scholarly journals Prognostic Value of CA125 Serum Levels in Female Patients with Acute Coronary Syndrome

2021 ◽  
Author(s):  
YanHong Luo ◽  
YongRan Cheng ◽  
XiaoFu Zhang ◽  
MingWei Wang ◽  
Bin Ni ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Coronary Syndrome ◽  
Prognostic Value ◽  
Serum Levels ◽  
Left Ventricular ◽  
Short Term ◽  
Female Patients ◽  
Coronary Syndrome ◽  
Ca125 Level

Abstract Background: carbohydrate antigen 125 (CA125) is an increasingly promising biomarker of heart failure (HF), but its prognostic value in female patients with acute coronary syndrome (ACS) is unclear. We aimed to determine the short-term and mid-term prognostic value of CA125 serum levels in female ACS patients.Methods: A total of 131 consecutive female patients with ACS were retrospective enrolled. Their CA125 levels, B-type natriuretic peptide (BNP) levels and biochemical parameters were measured, and echocardiography was performed at admission. All-cause mortality during hospitalization and two-year follow-up was investigated for the prognosis.Results: The median value of CA125 serum level in the entire ACS patients was 13.85 U/mL. Patients in Killip Ⅲ had the highest values of CA125 level, followed by Killip Ⅱ and then Killip Ⅰ (p < 0.05). However, no statical difference was observed between Killip Ⅳ and Ⅰ-Ⅲ groups respectively (P > 0.05). The CA125 serum levels showed weak positive correlation with left ventricular end-diastolic diameter (LVEDD) (r = 0.3, P < 0.01) and a weak negative correlation with left ventricular ejection fraction (LVEF) (r = –0.23, p < 0.01). A receive operating characteristic (ROC) curve analysis showed that the AUC of CA125 in predicting acute heart failure (AHF) in ACS patients during hospitalization was 0.912, exhibiting higher sensitivity and specificity than BNP (0.846). The optimal cut-off value for CA125 in predicting AHF was 16.4 U/mL with a sensitivity of 0.916 and specificity of 0.893. The Kaplan-Meier survival analysis demonstrated that patients with high values of CA125 level had a poor overall survival than those with low values of CA125 level (log-rank, p < 0.001), whether during hospitalization or mid-term follow-up. Conclusion: Elevated CA125 level can be used to predict AHF in female ACS patients. Patients with elevated CA125 levels had higher mortality in short-term and mid-term than those with low CA125 levels.

Can left ventricular global function index be a novel marker of unfavorable outcome in patients with acute coronary syndrome

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
L Minushkina ◽  
V Brazhnik ◽  
N Selezneva ◽  
V Safarjan ◽  
M Alekhin ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Myocardial Infarction ◽  
Heart Failure ◽  
Acute Coronary Syndrome ◽  
Left Ventricular ◽  
Global Function ◽  
Coronary Syndrome ◽  
History Of ◽  
Coronary Events

