cases and controls. Results: The mean age of cases and controls was 48.02 ± 10.90 & 45.89±10.09 years respectively. Lipid profile was similar in both cases and controls except triglycerides that were higher in controls (p=0.024). The mean lipoprotein (a) in cases was 47.03 ± 45.47 and in controls was 29.69±23.10 (p-value 0.001). Mean Lp(a) level was significantly high in cases vs controls in young subjects, (50.15±55.62 vs 25.75±15.84, p= 0.006), while in old ones, difference was not statistically significant (43.92±32.69 vs 33.64±28.22, p= 0.114). The frequency of desirable, borderline high, high, and very high Lp(a) levels in cases was 23(25.6%), 12(13.3%), 27(30.0%) and 28(31.1%), while in controls, it was 26(28.9%), 31(34.4%), 17(18.9%) and 16(17.8%), (p-value 0.003). Chi-Square test showed significant association of high Lp(a) with coronary artery disease in younger cases vs controls (P=0.004) with OR 3.65 but not in older (p-value 0.358). Conclusion: Serum lipoprotein(a) is strongly associated with coronary vascular disease especially in patients younger than 45 years of age despite comparable LDL and HDL between cases and controls, making Lp(a) likely independent risk factor for coronary vascular disease. doi: https://doi.org/10.12669/pjms.35.6.377 How to cite this:Hanif S, Akhtar B, Afzal MN. Serum Lipoprotein (a) levels in acute coronary syndrome; Comparison of younger and elderly patients with healthy controls. Pak J Med Sci. 2019;35(6):1718-1723. doi: https://doi.org/10.12669/pjms.35.6.377 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Prevalence of Vitamin-D Deficiency in Patients with Acute Coronary Syndrome in Syria

2016 ◽  
Vol 9 (6) ◽  
pp. 3544-3548
Author(s):  
Aya Hallak ◽  
Malhis Mahmoud ◽  
Yaser Abajy Mohammad
Keyword(s):  
Vitamin D ◽  
Acute Coronary Syndrome ◽  
Vitamin D Deficiency ◽  
Hypovitaminosis D ◽  
Control Group ◽  
Coronary Syndrome ◽  
Normal Individuals ◽  
Vitamin D Levels ◽  
25 Hydroxy Vitamin D ◽  
Coronary Syndromes

The objectives of this study were to estimate the prevalence of vitamin D deficiency in patients with acute coronary syndrome in comparison with normal individuals and study the correlation between these two conditions. We measured the plasma 25-hydroxy vitamin D (25-OH-D) levels in 60 patients with acute coronary syndromes (ACS) of both gender and in 30 age matched control individuals of both gender without any known cardiovascular or systemic diseases. The levels of 25-OH-D were measured by ELISA method and the results were statically analyzed to find out any possible correlation. We classified the cases according to their plasma 25(OH)D levels. 25(OH)D levels of ≥ 30 ng/ml were considered normal, levels < 30 and > 20 ng/ml were classified as insufficient, while levels of ≤ 20 ng/ml were classified as deficient. In the current study the prevalence of hypovitaminosis D in the patients group was much higher than it was in the control group. Vitamin D deficiency was observed in 80% and insufficiency in 13% of total patients of ACS, there by bringing the total count to 93%. Whereas only 7% of the patients had adequate vitamin D levels. Thus, these results indicate the existence of a significant correlation between the vitamin D deficiency and ACS in comparison to healthy controls

scholarly journals Bone marrow-derived NGFR+ cells regulate arterial remodeling and those poor mobilizations in peripheral blood in acute coronary syndrome predicts plaque progression at the non-targeted lesion

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
S Takashima ◽  
S Usui ◽  
S Matsuura ◽  
C Goten ◽  
O Inoue ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Acute Coronary Syndrome ◽  
Peripheral Blood ◽  
Funding Source ◽  
Arterial Remodeling ◽  
Plaque Progression ◽  
Wild Type ◽  
Plaque Volume ◽  
Coronary Syndrome

