scholarly journals Hyperhomocysteinemia and Acute Coronary Syndrome: A Hospital-Based Observational Study Among Very Young Adults ≤35 Years of Age

2020 ◽  
Author(s):  
Jiayin Sun ◽  
Wei Han ◽  
Sijing Wu ◽  
Shuo Jia ◽  
Zhenxian Yan ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Young Adults ◽  
Coronary Artery ◽  
Coronary Artery Stenosis ◽  
Young Patients ◽  
Left Ventricular ◽  
Artery Stenosis ◽  
Left Ventricular Ejection ◽  
Gensini Score ◽  
Coronary Syndrome

Abstract Background: The prevalence of acute coronary syndrome (ACS) continues to increase among young Chinese adults. Homocysteine (HCY) has been suggested as a crucial promoter of atherosclerosis leading to coronary artery disease (CAD). Yet, it remains uncertain whether HCY is associated with the ACS and the severity of coronary artery stenosis in very young adults.Methods: Very young patients (18-35years of age) diagnosed with ACS who underwent coronary angiography (CAG) at Anzhen Hospital between January 2013 and June 2019 were assigned to the ACS group. An equivalent age-matched population without CAD, as confirmed by CAG during the same period, was assigned to the non-CAD group. A serum HCY level>15µmol/L was defined as hyperhomocysteinemia (HHCY). The Gensini score assessed the severity of coronary artery stenosis.Results: A total of 1,103 participants, including 828 ACS patients and 275 non-CAD subjects, were included in this study. Very young ACS patients had higher level of serum HCY and greater prevalence of HHCY compared with non-CAD subjects [for HCY, 16.55 (11.93- 29.68) vs 12.50 (9.71- 17.42), P<0.001; for HHCY prevalence, 62.08% vs 26.18%, P<0.001]. Multivariate logistic regression analysis with the stepwise method indicated that HHCY was an independent predictor associated with the presence of ACS, after adjusting for traditional confounders (OR, 4.393; 95% CI, 3.171-6.087; P<0.001). Moreover, young ACS patients with HHCY had increased prevalence of ST-segment elevation myocardial infarction (STEMI) (P=0.041), multi-vessel disease (P=0.036), and decreased value of left ventricular ejection fraction (LVEF) (P=0.01). Also, the HCY level was significantly correlated with Gensini Score in ACS patients (r=0.142, P<0.001).Conclusion: HHCY was significantly associated with the presence of ACS and the severity of coronary artery stenosis in very young patients ≤35 years of age.

scholarly journals Associations between hyperhomocysteinemia and the presence and severity of acute coronary syndrome in young adults ≤ 35 years of age

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jiayin Sun ◽  
Wei Han ◽  
Sijing Wu ◽  
Shuo Jia ◽  
Zhenxian Yan ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Young Adults ◽  
Coronary Artery ◽  
Coronary Artery Stenosis ◽  
Left Ventricular ◽  
Artery Stenosis ◽  
Left Ventricular Ejection ◽  
Gensini Score ◽  
Ventricular Ejection Fraction ◽  
Coronary Syndrome

Abstract Background The prevalence of acute coronary syndrome (ACS) continues to increase among young Chinese adults. Homocysteine (HCY) has been suggested as a promoter of atherosclerosis leading to coronary artery disease (CAD). Yet, it remains uncertain whether HCY is associated with the ACS and the severity of coronary artery stenosis in young adults. Methods Young patients (18–35 years of age) diagnosed with ACS who underwent coronary angiography (CAG) at Anzhen Hospital between January 2013 and June 2019 were assigned to the ACS group. As confirmed by CAG during the same period, an equivalent age-matched population without CAD was assigned to the non-CAD group. A serum HCY level > 15 µmol/L was defined as hyperhomocysteinemia (HHCY). The Gensini score assessed the severity of coronary artery stenosis. Results A total of 1103 participants, including 828 ACS patients and 275 non-CAD subjects, were enrolled in this study. Young ACS patients had higher level of serum HCY and greater prevalence of HHCY compared with non-CAD subjects [for HCY, 16.55 (11.93–29.68) vs 12.50 (9.71–17.42), P < 0.001; for HHCY prevalence, 62.08% vs 26.18%, P < 0.001]. Multivariate logistic regression analysis with the stepwise method indicated that HHCY was an independent predictor associated with the presence of ACS, after adjusting for traditional confounders (OR, 4.561; 95% CI, 3.288–6.327; P < 0.001). Moreover, young ACS patients with HHCY had increased prevalence of ST-segment elevation myocardial infarction (STEMI) (P = 0.041), multi-vessel disease (P = 0.036), and decreased value of left ventricular ejection fraction (LVEF) (P = 0.01). Also, the HCY level was significantly correlated with Gensini Score in ACS patients (r = 0.142, P < 0.001). Conclusion HHCY is significantly associated with the presence of ACS and the severity of coronary artery stenosis in young adults ≤ 35 years of age.

