Clinical efficacy of cefoperazone-sulbactam in patients with acute myocardial infarction complicated with infection and effects on serum procalcitonin and serum inflammatory indicators Running tittle: Cefoperazone-sulbactam in acute myocardial infarction complicated with infection

2021 ◽  
Vol 7 (4) ◽  
pp. 730-740
Author(s):  
Shan Wang ◽  
Xiaohua Zhao ◽  
Wenbao Sun
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Therapeutic Effect ◽  
Clinical Efficacy ◽  
Predictive Value ◽  
Control Group ◽  
Bacterial Clearance ◽  
Hs Crp ◽  
Experimental Group

This study aimed to investigate clinical efficacy of cefoperazone-sulbactam in patients with acute myocardial infarction complicated by infection and effects on serum procalcitonin and serum inflammatory indicators. Prospective analysis was used in this study. A total of 109 cases of patients with acute myocardial infarction complicated with infection were collected. They were admitted to our hospital from August 2018 to September 2019 and were divided into a control group and an experimental group according to different treatment methods. Patients (53 cases) in the control group received treatment of cefoperazone, while patients (56 cases) in the experimental group received treatment of cefoperazone-sulbactam. Therapeutic effect, bacterial clearance rate and adverse reaction of the two groups were compared. Serum procalcitonin (PCT) and serum hypersensitive C-reactive protein (hs-CRP) levels were observed and compared. ROC curve was used to analyze the predictive value of PCT, hs-CRP for the treatment of acute myocardial infarction complicated by infection. Logistic regression analysis was used to analyze the risk factors for the effect of acute myocardial infarction complicated by infection. The effective rates and bacterial clearance rates of treatment in the experimental group were higher than those in the control group (P<0.05). After treatment, the PCT and hs-CRP levels of the experimental group were lower than those of the control group (P<0.05). Age, hypertension, length of hospital stay, heart failure and hs-CRP were independent risk factors affecting the effective rate of treatment for acute myocardial infarction complicated by infection. In conclusion, cefoperazone-sulbactam has good therapeutic effect on acute myocardial infarction complicated with infection. It can reduce the level of PCT and serum inflammatory indicator hs-CRP; PCT and hs-CRP have certain predictive value on the therapeutic effect, which is worthy of promotion.

scholarly journals Acute Myocardial Infarction In Systemic Mastocytosis: Case Report With Literature Review Of The Role Of Inflammatory Process In Acute Coronary Syndrome

2020 ◽  
Vol 16 ◽  
Author(s):  
Ayman Battisha ◽  
Khalid Sawalha ◽  
Bader Madoukh ◽  
Omar Sheikh ◽  
Karim Doughem ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Plasma Lipids ◽  
Plaque Rupture ◽  
Systemic Mastocytosis ◽  
Cardiac Risk ◽  
Control Group ◽  
Coronary Syndrome

: Systemic Mastocytosis (SM) is a disorder of excessive mast cell infiltration in multiple organ tissues. Atherosclerosis is a major risk factor for developing acute coronary syndrome [1]. In addition to lipid accumulation in the arterial wall, inflammation plays an important role in the pathogenesis of plaque rupture and activating the thrombosis cascade [2]. The Mast cells contribution to plaque destabilization has been well established in multiple animal and human studies [3]. In a recent study, SM has been proven to be associated with a higher incidence of acute coronary syndrome even with lower plasma lipids level [4]. The study showed that 20% of patients with SM had cardiovascular events compared to only 6% in the control group with adjustment to all cardiac risk factors. Here, we present a case of acute myocardial infarction in a patient with SM with limited risk factors other than age.

scholarly journals Evaluation of the Efficiency of N-terminal Pro-B-type Natriuretic Peptide for Diagnosis of Acute Myocardial Infarction

2020 ◽  
Author(s):  
Abuagla M. Dafalla ◽  
Leena A. Dafalla ◽  
ShamsEldein M. Ahmed ◽  
Yousif A. Mohammed ◽  
Adam D. Abakar ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Natriuretic Peptide ◽  
Predictive Value ◽  
Troponin I ◽  
Venous Blood ◽  
Cardiac Biomarkers ◽  
Control Group ◽  
Heart Cell ◽  
Cardiac Biomarker

