scholarly journals High triglyceride-glucose index is associated with adverse cardiovascular outcomes in patients with acute myocardial infarction

2020 ◽  
Author(s):  
Yue Zhang ◽  
Xiaosong Ding ◽  
Bing Hua ◽  
Qingbo Liu ◽  
Hui Gao ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Cardiac Death ◽  
Left Ventricular ◽  
Cardiovascular Outcomes ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Tyg Index ◽  
Significant Difference

Abstract Background Triglyceride glucose (TyG) index is considered a new marker for metabolic disorders. Although recent studies have found an association between TyG index level and vascular disease development, the prognostic value of TyG index in patients with acute myocardial infarction (AMI) remains unclear. Methods A total of 3181 patients with AMI, who underwent coronary angiography, were identified from the Cardiovascular Center of Beijing Friendship Hospital Database Bank and included in the analysis. Patients were stratified into 2 groups according to their baseline TyG index levels: the TyG index < 8.88 group and the TyG index ≥ 8.88 group. Clinical characteristics,biochemical parameters, and the incidence of major adverse cardiovascular events (MACEs) during a median of 33.3-month follow-up were recorded. The TyG index was calculated using the following formula: ln [fasting triglycerides (mg/dL) × fasting plasma glucose (mg/dL)/2]. Results Kaplan-Meier analysis revealed no significant difference in the incidence of all-cause death and cardiac death between the 2 groups. Compared with the TyG index < 8.88 group, the TyG index ≥ 8.88 group had significantly higher incidences of non-fatal MI, revascularization, cardiac rehospitalization and composite MACEs. Multivariable Cox regression models revealed that the TyG index was positively associated with all-cause death [HR (95% CI): 1.51 (1.10,2.06), P = 0.010], cardiac death [HR (95%CI): 1.68 (1.19,2.38), P = 0.004], revascularization [HR (95%CI): 1.50 (1.16,1.94), P = 0.002], cardiac rehospitalization [HR (95%CI): 1.25 (1.05,1.49), P = 0.012], and composite MACEs [HR (95%CI): 1.19 (1.01,1.41), P = 0.046] in patients with AMI. The independent predictive effect of TyG index on all-cause death and cardiac death was mainly reflected in the subgroups of male gender, body mass index ≥ 25 kg/m2, smoker, diabetes mellitus, estimated glomerular filtration rate (eGFR) ≥ 60 ml/min/1.73 m2, high-density lipoprotein cholesterol ≥ 1.01 mmol/L and left ventricular ejection fraction (LVEF) ≥ 0.50. The results also revealed that diabetes mellitus, previous AMI, eGFR, LVEF, and multi-vessel/left main coronary artery lesions were independent predictors of MACEs in patients with AMI (all P < 0.05). Conclusions High TyG index levels appeared to be associated with an increased risk of MACEs in patients with AMI. The TyG index might be a valid predictor of cardiovascular outcomes of patients with AMI. Trial registration: retrospectively registered

scholarly journals High triglyceride-glucose index is associated with adverse cardiovascular outcomes in patients with acute myocardial infarction

2020 ◽  
Author(s):  
Yue Zhang ◽  
Xiaosong Ding ◽  
Bing Hua ◽  
Qingbo Liu ◽  
Hui Gao ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Cardiac Death ◽  
Left Ventricular ◽  
Cardiovascular Outcomes ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Tyg Index ◽  
Increased Risk

