scholarly journals Analysis of distant cardiovascular events depending on the biomarker profile in patients with myocardial infarction

2019 ◽  
Vol 24 (3) ◽  
pp. 24-31
Author(s):  
A. F. Khamitova ◽  
Sh. Z. Zagidullin ◽  
I. R. Lakman ◽  
D. F. Gareeva ◽  
N. Sh. Zagidullin
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Risk Factor ◽  
Sudden Death ◽  
Cardiovascular Events ◽  
Prognostic Value ◽  
Pentraxin 3 ◽  
Coronary Syndrome ◽  
The World ◽  
New Biomarkers

Acute coronary syndrome (ACS) and its complications is one of the main reasons of mortality and invalidation in the world. New biomarkers, such as ST2, NT-proBNP и Pentraxin-3 (Ptx-3) present much more opportunities in the diagnostics of diseases and risk of its development.Aim.To investigate standards and “new” biomarkers in different variants of MI and cardiovascular events in 1 year after MI.Material and methods.In 180 patients with MI (61,4±1,7 years) we determined the serum concentration of standard and “new” (ST2, NT-proBNP, Ptx-3) biomarkers in groups with Q/non-Q, STEMI and NSTEMI and the endpoints (MI, strokes, repeated hospitalizations and sudden deaths) in 1 year (384,3±21,2 days) after MI.Results.Patients with Q-MI and STEMI had higher risk of unfavorable cardiovascular events (p<0,05). Ptx-3 >43,9 ng/ml was shown to be risk factor for sudden death (sensitivity 70,0%, specificity 52,9%), and >125,9±0,06 ng/ml (74,1% and 44,1%) — of recurrent MI.Conclusion.NT-proBNP, ST2 and Ptx-3 showed prognostic value in the diagnostics of unfavorable cardiovascular endpoints.

scholarly journals Long-Term Prognostic Value of Cognitive Impairment on Top of Frailty in Older Adults after Acute Coronary Syndrome

2021 ◽  
Vol 10 (3) ◽  
pp. 444
Author(s):  
Juan Sanchis ◽  
Clara Bonanad ◽  
Sergio García-Blas ◽  
Vicent Ruiz ◽  
Agustín Fernández-Cisnal ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Older Adults ◽  
Acute Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Prognostic Value ◽  
Adult Survivors ◽  
Prognostic Information ◽  
Coronary Syndrome

Frailty is a marker of poor prognosis in older adults after acute coronary syndrome. We investigated whether cognitive impairment provides additional prognostic information. The study population consisted of a prospective cohort of 342 older (>65 years) adult survivors after acute coronary syndrome. Frailty (Fried score) and cognitive function (Pfeiffer’s Short Portable Mental Status Questionnaire—SPMSQ) were assessed at discharge. The endpoints were mortality or acute myocardial infarction at 8.7-year median follow-up. Patient distribution according to SPMSQ results was: no cognitive impairment (SPMSQ = 0 errors; n = 248, 73%), mild impairment (SPMSQ = 1–2 errors; n = 52, 15%), and moderate to severe impairment (SPMSQ ≥3 errors; n = 42, 12%). A total of 245 (72%) patients died or had an acute myocardial infarction, and 216 (63%) patients died. After adjustment for clinical data, comorbidities, and Fried score, the SPMSQ added prognostic value for death or myocardial infarction (per number of errors; HR = 1.11, 95%, CI 1.04–1.19, p = 0.002) and death (HR = 1.11, 95% 1.03–1.20, p = 0.007). An SPMSQ with ≥3 errors identified the highest risk subgroup. Geriatric conditions (SPSMQ and Fried score) explained 19% and 43% of the overall chi-square of the models for predicting death or myocardial infarction and death, respectively. Geriatric assessment after acute coronary syndrome should include both frailty and cognitive function. This is particularly important given that cognitive impairment without dementia can be subclinical and thus remain undetected.

