scholarly journals Multicap to improve adherence after acute coronary syndromes: results of a randomized controlled clinical trial

2020 ◽  
Vol 14 ◽  
pp. 175394472091207
Author(s):  
Javier Mariani ◽  
Andrés Rosende ◽  
Maximiliano De Abreu ◽  
Gabriel Gonzalez Villa Monte ◽  
Heraldo D’Imperio ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Blood Pressure ◽  
Heart Rate ◽  
Platelet Aggregation ◽  
Fixed Dose ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Adherence To Treatment ◽  
C Reactive Protein ◽  
Reactive Protein

Background: Adherence to treatment after a myocardial infarction (MI) is poor, even in the early postinfarction period. Combining evidence-based drugs into a multicap could improve adherence in this population. No previous randomized trial assessing fixed-dose combination therapy has included patients early after a MI. We aimed to assess if a multicap containing four secondary prevention drugs increases adherence to treatment at 6 months after MI hospitalization. The study was designed as a randomized, parallel, open-label, controlled trial. Methods: Patients were randomized within 7 days of a MI to either multicap or control group. The multicap group received a capsule containing aspirin, atenolol, ramipril, and simvastatin. The control group received each drug in separate pills. The primary outcome was adherence at 6 months. We also measured blood pressure, heart rate, serum cholesterol levels, C-reactive protein, and platelet aggregation. Results: The study was stopped prematurely when 100 patients were included for futility. At 6 months, 92 (95.8%) patients were adherent to medical treatment: 98.0% in the multicap group and 93.5% in the control group [relative risk (RR) 1.05; 95% confidence interval (CI) 0.96–1.14; p = 0.347]. There were no differences between groups in systolic blood pressure ( p = 0.662), diastolic blood pressure ( p = 0.784), heart rate ( p = 0.533), total cholesterol ( p = 0.760), LDL-c ( p = 0.979), C-reactive protein ( p = 0.399), or in the proportion of patients with adequate platelet aggregation inhibition ( p = 0.600). Conclusions: The study did not find any improvement in the adherence at 6 months after a MI with a multicap-based strategy (Multicap for Increase Adherence After Acute Myocardial Infarction; [ ClinicalTrials.gov identifier: NCT02271178]).

scholarly journals The Effect of Eight Weeks of Massage on Blood Pressure, Heart Rate and C-Reactive Protein in Women With Hypertension

2020 ◽  
Vol 23 (3) ◽  
pp. 398-411
Author(s):  
Shahnaz Shahrjerdi ◽  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Control Group ◽  
Common Disease ◽  
Medical Sciences ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Massage Group ◽  
Quasi Experimental ◽  
And Control

Background and Aim: Hypertension is a common disease and universal that can cause cardiovascular disease and kidney damage. The purpose of this study was to determine the effect of an eight-weeks massage on blood pressure (systolic and diastolic), heart rate and C-reactive protein in women with hypertension.  Methods & Materials: In this quasi-experimental study, 44 volunteer women with Mean±SD age of 42.12±5.31years were selected from women referred to Arak Oil Company specialized polyclinic with hypertension. Four women excluded from the study for some reason, and the rest were divided into experimental and control groups. In massage group massage was done for three sessions per week, 45-60 minutes in each session, on the back and upper limbs for eight weeks. Data analysis was conducted using dependent and independent t-test by SPSS V. 25 statistical software at the significant level of (P≤0.05). Ethical Considerations: This study (Code: 92-160-26) was approved in Research Ethics Committee of Arak University of Medical Sciences. Results: The results showed that eight weeks of massage reduced blood pressure (P=0.001), the heart rate (P=0.001), and C-reactive protein (P=0.001) in women with hypertension compared to the control group (P=0.62). Conclusion: The findings of this study showed that massage for eight weeks is an efficient and appropriate method to improve systolic and diastolic blood pressure, heart rate, and C-reactive protein in patients with hypertension.