Abstract Background Triglyceride glucose (TyG) index is considered a new marker for metabolic disorders. Although recent studies have found an association between TyG index level and vascular disease development, the prognostic value of TyG index in patients with acute myocardial infarction (AMI) remains unclear. Methods A total of 3181 patients with AMI, who underwent coronary angiography, were identified from the Cardiovascular Center of Beijing Friendship Hospital Database Bank and included in the analysis. Patients were stratified into 2 groups according to their baseline TyG index levels: the TyG index <8.88 group and the TyG index ≥8.88 group. Clinical characteristics,biochemical parameters, and the incidence of major adverse cardiovascular events (MACEs) during a median of 33.3-month follow-up were recorded. The TyG index was calculated using the following formula: ln [fasting triglycerides (mg/dL) ×fasting plasma glucose (mg/dL)/2]. Results Compared with the TyG index<8.88 group, the TyG index≥8.88 group had significantly higher incidences of non-fatal MI, revascularization, cardiac rehospitalization and composite MACEs. Multivariable Cox regression models revealed that the TyG index was positively associated with all-cause death [HR (95% CI): 1.51 (1.10,2.06), P=0.010], cardiac death [HR (95%CI): 1.68 (1.19,2.38), P=0.004], revascularization [HR (95%CI): 1.50 (1.16,1.94), P=0.002], cardiac rehospitalization [HR (95%CI): 1.25 (1.05,1.49), P=0.012], and composite MACEs [HR (95%CI): 1.19 (1.01,1.41), P=0.046] in patients with AMI. The independent predictive effect of TyG index on all-cause death and cardiac death was mainly reflected in the subgroups of male gender, body mass index ≥25kg/m 2 , smoker, diabetes mellitus, estimated glomerular filtration rate (eGFR) ≥60ml/min/1.73m 2 , high-density lipoprotein cholesterol ≥1.01mmol/L and left ventricular ejection fraction (LVEF) ≥0.50. The results also revealed that diabetes mellitus, previous AMI, eGFR, LVEF, and multi-vessel/left main coronary artery lesions were independent predictors of MACEs in patients with AMI (all P<0.05). Conclusions High TyG index levels appeared to be associated with an increased risk of MACEs in patients with AMI. The TyG index might be a valid predictor of cardiovascular outcomes of patients with AMI.

scholarly journals Systematic Review of Compound Danshen Dropping Pill: A Chinese Patent Medicine for Acute Myocardial Infarction

2013 ◽  
Vol 2013 ◽  
pp. 1-15 ◽  
Author(s):  
Jing Luo ◽  
Hao Xu ◽  
Keji Chen
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Acute Myocardial Infarction ◽  
Cardiac Death ◽  
Data Extraction ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Quality Of Evidence

Objective. This paper systematically evaluated the efficacy and safety of compound Danshen dropping pill (CDDP) in patients with acute myocardial infarction (AMI).Methods. Randomized controlled trials (RCTs), comparing CDDP with no intervention, placebo, or conventional western medicine, were retrieved. Data extraction and analyses were conducted in accordance with the Cochrane standards. We assessed risk of bias for each included study and evaluated the strength of evidence on prespecified outcomes.Results. Seven RCTs enrolling 1215 patients were included. CDDP was associated with statistically significant reductions in the risk of cardiac death and heart failure compared with no intervention based on conventional therapy for AMI. In addition, CDDP was associated with improvement of quality of life and impaired left ventricular ejection fraction. Nevertheless, the safety of CDDP was unproven for the limited data. The quality of evidence for each outcome in the main comparison (CDDP versus no intervention) was “low” or “moderate.”Conclusion. CDDP showed some potential benefits for AMI patients, such as the reductions of cardiac death and heart failure. However, the overall quality of evidence was poor, and the safety of CDDP for AMI patients was not confirmed. More evidence from high quality RCTs is warranted to support the use of CDDP for AMI patients.

scholarly journals Danhong Injection (a Traditional Chinese Patent Medicine) for Acute Myocardial Infarction: A Systematic Review and Meta-Analysis

2015 ◽  
Vol 2015 ◽  
pp. 1-12 ◽  
Author(s):  
Pengda Liao ◽  
Lei Wang ◽  
Liheng Guo ◽  
Ruixiang Zeng ◽  
Juming Huang ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Western Medicine ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Limited Information ◽  
Efficacy And Safety ◽  
Ventricular Ejection Fraction ◽  
Danhong Injection ◽  
Significant Difference

Objective. We aimed to systematically assess the efficacy and safety of Danhong injection (DHI) for acute myocardial infarction (AMI) patients.Methods. We searched several electrical databases and hand searched several Chinese medical journals. Randomized controlled trials (RCTs) comparing DHI plus conventional western medicine with conventional western medicine plus placebo and RCTs comparing DHI plus conventional western medicine with conventional western medicine were retrieved. Study screening, data extraction, quality assessment, and data analysis were conducted in accordance with the Cochrane standards.Results. 13 RCTs enrolling 979 patients were included. Danhong injection could significantly reduce the risk of mortality, recurrent angina, arrhythmia, and heart failure. In addition, DHI was associated with improvement of left ventricular ejection fraction (LVEF) and reperfusion. No significant difference of DHI was found on recurrent acute myocardial infarction. However, the safety of DHI remained unknown for limited data.Conclusion. DHI might be a potentially efficacious treatment for AMI patients. Nevertheless, the safety of DHI remained uncertain for limited information. Due to the fact that the overall quality of all included studies is generally low, more high quality RCTs are expected to validate the efficacy and safety of DHI for AMI patients.

scholarly journals LEFT VENTRICULAR EJECTION FRACTION AFTER ACUTE MYOCARDIAL INFARCTION.

