Serum triglycerides predict first cardiovascular events in diabetic patients with hypercholesterolemia and retinopathy

2018 ◽  
Vol 25 (17) ◽  
pp. 1852-1860 ◽  
Author(s):  
Hayato Tada ◽  
Masa-aki Kawashiri ◽  
Akihiro Nomura ◽  
Kenichi Yoshimura ◽  
Hiroshi Itoh ◽  
...  
Keyword(s):  
Cardiovascular Diseases ◽  
Confidence Interval ◽  
Cardiovascular Events ◽  
Hazard Ratio ◽  
Adjusted Hazard Ratio ◽  
Major Adverse Cardiac Events ◽  
Diabetic Patients ◽  
Cardiac Events ◽  
Serum Triglycerides ◽  
Adverse Cardiac Events

Aims Low-density lipoprotein cholesterol predicts cardiovascular events in patients with diabetes. However, it is uncertain whether serum triglycerides level is also associated with an occurrence of future cardiovascular events in diabetic patients. We aimed to test whether serum triglycerides is associated with first cardiovascular events in diabetic patients. Methods and results We recruited 5042 participants with diabetes mellitus from the standard versus intEnsive statin therapy for hypercholesteroleMic Patients with diAbetic retinopaTHY (EMPATHY), multicenter, prospective, randomized, open-label, blinded-endpoint study. Median follow-up was three years. We evaluated an association of serum triglycerides with first cardiovascular events in cox-regression hazard models adjusted by age, sex, hypertension, current smoking, low-density lipoprotein cholesterol, and body mass index. Cardiovascular events were defined as (a) major adverse cardiac events including myocardial infarction, stroke, or cardiac death; and (b) cardiovascular diseases including myocardial infarction, unstable angina, ischemic stroke, or large artery disease or peripheral arterial disease. Serum triglycerides were associated with major adverse cardiac events (adjusted hazard ratio: 1.021 per 10 mg/dl; 95% confidence interval: 1.007–1.035; p = 0.0025) and cardiovascular diseases (adjusted hazard ratio: 1.023 per 10 mg/dl; 95% confidence interval: 1.013–1.034; p = 0.0000077). Comparing the top quintile (>185 mg/dl) with the bottom quintile (<79 mg/dl), the adjusted hazard ratio increased 1.89 (95% confidence interval: 1.03–2.80, p = 0.04) for major adverse cardiac events, and 1.90 (95% confidence interval: 1.18–3.07, p = 0.007) for cardiovascular diseases. There were no overall interactions of triglycerides and treatment assignment (standard/intensive statins) on both outcomes ( p-trend = 0.33 for major adverse cardiac events, p-trend = 0.62 for cardiovascular diseases). Conclusions Serum triglycerides were associated with first cardiovascular events among high-risk diabetes patients with hypercholesterolemia and retinopathy.

scholarly journals N-Terminal Pro-brain Natriuretic Peptide Identifies Patients at High Risk for Adverse Cardiac Outcome after Vascular Surgery

2007 ◽  
Vol 106 (6) ◽  
pp. 1088-1095 ◽  
Author(s):  
Elisabeth Mahla ◽  
Anneliese Baumann ◽  
Peter Rehak ◽  
Norbert Watzinger ◽  
Martin N. Vicenzi ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Vascular Surgery ◽  
Hazard Ratio ◽  
Adjusted Hazard Ratio ◽  
Cardiac Events ◽  
Characteristic Analysis ◽  
Prognostic Information ◽  
Adverse Cardiac Outcome ◽  
Cardiac Outcome

Background Preoperative N-terminal pro-BNP (NT-proBNP) is independently associated with adverse cardiac outcome but does not anticipate the dynamic consequences of anesthesia and surgery. The authors hypothesized that a single postoperative NT-proBNP level provides additional prognostic information for in-hospital and late cardiac events. Methods Two hundred eighteen patients scheduled to undergo vascular surgery were enrolled and followed up for 24-30 months. Logistic regression and Cox proportional hazards model were performed to evaluate predictors of in-hospital and long-term cardiac outcome. The optimal discriminatory level of preoperative and postoperative NT-proBNP was determined by receiver operating characteristic analysis. Results During a median follow-up of 826 days, 44 patients (20%) experienced 51 cardiac events. Perioperatively, median NT-proBNP increased from 215 to 557 pg/ml (interquartile range, 83/457 to 221/1178 pg/ml; P&lt;0.001). The optimum discriminate threshold for preoperative and postoperative NT-proBNP was 280 pg/ml (95% confidence interval, 123-400) and 860 pg/ml (95% confidence interval, 556-1,054), respectively. Adjusted for age, previous myocardial infarction, preoperative fibrinogen, creatinine, high-sensitivity C-reactive protein, type, duration, and surgical complications, only postoperative NT-proBNP remained significantly associated with in-hospital (adjusted hazard ratio, 19.8; 95% confidence interval, 3.4-115) and long-term cardiac outcome (adjusted hazard ratio, 4.88; 95% confidence interval, 2.43-9.81). Conclusion A single postoperative NT-proBNP determination provides important additional prognostic information to preoperative levels and may support therapeutic decisions to prevent subsequent structural myocardial damage.

