Abstract 13417: Impact of Sex on the Prognostic Value of Galectin-3 in Patients With Suspected or Known Coronary Artery Disease: The ANOX Study

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Hiromichi Wada ◽  
Kazuhiko Kotani ◽  
masahiro suzuki ◽  
Morihiro Matsuda ◽  
Yoichi Ajiro ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Prognostic Value ◽  
Prognostic Information ◽  
Standard Deviation Increase ◽  
Entire Cohort ◽  
Galectin 3 ◽  
Artery Disease ◽  
Using Data ◽  
The Impact

Background: High circulating levels of galectin-3 are associated with all-cause mortality, cardiovascular (CV) mortality, and/or major adverse CV events (MACE) in patients with CV diseases such as heart failure and coronary artery disease (CAD). However, the impact of sex on the prognostic value of galectin-3 in patients with suspected or known CAD remains unclear. Methods: Using data from a multicenter, prospective cohort of 2418 patients with suspected or known CAD, we assessed the impact of sex on the association between galectin-3 levels and the risks of all-cause death, CV death, and MACE defined as a composite of CV death, nonfetal myocardial infarction, and nonfetal stroke. Galectin-3 was measured in 1624 men and 794 women enrolled in the ANOX Study. Patients were followed up over 3 years. Results: The mean ages (standard deviations) were 69.8 (10.6) years in men and 72.2 (9.9) years in women ( P <0.001). Men exhibited significantly lower levels of galectin-3 compared to women (median [interquartile range], 9.0 [6.9-11.9] versus 9.6 [7.3-12.4] ng/mL, respectively; P =0.004). In the entire patient cohort, the galectin-3 level was significantly associated with all-cause death (hazard ratio per 1 standard deviation increase [HR], 1.28; 95% confidence interval [CI], 1.16-1.42), CV death (HR, 1.24; 95% CI, 1.04-1.46), and MACE (HR, 1.24; 95% CI, 1.09-1.41) after adjusting for potential clinical confounders. These associations were still significant in women (HR for all-cause death, 1.59; 95% CI, 1.26-1.98; HR for CV death, 1.53; 95% CI, 1.06-2.21; HR for MACE, 1.61; 95% CI, 1.21-2.09), whereas in men, galectin-3 was significantly associated with all-cause death (HR, 1.23; 95% CI, 1.08-1.39), but not with CV death (HR, 1.14; 95% CI, 0.93-1.40) or MACE (HR, 1.15; 95% CI, 0.99-1.35). Furthermore, galectin-3 provided incremental prognostic information for all-cause death, but not for CV death or MACE, to the model with potential clinical confounders and the established CV biomarkers in the entire cohort and in women, but not in men. Conclusions: We identified a significantly stronger prognostic value of galectin-3 in women than in men among patients with suspected or known CAD.

Abstract 18682: Inflammatory Biomarkers for Prognostication of Outcomes in Stable Coronary Artery Disease - Experiences From the STABILITY Trial

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Claes Held ◽  
Harvey D White ◽  
Ralph A Stewart ◽  
Andrzej Budaj ◽  
Christopher P Cannon ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Medical Treatment ◽  
Cox Regression ◽  
Stable Coronary Artery Disease ◽  
Cardiac Biomarkers ◽  
Prognostic Information ◽  
Hs Crp ◽  
Artery Disease ◽  
The Impact

Introduction: Prognostication of outcome in patients with stable coronary artery disease (CAD) is currently based on clinical characteristics and biomarkers indicating dysglycemia, dyslipidemia, renal dysfunction and possibly cardiac biomarkers. Hypothesis: We assessed the incremental prognostic value of biomarkers of inflammation in the Stabilization of Atherosclerotic Plaque By Initiation of Darapladib Therapy (STABILITY) trial. Methods: In STABILITY, 15,828 patients with chronic CAD on optimal medical treatment were randomized to treatment with darapladib or placebo. Serum levels of hs-C-reactive protein (CRP) and Interleukin (IL)-6 were measured at randomization in 14,373 and 4733 patients, respectively. Centrally adjudicated outcome events were accumulated during a median of 3.7 years follow-up. The associations between levels of the biomarkers and outcomes were evaluated by multivariable Cox regression. Results: The impact of biomarker levels at baseline in relation to the composite endpoint, MACE (major adverse cardiovascular event), of cardiovascular (CV) death, myocardial infarction (MI) and stroke, and its individual components are presented in the Table. Both hs-CRP and IL-6 provided strong prognostic information in addition to clinical predictors for outcomes of MACE, CV death and MI, but not for stroke. Conclusions: In conclusion, the cardiac biomarkers hs-CRP and IL-6, provided important complementary prognostic information on the risk of CV mortality and MI, but not for stroke in patients with stable CAD on optimal medical treatment.

