scholarly journals Current Knowledge of MicroRNAs (miRNAs) in Acute Coronary Syndrome (ACS): ST-Elevation Myocardial Infarction (STEMI)

Life ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 1057
Author(s):  
Daniela Maria Tanase ◽  
Evelina Maria Gosav ◽  
Anca Ouatu ◽  
Minerva Codruta Badescu ◽  
Nicoleta Dima ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Development ◽  
Current Knowledge ◽  
St Elevation Myocardial Infarction ◽  
Cardiac Damage ◽  
Coronary Syndrome ◽  
Coronary Syndromes ◽  
St Elevation ◽  
Artery Disease ◽  
Potential Use

Regardless of the newly diagnostic and therapeutic advances, coronary artery disease (CAD) and more explicitly, ST-elevation myocardial infarction (STEMI), remains one of the leading causes of morbidity and mortality worldwide. Thus, early and prompt diagnosis of cardiac dysfunction is pivotal in STEMI patients for a better prognosis and outcome. In recent years, microRNAs (miRNAs) gained attention as potential biomarkers in myocardial infarction (MI) and acute coronary syndromes (ACS), as they have key roles in heart development, various cardiac processes, and act as indicators of cardiac damage. In this review, we describe the current available knowledge about cardiac miRNAs and their functions, and focus mainly on their potential use as novel circulating diagnostic and prognostic biomarkers in STEMI.

scholarly journals MicroRNAs in Acute ST Elevation Myocardial Infarction—A New Tool for Diagnosis and Prognosis: Therapeutic Implications

2021 ◽  
Vol 22 (9) ◽  
pp. 4799
Author(s):  
Alina Ioana Scărlătescu ◽  
Miruna Mihaela Micheu ◽  
Nicoleta-Monica Popa-Fotea ◽  
Maria Dorobanțu
Keyword(s):  
Myocardial Infarction ◽  
Therapeutic Targets ◽  
St Elevation Myocardial Infarction ◽  
Cardiac Damage ◽  
Therapeutic Implications ◽  
Diagnosis And Prognosis ◽  
Coronary Syndromes ◽  
St Elevation ◽  
Artery Disease ◽  
Circulating Levels

Despite diagnostic and therapeutic advances, coronary artery disease and especially its extreme manifestation, ST elevation myocardial infarction (STEMI), remain the leading causes of morbidity and mortality worldwide. Early and prompt diagnosis is of great importance regarding the prognosis of STEMI patients. In recent years, microRNAs (miRNAs) have emerged as promising tools involved in many pathophysiological processes in various fields, including cardiovascular diseases. In acute coronary syndromes (ACS), circulating levels of miRNAs are significantly elevated, as an indicator of cardiac damage, making them a promising marker for early diagnosis of myocardial infarction. They also have prognostic value and great potential as therapeutic targets considering their key function in gene regulation. This review aims to summarize current information about miRNAs and their role as diagnostic, prognostic and therapeutic targets in STEMI patients.

scholarly journals Neutrophil Phenotypes in Coronary Artery Disease

2020 ◽  
Vol 9 (5) ◽  
pp. 1602
Author(s):  
Patrick Maréchal ◽  
Julien Tridetti ◽  
Mai-Linh Nguyen ◽  
Odile Wéra ◽  
Zheshen Jiang ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Plasma Levels ◽  
Stable Coronary Artery Disease ◽  
St Elevation Myocardial Infarction ◽  
Multivariable Logistic Regression Analysis ◽  
Coronary Syndrome ◽  
St Elevation ◽  
Artery Disease

