scholarly journals The Synergy Beteeen Diurnal Temperature Range and Calcium Concentration Help to Predict Hospital Mortality in Patients with Acute Myocardial Infarction

2022 ◽  
Author(s):  
Xingbo Gu ◽  
dandan liu ◽  
ning Hao ◽  
xinyong Sun ◽  
xiaoxu Duan ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Risk Factor ◽  
Hospital Mortality ◽  
Serum Calcium ◽  
Roc Curve ◽  
Diurnal Temperature Range ◽  
Calcium Concentration ◽  
Serum Calcium Concentration ◽  
Low Serum

Abstract Epidemiological studies have suggested that cold is an important contributor to acute cardiovascular events and mortality. However, little is known about the Diurnal Temperature Range(DTR)impact on mortality of the patients with myocardial infarction.Calcium ions(Ca2+)play a vital role in the human body, such as cardiac electrophysiology and contraction.To investigate whether DTR on admission moderates the association between serum calcium and in-hospital mortality in patients with acute myocardial infarction(AMI). This retrospective study enrolled consecutive adult patients with AMI at a single center in China (2003–2012). Patients were divided into four groups (Ca-Q1–4) according to serum calcium concentration quartiles. Multivariate logistic regression modeling was used to assess whether DTR moderated the association between serum calcium and in-hospital mortality. The predictive value of serum calcium was evaluated by receiver operating characteristic (ROC) curve and net reclassification improvement (NRI) analyses.The study included 3780 patients.In-hospital mortality was 4.97%(188/3780).DTR moderated the association between serum calcium and in-hospital mortality(P-interaction=0.020).Patients with low serum calcium in the highest DTR quartile exhibited an increased risk of in-hospital mortality(odds ratio for Ca-Q4 vs.Ca-Q1, 0.03;95%confidence interval[95%CI], 0.01–0.20;P for trend<0.001).In the highest DTR quartile, adding serum calcium concentration to the risk factor model increased the area under the ROC curve(0.81 vs.0.76;P<0.001)and increased NRI by 20.2%(95%CI 7.5–32.9;P=0.001).Low serum calcium was an independent risk factor for in-hospital mortality in patients with AMI, and this association was moderated by DTR.Careful attention should be paid to patients with low serum calcium who experience a higher DTR on admission.

scholarly journals Predictive value of three Inflammation-based Glasgow Prognostic Scores for major cardiovascular adverse events in patients with acute myocardial infarction during hospitalization: a retrospective study

PeerJ ◽  
2020 ◽  
Vol 8 ◽  
pp. e9068
Author(s):  
Houyong Zhu ◽  
Zhaodong Li ◽  
Xiaoqun Xu ◽  
Xiaojiang Fang ◽  
Tielong Chen ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Logistic Regression ◽  
Risk Factor ◽  
Roc Curve ◽  
Predictive Value ◽  
Independent Risk Factor ◽  
Prognostic Scores ◽  
All Cause Mortality ◽  
Grace Score

