scholarly journals Is There A Role of Glycated Hemoglobin for Predicting Major Ad- verse Cardiac Event in ST-Elevation Myocardial Infarction?

2020 ◽  
Vol 1 (3) ◽  
pp. 15-20
Author(s):  
Muhammad Abusari ◽  
Cholid Tri Tjahjono ◽  
Dadang Hendrawan ◽  
Yoga Waranugraha ◽  
Ayu Asri Devi Adityawati ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Myocardial Infarction ◽  
Hospital Admission ◽  
Cardiovascular Events ◽  
Hba1c Level ◽  
Glycated Hemoglobin ◽  
Major Adverse Cardiovascular Events ◽  
History Of ◽  
St Elevation

Background : Coronary Artery Disease (CAD) especially ST-Elevation Myocardial Infarction (STEMI) is the leading cause of mortality worldwide. Hyperglycemia and diabetes mellitus are both prevalent among patients with STEMI admitted to the hospital. Glycated hemoglobin (HbA1c) is a marker of glucose control. Objectives : We aimed to investigate the role of HbA1c as the predictor of major adverse cardiovascular events in STEMI patients. Methods : This was a retrospective cohort study. STEMI patients visiting Saiful Anwar General Hospital were registered. Patients were divided into three groups based on the HbA1c level <6.5%; 6.5-8.4% and ≥8.5%; respectively. The primary endpoint was in-hospital Major Adverse Cardiovascular Events (MACE), including cardiac death, recurrent myocardial infarction (MI), recurrent revascularization, acute pulmonary edema, cardiogenic shock, malignant arrhythmia, and stroke. Results: A total of 118 STEMI patients were included in this study, with distribution of 61 patients with HbA1c <6.5%, 25 patients with HbA1c 6.5-8.4%, and 31 patients with HbA1c ≥8.5%; respectively. The HbA1C level was associated with the history of diabetes mellitus (3.2% vs 36% vs 71%; p =0.000) and random blood glucose level at hospital admission (140.71 ± 39.67 mg/dL vs 172.96 ± 53.43 mg/dL vs 366.61 ± 169.67 mg/dL; p = 0.000). The MACE among three groups was not significantly different (17.7% vs 20% vs 35.5%; p=0,149). Conclusion: Our study reveals that the HbA1c level at hospital admission is associated with the history of diabetes mellitus and random blood glucose at hospital admission. However, HbA1c could not predict MACE in STEMI patients

scholarly journals Prognostic value of PCSK9 Levels in Non-ST elevation myocardial infarction patients undergoing percutaneous coronary intervention

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
J.-X Wang ◽  
P Han ◽  
M.-D Gao ◽  
J.-Y Xiao ◽  
X.-W Li ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
High Risk ◽  
Cardiovascular Events ◽  
Prognostic Value ◽  
St Elevation Myocardial Infarction ◽  
Major Adverse Cardiovascular Events ◽  
Distribution Width ◽  
St Elevation ◽  
Grace Score

Abstract Background The role of proprotein convertase subtilisin/kexin type 9 (PCSK9) in predicting major adverse cardiovascular events (MACEs) in Non-ST elevation myocardial infarction (NSTEMI) patients is still an open question and the PCSK9 concentration of clinical usefulness remains unknown in guiding treatment. Purpose To explore the role of PCSK9 in predicting major adverse cardiovascular events (MACEs) in Non-ST elevation myocardial infarction patients. Methods 272 patients with NSTEMI were included in our study, all patients received PCI therapy after admission. Patients were followed up for 1 year and MACEs were recored. Their baseline plasma PCSK9 levels were determined by ELISA. Patients were divided into high, medium and low PCSK9 groups and the associations of PCSK9 with other biomarkers and MACEs were evaluated. Results The results showed that PCSK9 levels was related to levels of lipoproteins, high-sensitivity C-reactive protein (r=0.162, P=0.008), platelet volume distribution width (r=0.299, P&lt;0.001) and D-dimer (r=0.285, P&lt;0.001). And the concentrations of PCSK9 was greater higher in people with MACEs (137.2ng/ml vs 243.6ng/ml) (Fig. 1A). The Kaplan-Meier curves showed patients with high PCSK9 level had lower event-free survival rate (Fig. 1B). Survival analysis indicated high level of PCSK9 predicted MACEs independently after adjusted for traditional cardiovascular risk factors and GRACE score (HR=2.646, 95CI%: 1.047–6.686, P=0.027) (Fig. 1C, Fig. 2). Subgroup analysis demonstrated the prognostic value of high PCSK9 level was greater for patients classified by the GRACE score as high risk (Fig. 1D). Conclusions In a NSTEMI setting, the concentration of PCSK9 is associated with hypercoagulability and hyper-inflammation. High levels of PCSK9 independently predict future MACEs in NSTEMI patients, particularly those classified by the GRACE score as high risk. FUNDunding Acknowledgement Type of funding sources: None.