Clinical evidence indicates that innate immune cells may contribute to acute coronary syndrome (ACS). Our prospective study aimed at investigating the association of neutrophil phenotypes with ACS. 108 patients were categorized into chronic stable coronary artery disease (n = 37), unstable angina (UA) (n = 19), Non-ST-Elevation Myocardial Infarction (NSTEMI) (n = 25), and ST-Elevation Myocardial Infarction (STEMI) (n = 27). At the time of inclusion, blood neutrophil subpopulations were analysed by flow cytometry. Differential blood cell count and plasma levels of neutrophilic soluble markers were recorded at admission and, for half of patients, at six-month follow-up. STEMI and NSTEMI patients displayed higher neutrophil count and neutrophil-to-lymphocyte ratio than stable and UA patients (p < 0.0001), which normalized at six-month post-MI. Atypical low-density neutrophils were detected in the blood of the four patient groups. STEMI patients were characterized by elevated percentages of band cells compared to the other patients (p = 0.019). Multivariable logistic regression analysis revealed that plasma levels of total myeloperoxidase was associated with STEMI compared to stable (OR: 1.434; 95% CI: 1.119–1.837; P < 0.0001), UA (1.47; 1.146–1.886; p = 0.002), and NSTEMI (1.213; 1.1–1.134; p = 0.0001) patients, while increased neutrophil side scatter (SSC) signal intensity was associated with NSTEMI compared to stable patients (3.828; 1.033–14.184; p = 0.045). Hence, changes in neutrophil phenotype are concomitant to ACS.

scholarly journals Coronary artery disease: Acute coronary syndrome

2010 ◽  
pp. 45-70
Author(s):  
Juan Carlos Kaski
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Acute Coronary Syndrome ◽  
St Elevation Myocardial Infarction ◽  
Atheromatous Plaque ◽  
Coronary Syndrome ◽  
Plaque Disruption ◽  
Prevention Therapy ◽  
St Elevation ◽  
Artery Disease

Background 46 Management of ST elevation myocardial infarction (STEMI) 48 Non-ST elevation myocardial infarction (NSTEMI) 52 Unstable angina 52 Therapeutic agents 56 Drugs for secondary prevention therapy after ACS 66 Further reading 70 Acute coronary syndrome (ACS) encompasses a spectrum of disorders resulting from severe acute myocardial ischaemia. The most common pathogenic mechanism is acute intracoronary thrombosis resulting from atheromatous plaque disruption or erosion. Platelet activation, thrombosis, and coronary vasoconstriction are all important pathogenic mechanisms in ACS....

Anti-Platelet and Anti-Thrombotic Therapy Post-AMI

2011 ◽  
Author(s):  
Dana Dawson ◽  
Keith Fox
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Acute Coronary Syndromes ◽  
Myocardial Reperfusion ◽  
St Elevation Myocardial Infarction ◽  
Coagulation Cascade ◽  
Coronary Syndrome ◽  
Coronary Syndromes ◽  
St Elevation

• Acute coronary syndromes (ACS) encompass a spectrum of presentations which include unstable angina, non-ST-elevation myocardial infarction (NSTEMI or NSTE-ACS), and ST-elevation myocardial infarction (STEMI or STE-ACS)• Anti-platelet and anti-thrombotic agents are administered as ancillary therapy to myocardial reperfusion in patients presenting with an acute coronary syndrome, to maintain the patency of the infarct-related coronary artery• More specific and potent inhibitors of platelet activation and of the coagulation cascade are emerging with the aim being to further improve clinical outcomes in patients presenting with an acute coronary syndrome, without increasing the risks of major bleeding.

Epidemiology and pathophysiology of coronary artery disease

2016 ◽  
Author(s):  
Demosthenes G. Katritsis ◽  
Bernard J. Gersh ◽  
A. John Camm
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Heart Disease ◽  
Coronary Artery ◽  
Unstable Angina ◽  
Acute Coronary Syndromes ◽  
St Elevation Myocardial Infarction ◽  
Coronary Syndromes ◽  
St Elevation ◽  
Artery Disease

This chapter presents the epidemiology and pathophysiology of stable ischaemic heart disease and acute coronary syndromes, i.e. unstable angina/non-ST elevation myocardial infarction and ST elevation myocardial infarction.

scholarly journals Clinical characteristics, risk factors and angiographic profile of acute coronary syndrome patients in a tertiary care center of Nepal.