Abstract 5393: Increased C-Reactive Protein Expression Exacerbates Left Ventricular Dysfunction and Remodeling after Myocardial Infarction

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Toshiyuki Takahashi ◽  
Toshihisa Anzai ◽  
Hidehiro Kaneko ◽  
Atsushi Anzai ◽  
Yoshinori Mano ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Angiotensin Ii ◽  
Left Ventricular ◽  
Receptor Expression ◽  
Border Zone ◽  
Histological Evaluation ◽  
Control Group ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Lv Remodeling

We have previously reported that elevated serum C-reactive protein (CRP) level after acute myocardial infarction (MI) is associated with adverse outcomes including cardiac rupture, left ventricular (LV) remodeling and cardiac death. Recent experimental studies have shown that CRP per se has some biological properties including proinflammatory and proapoptotic effects, suggesting a pathogenetic role of CRP in the remodeling process after MI. We tested the hypothesis that increased CRP expression would exacerbate adverse LV remodeling after MI through some deleterious effects of CRP. Transgenic mice with human CRP expression (CRP-Tg) and their nontransgenic littermates (Control) underwent proximal ligation of the left coronary artery. Despite increased serum CRP level and cardiac CRP expression in CRP-Tg mice, there was no difference in phenotype between CRP-Tg and control mice before MI. Mortality at five weeks after MI was not different between groups (CRP-Tg: 49%, n=35; Control: 38%, n=40, P =0.28). Five weeks after MI, echocardiography showed that CRP-Tg mice had more LV dilation (LVEDD, CRP-Tg: 5.8 ± 0.1 mm, n=14; Control: 5.2 ± 0.1 mm, n=17, P =0.002) and worse LV function (EF, CRP-Tg: 13 ± 2%, n=14; Control: 19 ± 1%, n=17, P =0.01). Hemodynamic studies indicated that LV +dP/dt (CRP-Tg: 2,947 ± 480 mmHg/s, n=9; Control: 3,788 ± 656 mmHg/s, n=10, P =0.02) and -dP/dt (CRP-Tg: −2,230 ± 48 mmHg/s, n=9; Control: −2,890 ± 161 mmHg/s, n=10, P =0.003) were lower in the CRP-Tg group than in the Control group, although infarct size was comparable. Histological evaluation at one week after MI showed a higher rate of apoptosis in the border zone of infarcted hearts from CRP-Tg mice (CRP-Tg: 1,434 ± 322 per 10 5 nuclei; Control: 596 ± 112 per 10 5 nuclei, n=6 for each, P =0.03). Quantitative RT-PCR showed that angiotensin II type 1a receptor and interleukin-6 were upregulated in viable LV samples from CRP-Tg mice compared with controls. Increased CRP expression exacerbates LV dysfunction and remodeling after MI, associated with increased apoptotic rates, increased angiotensin II receptor expression and exaggerated inflammatory response.

scholarly journals Plasma Level of High-Sensitive C-Reactive Protein in Patients with Acute Myocardial Infarction and Arterial Hypertension

2017 ◽  
Vol 23 (1) ◽  
Author(s):  
Wael Rumaneh
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Plasma Level ◽  
Arterial Hypertension ◽  
Ventricular Remodeling ◽  
Left Ventricular ◽  
Control Group ◽  
Blood Levels ◽  
C Reactive Protein ◽  
Reactive Protein

Arterial hypertension is an independent predictor of acute myocardial infarction. Nowadays, plasma level of high-sensitive C-reactive protein is a marker of cardiovascular risk. The objective of the research was to evaluate plasma level of high-sensitive C-reactive protein in patients with acute myocardial infarction and arterial hypertension depending on myocardial remodeling type. Materials and methods. 130 patients with myocardial infarction (63 individuals with concomitant arterial hypertension and 67 individuals without it) were observed. Transthoracic echocardiogram was used. To evaluate plasma level of high-sensitive C-reactive protein the ELISA method was applied. Results. Plasma level of high-sensitive C-reactive protein in patients with acute myocardial infarction increased by 5.11 times compared to the control group: (10.67 [5.43; 12.89]) mg/l and (2.09 [1.40; 4.60]) mg/l, respectively (p<0.001). In myocardial infarction and arterial hypertension, this parameter increased by 6.57 times (to (13.73 [7.05; 15.17]) mg/l) (p<0.001), and by 1.27 times (p<0.05) as compared to patients without arterial hypertension. No differences in plasma level of high-sensitive C-reactive protein were detected in patients with different types of left ventricular remodeling.Conclusions. Acute myocardial infarction caused by high plasma level of high-sensitive C-reactive protein is severer in co-existent arterial hypertension. There are no differences in blood levels of high-sensitive C-reactive protein depending on the type of left ventricular remodeling.