Aim Inflammation-based Glasgow Prognostic Scores (GPS) have been reported to predict the prognosis of patients with acute ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). The goal of this study was to investigate whether three kinds of GPSs can effectively predict major cardiovascular adverse events (MACEs) in STEMI or non-ST-segment elevation myocardial infarction (NSTEMI) patients undergoing PPCI, elective PCI (EPCI) or conservative drug therapy during hospitalization. Methods In this retrospective cohort study, patients with acute myocardial infarction (AMI) were divided into 0, 1 or 2 score according to the GPSs. Logistic regression and receiver operating characteristic (ROC) curve analysis were performed to assess the predictive value of GPSs for MACE and all-cause mortality during hospitalization. Three kinds of GPSs, Inflammation-based Glasgow Prognostic Score (GPS), modified GPS (MGPS) and high-sensitivity CRP-modified GPS (HS-MGPS) and Global Registry of Acute Coronary Events (GRACE) score were applied in this study. Results A total of 188 patients were enrolled. The ROC curve with MACE showed that the AUC of GPS (0.820 (95% confidence interval (CI) [0.754–0.885]), P < 0.001) was larger than that of MGPS (0.789 (95% CI [0.715–0.863]), P < 0.001), HS-MGPS (0.787 (95% CI [0.717–0.856]), P < 0.001) and GRACE score (0.743 (95% CI [0.672–0.814]), P < 0.001). The ROC curve with all-cause mortality showed that the AUC of GPS (0.696 (95% CI [0.561–0.831]), P = 0.005) was similar to the HS-MGPS (0.698 (95% CI [0.569–0.826]), P = 0.005) and higher than the MGPS (0.668 (95% CI [0.525–0.812]), P = 0.016), but lower than the GRACE score (0.812 (95% CI [0.734–0.889]), P < 0.001). Multivariate logistic regression analysis showed that the GPS was an independent risk factor for the incidence of MACE during hospitalization. Compared with the odds ratio (OR) value for a GPS of 0, the OR for a GPS of 1 was 7.173 (95% CI [2.425–21.216]), P < 0.001), and that for a GPS of 2 was 18.636 (95% CI [5.813–59.746]), P < 0.001), but not an independent risk factor for all-cause mortality (P = 0.302). GRACE score was an independent risk factor for MACE (1.019 (95% CI [1.004–1.035]), P = 0.015) and all-cause mortality (1.040 (95% CI [1.017–1.064]), P = 0.001). In the subgroups classified according to the type of AMI, the presence of disease interference GPSs and the type of PCI, the ability of GPS to predict the occurrence of MACE seemed to be greater than that of MGPS and HS-MGPS. Conclusion The GPS has a good predictive value for the occurrence of MACE during hospitalization in patients with AMI, regardless of STEMI or NSTEMI, the choice of PCI mode and the presence or absence of diseases that interfere with GPS. However, GPS is less predictive of all-cause mortality during hospitalization than GRACE score, which may be due to the interference of patients with other diseases.

scholarly journals Estimated plasma volume status (ePVS) is a predictor for acute myocardial infarction in-hospital mortality: analysis based on MIMIC-III database

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jun Chen ◽  
Jiayi Shen ◽  
Dongsheng Cai ◽  
Tiemin Wei ◽  
Renyi Qian ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Hospital Mortality ◽  
Plasma Volume ◽  
Roc Curve ◽  
Poor Prognosis ◽  
Volume Status ◽  
Kaplan Meier ◽  
High Level ◽  
Mimic Iii

Abstract Background Estimated plasma volume status (ePVS) has been reported that associated with poor prognosis in heart failure patients. However, no researchinvestigated the association of ePVS and prognosis in patients with acute myocardial infarction (AMI). Therefore, we aimed to determine the association between ePVS and in-hospital mortality in AMI patients. Methods and results We extracted AMI patients data from MIMIC-III database. A generalized additive model and logistic regression model were used to demonstrate the association between ePVS levels and in-hospital mortality in AMI patients. Kaplan–Meier survival analysis was used to pooled the in-hospital mortality between the various group. ROC curve analysis were used to assessed the discrimination of ePVS for predicting in-hospital mortality. 1534 eligible subjects (1004 males and 530 females) with an average age of 67.36 ± 0.36 years old were included in our study finally. 136 patients (73 males and 63 females) died in hospital, with the prevalence of in-hospital mortality was 8.9%. The result of the Kaplan–Meier analysis showed that the high-ePVS group (ePVS ≥ 5.28 mL/g) had significant lower survival possibility in-hospital admission compared with the low-ePVS group (ePVS < 5.28 mL/g). In the unadjusted model, high-level of ePVS was associated with higher OR (1.09; 95% CI 1.06–1.12; P < 0.001) compared with low-level of ePVS. After adjusted the vital signs data, laboratory data, and treatment, high-level of ePVS were also associated with increased OR of in-hospital mortality, 1.06 (95% CI 1.03–1.09; P < 0.001), 1.05 (95% CI 1.01–1.08; P = 0.009), 1.04 (95% CI 1.01–1.07; P = 0.023), respectively. The ROC curve indicated that ePVS has acceptable discrimination for predicting in-hospital mortality. The AUC value was found to be 0.667 (95% CI 0.653–0.681). Conclusion Higher ePVS values, calculated simply from Duarte’s formula (based on hemoglobin/hematocrit) was associated with poor prognosis in AMI patients. EPVS is a predictor for predicting in-hospital mortality of AMI, and could help refine risk stratification.