Background: Cardiac diseases are one of the major causes of death worldwide with increasing incidence rate per year, particularly in developing countries such as Sudan owing to urbanization and changing lifestyle. Myocardial infarction is a consequence of the imbalance between the heart blood supply and the required heart cell; this disorder leads to necrosis of myocardium and may cause death. It could be diagnosed by at least two of the following criteria: chest pain, electrocardiography (ECG) elevation, and levels on cardiac biomarkers. This study aimed to evaluate the efficiency of N-terminal pro-B-type natriuretic peptide (NTproBNP) for the diagnosis of acute myocardial infarction (AMI).  Methods: This analytical case–control hospital-based study was conducted on a total of 70 individuals, of which 40 participants were suspected of or diagnosed with AMI, while 30 healthy subjects  were included as a control group. Three ml of venous blood were collected in lithium heparin containers. Troponin I (TnI) as a cardiac biomarker was measured by TOSOH AIA-360, while the NTproBNP level was detected using I-Chroma II. Personal and clinical data were collected directly from each participant using a predesigned questionnaire. Results: A significant increase in the TnI level (mean: 13.13 ± 18.9 ng/ml) and NTproBNP (mean: 5756.5 ± 8378.2 pg/mL) in AMI patients were detected when compared with control mean (0.02 ± 0.00 ng/ml and 57.8 ± 42.32 pg/mL, respectively). Conclusions: NTproBNP gave a high sensitivity (87.5%), specificity (100%), positive predictive value (100%), and negative predictive value (85.7%) in the diagnosis of AMI when compared with another cardiac biomarker such as TnI. Keywords: acute myocardial infarction, NTproBNP, troponin I, Medani Heart Center, Sudan

scholarly journals Artificial Neural Network-Based Predicting the Risk of Complicating Ventricular Tachyarrhythmia after Acute Myocardial Infarction During Hospitalization

2020 ◽  
Author(s):  
Xifeng Zheng ◽  
Weidong Nong ◽  
Dehui Feng ◽  
Junxian Wang ◽  
Yan He
Keyword(s):  
Neural Network ◽  
Risk Factors ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Artificial Neural Network ◽  
Predictive Value ◽  
Confusion Matrix ◽  
Ventricular Tachyarrhythmia ◽  
Ann Model ◽  
Training Set

Abstract An artificial neural network (ANN) model was developed to predict the risks of complicating ventricular tachyarrhythmia (VTA) in patients with acute myocardial infarction (AMI). We enrolled information of 503 patients with 13 risk factors from the affiliated hospital of Guangdong medical university from January 2017 to December 2019. Risk factors were dimensionally reduced and simplified as new variables by principal component analysis (PCA). The cohort were randomly divided into a training set and a testing set at the ratio of 70%:30%. Training set was used to develop a model for the prediction of VTA while testing set was used to evaluate the performance of the model. Three new comprehensive variables by PCA are able to reflect all information of the original data. We determined the prediction model with optimizing parameters by cyclic searching which includes an input layer of three comprehensive variables, a single hidden layer composed of two neurons and a output layer. The area under curve (AUC) is 0.812 in training set and confusion matrix with accuracy 94.60%, sensitivity 63.04%, specificity 99.35%, positive predicative value 93.55%, negative predictive value 94.70%. The model displayed a decreased but medium discrimination with an AUC of 0.688 in the independent testing cohort, confusion matrix with accuracy 87.42%, Sensitivity 39.26%, specificity 98.37%, positive predicative value 84.62%, negative predictive value 87.68%. The research suggests that ANN model could be used to predict the risk of complicating ventricular tachyarrhythmia after acute myocardial infarction while should be further improved.

scholarly journals Artificial Neural Network-based Predicting the Risk of Complicating Ventricular Tachyarrhythmia After Acute Myocardial Infarction During Hospitalization

2020 ◽  
Author(s):  
Xifeng Zheng ◽  
Weidong Nong ◽  
Dehui Feng ◽  
Junxian Wang ◽  
Yan He
Keyword(s):  
Neural Network ◽  
Risk Factors ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Artificial Neural Network ◽  
Predictive Value ◽  
Confusion Matrix ◽  
Ventricular Tachyarrhythmia ◽  
Ann Model ◽  
Training Set

Abstract An artificial neural network (ANN) model was developed to predict the risks of complicating ventricular tachyarrhythmia (VTA) in patients with acute myocardial infarction (AMI). We enrolled information of 503 patients with 13 risk factors from the affiliated hospital of Guangdong medical university from January 2017 to December 2019. Risk factors were dimensionally reduced and simplified as new variables by principal component analysis (PCA). The cohort were randomly divided into a training set and a testing set at the ratio of 70%:30%. Training set was used to develop a model for the prediction of VTA while testing set was used to evaluate the performance of the model. Three new comprehensive variables by PCA are able to reflect all information of the original data. We determined the prediction model with optimizing parameters by cyclic searching which includes an input layer of three comprehensive variables, a single hidden layer composed of two neurons and a output layer. The area under curve (AUC) is 0.812 in training set and confusion matrix with accuracy 94.60%, sensitivity 63.04%, specificity 99.35%, positive predicative value 93.55%, negative predictive value 94.70%. The model displayed a decreased but medium discrimination with an AUC of 0.688 in the independent testing cohort, confusion matrix with accuracy 87.42%, Sensitivity 39.26%, specificity 98.37%, positive predicative value 84.62%, negative predictive value 87.68%. The research suggests that ANN model could be used to predict the risk of complicating ventricular tachyarrhythmia after acute myocardial infarction while should be further improved.

