scholarly journals Peptide YY (PYY) Is Associated with Cardiovascular Risk in Patients with Acute Myocardial Infarction

2020 ◽  
Vol 9 (12) ◽  
pp. 3952
Author(s):  
Elias Haj-Yehia ◽  
Robert Werner Mertens ◽  
Florian Kahles ◽  
Marcia Viviane Rückbeil ◽  
Matthias Rau ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Cardiovascular Risk ◽  
Cardiovascular Events ◽  
Cox Regression ◽  
Peptide Yy ◽  
St Elevation Myocardial Infarction ◽  
Gastrointestinal Hormone ◽  
All Cause Mortality ◽  
St Elevation

Aims: Recent studies have found circulating concentrations of the gastrointestinal hormone GLP-1 to be an excellent predictor of cardiovascular risk in patients with myocardial infarction. This illustrates a yet not appreciated crosstalk between the gastrointestinal and cardiovascular systems, which requires further investigation. The gut-derived hormone Peptide YY (PYY) is secreted from the same intestinal L-cells as GLP-1. Relevance of PYY in the context of cardiovascular disease has not been explored. In this study, we aimed to investigate PYY serum concentrations in patients with acute myocardial infarction and to evaluate their association with cardiovascular events. Material and Methods: PYY levels were assessed in 834 patients presenting with acute myocardial infarction (553 Non-ST-Elevation Myocardial Infarction (NSTEMI) and 281 ST-Elevation Myocardial Infarction (STEMI)) at the time of hospital admission. The composite outcomes of first occurrence of cardiovascular death, nonfatal myocardial infarction, nonfatal stroke (3-P-MACE), and all-cause mortality were assessed with a median follow-up of 338 days. Results: PYY levels were significantly associated with age and cardiovascular risk factors, including hypertension, diabetes, and kidney function in addition to biomarkers of heart failure (NT-pro BNP) and inflammation (hs-CRP). Further, PYY was significantly associated with 3-P-MACE (HR: 1.7; 95% CI: 1–2.97; p = 0.0495) and all-cause mortality (HR: 2.69; 95% CI: 1.61–4.47; p = 0.0001) by univariable Cox regression analyses, which was however lost after adjusting for multiple confounders. Conclusions: PYY levels are associated with parameters of cardiovascular risk as well as cardiovascular events and mortality in patients presenting with acute myocardial infarction. However, this significant association is lost after adjustment for further confounders.

scholarly journals The High-Sensitivity C-Reactive Protein to Prealbumin Ratio Predicts Adverse Cardiovascular Events after ST-Elevation Myocardial Infarction

2021 ◽  
Vol 24 (1) ◽  
pp. E153-E157
Author(s):  
Hongqiang Ren ◽  
Li Zhao ◽  
Yijun Liu ◽  
Zhen Tan ◽  
Guiquan Luo ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Roc Curve ◽  
Cardiovascular Events ◽  
Cox Regression ◽  
High Sensitivity ◽  
St Elevation Myocardial Infarction ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Increased Risk ◽  
St Elevation

Background: This study evaluated the association of the high-sensitivity C-reactive protein to prealbumin ratio (CPR) with adverse cardiovascular events after ST-elevation myocardial infarction (STEMI) in patients undergoing primary percutaneous coronary intervention (PCI). Methods: The study included 682 patients who presented with STEMI and were treated with primary PCI. Patients were divided into 2 groups: high CPR (CPR ≥0.02) and low CPR (CPR <0.02). The primary endpoint of the study was the occurrence of major adverse cardiovascular events (MACE), defined as cardiovascular mortality or admission due to recurrent AMI or heart failure. Multivariate Cox regression models were used to assess the prognostic value of CPR on MACE in patients with STEMI. Results: During a median follow-up of 18 months, the accumulated incidence rate of MACE was significantly higher in the high-CPR group than in the low-CPR group (38.7% versus 12.0%, P < .01). Multivariate analysis revealed that CPR was an independent predictor for increased risk of MACE (hazard ratio = 3.27, 95% confidence interval [CI] 2.14 to 4.49, P < .01). Receiver operating characteristic (ROC) curve analysis showed that the area under the ROC curve for predicting the diagnosis of MACE was higher for CPR (0.82, 95% CI 0.77 to 0.87) than hs-CRP (0.70, 95% CI 0.65 to 0.75). Conclusion: CPR was independently associated with MACE and can be used for risk stratification in patients with STEMI.

scholarly journals Circulating Matrix Metalloproteinase-28 Levels Are Related to GRACE Scores and Short-Term Outcomes in Patients with Acute Myocardial Infarction