2008 ◽  
Vol 15 (02) ◽  
pp. 234-239
Author(s):  
HAFIZ MUGHEES ATHER
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Ejection Fraction ◽  
Left Ventricular ◽  
Left Ventricular Failure ◽  
Left Ventricular Ejection ◽  
Ventricular Failure ◽  
Ventricular Ejection Fraction ◽  
Myocardial Wall ◽  
Significant Difference

Objective: (1). To measure and compare Left Ventricular EjectionFraction (LVEF) after acute anterior wall and inferiorwall myocardial Infarction and correlate LVEF with clinical findingsin the patients. (2) To see prevalence of Left Ventricular Failure (LVF) after AMI. Design: Prospective observationalechocardiography based study.Setting: Sheikh Zayed Hospital Lahore. Period: From 2001 to 2002. A total of 60 (sixty)patients of (anterior or inferior) Acute Myocardial infarction (AMI) were included in the study. Patients were divided intwo groups on the basis of anterior myocardial wall MI (AWMI) or inferior myocardial wall MI (IWMI). Echocardiographywas done on all cases and ejection fraction was calculated by applying Simpson’s Rule and patients were examinedat the same time to see the presence of signs of left ventricular failure (LVF). (LVEF) was correlated with the findingsof LVF in these patients. Results: In patients with LVF mean ejection fraction (EF) was 37.13 with standard deviation(SD) of 8.4 %. In patients without failure the mean EF was 56.29% with SD of 3.75. In 30 patients of IWMI, mean EFwas 54.93% with SD of 6.86. In 30 patients of AWMI it was 46.07% with SD of 11.72. In all 60 patients minimum EFwas 30% and maximum was 60% with a mean of 50.50 with SD of 10.52. In AWMI, 53% patients had signs of leftventricular failure. In patients of IWMI, 13.3% had signs of LVF. Conclusions: AWMI causes more decrease in LVEF.LVF is more commonly associated with AWMI than IWMI. There is statistically significant difference in LVEF of patientswith and without LVF.

scholarly journals Inferior acute myocardial infarction caused by left anterior descending coronary artery, worse prognosis? experience in our center

2021 ◽  
Vol 10 (Supplement_1) ◽  
Author(s):  
IR Martinez Primoy ◽  
J Carmona Carmona ◽  
T Seoane Garcia ◽  
R Martinez Nunez ◽  
DF Arroyo Monino ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Coronary Artery ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Inferior Wall ◽  
Circumflex Artery ◽  
Ventricular Ejection Fraction ◽  
St Segment Elevation ◽  
Significant Difference