Abstract P019: A Single Model For Predicting Major Adverse Cardiovascular Events In Individuals With And Without History Of Atherosclerotic Cardiovascular Disease: The Atherosclerosis Risk In Communities (aric) Study

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Yejin Mok ◽  
Lena Mathews ◽  
Ron C Hoogeveen ◽  
Michael J Blaha ◽  
Christie M Ballantyne ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cardiovascular Disease ◽  
High Risk ◽  
Risk Stratification ◽  
Cardiovascular Events ◽  
Major Adverse Cardiovascular Events ◽  
Atherosclerotic Cardiovascular Disease ◽  
Single Model ◽  
History Of ◽  
Very High

Background: In the 2018 AHA/ACC Cholesterol guideline, risk stratification is an essential element. The use of a Pooled Cohort Equation (PCE) is recommended for individuals without atherosclerotic cardiovascular disease (ASCVD), and the new dichotomous classification of very high-risk vs. high-risk has been introduced for patients with ASCVD. These distinct risk stratification systems mainly rely on traditional risk factors, raising the possibility that a single model can predict major adverse cardiovascular events (MACEs) in persons with and without ASCVD. Methods: We studied 11,335 ARIC participants with (n=885) and without (n=10,450) a history of ASCVD (myocardial infarction, ischemic stroke, and symptomatic peripheral artery disease) at baseline (1996-98). We modeled factors in the PCE and the new classification for ASCVD patients (Figure legend) in a single CVD prediction model. We examined their associations with MACEs (myocardial infarction, stroke, and heart failure) using Cox models and evaluated the discrimination and calibration for a single model including those factors. Results: During a median follow-up of 18.4 years, there were 3,658 MACEs (3,105 in participants without ASCVD). In general, the factors in the PCE and the risk classification system for ASCVD patients were associated similarly with MACEs regardless of baseline ASCVD status, although age and systolic blood pressure showed significant interactions. A single model with these predictors and the relevant interaction terms showed good calibration and discrimination for those with and without ASCVD (c-statistic=0.729 and 0.704, respectively) (Figure). Conclusion: A single CVD prediction model performed well in persons with and without ASCVD. This approach will provide a specific predicted risk to ASCVD patients (instead of dichotomy of very high vs. high risk) and eliminate a practice gap between primary vs. secondary prevention due to different risk prediction tools.

scholarly journals Comparison of the Predictive Roles of Risk Scores of In-Hospital Major Adverse Cardiovascular Events in Patients with Non-ST Elevation Myocardial Infarction Undergoing Percutaneous Coronary Intervention

2018 ◽  
Vol 27 (5) ◽  
pp. 459-465 ◽  
Author(s):  
Erdal Aktürk ◽  
Lütfü Aşkın ◽  
Hakan Taşolar ◽  
Serdar Türkmen ◽  
Hakan Kaya
Keyword(s):  
Myocardial Infarction ◽  
Hospital Mortality ◽  
Cardiovascular Events ◽  
Coronary Intervention ◽  
Nonfatal Myocardial Infarction ◽  
Risk Scores ◽  
Major Adverse Cardiovascular Events ◽  
Syntax Score ◽  
Percutaneous Coronary ◽  
St Elevation