Abstract   Left ventricular (LV) global function index (LVGFI) is a MRI marker of left ventricular remodeling. LVGFI has high predictive significance in young healthy individuals. The aim of the study was to assess prognostic significance in patients with acute coronary syndrome (ACS). We include into this analysis 2169 patients with ACS (1340 (61.8%) men and 829 (38.2%) women), mean age 64.08±12.601 years. All patients were observed in 2 Russian multicenter observational studies: ORACLE I (ObseRvation after Acute Coronary syndrome for deveLopment of trEatment options) (2004–2007 years) and ORACLE II (NCT04068909) (2014–2019 years). 1886 (87.0%) pts had arterial hypertension, 1539 (71.0%) – history of coronary artery disease, 647 (29.8%) – history of myocardial infarction, 444 (20.5%) - diabetes mellitus. Duration of the follow-up was 1 years after the hospital discharge. Cases of death from any cause, coronary deaths, repeated coronary events (fatal and non-fatal) were recorded. An echocardiographic study was conducted 5–7 days from the time of hospitalization. The LVGFI was defined as LV stroke volume/LV global volume × 100, where LV global volume was the sum of the LV mean cavity volume ((LV end-diastolic volume + LV end-systolic volume)/2) and myocardial volume (LV mass/density). During the follow-up, 193 deaths were recorded (8.9%), 122 deaths (5.6%) were coronary. In total, repeated coronary events were recorded in 253 (11.7%) patients. Mean LVGFI was 22.64±8.121%. Patients who died during the follow-up were older (73.03±10.936 years and 63.15±12.429 years, p=0.001), had a higher blood glucose level at the admission to the hospital (8.12±3.887 mmol/L and 7.17±3.355 mmol/L, p=0.041), serum creatinine (110.86±53.954 μmol/L and 99.25±30.273 μmol/L, p=0.007), maximum systolic blood pressure (196.3±25.17 mm Hg and 190.3±27.83 mm Hg, p=0.042). Those who died had a lower LVGFI value (19.75±6.77% and 23.01±8.243%, p&lt;0.001). Myocardial mass index, ejection fraction and other left ventricular parameters did not significantly differ between died and alive patients. Among the patients who died, there were higher rate of women, pts with a history of myocardial infarction, heart failure, diabetes. In a multivariate analysis, diabetes mellitus OR1.67 95% CI [1.12–2.51] p=0.012, history of heart failure (1.78 [1.2.-2.59], p=0.003), a history of myocardial infarction (1.47 [1.05–2.05], p=0024), age (1.06 [1.05–1.08], p=0.001) and LVGFI &lt;22% (1.53 [1.08–2.17], p=0.015) were independent predictors of death from any cause. The LVGFI was also independently associated with the risk of coronary death, but not with the risk of all recurring coronary events. Thus, LVGFI may be useful the marker to assess risk in patients who have experienced an ACS episode. Funding Acknowledgement Type of funding source: None

scholarly journals P1512 Combination of mitral annular peak systolic and early diastolic velocities with early transmitral peak flow velocity: a new prognostic echo index in patients with acute coronary syndrome

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
K Nakamura ◽  
A Yamada ◽  
M Kato ◽  
S Jinno ◽  
A Takahashi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Coronary Syndrome ◽  
Flow Velocity ◽  
Peak Flow ◽  
Left Ventricular ◽  
Volume Index ◽  
Cardiac Events ◽  
Coronary Syndrome ◽  
Peak Flow Velocity

Abstract Background One of the novel echocardiographic indices reflecting left ventricular (LV) diastolic filling is the combination of mitral annular peak systolic (s’) and early diastolic velocities (e’) with early transmitral peak flow velocity (E); E/(e’ x s’). This index is reported to be useful to predict a prognosis of heart failure patients regardless of their LV ejection fraction (LVEF).Purpose: The aim of this study was to examine whether or not E/(e’ x s’) could predict cardiac events in patients with acute coronary syndrome (ACS).Methods: We studies consecutive ACS patients hospitalized in our institution between December 2009 and February 2012. They underwent echo examination within 7 days after admission. By use of Doppler tissue imaging, e’ and s’ were respectively calculated by averaging the peak velocities measured at both septal and lateral mitral annulus in 4-chamber view. The exclusion criteria were as follows: atrial fibrillation, significant valvular diseases and inadequate echo images. Cardiac events were defined as re-hospitalization due to recurrent ACS and/or heart failure, and cardiac mortality.Results: In total, 168 patients were eligible for this study (mean age 67 ± 11 years, mean LVEF 51.7 ± 10.3 %). Median follow-up period was 22.5 months. During the follow-up, cardiac events occurred in 27 patients (16.1%). Between the patients with cardiac events and those without, there were significant differences in LV end-systolic volume (44.2 ± 29.1 vs 33.2 ± 13.6 ml, p &lt; 0.05), LV mass index (122.4 ± 38.9 vs 107.5 ± 26.4 g/m², p &lt; 0.05), left atrial volume index (31.7 ± 9.2 vs 27.6 ± 9.4 ml/m², p &lt; 0.05), LVEF (45.7 ± 13.5 vs 52.9 ± 9.2 %, p &lt; 0.05), s’ (5.1 ± 1.6 vs 7.1 ± 1.7 cm/sec, p &lt; 0.001), e’ (4.8 ± 1.3 vs 6.0 ± 1.9 cm/sec, p &lt; 0.05), E/e’ (16.4 ± 6.6 vs 12.5 ± 4.9, p &lt; 0.05), E/(e’ x s’) (3.78 ± 2.52 vs 1.94 ± 1.08, p &lt; 0.001), and serum B-type natriuretic peptide (334.7 ± 420.1 vs 113.8 ± 177.2 pg/ml, p &lt; 0.05). While Cox proportional hazard multivariate analysis detected that E/(e’ x s’) and E/e’ were independent predictors of cardiac events, E/(e’ x s’) was more powerful than E/e’ (p = 0.0002 vs p = 0.0072). ROC analysis revealed that 2.35 of E/(e’ x s’) was the optimal cutoff values to predict cardiac events in ACS patients (AUC 0.79). Patients with E/(e’ x s’) &lt;2.35 had significantly better prognosis than the rest (p &lt; 0.0001, Log-rank; Figure)Conclusion: E/(e’ x s’) could be a useful echo marker to predict cardiac events in ACS patients. Abstract P1512 Figure.