scholarly journals Genderspecific risk factors and outcomes of ischemic heart disease

2018 ◽  
Vol 96 (9) ◽  
pp. 837-843
Author(s):  
S. A. Berns ◽  
Evgeniya A. Schmidt ◽  
A. A. Golikova ◽  
O. A. Nagirnyak ◽  
A. V. Klimenkova ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery ◽  
Cardiovascular Events ◽  
Coronary Artery Stenosis ◽  
Left Ventricular ◽  
Artery Stenosis ◽  
Left Ventricular Ejection ◽  
Syntax Score ◽  
Ventricular Ejection Fraction ◽  
Coronary Syndrome

Objective. To study the relationship of gender with the risk factors for coronary artery disease and adverse long-term outcomes in patients with acute coronary syndrome without ST segment elevation (nonST-ACS). Results. Women were older than men, significantly more likely had arterial hypertension and diabetes, but six times less smoked. Coronary artery stenosis >50% in history occurred in men more often than women: 24.2% vs. 11.7%. The median value of the left ventricular ejection fraction in men was significantly lower than in women (56 (49; 63) vs. 60 (50; 64.7), p=0.028). Men were significantly more likely to have a low risk (39.6% versus 24.5%, p=0.0027), and women had a high risk on the GRACE scale (35% versus 21.6%, p=0.0053). Women significantly (p<0.001) were less likely to undergo coronary angiography, while coronary artery stenosis was more frequent (p<0.001) in men than in women. The median scores on the Syntax score were significantly (p<0.001) lower in women - 9.5 (6; 16.5) compared to the same in men - 14 (7; 22). PCI was performed significantly more often in men (p<0.001). Differences in the incidence of adverse cardiovascular events during the five-year follow-up period after discharge after index nonST-ACS for men and women have not been identified. Conclusion. Women with nonST-ACS have more cardiovascular risk factors, in this case, the incidence of adverse cardiovascular events is the same as men with less pronounced coronary lesions, so need to use more actively invasive strategy of women during the index hospitalization.

scholarly journals A pebble clogging a river: a case report of thrombosed coronary aneurysmal ectasia

2020 ◽  
Author(s):  
Akshar Jaglan ◽  
Tarek Ajam ◽  
Steven C Port ◽  
Tanvir Bajwa ◽  
A Jamil Tajik
Keyword(s):  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Kawasaki Disease ◽  
Treatment Options ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Coronary Artery Ectasia ◽  
Ventricular Ejection Fraction ◽  
Coronary Syndrome ◽  
Patient Reported

Abstract Background Coronary artery ectasia (CAE) is a rare anomaly that can present at any age. Predisposing risk factors include Kawasaki disease in a younger population and atherosclerosis in the older generation. We present a unique case of the management of a young woman diagnosed with multivessel CAE with aneurysmal changes in the setting of acute coronary syndrome and subsequently during pregnancy. Case summary A 23-year-old woman presented with acute onset chest pain. Electrocardiogram revealed no ischaemic changes; however, troponin I peaked at 16 ng/mL (reference range 0–0.04 ng/mL). Echocardiogram showed apical dyskinesis with preserved left ventricular ejection fraction. Coronary angiography showed multivessel CAE along with significant thrombus burden in an ectatic lesion of the left anterior descending artery. Since the patient was haemodynamically stable, conservative management with dual antiplatelet therapy and anticoagulation was started. On follow-up, coronary computed tomographic angiogram illustrated resolution of the coronary thrombi and echocardiogram showed improvement to the apical dyskinesis. It was presumed that Kawasaki disease was the most likely aetiology of her disease. Subsequently the patient reported that, contrary to medical advice, she was pregnant, adding another layer of complexity to her case. Discussion Coronary artery ectasia can be discovered as an incidental finding or can present with an acute coronary syndrome. Management is challenging in the absence of randomized trials and large-scale data. Treatment options include medications, percutaneous intervention, and surgical revascularization. Close surveillance is required in these patients to assess progression of disease. Here we discuss treatment options during acute coronary syndrome and pregnancy.