scholarly journals Lipid Profile of Patients with Acute Myocardial Infarction and its Correlation with Systemic Inflammation

2013 ◽  
Vol 8 ◽  
pp. BMI.S11015 ◽  
Author(s):  
Haseeb A. Khan ◽  
Abdullah S. Alhomida ◽  
Samia H. Sobki
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Chest Pain ◽  
Lipid Profile ◽  
Systemic Inflammation ◽  
Density Lipoprotein ◽  
Normal Subjects ◽  
Lipoprotein Cholesterol ◽  
Control Group ◽  
Hs Crp

The biomarker potential of using various lipids fractions for predicting risk of acute myocardial infarction (AMI) is controversial. We therefore compared the lipid profiles, including serum total cholesterol (TC), low-density lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol (HDL) and triglycerides (TG), in 67 AMI patients. Patients included 28 STEMI (ST-elevated myocardial infarction) patients, 39 NSTEMI (non-ST-elevated myocardial infarction) patients and 25 patients with chest pain. Control group included 54 age- and gender-matched normal subjects. We also studied the correlation between lipid profile and systemic inflammation in these subjects. There were significant decreases in TC, LDL and HDL levels in both STEMI and NSTEMI patients as compared to normal subjects; however, patients with chest pain did not show any significant change in these lipids. Serum TG levels did not differ significantly among the study groups. There were significant increases in serum high-sensitive C-reactive protein (hs-CRP) levels in STEMI and NSTEMI patients, as compared to control group. Serum hs-CRP showed significant inverse correlation with HDL; however, hs-CRP was not correlated with TC, LDL, and TG. In conclusion, our findings suggest that reduction in serum TC does not prevent the risk of AMI, whereas a decrease in serum HDL and increase in hs-CRP strongly predisposes the risky individuals to an AMI event. We emphasize the importance of HDL and CRP measurements for the assessment of a combined lipid-inflammation risk factor that could be a useful predictor of high risk individuals, as well as a prognostic marker in AMI patients.

scholarly journals Effect of Tirofiban Injection on vascular endothelial function, cardiac function and inflammatory cytokines in patients with acute myocardial infarction after emergency Percutaneous Coronary Intervention

2021 ◽  
Vol 38 (1) ◽  
Author(s):  
Shi-xin Kang ◽  
Xiao-min Meng ◽  
Jing Li
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Endothelial Function ◽  
Cardiac Function ◽  
Inflammatory Cytokines ◽  
Control Group ◽  
Vascular Endothelial ◽  
Vascular Endothelial Function ◽  
Significant Difference ◽  
Experimental Group