Abstract Background In our previous 5-year cohort study, we demonstrated that low gene expression of nerve growth factor receptor (NGFR) in peripheral leucocytes in acute coronary syndrome (ACS) predicted repetitive coronary interventions at the de novo lesions. An NGFR-positive cell has been demonstrated to reside in bone marrow (BM) stromal fraction and to be increased in peripheral blood mononuclear cell (MNCs) fraction in patients with ischemic heart disease. Purpose To investigate whether the BM-NGFR+ cell is associated with arterial remodeling and the relationship between the levels of peripheral NGFR+ cells after ACS and coronary plaque progression in an experimental and prospective clinical study. Methods and results In an experimental study, 8-week-old C57B6/J wild type male mice were subjected to irradiation with 9.6 Gy and transplantation with BM (BMT) isolated from GFP-transgenic NGFR wild type (WT) or knock-out (KO) mice at day 1. Four weeks after BMT, the right carotid artery was ligated for 4 weeks. Induced neointimal area was increased (p&lt;0.05), where cells under apoptosis were decreased (p&lt;0.05) in NGFR-KO-BMT group compared to WT-BMT group (n=4). NGFR+ cells were not detected in wild type sham-operated artery, whereas in the ligated artery in WT-BMT group NGFR+ cells assembled in the developed neointima and exclusively presented double positive with GFP, but absent in NGFR-KO-BMT group (p&lt;0.05, n=4). In a clinical study, thirty patients with ACS who underwent primary percutaneous coronary intervention (PCI) were enrolled. The peripheral blood sample was collected on days 0, 3 and 7, and 9 months follow-up and the number of NGFR+MNCs were measured by flowcytometric analysis. The plaque volume at non-targeted coronary lesion (non-TL:&gt;5 mm proximal or distal to the implanted stents) were quantitatively analysed using gray-scale intravascular ultrasound (IVUS) and Q-IVUS™ software at the acute phase and 9 months follow-up. The number of NGFR+MNCs in peripheral blood was 1.5-fold increased at day 3 (0.064±0.056%) compared to day 0 (0.042±0.030%) (p&lt;0.05). The change in normalized total plaque volume (TAVN) at non-TL at 9 months was negatively correlated with the number of NGFR+MNCs at day 0 (r=−0.51), day 3 (r=−0.51) and 9 months (r=−0.59) after ACS (p&lt;0.05). Multiple regression analysis showed that NGFR+MNCs at day 0 (β=−0.48, p=0.01) and CRP (β=−0.53, P&lt;0.01) are independent factors associating with TAVN change at non-TL at 9 months, regardless of LDL-cholesterol control level. ROC analysis revealed that NGFR+MNCs &lt;0.049 at day 0 predicted the increase of TAVN with AUC 0.78; sensitivity 0.82 and specificity 0.67. Conclusions Bone marrow-derived peripheral NGFR+ cells negatively regulate arterial remodeling through appropriate apoptosis of neointimal cells and the peripheral level of NGFR+ cells in ACS predicts plaque progression at the non-targeted lesion. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): KAKENHI

scholarly journals Acute coronary syndrome: which age group tends to delay call for help?

2021 ◽  
Vol 73 (1) ◽  
Author(s):  
Ahmed Ayuna ◽  
Ayyaz Sultan
Keyword(s):  
Acute Coronary Syndrome ◽  
Time Delay ◽  
Local Population ◽  
Age Groups ◽  
Age Group ◽  
Teaching Programme ◽  
The Road ◽  
Coronary Syndrome ◽  
The Mean ◽  
Mean Time

Abstract Background Early diagnosis and treatment of ACS can reduce the risk of complications and death. Delay calling for help can increase morbidity and mortality. It is unclear which age group among patients with acute coronary syndrome tend to delay their call for help. Results Our observational retrospective study showed that men and women in their 50s and 40s respectively tend to delay their call for help from symptoms onset. For the former, the mean time delays (590 ± 71.1 min), whereas for the latter it was (1084 ± 120.1 min). Moreover, these groups tend to have a longer time delay between symptoms onset and arrival at the hospital. Among deaths, we observed that the death rate was proportional to the time delay, which is not unexpected. Next step, we plan to perform a qualitative study in the form of questionnaires to target the individuals with a high risk of CVD within these age groups. Conclusion Middle age group of both genders tend to delay their call for help when they experience symptoms of ACS; moreover, regardless of the age, the longer the delay, the higher the mortality rate. The results of this study gave us a better understanding of our local population and will pave the road for a well-structured teaching programme for them to minimise the time delay for calling for help.