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Ke Zhou ◽  
Yuanmin Li ◽  
Yawei Xu ◽  
Rong Guo
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Matrix Metalloproteinase ◽  
Cardiovascular Events ◽  
St Elevation Myocardial Infarction ◽  
Cardiac Events ◽  
Short Term ◽  
St Elevation ◽  
Coronary Events ◽  
Grace Score

Objective. To investigate the relationship between the level of matrix metalloproteinase-28 (MMP-28) in patients with acute myocardial infarction (AMI) and the global registry of acute coronary events (GRACE) scores as well as their short-term prognosis. Methods. Two hundred eleven patients with AMI were enrolled, and their basic clinical characteristics were collected for determining the GRACE score. We measured the plasma levels of MMP-28 and other biomarkers in the study population. The association of MMP-28 levels with cardiac events and cardiac deaths occurring within 30 days of discharge was evaluated with multivariable Cox proportional hazard models. Results. The MMP-28 levels were significantly higher in patients with acute ST-elevation myocardial infarction (STEMI) than in patients with non-ST-elevation myocardial infarction (NSTEMI) (P<0.01). Correlation analysis showed that the level of MMP-28 was positively correlated with the GRACE score in patients with AMI (R2=0.366, P<0.05). Cox multivariate regression results showed that MMP-28 was associated with cardiovascular events during the hospitalization and 30 days after discharge (P<0.01). In addition, Kaplan–Meier analysis showed that cardiac events and deaths were significantly higher in patients with MMP-28≥1.21 ng/mL (all P<0.01). Conclusion. There is a correlation between the plasma MMP-28 level and GRACE score in patients with AMI. MMP-28 is also associated with cardiovascular events and cardiovascular deaths during the hospitalization of patients and within 30 days of discharge.

scholarly journals Measuring Heart Rate Variability in Patients Admitted with ST-Elevation Myocardial Infarction for the Prediction of Subsequent Cardiovascular Events: A Systematic Review

Medicina ◽  
2021 ◽  
Vol 57 (10) ◽  
pp. 1021
Author(s):  
Crischentian Brinza ◽  
Mariana Floria ◽  
Adrian Covic ◽  
Alexandru Burlacu
Keyword(s):  
Myocardial Infarction ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Cardiovascular Events ◽  
St Elevation Myocardial Infarction ◽  
Major Adverse Cardiovascular Events ◽  
Prognostic Information ◽  
Increased Risk ◽  
All Cause Mortality ◽  
St Elevation

Ischemic heart disease represents the leading cause of death, emphasizing risk stratification and early therapeutic intervention. Heart rate variability (HRV), an indirect marker of autonomic nervous system activity, was investigated extensively as a risk factor for adverse cardiovascular events following acute myocardial infarction. Thus, we systematically reviewed the literature to investigate the association of HRV parameters with mortality and adverse cardiovascular events in patients presenting with ST-elevation myocardial infarction (STEMI). Following the search process in the MEDLINE (PubMed), Embase, and Cochrane databases, nine studies were included in the final analysis. Lower time-domain HRV parameters and a higher ratio between power in the low-frequency (LF) band and power in the high-frequency (HF) band (LF/HF) were associated with higher all-cause mortality during follow-up, even in patients treated mainly with percutaneous coronary interventions (PCI). Although most studies measured HRV on 24 h ECG recordings, short- and ultra-short-term measures (1 min and 10 s, respectively) were also associated with an increased risk of all-cause mortality. Although data were discrepant, some studies found an association between HRV and cardiac mortality, reinfarction, and other major adverse cardiovascular events. In conclusion, HRV measurement in patients with STEMI could bring crucial prognostic information, as it was associated with an increased risk of all-cause mortality documented in clinical studies. More and larger clinical trials are required to validate these findings in contemporary patients with STEMI in the context of the new generation of drug-eluting stents and current antithrombotic and risk-modifying therapies.

scholarly journals Androgen receptor polymorphism, testosterone levels and prognosis in patients with acute myocardial infarction

2021 ◽  
Author(s):  
Anne Wang ◽  
John Flanagan ◽  
Stefan Arver ◽  
Anna Norhammar ◽  
Per Näsman ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Androgen Receptor ◽  
Cardiovascular Events ◽  
Cox Regression ◽  
Repeat Length ◽  
Cag Repeat ◽  
Time Points ◽  
Testosterone Levels ◽  
All Cause Mortality