Objectives: To evaluate the effect of tirofiban injection on vascular endothelial function, cardiac function, inflammatory cytokines and other indicators in patients with acute myocardial infarction after emergency PCI and its clinical significance. Methods: Eighty patients with acute myocardial infarction admitted to Affiliated Hospital of Hebei University from March 18, 2020 to October 18, 2020 were enrolled and randomly divided into two groups: the experimental group and the control group, with 40 cases in each group. Patients in both groups underwent PCI. Patients in the control group were given oxygen inhalation, monitoring, and basic medications for myocardial infarction, such as nutritional myocardial drugs, statins, aspirin, nitrates, clopidogrel, and β-blockers. In contrast, patients in the experimental group received tirofiban 10 ug/kg intravenously over 5min immediately before PCI in addition to basic treatment, and then tirofiban 0.1 ug/(kg/min) was pumped via intravenous pump postoperatively for 48 hour. The changes of vascular endothelial function, cardiac function and adverse drug reactions (ADRs) in the two groups before treatment, one week and one month after treatment, as well as changes of inflammatory cytokines such as CRP and IL-6 in the two groups before and after treatment were compared and analyzed. Results: Compared with the control group, FMD, NO, ET-1 and other indexes in the experimental group were significantly improved one week and one month after treatment, with statistically significant differences (p<0.05). BNP, LVEDD, LVEF and additional indexes in the experimental group were significantly lower than those in the control group at one week and one month after treatment, with statistically significant differences (p=0.00). Moreover, the incidence of ST-segment fallback > 70% in the experimental group was 72.5% after treatment, which was significantly better than that of 47.5% in the control group, with a statistically significant difference (p=0.03). CRP and IL-6 in the experimental group were significantly lower than those in the control group after treatment, with a statistically significant difference (p=0.00). There was no statistical significance in the incidence of ADRs between the two groups after treatment (p=0.42). Conclusion: Tirofiban injection after emergency PCI is a beneficial treatment regime for patients with STEMI. With such a treatment regime, cardiac function and vascular endothelial function of patients can be dramatically improved, coronary blood supply will be ameliorated, inflammatory cytokines can be reduced, and no significant increase can be seen in the incidence of adverse reactions. doi: https://doi.org/10.12669/pjms.38.1.4413 How to cite this:Kang S, Meng X, Li J. Effect of Tirofiban Injection on vascular endothelial function, cardiac function and inflammatory cytokines in patients with acute myocardial infarction after emergency Percutaneous Coronary Intervention. Pak J Med Sci. 2022;38(1):---------. doi: https://doi.org/10.12669/pjms.38.1.4413 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals HIGH SENSITIVITY C-REACTIVE PROTEIN SEBAGAI FAKTOR RESIKO INDEPENDEN DIBANDING FAKTOR RESIKO KARDIOVASKULER KLASIK PADA INFARK MIOKARD AKUT

2015 ◽  
Vol 38 (3) ◽  
pp. 173
Author(s):  
Eka Fithra Elfi
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Pearson Correlation ◽  
High Sensitivity ◽  
T Test ◽  
Hs Crp ◽  
Elisa Data

AbstrakPenelitian ini bertujuan menganalisis hubungan antara hs-CRP dengan faktor resiko kardiovaskuler klasik pada pasien dengan infark miokard akut. Penelitian ini merupakan subgroup analisis pada penderita infark miokard akut yang dirawat di RSUP Dr.M.Djamil mulai Januari-April 2013. Faktor resiko kardiovaskuler sebagai variabel independen berupa umur, riwayat hipertensi, diabetes, merokok, dan dislipidemia. Pengukuran IMT, profil lipid, dan gula darah random diambil saat pasien masuk dan diperiksa di Laboratorium Sentral RSUP Dr. M. Djamil Padang. Variabel dependen hs-CRP diambil dalam 24-36 jam rawatan dan diperiksa dengan metode ELISA. Data dianalisis dengan t-test dan uji korelasi Pearson. Hasil penelitian menunjukkan peningkatan hs-CRP, secara statistik berhubungan signifikan terhadap IMT (r=0,45; p=0,01), namun tidak berhubungan dengan faktor resiko kardiovaskuler lain seperti usia, hipertensi, diabetes, merokok, dan dislipidemia. Penelitian ini dapat disimpulkan bahwa peningkatan hs-CRP tidak berhubungan dengan faktor resiko kardiovaskuler klasik dan hs-CRP merupakan faktor resiko yang bersifat independen. Pemeriksaan ini bisa menjadi prediksi penyakit kardiovaskuler dan juga sebagai nilai prognostik pada pasien infark miokard akut.Abstract This study aimed to analyze the relationship between hs-CRP with classic cardiovascular risk factors in patients with acute myocardial infarction. This study was a subgroup analysis in patients with acute myocardial infarction who were hospitalized in Dr.M.Djamil hospital started from January to April 2013. Cardiovascular risk factors as independent variables were age, history of hypertension, diabetes, smoking, and dyslipidemia. Measurement of BMI, lipid profile, and random blood sugar were taken and examined at admission. The dependent variable hs-CRP were taken within 24-36 hours of admission and examined by ELISA. Data was analyzed by t-test and Pearson correlation test. The results showed an increase in hs-CRP and significantly related to BMI (r = 0.45; p=0.01), but not associated with other cardiovascular risk factors such as age, hypertension, diabetes, smoking, and dyslipidemia. It was concluded that increased hs-CRP was not associated with classic cardiovascular risk factors and hs-CRP is an independent risk factor. Hs-CRP examination could be a predictive of cardiovascular disease as well as prognostic value in patients with acute myocardial infarction.

scholarly journals Predictive value of elevated alanine aminotransferase for in-hospital mortality in patients with acute myocardial infarction

