scholarly journals Gamma glutamyl transferase as an atherogenic predictive marker in acute coronary syndrome

2017 ◽  
Vol 5 (3) ◽  
pp. 1095
Author(s):  
Sujesh Kumar N. ◽  
Sajitha Krishnan
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Gamma Glutamyl Transferase ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
Segment Elevation Myocardial Infarction ◽  
Control Subjects ◽  
St Segment ◽  
Significant Difference ◽  
Glutamyl Transferase

Background: Acute coronary syndrome (ACS) remains a leading cause of mortality and morbidity world-wide. Atherosclerosis is the predominant cause of ACS and biomarkers that could detect vulnerable atherosclerotic plaque could potentially be of great value in identifying patients at risk of developing coronary events. The aim was to assess the role of gamma-glutamyl transferase (GGT) in atherosclerosis process. The objective was to compare serum levels of GGT in patients with ACS and control subjects, and also to find out the association between GGT and atherogenic risk factors such as diabetes mellitus, hypertension, dyslipidemia and smoking.Methods: The design was a prospective case control study where a total of 151 patients, 100 ACS patients and 51 control subjects with the age group of 30-80 years were enrolled for the study. GGT was estimated by kinetic colour test using Beckman Coulter AU2700 analyser.Results: The mean GGT levels of ST-segment elevation myocardial infarction (STEMI), non-ST-segment elevation myocardial infarction (NSTEMI) and unstable angina (UA) subgroups were 93.86, 87.87 and 29.27 U/L respectively, which showed statistical significant difference (p<0.001) when compared with control subjects 21.99 U/L. The higher GGT levels in ACS patients also correlated with angiographic diagnosis of atherosclerosis. No significant difference was noted in GGT levels among ACS subgroups having risk factors and without having risk factors. Conclusions: Significantly higher GGT levels found in ACS patients reflects the burden of atherosclerotic changes and this association implies that GGT estimation can be used as an adjuvant biomarker that may help in identifying patients who are potentially at risk of coronary atherosclerosis.

scholarly journals Effect of PCSK9 E670G and R46L Polymorphisms on Major Adverse Cardio-Cerebrovascular Events in Patients with ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

2021 ◽  
Author(s):  
Anwar Santoso ◽  
Yulianto Yulianto ◽  
Hendra Simarmata ◽  
Abhirama Nofandra Putra ◽  
Erlin Listiyaningsih
Keyword(s):  
Myocardial Infarction ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
Segment Elevation Myocardial Infarction ◽  
Cerebrovascular Events ◽  
St Segment ◽  
Significant Difference

AbstractMajor adverse cardio-cerebrovascular events (MACCE) in ST-segment elevation myocardial infarction (STEMI) are still high, although there have been advances in pharmacology and interventional procedures. Proprotein convertase subtilisin/Kexin type 9 (PCSK9) is a serine protease regulating lipid metabolism associated with inflammation in acute coronary syndrome. The MACCE is possibly related to polymorphisms in PCSK9. A prospective cohort observational study was designed to confirm the association between polymorphism of E670G and R46L in the PCSK9 gene with MACCE in STEMI. The Cox proportional hazards model and Spearman correlation were utilized in the study. The Genotyping of PCSK9 and ELISA was assayed.Sixty-five of 423 STEMI patients experienced MACCE in 6 months. The E670G polymorphism in PCSK9 was associated with MACCE (hazard ratio = 45.40; 95% confidence interval: 5.30–390.30; p = 0.00). There was a significant difference of PCSK9 plasma levels in patients with previous statin consumption (310 [220–1,220] pg/mL) versus those free of any statins (280 [190–1,520] pg/mL) (p = 0.001).E670G polymorphism of PCSK9 was associated with MACCE in STEMI within a 6-month follow-up. The plasma PCSK9 level was higher in statin users.

scholarly journals Analysis of risk factors for different subtypes of acute coronary syndrome