Abstract Funding Acknowledgements Type of funding sources: None. I Key diagnostic test in acute myocardial infarction with ST segment elevation(STEMI)is 12-lead electrocardiogram, which guides initial treatment and informs about area at necrosis risk, necrosis extension, and culprit coronary artery. ST elevation in leads II, III, aVF is related to obstruction of right coronary artery(RCA)or circumflex artery. Inferior STEMI with occlusion of left anterior descending artery(LAD)has been described. Our goal is to analyse incidence and characteristics of inferior STEMI due to LAD occlusion. M Observational retrospective study, of patients admitted to our Coronary Care Unit due to inferior STEMI, between08/2011-12/2020. We analysed all patients whose culprit artery was LAD and a random sample of138patients among those with RCA as culprit. Chi-square, Student-t or Mann-Whitney tests were used. R there were a total of2498acute coronay syndromes, 1541were STEMI. 47.7%of them(n:735)were from inferior wall. From inferior STEMI, 12were caused by LAD occlusion(1.6%, 95%confidence interval0.8-2.8%), representing0.8%of all STEMI. There were21.3%women(n:32)and a mean age of61.6 ± 12.5years, without differences by culprit artery. STEMI related with RCA presented a 28.3% of  either right ventricular dysfunction or atrioventricular block, versus none of those related to LAD(p0.037). There was difference in dominance: STEMI caused by LAD presented right dominance in72.7%of cases, while caused by RCA in94.4%(p0.034). All inferior LAD STEMIs had normal left ventricular ejection fraction(LVEF) at admission. There was no statistically significant difference in LVEF at discharge(RCA54.3 ± 7.6vsLAD50.5 ± 13.6), but there was in maximum troponin, which was higher in those STEMI related to RCA(2208 ± 1756mg/dl vs 4095 ± 3833mg/dl, p0.040). Complementary comparisons in Table. Conclusion we found that1.6%of inferior STEMI are caused by LAD occlusion instead of RCA or circumflex coronary artery. These STEMI do not cause more severe affectation of left ventricle and run without typical complications of inferior STEMI. RCALADSite of occlusion-nProximal65(47.1%)5(41.7%)Medium41(29.7%)5(41.7%)Distal32(23.2%)2(16.7%)Worst Killip-Kimbal-nI112(81.2%)10(83.3%)II11(8.0%)1(8.3%)III2(1.4%)1(8.3%)IV13(9.4%)0

Randomized, double blind, placebo-controlled, safety and efficacy study of dutogliptin in combination with filgrastim in early recovery post-MI: rationale, design and first interim analysis

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
D Von Lewinski ◽  
B Merkely ◽  
I Buysschaert ◽  
R.A Schatz ◽  
G.G Nagy ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Stem Cells ◽  
Adverse Events ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Funding Source ◽  
Early Recovery ◽  
Ventricular Ejection Fraction ◽  
Combined Application

Abstract Background Regenerative therapies offer new approaches to improve cardiac function after acute ST-elevation myocardial infarction (STEMI). Mobilization of stem cells and homing within the infarcted area have been identified as the key mechanisms for successful treatment. Application of granulocyte-colony stimulating factor (G-CSF) is the least invasive way to mobilize stem cells while DDP4-inhibitor facilitates homing via stromal cell-derived factor 1 alpha (SDF-1α). Dutogliptin, a novel DPP4 inhibitor, combined with stem cell mobilization using G-CSF significantly improved survival and reduced infarct size in a murine model. Purpose We initiated a phase II, multicenter, randomized, placebo-controlled efficacy and safety study (N=140) analyzing the effect of combined application of G-CSF and dutogliptin, a small molecule DPP-IV-inhibitor for subcutaneous use after acute myocardial infarction. Methods The primary objective of the study is to evaluate the safety and tolerability of dutogliptin (14 days) in combination with filgrastim (5 days) in patients with STEMI (EF &lt;45%) following percutaneous coronary intervention (PCI). Preliminary efficacy will be analyzed using cardiac magnetic resonance imaging (cMRI) to detect &gt;3.8% improvement in left ventricular ejection fraction (LV-EF). 140 subjects will be randomized to filgrastim plus dutogliptin or matching placebos. Results Baseline characteristics of the first 26 patients randomized (24 treated) in this trial reveal a majority of male patients (70.8%) and a medium age of 58.4 years (37 to 84). During the 2-week active treatment period, 35 adverse events occurred in 13 patients, with 4 rated as serious (hospitalization due to pneumonia N=3, hospitalization due to acute myocardial infarction N=1), and 1 adverse event was rated as severe (fatal pneumonia), 9 moderate, and 25 as mild. 6 adverse events were considered possibly related to the study medication, including cases of increased hepatic enzymes (N=3), nausea (N=1), subcutaneous node/suffusion (N=1) and syncope (N=1). Conclusions Our data demonstrate that the combined application of dutogliptin and G-CSF appears to be safe on the short term and feasible after acute myocardial infarction and may represent a new therapeutic option in future. Funding Acknowledgement Type of funding source: Other. Main funding source(s): This research is funded by the sponsor RECARDIO, Inc., 1 Market Street San Francisco, CA 94150, USA. RECARDIO Inc. is funding the complete study. The Scientific Board of RECARDIO designed the study. Data Collection is at the participating sites. Interpretation of the data by the Scientific Board and Manuscript written by the authors and approved by the Sponsor

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