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jian Li ◽  
Zhuo Zhao ◽  
Hui Jiang ◽  
Minjie Jiang ◽  
Ge Yu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Liver Disease ◽  
Hospital Mortality ◽  
Predictive Value ◽  
Alanine Aminotransferase ◽  
Primary Outcome ◽  
All Cause Mortality ◽  
D Dimer

Abstract Background and aims Liver enzymes, including alanine aminotransferase (ALT) and aspartate aminotransferase (AST), are markers of hepatic dysfunction and fatty liver disease. Although ALT and AST have been suggested as risk factors for cardiovascular disease, their role as predictors of mortality after acute myocardial infarction (AMI) has not been established. The objective of this study was to investigate the predictive value of ALT and AST for mortality in patients with AMI. Methods We analyzed records of 712 patients with AMI and no known liver disease treated at the Department of Cardiovascular Center in the First Hospital of Jilin University. The primary outcome was all-cause in-hospital mortality. Relationships between primary outcome and various risk factors, including serum transaminase levels, were assessed using multivariate logistic regression analysis. Results Age (P < 0.001), hypertension (P = 0.034), prior myocardial infarction (P < 0.001), AST (P < 0.001), ALT (P < 0.001), creatinine (P = 0.007), blood urea nitrogen (P = 0.006), and troponin I (P < 0.001) differed significantly between ST-segment elevation myocardial infarction (STEMI) and non-STEMI. The following factors were associated with an increased risk of in-hospital all-cause mortality in patients with AMI: ALT ≥ 2ULN (adjusted odds ratio [AOR] 2.240 [95% confidence interval (CI), 1.331–3.771]; P = 0.002); age ≥ 65 year (AOR 4.320 [95% CI 2.687–6.947]; P < 0.001); increased fasting plasma glucose (FPG) (AOR 2.319 [95% CI 1.564–3.438]; P < 0.001); elevated D-dimer (AOR 2.117 [95% CI 1.407–3.184]; P < 0.001); elevated fibrinogen (AOR 1.601 [95% CI 1.077–2.380]; P = 0.20); and reduced estimated glomerular filtration rate (eGFR) (AOR 2.279 [95% CI 1.519–3.419]; P < 0.001). Conclusions Our findings demonstrated that elevated ALT was independently associated with increased in-hospital all-cause mortality in patients with AMI. Other risk factors were increased age, FPG, D-dimer, and fibrinogen and decreased eGFR.

Clinical Efficacy and Safety Analysis on Targeted Nursing Intervention Combined with Drug Therapy of Aspirin and Clopidogrel in the Treatment of Ischemic Stroke

2021 ◽  
Vol 7 (5) ◽  
pp. 3988-3996
Author(s):  
Wanjiao Tang ◽  
Chilei Ma
Keyword(s):  
Ischemic Stroke ◽  
Drug Therapy ◽  
Platelet Aggregation ◽  
Clinical Efficacy ◽  
Nursing Intervention ◽  
Control Group ◽  
Efficacy And Safety ◽  
Hs Crp ◽  
Experimental Group ◽  
Better Than

Objective. The purpose of the study was to investigate the clinical efficacy and safety of targeted nursing intervention combined with drug therapy of aspirin and clopidogrel in the treatment of ischemic stroke. Methods. A total of 118 ischemic stroke patients admitted to our hospital from January 2018 to January 2020 were selected and divided into control group (n=59) and experimental group (n=59) according to the order of admission, and their clinical data were retrospectively analyzed. Among them, the control group patients were treated with aspirin, while the patients in the experimental group received the drug therapy of aspirin combined with clopidogrel. After that, the indexes related to the clinical efficacy and safety of treatment were compared between the two groups. Results. The total effective rate of treatment in the experimental group was significantly higher than that in the control group; the NIHSS and ADL scores in both groups after treatment were significantly better than those before treatment, and after treatment, the NIHSS and ADL scores in the experimental group were significantly better than those in the control group; the serum hs-CRP levels and platelet aggregation rate of the patients after treatment were significantly lower than those before treatment, and the serum hs-CRP levels and platelet aggregation rate of the patients in the experimental group were lower than those in the control group, and after treatment, the mean hs-CRP levels of the patients in the experimental group were within the normal range, with statistically significant differences; during treatment, there were 2 cases of epistaxis in the control group, and 1 case of epistaxis as well as 2 cases of gingival bleeding in the experimental group, and there were no adverse reactions occurring in patients’ skin and mucosa, digestive tract, brain, etc. Conclusion. Over a short period of time, targeted nursing intervention combined with drug therapy of aspirin and clopidogrel, with obvious clinical efficacy and high safety, can effectively improve serum hs-CRP levels, inhibit platelet aggregation as well as improve prognosis in patients.

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