scholarly journals Cytokine status in patients with myocardial infarction as a possible predictor of coronary atherosclerosis severity

2020 ◽  
Vol 19 (3) ◽  
pp. 2316
Author(s):  
O. V. Khlynova ◽  
E. A. Shishkina ◽  
N. I. Abgaryan
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Coronary Atherosclerosis ◽  
Enzyme Linked Immunosorbent Assay ◽  
Control Group ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Coronary Artery Atherosclerosis ◽  
Tnf Α ◽  
Atherosclerosis Severity

Aim. To study the association of cytokine status with coronary atherosclerosis severity in patients with myocardial infarction (MI).Material and methods. Between 11.2018 and 07.2019, 92 patients hospitalized with MI in Perm Clinical Cardiology Dispensary were included in the study. The control group consisted of 23 patients with stable coronary artery disease. In addition to the standard examination, enzyme-linked immunosorbent assay was used to determine the levels of interleukins (IL)-6, -10, tumor necrosis factor alpha (TNF-α), C-reactive protein.Results. Significant increase in plasma IL-6, TNF-α and C-reactive protein levels in MI patients compared with the control group. The increase in the concentration of IL-6, TNF-α, as well as the IL-6/IL-10 ratio occurs in proportion to coronary atherosclerosis severity. A direct correlation of Gensini score with IL-6, TNF-α, and IL-6/IL-10 ratio was established.Conclusion. Further study of cytokine profile parameters in MI patients will help a clearer understanding pathogenesis of coronary artery atherosclerosis. An increase in concentrations of IL-6, TNF-α, and IL-6/IL-10 ratio is associated with an increase in coronary atherosclerosis severity and can be used in practice for its prediction.

scholarly journals Evolutionary and prognostic implications in patient with acute coronary syndrome and dysthyroidism

2021 ◽  
Vol 16 (2) ◽  
pp. 225-233
Author(s):  
Eleonora DRĂGAN ◽  
◽  
Maria Suzana GUBERNA ◽  
Cătălina Liliana ANDREI ◽  
Crina-Julieta SINESCU ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Blood Pressure ◽  
Acute Coronary Syndrome ◽  
Heart Disease ◽  
C Reactive Protein ◽  
St Segment Elevation ◽  
Reactive Protein ◽  
Coronary Syndrome ◽  
St Segment

Purpose. The study aims to determine the impact of dysthyroidism on the severity and type of coronary lesion, on vascular function, as well as on the morbidity and mortality of patients with acute coronary syndrome, by finding predictive markers that can be translated into preventive measures that contribute substantially to reduce the number of newly diagnosed patients with coronary heart disease. Methods. We introduced in the study 100 patients recently diagnosed with acute coronary syndrome, without history of ischemic heart disease or thyroid disease, hospitalized in the Cardiology Clinic of the “Bagdasar-Arseni“ Emergency Clinical Hospital Bucharest, for the interventional treatment of acute coronary syndrome. The studied patients were hospitalized between November 2014 and April 2015, with regular follow-up of up to 5 years (telephone or direct interview, conducted at 6 months, 12 months, 24 months, 36 months, 48 months, 60 months), with an average period follow-up of 1006 days, evaluated clinically, bio-humorally, by echocardiography, explored with coronary angiography with the calculation of the SYNTAX score and with the performance of electrocardiogram and pulse wave. The obtained data were integrated in Excel sheets and statistically processed with the Python program. Results. The mortality rate in the patient group was 7% (7 deaths). Descriptively, of the deceased, 6 patients (86%) were male, and as thyroid status 1 hyperthyroid patient (14%), 3 hypothyroid patients (43%) and 3 patients (43%) normothyroid. There were 4 deaths (8%) in the group of patients with unstable angina and 3 deaths (8%) in the group of patients with myocardial infarction without ST-segment elevation. There were no deaths in the group of patients with acute myocardial infarction with ST-segment elevation. At follow-up, 41 patients (41%) were readmitted. Re-hospitalization was influenced by elevated values of mean blood pressure, diastolic blood pressure and C-reactive protein, unicoronary atherosclerotic disease and unstable angina at admission. At follow-up, the development of noncardiac events was noted in the evolution of patients, diabetes mellitus occurring in the majority, in almost a quarter of patients (22 patients, respectively 24% developed diabetes over time), 34% (19 patients) in euthyroidism and 8% (3 patients) dysthyroidism. Discussions. Predictive factors for the readmission of the patient with acute coronary syndrome are highlighted the following: increased level of C-reactive protein (p = 0.017), tricoronary vascular damage (p = 0.01), diastolic blood pressure greater than 80 mmHg (p = 0.025), and euthyroid status (p = 0.04). The probability of death for the patient with acute coronary syndrome rises to 66% in the presence of severe systolic dysfunction of the left ventricle (p = 0.006), and to 61% in the case of elevated values of hs troponin I (p = 0.008). In our study, the presence of dysthyroidism in the patient with acute coronary syndrome has a protective role in the development of diabetes in the first 5 years (p = 0.025). Conclusion. Dysthyroidism is associated with increased morbidity and mortality from cardiovascular disease.