scholarly journals New biochemical predictor of the ventricular tachyarrhythmias in patients with ischemic cardiomyopathy

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
T Atabekov ◽  
R Batalov ◽  
S Sazonova ◽  
S Gusakova ◽  
S Krivolapov ◽  
...  
Keyword(s):  
Heart Failure ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Prognostic Value ◽  
Ischemic Cardiomyopathy ◽  
Roc Analysis ◽  
Ventricular Tachyarrhythmias ◽  
Icd Implantation ◽  
Galectin 3 ◽  
Artery Disease

Abstract Funding Acknowledgements Type of funding sources: None. Introduction. The cardioverter-defibrillator (ICD) implantation is the most effective method for the sudden cardiac death (SCD) prevention. However, about 25% patients did not receive an ICD therapy during the first 5-years follow-up. At the same time ICD does not register ventricular tachyarrhythmias (VTA) events in patients with ICD implanted for the primary prevention of SCD. So, it’s necessary to find out new prognostic markers of the VTA incidence, which will help to optimize the selection of patients who really need an ICD implantation. Currently, ST-2 and galectin-3 are actively studied in patients with coronary artery disease (CAD) and chronic heart failure due to their high potential prognostic value. Moreover, their role in the development of life-threatening arrhythmias is still poorly understood. In this regard, the study of the level of biomarkers of inflammation and myocardial fibrosis is relevant. Aim. To evaluate the prognostic value of the ST-2 and galectin-3 in VTA predicting in patients with coronary artery disease and left ventricular ejection fraction less than 35 %. Material and methods. The study included 40 patients (males – 36, median age – 64,5 [57,5; 68,5] years) with CAD, II and III functional class of chronic heart failure, left ventricle ejection fraction less than 35 % and ICD implantation indications (primary prevention of the SCD). ST-2 and galectin-3 blood concentration were determined before ICD implantation. All patients were followed-up during 18 months. There were assessed arrhythmological events recorded in ICD memory and ICD-lead parameters. Results. The 1st group consisted of 10 (25,0 %) patients with VTA events terminated with ICD antitachycardia pacing or shock, the 2nd group – 30 (75,0 %) patients without VTA events. The univariate ROC-analysis showed that the high values of the ST-2 (p = 0,003) and galectin-3 (p = 0,045) were associated with frequent VTA events. Kaplan-Meier analysis showed that the ST-2 &gt; 22,48 ng/ml (p = 0,02) and galectin-3 &gt; 10,95 ng/ml (p = 0,009) significantly increase the risk of the VTA events. The multivariate ROC-analysis showed that only ST-2 increase (OR = 1,1053; CI 95 %: 1,0134-1,2056; р = 0,023) leaded to frequent VTA events. Conclusion. An increase of ST-2 more than 22,48 ng/ml and galectin-3 more than 10,95 ng/ml has predictive value in VTA assessing risk in patients with ischemic cardiomyopathy. In multivariate analysis, an independent predictor of VTA is the ST-2 increase more than 22,48 ng/ml.

scholarly journals The impact of renal function on the prognostic value of N-terminal pro–B-type natriuretic peptide in patients with coronary artery disease

2020 ◽  
Vol 26 (6) ◽  
pp. 696-703
Author(s):  
Fei Chen ◽  
Jia-qi Li ◽  
Yuan-Wei-Xiang Ou ◽  
Tian-li Xia ◽  
Fang-yang Huang ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Renal Function ◽  
Coronary Artery ◽  
Natriuretic Peptide ◽  
Prognostic Value ◽  
Artery Disease ◽  
The Impact

Abstract 14103: Impact of Chronic Kidney Disease on the Association of Cardiovascular and Renal Biomarkers With the Presence and Severity of Coronary Artery Disease in Patients With Suspected Coronary Artery Disease: The EXCEED-J Study

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Hiromichi Wada ◽  
Tsuyoshi Shinozaki ◽  
masahiro suzuki ◽  
Satoru Sakagami ◽  
Yoichi Ajiro ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Chronic Kidney Disease ◽  
Coronary Artery ◽  
Growth Factor ◽  
Serum Levels ◽  
Gensini Score ◽  
Entire Cohort ◽  
Renal Biomarkers ◽  
Artery Disease ◽  
The Impact