2021 ◽  
Vol 49 (5) ◽  
pp. 030006052110083
Author(s):  
Lei Zhang ◽  
Juledezi Hailati ◽  
Xiaoyun Ma ◽  
Jiangping Liu ◽  
Zhiqiang Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Brain Natriuretic Peptide ◽  
Left Ventricular ◽  
St Segment Elevation ◽  
Amino Terminal ◽  
Coronary Syndrome ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment

Aims To investigate the different risk factors among different subtypes of patients with acute coronary syndrome (ACS). Methods A total of 296 patients who had ACS were retrospectively enrolled. Blood and echocardiographic indices were assessed within 24 hours after admission. Differences in risk factors and Gensini scores of coronary lesions among three groups were analyzed. Results Univariate analysis of risk factors for ACS subtypes showed that age, and levels of fasting plasma glucose, amino-terminal pro-brain natriuretic peptide, and creatine kinase isoenzyme were significantly higher in patients with non-ST-segment elevation myocardial infarction (NSTEMI) than in those with unstable angina pectoris (UAP). Logistic multivariate regression analysis showed that amino-terminal pro-brain natriuretic peptide and the left ventricular ejection fraction (LVEF) were related to ACS subtypes. The left ventricular end-diastolic diameter was an independent risk factor for UAP and ST-segment elevation myocardial infarction (STEMI) subtypes. The severity of coronary stenosis was significantly higher in NSTEMI and STEMI than in UAP. Gensini scores in the STEMI group were positively correlated with D-dimer levels (r = 0.429) and negatively correlated with the LVEF (r = −0.602). Conclusion Different subtypes of ACS have different risk factors. Our findings may have important guiding significance for ACS subtype risk assessment and clinical treatment.

scholarly journals Good Practices in the Clinical Management of Patients with Acute Coronary Syndrome: Retrospective Analysis in a Third-Level Hospital in Mexico

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Héctor E. Flores-Salinas ◽  
Fidel Casillas-Muñoz ◽  
Yeminia Valle ◽  
Cesar M. Guzmán-Sánchez ◽  
Jorge Ramon Padilla-Gutiérrez
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Heart Surgery ◽  
Coronary Intervention ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Percutaneous Coronary

Introduction and Objective. In Mexico, there has been an increase in the risk of cardiovascular disease due to rising life expectancy, westernized lifestyle, lack of prevention, and industrialized exposure. This article describes the pharmacological treatment, surgical interventions, and associated clinical complications in patients diagnosed with acute coronary syndrome (ACS) and their impact on in-hospital mortality frequency in a Cardiology Unit in Instituto Mexicano del Seguro Social. Methods. This is a retrospective study including male and female patients aged ≥18 years who were diagnosed with ACS. The collected data included demographic characteristics, risk factors, medications, electrocardiograms, surgical procedures, and in-hospital deaths. Results. There are at least 20% more diagnoses of ST-segment elevation myocardial infarction in this hospital compared to the latest national reports in Mexico. The most common risk factors were type 2 diabetes mellitus, hypertension, smoking, and dyslipidaemia. Diabetic patients with a clinical history of percutaneous coronary intervention had a higher risk of non-ST-segment elevation myocardial infarction than nondiabetics (OR: 2.34; p=0.013), also smoking patients with previous heart surgery than nonsmokers (OR: 7.73; p=0.0007). The average in-hospital mortality was 3.6% for ACS. Conclusions. There is a higher percentage of coronary interventionism and improvement in pharmacological treatment, which is reflected in lower mortality. The substantial burden of T2DM could be related to a higher number of cases of STEMI. Diabetics with precedent percutaneous coronary intervention and smokers with previous heart surgery have an increased risk of subsequent infarction.

scholarly journals Dyslipidemia and Conventional Risk Factors in Patients with Acute Coronary Syndrome Admitted in a CCU of a Tertiary Care Hospital of Bangladesh

2021 ◽  
Vol 14 (1) ◽  
pp. 24-29
Author(s):  
Md Mahfuzur Rahman ◽  
Farid Uddin Ahmed ◽  
Sanjida Sharmin ◽  
Tanvir Hyder ◽  
Saifuddin Nehal
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Risk Factor ◽  
Tertiary Care ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Conventional Risk Factors

