scholarly journals Copeptin, myeloperoxidase and pro-adrenomedullin for acute coronary syndrome in patients with chronic kidney disease

2019 ◽  
Vol 28 (3) ◽  
pp. 173-183
Author(s):  
Jen Heng Pek ◽  
Stephanie Man Chung Fook-Chong ◽  
Jason Chon Jun Choo ◽  
Carol Hui Chen Tan ◽  
Ziwei Lin ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Acute Coronary Syndrome ◽  
Kidney Disease ◽  
Poor Performance ◽  
Cardiac Events ◽  
Cardiac Marker ◽  
Routine Testing ◽  
Coronary Syndrome ◽  
Diagnosis And Prognosis ◽  
Adverse Cardiac Events

Objectives:Copeptin, myeloperoxidase and pro-adrenomedullin have emerged as potential biomarkers for diagnosis and prognosis of acute coronary syndrome (ACS). However, their applicability in patients with chronic kidney disease (CKD) remains unknown as these patients were excluded from previous studies. Our objective was to determine the superior novel cardiac marker to predict 30-day and six-month adverse cardiac events (ACEs) defined as cardiac-related death, myocardial infarction and ventricular fibrillation.Methods:A prospective observational study was carried out. Patients were included if they presented to the emergency department with symptoms suggestive of ACS and had CKD as defined as a serum creatinine of more than 130 µmol/l. Copeptin, myeloperoxidase and pro-adrenomedulin assays were performed. Occurrence of ACE was traced from review of the patients’ case records and the registry of deaths.Results:A total of 724 patients were recruited: 60.6% were male and 68.6% were Chinese. The median age was 67 years. Among those recruited, 88.3% had CKD stages 4 and 5, with 33.5% on dialysis. The rates of ACE at 30 days and six months were 15.1% and 21.7%, respectively. All readings of the three biomarkers were not significantly different in patients with ACE compared with those without both at 30 days and six months. The areas under the curve for copeptin, myeloperoxidase and pro-adrenomedullin were 0.53, 0.50 and 0.45, respectively ( p > 0.05).Conclusions:The poor performance of the biomarkers may be attributable to lack of specificity for ACS, as elevated levels could be from other causes in CKD patients. Routine testing cannot be recommended.

scholarly journals The Role of Neutrophil Lymphocyte Ratio as a Major Adverse Cardiac Events Predictor and Its Correlation with Coronary Severity in Acute Coronary Syndrome Patients with Chronic Kidney Disease: A Case Control and Cross-Sectional Study

2021 ◽  
Vol 9 (B) ◽  
pp. 1758-1763
Author(s):  
Suzanna Immanuel ◽  
Eka Ginanjar ◽  
Fahrani Imanina Putri Nurtyas ◽  
Ninik Sukartini ◽  
Yusra Yusra ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Acute Coronary Syndrome ◽  
Case Control ◽  
Gensini Score ◽  
Cardiac Events ◽  
Cross Sectional ◽  
Neutrophil Lymphocyte Ratio ◽  
Coronary Syndrome ◽  
Adverse Cardiac Events

BACKGROUND: Acute coronary syndrome (ACS) patients with chronic kidney disease (CKD) are known to have a higher risk of mortality compared to ACS patients without CKD. In ACS patients with CKD, chronic inflammation plays an important role in morphological and functional changes in endothelial cells, resulting in atherosclerosis acceleration associated with coronary severity that leads to an increase in major adverse cardiac events (MACE). AIM: Therefore, this study aims to determine the role of neutrophil lymphocyte ratio (NLR) as a predictor of MACE and its correlation with coronary severity in ACS patients with CKD. METHODS: The study was conducted at National General Hospital Cipto Mangunkusumo Jakarta, Indonesia in October to November 2019. We used quota sampling with two designs study. First, a nested case control study was conducted with a total of 59 ACS patients with CKD: 31 subjects who had experienced MACE as a case group and 28 subjects who had not experienced MACE as a control group. Second, a correlative study with a cross-sectional approach was undertaken. RESULTS: There was no significant difference or relationship between NLR and MACE (p > 0.05; OR = 2.16 [95% CI = 0.63–7.51]), also no correlation between NLR and coronary severity degree assessed using the Gensini score (r = 0.10; p = 0.474). CONCLUSION: NLR can not predict MACE in ACS patients with CKD nor be employed interchangeably with the Gensini score in assessing coronary severity in ACS patients with CKD.

A PILOT STUDY: PLASMA GALECTIN-3 LEVEL IN HEART FAILURE PATIENTS

2017 ◽  
pp. 101-106
Author(s):  
Thi Thanh Hien Bui ◽  
Hieu Nhan Dinh ◽  
Anh Tien Hoang
Keyword(s):  
Heart Failure ◽  
Chronic Kidney Disease ◽  
Acute Coronary Syndrome ◽  
Kidney Disease ◽  
Heart Failure Patients ◽  
Coronary Syndrome ◽  
Nyha Classification ◽  
Galectin 3 ◽  
Severe Chronic Kidney Disease ◽  
Esc Guidelines