Serum exosomal miR-122-5p is a new biomarker for both acute coronary syndrome and underlying coronary artery stenosis

Biomarkers ◽  
2020 ◽  
Vol 25 (7) ◽  
pp. 539-547
Author(s):  
Hao Ling ◽  
Ziyuan Guo ◽  
Shuangshuang Du ◽  
Yinghong Liao ◽  
Yunyan Li ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Coronary Artery Stenosis ◽  
Artery Stenosis ◽  
Coronary Syndrome

scholarly journals Non-mercaptalbumin is Significantly Associated with the Coronary Plaque Burden and the Severity of Coronary Artery Disease

2021 ◽  
Author(s):  
Shengpu Chou ◽  
Keiko Yasukawa ◽  
Yusuke Fujino ◽  
Midori Ishibashi ◽  
Mikiko Haraguchi ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Artery Stenosis ◽  
Strong Predictor ◽  
Artery Stenosis ◽  
Plaque Burden ◽  
Gensini Score ◽  
Coronary Syndrome ◽  
Vessel Disease ◽  
Artery Disease

Abstract Human non-mercaptalbumin (HNA), oxidized form of serum albumin, has been reported as a useful marker in oxidative stress-related diseases; however, few reports have examined the association between HNA and the severity of coronary artery disease (CAD). The present study evaluated whether the HNA fraction is correlated with coronary artery stenosis in 140 patients considered to have a high risk of CAD or who were suspected of having acute coronary syndrome. The severity of CAD was defined by the number of stenotic coronary vessels and a severity score system (the Gensini score). HNA measurements were performed using our newly established high-performance liquid chromatography methodology. The results had shown that HNA was significantly increased in patients with three-vessel disease, compared with those without CAD or with single-vessel disease (p=0.025), and was positively correlated with the Gensini score (ρ=0.421, p<0.001). A multivariate analysis showed that the number of stenotic vessels was an independent and significant factor associated with HNA (ρ=1.246, p=0.012). A logistic regression analysis showed that HNA was a strong predictor of multivessel CAD (odds ratio, 1.12; 95% confidence interval, 1.020-1.229; p=0.017). These findings indicate that the measurement of HNA could be clinically practical for predicting the severity of coronary artery stenosis.

Associations of Circulating microRNA-221 and 222 With the Severity of Coronary Artery Lesions in Acute Coronary Syndrome Patients

Angiology ◽  
2021 ◽  
pp. 000331972110342
Author(s):  
Xin Yu ◽  
Jian-feng Xu ◽  
Ming Song ◽  
Lei Zhang ◽  
Yi-hui Li ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Coronary Artery Stenosis ◽  
Quantitative Polymerase Chain Reaction ◽  
Area Under The Curve ◽  
Artery Stenosis ◽  
Circulating Microrna ◽  
Coronary Artery Lesions ◽  
Expression Levels ◽  
Coronary Syndrome

Circulating levels of microRNA-221 and 222 (miR-221/222) in patients with coronary artery disease (CAD) are elevated, yet the relationship between circulating miR-221/222 and the severity of coronary lesions in patients with acute coronary syndrome (ACS) remains unknown. In this study, the relative expression levels of circulating miR-221/222 in patients with ACS (n = 267) and controls (n = 71) were compared by real-time fluorescence quantitative-polymerase chain reaction (RT-qPCR). The ACS group was further divided into unstable angina pectoris (UA) group (n = 191) and acute myocardial infarction (AMI) group (n = 76). Significant upregulation of circulating miR-221/222 was observed in ACS. A positive linear correlation between circulating miR-221/222 and Gensini scores was demonstrated. The area under the curve (AUC) of circulating miR-221/222 in the diagnosis of coronary artery stenosis ≥50% was 0.605 and 0.643, respectively. The circulating miRNA-221/222 expression levels in ACS patients were elevated and positively associated with the severity of the coronary artery lesions. Circulating miR-221/222 may be novel biomarkers for the diagnosis of coronary artery stenosis ≥50% and the occurrence of ACS.

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