Background: Coronary artery disease (CAD) is the single largest cause of death in the developed countries and is one of the leading causes of disease burden in developing countries. The prevalence of dyslipidemia and conventional risk factors profile at the time of admission in patients with Acute Coronary Syndrome (ACS) is not well described in our context. The aim of this study was to investigate the prevalence of dyslipidemia and conventional risk factors profiles of patients with ACS in a tertiary care center of Bangladesh. Methods: This descriptive cross-sectional study included 96 admitted patients of ACS [30 cases of Unstable Angina, 25 cases of Non ST segment Elevation Myocardial Infarction and 41 cases of ST segment Elevation Myocardial Infarction] from the Department of Cardiology, Abdul Malek Ukil Medical College Hospital, Noakhali, Bangladesh from January 2019 to June 2019. Fasting serum lipid profile was obtained within 24 hours of hospitalization and demographic and other cardiovascular risk factors were documented. Results: The mean age of the subjects were 57.7±14.4 years with majority (71.9%) being male. The most frequent reported risk factor was smoking, present in 55.2% of patients, followed by hypertension (47.9%), diabetes (37.5%), dyslipidemia (27.1%) and family history of CAD (15.6%). Based on Body Mass index 50% patients were obese (≥25kg/m2) and 69.8% had central obesity based on waist circumference. The lipid profile analysis revealed that 99% of patients had some type of dyslipidemia, and the most frequent was high level of triglyceride and low levels of high-density lipoprotein cholesterol (68.8% of cases in each). Conclusion: Dyslipidemia is a significant risk factor in patients with ACS and high TG and low HDL-C were more prevalent. Careful attention to its management may help to reduce further events. Cardiovasc j 2021; 14(1): 24-29

Evolution of hospital discharge medication and 6 months outcomes of ST-Segment Elevation Myocardial Infarction patients in Portugal over the years

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J.P De Sousa Bispo ◽  
T.F Mota ◽  
R Fernandes ◽  
P Azevedo ◽  
D Carvalho ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Hospital Discharge ◽  
Public Institution ◽  
Categorical Variables ◽  
Funding Source ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
Segment Elevation Myocardial Infarction ◽  
Discharge Medication ◽  
St Segment

Abstract Objectives To assess the evolution of hospital discharge management, 6 months hospitalization and mortality over the years of all patients admitted with ST segment elevation myocardial infarction (STEMI) in Portugal. Methods A nationwide electronic prospective registry that included all patients admitted to Portuguese hospitals with a diagnosis of Acute Coronary Syndrome since 2002 until 2018 was used to collect all data relative to patients admitted with a STEMI diagnosis during that time frame. Data on demographic data, clinical status, revascularization strategy, discharge medication and 6 months hospitalization and mortality were obtained. We compared the data and its evolution over the years to assess for trends. For statistical analysis, Qui-square tests were used to assess trends in categorical variables, and Kruskal-Wallis tests were used to assess trends in numerical variables. A p-value &lt;0.05 was considered statistically significant. Results During the study, a total of 23807 patients were admitted for STEMI in Portuguese hospitals, 74.3% were male and average age of 63.9±13.6 years. We report a progressive and significant increase the use of primary angioplasty versus fibrinolysis (24.3% to 98.4%, p&lt;0.001), in coronary angioplasties (36.4% to 73.2%, p&lt;0.001), in the use of drug-eluting stents (0% to 70.1%, p&lt;0.001), and a decrease in the patients that underwent surgery (6.8% to 1.3%, p&lt;0.001) and intra-aortic balloon pump (1.8% to 0%, p=0.009), resulting in a decrease in in-hospital mortality from 9.9% to 6.1% (p&lt;0.001). At discharge, we report a progressive increase in the prescription of P2Y12 inhibitors (21.1% to 95.2%, p&lt;0.001), beta-blockers (68.8% to 83.8%, p&lt;0.001), RAAS inhibitors (69.5% to 86.7%, p&lt;0.001) and statins (79.6% to 94.9%, p&lt;0.001), while the prescription of aspirin (94.1% para 94.8%, p=0.428), calcium channel blockers (5.3% to 5.6%, p&lt;0.684) stayed stable, and there was a decrease in the prescription of nitrates (52.9% to 5.8%, p&lt;0.001). Hospital admissions at 6 months consistently and progressively reduced over time (18.6% to 8.5%, p&lt;0.001) as well as mortality (6.7% para 4.3%, p&lt;0.001). Conclusion Post discharge treatment of STEMI patients in Portuguese hospitals has evolved according to guidelines, with higher prescription of medication proven to reduce outcomes, resulting in lower hospitalization rates and mortality. 6 Month Outcomes over the years Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): Sociedade Portuguesa de Cardiologia