The Reduction of Cardiac Patients in the Coronary Care Unit of the Santa Izabel Hospital During the COVID-19 Pandemic

2021 ◽  
Vol 4 (3/4) ◽  
pp. 131-134
Author(s):  
Gilson Feitosa ◽  
Leandro Cavalcanti ◽  
Amanda Fraga ◽  
Milana Prado ◽  
Gilson Feitosa Filho ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Angina Pectoris ◽  
Coronary Care Unit ◽  
Myocardial Revascularization ◽  
St Elevation Myocardial Infarction ◽  
Coronary Syndrome ◽  
The World ◽  
St Elevation ◽  
Coronary Care

The coronary care unit by Santa Izabel Hospital (Salvador, Bahia, Brazil) made a comparison of admitted patients with coronary disease cases admitted between two equivalent periods ranging from April through July in 2019 and 2020. There was a striking reduction in 2020 of cases of ST-elevation myocardial infarction (39%); non-ST elevation myocardial infarction (19%); and unstable angina pectoris (21%). This occurred in parallel with what happened in many parts of the world and hampered offering the best treatment strategy to these patients with an acute coronary syndrome such as invasive stratification and myocardial revascularization.  

P3825Long-term prognostic value of growth differentiation factor-15 in acute coronary syndrome

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
O M Peiro Ibanez ◽  
J Ordonez ◽  
A Garcia ◽  
G Bonet ◽  
V Quintern ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Acute Coronary Syndrome ◽  
Prognostic Value ◽  
Clinical Model ◽  
Growth Differentiation Factor 15 ◽  
Coronary Syndrome ◽  
St Elevation ◽  
Incremental Prognostic Value

Abstract Introduction Biomarkers plays a critical role in diagnostic, prognostication, and decision-making in cardiovascular medicine. Growth differentiation factor-15 (GDF-15) has been reported as a potential biomarker in acute coronary syndrome (ACS). However, there is limited data on the long-term prognostic value after an ACS. Purpose To study the long-term prognostic value of GDF-15 in ACS. Methods We included patients with ACS who underwent coronary angiography. During angiography an arterial blood sample was collected. Plasma GDF-15 were measured and clinical data and long-term events were obtained. As previously reported, risk categories were defined as low risk (<1200ng/L), intermediate (1200–1800ng/L) and high risk (>1800ng/L). Incremental prognostic value of GDF-15 for all-cause death was assessed on top of a clinical model (GRACE score, LVEF<40% and age). Results A total of 358 patients were included; 157 as a low risk, 85 as an intermediate and 116 as a high risk. The median (IQR) age was 65 (56–74) years and 27.4% were female. Of all patients, 61.5% were admitted with non-ST-elevation myocardial infarction, 24.0% with ST-elevation myocardial infarction and 14.5% with unstable angina. Higher values of GDF-15 were consistently associated with an increased prevalence of cardiovascular risk factors. During 6 years of follow-up 54 patients died. Of those patients, 7 (4.5%) had values of GDF-15 below 1200ng/L, 6 (7.1%) between 1200–1800ng/L and 41 (35.3%) above 1800ng/L. After adjustment for a multivariate Cox regression model, GDF-15 >1800ng/L were independently associated with all-cause death (HR 4.5; 95% CI 1.8–11.6; p=0.002) and the composite of major adverse cardiovascular events (MACE) which were identified as all-cause death, nonfatal MI and heart failure (HR 2.5; 95% CI 1.4–4.4; p=0.001). For long-term all-cause death a significant increase of the c-statistic was seen after addition of GDF-15 to the clinical model 0.871 (95% CI 0.817–0.924; p=0.019) as well as net reclassification improvement (0.769; 95% CI 0.487–1.051; p<0.001) and integrated discrimination improvement (0.117; 95% CI 0.062–0.172; p<0.001). Of 18 events of heart failure, 17 occurred in patients with GDF>1800ng/L. A multivariate competing risk model showed a significant association between GDF-15>1800ng/L and incidence of heart failure (adjusted HR 30.8; 95% CI 4.1–231.5; p=0.001) but non-significant association were found for myocardial infarction. KM figures and all-cause death ROC curve Conclusions In the setting of ACS GDF-15 can predict long-term all-cause death, MACE and heart failure and provides incremental prognostic value beyond traditional risks factors in the long-term all-cause death.

scholarly journals Cerebrovascular accident and acute coronary syndrome and perioperative outcomes (CAPO) study protocol: a 10-year database linkage between Hospital Episode Statistics Admitted Patient Care, Myocardial Infarction National Audit Project and Office for National Statistics registries for time-dependent risk analysis of perioperative outcomes in English NHS hospitals