Abstract 2659: Increased Cystatin C Serum Levels Improve Risk Stratification in Patients with Acute Coronary Syndrome and Normal Glomerular Filtration Rate

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Jose Garcia-Acuna ◽  
Eva Garcia-Babarro ◽  
Mario Gutierrez ◽  
Jose Ramon Gonzalez-Juanatey
Keyword(s):  
Heart Failure ◽  
Coronary Artery Disease ◽  
Acute Coronary Syndrome ◽  
Renal Function ◽  
Filtration Rate ◽  
Serum Levels ◽  
Coronary Syndrome ◽  
Artery Disease ◽  
New Onset

Use of Cystatin C serum levels (CC) is a more sensible marker of renal function than serum Creatinine levels (Cr) and Glomerular Filtration Rate (GFR). Previous studies have shown that increased serum CC levels with normal GFR in a population with cardiovascular risks factors but without any cardiovascular disease is associated with increased cardiovascular events but this was not analyzed in ischemic heart disease patients. We prospectively studied 203 patients hospitalized with Acute Coronary Syndrome (ACS). Serum CC levels were determined in the first 24 hours of hospitalization in all cases and two groups were identified (>and< 0.95 mg/L). GFR was calculated by MDRD formulation using the first serum Cr determination in all patients and were established two groups (> and < 60 ml/min/1.73m2). Coronariography was performed in all patients. During 13 months follow-up period we analyzed Mayor Adverse Coronary Events (MACE) and Mortality. Patients with serum CC levels >0.95 were older, with higher hypertension prevalence, prior stroke, high frequency of renal disease and greater severity of coronary artery disease (42% patients with three-vessel coronary artery disease, p=0.05). During the follow-up these patients showed a significantly higher risk of heart failure new-onset (62% p=0.001) and mortality (14 %, p=0.001). Patients with GFR >60 and serum CC levels <0.95 presented significantly higher values of MACE (61%; p=0.001) and mortality (8%; p=0.001) in opposition to 18% and 3% respectively in the group of patients with GFR 3 60 and serum CC levels 30.95. Nevertheless significant prognostic differences between GFR >60 and serum CC levels <0.95 group and GFR >60 and serum CC levels >0.95 group were observed. In the multivariate analysis was observed than serum CC levels was an independent predictor to develop of new-onset heart failure (RR: 3.9 CI 95% 1.5–9.9; p=0.002), and mortality (RR: 2. CI 95% 1.2–3.6, p=0.001) during the follow-up. Serum CC levels are a powerful both mortality and heart failure predictor in patients with high risk ACS. High serum CC levels in patients with ACS and normal renal function identify a higher risk group. Serum CC determination may be include in the risk evaluation of patients with ACS.