Clots Kill: Hematologic Pharmacology for ST-Segment Elevation Myocardial Infarction

2012 ◽  
Vol 32 (6) ◽  
pp. 35-41
Author(s):  
Stacy H. James
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Antiplatelet Agents ◽  
Thrombin Inhibitors ◽  
Fibrinolytic Agents ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment

Drugs that work on the hematologic system play an important role in helping to limit the morbidity and mortality that can be associated with an acute coronary syndrome. The pharmacology of the fibrinolytic agents, thrombin inhibitors, and antiplatelet agents is described. A case study of a woman having an ST-segment elevation myocardial infarction is reviewed to highlight the importance of drugs that work on the hematologic system.

scholarly journals The stress hyperglycaemia ratio is associated with left ventricular remodelling after first acute ST-segment elevation myocardial infarction

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shuai Meng ◽  
Yong Zhu ◽  
Kesen Liu ◽  
Ruofei Jia ◽  
Jing Nan ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
Stress Hyperglycaemia ◽  
St Segment ◽  
Significant Difference ◽  
First Time

Abstract Background Left ventricular negative remodelling after ST-segment elevation myocardial infarction (STEMI) is considered as the major cause for the poor prognosis. But the predisposing factors and potential mechanisms of left ventricular negative remodelling after STEMI remain not fully understood. The present research mainly assessed the association between the stress hyperglycaemia ratio (SHR) and left ventricular negative remodelling. Methods We recruited 127 first-time, anterior, and acute STEMI patients in the present study. All enrolled patients were divided into 2 subgroups equally according to the median value of SHR level (1.191). Echocardiography was conducted within 24 h after admission and 6 months post-STEMI to measure left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD), and left ventricular end-systolic diameter (LVESD). Changes in echocardiography parameters (δLVEF, δLVEDD, δLVESD) were calculated as LVEF, LVEDD, and LVESD at 6 months after infarction minus baseline LVEF, LVEDD and LVESD, respectively. Results In the present study, the mean SHR was 1.22 ± 0.25 and there was significant difference in SHR between the 2 subgroups (1.05 (0.95, 1.11) vs 1.39 (1.28, 1.50), p < 0.0001). The global LVEF at 6 months post-STEMI was significantly higher in the low SHR group than the high SHR group (59.37 ± 7.33 vs 54.03 ± 9.64, p  = 0.001). Additionally, the global LVEDD (49.84 ± 5.10 vs 51.81 ± 5.60, p  = 0.040) and LVESD (33.27 ± 5.03 vs 35.38 ± 6.05, p  = 0.035) at 6 months after STEMI were lower in the low SHR group. Most importantly, after adjusting through multivariable linear regression analysis, SHR remained associated with δLVEF (beta = −9.825, 95% CI −15.168 to −4.481, p  < 0.0001), δLVEDD (beta = 4.879, 95% CI 1.725 to 8.069, p  = 0.003), and δLVESD (beta = 5.079, 95% CI 1.421 to 8.738, p  = 0.007). Conclusions In the present research, we demonstrated for the first time that SHR is significantly correlated with left ventricular negative remodelling after STEMI.

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