scholarly journals Incidence of postoperative, major, adverse cardiac events in patients undergoing carotid endarterectomy: A single-center, retrospective study

2022 ◽  
Vol 10 ◽  
pp. 205031212110703
Author(s):  
Aphichat Suphathamwit ◽  
Chutima Leewatchararoongjaroen ◽  
Pongprueth Rujirachun ◽  
Kittipatr Poopong ◽  
Apichaya Leesakul ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Congestive Heart Failure ◽  
Retrospective Study ◽  
Confidence Interval ◽  
Carotid Endarterectomy ◽  
Major Adverse Cardiac Events ◽  
Single Center ◽  
Cardiac Events ◽  
Adverse Cardiac Events

Objective: This study aimed to determine the incidence of postoperative major adverse cardiac events for patients undergoing carotid endarterectomy. Methods: This single-center, retrospective study recruited 171 carotid endarterectomy patients between January 1999 and June 2018. Patients who received a carotid endarterectomy in conjunction with other surgery were excluded. The primary outcomes were the incidences of major adverse cardiac events (comprising myocardial infarction, significant arrhythmias, congestive heart failure, and cardiac death) within 7 days, 7–30 days, and > 30 days–1 year, postoperatively. The secondary outcomes were the factors related to major adverse cardiac events and the incidence of postoperative stroke. The patients’ charts were reviewed, and direct contact was made with them to obtain information on their status post discharge. Results: The incidences of major adverse cardiac events within 7 days, 7–30 days, and >30 days–1 year of the carotid endarterectomy were 3.5% of patients (95% confidence interval: 0.008–0.063), 1.2% (95% confidence interval: 0.004–0.028), and 1.8% (95% confidence interval: 0.002–0.037), respectively. The major adverse cardiac events occurring within 7 days were arrhythmia (2.3% of patients), cardiac arrest (1.8%), myocardial infarction (1.2%), and congestive heart failure (1.2%), while the corresponding postoperative stroke rate was 4.7%. Conclusion: The 7-day incidence of major adverse cardiac events after the carotid endarterectomy was 3.5%. The most common major adverse cardiac event during that period was cardiac arrhythmia.

scholarly journals The Association between Type-2 Diabetes Duration and Major Adverse Cardiac Events after Percutaneous Coronary Intervention

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Botey Katamu Benjamin ◽  
Chunguang Qiu ◽  
Zhanying Han ◽  
Wenjie Lu ◽  
Guoju Sun ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Diabetes Duration ◽  
Major Adverse Cardiac Events ◽  
Diabetic Patients ◽  
Cardiac Events ◽  
Repeat Revascularization ◽  
Adverse Cardiac Events ◽  
Percutaneous Coronary

Background. Diabetes is an independent risk factor for coronary artery disease and portends adverse prognosis in diabetic patients undergoing percutaneous coronary intervention (PCI) compared to nondiabetic patients. Few studies are currently available regarding the relationship between diabetes duration and major adverse cardiac events (MACEs) post-PCI. This study is aimed at assessing the association between diabetes duration and major adverse cardiac events after PCI. Methods. A total of 302 cases of diabetic patients undergoing an elective PCI with drug-eluting stent (DES) deployment and or percutaneous transluminal coronary angioplasty (PTCA) using a drug-coated balloon (DCB) were prospectively studied. We divided patients into three groups based on diabetes duration: <5 years group ( n = 165 ), 5–10 years’ group ( n = 72 ), and ≥10 years’ group ( n = 65 ). Angiographic and clinical follow-up were conducted 12 months after the procedures for all the patients and at any given time during the study when needed. Results. A significantly higher rate of myocardial infarction (MI) in diabetic patients with the longest diabetes duration (7.7% vs. 0% and 0.6%, P = 0.001 ) was observed compared with groups of shorter duration. Repeat coronary revascularization was found to be significantly higher in the >10-year group than was it in groups with shorter duration of diabetes (23.1% vs. 19.4% and 9.10%, P = 0.03 ). After adjustment for confounding risk factors, longer diabetes duration remained an independent predictor of MI (hazard ratio (HR): 5.525, confidence interval (CI): 1.273-23.978, P = 0.022 ) and repeat revascularization (HR: 1.608, CI: 1.058-2.443, P = 0.026 ). Repeat revascularization was significantly related to the progression of nontreated lesions (De novo lesions 20% vs. 18% and 7.3%, P = 0.009 ) compared to previously treated lesions (target lesion revascularization (TLR) 3% vs. 1.3% and 2%, P = 0.774 ). However, all-cause mortality was not significantly different among the groups (3.1% vs. 5.6% and 0.6%, P = 0.06 , HR: 2.403, CI: 0.464-12.436, P = 0.293 ). Conclusion. Diabetes duration was associated with significant differences in major adverse cardiac events after the percutaneous coronary intervention; the longest diabetes duration portended higher rates of MACEs than shorter duration at the 12-month follow-up.