Serum Endothelial Cell–Specific Molecule 1 (Endocan) Levels in Patients With Acute Myocardial Infarction and Its Clinical Significance

Angiology ◽  
2016 ◽  
Vol 68 (4) ◽  
pp. 354-359 ◽  
Author(s):  
Chong-Rong Qiu ◽  
Qiang Fu ◽  
Jian Sui ◽  
Qian Zhang ◽  
Peng Wei ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Endothelial Cell ◽  
Endothelial Dysfunction ◽  
High Sensitivity ◽  
Control Group ◽  
C Reactive Protein ◽  
Protein Levels ◽  
Reactive Protein ◽  
The Relationship

Endothelial dysfunction is involved in the process of acute myocardial infarction (AMI), that is, the endothelial cell–specific molecule 1 (ESM-1; endocan) is a novel endothelial dysfunction marker. However, the relationship between patients with AMI and serum ESM-1 levels is not very clear. Patients with AMI (n = 216) and a control group (n = 60) without AMI were included in the study. High-sensitivity C-reactive protein (hsCRP) was measured, and the severity of AMI was assessed by a modified Gensini stenosis scoring system. Serum ESM-1 levels were significantly higher in the AMI group ( P < .05). High-sensitivity C-reactive protein levels were also significantly higher in the AMI group ( P < .05). In patients with AMI, serum ESM-1 levels were not significantly correlated with hsCRP levels. There was no significant correlation between serum ESM-1 level and Gensini score. Our findings suggest that serum ESM-1 levels may be a novel biomarker of endothelial dysfunction in patients with AMI.

scholarly journals Detection and Optimization of Cardiac Markers Based on High Sensitivity C-Reactive Protein

2020 ◽  
Vol 9 (1) ◽  
pp. 9
Author(s):  
Dai Chen
Keyword(s):  
Myocardial Infarction ◽  
High Sensitivity ◽  
Healthy People ◽  
Detection Methods ◽  
Practical Significance ◽  
Control Group ◽  
Cardiac Markers ◽  
C Reactive Protein ◽  
Optimal Method ◽  
Reactive Protein

Cardiac markers play an important role in prognosis and follow-up treatment. Therefore, it is of great practical significance to study the detection methods of high-sensitivity C-reactive protein cardiac markers. The purpose of this paper is to study the optimal method for the detection of cardiac markers of high-sensitivity C-reactive protein. In this paper, the significance of cardiac markers and high-sensitivity C-reactive protein and the relationship between them and myocardial infarction were first described. The BCA method for the purification and identification of C-reactive protein was studied, and then the determination and optimization of high-sensitivity C-reactive protein and high-sensitivity C-reactive protein in healthy people were further understood. To explore the application of serum high sensitive C-reactive protein in the detection of cardiac markers in 50 patients with acute myocardial infarction and 50 healthy people. The results showed that the experimental group was (21.57 ± 1.50), (37.62 ± 1.66), (529.20 ± 5.72), (95.79 ± 6.24) ng / ml, the control group was (0.90 ± 1.10), (1.71 ± 0.14), (35.25 ± 4.21), (0.99 ± 0.71) ng / ml, and the difference between the two groups was statistically significant (P < 0.05).