Redefining residual inflammatory risk after acute coronary syndrome

2021 ◽  
Author(s):  
Marco G Del Buono ◽  
Rocco A Montone ◽  
Giulia Iannaccone ◽  
Riccardo Rinaldi ◽  
Giulia La Vecchia ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Cardiovascular Events ◽  
Multimodality Imaging ◽  
Short Review ◽  
Local Inflammation ◽  
Coronary Syndrome ◽  
Increased Risk ◽  
Atherosclerotic Plaque Formation ◽  
Long Term Follow Up ◽  
Coronary Syndromes

Over the last decades, inflammation proved to play a pivotal role in atherosclerotic plaque formation, progression and destabilization. Several studies showed that the patients presenting with acute coronary syndrome are at increased risk of adverse cardiovascular events at both short- and long-term follow-up. Results from different clinical trials highlighted that a residual inflammatory risk exist and targeting inflammation is a successful strategy in selected cases associated to an increased inflammatory burden. Recently, the optimization of intracoronary and multimodality imaging allowed to also assess the entity of local inflammation, thus encouraging the individuation of plaque characteristics that portend a higher risk of future cardiovascular events. In this short review, we aim to highlight the role of systemic and local inflammation in acute coronary syndromes, to provide a summarized overview of the possible medical strategies applicable in selected cases and to underline the diagnostic and prognostic potential of multimodality imaging.

IMMEDIATE AND 4-YEAR OUTCOME OF PATIENTS WITH ACUTE CORONARY SYNDROME UNDERGOING PERCUTANEOUS CORONARY INTERVENTION FOR LEFT MAIN CORONARY ARTERY DISEASE

2021 ◽  
pp. 8-11
Author(s):  
Saroj Mandal ◽  
Sidnath Singh ◽  
Kaushik Banerjee ◽  
Aditya Verma ◽  
Vignesh R.
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Ejection Fraction ◽  
Coronary Intervention ◽  
Left Ventricular Ejection ◽  
Coronary Syndrome ◽  
Percutaneous Coronary ◽  
The Mean

Background: The treatment of LMCAD has shifted from coronary artery bypass grafting (CABG) to Percutaneous coronary intervention (PCI). However, data on long-term outcomes of PCI for LMCA disease, especially in patients with acute coronary syndrome (ACS) remains limited and conicting. This study aims to nd the association of the immediate and 4-year mortality in ACS patients with LMCA disease treated by PCI based on ejection fractions at admission. Methods: A retrospective analytical study was conducted. Patients were divided at admission into those with reduced left ventricular ejection fraction and those with preserved ejection fraction. Results: Forty (58.8%) of the patients presented with preserved EF. The mean age of the patients was 71.6±7.1 years. The mean LVEF of the preserved group was 61.6±4.3% and signicantly higher than that of the reduced group. Age and cardiovascular risk factor prole was similar between the two groups. Patients with reduced ejection fraction had signicantly higher levels of serum creatinine and signicantly lower levels of Hb and HDL. Mean hospital stay was signicantly longer for patients with preserved EF. In-hospital deaths were also similar between the two groups. The reduced EF group had a signicantly higher allcause mortality in the 4-year follow-up period. The mean years of follow-up for all participants was 4.2±1.3 years. Conclusion: It was seen that in patients presenting with ACS and undergoing PCI due to LMCAD, LVEF at admission, singly and in in multivariate regression is an important predictor of in hospital and 4-year mortality

scholarly journals Clozapine-Induced Myocarditis or Acute Coronary Syndrome? Optical Coherence Tomography to the Rescue

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Ayodeji Dina ◽  
Peter Barlis ◽  
William van Gaal
Keyword(s):  
Acute Coronary Syndrome ◽  
Patient Outcomes ◽  
Myocardial Perfusion Scintigraphy ◽  
Underlying Mechanism ◽  
Perfusion Scintigraphy ◽  
Troponin Elevation ◽  
X Ray ◽  
Coronary Syndrome ◽  
Coronary Syndromes ◽  
Chest X Ray

Chest pain and troponin elevation may be due to an acute coronary syndrome, myocarditis, acute cardiomyopathy, or other less common conditions. Management differs depending on the aetiology, and the pathophysiologic diagnosis has direct implications on treatment and patient outcomes. History and clinical examination is supplemented by selected investigations including the electrocardiogram, chest X-ray, echocardiography, coronary angiography, and even myocardial perfusion scintigraphy or cardiac magnetic resonance imaging. Intravascular imaging can provide important insights into the underlying mechanism of acute coronary syndromes, especially when angiography is ambiguous.