2019 ◽  
Vol 16 (1) ◽  
pp. 27-32 ◽  
Author(s):  
Abhishesh Shakya ◽  
Sunil Chandra Jha ◽  
Ratna Mani Gajurel ◽  
Chandra Mani Poudel ◽  
Ravi Sahi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
St Elevation Myocardial Infarction ◽  
Coronary Syndrome ◽  
Vessel Disease ◽  
St Elevation ◽  
Artery Disease

Background and Aims: Acute coronary syndrome (ACS) refers to a group of clinical symptoms consistent with new onset or worsening ischemic symptoms. ST-elevation myocardial infarction (STEMI), non-ST elevation myocardial infarction (NSTEMI) and unstable angina (UA) are the three types of ACS. The objectives were to study the risk factors prevalence, angiographic distribution and severity of coronary artery stenosis in ACS among patients admitted in Cardiology Department of Manmohan Cardiothoracic Vascular and Transplant Center (MCVTC). Methods: This is a restrospective study of 419 ACS patients admitted and treated in MCVTC from November 2017 to October 2018. Patients were divided into STEMI, NSTEMI and UA then analyzed for various risk factors, angiographic patterns and severity of coronary artery disease. Results: Mean age of presentation was 59.3Å}12.8 years. Majority were male 317(75.7%). Most patients had STEMI 252 (60.1%) followed by NSTEMI 98 (23.4%) and UA 69 (16.5 %). Risk factors: smoking was present in 241 (57.5%), hypertension in 212 (50.6%), diabetes in 144 (34.4%), dyslipidemia in 58 (13.8%). Single-vessel disease was present in 34.6 % patients, double- vessel disease was present in 27.44 % patients and triple vessel disease was present in 26.3 % patients, left main disease in 1.4 % patients. Normal coronaries were present in 6.4% patients and minor coronary artery disease in 3.8 % patients. Conclusions: STEMI was the most common presentation. Three quarters of ACS were male patients. Smoking was most prevalent risk factor. Single vessel involvement was the most common CAG finding in all spectrum of ACS. Diabetic patients had more multivessel disease.

Acute coronary syndromes

2018 ◽  
Author(s):  
Cheerag Shirodaria ◽  
Sam Dawkins
Keyword(s):  
Myocardial Infarction ◽  
Unstable Angina ◽  
Myocardial Necrosis ◽  
St Elevation Myocardial Infarction ◽  
Coronary Syndrome ◽  
St Depression ◽  
Wave Inversion ◽  
Coronary Syndromes ◽  
St Elevation ◽  
The Difference

The term ‘acute coronary syndrome’ includes unstable angina, ST-elevation myocardial infarction (STEMI), and non-ST-elevation myocardial infarction (NSTEMI). The difference between these three syndromes is as follows. In STEMI and NSTEMI, there is evidence of myocardial necrosis, as evidenced by raised cardiac enzymes, specifically, the very sensitive cardiac biomarker troponin. STEMI is diagnosed when the ECG shows persisting ST elevation in an appropriate territory consistent with STEMI whereas, in NSTEMI, there can be any or no ECG changes, or very transient, self-limiting ST elevation. In unstable angina, there is no myocardial necrosis, and troponins are normal. The ECG is as for NSTEMI and often shows no change, ST depression, or T-wave inversion. The prognoses in STEMI and NSTEMI are identical; unstable angina has a better prognosis than either STEMI or NSTEMI.

Cardiac surgery

2016 ◽  
Author(s):  
Maria Kisiel ◽  
Alison Smith
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Treatment Options ◽  
Signs And Symptoms ◽  
St Elevation Myocardial Infarction ◽  
Surgical Interventions ◽  
Coronary Syndrome ◽  
St Elevation ◽  
Artery Disease

Coronary heart disease is caused by the build-up of atherosclerotic plaques which, over time, narrow the lumen of the coronary arteries. Acute coronary syndrome describes a spectrum of conditions caused by coronary artery disease; these are unstable angina, ST-elevation myocardial infarction (STEMI), and non-ST-elevation myocardial infarction (NSTEMI). Coronary artery disease is the leading cause for cardiac surgical interventions, but other causes are hypertension, valve disease, arrhythmias, cardiomyopathies, infections, and congenital abnormalities. This chapter provides an overview of the signs and symptoms of these conditions, as well as the diagnosis and treatment options available.