scholarly journals Clinical and anamnestic characteristics of patients with non-ST elevation myocardial infarction after COVID-19

2021 ◽  
Vol 20 (7) ◽  
pp. 3062
Author(s):  
M. G. Chashchin ◽  
A. Yu. Gorshkov ◽  
O. M. Drapkina ◽  
I. V. Kositsyna ◽  
A. V. Golubev ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Troponin I ◽  
St Elevation Myocardial Infarction ◽  
Control Group ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Exertional Angina ◽  
History Of ◽  
St Elevation ◽  
Experimental Group

Aim. To study clinical, medical history and paraclinical characteristics of patients with non-ST elevation myocardial infarction (NSTEMI) after coronavirus disease 2019 (COVID-19).Material and methods. The study included 209 patients with NSTEMI who were admitted to the Demikhov City Clinical Hospital (Moscow). The patients were divided into 2 groups: the experimental one (n=104)  — those after COVID-19, the control one (n=105)  — those without history of COVID-19. All patients underwent routine diagnostic investigations in accordance with current standards and clinical guidelines.Results. The mean age of patients in the experimental group was 61,8±12,2 years, while in the control one — 69,0±13,0 years (p<0,0001). Myocardial infarction developed 49 days [34.0; 82.0] after COVID-19. Prior exertional angina was observed in 76,9% of patients in the experimental group and in 88,6% in the control one (χ2 =4,97; p=0,0258). The level of C-reactive protein in the experimental group was 19,2 mg/l [4,9; 53,0], and in the control one — 5,6 mg/l [0,4; 21,8] (p=0,0007). The average troponin I level in the experimental group was 2,7 ng/ml [1,3; 8,0], while in the control one — 1,8 ng/ml [0,8; 3,5] (p=0,0091).Conclusion. Patients with NSTEMI after COVID-19 were significantly younger compared to patients without a history of COVID-19. They had less common exertional angina prior to MI, while C-reactive protein and troponin I levels were significantly higher than in the control group. In addition, in NSTEMI patients after COVID-19, the estimated pulmonary artery systolic pressure was significantly higher compared to patients without a history of COVID-19.

scholarly journals Galectin-3 in Acute Myocardial Infarction Patients with Atrial Fibrillation

2019 ◽  
Vol 28 (3) ◽  
pp. 284-290 ◽  
Author(s):  
Dragana Stanojevic ◽  
Svetlana Apostolovic ◽  
Dragana Stokanovic ◽  
Stefan Momčilović ◽  
Tatjana Jevtovic-Stoimenov ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Atrial Fibrillation ◽  
Acute Myocardial Infarction ◽  
Venous Blood ◽  
Control Group ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Galectin 3 ◽  
Predictive Role

Objective: Atrial fibrillation (AF) is common in acute myocardial infarction (AMI), and galectin-3 is possibly involved in its occurrence. Galectin-3 has been shown to play a central role in fibrosis and tissue remodeling and has a role in inflammatory and proliferative responses. The aim of our study was to measure galectin-3 levels in patients with myocardial infarction and to compare its levels in patients with or without AF, in order to investigate the potential predictive role of galectin-3 in this setting. Subjects and Methods: The study included 51 consecutive AMI patients with AF; 27 AMI patients (52.9%) had permanent/persistent AF, and 24 patients (47.1%) had paroxysmal AF. Thirty-eight consecutive AMI patients without AF were used as a control group. Blood samples were obtained from venous blood on the third day after reperfusion. Results: Patients with AF had higher levels of C-reactive protein (p < 0.01) and galectin-3 (p < 0.05) than those without AF. Patients with high galectin-3 had 4.4 times greater odds of having AF. Galectin-3 levels were lower in patients without AF (p < 0.01) than in those with permanent/persistent AF. Conclusion: AMI patients with AF had higher levels of galectin-3 than those without this arrhythmia. This biomarker of inflammation and fibrosis could be a potential target for treating AMI patients at high risk.

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