Background: The impact of chronic kidney disease (CKD) on the association of cardiovascular (CV) and renal biomarkers with the presence and severity of coronary artery disease (CAD) in patients with suspected CAD are unclear. Methods: Using data from a multicenter, prospective cohort of 2324 patients with suspected but no history of CAD undergoing elective coronary angiography, we assessed the impact of CKD on the association of CV and renal biomarkers with the presence and severity of CAD. Heparin-free fasting serum levels of soluble vascular endothelial growth factor (VEGF) receptor-1 (sFlt-1), VEGF, placental growth factor (PlGF), N-terminal pro-brain natriuretic peptide (NT-proBNP), contemporary sensitive cardiac troponin-I (cTnI), high-sensitivity CRP (hs-CRP), cystatin C, and neutrophil gelatinase-associated lipocalin (NGAL) were measured in 887 CKD and 1437 non-CKD patients enrolled in the EXCEED-J study. The severity of CAD was quantified using the Gensini score. Results: The mean age (standard deviation) of the patients was 69.8 (10.8) years; 65.6% were men. Serum levels of all biomarkers except PlGF were significantly higher in CKD than in non-CKD patients. In the entire patient cohort, only natural log-transformed (Ln-) cTnI was significantly associated with CAD, multi-vessel or left main trunk disease (MVD/LMTD), and Ln-Gensini score after adjustment for potential confounders. These associations were still significant in non-CKD, but not in CKD: Ln-cTnI was significantly associated with MVD/LMTD and Ln-Gensini score, but not with CAD. Stepwise regression analyses including potential confounders and all biomarkers revealed that Ln-cTnI was independently associated with CAD, MVD/LMTD, and Ln-Gensini score in the entire cohort and in non-CKD, but not in CKD: Ln-cTnI was independently associated with MVD/LMTD and Ln-Gensini score, but not with CAD. No other biomarker exhibited an independent association with CAD, MVD/LMTD, or Ln-Gensini score in the entire cohort, in non-CKD, or in CKD. Conclusions: Among CV and renal biomarkers measured in this study, only Ln-cTnI was independently associated with the presence and severity of CAD in patients with suspected CAD. These associations were attenuated in patients with CKD.

Stress-induced Myocardial Ischaemia – Perfusion Contrast Echocardiography to Evaluate Presence and Severity of Coronary Artery Disease

2011 ◽  
Vol 7 (3) ◽  
pp. 172
Author(s):  
Benoy Nalin Shah ◽  
Roxy Senior ◽  
◽  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Myocardial Perfusion ◽  
Contrast Echocardiography ◽  
Evidence Base ◽  
Suspected Coronary Artery Disease ◽  
Ultrasound Contrast Agents ◽  
Prognostic Information ◽  
Non Invasive ◽  
Artery Disease

The development of stable transpulmonary ultrasound contrast agents (UCAs) has allowed the echocardiographic assessment of myocardial perfusion, a technique known as myocardial contrast echocardiography (MCE). MCE exploits the ultrasonic properties of UCAs, which consist of acoustically active gas-filled microspheres. These are intravascular agents that have a rheology similar to red blood cells and thus allow analysis of myocardial blood flow both at rest and after stress. The combined assessment of wall motion and myocardial perfusion provides significant diagnostic and prognostic information during stress echocardiography. Functional imaging tests, such as myocardial perfusion scintigraphy and stress cardiac magnetic resonance imaging, are also used for non-invasive assessment of coronary disease. The principal advantages of MCE are that it does not expose the patient to ionising radiation or radioactive pharmaceuticals, is not contraindicated in patients with an implanted metallic device or who suffer from claustrophobia and it can be performed at the bedside. The purpose of this article is to outline the physiological principles underpinning ischaemia testing with MCE before proceeding to review the evidence base for MCE in patients with known or suspected coronary artery disease.

The Impact of Smoking on Cardiovascular Outcomes and Comorbidities in Statin-treated Patients with Coronary Artery Disease: A Post hoc Analysis of the GREACE Study

2013 ◽  
Vol 11 (5) ◽  
pp. 779-784 ◽  
Author(s):  
Vasilios G. Athyros ◽  
Konstantinos Tziomalos ◽  
Niki Katsiki ◽  
Thomas D. Gossios ◽  
Olga Giouleme ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Cardiovascular Outcomes ◽  
Post Hoc Analysis ◽  
Artery Disease ◽  
Post Hoc ◽  
The Impact
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