Abstract Aims Low testosterone has been associated with cardiovascular disease in men but with contradictory findings. Testosterone bind to the androgen receptor and polymorphisms of the receptor gene such as CAG repeat length may affect transcriptional activity, possibly mitigating testosterone effects. The aims were to study the CAG repeat length and testosterone levels at four time-points following a myocardial infarction and to analyse possible relationships between CAG repeat length and cardiovascular prognosis. Methods Male patients admitted for acute myocardial infarction (n = 122) from the Glucose in Acute Myocardial Infarction study were included. Blood samples were drawn at four time-points (day after admission, at discharge, and at 3 and 12 months post-infarction) for assessment of testosterone levels. Patients were followed for a median of 11.6 years. Cox regression analyses were performed for CAG repeat length by one unit increment and by &gt; vs ≤ median for cardiovascular events and all-cause mortality. Results Median CAG repeat length was 20. There was no difference in testosterone levels at each time-point when dividing the cohort into ≤ vs &gt; CAG repeat median (=20). There was no association between CAG repeat length either as a continuous or categorical variable in unadjusted and age-adjusted Cox analyses for cardiovascular events. While CAG &gt;20 was associated with all-cause mortality in unadjusted analyses (HR 2.19; 95% CI 1.13-4.22; p = 0.02), it did not remain significant following adjustment for age. Conclusion CAG repeat length was not associated with testosterone levels or prognosis in men with acute myocardial infarction.

A kórházi felvétel idején rögzített EKG jelentősége a szívinfarktus miatt kezelt betegek prognózisának meghatározásában

2018 ◽  
Vol 159 (17) ◽  
pp. 677-681
Author(s):  
András Jánosi ◽  
Péter Ofner ◽  
János Tomcsányi ◽  
Gábor Müller ◽  
Richárd Hável ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Clinical Diagnosis ◽  
Patient Population ◽  
Proportional Hazards ◽  
Cox Regression ◽  
Prognostic Significance ◽  
National Registry ◽  
St Elevation Myocardial Infarction ◽  
St Elevation

Abstract: Introduction and aim: By using the database of the National Registry of Myocardial Infarction, the authors examine the prognosis of patients treated with acute myocardial infarction, in case of whom there was new or presumably new left bundle branch block (nLBBB) on the ECG recorded at hospitalization. Method: We recorded the details of 18 091 patients treated with acute myocardial infarction (AMI) between 1 January 2014 and 30 June 2015 in the National Registry of Myocardial Infarction. In case of 8334 patients, the clinical diagnosis was ST-elevation myocardial infarction (STEMI), whereas in 9757 cases it was non-ST elevation myocardial infarction (NSTEMI). In the STEMI population we examined the clinical characteristics and prognosis of patients with ST-elevation (n = 7937) and nLBBB (n = 397). We used the proportional hazards regression model (Cox-regression) to examine mortality. Results: In the AMI patient population, we found LBBB in 1274 cases (7%). In case of STEMI clinical diagnosis, the patients belonging to the nLBBB subpopulation (n = 397) were older, and the proportion of men and the occurrence of co-morbidities was higher than in case of those who had ST-elevation on their ECG recorded at hospitalization. The mortality rate of the LBBB population was higher than that of the ST-elevation patient population in both the 30-day (25.4% versus 12.4%) and the 1-year period (47.3 versus 19.9%). Percutaneous coronary intervention (PCI) had significantly lower mortality in both populations. In the course of a multifactorial analysis we verified the independent prognostic significance of LBBB: the hazard ratio compared to ST-elevation was 1.33 (95% confidence interval: 1.10–1.62), checked for gender, age, occurrence of PCI, systolic blood pressure, cardiac frequency, serum creatinine difference, and the details of five anamneses/co-morbidities. Conclusion: The admission ECG has prognostic significance. Patients with LBBB have poorer prognosis compared to patients with ST-elevation on admission ECG. Orv Hetil. 2018; 159(17): 677–681.

The effect of preloading statins prior to primary reperfusion on in-hospital mortality risk in a contemporary large-scale cohort of patients with ST-elevation myocardial infarction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
R Fu ◽  
C.X Song ◽  
X.D Li ◽  
Y.J Yang
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Hospital Mortality ◽  
Mortality Risk ◽  
Large Scale ◽  
Reperfusion Therapy ◽  
St Elevation Myocardial Infarction ◽  
Control Group ◽  
Funding Source ◽  
St Elevation