Objective: We evaluated the relationship between various risk scores (SYNTAX score [SS], SYNTAX score-II [SS-II], thrombolysis in myocardial infarction [TIMI] risk scores, and Global Registry of Acute Coronary Events [GRACE] risk scores) and major adverse cardiovascular events (MACE) in non-ST elevation myocardial infarction (NSTEMI) patients undergoing percutaneous coronary intervention (PCI). Subjects and Methods: The study population were selected from among 589 patients who underwent coronary angiography with a diagnosis of NSTEMI. TIMI and GRACE risk scores were calculated. SS and SS-II were calculated in all patients, and points were added according to the predefined algorithm, taking into account the other 6 clinical variables being monitored (age, sex, left ventricular ejection fraction, creatinine clearance, chronic obstructive pulmonary disease, and peripheral artery disease). Patients were classified into tertile 1 (SS < 22), tertile 2 (SS 23–32), and tertile 3 (SS > 32). Results: The group with high SS-II for PCI values in the risk scores were observed from tertile 1 to tertile 3 (from 25.0 ± 7.7 to 31.6 ± 9.4, p < 0.001, respectively). The SS-II score in patients with PCI was an independent predictor of MACE, in-hospital mortality, nonfatal myocardial infarction, and stent thrombosis (OR 1.082, 95% CI 1.036–1.131, p < 0.001). The overall MACE, in-hospital mortality, and nonfatal myocardial infarction rates were significantly higher in the high SS-II for PCI group (p < 0.001). Conclusion: TIMI and GRACE risk scores were able to predict MACE. In addition to these, SS-II was also able to predict in-hospital mortality, nonfatal myocardial infarction, and stent thrombosis.

scholarly journals Plasma visfatin levels are associated with major adverse cardiovascular events in patients with acute ST-elevation myocardial infarction

2015 ◽  
Vol 38 (3) ◽  
pp. 100 ◽  
Author(s):  
Wei-Chin Hung ◽  
Teng-Hung Yu ◽  
Chia-Chang Hsu ◽  
Li-Fen Lu ◽  
Fu-Mei Chung ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Relative Risk ◽  
Cardiovascular Events ◽  
Target Lesion ◽  
St Elevation Myocardial Infarction ◽  
Major Adverse Cardiovascular Events ◽  
Kaplan Meier ◽  
Acute Myocardial Injury ◽  
St Elevation ◽  
Visfatin Level

Purpose: Circulating levels of visfatin, a ubiquitous adipokine, may reflect both the severity of plaque as well as degree of plaque stabilization in acute myocardial injury. The purpose of this study was to test whether the level of visfatin is associated with the occurrence of major adverse cardiovascular events (MACEs) in patients with acute ST-elevation myocardial infarction (STEMI). Methods: Consecutive patients (n=185) with acute STEMI were prospectively enrolled in the study. ELISA was used to measure plasma visfatin concentrations. Composite MACEs included death, recurrent myocardial infarction, target lesion revascularization or re-advanced heart failure. Results: Plasma visfatin levels were significantly higher in composite MACE patients than in non-MACE patients. A multivariate Cox hazard regression model revealed that the predictive independent risk factors for the occurrence of composite MACEs were visfatin level (relative risk = 1.04) and age (relative risk = 6.05). When patients were grouped according to their plasma visfatin levels, composite MACEs occurred more frequently in patients presenting with high visfatin levels. Moreover, Kaplan-Meier analysis revealed that high visfatin levels were significantly associated with the occurrence of composite MACEs. Conclusions: The level of plasma visfatin may be associated with risk of composite MACEs in STEMI patients, and may be useful for risk stratification.

scholarly journals The Role of HbA1c in Severity and Mortality Rate of ST Segment Elevation Myocardial Infarction for Hospitalized Libyan Non-Diabetic Patients

2019 ◽  
Vol 12 (3) ◽  
Author(s):  
Hanan KG Altalhi
Keyword(s):  
Diabetes Mellitus ◽  
Myocardial Infarction ◽  
Hospital Mortality ◽  
Diabetic Patient ◽  
Hba1c Level ◽  
Diabetic Patients ◽  
St Segment Elevation ◽  
Hospital Patients ◽  
History Of ◽  
Group 2