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e037904
Author(s):  
Matthew Stephen Luney ◽  
William Lindsay ◽  
Tricia M McKeever ◽  
Iain Keith Moppett
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Cerebrovascular Accident ◽  
Cardiovascular Events ◽  
Hospital Episode Statistics ◽  
Perioperative Outcomes ◽  
National Audit ◽  
Coronary Syndrome ◽  
National Statistics ◽  
Audit Project

IntroductionAn increasing number of people who have a history of acute coronary syndrome or cerebrovascular accident (termed cardiovascular events) are being considered for surgery. Up-to-date evidence of the impact of these prior events is needed to inform person-centred decision making. While perioperative risk for major adverse cardiac events immediately after a cardiovascular event is known to be elevated, the duration of time after the event for which the perioperative risk is increased is not clear.Methods and analysisThis is an individual patient-level database linkage study of all patients in England with at least one operation between 2007 and 2017 in the Hospital Episode Statistics Admitted Patient Care database. Data will be linked to mortality data from the Office for National Statistics up to 2018, for 30-day, 90-day and 1-year mortality and to the Myocardial Ischaemia National Audit Project, a UK registry of acute coronary syndromes. The primary outcome will be the association between time from cardiovascular event to index surgery and 30-day all-cause mortality. Additional associations we will report are all unplanned readmissions, prolonged length of stay, 30-day hospital free survival and incidence of new cardiovascular events within one postoperative year. Important subgroups will be surgery specific (invasiveness, urgency and subspecialty), type of acute coronary syndrome (ST or non-ST elevation myocardial infarction) and type of cerebrovascular accident (ischaemic or haemorrhagic stroke).Ethics and disseminationEthical approval for this observational study has been obtained from East Midlands—Nottingham 1 Research Ethics Committee; REC reference: 18/EM0403. The results of the study will be made available through peer-reviewed publications and via the Health Services Research Centre of the Royal College of Anaesthetists, London.

scholarly journals Temporal Biomarker Profiling Reveals Longitudinal Changes in Risk of Death or Myocardial Infarction in Non–ST-Segment Elevation Acute Coronary Syndrome

2017 ◽  
Vol 63 (7) ◽  
pp. 1214-1226 ◽  
Author(s):  
Mark Y Chan ◽  
Megan L Neely ◽  
Matthew T Roe ◽  
Shaun G Goodman ◽  
David Erlinge ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Cardiovascular Events ◽  
Basic Unit ◽  
St Segment Elevation ◽  
Time Points ◽  
Coronary Syndrome ◽  
St Segment ◽  
Elevation Acute Coronary Syndrome ◽  
Hs Crp

Abstract BACKGROUND There are conflicting data on whether changes in N-terminal pro–B-type natriuretic peptide (NT-proBNP) and high-sensitivity C-reactive protein (hs-CRP) concentrations between time points (delta NT-proBNP and hs-CRP) are associated with a change in prognosis. METHODS We measured NT-proBNP and hs-CRP at 3 time points in 1665 patients with non–ST-segment elevation acute coronary syndrome (NSTEACS). Cox proportional hazards was applied to the delta between temporal measurements to determine the continuous association with cardiovascular events. Effect estimates for delta NT-proBNP and hs-CRP are presented per 40% increase as the basic unit of temporal change. RESULTS Median NT-proBNP was 370.0 (25th, 75th percentiles, 130.0, 996.0), 340.0 (135.0, 875.0), and 267.0 (111.0, 684.0) ng/L; and median hs-CRP was 4.6 (1.7, 13.1), 1.9 (0.8, 4.5), and 1.8 (0.8, 4.4) mg/L at baseline, 30 days, and 6 months, respectively. The deltas between baseline and 6 months were the most prognostically informative. Every +40% increase of delta NT-proBNP (baseline to 6 months) was associated with a 14% greater risk of cardiovascular death (adjusted hazard ratio (HR) 1.14, 95% CI, 1.03–1.27) and with a 14% greater risk of all-cause death (adjusted HR 1.14, 95% CI, 1.04–1.26), while every +40% increase of delta hs-CRP (baseline to 6 months) was associated with a 9% greater risk of the composite end point (adjusted HR 1.09, 95% CI, 1.02–1.17) and a 10% greater risk of myocardial infarction (adjusted HR 1.10, 95%, CI 1.00–1.20). CONCLUSIONS Temporal changes in NT-proBNP and hs-CRP are quantitatively associated with future cardiovascular events, supporting their role in dynamic risk stratification of NSTEACS. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov identifier NCT00699998

scholarly journals Profile of Acute Coronary Syndrome In Young People: A Hospital Based Observational Study in Western Nepal