scholarly journals Circulatory microRNAs as potential biomarkers for major adverse cardiac events in patients with atrial fibrillation

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
S Nopp ◽  
M.L Van Der Bent ◽  
O Koenigsbruegge ◽  
J Wojta ◽  
I Pabinger ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cardiovascular Events ◽  
Cardiovascular Death ◽  
Major Adverse Cardiac Events ◽  
Small Rna Sequencing ◽  
P Value ◽  
Cardiac Events ◽  
Adverse Cardiac Events ◽  
Non Coding Rnas ◽  
Potential Biomarkers

Abstract Background Stratification for subsequent cardiovascular events among patients with atrial fibrillation is of great interest and could aid in guiding preventative strategies. However, current clinical and routine laboratory markers lack in accuracy to predict major adverse cardiac events (MACE). Thus, new prognostic approaches are needed. Small non-coding RNAs are present and stable in the circulation and reflect their tissue, or even their vascular bed, of origin, and may therefore be optimal candidate biomarkers to reflect disease status. Purpose We aimed to investigate small non-coding RNAs (e.g. microRNAs [miRNAs], transfer RNAs [tRNAs] -derived fragments) and their prognostic potential as biomarkers for cardiovascular events in patients with atrial fibrillation. Methods We conducted a nested case-control study within the framework of the BRAHMS (BioRepository of Atrial Fibrillation and HeMostasiS) registry, in which patients with atrial fibrillation were included and followed-up at a 6- to 12-month interval. Patients who experienced MACE (i.e. stroke, myocardial infarction, cardiovascular death) within a year after inclusion were defined as cases (n=13) and were matched by age, sex, and CHA2DS2-VASc score to controls who remained event-free (n=13). In all 26 patients, total small RNA-sequencing was performed on plasma samples collected and stored at study inclusion. The Benjamini-Hochberg procedure was used to control the false discovery rate (FDR). Results We detected 184 well-expressed miRNAs, 47 tRNAs, and 280 other non-coding RNAs, and did not find differences in expression between cases and controls, respecting a threshold of an FDR-adjusted p-value &lt;0.05. However, in the subgroup analysis of patients with subsequent cardiovascular death (5 cases vs. matched controls), three miRNAs (miR-150-5p, miR-127-3p, miR-1908-5p) were significantly associated with cardiovascular mortality (FDR-adjusted p&lt;0.05) (Figure 1). Conclusion This study proposes three well-expressed circulating miRNAs derived from peripheral blood as potential biomarkers for early cardiovascular death in patients with atrial fibrillation. Our findings are currently being verified in a larger study and in a different patient population. FUNDunding Acknowledgement Type of funding sources: None.

scholarly journals Serum Chemerin as a Novel Prognostic Indicator in Chronic Heart Failure

2019 ◽  
Vol 8 (15) ◽  
Author(s):  
Xiang Zhou ◽  
Yifei Tao ◽  
Yuqi Chen ◽  
Weiting Xu ◽  
Zhiyuan Qian ◽  
...  
Keyword(s):  
Heart Failure ◽  
Regression Analysis ◽  
Chronic Heart Failure ◽  
Cox Regression ◽  
Prognostic Indicator ◽  
Hazard Ratio ◽  
Major Adverse Cardiac Events ◽  
Cardiac Events ◽  
Cox Regression Analysis ◽  
Adverse Cardiac Events

Background It has been documented that circulating chemerin is associated with inflammation, metabolic syndrome, and coronary artery disease. The present study was aimed to evaluate the prognostic value of serum chemerin in patients with chronic heart failure. Methods and Results We included 834 patients with chronic heart failure in a prospective cohort study and investigated the association between serum chemerin and clinical outcomes using multivariate Cox regression analysis. Patients with higher chemerin levels tended to be older and women and were more likely to experience hypertension, diabetes mellitus, and hyperlipemia. Cox regression analysis showed that chemerin was a significant predictor of major adverse cardiac events (hazard ratio, 1.83; 95% CI, 1.31–2.96) after adjustment for conventional risk factors. Net reclassification and integrated discrimination improvements for major adverse cardiac events were markedly improved by addition of chemerin to the reference model. In addition, chemerin was an independent predictor of all‐cause mortality (hazard ratio, 1.67; 95% CI, 1.21–2.73) after multivariable adjustment. Furthermore, the Kaplan–Meier survival analysis revealed that chemerin was a prognostic indicator of major adverse cardiac events in patients with chronic heart failure and NT‐proBNP (N‐terminal pro‐B‐type natriuretic peptide) levels above and below the median. Conclusions Our study suggests that chemerin is a novel serum marker for predicting major adverse cardiac events in patients with chronic heart failure.

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