scholarly journals 491 Short-term prognostic implications of left ventricular myocardial work indices in advanced heart failure patients treated with repetitive Levosimendan infusions

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Fabio Fazzari ◽  
Francesco Cannata ◽  
Daniele Banfi ◽  
Marta Pellegrino ◽  
Beniamino Pagliaro ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiovascular Events ◽  
Prognostic Value ◽  
Clinical Laboratory ◽  
Left Ventricular ◽  
Advanced Heart Failure ◽  
Short Term ◽  
Heart Failure Patients ◽  
Global Work

Abstract Aims Repetitive Levosimendan treatment in advanced heart failure patients has not been investigated yet via myocardial work indices (MWI), which could more accurately detect the effects of this both inotropic and vasodilatory drug. The aims of this study were (1) to describe variations of myocardial work indices, as a consequence of repetitive Levosimendan infusions and (2) to assess the prognostic value of myocardial work parameters in these patients. Methods and results Fourteen patients with advanced heart failure treated with intermittent in-hospital levosimendan infusions were prospectively included. Clinical, laboratory, and echocardiographic assessment were performed before and after every Levosimendan infusion. The primary endpoint was a composite of any episode of decompensated HF, urgent HF rehospitalization, cardiogenic shock, cardiac arrest and cardiovascular death at 4–6 weeks follow-up after each planned infusion. During follow-up (mean: 150 ± 99 days) a total of 37 infusions were performed and a total of 11 cardiovascular events occurred. Global constructive work (GCW), global work efficiency (GWE), and global work index (GWI) increased after Levosimendan infusion in 62.2%, 73.0%, and 70.3% of cases, with significant differences between patients with and without outcomes [delta GCW: −7.36 mmHg% (134.12) vs. 113.81 mmHg% (204.41), P = 0.007; delta GWE: −3.27% (8.38) vs. 4.30% (5.58), P = 0.002]. Delta value of GWE showed the largest area under curve (AUC: 0.82, 95% CI: 0.64–1.00, P = 0.002) for outcome prediction with a cut-off point of 0.5%. Independent prognostic value of GWE variation was confirmed in multivariable regression models (OR: 0.825, 95% CI: 0.702–0.970, P = 0.02). Conclusions GWE and GCW provided incremental and independent prognostic value at short-term follow-up over traditional echocardiographic parameters. The differentiation of patients into ‘workers’, whose GWE improved after Levosimendan infusion, and ‘non-workers’, who failed to improve their GWE, permitted to identify patients at higher risk of forthcoming cardiovascular events. Monitoring these patients with MWI may have relevant clinical implications.

Prognostic value of VEGF mRNA expression in short-term follow-up of patients with acute coronary syndrome

2014 ◽  
Vol 24 (1) ◽  
pp. 133-137
Author(s):  
Fadia M. Attia ◽  
Hussein M. Ismail ◽  
Maha Anani ◽  
Amany Moustafa Hassan ◽  
Ranya Morsy
Keyword(s):  
Acute Coronary Syndrome ◽  
Mrna Expression ◽  
Prognostic Value ◽  
Short Term ◽  
Vegf Mrna ◽  
Coronary Syndrome ◽  
Vegf Mrna Expression

scholarly journals Short-term and long-term prognostic value of circulating soluble suppression of tumorigenicity-2 concentration in acute coronary syndrome: a meta-analysis

2019 ◽  
Vol 39 (6) ◽  
Author(s):  
Linlin Gu ◽  
Jing Li
Keyword(s):  
Acute Coronary Syndrome ◽  
Prognostic Value ◽  
Meta Analysis ◽  
Continuous Variables ◽  
Short Term ◽  
Coronary Syndrome ◽  
Increased Risk ◽  
All Cause Mortality