Background: Despite of considerable advances in its diagnosis and management, heart failure remains an unsettled problem and life threatening. Heart failure with a growing prevalence represents a burden to healthcare system, responsible for deterioration of patient’s daily activities. Galectin-3 is a new cardiac biomarker in prognosis for heart failure. Serum galectin-3 has some relation to heart failure NYHA classification, acute coronary syndrome and clinical outcome. Level of serum galectin-3 give information for prognosis and help risk stratifications in patient with heart failure, so intensive therapeutics can be approached to patients with high risk. Objective: To examine plasma galectin-3 level in hospitalized heart failure patients, investigate the relationship between galectin-3 level with associated diseases, clinical conditions and disease progression in hospital. Methodology: Cross sectional study. Result: 20 patients with severe heart failure as NYHA classification were diagnosed by The ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure (2012) and performed blood test for serum galectin-3 level. Increasing of serum galectin-3 level have seen in all patients, mean value is 36.5 (13.7 – 74.0), especially high level in patient with acute coronary syndrome and patients with severe chronic kidney disease. There are five patients dead. Conclusion: Serum galectin-3 level increase in patients with heart failure and has some relation to NYHA classification, acute coronary syndrome. However, level of serum galectin-3 can be affected by severe chronic kidney disease, more research is needed on this aspect Key words: Serum galectin-3, heart failure, ESC Guidelines, NYHA

scholarly journals Relation of Functional Activity of Platelets to Prognosis of Unfavorable Cardiovascular Events in Patients with Acute Coronary Syndrome. Results of a Registry Study

Kardiologiia ◽  
2019 ◽  
Vol 59 (10) ◽  
pp. 5-13
Author(s):  
N. V. Lomakin ◽  
L. I. Buryachkovskaya ◽  
A. B. Sumarokov ◽  
Z. A. Gabbasov ◽  
A. N. Gerasimov
Keyword(s):  
Chronic Kidney Disease ◽  
Acute Coronary Syndrome ◽  
Platelet Aggregation ◽  
Kidney Disease ◽  
Functional Activity ◽  
Cardiovascular Events ◽  
Platelet Reactivity ◽  
Coronary Syndrome ◽  
C Statistic

Aim: to assess relation ofhigh functional activity ofplatelets to prognosis ofunfavorable cardiovascular events in patients with Acute Coronary Syndrome (ACS).Materials. The study was based on the data of a single center ACS registry conducted in the Central Clinical Hospital of the Presidential Affairs Department of Russian Federation. Of 529 included patients in 425 without contraindications to double antiplatelet therapy we carried out analysis of dependence of 30 days level of unfavorable events on parameters of functional activity of platelets.Results. High on-treatment platelet reactivity (HTPR) was found to be associated with 3.5 increase of mortality in the group of patients with high cardiovascular risk. Logistic model of prognosis of unfavorable events based on multifactorial analysis of data from patients with measured platelet aggregation included chronic kidney disease, type of myocardial infarction, and degree ofplatelet aggregation >45%. C -statistic was equal to 0.77. We also present in this paper discussion of problems related to studying approaches to individualization of anti-aggregation therapy in real clinical practice and problems of organization ofsimilar studies.Conclusion. The study showed that patients with ACS increased platelet aggregation, as well as chronic kidney disease and type 2 MI are associated with a 30 day prognosis of adverse events.

Abstract 2602: Elevated Serum Neopterin Levels and Adverse Cardiac Events in Patients with Non-ST-Segment Elevation Acute Coronary Syndrome

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Juan Carlos Kaski ◽  
Luciano Consuegra-Sanchez ◽  
Daniel J. Fernandez-Berges ◽  
Jose M Cruz-Fernandez ◽  
Xavier Garcia-Moll ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Unstable Angina ◽  
Elevated Serum ◽  
Cardiac Events ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
St Segment ◽  
Adverse Cardiac Events ◽  
Elevation Acute Coronary Syndrome

Objectives: We sought to assess whether plasma neopterin predicts adverse clinical outcomes in patients with NSTEACS. Background: Circulating C reactive protein (CRP), a marker of inflammation, correlates with events in patients with non-ST-segment elevation acute coronary syndrome (NSTEACS). High neopterin levels - a marker of macrophage activation - predict cardiovascular events in stable angina patients but their prognostic role in NSTEACS has not been systematically evaluated. Methods: We prospectively assessed 397 patients (74 % men) admitted with NSTEACS: 169 (42.5%) had unstable angina and 228 (57.5%) non-ST-segment elevation myocardial infarction (NSTEMI). Blood samples for neopterin and CRP assessment were obtained at admission. TIMI risk score was also assessed among other clinical and biochemical variables. The study end point was the composite of cardiac death, acute myocardial infarction and recurrent angina at 180-days. Results: Baseline neopterin concentrations (nmol/L) were similar in unstable angina and NSTEMI patients (8.3 [6.5–10.6] vs 8.0 [6.2–11.1], p = 0.54). Fifty-nine patients (14.9 %) had events during follow-up (highest third (%) 21.5 vs 1 st and 2 nd thirds 11.5, log rank 7.341, p = 0.007). On multivariable hazard Cox regression, only neopterin (highest vs 1 st and 2 nd thirds, HR 2.15, 95 % CI [1.21–3.81]) was independently associated with the combined endpoint.CRP levels, however, were not significantly different in patients with events compared to those without events (adjusted HR = 0.98, p = 0.89, 95% CI 0.80 –1.21). Conclusion: Increased neopterin levels are an independent predictor of 180-day adverse cardiac events in patients with NSTEACS.

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