scholarly journals Impact of Raised Blood Glucose Level on In-Hospital Outcome of Thrombolysed Patients with Acute Myocardial Infarction

2020 ◽  
Vol 35 (1) ◽  
pp. 14-19
Author(s):  
Musammat Sufia Akhter ◽  
Md Faruque ◽  
Md Toufiqur Rahman ◽  
Mohammad Arifur Rahman ◽  
Mirza Abul Kalam Mohiuddin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Risk Factor ◽  
Blood Glucose ◽  
Hospital Mortality ◽  
Adverse Outcome ◽  
Diabetic Group ◽  
Diabetic Status ◽  
History Of

Background: Diabetes mellitus (DM) is an established major cardiovascular risk factor associated with increased prevalence of coronary artery disease (CAD). Patients with diabetes often have numerous concomitant cardiac risk factors with a higher incidence of acute myocardial infarction (AMI) and congestive heart failure (CHF). Patients either with or without a prior history of DM may present with hyperglycemia during AMI. We analysed our population to determine whether admission hyperglycemia was a strong risk factor for in-hospital mortality and morbidity in patients with AMI and may be even stronger than a previous history of diabetes.In-hospital death risk of AMI patients without DM was about 2 to 4 times higher in patients with hyperglycemia than in those without hyperglycemia. Methods: This Prospective observational study was carried out at the National Institute of Cardiovascular Diseases (NICVD), Dhaka. A total number of 200 STsegment elevation AMI patients were enrolled in this study as per inclusion and exclusion criteria. They were subdivided on the basis of admission blood glucose into two groups. Group-1A and 2A were 50 patients with blood glucose <200mg/dl (<11.1mmol/l) and Group-1B and 2B were 50 patients with blood glucose ≥200mg/dl (11.1 ≥mmol/l). The numerical data obtained from the study were analyzed and significance of differences were estimated by using statistical methods. Computer based SPSS (Statistical Package for Social Science) were used. Results: In the present study mean age of the male and female were 56.10±11.86 and 57.83±13.74 years, p>0.05%. There was no significant difference regarding risk factors and smoking was higher in both group. Regarding inhospital adverse outcome, death was significantly higher in hyperglycemic non diabetic group (p<0.0001). It was two times (56%) higher than diabetic hyperglycemic (28%) group.Cardiogenic shock (66%) and CHF (56%) were also more common in hyperglycemic non diabetic group. Lowest patients (8%) died of AMI without DM with random blood glucose <11.1 mmol/l (controlled). On the other hand highest improvement was in the controlled group (p<0.0001).Multivariate analysis showed Diabetic status with normal blood sugar was a predictor of adverse outcome; but patients with hyperglycemia and no history of diabetes had a worse outcome and were independently associated with significant risk of in-hospital mortality. Age group >65 years and Male sex were also associated with significant in-hospital mortality. Conclusion: Independent of diabetic status, the occurrence of hyperglycemia during AMI is associated with a subpopulation of patients at particularly high risk for an adverse clinical outcome. Even with the highly efficacious treatment strategies currently available, persons presenting with AMI and hyperglycemia are at increased risk for cardiogenic shock and CHF or death in hospital. Bangladesh Heart Journal 2020; 35(1) : 14-19

scholarly journals Low serum calcium levels on admission independently predict mortality in patients with acute myocardial infarction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
W Su ◽  
J.G Zhu ◽  
M Wang ◽  
X.Q Zhao ◽  
W.P Li ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Serum Calcium ◽  
Calcium Supplementation ◽  
Funding Source ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Quartile Group ◽  
Cox Analysis ◽  
Low Serum