Abstract Background: Higher circulating soluble suppression of tumorigenicity-2 (sST2) concentration is suggested as a marker of prognosis in many cardiovascular diseases. However, the short-term and long-term prognostic value of sST2 concentration in acute coronary syndrome (ACS) remains to be summarized. Methods: A meta-analysis of follow-up studies was performed. Studies were identified via systematic search of databases including PubMed, Cochrane’s Library, and Embase. A fixed- or random-effect model was applied according to the heterogeneity. We reported the prognostic value of sST2 concentration for all-cause mortality, heart failure (HF) events, and major adverse cardiovascular events (MACEs) within 1 month after hospitalization and during subsequent follow-up. Results: Twelve studies with 11690 ACS patients were included. Higher baseline sST2 concentration as continuous variables predicte the increased risk of all-cause mortality (risk ratio [RR]: 3.16, P=0.002), HF events (RR: 1.48, P<0.001), and MACEs (RR: 1.47, P<0.001) within 1 month after hospitalization, which is consistent with the results with sST2 concentration as categorized variables (RR = 2.14, 2.89, and 2.89 respectively, P all <0.001). Moreover, higher baseline sST2 concentration as continuous variables predict the increased risk of all-cause mortality (RR: 2.20, P<0.001), HF events (RR: 1.39, P<0.001), and MACEs (RR: 1.53, P=0.02) during subsequent follow-up. Meta-analysis with sST2 concentration as categorized variables retrieved similar results (RR = 2.65, 2.59, and 1.81 respectively, P all <0.001). Conclusions: Higher circulating sST2 concentration at baseline predicts poor clinical outcome in ACS patients.

Abstract 13497: Prognostic Value of the Combination of the Echocardiographic Derived Pulmonary Artery Wedge Pressure and Body Mass Index in Patients With Heart Failure With Preserved Ejection Fraction: Insights From PURSUIT-HFpEF Registry

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Kumpei Ueda ◽  
Shungo Hikoso ◽  
Daisaku D Nakatani ◽  
Shunsuke Tamaki ◽  
Masamichi Yano ◽  
...  
Keyword(s):  
Heart Failure ◽  
Body Mass Index ◽  
Ejection Fraction ◽  
Prognostic Value ◽  
Left Ventricular ◽  
Preserved Ejection Fraction ◽  
Pulmonary Artery Wedge Pressure ◽  
Patients With Heart Failure ◽  
Wedge Pressure

Background: An elevated pulmonary artery wedge pressure (PAWP), a surrogate of left ventricular filling pressure, is associated with poor outcomes in patients with heart failure (HF). In addition, obesity paradox is well recognized in HF patients and body mass index (BMI) also provides a prognostic information. However, there is little information available on the prognostic value of the combination of the echocardiographic derived PAWP and BMI in patients with HF with preserved ejection fraction (HFpEF). Methods and Results: Patients data were extracted from The Prospective mUlticenteR obServational stUdy of patIenTs with Heart Failure with Preserved Ejection Fraction (PURSUIT HFpEF) study, which is a prospective multicenter observational registry for acute decompensated heart failure (ADHF) patients with HFpEF. We analyzed 548 patients after exclusion of patients undergoing hemodialysis, patients with in-hospital death, missing follow-up data, or missing data to calculate PAWP or BMI. Body weight measurement and echocardiography were performed just before discharge. PAWP was calculated using the Nagueh formula [PAWP = 1.24* (E/e’) + 1.9] with e’ = [(e’ septal + e’ lateral ) /2]. During a mean follow up period of 1.5±0.8 years, 86 patients had all-cause death (ACD). Multivariate Cox analysis showed that both PAWP (p=0.020) and BMI (p=0.0001) were significantly associated with ACD, independently of age and previous history of HF hospitalization, after the adjustment with gender, left ventricular ejection fraction, NT-proBNP and estimated glomerular filtration rate. Kaplan-Meier curve analysis revealed that there was a significant difference in the risk of ACD when patients were stratified into 3 groups based on the median values of PAWP (17.3) and BMI (21.4). Conclusions: The combination of the echocardiographic derived PAWP and BMI might be useful for stratifying ADHF patients with HFpEF at risk for the total mortality.

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