scholarly journals A comparative study of serum adiponectin levels in patients of acute coronary syndrome with and without central obesity

2019 ◽  
Vol 6 (1) ◽  
pp. 66
Author(s):  
Shashank R. Tiwari ◽  
Lokesh S. ◽  
Arunprasath P. ◽  
Arun Kumar R.
Keyword(s):  
Acute Coronary Syndrome ◽  
Central Obesity ◽  
Adiponectin Level ◽  
Serum Adiponectin ◽  
South Indian Population ◽  
Coronary Syndrome ◽  
South Indian ◽  
Tertiary Center ◽  
The Mean ◽  
First Time

Background: Coronary artery disease burden has been on a rise globally with it emerging as the principle cause of death even in the Indian subcontinent. Serum adiponectin has recently gained interest due to its close relation with atherosclerotic CAD and Metabolic syndrome. The levels of serum adiponectin are reduced in ACS. There is a paucity of studies in South Indian population comparing the effect of central obesity in patient with ACS. The aim of the present endeavour was to study the association of serum adiponectin in risk evaluation of patient with acute coronary syndrome with and without central obesityMethods: The study was conducted in a tertiary center in patient who presented with first time ACS they were grouped into two groups based on the presence and absence of central obesity. Central obesity was defined on the basis of waist to hip ratio. Serum adiponectin levels were estimated in both the groups using ELISA method. The results were statistically analyzed using t- test.Results: Authors concluded that the mean age of patients presenting first time with ACS was 55±12years in both the group. There was a significantly raised LDL and Total Cholesterol (TC) level in patient with central obesity. The estimated serum adiponectin level was reduced in both the group with more significant reduction in group with central obesity. The mean adiponectin level in CAD patients with central obesity was 2.326±1.437µg/ml as compared to 3.486±1.6999μg/ml in patients without central obesity, which was statistically significant (p value <0.0049).Conclusions: Authors concluded that serum adiponectin levels were reduced in both the group with ACS with a further reduction in patient with central obesity. It was also observed that there was a significant relation between adiponectin level and visceral fat as compared to superficial fat, as adiponectin was significantly reduced in patient higher waist-hip ratio.

scholarly journals Factors Affecting Nursing Ability To Know Acute Coroner Syndrome In Emergency Installation

2018 ◽  
Vol 2 (1) ◽  
pp. 64-72
Author(s):  
Agus Riyadi ◽  
Karmiati Karmiati
Keyword(s):  
Emergency Department ◽  
Acute Coronary Syndrome ◽  
Emergency Services ◽  
P Value ◽  
Cross Sectional ◽  
Factors Affecting ◽  
Research Education ◽  
Coronary Syndrome ◽  
Coronary Syndromes ◽  
Almost All

Background: Coronary heart disease is the most cardiovascular disease that causes death in the world. The ability of nurses to recognize acute coronary syndromes is very necessary as part of the emergency services team. Purpose : The purpose of this study was to determine the description of the factors that influence the ability of nurses to know acute coronary syndrome in the emergency department of dr. Iskak Tulungagung. Methods : The design of this research is descriptive analytic with a cross sectional approach with the population of all nurses who work in the Emergency Department of dr. Iskak Tulungagung. The population is 55 nurses. The sample is all of the population, namely 55 respondents with total sampling sampling techniques. The data that has been collected is processed by a statistical test of Multivariate Analysis, Ordinal Regression with significance α = 0.05. Result : The results showed that most of the respondents with D3 education were 33 respondents (60.0%), almost all respondents had never attended ECG training in the amount of 50 respondents (90.9%) and almost half of the respondents had a working period of 2-5 year is 25 respondents (45.5%). The results of the regression regression analysis showed that the p-value = 0.855 on the education factor which means that H0 was accepted, the p-value = 0.041 in the training factor which means H1 is received, the p-value = 0.003 on the working period, which means that H1 is accepted Conclusion : Based on research, education does not affect the ability to recognize acute coronary syndrome. The education obtained will develop according to the increase in the work period and the frequent training that is obtained and practiced directly in real situations

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