Abstract Background Serum calcium levels were reported to be associated with risk of cardiovascular diseases. The aim of this study was to analyze the association between serum calcium levels and all-cause mortality in patients with acute myocardial infarction (AMI). Methods A total of consecutive 3886 AMI patients with serum calcium data available were included in this analysis. The baseline characteristics, including clinical and laboratory parameters were collected. Patients were classified into 4 equally-sized groups based on serum calcium values (≤2.15, 2.16–2.23, 2.24–2.31, ≥2.32 mmol/L). Serum calcium tests were finished within 12 hours after admission. Patients were followed up for a median of 2.0 years (interquartile range 0.6–4.0). The primary endpoint was all-cause mortality. Results Compared to upper quartiles of serum calcium groups, subjects in the lowest quartile group (≤2.15 mmol/L) were older, lower body mass index (BMI), had lower levels of LDL-C and albumin, but higher level of NTproBNP. During a median follow-up period of 2.0 years, all-cause death occurred significantly more in the lowest quartile group (19.8%, 11.9%, 8.0% and 9.2% among the 4 groups from lowest to highest quartile, p&lt;0.001 for trend). After adjusting for potentially confounding variables, the Cox analysis revealed that low serum calcium levels independently predict subsequent all-cause mortality (OR=0.36, 95% CI: 0.18–0.73), and identified that older age, lower BMI, smoking, and higher levels of creatinine were also independently associated with increased risk of mortality. Conclusion Low serum calcium levels on admission independently predict mortality in patients with AMI. Further studies are required to determine whether calcium supplementation could improve outcomes in AMI patients with hypocalcemia. Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): Beijing Natural Science Foundation (no. 7194253);Scientific Research Common Program of Beijing Municipal Commission of Education (KM201910025017)

Serum Calcium and Its Association with Preeclampsia

2021 ◽  
Vol 20 (2) ◽  
pp. 379-383
Author(s):  
Sultana Parvin ◽  
Saleha Begum Chowdhury ◽  
KN Nahar ◽  
MD Mozammel Hoque
Keyword(s):  
Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Serum Calcium ◽  
Calcium Concentration ◽  
Medical Science ◽  
Serum Calcium Concentration ◽  
Group A ◽  
Group B ◽  
And Control ◽  
Low Serum

Background: The purpose of the study was to evaluate association of serum calcium concentration with preeclampsia. Method: This study was carried out in the Department of Obstetrics and Gynaecology of Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from January 2016 to December 2016 including 120 antenatal patients in their second half of pregnancy. All the included patients were classified as 40 mild preeclampsia (Group A) 40 severe preeclampsia (Group B) and 40 normal pregnant women (Group C). Serum calcium was estimated in the Department of Biochemistry and correlated with preeclampsia. Result: In results the mean serum calcium concentration was found 8.2±0.2mg /dl in Group A, 7.6 ± 0.3 mg/dl in Group B and 9.0±0.5 mg/dl in Group C (p=0.001). Low serum calcium was found 53.7% and 12.5% in case and control respectively. The difference was statistically significant (p=<0.05) between case and control groups having OR=8.1 with 95% CI (2.7 - 26.5) %. Pearson’s correlation test revealed that both systolic and diastolic blood pressure had negative correlation with the serum calcium concentration (p=<0.05). Conclusion: In conclusion this study showed that low serum calcium is associated with preeclampsia and its concentration inversely proportional to the severity of preeclampsia and both systolic and diastolic blood pressure. Bangladesh Journal of Medical Science Vol.20(2) 2021 p.379-383

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