scholarly journals The prediction of cardiac events in patients with acute ST segment elevation myocardial infarction: A meta–analysis of serum uric acid

2018 ◽  
Vol 13 (1) ◽  
pp. 413-421
Author(s):  
Hailong Wang ◽  
Jianjun Yang ◽  
Jiang Sao ◽  
Jianming Zhang ◽  
Xiaohua Pang
Keyword(s):  
Myocardial Infarction ◽  
Uric Acid ◽  
Hospital Mortality ◽  
Serum Uric Acid ◽  
Meta Analysis ◽  
Systematic Analysis ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
One Year

AbstractObjectiveThe current study aimed to explore the predictive ability of serum uric acid (SUA) in patients suffering from acute ST segment elevation myocardial infarction (STEMI).MethodPubMed, EMBASE, Cochrane Library, and Medline databases were systematically searched from their respective inceptions to February 2018. Systematic analysis and random-effects meta–analysis of prognostic effects were performed to evaluate STEMI outcomes [i.e., in-hospital mortality, one-year mortality, in-hospital Major Adverse Cardiovascular Events (MACE)] in relation to SUA.ResultsA total of 12 studies (containing 7,735 patients with acute STEMI) were identified (5,562 low SUA patients and 3,173 high SUA patients). Systematic analysis of these studies showed that high SUA patients exhibited a higher incidence of in-hospital MACE (OR, 2.30; P < 0.00001), in-hospital mortality (OR, 3.03; P < 0.0001), and one-year mortality (OR, 2.58; P < 0.00001), compared with low SUA patients.ConclusionsAcute STEMI patients with high SUA exhibited an elevated incidence rate of in-hospital MACE, in-hospital mortality, and one-year mortality. Further randomized controlled trials will be needed to verify these results.

scholarly journals Serum Uric Acid Levels and Renal Impairment among ST-Segment Elevation Myocardial Infarction Patients Undergoing Primary Percutaneous Intervention

2016 ◽  
Vol 6 (3) ◽  
pp. 191-197 ◽  
Author(s):  
Yacov Shacham ◽  
Amir Gal-Oz ◽  
Nir Flint ◽  
Gad Keren ◽  
Yaron Arbel
Keyword(s):  
Myocardial Infarction ◽  
Uric Acid ◽  
Serum Uric Acid ◽  
Elevated Serum ◽  
Significant Risk ◽  
Adverse Outcomes ◽  
Primary Pci ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment

Background: Elevated serum uric acid (UA) levels are associated with adverse outcomes in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI). However, the relation between UA and acute kidney injury (AKI) in this population is unclear. We evaluated the effect of elevated UA levels on the risk to develop AKI among consecutive STEMI patients treated with primary PCI. Methods: We performed a retrospective analysis of 1,372 consecutive patients admitted with the diagnosis of STEMI between January 2008 and February 2015. Patients were stratified into quartiles according to UA levels as follows: quartile 1, <4.7 mg/dl; quartile 2, 4.8 to <5.6 mg/dl; quartile 3, 5.7 to <6.6 mg/dl, and quartile 4, >6.7 mg/dl. Results: STEMI patients with elevated UA levels had a higher frequency of AKI (4 vs. 6% vs. 10 vs. 24%; p < 0.001). In a subgroup analysis of patients with reduced baseline estimated glomerular filtration rate (≤60 ml/min/1.73 m2), an elevated UA level was associated with a significant risk to develop AKI, with 46% of patients developing AKI in the highest UA quartile. In a multivariate logistic regression model, for every 1-mg/dl increase in the UA concentration, the adjusted risk for AKI increased by 46% (OR = 1.46, 95% CI 1.18-1.66; p < 0.001). Conclusions: Among STEMI patients undergoing primary PCI, elevated UA levels are an independent predictor of AKI.

scholarly journals Neutrophil-to-lymphocyte ratio for predictor of in-hospital mortality in ST-segment elevation myocardial infarction: a meta-analysis

2020 ◽  
Vol 29 (2) ◽  
pp. 172-82
Author(s):  
Rodry Mikhael ◽  
Evan Hindoro ◽  
Sharleen Taner ◽  
Antonia Anna Lukito
Keyword(s):  
Myocardial Infarction ◽  
Hospital Mortality ◽  
Meta Analysis ◽  
Neutrophil To Lymphocyte Ratio ◽  
St Segment Elevation ◽  
Lymphocyte Ratio ◽  
Coronary Syndrome ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
All Cause Mortality