scholarly journals Management of multivessel coronary artery disease in patients with non-ST-elevation myocardial infarction: a complex path to precision medicine

2020 ◽  
Vol 11 ◽  
pp. 204062232093852
Author(s):  
Angus A. W. Baumann ◽  
Aashka Mishra ◽  
Matthew I. Worthley ◽  
Adam J. Nelson ◽  
Peter J. Psaltis
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Stable Coronary Artery Disease ◽  
St Elevation Myocardial Infarction ◽  
Complete Revascularization ◽  
Multivessel Coronary Artery Disease ◽  
Coronary Syndrome ◽  
St Elevation ◽  
Artery Disease

Recent analyses suggest the incidence of acute coronary syndrome is declining in high- and middle-income countries. Despite this, overall rates of non-ST-elevation myocardial infarction (NSTEMI) continue to rise. Furthermore, NSTEMI is a greater contributor to mortality after hospital discharge than ST-elevation myocardial infarction (STEMI). Patients with NSTEMI are often older, comorbid and have a high likelihood of multivessel coronary artery disease (MVD), which is associated with worse clinical outcomes. Currently, optimal treatment strategies for MVD in NSTEMI are less well established than for STEMI or stable coronary artery disease. Specifically, in relation to percutaneous coronary intervention (PCI) there is a paucity of randomized, prospective data comparing multivessel and culprit lesion-only PCI. Given the heterogeneous pathological basis for NSTEMI with MVD, an approach of complete revascularization may not be appropriate or necessary in all patients. Recognizing this, this review summarizes the limited evidence base for the interventional management of non-culprit disease in NSTEMI by comparing culprit-only and multivessel PCI strategies. We then explore how a personalized, precise approach to investigation, therapy and follow up may be achieved based on patient-, disease- and lesion-specific factors.

scholarly journals Predominance of STEMI and severity of coronary artery disease in a cohort of patients hospitalized with acute coronary syndrome: a report from ABC Medical School

2015 ◽  
Vol 61 (3) ◽  
pp. 240-243 ◽  
Author(s):  
Marcelo Rodrigues Bacci ◽  
Fernando Luiz Affonso Fonseca ◽  
Leonardo Fernando Ferrari Nogueira ◽  
Felipe Ribeiro Bruniera ◽  
Felipe Moreira Ferreira ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Coronary Angiography ◽  
Emergency Room ◽  
Acute Coronary Syndromes ◽  
St Elevation Myocardial Infarction ◽  
Coronary Syndrome ◽  
Coronary Syndromes ◽  
St Elevation ◽  
The City

Summary Introduction: acute coronary syndromes (ACS) represent a widely prevalent health issue with high mortality in Brazil and worldwide. The severity of ACS is not known in patients in the city of São Bernardo do Campo a municipality contiguous and adjacent to the city of São Paulo. Objectives: to study the profile of coronary disease in patients hospitalized with ACS who underwent coronary angiography in the emergency room between 2012 and 2013. Methods: this is an observational study that included consecutive patients with ACS admitted to the emergency room of a hospital. Data collection was performed using medical records with the following variables: sex, age, risk factors for cardiovascular disease, coronary angiography. Results: the sample in this period included 131 patients, of which 64.8% were men. The most prevalent diagnosis was ST-elevation myocardial infarction (STEMI) (57.2%) followed by non-ST-elevation myocardial infarction (NSTEMI) (22.1%) and unstable angina (UA) (20.6%). There were no significant differences in the epidemiology and risk factors between the diagnoses, except that heart failure was more prevalent in patients with UA. Discussion: there were no differences between groups regarding the coronaries involved; however, STEMI patients showed similar numbers of multi- and singlevessel lesions, NSTEMI patients showed more multivessel lesions, and UA patients showed more multivessel lesions or lesion-free arteries. Although multivessel lesions were prevalent in all groups, STEMI patients showed a significantly higher number of single-vessel lesions compared with the other acute coronary syndromes. Conclusion: the study demonstrated a predominance of STEMI in the studied population, which differs from the usual results in ACS.

Sign in / Sign up

Export Citation Format

Share Document