Abstract Background The benefit of statins in secondary prevention of patients stabilized after acute coronary syndrome (ACS) has been well established. However, the benefit of preloading statins, i.e. high-intensity statins prior to reperfusion therapy remains unclear. Most previous studies included all types of ACS patients, and subgroup analysis indicated the benefit of preloading statins was only seen in ST-elevation myocardial infarction (STEMI) patients who underwent percutaneous coronary intervention (PCI). However, the sample size of subgroup population was relatively small and such benefit requires further validation. Objective To investigate the effect of loading dose of statins before primary reperfusion on 30-mortality in patients with STEMI. Methods We enrolled patients in China Acute Myocardial Infarction (CAMI) registry from January 2013 to September 2014. CAMI registry was a prospective multicenter registry of patients with acute acute myocardial infarction in China. Patients were divided into two groups according to statins usage: preloading group and control group. Patients in preloading group received loading does of statins before primary reperfusion and during hospitalization. Patients in control group did not receive statins during hospitalization or at discharge. Primary outcome was in-hospital mortality. Baseline characteristics, angiographic characteristics and outcome were compared between groups. Propensity score (PS) matching was used to mitigate baseline differences between groups and examine the association between preloading statins on in-hospital mortality risk. The following variables were used to establish PS matching score: age, sex, classification of hospitals, clinical presentation (heart failure at presentation, cardiac shock, cardiac arrest, Killip classification), hypertension, diabetes, prior angina, prior myocardial infarction history, prior stroke, initial treatment. Results A total of 1169 patients were enrolled in control group and 6795 in preloading group. A total of 833 patients (334 in control group and 499 in preloading group) died during hospitalization. Compared with control group, preloading group were younger, more likely to be male and present with Killip I classification. The proportion of hypertension and diabetes were higher in preloading group. After PS matching, all the variables used to generate PS score were well balanced. In the PS-matched cohort, 30-day mortality risk was 26.3% (292/1112) in the control group and 11.9% (132/1112) in the preloading group (p&lt;0.0001). Conclusions The current study found preloading statins treatment prior to reperfusion therapy reduced in-hospital mortality risk in a large-scale contemporary cohort of patients with STEMI. Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): Chinese Academy of Medical Sciences

Value of Albumin–Globulin Ratio as a Predictor of All-Cause Mortality After Non-ST Elevation Myocardial Infarction

Angiology ◽  
2012 ◽  
Vol 64 (2) ◽  
pp. 137-145 ◽  
Author(s):  
Basem Azab ◽  
John Bibawy ◽  
Kassem Harris ◽  
Georges Khoueiry ◽  
Meredith Akerman ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
St Elevation Myocardial Infarction ◽  
All Cause Mortality ◽  
St Elevation

scholarly journals Characteristics and long-term mortality of patients with ST-elevation or non-ST-elevation myocardial infarction after orthopaedic surgery

2021 ◽  
Vol 49 (3) ◽  
pp. 030006052199299
Author(s):  
Wenlan Hu ◽  
Kaiping Zhao ◽  
Youzhou Chen ◽  
Jihong Wang ◽  
Mei Zheng ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Orthopaedic Surgery ◽  
Troponin I ◽  
Cox Regression ◽  
St Elevation Myocardial Infarction ◽  
Entire Cohort ◽  
St Elevation ◽  
Universal Definition ◽  
Long Term Mortality

Objective To investigate the clinical characteristics and long-term mortality of patients with ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI) after orthopaedic surgery. Methods This retrospective, single-centre study enrolled patients that underwent inpatient orthopaedic surgery from 2009 to 2017 in Beijing Jishuitan Hospital. The patients were screened for a cardiac troponin I elevation and fulfilled the Fourth Universal Definition of Myocardial Infarction within 30 days of surgery. Results A total of 180 patients that developed perioperative myocardial infarction (MI) were included in the study. Among them, 14 patients (7.8%) were classified as STEMI, and 166 (92.2%) had NSTEMI. Compared with those with NSTEMI, STEMI patients had significantly higher 30-day and long-term mortality rates (50.0% versus 5.4%; 71.4% versus 22.3%; respectively). Multivariate Cox regression model analysis among the entire cohort demonstrated that STEMI (hazard ratio [HR] 5.78, 95% confidence interval [CI] 2.50, 13.38) and prior MI (HR 2.35, 95% CI 1.02, 5.38) were the most significant independent predictors of long-term mortality. Conclusion Perioperative MI after orthopaedic surgery was associated with a high mortality rate. STEMI was independently associated with a significant increase in short- and long-term mortality.

scholarly journals 98 Assessment of Endogenous Thrombolysis Predicts Cardiovascular Risk in Patient with ST-elevation Myocardial Infarction

Heart ◽  
2016 ◽  
Vol 102 (Suppl 6) ◽  
pp. A69-A70 ◽  
Author(s):  
Mohamed Farag ◽  
Manivannan Srinivasan ◽  
David Wellsted ◽  
Keith Sullivan ◽  
Diana A Gorog
Keyword(s):  
Myocardial Infarction ◽  
Cardiovascular Risk ◽  
St Elevation Myocardial Infarction ◽  
St Elevation
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