BACKGROUND ST-segment elevation myocardial infarction (STEMI) is the most life-threatening condition of acute coronary syndrome that carries a poor prognosis of in-hospital mortality. Multiple scoring systems have been developed to predict in-hospital mortality and other cardiovascular events. Neutrophil-to-lymphocyte ratio (NLR) is hardly used as a predictor of in-hospital mortality. This study was aimed to determine the predictive value of NLR concerning in-hospital mortality in STEMI patients. METHODS Literature search and pooled analysis related to studies on MEDLINE/PubMed, EBSCO, Science Direct, Cochrane, and ProQuest were retrieved. Inclusion criteria were met if they were cohort studies, the subjects were STEMI patient, contained pretreatment NLR cut-off, and considered in-hospital mortality, which is defined as cardiac or all-cause mortality. Quality assessment was conducted using Newcastle-Ottawa scale. Review Manager version 5.3 (The Nordic Cochrane Centre, Copenhagen) was used for meta-analysis. RESULTS We found 12 studies with a total of 7,251 STEMI subjects with median NLR cut-off value of 5.6. Elevated NLR on admission carries a high risk of in-hospital mortality (odds ratio [OR] = 3.00, 95% confidence interval [CI] = 2.46–3.67). A slightly higher risk of all-cause mortality (OR = 2.74, 95% CI = 1.99–3.77) was observed compared with cardiac-related mortality (OR = 3.20, 95% CI = 2.47–4.14). No significant heterogeneity was observed between these studies (p = 0.46, I2 = 0%). CONCLUSIONS Elevated NLR predicts a higher in-hospital mortality rate of STEMI patients.

scholarly journals Assessment of morbidity and fatal outcomes of Acute Coronary Syndrome in Scotland

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Grant Wyper ◽  
Samantha Alvarez-Madrazo ◽  
Kim Kavanagh ◽  
Martin Denvir ◽  
Marion Bennie
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Hospital Mortality ◽  
Secondary Care ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
Segment Elevation Myocardial Infarction ◽  
Diagnostic Threshold ◽  
St Segment ◽  
One Year

ABSTRACTObjectivesThere have been a number of key changes in the clinical definition and diagnostic threshold of acute coronary syndromes in the last 10 years. We have characterised temporal and geographic changes in the incidence and outcomes following Acute Coronary Syndrome (ACS: Unstable Angina (UA), Non ST-segment elevation myocardial infarction (NSTEMI) and ST-segment elevation myocardial infarction (STEMI)) between 2009 and 2013. Approach65,137 hospitals stays were identified involving ACS (ICD-10: I20.0, I21 and I22) relating to 55,369 individuals identified through secondary care primary diagnosis records during 2009-2013. All prior and subsequent secondary care diagnoses from 1981-2014 were sourced for these patients and records were deterministically matched on a pseudo patient identifier to obtain the cause and date of death for purposes of follow-up. An incident ACS case was defined as such if the patient had not suffered an ACS in the five years prior to the hospital admission and all co-morbidities were derived from hospital diagnostic codes accompanying the ACS codes. ResultsFor the entire cohort, patients with an incident ACS were predominantly male (61.5%) with mean age 68 (SD=13.7 years). Co-morbidities included: 65.5% Other Ischaemic Heart Disease; 5.2% Stroke; 7.5% Peripheral Artery Disease; 14.8% Atrial Fibrillation; 42.0% Hypertension; 18.0% Diabetes Mellitus and 8.4% Chronic Kidney Disease. The overall incidence of ACS in 2009 was 204/100,000 and fell by 8.1% to 188/100,000 in 2013. Subtypes of ACS comprised 9.4% UA, 50.9% NSTEMI, 29.0% STEMI and 10.8% MI unspecified in 2013. In-hospital mortality following an incident ACS was 9.7% (95% CI: 9.2-10.3%) in 2009 and varied from 7.9 to 19.0% across the NHS boards. In 2013, in-hospital mortality was 8.5% (95% CI: 7.9-9.0%) ranging from 4.5 to 10.5% across the NHS boards. One-year mortality following an incident ACS in 2009 was 18.6% (95% CI: 17.9-19.4%) falling to 16.8% (95% CI: 16.1-17.5%) in 2013. Stratified by NHS board, the one-year mortality rate in 2009 varied from 16.9 to 28.0% and in 2013 ranged from 11.9 to 20.0% across the NHS boards. ConclusionThese findings highlight the importance of a cohort based record linkage approach to routine healthcare datasets. While there appears to be changes in incidence of ACS and its subtypes and changes in mortality over time, these findings reflect significant changes in clinical practice with respect to definition and diagnosis. Cautious interpretation is needed combined with further research to fully understand the epidemiological implications of our findings.

scholarly journals Gambaran kadar asam urat pada pasien sindrom koroner akut di RSUP Prof. Dr. R. D. Kandou Manado periode Januari-Desember 2015

e-CliniC ◽  
2016 ◽  
Vol 4 (2) ◽  
Author(s):  
Annisa Syahfitri ◽  
Victor Joseph ◽  
Starry H. Rampengan
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Uric Acid ◽  
Angina Pectoris ◽  
Serum Uric Acid ◽  
Elevated Serum ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment

Abstract: Acute coronary syndrome (ACS) is the term for symptoms due to disorder of blood flow inside the coronary arteries. ACS consists of unstable angina pectoris (UAP), non–ST-segment elevation myocardial infarction (NSTEMI), and ST-segment elevation myocardial infarction (STEMI). One predisposition factor of ACS that is still debated is uric acid. Its role in cardiovascular diseases is assumed due to endothelial disruption caused by elevated serum uric acid. This study was aimed to obtain the profile of uric acid serum in ACS patients at Prof. Dr. R. D. Kandou hospital Manado from January to December 2015. This was a retrospective study with a descriptive observational method using medical record of Prof Dr. R. D. Kandou Hospital Manado. The results showed that there were 97 patients with ACS, including 43 (44.33%) patients with NSTEMI, 43 (44.33%) patients with UAP, and 11 (11.34%) patients with STEMI. Males were more common than females. Most patient were aged 55-65 years old. Elevated serum uric acid was found in 52% of patients, generally in males and NSTEMI cases. More than half of the patients had history of elevated serum uric acid. The most risk factor in the cases were hypertension and smoking.Keywords: description, uric acid, acute coronary syndrome Abstrak: Sindrom koroner akut (SKA) merupakan sekelompok gejala akibat gangguan aliran darah pada arteri koroner. SKA terdiri dari unstable angina pectoris (UAP), infark miokard tanpa elevasi ST (NSTEMI), dan infark miokard dengan elevasi ST (STEMI). Salah satu faktor predisposisi SKA yang hingga kini masih diperdebatkan ialah asam urat. Diduga peran asam urat terhadap penyakit kardiovaskular terletak pada gangguan endotel pembuluh darah yang ditimbulkannya. Penelitian ini bertujuan untuk mengetahui gambaran kadar asam urat pada pasien SKA di RSUP Prof. Dr. R. D. Kandou Manado selama periode Januari-Desember 2015. Jenis penelitian ialah retrospektif dengan metode observasional-deskriptif yang dilaksanakan di Bagian Rekam Medik RSUP Prof. Dr. R. D. Kandou Manado. Hasil penelitian mendapatkan 97 pasien SKA dengan data lengkap, diantaranya 43 kasus (44,33%) NSTEMI, 43 kasus (44,33%) UAP, dan 11 kasus (11,34%) STEMI. Pasien terbanyak terdapat pada laki-laki dan kelompok usia 55-65 tahun. Peningkatan kadar asam urat dijumpai pada 52% pasien, umumnya pada laki-laki dan kasus NSTEMI. Umumnya pasien juga memiliki riwayat asam urat. Faktor risiko terbanyak yang dimiliki ialah hipertensi dan merokok. Kata kunci: deskripsi, asam urat, sindrom koroner akut

scholarly journals Uric acid as a biomarker in acute myocardial infarction

2020 ◽  
Vol 11 (SPL2) ◽  
pp. 281-283
Author(s):  
Merriwin D ◽  
Lakshmi N ◽  
Abraham Sam Rajan P. M.
Keyword(s):  
Myocardial Infarction ◽  
Cardiovascular Disease ◽  
Acute Myocardial Infarction ◽  
Uric Acid ◽  
Serum Uric Acid ◽  
World Population ◽  
Uric Acid Concentration ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment

Acute Myocardial Infarction (AMI) is a global threat to health, particularly for developing countries. Every year about 17 million of the world population die of cardiovascular disease. The activity of the enzyme xanthine oxidase and the oxidative stress level is reflected by the levels of serum uric acid. Uric acid, an independent marker in populations with AMI has been shown to reflect the short and long term adverse cardiac outcomes. Elevated uric acid levels are associated with reduced glomerular filtration rate, hypertension, arterial stiffness, cardiac hypertrophy and heart failure. There exists a five to six-fold rise in uric acid concentration in atherosclerotic patients. The mortality index in patients with cardiovascular disease can be predicted by high uric acid levels. The aim of our study was to correlate the increased uric acid levels with the severity and prognosis in myocardial infarction patients. Our study included 55 patients with AMI, including both ST-segment elevation myocardial infarction (STEMI) and non-ST segment elevation myocardial infarction (NSTEMI), in whom serum uric acid was measured. The results were analyzed using the Statistical Package of Social Sciences (SPSS) software. A statistically significant (p <0.001) increase in the serum uric acid levels were noted in the patients diagnosed with Myocardial Infarction (MI). The increase in uric acid levels helps to predict mortality in acute MI patients.

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