Background: The severity of coronary artery disease (CAD) is directly related to the quality of glucose control in diabetic patient. Additionally, diabetes is associated with increased mortality following acute myocardial infarction compared to general population. Objectives: To evaluate the association of HbA1c level and severity of CAD, and outcome of non-diabetic patient with STEMI in our hospital. Patients and Methods: 60 consecutives non-diabetic patient with acute ST elevation myocardial infarction were treated with thrombolytic therapy included in the present prospective study. Blood glucose and HbA1c level of all patients were measured within 3 hours of admission. Patient were divided in to 3 groups according to HbA1c level: with cut-off 6.5% as diagnostic criteria of diabetes mellitus according to (American diabetes association) group (1) 6.5%, group (2) 6.5 to 8.5%, group (3) 8.5% and above. In hospital. mortality and morbidities of acute STEMI were compared between groups. Results: The mean age was 63±15 year and mean body mass index was 26. 6±6 kg/m², 24 patients (40%) had history of hypertension, 27 patients (45%) of dyslipidemia, 36 patients (60%) were smoker. We found 45 patients with HbA1c ≤ 6 5%, 5 patients with HbA1c 6.5 -8.5 %, 10 patients with HbA1c ≥ 8.5%. There was strong correlation between admission of HbA1c and admission glucose level (P< 0.001). Infarct size as measured by peak creatinin kinase, was not correlated with HbA1c level. Conclusions: HbA1c is an important risk marker in the absence of history of diabetes mellitus in patients with AMI. The optimal management in these patients may contribute in decrease hospital mortality.

scholarly journals MO466A NOVEL PREDICTION MARKER OF 10-YEAR RISK AND LIFETIME RISK OF RECURRENT CARDIOVASCULAR EVENTS IN PATIENTS WITH CKD AND DIABETES MELLITUS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Guido Gembillo ◽  
Valeria Cernaro ◽  
Rossella Siligato ◽  
Alfio Edoardo Giuffrida ◽  
Vincenzo Labbozzetta ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Diabetes Mellitus ◽  
Myocardial Infarction ◽  
Life Expectancy ◽  
Cardiovascular Events ◽  
Significant Risk ◽  
Lifetime Risk ◽  
Diabetic Patients ◽  
Inflammatory Status ◽  
History Of

Abstract Background and Aims Chronic kidney disease (CKD) is one of the most prevalent complication of Diabetes Mellitus and patients with both diseases are more exposed to atherosclerosis injury and premature death from cardiovascular disease (CVD). CVD is worsened by inflammation, oxidative stress, lipid accumulation and high-density lipoprotein cholesterol (HDL) reduction: patients with altered lipid metabolism more often present monocyte profile changes, with an altered pro-inflammatory phenotype leading to a significant risk of plaque formation and atherosclerosis. The alteration of the balance between monocyte and HDL, represented by the Monocyte/HDL ratio (MHR), is an easy way to evaluate the inflammatory status and to study appropriate strategies to treat high-risk patients. Method We evaluated 150 consecutive diabetic patients with CKD hospitalized in the Unit of Nephrology and Dialysis of the Policlinic G. Martino of Messina, Italy, with a history of CVD. We used the SMART-REACH SCORE, a model created to estimate life expectancy without recurrent cardiovascular events for individuals with a history of CVD. We performed a retrospective analysis of the MHR status of our patients to study its correlations with the 10-year risk and lifetime risk for myocardial infarction, stroke or vascular death, recurrent CVD events and free life-expectancy if standard care is provided. Results In the entire cohort of patients, MHR appeared to be positively correlated with ten-year risk (ρ=0.469; P &lt;0.0001) (Figure 1) and lifetime risk of myocardial infarction, stroke, or CV death (ρ=0.428; P &lt;0.0001) (Figure 2). Furthermore, patients with higher MHR levels had a significantly smaller number of years of CVD-free life expectancy (ρ=-0.364; P &lt;0.0001) (Figure 3). Conclusion MHR can represent a valid tool to predict the recurrence of CVD in CKD patients with diabetes. This easy-to-perform marker of oxidative stress and CVD risk can be used alone or in a multiple biomarker panel, improving the stratification and management of patients with comorbidities and risk of life- threatening conditions.

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