2018 ◽  
Vol 3 (1) ◽  
pp. 361-365
Author(s):  
Navaraj Paudel ◽  
Vijay Madhab Alurkar ◽  
Girija Shankar Jha ◽  
Ramchandra Kafle ◽  
Subash Sapkota ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Risk Factor ◽  
Young People ◽  
Common Finding ◽  
Coronary Syndrome ◽  
Vessel Disease ◽  
Single Vessel ◽  
Males And Females ◽  
Single Vessel Disease

Introduction: Acute coronary syndrome is associated with high mortality and morbidity. The incidence of acute coronary events in young is increasing.Objectives: This study aimed at evaluating the profile of acute coronary syndrome in young people in the western part of Nepal.Methodology: A retrospective study was designed. All patients admitted for acute coronary syndromes were taken and data of acute coronary syndrome involving patients aged less than 45 years from April 2015 through December 2017 were collected in a pre-structured proforma and analyzed.Results: There were 712 (489 males and 223 females with M:F=2.19:1) acute coronary syndrome patients admitted during the study period. Only 79 (12.9%) patients were patients <45 years of age. Commonest risk factor of acute coronary syndrome was smoking (69%) followed by dyslipidemia (46.8%), hypertension (45.5%) and diabetes (14%). Out of 79 patients of young acute coronary syndrome, 37 (46.8%) presented with ST elevated myocardial infarction, 16 (20.2%) with non-ST elevated myocardial infarction and 26 (32.9%) with unstable angina. Most common finding in coronary angiography was single vessel disease (35%) –left anterior descending artery being the commonest (53% of single vessel disease), double vessel disease (17.7%), non-critical coronary artery disease (16.4%), triple vessel disease (7.6%) and left main (1.2%). Myocardial bridging was seen in 1.2% and 20% had normal coronaries. Comparison of males and females in different categories of acute coronary showed that males predominate significantly in ST elevated myocardial infarction (odds ratio: 2.99; p=0.03) but there was no significant difference between the males and females presenting either with Non ST elevated myocardial infarction or unstable angina.Conclusion: Acute coronary syndrome in young people was common (12.9%) particularly males with Non ST elevated myocardial infarction. Smoking was the commonest risk factor. Public awareness regarding stoppage of cigarette smoking should be focused to prevent such events especially in the young population. BJHS 2018;3(1)5 : 361-365

scholarly journals Estimation of metformin and other sugar reducing therapy influence on the outcomes in patients with acute coronary syndrome and diabetes mellitus type II

2021 ◽  
Vol 10 (4) ◽  
pp. 39-47
Author(s):  
K. Yu. Nikolaev ◽  
K. I. Bondareva ◽  
A. Ya. Kovaleva ◽  
G. I. Lifshits
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Cardiovascular Events ◽  
Diabetes Type 2 ◽  
Diabetes Type ◽  
Coronary Syndrome ◽  
Estimated Risk ◽  
Long Term Prognosis

Aim. To study the influence of hypoglycemic therapy on hospital and long-term prognosis in patients with acute coronary syndrome (ACS) and diabetes type 2.Methods. The study included 63 patients with ACS and type 2 diabetes. All patients had a clinical examination, assessment of mortality risk and myocardial infarction on GRACE scale (Global Registry of Acute Coronary Events) and TIMI (Thrombolisis In Myocardial Infarction) in-hospital and six months after hospitalization.Results. Metformin is associated with a lower estimated risk of in-hospital mortality and within 6 months after discharge in patients with acute coronary syndrome on the background of type 2 diabetes and with less risk of adverse cardiovascular events within 14 days of their occurrence in patients with unstable angina pectoris on the background of diabetes. High daily doses of metformin have also been associated with a decrease in the estimated risk of in-hospital mortality and within 6 months after discharge in patients with ACS associated with diabetes. The inverse association between the daily dosage of metformin and the presence of angina pectoris in patients with ACS and diabetes type 2 indicates a protective effect of metformin high daily dosages in relation to the risk of complications within six months after the discharge from hospital.Conclusion. One of the important aspects of ACS treatment, along with effective therapy, is the impact on concomitant risk factors, including blood glucose control. The main groups of hypoglycemic drugs have currently been identified; their effect on cardiovascular events, long-term effects and long-term prognosis are being investigated.

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